4 ms·

"Eg few if any insurances around the world pays for laser eye surgery. And it's one of the few common healthcare procedures whose costs have dropped massively i

"Eg few if any insurances around the world pays for laser eye surgery. And it's one of the few common healthcare procedures whose costs have dropped massively in recent decades" I don't know that an elective procedure is the best example, but it's still an example. One counter is prescription drugs. My insurance would only allow a small number of tablets for my migraine medication because the cost for them was so artificially high. When I called the insurance company to ask why they wouldn't pay for the number of tablets that I needed, I was told that my doctor should do a better job of controlling the number of migraines that I get. Where do I get this medication now that I don't have insurance? From countries that have socialized medicine, and the cost is substantially less. Unreasonably high costs for prescription meds in the US is not unusual. I recently had to take doxycycline for Lyme disease. Back in 2012, this cost 6 cents per dose. That price increased by over 6,000 in one year, just as Lyme cases were also skyrocketing.

eru 7y ago
Yes, the medical system in the US sucks. There are parts of the world where it works much better. (And not all of them have socialized health care.) In any case, the socialized health care probably doesn't cover the drugs that get to exported to foreigners like you? > Unreasonably high costs for prescription meds in the US is not unusual. Yes, that's a separate problem. Enabling (re-) imports is an important safety valve. Medical tourism is another. Ideally, the US would fix their healthcare system. But I wouldn't hold my breath.
- DanBC 7y ago
  > In any case, the socialized health care probably doesn't cover the drugs that get to exported to foreigners like you? Maybe I'm misunderstanding, but large markets (socialised healthcare systems) can negotiate a fair market price for medications. This is something that the US system prevents. Have a look at mebendazole. It's on the WHO list of essential medication. It's old so available as generic. In the UK this costs a few pounds per tablet. https://bnf.nice.org.uk/medicinal-forms/mebendazole.html https://bnf.nice.org.uk/medicinal-forms/mebendazole.html In the US it currently costs $440 (about £340) per tablet. There are many similar examples: Americans pay huge amounts for medications that should be cheap.
  - eru 7y ago
    In economics, the usual prescription for high price despite low manufacturing costs is to lower barriers to entry. There's probably a legal reason why someone can't just set up a company to buy mebendazole in bulk in the UK and ship it to the US and sell it for eg $200 per tablet?
- DiogenesKynikos 7y ago
  > There are parts of the world where it works much better. (And not all of them have socialized health care.) Almost all developed countries have socialized healthcare. What countries do you have in mind?
  - eru 7y ago
    It depends a bit on exactly what you mean by socialized, but I have the Singaporean system in mind. (I was just quoting Cougher when using the term socialized.) Singapore has some of the best healthcare outcomes in the world, and costs about half as much as a share of GDP per capita as the British NHS. Where the American system seems to combine the worst of public and private healthcare, Singapore combines the best. In the Singaporean system individuals use a health savings account to pay for small, routine health care costs. The insurance part of the system only kicks in for larger, costlier, uncertain items. There's plenty of subsidies for poor people, too. See eg https://www.nytimes.com/2019/04/22/upshot/singapore-health-system-lessons.html https://www.nytimes.com/2019/04/22/upshot/singapore-health-s... for an American perspective. There's also plenty of easy to find material on the web. I especially like that doctors usually have a list with price ranges for their most common items hanging out prominently. Very transparent.
    - DiogenesKynikos 7y ago
      Singapore has socialized healthcare. On the provider side, most of the hospitals are owned by the government. On the insurance side, employees are required by the government to pay into health savings accounts (with nearly matching employer contributions). There are additional public insurance schemes for the poor and elderly. On top of that, costs in the public hospitals are subsidized to a significant extent.
      - eru 7y ago
        Seems to be an American term? https://en.wikipedia.org/wiki/Socialized_medicine https://en.wikipedia.org/wiki/Socialized_medicine But I agree with what you are stating. (Though if you call that system 'socialized', then the American systems are also 'socialized' to a large extent. So it's probably better to just talk about specific feature instead of such a loaded term.) The aspect of the system that I wanted to highlight is that routine care is paid for out of the health savings account (Medisave), and not out of the insurance portion. Another interesting aspect is that the bill you get for treatments always mentions the total cost and any subsidies you are getting. All very transparent. There's also always a co-pay as a matter of principle, even if it's just a few dollars.

eru 7y ago

Yes, the medical system in the US sucks. There are parts of the world where it works much better. (And not all of them have socialized health care.) In any case, the socialized health care probably doesn't cover the drugs that get to exported to foreigners like you? > Unreasonably high costs for prescription meds in the US is not unusual. Yes, that's a separate problem. Enabling (re-) imports is an important safety valve. Medical tourism is another. Ideally, the US would fix their healthcare system. But I wouldn't hold my breath.

DanBC 7y ago
> In any case, the socialized health care probably doesn't cover the drugs that get to exported to foreigners like you? Maybe I'm misunderstanding, but large markets (socialised healthcare systems) can negotiate a fair market price for medications. This is something that the US system prevents. Have a look at mebendazole. It's on the WHO list of essential medication. It's old so available as generic. In the UK this costs a few pounds per tablet. https://bnf.nice.org.uk/medicinal-forms/mebendazole.html https://bnf.nice.org.uk/medicinal-forms/mebendazole.html In the US it currently costs $440 (about £340) per tablet. There are many similar examples: Americans pay huge amounts for medications that should be cheap.
- eru 7y ago
  In economics, the usual prescription for high price despite low manufacturing costs is to lower barriers to entry. There's probably a legal reason why someone can't just set up a company to buy mebendazole in bulk in the UK and ship it to the US and sell it for eg $200 per tablet?
DiogenesKynikos 7y ago
> There are parts of the world where it works much better. (And not all of them have socialized health care.) Almost all developed countries have socialized healthcare. What countries do you have in mind?
- eru 7y ago
  It depends a bit on exactly what you mean by socialized, but I have the Singaporean system in mind. (I was just quoting Cougher when using the term socialized.) Singapore has some of the best healthcare outcomes in the world, and costs about half as much as a share of GDP per capita as the British NHS. Where the American system seems to combine the worst of public and private healthcare, Singapore combines the best. In the Singaporean system individuals use a health savings account to pay for small, routine health care costs. The insurance part of the system only kicks in for larger, costlier, uncertain items. There's plenty of subsidies for poor people, too. See eg https://www.nytimes.com/2019/04/22/upshot/singapore-health-system-lessons.html https://www.nytimes.com/2019/04/22/upshot/singapore-health-s... for an American perspective. There's also plenty of easy to find material on the web. I especially like that doctors usually have a list with price ranges for their most common items hanging out prominently. Very transparent.
  - DiogenesKynikos 7y ago
    Singapore has socialized healthcare. On the provider side, most of the hospitals are owned by the government. On the insurance side, employees are required by the government to pay into health savings accounts (with nearly matching employer contributions). There are additional public insurance schemes for the poor and elderly. On top of that, costs in the public hospitals are subsidized to a significant extent.
    - eru 7y ago
      Seems to be an American term? https://en.wikipedia.org/wiki/Socialized_medicine https://en.wikipedia.org/wiki/Socialized_medicine But I agree with what you are stating. (Though if you call that system 'socialized', then the American systems are also 'socialized' to a large extent. So it's probably better to just talk about specific feature instead of such a loaded term.) The aspect of the system that I wanted to highlight is that routine care is paid for out of the health savings account (Medisave), and not out of the insurance portion. Another interesting aspect is that the bill you get for treatments always mentions the total cost and any subsidies you are getting. All very transparent. There's also always a co-pay as a matter of principle, even if it's just a few dollars.