6 ms·

I am from Central Europe and I opt for a private doctor (meaning I pay for all of it) and while it is insanely cheaper here compared to the US trust me that the

I am from Central Europe and I opt for a private doctor (meaning I pay for all of it) and while it is insanely cheaper here compared to the US trust me that the "free healthcare" is a myth in a sense it is not a silver bullet.

davidw 8y ago
No system is perfect and, no, there is no silver bullet. But US health care costs more as a % of GDP, and doesn't lead to appreciably better outcomes.
- bluGill 8y ago
  I'm told that most of the cost is the US will treat people longer who are going to die in a short time. Someone who will die in 2 weeks can have their life extended to 4 weeks with expensive care... Of course the costs are much higher and outcomes don't change much. For normal care (meaning you are expected to live a good life for a long time latter) costs are more in line.
  - davidw 8y ago
    When I'd go to the doctor in Italy, I'd basically go the waiting room and take a number. When it was your turn (some doctors were pretty fast - 10/15 minute wait - others were slow) you'd go in and see the doctor. No other staff needed. Compare and contrast with a US doctor who has a number of support staff, one of whom is probably full time doing nothing but insurance paperwork. IDK all the details, but when the US looks more bureaucratic than Italy of all places... something isn't right. Of course it's definitely a complicated system and more expensive end of life care is probably part of it too.
    - pkaye 8y ago
      I think some of those staff are there because doctors are highly compensated in the US. The staff is there to maximize the utilization of the doctor's time.
      - ap3 8y ago
        Or because they need to maximize the doctor’s time so he can stay highly compensated.
  - rhcom2 8y ago
    Sidenote, this is a good argument for talking to your loved ones about palliative care and what you'd want in end of life scenarios.
  - mdorazio 8y ago
    It's a combination of many different factors that all add up. Off the top of my head: - End of life care in the US is indeed a lot more extensive than in other countries. - As davidw said, administrative overhead throughout healthcare is ridiculously inflated due to the nature of having to deal with insurance companies and billing. This is both people and software. - Drugs generally cost a lot more than they do elsewhere in the world due to a lack of regulation on costs and the need of pharmaceutical companies to recoup their development costs by charging Americans more than they can make elsewhere. - Without a single payer system, billing is completely ridiculous and leads to hospitals way overcharging for services, knowing that insurance companies will negotiate it back down. - Hospitals are required by law to treat everyone, even uninsured and homeless people who will never be able to pay for their care, so they have to charge more to everyone else to compensate. - The profession of doctor in the US is a weird semi-monopoly setup with artificial constraints on how many new doctors enter the market each year. As a result, you end up with people spending a good chunk of their lives studying to be a doctor, regardless of what kind, and taking on huge debt until they become a "real" doctor. The end result is that the profession makes a lot more money than it does in other countries. - Because healthcare in the US is so expensive even with insurance (the amount you have to pay before your insurance kicks in can easily be thousands of dollars a year), many Americans don't use healthcare for preventive care and thus health issues that would be cheap to prevent become expensive to treat later. - Hospitals in the US are mostly private and for-profit, with margins in the 6-8% range. That's money going to executives and shareholders rather than to actual healthcare.
    - davidw 8y ago
      > The end result is that the profession makes a lot more money than it does in other countries. I don't doubt that, but it's worth pointing out that they make good money - as they should - in other places too. My wife has a family friend in Italy, who has a ski house up in the mountains a motorboat on the Po river delta and regularly goes on fancy vacations. And that's as a general practitioner. I think most of us want doctors to be well compensated for the service they perform and would be wary of a system where that's not the case.
      - 8y ago
  - cadlin 8y ago
    U.S. Healthcare is more expensive because every single step along the way costs more. This blog series[1] by healthcare professionals goes through it all. The primary culprits are: more expensive inpatient care, more expensive outpatient care, more expensive drugs, higher administrative costs, higher insurance costs, higher health investment costs, higher disease prevalence costs, and higher defensive medicine costs. https://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-conclusion/ https://theincidentaleconomist.com/wordpress/what-makes-the-...
hopler 8y ago
"private paid healthcare" is also a myth in the same sense, so this isn't a useful line of analysis to distinguish the two.
dominotw 8y ago
> I opt for a private doctor curious. why?
- conanbatt 8y ago
  Socialized systems can engage in agressive cost-cutting, meaning that the poor use the public system and the better off private system. Thats how it is in argentina as well.
- theredbox 8y ago
  Because I want to be treated like a human not a nuisance or just a mere number. I do not have the time to wait and I do not have the nerves getting misdiagnosed.I do not have the luxury of wasting time and my own resources being treated by someone that does not care. Dont take me wrong I do not think that the private doctor cares about me.He cares about me because I am a paying customer. I do not want the doctor acting like I am 5. I do not need an authoritative figure that acts like a bureaucrat. I want a person that gives me an honest, objective assessment. I want to be able to talk to my doctor about things that matter to me and I do not need to make a visit every time I need to ask something. I would rather shoot him an e-mail get his opinion and act accordingly. I do not want to waste time going to the doctor getting some generic drugs. I want the doctor to be professional, giving me you know options regardless of whether they are covered by an insurance or not. And also because I really do not want to visit doctors. I do not want to plan it. I do not want to spend half a day going from one doctor to another. I want an exact appointment and I want the doctor not waste his time gossiping with patients and nurses. He has the right for break but not every 20 minutes especially when he has people waiting for him. The amount of money I spend on healthcare with my taxes is MUCH higher than what I spend a year. And now I do not have any sense of solidarity with the rest of the country. I could not care less. To me this kind of taxation is nothing but a theft.
Foobar8568 8y ago
I am French living in Switzerland, sorry but private health care is a scam. Switzerland choose to privatize insurance because it would be supposedly better and cheaper. 10-15% inflation a year on premiums.
- theredbox 8y ago
  I am glad it works for you it just does not work for me and I'd rather manage my own resources than having the state have a say in that.

davidw 8y ago

No system is perfect and, no, there is no silver bullet. But US health care costs more as a % of GDP, and doesn't lead to appreciably better outcomes.

bluGill 8y ago
I'm told that most of the cost is the US will treat people longer who are going to die in a short time. Someone who will die in 2 weeks can have their life extended to 4 weeks with expensive care... Of course the costs are much higher and outcomes don't change much. For normal care (meaning you are expected to live a good life for a long time latter) costs are more in line.
- davidw 8y ago
  When I'd go to the doctor in Italy, I'd basically go the waiting room and take a number. When it was your turn (some doctors were pretty fast - 10/15 minute wait - others were slow) you'd go in and see the doctor. No other staff needed. Compare and contrast with a US doctor who has a number of support staff, one of whom is probably full time doing nothing but insurance paperwork. IDK all the details, but when the US looks more bureaucratic than Italy of all places... something isn't right. Of course it's definitely a complicated system and more expensive end of life care is probably part of it too.
  - pkaye 8y ago
    I think some of those staff are there because doctors are highly compensated in the US. The staff is there to maximize the utilization of the doctor's time.
    - ap3 8y ago
      Or because they need to maximize the doctor’s time so he can stay highly compensated.
- rhcom2 8y ago
  Sidenote, this is a good argument for talking to your loved ones about palliative care and what you'd want in end of life scenarios.
- mdorazio 8y ago
  It's a combination of many different factors that all add up. Off the top of my head: - End of life care in the US is indeed a lot more extensive than in other countries. - As davidw said, administrative overhead throughout healthcare is ridiculously inflated due to the nature of having to deal with insurance companies and billing. This is both people and software. - Drugs generally cost a lot more than they do elsewhere in the world due to a lack of regulation on costs and the need of pharmaceutical companies to recoup their development costs by charging Americans more than they can make elsewhere. - Without a single payer system, billing is completely ridiculous and leads to hospitals way overcharging for services, knowing that insurance companies will negotiate it back down. - Hospitals are required by law to treat everyone, even uninsured and homeless people who will never be able to pay for their care, so they have to charge more to everyone else to compensate. - The profession of doctor in the US is a weird semi-monopoly setup with artificial constraints on how many new doctors enter the market each year. As a result, you end up with people spending a good chunk of their lives studying to be a doctor, regardless of what kind, and taking on huge debt until they become a "real" doctor. The end result is that the profession makes a lot more money than it does in other countries. - Because healthcare in the US is so expensive even with insurance (the amount you have to pay before your insurance kicks in can easily be thousands of dollars a year), many Americans don't use healthcare for preventive care and thus health issues that would be cheap to prevent become expensive to treat later. - Hospitals in the US are mostly private and for-profit, with margins in the 6-8% range. That's money going to executives and shareholders rather than to actual healthcare.
  - davidw 8y ago
    > The end result is that the profession makes a lot more money than it does in other countries. I don't doubt that, but it's worth pointing out that they make good money - as they should - in other places too. My wife has a family friend in Italy, who has a ski house up in the mountains a motorboat on the Po river delta and regularly goes on fancy vacations. And that's as a general practitioner. I think most of us want doctors to be well compensated for the service they perform and would be wary of a system where that's not the case.
    - 8y ago
- cadlin 8y ago
  U.S. Healthcare is more expensive because every single step along the way costs more. This blog series[1] by healthcare professionals goes through it all. The primary culprits are: more expensive inpatient care, more expensive outpatient care, more expensive drugs, higher administrative costs, higher insurance costs, higher health investment costs, higher disease prevalence costs, and higher defensive medicine costs. https://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-conclusion/ https://theincidentaleconomist.com/wordpress/what-makes-the-...

hopler 8y ago

"private paid healthcare" is also a myth in the same sense, so this isn't a useful line of analysis to distinguish the two.

dominotw 8y ago

> I opt for a private doctor curious. why?

conanbatt 8y ago
Socialized systems can engage in agressive cost-cutting, meaning that the poor use the public system and the better off private system. Thats how it is in argentina as well.
theredbox 8y ago
Because I want to be treated like a human not a nuisance or just a mere number. I do not have the time to wait and I do not have the nerves getting misdiagnosed.I do not have the luxury of wasting time and my own resources being treated by someone that does not care. Dont take me wrong I do not think that the private doctor cares about me.He cares about me because I am a paying customer. I do not want the doctor acting like I am 5. I do not need an authoritative figure that acts like a bureaucrat. I want a person that gives me an honest, objective assessment. I want to be able to talk to my doctor about things that matter to me and I do not need to make a visit every time I need to ask something. I would rather shoot him an e-mail get his opinion and act accordingly. I do not want to waste time going to the doctor getting some generic drugs. I want the doctor to be professional, giving me you know options regardless of whether they are covered by an insurance or not. And also because I really do not want to visit doctors. I do not want to plan it. I do not want to spend half a day going from one doctor to another. I want an exact appointment and I want the doctor not waste his time gossiping with patients and nurses. He has the right for break but not every 20 minutes especially when he has people waiting for him. The amount of money I spend on healthcare with my taxes is MUCH higher than what I spend a year. And now I do not have any sense of solidarity with the rest of the country. I could not care less. To me this kind of taxation is nothing but a theft.

Foobar8568 8y ago

I am French living in Switzerland, sorry but private health care is a scam. Switzerland choose to privatize insurance because it would be supposedly better and cheaper. 10-15% inflation a year on premiums.

theredbox 8y ago
I am glad it works for you it just does not work for me and I'd rather manage my own resources than having the state have a say in that.