I understand that insurances covers part of the cost. However, the total cost (before coverage) is still much higher in America. Why?
Is the supply chain different? Are doctors and staff paid better in America?
In: 188
Read the article ‘How American Healthcare Killed my Father.’ amazingly detailed answer.
[Link from the Atlantic](https://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/)
“U.S. prices were 256 percent of those in the 32 comparison countries combined. In comparisons with individual countries, U.S. prices ranged from 170 percent of prices in Mexico to 779 percent of prices in Turkey.” https://aspe.hhs.gov/reports/international-prescription-drug-price-comparisons
US decided a couple things to make this happen. In 1981 or so, the Baylor-Dole act said private companies can own public university research. All that drug research, done at universities, belongs to the drug companies, and the drug companies can pick and choose which research comes to light, so only the favorable stuff does.
During the Bush administration Congress said medicare, the biggest drug buyer, could not negotiate prices.
Drug companies ply, bribe, and sell to doctors, who then prescribe pills to whoever bought them some pens or sent them on a vacation for “CME”. The doctors and the drug dealers have an interest in people being sick, just sick enough to pay. For evidence of this, see the Sacklers and Purdue Pharma, who used these tactics to create the opioid epidemic.
With so much money at stake, druggies can easily buy politicians to make the rules in their favor.
Insurance companies also bought politicians, who made it so there is a fine if you don’t buy insurance. Insurance skims 10% or more off of all US healthcare spending.
In the US, people with the money make the rules, and the rules are made so they keep making money.
The other side of this, is that every life in the US is worth something like $2M. so if you even touch someone, and they die, you’re on the hook for $2M. Everything has to be super safe to avoid this. A hospital can’t just buy an outlet for the wall, it has to be medical grade, meaning the people that made and sold the outlet charged enough that they can stand some lawsuits.
In the US we can’t let people die. 90% of healthcare spending is done by 10% of the people. We’ll spend zillions to get one more year out of a cancer patient lying in bed. We can’t have “death panels” to consider what treatments etc. are best on a population macro economic scale, it is all about who can pay. If it is you faced with death, you’ll go to great ends for that last year, esp. when it is other people paying.
Because American companies have perfected the illusion of choice and the illusion that this is as good as it can get while you work yourself to death.
turns out when you run things as a business instead of the most efficient system you get a system designed for maximum profits and minimal costs. Does that sound like the sound basis for healthcare?
It’s the victory of profit over human needs.
Capitalism…
“One ring to rule them all, one ring to find them, One ring to bring them all, and in the darkness bind them; In the Land of Mordor where the shadows lie.”
The planet is falling into the void of profit…
In America, healthcare is provided by a large number of individual companies, all working to make a profit. There is no incentive to keep costs down.
In countries with socialised healthcare, it is typically provided by a single organisation that doesn’t operate for profit which keeps costs down. In addition, because it is a single organisation it is in a massively favourable bargaining position when it buys supplies from drug companies and medical equipment manufacturers. It is essentially a reverse monopoly, being the only customer in the country. This pushes costs down further as companies need to offer reasonable prices or risk not doing business in the country at all.
This is why a vial of insulin costs $98 in the US, but only $7.50 in the UK.
It costs a lot in every other place in the world as well, but healthcare in those countries where healthcare is cheap for the citizens aren’t subject to the outrageous pricing the hospital industry in the USA has put on its goods and services.
Back in the day insurance companies wanted discounts on said goods and services, and in response the hospitals just jacked up their prices and agreed to giving discounts on the inflated price. Much in the same way stores increase prices during a sale so the “discounted” price is the original price, or higher.
And every increase in cost since has come from other issues like supply/demand, shortage of staff and increasing cost on pharmaceuticals.
In short:
Healthcare cost in America stems mostly from unadulterated greed.
US doctors are paid more.
Malpractice insurance adds cost to the system.
The for profit insurance industry adds cost to the system, in the form of additional layers of bureaucracy and profit-taking.
The bill for services model (as opposed to pay for outcomes) prioritizes procedures and tests which adds cost to the system.
The practice of using urgent care in place of routine care adds cost to the system.
Not sure if anyone has mentioned this but the US :
A) essentially subsidizes European defense as they are under our defense umbrella so spend vastly less than they would if we were not guaranteeing their safety
B) funds a huge amount of global R&D for pharmaceuticals
You’re welcome.
While not the total cause or even the biggest cause, there are additional logistic issues caused by having your total population spread across a large area. In short, density of other “1st world” countries makes a lot of commerce including healthcare easier.
Latest Answers