5 ms·

It works in 36 out of 37 modern OECD nations, with the US paying the most, and more than double all the other nations which have the government negotiate a bett

by dv_dt 8y ago

It works in 36 out of 37 modern OECD nations, with the US paying the most, and more than double all the other nations which have the government negotiate a better price. Even in our own VA system, their negotiated prices are lower for drugs than the Medicare part D program, barred from negotiating (and with large pieces managed by private companies). I think your skepticism should primarily be directed to wondering if private systems can ever negotiate a fair price in healthcare products and services.

dragonwriter 8y ago
> It works in 36 out of 37 modern OECD nations The rest of the OECD has universal healthcare, but not necessarily fully public healthcare (the model vary considerably.) Which just means that there are lots of good proven models that the US could adopt.
- dv_dt 8y ago
  There are lots of good models which all have in common a strong gov't negotiated price control somewhere in a system driven by universal healthcare principles instead of profit and market oriented principles.
krupan 8y ago
Is cost the only measure we want to optimize for?
- dv_dt 8y ago
  I think the US has better cancer survival rates in areas than other nations, but if that is all-around significant one would think that would reflect out in better life expectancy overall. However, the US is a huge negative outlier in life expectancy and child mortality with universal healthcare nations outperforming on those measures too. https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-... The most recent life expectancy numbers are the hardest to interpret, the US has the only three-year-running negative life expectancy growth in the first world nations - but some argue we should separate healthcare from the suicide numbers that are a big contributors. I don't know that I agree with that as there is a fuzzy line between healthcare and social care efforts.
  - amalcon 8y ago
    Life expectancy is a weird stat by which to measure healthcare outcomes. For starters, it responds rather strongly to demographics. E.g. having more males reduces life expectancy holding all else equal. There are many things like this. Age-adjusted all-cause death rate is the better stat for measuring life-saving outcomes. Child mortality is certainly a useful stat for its purpose, though.
    - dv_dt 8y ago
      > Age-adjusted all-cause death rate is the better stat for measuring life-saving outcomes. Are there sources of that stat over time and between nations that you would recommend?
      - amalcon 8y ago
        WHO is the best source I know of for most things like this. I was unable to find the exact stat I was looking for, but here is e.g. data on all-cause mortality rate between ages 18 and 60: http://apps.who.int/gho/data/view.main.1360?lang=en http://apps.who.int/gho/data/view.main.1360?lang=en It probably still supports the point you are trying to make, I just get grumpy about statistic selection.

by dv_dt 8y ago

dragonwriter 8y ago

> It works in 36 out of 37 modern OECD nations The rest of the OECD has universal healthcare, but not necessarily fully public healthcare (the model vary considerably.) Which just means that there are lots of good proven models that the US could adopt.

dv_dt 8y ago
There are lots of good models which all have in common a strong gov't negotiated price control somewhere in a system driven by universal healthcare principles instead of profit and market oriented principles.

krupan 8y ago

Is cost the only measure we want to optimize for?

dv_dt 8y ago
I think the US has better cancer survival rates in areas than other nations, but if that is all-around significant one would think that would reflect out in better life expectancy overall. However, the US is a huge negative outlier in life expectancy and child mortality with universal healthcare nations outperforming on those measures too. https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-... The most recent life expectancy numbers are the hardest to interpret, the US has the only three-year-running negative life expectancy growth in the first world nations - but some argue we should separate healthcare from the suicide numbers that are a big contributors. I don't know that I agree with that as there is a fuzzy line between healthcare and social care efforts.
- amalcon 8y ago
  Life expectancy is a weird stat by which to measure healthcare outcomes. For starters, it responds rather strongly to demographics. E.g. having more males reduces life expectancy holding all else equal. There are many things like this. Age-adjusted all-cause death rate is the better stat for measuring life-saving outcomes. Child mortality is certainly a useful stat for its purpose, though.
  - dv_dt 8y ago
    > Age-adjusted all-cause death rate is the better stat for measuring life-saving outcomes. Are there sources of that stat over time and between nations that you would recommend?
    - amalcon 8y ago
      WHO is the best source I know of for most things like this. I was unable to find the exact stat I was looking for, but here is e.g. data on all-cause mortality rate between ages 18 and 60: http://apps.who.int/gho/data/view.main.1360?lang=en http://apps.who.int/gho/data/view.main.1360?lang=en It probably still supports the point you are trying to make, I just get grumpy about statistic selection.