6 ms·

I want my goverment helping people avoid health issues, rather than subsidising costs that could have been prevented. I've yet to see any one industry that has

• DanBC 11y ago
  In the US the government bits of health care out-perform the private bits of health care. One of the reasons the US has good health outcomes for some things like cancer is because of the huge amounts of government spending.
  • antr 11y ago
    I hope this clarifies my comment https://news.ycombinator.com/item?id=10251846 https://news.ycombinator.com/item?id=10251846
• pessimizer 11y ago
  Virtually all national health care systems perform better (in every sense) than the American private sector one.
  • antr 11y ago
    I agree, a healthcare system, the question is at what cost per patient/treatment. The healthcare system, is a system, not an industry per se. Don't get me wrong, I'm all for public healthcare... but the comment feels like a knee jerk reaction.
    • pessimizer 11y ago
      The US government currently spends more per capita on healthcare costs than Britain, France, or Canada.
      • fnordfnordfnord 11y ago
        Is that true? Because when you combine that with the amount that US citizens spend on private insurance and other self-funded health care expenses, wow.
        • darkr 11y ago
          Edit: Actually I found some OECD stats[4] on that suggest that _public_ spend in the U.S is actually higher than the _public_ spend in Canada/UK/France (though for the latter two they are almost in margin of error territory) so the parent is correct. Original post: No, it's not true. In 2010-2011[1], US had the highest expenditure in the world on health per capita according to WHO and OECD, but those stats are combined public _and_ private expenditure. World Bank stats show Norway & Switzerland as spending more per capita[2] over the same period, but then says that 'data is in current U.S dollars'. The data for these stats is from WHO, so not sure if currency fluctuation or something else is a factor here? According to [3], per capita public healthcare budget for 2011 was $3,768 vs. an overall spend of $9,146, so 41% of the total healthcare spend was public money. In any case, I think all these stats can reliably posit is is that combined public and private spending on healthcare in the U.S per capita is one of the highest, if not the highest. 1: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... 2: http://data.worldbank.org/indicator/SH.XPD.PCAP?order=wbapi_data_value_2012+wbapi_data_value&sort=desc http://data.worldbank.org/indicator/SH.XPD.PCAP?order=wbapi_... 3: http://www.usgovernmentspending.com/year_spending_2011USdn_16ds2n#usgs302 http://www.usgovernmentspending.com/year_spending_2011USdn_1... 4: https://www.oecd.org/unitedstates/Briefing-Note-UNITED-STATES-2014.pdf https://www.oecd.org/unitedstates/Briefing-Note-UNITED-STATE...
          • fnordfnordfnord 11y ago
            re: edit: wow confirmed. That's amazing, and pretty embarrassing.
  • refurb 11y ago
    That's definitely untrue. Check out the cancer survival rates. The US exceeds most countries by far. Now, if you had said "Virtually all national healthcare system provide better care based on cost" I would have agreed with you.
    • pessimizer 11y ago
      The US system is motivated to overdiagnose cancer. ----- "We need to be careful when comparing US and UK cancer care" http://scienceblog.cancerresearchuk.org/2009/08/17/we-need-to-be-careful-when-comparing-us-and-uk-cancer-care/ http://scienceblog.cancerresearchuk.org/2009/08/17/we-need-t...
    • tech-no-logical 11y ago
      according to the last CONCORD study, this seems to be not true. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962038-9/abstract http://www.thelancet.com/journals/lancet/article/PIIS0140-67... numbers in the US are good, but not significantly better than, say, germany.
    • thinkcontext 11y ago
      There are many rankings that put the US healthcare system as a whole behind its economic peer countries whilst spending far more per capita. Example: http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror http://www.commonwealthfund.org/publications/fund-reports/20... Excluding 15% of the population from all but emergency care pretty much guarantees this outcome.
      • markus2012 11y ago
        This. I used to buy breakfast from a small food place. The 21-ish cashier lady always gave me a nice 'good morning' and a smile. She wasn't there one morning and I asked where she was. She died - something to do with her kidneys and she didn't have health insurance. Now the US gets to statistically ignore her death and claim it provides excellent health care to its citizens?
• jjoonathan 11y ago
  Except for socialized health care? http://healthcarereform.procon.org/view.resource.php?resourceID=005522 http://healthcarereform.procon.org/view.resource.php?resourc... And roads, electricity, emergency services, internet service... > performing better (in every sense) Oh, I see, you didn't really want a fair comparison. No matter how far you separate the means of two gaussians their tails will always overlap, and therefore you are tautologically correct. I'll try to remember that next time I go to pay 2x what I would pay in a contemporary social system for health insurance, I'm sure it will make me feel better.
  • antr 11y ago
    I don't think you understood my comment. "Socialised healthcare" is a system where a public institution puts capital to take care of a patient by using private-made products and services. i.e. the needles, IT systems, ambulances, drugs, etc, the public system is a platform, but not an industry. Let the market be free, private companies are better at solving real problems. If the price of a drug is expensive (i) a public health system will take care of it, and (ii) new players will want a slice of that expensive drug by making one better and cheaper. This is my point. Governments are not good at making realiable and quality products and services.
    • bkor 11y ago
      Loads of things have been handed over from the government to companies within The Netherlands. Your general statement that governments are not good I highly doubt. Especially for basic services, governments seem to run them cheaper and more reliably.
      • antr 11y ago
        When you say "cheaper" you mean to partialy subsidised services. I'm refering to tollroads, train networks, healthcare, pensions, etc. What you "pay" is not the real cost, but paid for in good part by the Government's budget.
        • 11y ago
• JulianMorrison 11y ago
  One way to "avoid health issues" is to treat people when they get sick, not wait until they get sick enough that their terror of bankruptcy is overridden by their suffering. This is what the "national health service" in the UK will do. You go in when you have an infected hangnail, not wait until you have blood poisoning. And they treat you. And it's free.
• assface 11y ago
  > I've yet to see any one industry that has been nationalised as is performing better (in every sense) than the private sector. The nationalized health care programs seem to be performing better in other countries than ours.
  • ams6110 11y ago
    Depends on how you define "better." In any nationalized system with controlled prices, you will have shortages.
    • DanBC 11y ago
      The US has plenty of shortages of meds, but in that system the shortages are blamed on the intended recipient. "You didn't have a good enough job; you didn't have good enough insurance".
    • crdoconnor 11y ago
      You define it as better healthcare outcomes (life expectancy, infant mortality, etc.) at 50% of the cost (UK). Or, in one extreme case - the same healthcare outcomes at 1/10th of the cost (Cuba). >In any nationalized system with controlled prices, you will have shortages. In any system where there is scarcity you will have shortages. Period.
      • paulmd 11y ago
        Cuba is a really interesting example because it demonstrates the importance of least-common-denominator care. You're not getting high-tech imaging or brand new drugs, but they deliver a basic level of care pretty uniformly across its population. And the outcomes speak for themselves - on average they're just as good as the US. The problem with US outcomes is really disparity. A lot of people have very little access to health care and that drags our averages down like crazy. If we could get these kind of "solved-problem" drugs out to everyone who needs them, our average outcomes would jump quite a bit. Cost is a whole different situation, and that's a much more difficult one to solve. Everyone from manufacturer to insurer to doctor wants their cut, the elasticity of demand for a good without which you will die is zero, so there's very little incentive to keep cost down. There's a few places you can point that are particularly excessive (direct-to-patient marketing, excessive spending on terminal patients circling the drain, etc), but in general it's the death of a million cuts. Pumping generics is one of those cases that's clearly abusive. With regard to the specific problem, if you try to limit their profits pharmas will simply take their ball and go home - they won't produce it. For a real-world example of this, you can no longer get the Lyme Disease vaccine for humans - nobody makes it anymore, you can only get it for the veterinary market. Evergreening is a similar problem. In such cases the government really needs to either contract out production of a supply, at-cost (including interest, distribution, etc). If no one will do it, bite the bullet and make it ourselves. If our national labs can figure out how to manufacture high-quality biological or chemical agents, we can figure out how to make high-quality vaccines and drugs as well. Public health is a matter of national security when you get right down to it. Shouldn't we be able to ramp up production of an Ebola vaccine if we really needed it?
• realusername 11y ago
  I would say that it depends of the sector. The 'laissez-faire' policy works very well in some markets and fails badly in some others. A good example of a market which works well almost without intervention could be the coffee market, since it's really difficult to have a monopoly on any side (farming, distribution, selling) and the incentive is aligned with the customer's best interest (selling coffee to get more money). A lot of physical consumer goods are in this category. In between, you have markets with a high cost infrastructure but where the main goal is to be a public good. These market need constant input because their interest is not entirely aligned with the consumer. ISPs can be a good example of this, if you don't put laws to correct the default behaviour, it will never work well. But with good laws, it's fixable. At the opposite end I suspect there is markets where the private system will never work, whatever laws you put in place. Education, Health related industries, Prison and Justice system would fall in this category. There will be no law strong enough to change their incentive so it's aligned with the public.