7 ms·

I think the healthcare system and medical supply chain are two separate things. A universal healthcare system (for E.g. Sweden) still has a normal supply chain.

I think the healthcare system and medical supply chain are two separate things. A universal healthcare system (for E.g. Sweden) still has a normal supply chain. The only difference is the profit motives are not present and the government can effectively pump money in without violating economic principles of supply/demand and pricing.

jacquesm 7y ago
A commercialized health care system has lots of perverse incentives leading to price increases and profiteering. This sets the weakest fraction of the population up for losing all they've built up in the last 3 months of their life while barely impacting the strong. It also means that those hospitals don't care about overpaying for their supplies and medication (but not their workforce) because they get to pass those costs on to those already weakened people. FWIW: Gall bladder operation in NL all in: 1500 euros, non-subsidized and paid for out of pocket because I wasn't paying into the local healthcare system when it happened. Same procedure in the USA: $24000! https://www.lendingpoint.com/blog/gallbladder-surgery-costs-pay/ https://www.lendingpoint.com/blog/gallbladder-surgery-costs-...
- spectramax 7y ago
  Yes, definitely, American healthcare system needs a reboot - this might be a good time to do that. The only difference is that I would be paying about the same but the insurance would cover the rest. The problem being - if you're well off, you pay $1500, if you're not, you pay $24000 and potentially go broke. That is the problem with the American healthcare system.
- unishark 7y ago
  The US has had a private healthcare system for its entire history. Economics and incentives were the same throughout that history. Meanwhile prices only became stupid very recently.
- lutorm 7y ago
  A commercialized health care system also has absolutely no incentive to keep excess capacity for emergencies. It seems to be very good at finding the optimal efficiency point, which essentially is very close to "no unused resources in the nimal situation". But societal resiliency requires that health care, utilities, food supply, etc, has some excess capacity just because at some point something will happen. A public system can at least be responsive to the value society puts on resiliency.
  - malandrew 7y ago
    How does that square with a system that has the most critical care beds per capita: https://sccm.org/Blog/March-2020/United-States-Resource-Availability-for-COVID-19 https://sccm.org/Blog/March-2020/United-States-Resource-Avai...
    - rblatz 7y ago
      Interesting, the last number I saw was 10x less. That is comforting
    - chmod775 7y ago
      Second most at best. Turkey has 46 / 100k. https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds#Numbers https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...
    - bildung 7y ago
      As user lima-lima pointed out above, this most probably is an artifact resulting from different definitions of what constitutes an ICU bed - for example pediatric and neoanatal beds are included for the US, but excluded in the European numbers. It also fails the sniff test: The US has less total hospital beds than almost every other industrial nation, but at the same time the most ICU beds?
      - malandrew 7y ago
        It only has less total beds if you exclude outpatient facility beds.
- chasd00 7y ago
  it may have been mentioned already but in the US healthcare prices are negotiable. It's strange because you can't go to a US grocery store and haggle over the price of cucumbers like you can in many other nations but you can do that with healthcare. So $24000 is like the asking price, you can come back and say "yeah well, i'll write you a check right now for $2500 otherwise you're sol.". Once a provider realizes what the max they're going to get is then, magically, that becomes the price. To anyone who doesn't know this, don't you dare pay out of pocket what the bill says. Never. What's on the bill is not based in reality at all.

jacquesm 7y ago

A commercialized health care system has lots of perverse incentives leading to price increases and profiteering. This sets the weakest fraction of the population up for losing all they've built up in the last 3 months of their life while barely impacting the strong. It also means that those hospitals don't care about overpaying for their supplies and medication (but not their workforce) because they get to pass those costs on to those already weakened people. FWIW: Gall bladder operation in NL all in: 1500 euros, non-subsidized and paid for out of pocket because I wasn't paying into the local healthcare system when it happened. Same procedure in the USA: $24000! https://www.lendingpoint.com/blog/gallbladder-surgery-costs-pay/ https://www.lendingpoint.com/blog/gallbladder-surgery-costs-...

spectramax 7y ago
Yes, definitely, American healthcare system needs a reboot - this might be a good time to do that. The only difference is that I would be paying about the same but the insurance would cover the rest. The problem being - if you're well off, you pay $1500, if you're not, you pay $24000 and potentially go broke. That is the problem with the American healthcare system.
unishark 7y ago
The US has had a private healthcare system for its entire history. Economics and incentives were the same throughout that history. Meanwhile prices only became stupid very recently.
lutorm 7y ago
A commercialized health care system also has absolutely no incentive to keep excess capacity for emergencies. It seems to be very good at finding the optimal efficiency point, which essentially is very close to "no unused resources in the nimal situation". But societal resiliency requires that health care, utilities, food supply, etc, has some excess capacity just because at some point something will happen. A public system can at least be responsive to the value society puts on resiliency.
- malandrew 7y ago
  How does that square with a system that has the most critical care beds per capita: https://sccm.org/Blog/March-2020/United-States-Resource-Availability-for-COVID-19 https://sccm.org/Blog/March-2020/United-States-Resource-Avai...
  - rblatz 7y ago
    Interesting, the last number I saw was 10x less. That is comforting
  - chmod775 7y ago
    Second most at best. Turkey has 46 / 100k. https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds#Numbers https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...
  - bildung 7y ago
    As user lima-lima pointed out above, this most probably is an artifact resulting from different definitions of what constitutes an ICU bed - for example pediatric and neoanatal beds are included for the US, but excluded in the European numbers. It also fails the sniff test: The US has less total hospital beds than almost every other industrial nation, but at the same time the most ICU beds?
    - malandrew 7y ago
      It only has less total beds if you exclude outpatient facility beds.
chasd00 7y ago
it may have been mentioned already but in the US healthcare prices are negotiable. It's strange because you can't go to a US grocery store and haggle over the price of cucumbers like you can in many other nations but you can do that with healthcare. So $24000 is like the asking price, you can come back and say "yeah well, i'll write you a check right now for $2500 otherwise you're sol.". Once a provider realizes what the max they're going to get is then, magically, that becomes the price. To anyone who doesn't know this, don't you dare pay out of pocket what the bill says. Never. What's on the bill is not based in reality at all.