9 ms·

Why Americans Spend So Much on Health Care–In 12 Charts

38 points by jedwhite 8y ago

zbrt 8y ago
Would like to read, article is behind a paywall.
- bgentry 8y ago
  This works for WSJ: 1. Find link to article on Twitter ( https://mobile.twitter.com/WSJ/status/1024306968029224960 https://mobile.twitter.com/WSJ/status/1024306968029224960 ) 2. Click it.
  - kurthr 8y ago
    Unfortunately, not any more (at least for me). I'll try a fresh browser VM without cookies. Yes, that worked.
- JTbane 8y ago
  You can prepend "facebook.com/l.php?u=" to the link
pettersolberg 8y ago
They spend so much, because it's basically Health Business not Care.
- WillPostForFood 8y ago
  I'd go with MoneyCaid. Health run care by big bureaucratic business deeply intertwined with big bureaucratic government. So there's lots of money flowing, but not as much care.
  - Arnt 8y ago
    Germany too has large businesses providing health care and mucho government. When I had my tonsils removed a few years ago, a €>1b/y organisation did the knifework, another organisation with an even bigger budget paid, and neither of them set the rates. So why does this combination work in Germany and fail so spectacularly in the US?
  - opportune 8y ago
    As someone who got a peak into some of the intimate details of a large Hospice services provider, I have to agree. The fact that there are, no matter what they call themselves, salesmen who wine and dine hospital and senior home officials so that their employer can be made a part of their hospice pipeline is sickening. What’s worse is when you discover how many “palliative” patients will routinely temporarily leave care for surgeries, then cycle back on, for years. Not to mention that many of my relatives, and myself, have been egregiously misbilled or convinced to purchase very expensive, extremely unnecessary devices/treatment. I’m sure a lot of people in healthcare are good, but the people calling the shots - including even some doctors - don’t give a shit
- davidw 8y ago
  Yep. It's also important to understand that doctors - rightfully - still do pretty well by themselves in countries with single payer or other systems. It's all the extra insurance infrastructure that doesn't exist/rake in money hand over fist.
- kurthr 8y ago
  Well, yes... but it's not really the insurance companies fault. They're regulated and can only make a percentage of total costs so they need spending to increase so they can deliver growth to their stockholders. They negotiate higher prices for the consumer with the large medical services and drive out low cost providers so they can provide stable dividends. They make collecting benefits or reading a bill impossible and renege on agreed payments so that they can pay their employees to live in the style they are accustomed to. Actually, I hate the player as much as the game. It's disgusting.
deleted 8y ago
[deleted]
esturk 8y ago
Alternative link. https://t.co/qiNptlTJ9b?amp=1 https://t.co/qiNptlTJ9b?amp=1
webbles 8y ago
I can do it in one word: republicans.
komali2 8y ago
Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.
- malvosenior 8y ago
  You do realize that it was under democratic leadership that healthcare costs shot up so much. Obamacare increased my monthly payment almost 2X.
  - knuththetruth 8y ago
    ...implementing a healthcare policy cooked up by conservative think tanks in the 1990s. The rest of the developed world shows that anything short of national healthcare system is an expensive mistake.
    - malvosenior 8y ago
      So the democrats are not to blame for implementing it? I don't see how you can single out any particular party for this situation and if I had to, I'd go with the people that actually jacked up my premiums (democrats).
      - knuththetruth 8y ago
        Oh, they’re entirely to blame and I’m just as angry as anyone for them furthering this broken system. But their choice of doing so was guided by right-wing ideology. The Democratic Party is a center-right party. You might not be able to single out any one party for this problem, but you can certainly indict those who further this kind of thinking in the face of its demonstrable moral and economic failure.
        malvosenior 8y ago
swarnie_ 8y ago
Please can someone explain the USA's lack of free healthcare to me? Every time i see it suggested or attempted its immediately sabotaged by just about everyone. The NHS is one of the greatest things to come out the UK but you guys seem so opposed to the notion.
- koolba 8y ago
  The abridged version is that they were working on it but the head of Kaiser convinced Nixon that private health insurance was a better option. Fast forward a few decades and there is too much at stake for the companies providing the care^insurance for a graceful change. Large companies also don't give a hoot because they're able to offer corporate self-insured plans which constitutes a competitive advantage against smaller employers. My personal opinion is that the ACA was also complete garbage. Either go single payer (or at least an option to buy into a single payer) or don't go at all. The half assed approach we've ended up with is the worst combination as the individual is forced to purchase insurance in a market with perverse incentives on all sides and no real competition.
  - improbable22 8y ago
    There are lots of other systems besides single-payer (like the NHS grandparent mentions liking) or the US. It isn't some law of nature that anything "in-between" is doomed to failure. For example, read a bit about the Swiss system: https://en.wikipedia.org/wiki/Healthcare_in_Switzerland https://en.wikipedia.org/wiki/Healthcare_in_Switzerland
  - yardie 8y ago
    The ACA isn't all bad. One thing it did do was open the market to more providers. Prior to that every state had their own insurance companies (ie. BCBS-FL, BCBS-VA, BCBS-WA). And if you wanted it there were maybe 2-3 companies you could choose from.
- johan_larson 8y ago
  A hefty portion of the population hates, fears, or scorns the government. They think putting healthcare (even more) in the hands of the state will either lead to worse results or give the state even more leverage to push them around. Also, a big and influential portion of the citizenry is served just fine by the current arrangement. If you don't have any long-term medical conditions and you have a job good enough that your employer provides medical insurance, you're doing just fine, thank you. Finally, there are large and influential groups that are making a lot of money under the current system, and expect they would make less under a more socialized system. Among these are doctors, insurance companies, and pharmaceutical companies. All these factors add up to a formidable bulwark against large-scale change.
howard941 8y ago
> Consumers, meanwhile, buoyed by insurance and tax breaks, have little idea how much they are really spending and little incentive to know underlying costs. Almost weekly there's another post showing that consumers literally cannot find out costs usually because the provider cannot supply it. It's time to put a stake in the heart of the recurring blame-the-consumer trope.
- WillPostForFood 8y ago
  I agree, but I think they are talking about a different aspect of "not knowing". Which is, I get health coverage from my employer, I go to the doctor, I get some sort of bill that seems high but not crazy, I assume that is the cost of visit. But I am not seeing the transactions behind the scene between doctor/insurer/employer that may be several times what I am directly out of pocket, but pay indirectly.
  - gameswithgo 8y ago
    there are other kinds of problems. You are in the hospital, you feel queasy after surgery, nurse asks if you would like medication for that. "how much is it?" If you even think to ask that, usually they will not know, and can't or will not find out for you. So you can't make a rational decision about whether to deal with the discomfort or not. Similarly, doctors often won't know the cost difference between various medication options, and those costs are always extremely difficult to figure out since there are usually various coupons that last for various amounts of time, which if you are willing to sort through you can game the system a lot. But in the long run it would be better if those games didn't exist. Switching asthma meds as you run through coupon time limits isn't really the healthiest thing anyway. Or you are hit by a car, an amublance shows up "what will the bill be? Oh I'll call a different service" no, you can't do that while you are bleeding out, nor will you have any way of knowing which hospital will have the best rates to fix you, you don't even know what is wrong yet! One might conclude that private, free markets don't make sense in this domain at all, perhaps.
    - chimeracoder 8y ago
jpmonette 8y ago
You can skip the paywall here (if you have a Facebook account, of course): http://facebook.com/l.php?u=https://www.wsj.com/articles/why-americans-spend-so-much-on-health-carein-12-charts-1533047243 http://facebook.com/l.php?u=https://www.wsj.com/articles/why...
- esturk 8y ago
  You can avoid having a FB account if you just use the twitter link I posted.
gdaxthrowaway 8y ago
I spend 0$ on healthcare in US. Government pays for everything. That's easy. Hide your income and get a Medicaid.
burlesona 8y ago
> The health-care industry overtook the retail sector as the nation’s largest employer in December, giving local economies and their workers a stake in the industry’s growth. Health jobs surpassed manufacturing jobs in 2008. This seems to me the biggest source of the problem. As the saying goes it’s hard to get someone to understand something when their salary depends on them not understanding it. These days healthcare jobs - technicians and clerks and so on - are the new factory line work. Ie readily available good paying jobs that you can get (in many cases) without a college degree. These personal care jobs are also hard to replace with automation since the entire point is to deal with other humans. Thus most people agree “the system” is broken but any specific proposal made to change it meets a big backlash of people who imagine - perhaps rightly so - “that could cost my job!”
y-c-o-m-b 8y ago
Healthcare costs are by far the #1 reason why I want to move out of the U.S. as soon as possible. I am well off, but due to recent experience I have a major anxiety about going bankrupt from another unexpected health issue. I had emergency spine surgery last year and despite coordinating everything I could to stay in network prior to entering the hospital - surgeon was in network, hospital in network, etc... - the monitoring group that was in the surgery room was NOT in network and neither was the assisting physician. Their fees were so high, that insurance refused to negotiate with them and so I was responsible for the charges despite meeting my out of pocket maximum for out of network charges. Basically out of network maximums are worthless! If it's set at 10k and the bill comes back 100k, insurance can pay up to the 10k (if even that) and you will be responsible for 90k afterwards. It's a mess. I did some reading on this and it turns out to be a huge problem across the US, especially in states like Texas where finding in-network providers and facilities is less likely. I remember when I started working in the early 2000s at a gas station. I was getting 100% paid medical benefits through Aetna and coverage was 90% through the insurance. As time went on and I got better jobs (in IT), that turned into a small monthly premium. Then the premiums just kept growing every year until it became a significant chunk of my monthly take-home check. Starting a few years ago, they've introduced reduced coverage all the way down to 70% as premiums continue to climb and with huge deductibles and higher out of pocket maximums. How long can they continue doing this before the whole system collapses?
- linuxftw 8y ago
  > How long can they continue doing this before the whole system collapses? The system is working as designed. Regulation ensures the corporations are getting rich and you're going broke. When the government decided to make insurance a mandatory product, what did you really think the outcome was going to be? Insurance companies acted in their own interest: lowered payments to providers which forced providers out of their 'networks.' I know, I know. The insurance companies (that formed 'non-profit' entities) are 'losing' money. But, thankfully, the laws provided for subsidies in case of 'losses.' It's all smoke and mirrors.
- ta1234567890 8y ago
  So sorry for what happened to you. Can relate a bit. A few months ago, when we learned that my wife would have to get a C-section, we tried getting an estimate for how much it would cost - asked doctors, nurses, hospital staff, insurance company, etc. No one could or would tell us, not even give us a range. Our best guess was to read online articles, which don't really help very much (unless you are into stressing yourself out). It's been 5 months after the C-section now and we still haven't gotten the bill. Our insurance agent told us it looks like it's going to be $85k total before coverage, and we have no idea how much we'll have to pay out of that. Btw, this was in SF which apparently is the most expensive city in the US where to give birth :(
triangleman 8y ago
Is there a printable view of this? Not that it's multiple pages but if you try to print it, you lose all the charts after the first!
ElmntOfSurprise 8y ago
The charts are not really "Why Americans Spend Much on Health Care", just "Americans Spend Much on Health Care (or More than Others and More than They Used To, Anyway)". Believable causes that I have read being suggested are "demographics", "lack of single payer health care", "unhealthy lifestyle", "inefficient allocation of resources towards terminally ill patients", "Americans pay for drug research that inhabitants of other countries get for free", "expensive safeguards against malpractice lawsuits". Lobbying, taxation and opacity to consumers seems like a poor explanation of why healthcare in the US is so much more expensive than in other countries, and more expensive than in the past.
t1lthesky 8y ago
Americans spend too much on nearly all government provided services. Anyone who thinks that more government spending is the solution really doesn’t understand the underlying issues at all. When it costs 5x as much to build a new subway line in NYC compared to Paris [1], spending 20% more on infrastructure isn’t going to do anything. Arguably it will make things worse, allowing the existing inefficiencies to continue. This problem occurs in all the areas where America lags behind other first world countries. Education, healthcare, infrastructure - spending is equal or greater than comparable nations, but the returns on each dollar spent is much smaller. People try to simplify this issue in a partisan manner to having bigger government (Democrats) vs having more free markets (Republicans), but when you look at each of these areas in greater depth you realize that it’s not that simple. There are a multitude of causes unique to America that contributes to costs being so high, as exemplified in this thread’s article. In the case of health care, elsewhere in the world there exist both free market and government provided solutions that deliver better outcomes than the American system. For a more in depth coverage on this topic, I highly recommend: http://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ http://slatestarcodex.com/2017/02/09/considerations-on-cost-... [1] https://www.nytimes.com/2017/12/28/nyregion/new-york-subway-construction-costs.html https://www.nytimes.com/2017/12/28/nyregion/new-york-subway-...
tzs 8y ago
I wish we didn't overpay compared to other first world countries, but although that is very annoying it is probably sustainable. Furthermore, we have several examples of other first world countries paying much less, using systems ranging from full socialized medicine (the UK) to almost fully private systems with some government regulation (Switzerland), so that fixing this is not a matter of figuring out something that works. It is a matter of getting enough people to agree on the same fix. What worries me more is how the costs keep going up, and that's when measured as a percentage of GDP, so you can't just hand wave it away as part of everything going up over time due to inflation. That's not sustainable. Worse, the same thing is happening in other first world countries, with the costs going up at similar rates as they are here, so unlike the overspending problem this is not just a matter of getting the will to adopt one of the known solutions. There's a great interactive view of the data at the OECD health spending page: https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm Uncheck the "latest data available" box, and that will enable the year range sliders. Set them to 1970-2017 and the graph will show the growth over time for several countries. Mouse over the lines on the graph and it will give you number.
alphabettsy 8y ago
The common refrain that we will improve healthcare by keeping the government away and relying on the free market ignores the fact that most people are unable to shop for healthcare. Consolidation, price obscurity and immediate need makes that impossible. Even if it were possible, will there be uniform methods for describing the services and total price of services so that people can shop around?
neonate 8y ago
http://archive.is/u9WHs http://archive.is/u9WHs

38 points by jedwhite 8y ago

zbrt 8y ago

Would like to read, article is behind a paywall.

bgentry 8y ago
This works for WSJ: 1. Find link to article on Twitter ( https://mobile.twitter.com/WSJ/status/1024306968029224960 https://mobile.twitter.com/WSJ/status/1024306968029224960 ) 2. Click it.
- kurthr 8y ago
  Unfortunately, not any more (at least for me). I'll try a fresh browser VM without cookies. Yes, that worked.
JTbane 8y ago
You can prepend "facebook.com/l.php?u=" to the link

pettersolberg 8y ago

They spend so much, because it's basically Health Business not Care.

WillPostForFood 8y ago
I'd go with MoneyCaid. Health run care by big bureaucratic business deeply intertwined with big bureaucratic government. So there's lots of money flowing, but not as much care.
- Arnt 8y ago
  Germany too has large businesses providing health care and mucho government. When I had my tonsils removed a few years ago, a €>1b/y organisation did the knifework, another organisation with an even bigger budget paid, and neither of them set the rates. So why does this combination work in Germany and fail so spectacularly in the US?
- opportune 8y ago
  As someone who got a peak into some of the intimate details of a large Hospice services provider, I have to agree. The fact that there are, no matter what they call themselves, salesmen who wine and dine hospital and senior home officials so that their employer can be made a part of their hospice pipeline is sickening. What’s worse is when you discover how many “palliative” patients will routinely temporarily leave care for surgeries, then cycle back on, for years. Not to mention that many of my relatives, and myself, have been egregiously misbilled or convinced to purchase very expensive, extremely unnecessary devices/treatment. I’m sure a lot of people in healthcare are good, but the people calling the shots - including even some doctors - don’t give a shit
davidw 8y ago
Yep. It's also important to understand that doctors - rightfully - still do pretty well by themselves in countries with single payer or other systems. It's all the extra insurance infrastructure that doesn't exist/rake in money hand over fist.
kurthr 8y ago
Well, yes... but it's not really the insurance companies fault. They're regulated and can only make a percentage of total costs so they need spending to increase so they can deliver growth to their stockholders. They negotiate higher prices for the consumer with the large medical services and drive out low cost providers so they can provide stable dividends. They make collecting benefits or reading a bill impossible and renege on agreed payments so that they can pay their employees to live in the style they are accustomed to. Actually, I hate the player as much as the game. It's disgusting.

deleted 8y ago

[deleted]

esturk 8y ago

Alternative link. https://t.co/qiNptlTJ9b?amp=1 https://t.co/qiNptlTJ9b?amp=1

webbles 8y ago

I can do it in one word: republicans.

komali2 8y ago

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

malvosenior 8y ago
You do realize that it was under democratic leadership that healthcare costs shot up so much. Obamacare increased my monthly payment almost 2X.
- knuththetruth 8y ago
  ...implementing a healthcare policy cooked up by conservative think tanks in the 1990s. The rest of the developed world shows that anything short of national healthcare system is an expensive mistake.
  - malvosenior 8y ago
    So the democrats are not to blame for implementing it? I don't see how you can single out any particular party for this situation and if I had to, I'd go with the people that actually jacked up my premiums (democrats).
    - knuththetruth 8y ago
      Oh, they’re entirely to blame and I’m just as angry as anyone for them furthering this broken system. But their choice of doing so was guided by right-wing ideology. The Democratic Party is a center-right party. You might not be able to single out any one party for this problem, but you can certainly indict those who further this kind of thinking in the face of its demonstrable moral and economic failure.
      - malvosenior 8y ago

swarnie_ 8y ago

Please can someone explain the USA's lack of free healthcare to me? Every time i see it suggested or attempted its immediately sabotaged by just about everyone. The NHS is one of the greatest things to come out the UK but you guys seem so opposed to the notion.

koolba 8y ago
The abridged version is that they were working on it but the head of Kaiser convinced Nixon that private health insurance was a better option. Fast forward a few decades and there is too much at stake for the companies providing the care^insurance for a graceful change. Large companies also don't give a hoot because they're able to offer corporate self-insured plans which constitutes a competitive advantage against smaller employers. My personal opinion is that the ACA was also complete garbage. Either go single payer (or at least an option to buy into a single payer) or don't go at all. The half assed approach we've ended up with is the worst combination as the individual is forced to purchase insurance in a market with perverse incentives on all sides and no real competition.
- improbable22 8y ago
  There are lots of other systems besides single-payer (like the NHS grandparent mentions liking) or the US. It isn't some law of nature that anything "in-between" is doomed to failure. For example, read a bit about the Swiss system: https://en.wikipedia.org/wiki/Healthcare_in_Switzerland https://en.wikipedia.org/wiki/Healthcare_in_Switzerland
- yardie 8y ago
  The ACA isn't all bad. One thing it did do was open the market to more providers. Prior to that every state had their own insurance companies (ie. BCBS-FL, BCBS-VA, BCBS-WA). And if you wanted it there were maybe 2-3 companies you could choose from.
johan_larson 8y ago
A hefty portion of the population hates, fears, or scorns the government. They think putting healthcare (even more) in the hands of the state will either lead to worse results or give the state even more leverage to push them around. Also, a big and influential portion of the citizenry is served just fine by the current arrangement. If you don't have any long-term medical conditions and you have a job good enough that your employer provides medical insurance, you're doing just fine, thank you. Finally, there are large and influential groups that are making a lot of money under the current system, and expect they would make less under a more socialized system. Among these are doctors, insurance companies, and pharmaceutical companies. All these factors add up to a formidable bulwark against large-scale change.

howard941 8y ago

> Consumers, meanwhile, buoyed by insurance and tax breaks, have little idea how much they are really spending and little incentive to know underlying costs. Almost weekly there's another post showing that consumers literally cannot find out costs usually because the provider cannot supply it. It's time to put a stake in the heart of the recurring blame-the-consumer trope.

WillPostForFood 8y ago
I agree, but I think they are talking about a different aspect of "not knowing". Which is, I get health coverage from my employer, I go to the doctor, I get some sort of bill that seems high but not crazy, I assume that is the cost of visit. But I am not seeing the transactions behind the scene between doctor/insurer/employer that may be several times what I am directly out of pocket, but pay indirectly.
- gameswithgo 8y ago
  there are other kinds of problems. You are in the hospital, you feel queasy after surgery, nurse asks if you would like medication for that. "how much is it?" If you even think to ask that, usually they will not know, and can't or will not find out for you. So you can't make a rational decision about whether to deal with the discomfort or not. Similarly, doctors often won't know the cost difference between various medication options, and those costs are always extremely difficult to figure out since there are usually various coupons that last for various amounts of time, which if you are willing to sort through you can game the system a lot. But in the long run it would be better if those games didn't exist. Switching asthma meds as you run through coupon time limits isn't really the healthiest thing anyway. Or you are hit by a car, an amublance shows up "what will the bill be? Oh I'll call a different service" no, you can't do that while you are bleeding out, nor will you have any way of knowing which hospital will have the best rates to fix you, you don't even know what is wrong yet! One might conclude that private, free markets don't make sense in this domain at all, perhaps.
  - chimeracoder 8y ago

jpmonette 8y ago

You can skip the paywall here (if you have a Facebook account, of course): http://facebook.com/l.php?u=https://www.wsj.com/articles/why-americans-spend-so-much-on-health-carein-12-charts-1533047243 http://facebook.com/l.php?u=https://www.wsj.com/articles/why...

esturk 8y ago
You can avoid having a FB account if you just use the twitter link I posted.

gdaxthrowaway 8y ago

I spend 0$ on healthcare in US. Government pays for everything. That's easy. Hide your income and get a Medicaid.

burlesona 8y ago

> The health-care industry overtook the retail sector as the nation’s largest employer in December, giving local economies and their workers a stake in the industry’s growth. Health jobs surpassed manufacturing jobs in 2008. This seems to me the biggest source of the problem. As the saying goes it’s hard to get someone to understand something when their salary depends on them not understanding it. These days healthcare jobs - technicians and clerks and so on - are the new factory line work. Ie readily available good paying jobs that you can get (in many cases) without a college degree. These personal care jobs are also hard to replace with automation since the entire point is to deal with other humans. Thus most people agree “the system” is broken but any specific proposal made to change it meets a big backlash of people who imagine - perhaps rightly so - “that could cost my job!”

y-c-o-m-b 8y ago

Healthcare costs are by far the #1 reason why I want to move out of the U.S. as soon as possible. I am well off, but due to recent experience I have a major anxiety about going bankrupt from another unexpected health issue. I had emergency spine surgery last year and despite coordinating everything I could to stay in network prior to entering the hospital - surgeon was in network, hospital in network, etc... - the monitoring group that was in the surgery room was NOT in network and neither was the assisting physician. Their fees were so high, that insurance refused to negotiate with them and so I was responsible for the charges despite meeting my out of pocket maximum for out of network charges. Basically out of network maximums are worthless! If it's set at 10k and the bill comes back 100k, insurance can pay up to the 10k (if even that) and you will be responsible for 90k afterwards. It's a mess. I did some reading on this and it turns out to be a huge problem across the US, especially in states like Texas where finding in-network providers and facilities is less likely. I remember when I started working in the early 2000s at a gas station. I was getting 100% paid medical benefits through Aetna and coverage was 90% through the insurance. As time went on and I got better jobs (in IT), that turned into a small monthly premium. Then the premiums just kept growing every year until it became a significant chunk of my monthly take-home check. Starting a few years ago, they've introduced reduced coverage all the way down to 70% as premiums continue to climb and with huge deductibles and higher out of pocket maximums. How long can they continue doing this before the whole system collapses?

linuxftw 8y ago
> How long can they continue doing this before the whole system collapses? The system is working as designed. Regulation ensures the corporations are getting rich and you're going broke. When the government decided to make insurance a mandatory product, what did you really think the outcome was going to be? Insurance companies acted in their own interest: lowered payments to providers which forced providers out of their 'networks.' I know, I know. The insurance companies (that formed 'non-profit' entities) are 'losing' money. But, thankfully, the laws provided for subsidies in case of 'losses.' It's all smoke and mirrors.
ta1234567890 8y ago
So sorry for what happened to you. Can relate a bit. A few months ago, when we learned that my wife would have to get a C-section, we tried getting an estimate for how much it would cost - asked doctors, nurses, hospital staff, insurance company, etc. No one could or would tell us, not even give us a range. Our best guess was to read online articles, which don't really help very much (unless you are into stressing yourself out). It's been 5 months after the C-section now and we still haven't gotten the bill. Our insurance agent told us it looks like it's going to be $85k total before coverage, and we have no idea how much we'll have to pay out of that. Btw, this was in SF which apparently is the most expensive city in the US where to give birth :(

triangleman 8y ago

Is there a printable view of this? Not that it's multiple pages but if you try to print it, you lose all the charts after the first!

ElmntOfSurprise 8y ago

The charts are not really "Why Americans Spend Much on Health Care", just "Americans Spend Much on Health Care (or More than Others and More than They Used To, Anyway)". Believable causes that I have read being suggested are "demographics", "lack of single payer health care", "unhealthy lifestyle", "inefficient allocation of resources towards terminally ill patients", "Americans pay for drug research that inhabitants of other countries get for free", "expensive safeguards against malpractice lawsuits". Lobbying, taxation and opacity to consumers seems like a poor explanation of why healthcare in the US is so much more expensive than in other countries, and more expensive than in the past.

t1lthesky 8y ago

Americans spend too much on nearly all government provided services. Anyone who thinks that more government spending is the solution really doesn’t understand the underlying issues at all. When it costs 5x as much to build a new subway line in NYC compared to Paris [1], spending 20% more on infrastructure isn’t going to do anything. Arguably it will make things worse, allowing the existing inefficiencies to continue. This problem occurs in all the areas where America lags behind other first world countries. Education, healthcare, infrastructure - spending is equal or greater than comparable nations, but the returns on each dollar spent is much smaller. People try to simplify this issue in a partisan manner to having bigger government (Democrats) vs having more free markets (Republicans), but when you look at each of these areas in greater depth you realize that it’s not that simple. There are a multitude of causes unique to America that contributes to costs being so high, as exemplified in this thread’s article. In the case of health care, elsewhere in the world there exist both free market and government provided solutions that deliver better outcomes than the American system. For a more in depth coverage on this topic, I highly recommend: http://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ http://slatestarcodex.com/2017/02/09/considerations-on-cost-... [1] https://www.nytimes.com/2017/12/28/nyregion/new-york-subway-construction-costs.html https://www.nytimes.com/2017/12/28/nyregion/new-york-subway-...

tzs 8y ago

I wish we didn't overpay compared to other first world countries, but although that is very annoying it is probably sustainable. Furthermore, we have several examples of other first world countries paying much less, using systems ranging from full socialized medicine (the UK) to almost fully private systems with some government regulation (Switzerland), so that fixing this is not a matter of figuring out something that works. It is a matter of getting enough people to agree on the same fix. What worries me more is how the costs keep going up, and that's when measured as a percentage of GDP, so you can't just hand wave it away as part of everything going up over time due to inflation. That's not sustainable. Worse, the same thing is happening in other first world countries, with the costs going up at similar rates as they are here, so unlike the overspending problem this is not just a matter of getting the will to adopt one of the known solutions. There's a great interactive view of the data at the OECD health spending page: https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm Uncheck the "latest data available" box, and that will enable the year range sliders. Set them to 1970-2017 and the graph will show the growth over time for several countries. Mouse over the lines on the graph and it will give you number.

alphabettsy 8y ago

The common refrain that we will improve healthcare by keeping the government away and relying on the free market ignores the fact that most people are unable to shop for healthcare. Consolidation, price obscurity and immediate need makes that impossible. Even if it were possible, will there be uniform methods for describing the services and total price of services so that people can shop around?

neonate 8y ago

http://archive.is/u9WHs http://archive.is/u9WHs