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Overall I tend to agree with this. However the other half of the insane cost (19% of GDP) is the overpay on drugs. The US has so many idiotic laws that often d

by nickik 7y ago

Overall I tend to agree with this. However the other half of the insane cost (19% of GDP) is the overpay on drugs. The US has so many idiotic laws that often date back to 1900-1950 in terms of health care. During WW2 because of wage caps companies started to offer health care and that was essentially institutionalized. This is one of the single dumbest polices ever, since it means people who lose their job lose their health care. It means much less diversity in terms of the type of health care coverage that can be used. It also means that people have much less visibility into the cost of their health care, people often say median wages haven't gone up but a large part of that is because health care cost have gone up in almost equal measure. If you systematically go threw the US health care system it is littered with anti-competitive rules that benefit particular groups on every level. I think people often make it out to be a simple US is "private" system and its bad, so if you change it to a public system its gone be good. I don't know if that is true, many of the same issues persist and somebody has to pay the money eventually. Such a system would help the people who now pay way to much now but society will pay either way and probably +20% of GDP. At the same time the cost of most non-insurance health care and operations go down. Beauty, eyes and so on go down and down. Cash only health care is WAY cheaper. Something is seriously wrong with this system.

rsj_hn 7y ago
Agree that drug costs are also crazy. To me that is part of overall healthcare costs being too high. I used to believe that the cost of non-insurance goes down until you look at the costs of veterinary care, which has been rising even faster and which is generally cash based. Bottom line, it's best to think of health care as a type of extraction racket. How much does it cost? Well, how much do you have? If you love your pet or your own life, you will end up paying. There are a number of things that can be done to lower costs. Limit drug patents, force drug makers to make samples available to generics competitors, insurance adequacy laws that ban out of coverage charges, ban surprise charges, mandate a law of one price so that different patients can't get charged different prices based on whether they pay cash or insurance or what type of insurance. Mandate price transparency, mandate citing bills ahead of time rather than forcing customers to make general 'promises to pay'. There is lots of progress to be made and low hanging fruit available. This supply side intervention is not a substitute for addressing the insurance market, which should be addressed. But the bulk of the problem is on the supply side, not the demand side, and as you drive costs down, then different types of insurance reforms become more affordable and thus more politically feasible. But it makes you wonder why even the most strident advocates of single payer are not talking about cutting costs nearly so much as they are talking about the government paying your bill. This is just a sign that they know there is not political support to tackle the tough questions, there is only political support to advocate for benefits, which is another way of saying there is no real political support to tackle this problem. And if there is no political will to make reforms on the supply side now when individual Americans are being hit with exorbitant bills, then what will be the political will to do this when it is "government" that is on the hook for the bill?

by nickik 7y ago

rsj_hn 7y ago

Agree that drug costs are also crazy. To me that is part of overall healthcare costs being too high. I used to believe that the cost of non-insurance goes down until you look at the costs of veterinary care, which has been rising even faster and which is generally cash based. Bottom line, it's best to think of health care as a type of extraction racket. How much does it cost? Well, how much do you have? If you love your pet or your own life, you will end up paying. There are a number of things that can be done to lower costs. Limit drug patents, force drug makers to make samples available to generics competitors, insurance adequacy laws that ban out of coverage charges, ban surprise charges, mandate a law of one price so that different patients can't get charged different prices based on whether they pay cash or insurance or what type of insurance. Mandate price transparency, mandate citing bills ahead of time rather than forcing customers to make general 'promises to pay'. There is lots of progress to be made and low hanging fruit available. This supply side intervention is not a substitute for addressing the insurance market, which should be addressed. But the bulk of the problem is on the supply side, not the demand side, and as you drive costs down, then different types of insurance reforms become more affordable and thus more politically feasible. But it makes you wonder why even the most strident advocates of single payer are not talking about cutting costs nearly so much as they are talking about the government paying your bill. This is just a sign that they know there is not political support to tackle the tough questions, there is only political support to advocate for benefits, which is another way of saying there is no real political support to tackle this problem. And if there is no political will to make reforms on the supply side now when individual Americans are being hit with exorbitant bills, then what will be the political will to do this when it is "government" that is on the hook for the bill?