Free Capitalist Network - Community Archive
Mises Community Archive
An online community for fans of Austrian economics and libertarianism, featuring forums, user blogs, and more.

Why is U.S. health care more expensive & worse than other countries?

rated by 0 users
This post has 35 Replies | 10 Followers

Top 500 Contributor
Posts 186
Points 6,000
ravochol Posted: Thu, Jun 24 2010 6:40 PM

 

At least, that's the common view, which a recent report confirms today:

http://www.reuters.com/article/idUSTRE65M0SU20100623

(Reuters) - Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.

U.S.  |  Health  |  Lifestyle  |  Healthcare Reform

The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.

"As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it," Commonwealth Fund president Karen Davis told reporters in a telephone briefing.

Previous reports by the nonprofit fund, which conducts research into healthcare performance and promotes changes in the U.S. system, have been heavily used by policymakers and politicians pressing for healthcare reform.

Davis said she hoped health reform legislation passed in March would lead to improvements.

The current report uses data from nationally representative patient and physician surveys in seven countries in 2007, 2008, and 2009. It is available here

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

This is a big rise from the Fund's last similar survey, in 2007, which found Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product.

"We rank last on safety and do poorly on several dimensions of quality," Schoen told reporters. "We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care."

NETHERLANDS RANKED FIRST OVERALL

The report looks at five measures of healthcare -- quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives.

Britain, whose nationalized healthcare system was widely derided by opponents of U.S. healthcare reform, ranks first in quality while the Netherlands ranked first overall on all scores, the Commonwealth team found.

U.S. patients with chronic conditions were the most likely to say they gotten the wrong drug or had to wait to learn of abnormal test results.

"The findings demonstrate the need to quickly implement provisions in the new health reform law," the report reads.

Critics of reports that show Europeans or Australians are healthier than Americans point to the U.S. lifestyle as a bigger factor than healthcare. Americans have higher rates of obesity than other developed countries, for instance.

"On the other hand, the other countries have higher rates of smoking," Davis countered. And Germany, for instance, has a much older population more prone to chronic disease.

Every other system covers all its citizens, the report noted and said the U.S. system, which leaves 46 million Americans or 15 percent of the population without health insurance, is the most unfair.

"The lower the performance score for equity, the lower the performance on other measures. This suggests that, when a country fails to meet the needs of the most vulnerable, it also fails to meet the needs of the average citizen," the report reads.

(Editing by Sandra Maler and Cynthia Osterman)

  • | Post Points: 95
Top 25 Contributor
Male
Posts 3,055
Points 41,895

1.  Total spending per capita /= cost per unit of service.

2.  How do you figure a country with 25% more M.D.'s per capita than anywhere else has "worse" health care than anywhere else?

More like basis economics.  Supply creates its own demand.  More supply.  More spending.  Everywhere else has lower spending because the state determines the spending and they determine it low.

  • | Post Points: 5
Top 75 Contributor
Male
Posts 1,434
Points 29,210

I personally don't like the idea of healthcare insurance in the first place. A surgeon who I was shadowing said that things would be a lot cheaper for people if there was no such thing as insurance and people simply had to pay for the service they received. He explained that the malpractice insurance company actually made him charge his patients twice the amount of money for time in the operating room, so he made the same amount of money no matter what.

But, in any case, the privatized insurance industry is infinitely better than the socialized bureaucracies set up in other countries. The idea that you somehow have a right to a doctor's services, skills that took around 6-10 years of training to acquire, is sickening.

"Every normal man must be tempted at times to spit on his hands, hoist the black flag, and begin to slit throats." - H.L. Mencken.

  • | Post Points: 35
Top 25 Contributor
Male
Posts 3,055
Points 41,895

Commonwealth Fund is funded by Empire Blue Cross Blue Shield, an insurance company.

Rule #1: Indexes always use methods tailored to the desired conclusion.

It's not like they set out to find the unvarnished truth and, lo and behold, they found it as presented.

  • | Post Points: 5
Top 50 Contributor
Male
Posts 1,687
Points 22,990
Bogart replied on Fri, Jun 25 2010 12:00 PM

How do you determine worse?  If you ask am I being ripped off as my company spent easily over 100K in the past 15 years on my health insurance then I would say yes.  If you ask do I get better, more timely and more advanced healthcare in the USA than I would in any of those other countries, I would say absolutely. 

I find it funny that Britian has the "best".  I have never heard good things about their health system.

Besides, there are three completely socialized health systems in the USA and I would rather fork over the money and buy my own care.  They are: Veterans Administration, Indian Health Service and Military.  I have experienced the benefits of two of the three and have only heard bad things about the Indian Health Service.

Face it, these clowns who obviously have an agenda when making these "Objective" studies but are limited in that no matter how they feel, they can not ignore the laws of economics.  The first is as the price is artificially lowered, the more of a product or service is demanded and the less is supplied, which results in political/violent rationing.  The second being that socialism can not endure as it is impossible for the socialists to perform economic calculations.  And this even includes performing economic calculations in healthcare.

  • | Post Points: 5
Top 200 Contributor
Posts 468
Points 8,085
Wibee replied on Fri, Jun 25 2010 9:57 PM

About $85 It cost me to get my cat spayed.  Getting a human hernia fixed,  $5000+.  

  • | Post Points: 20
Top 500 Contributor
Posts 108
Points 2,600

Because it is not a true free market system. This is all due to government.

Not offices and bureaucrats, but big business deserves credit for the fact that most of the families in the United States own a motorcar and a radio set.Ludwig von Mises

  • | Post Points: 20
Top 500 Contributor
Posts 186
Points 6,000
ravochol replied on Sat, Jun 26 2010 12:17 AM

I dunno, I don't think it's too hard to find objective measures for how healthy we are.  Take infant mortality - U.S is behind 44 other countries according to the CIA. For life expectancy we're #47. Both of those things are easy to measure objectively and have a lot to do with how good a nations health care provision is.  And the U.S. objectively is behind other comparable nations - so then when you consider that the outcomes are only so-so, but we spend about twice as much on 'health care' as other nations, the only conclusion that makes any sense to me is the health care provision is abysmal.  

I once got charged $600 for spending maybe ten minutes with a doctor and being told to go home.  That seems more like legal extortion to me, and I didn't see any government officials lurking in the bushes telling the hospital they had to charge such ridiculous rates without even warning their customers before hand what they were getting into.  

I think the problem is health care providers have captured the government.  The doctors mafia, the AMA, pharmaceutical companies, HMOs and insurance companies are just writing all the laws with bribed congresspeople. Sure, I'd support the government getting out of the health marketplace, but they'd just be bribed to get back into it the next day by the same people who are bribing them to be in it now. If the government didn't exist, they'd just hire one to protect their market share.

  • | Post Points: 65
Top 500 Contributor
Male
Posts 194
Points 4,315
Mike replied on Sat, Jun 26 2010 12:03 PM

anyone who believes the infant mortality / life expectancy is a reliable statistic needs to do some research before speaking... the way infant mortality is measured across the world is apples/oranges..  i wish people ( all of us) who have the energy to post "facts" in forums would also have the energy to look into every freaking static and fact they hear... because facts are like iceburgs- you need to look below the surface to see the whole thing.

[insult censored]

Be responsible, ease suffering; spay or neuter your pets.

We must get them to understand that government solutions are the problem!

  • | Post Points: 35
Top 75 Contributor
Posts 1,005
Points 19,030
fakename replied on Sat, Jun 26 2010 12:05 PM


 

Well there are interpretation issues (what is mortality, is it different from abortion, should one figure in wars, etc.?) and indeed different countries have different laws regarding what has to reported as what some of which, seem to stretch the common sense notion of "objective".

Do we even know what the scale of this report is -is the report a simple ordinal ranking or is it somehow based around a fixed mean with standard deviations from that mean?  Are there indexes to standardize this report, etc. And what is "equity"?

  • | Post Points: 5
Top 75 Contributor
Male
Posts 1,434
Points 29,210

@mike:

anyone who believes the infant mortality / life expectancy is a reliable statistic needs to do some research before speaking...

The infant mortality rate counts all infants who are 1 year old or younger, correct? So does that mean an infant who dies at the age of 10 months or so at their own parents' home is counted into the infant mortality rate? What methods do they have of counting the rate?

"Every normal man must be tempted at times to spit on his hands, hoist the black flag, and begin to slit throats." - H.L. Mencken.

  • | Post Points: 20
Top 500 Contributor
Male
Posts 166
Points 2,875
Beefheart replied on Sun, Jun 27 2010 1:28 AM

Most countries do not count premature babies, who usually die, as infant mortalities, but as stillborns or something. America counts the deaths of premature babies (and most of them do die).

My personal Anarcho-Capitalist flag. The symbol in the center stands for "harmony" and "protection"-- I'm hoping to illustrate the bond between order/justice and anarchy.

  • | Post Points: 20
Top 500 Contributor
Male
Posts 194
Points 4,315
Mike replied on Sun, Jun 27 2010 10:49 AM

i'm not sure on the stillborn aspect, but aside from different ways of calculating what is " infant mortality" there is also the whole area of demographics, drug addics, personal choices of prenatal care etc. gun deaths, traffic accidents and obesity unfortunelty are much higher in US, which has little to do with quality of medical care, yet are considered in the life expectancy statistics - except of course by those trying to be accurate. 

Be responsible, ease suffering; spay or neuter your pets.

We must get them to understand that government solutions are the problem!

  • | Post Points: 20
Top 500 Contributor
Posts 158
Points 3,965

america has the best cancer survival rate , best drug research and the best responsiveness(ambulances) in the world

 

considering the price controls and regulations

  • | Post Points: 20
Top 500 Contributor
Posts 158
Points 3,965

also there are a lot more c sections which most of the time are unnecessary cause a lot of complications during labor

which can contributed to the birth rate

  • | Post Points: 20
Top 500 Contributor
Male
Posts 194
Points 4,315
Mike replied on Sun, Jun 27 2010 5:39 PM

i understand that the multi millionaire ambulance chaser abomination called John Edwards, hero of the poor - won a lawsuit that has had affect of dramatically increasing the use of C sections. most of which are unnecessary.

Be responsible, ease suffering; spay or neuter your pets.

We must get them to understand that government solutions are the problem!

  • | Post Points: 20
Top 500 Contributor
Posts 300
Points 5,325

The US has a state-controlled system, so it's not surprising.  In fact, the US government spends more per person than in any other country.

  • | Post Points: 5
Top 500 Contributor
Posts 366
Points 7,345
Fephisto replied on Sun, Jun 27 2010 7:11 PM

About $85 It cost me to get my cat spayed.  Getting a human hernia fixed,  $5000+.  

I think this subtly says everything that is wrong with healthcare (vets have to have a lot more expertise to work on a variety of animals, and yet still have lower prices) and how to fix it (which doesn't have all the government interventions and subsidies?).

Latest Projects

"Even when leftists talk about discrimination and sexism, they're damn well talking about the results of the economic system" ~Neodoxy

  • | Post Points: 20
Top 500 Contributor
Male
Posts 194
Points 4,315
Mike replied on Sun, Jun 27 2010 8:06 PM

This is really not a good comparison in so many ways. A couple of surface reasons; one vet does not need to charge higher prices to you to subsidize the cost of all the other animals that do not have insurance or are mandated low fee’s like medicare/medicade. There is not nearly the capital investment required for animal machines, doctor training, drug research etc. etc. The vet does not need to carry multi-million dollar liability insurance for fear of being sued because your cat lost its psychic ability after surgery. Obviously weighing 10x’s that of most animals a person would also require 10 times the drugs and anesthesia. Bottom line though, in a free market (which health care is not)  prices would be dramatically lower.

 

p.s. thanks for being responsible and getting your pet fixed.

Be responsible, ease suffering; spay or neuter your pets.

We must get them to understand that government solutions are the problem!

  • | Post Points: 20
Top 200 Contributor
Posts 468
Points 8,085
Wibee replied on Sun, Jun 27 2010 9:33 PM

Johnny Smith had that problem.  :) 

 

That was the purpose of my comparison.  That the cost of healthcare is so high due to the amount of regulation.  For animals, it's not as bad and simple operations cost less than a doctor consultation.  And as far as I know, the work that was done has to be decent.  A vet with dead cats after surgery would not be in business long, and probably  have even more problems. 

  • | Post Points: 5
Top 500 Contributor
Posts 186
Points 6,000
ravochol replied on Mon, Jun 28 2010 9:31 AM

anyone who believes the infant mortality / life expectancy is a reliable statistic needs to do some research before speaking

It's sure better than any evidence you have. Welcome to the social sciences. 

  • | Post Points: 20
Top 500 Contributor
Posts 186
Points 6,000
ravochol replied on Mon, Jun 28 2010 9:39 AM

"america has the best cancer survival rate" - I can't find that data, but here's the overall cancer mortality rate - America is middling.

 

# 1   Netherlands: 433 deaths per 100,000 peopl 
 
# 2   Italy: 418 deaths per 100,000 peopl 
 
# 3   Hungary: 411 deaths per 100,000 peopl 
 
# 4   Luxembourg: 409.7 deaths per 100,000 peopl 
 
# 5   Slovakia: 405.3 deaths per 100,000 peopl 
 
# 6   Ireland: 357.6 deaths per 100,000 peopl 
 
# 7   Czech Republic: 335.4 deaths per 100,000 peopl 
 
# 8   New Zealand: 327.3 deaths per 100,000 peopl 
 
# 9   United States: 321.9 deaths per 100,000 peopl 
 
# 10   Australia: 298.9 deaths per 100,000 peopl 
 
# 11   Norway: 289.4 deaths per 100,000 peopl 
 
# 12   France: 286.1 deaths per 100,000 peopl 
 
# 13   Austria: 280 deaths per 100,000 peopl 
 
# 14   Sweden: 268.2 deaths per 100,000 peopl 
 
# 15   Finland: 255.4 deaths per 100,000 peopl 
 
# 16   United Kingdom: 253.5 deaths per 100,000 peopl

SOURCE: OECD Health Data 2004

Again, that's with the U.S.spending more than $6000 per capita and the U.K. spending  $2,900 per capita, and the U.K. is getting much better results:

http://www.nationmaster.com/graph/hea_exp_per_cap_cur_us-expenditure-per-capita-current-us

If that's not a pathetic, ineffective rip-off, I don't know what is.

  • | Post Points: 5
Not Ranked
Posts 2
Points 10

Would you consider that part of the problem could be due to unethical practices of businesses combined with the lack of government controls over unethical market-distorting practices.

Example: Drug Companies Pay to other Drug Companies Keep Drug Prices High -- they pay them to delay the introduction of generic drugs.

The FTC has been fighting to stop companies from paying other companies to withhold generic versions of drugs.  In court, this has met with mix success. Pushes for legislation to ban this practice have not been successful.  (see this Reuters article).  Aside from this being a immoral practice, free trade advocates -- please note that this practice files in the face of free trade principles. It’s not about free trade, its about creating market distortions.  Some regulation is needed to keep markets free and open -- which means allowing competition.

http://nelsonwilberforce.blogspot.com/

Top 100 Contributor
Posts 875
Points 14,180
xahrx replied on Tue, Jul 20 2010 7:39 AM

"I dunno, I don't think it's too hard to find objective measures for how healthy we are.  Take infant mortality - U.S is behind 44 other countries according to the CIA. For life expectancy we're #47. Both of those things are easy to measure objectively and have a lot to do with how good a nations health care provision is." - ravochol

And if in the US more problematic pregnancies are taken to and beyond term because our medical facilities allow babies that would die in the womb or be terminated in other countries to live we would have higher infant mortality because our health care was better.

"I think the problem is health care providers have captured the government."

The government is the one with the guns and the legal authority to kill, how were they captured?  I always love how the government is supposed to solve all these problems and has all the guns and legal authority possible but somehow never seems to be able to resist the massive and terrible onslaught by all these greedy capitalists hell bent on screwing the rest of society.  Never in the history of the planet have people so doggedly begged for help from an organiztion that is in their own estimation one of the most impotent and incompetent that could ever exist.

"I was just in the bathroom getting ready to leave the house, if you must know, and a sudden wave of admiration for the cotton swab came over me." - Anonymous
  • | Post Points: 20
Not Ranked
Posts 2
Points 10

I also belive that it is a problem that industry has captured the goverement.  How has this happened?  With the power of money.  Goverment for the benefit of industry is an oldish idea.  It served facist Italy.  It was the way of the British Empire at its height.  We need to start distignusihing between honest buisness who provide goods and services and -- those who simply suck money from the system through specualtion,  legalized piracy, and the kind of "captitalist" who invest in lawyers and lobbiest as a means to profit rather than in machinery and people.

  • | Post Points: 5
Top 200 Contributor
Male
Posts 458
Points 6,985
gocrew replied on Tue, Jul 20 2010 12:25 PM

ravochol:

I dunno, I don't think it's too hard to find objective measures for how healthy we are.  Take infant mortality - U.S is behind 44 other countries according to the CIA. For life expectancy we're #47. Both of those things are easy to measure objectively and have a lot to do with how good a nations health care provision is.  And the U.S. objectively is behind other comparable nations - so then when you consider that the outcomes are only so-so, but we spend about twice as much on 'health care' as other nations, the only conclusion that makes any sense to me is the health care provision is abysmal.  

I once got charged $600 for spending maybe ten minutes with a doctor and being told to go home.  That seems more like legal extortion to me, and I didn't see any government officials lurking in the bushes telling the hospital they had to charge such ridiculous rates without even warning their customers before hand what they were getting into.  

I think the problem is health care providers have captured the government.  The doctors mafia, the AMA, pharmaceutical companies, HMOs and insurance companies are just writing all the laws with bribed congresspeople. Sure, I'd support the government getting out of the health marketplace, but they'd just be bribed to get back into it the next day by the same people who are bribing them to be in it now. If the government didn't exist, they'd just hire one to protect their market share.

 

Dude, this is silly.  Infant mortality and life expectancy are influenced by all sorts of things besides health care.  Obesity and race influence infant mortality, and homicide, car accidents and race influence life expectancy.  Americans, for instance, live longer than Canadians once obesity, homicide and automobile accidents are controlled for.

If you want to see which country has better health care, why not - I don't know - look at who has better health care?  Cancer survival rates are better in the US than in other countries.  People do not die in waiting lines here.  People do not pull out their own rotten teeth here.  Survival rates for all kinds of nasty diseases are typically higher in the US than in other Western nations.  That's the measure of health care.

Now as far as the entire health care system goes, ours sucks, but not because it doesn't get results.  It just bankrupts you in the process.

Every decent man is ashamed of the government he lives under - Mencken

  • | Post Points: 20
Top 150 Contributor
Male
Posts 694
Points 11,400
Joe replied on Tue, Jul 20 2010 12:43 PM

infant mortality is not calculated in the same way in every country.

  • | Post Points: 5
Top 500 Contributor
Male
Posts 290
Points 6,115
wolfman replied on Tue, Jul 20 2010 1:06 PM

Very simple. Corporatism.

The Health Care industry is almost at 100% under corporatism.

This is the biggest enemy of capitalism and the closest thing to communism.

  • | Post Points: 5
Top 500 Contributor
Male
Posts 111
Points 2,910

<<< The idea that you somehow have a right to a doctor's services, skills that took around 6-10 years of training to acquire, is sickening. >>>

Ever heard of the oath of Hippocratis?

  • | Post Points: 35
Top 75 Contributor
Male
Posts 1,129
Points 16,635
Giant_Joe replied on Thu, Aug 12 2010 2:26 PM

anyone who believes the infant mortality / life expectancy is a reliable statistic needs to do some research before speaking

It's sure better than any evidence you have. Welcome to the social sciences.

What's an objective standard on good evidence? Is misinformation better than no information?

Here's a little something on Cuba's healthcare:

http://www.youtube.com/watch?v=IUSdYY243pk

  • | Post Points: 5
Top 75 Contributor
Male
Posts 1,129
Points 16,635
Giant_Joe replied on Thu, Aug 12 2010 2:27 PM

Ever heard of the oath of Hippocratis?

The doctor freely undertakes that oath. The poster was talking about forcing people to provide medical services.

  • | Post Points: 20
Top 25 Contributor
Male
Posts 3,055
Points 41,895

The Hippocratic Oath was so backward and stupid that it has not been practiced in ages.

  • | Post Points: 20
Top 25 Contributor
Male
Posts 3,592
Points 63,685
Sieben replied on Thu, Aug 12 2010 4:34 PM

So if doctors didn't take the hippopotamous oath Rob's argument would fall apart?

Banned
  • | Post Points: 20
Top 25 Contributor
Male
Posts 3,055
Points 41,895

He is suggesting that it obliges M.D.'s to treat people for free.  I don't know where that came from.

  • | Post Points: 20
Top 50 Contributor
Posts 2,360
Points 43,785
z1235 replied on Thu, Aug 12 2010 5:59 PM

Haven't you also heard of:

The Chef's Oath obliging cooks/chefs to feed all the hungry for free?

The Stripper's Oath obliging strippers to strip for all the horny for free?


 

  • | Post Points: 5
Top 25 Contributor
Male
Posts 3,260
Points 61,905
ForumsAdministrator
Moderator
Staff
SystemAdministrator

Rob Heusdens:

<<< The idea that you somehow have a right to a doctor's services, skills that took around 6-10 years of training to acquire, is sickening. >>>

Ever heard of the oath of Hippocratis?

 

"First do no harm" approximates much more to the non-aggression principle than it does to any claims people allegedly have upon the labor of others.

"the obligation to justice is founded entirely on the interests of society, which require mutual abstinence from property" -David Hume
  • | Post Points: 5
Page 1 of 1 (36 items) | RSS