2 ms·

The problem is not the raw number for how much profit is made; it's how much waste is generated in pursuit of that profit. For example, the entire concept of "

The problem is not the raw number for how much profit is made; it's how much waste is generated in pursuit of that profit. For example, the entire concept of "negotiated rates" as they apply to the US healthcare system is based around various entities trying to maximize profit, rather than maximize provision of care.[1][2][3] This results in patients being stuck with enormous bills, and services not being provided, or being provided at unreasonable costs. And this is just one area where this is the case. Costs for prescription drugs (especially new/non-generic ones) are another great example. Because of the system's desire for profit, much of that $3.5 trillion is being spent to try to pump up that $50 billion -- and it's not even doing a particularly good job, as you note yourself, since other nations with for-profit systems have much lower costs. I'm not saying that no for-profit system could exist that wouldn't be better. But whether that theoretical new system is for-profit or not-for-profit (or, as it most likely would be, a hybrid as we see in many developed countries), we'd have to rip out a substantial amount of the current system to get it. [1] https://www.policygenius.com/health-insurance/what-is-a-negotiated-rate/ https://www.policygenius.com/health-insurance/what-is-a-nego... [2] https://www.americanprogress.org/press/release/2019/06/26/471491/release-new-report-shows-hospitals-raise-prices-private-insurance/ https://www.americanprogress.org/press/release/2019/06/26/47... (note: American Progress is a liberal-skewed source, but their stats should be good) [3] https://www.bu.edu/questrom/2018/12/04/insurers-negotiated-rates-can-dramatically-affect-health-care-prices/ https://www.bu.edu/questrom/2018/12/04/insurers-negotiated-r...

tptacek 7y ago
Negotiated cartel rates and lack of price insurance sure do seem like a plausible component of our health care debacle. But other countries have for-profit providers and private insurance and they don't have these problems. Why is that? The prescription drug market is dysfunctional. But what did the last breakdown you look at say about the percentage of our health dollars swallowed by prescription drugs, compared to caregiver salaries, hospital procedures, and long-term care costs?
- ivraatiems 7y ago
  > Negotiated cartel rates and lack of price insurance sure do seem like a plausible component of our health care debacle. But other countries have for-profit providers and private insurance and they don't have these problems. Why is that? I'm reading your question as slightly rhetorical. If that's the case, and you have some thoughts, you should share them. For my part, I'd start by looking at the way other privatized systems are managed and regulated, such as Sweden's: https://www.theguardian.com/society/2012/dec/18/private-healthcare-lessons-from-sweden https://www.theguardian.com/society/2012/dec/18/private-heal... > But what did the last breakdown you look at say about the percentage of our health dollars swallowed by prescription drugs, compared to caregiver salaries, hospital procedures, and long-term care costs? I'm not making the point that prescription drugs are the largest or even a particularly substantial contributor to the overall number. I'm arguing they're an easy-to-see example of the overall problems that most facets of the current system face. (By the way, the breakdown another user higher in the chain posted puts prescription drugs at 10% of overall costs, so that's a big chunk.)

tptacek 7y ago

Negotiated cartel rates and lack of price insurance sure do seem like a plausible component of our health care debacle. But other countries have for-profit providers and private insurance and they don't have these problems. Why is that? The prescription drug market is dysfunctional. But what did the last breakdown you look at say about the percentage of our health dollars swallowed by prescription drugs, compared to caregiver salaries, hospital procedures, and long-term care costs?

ivraatiems 7y ago
> Negotiated cartel rates and lack of price insurance sure do seem like a plausible component of our health care debacle. But other countries have for-profit providers and private insurance and they don't have these problems. Why is that? I'm reading your question as slightly rhetorical. If that's the case, and you have some thoughts, you should share them. For my part, I'd start by looking at the way other privatized systems are managed and regulated, such as Sweden's: https://www.theguardian.com/society/2012/dec/18/private-healthcare-lessons-from-sweden https://www.theguardian.com/society/2012/dec/18/private-heal... > But what did the last breakdown you look at say about the percentage of our health dollars swallowed by prescription drugs, compared to caregiver salaries, hospital procedures, and long-term care costs? I'm not making the point that prescription drugs are the largest or even a particularly substantial contributor to the overall number. I'm arguing they're an easy-to-see example of the overall problems that most facets of the current system face. (By the way, the breakdown another user higher in the chain posted puts prescription drugs at 10% of overall costs, so that's a big chunk.)