4 ms·

You have to be able to see that the numbers do not add up, right? 200b is how much out of 3+ trillions? Also, just because Canadian adminstrative costs are hidd

You have to be able to see that the numbers do not add up, right? 200b is how much out of 3+ trillions? Also, just because Canadian adminstrative costs are hidden, does not mean they are proportionally lower than in the US

lippel82 7y ago
What do you mean, the numbers don't add up? From the article: "Insurers’ overhead, the largest category, totaled $275.4 billion in the U.S. in 2017, or 7.9% of all national health expenditures, compared with $5.36 billion in Canada, or 2.8% of national health expenditures."
- AzzieElbab 7y ago
  What I meant is that if insurance costs disappear completely, US healthcare will remain 5 times more expensive than Canadian. It is percentage based markup on already super overpriced system. Therefore, real reasons for why it is so expensive are elsewhere
  - specialist 7y ago
    Thanks. I've reluctantly come to agree with your conclusion. There is no silver bullet. Repeating myself: Another low hanging fruit is transition from free-for-service to rewarding wellness (capitation). Some are already doing this. I'd like to understand if, how, why cost disease is a factor. https://en.wikipedia.org/wiki/Baumol's_cost_disease https://en.wikipedia.org/wiki/Baumol's_cost_disease I have zero understanding, intuition about this. Feels like black magic. But some of the experts I've read say it's important. There's no shortage of management efficiency and quality of care innovations to explore. In the spirit of Atul Gawanda's book Better, like specialized clinics for cystic fibrosis, diabetes, and whatnot. And whatever we're calling people traveling for procedures. Like USA people going to Thailand and Mexico clinics. USA's R&D and regulatory overhead (FDA) carries the world. That first adopter expense might be easier to accept if the accounting was transparent. Any way. I designed, implemented, supported 5 regional healthcare exchanges. Even in our little corner of the problem space, there was so much room for improvement. Alas, most of it was prevented, because our participants were competitors, so the incentives were all wrong. A single payer system (or rough equivalent) completely moot most of those roadblocks.
    - deleted 7y ago
      [deleted]
ineedasername 7y ago
The Canadian comparison had nothing to do with my comment, or the GP post to which I replied. I cited a cost, and provided the source for it. You're assuming I was in some way affirming the other conclusions of that article: I was not, and did not consider them one way or another. The GP comment was about rising administrative costs. I gave the source & amount of those costs. That was all. I otherwise agree with you: administrative costs are not the prime culprit in understanding why US costs are so high.

lippel82 7y ago

What do you mean, the numbers don't add up? From the article: "Insurers’ overhead, the largest category, totaled $275.4 billion in the U.S. in 2017, or 7.9% of all national health expenditures, compared with $5.36 billion in Canada, or 2.8% of national health expenditures."

AzzieElbab 7y ago
What I meant is that if insurance costs disappear completely, US healthcare will remain 5 times more expensive than Canadian. It is percentage based markup on already super overpriced system. Therefore, real reasons for why it is so expensive are elsewhere
- specialist 7y ago
  Thanks. I've reluctantly come to agree with your conclusion. There is no silver bullet. Repeating myself: Another low hanging fruit is transition from free-for-service to rewarding wellness (capitation). Some are already doing this. I'd like to understand if, how, why cost disease is a factor. https://en.wikipedia.org/wiki/Baumol's_cost_disease https://en.wikipedia.org/wiki/Baumol's_cost_disease I have zero understanding, intuition about this. Feels like black magic. But some of the experts I've read say it's important. There's no shortage of management efficiency and quality of care innovations to explore. In the spirit of Atul Gawanda's book Better, like specialized clinics for cystic fibrosis, diabetes, and whatnot. And whatever we're calling people traveling for procedures. Like USA people going to Thailand and Mexico clinics. USA's R&D and regulatory overhead (FDA) carries the world. That first adopter expense might be easier to accept if the accounting was transparent. Any way. I designed, implemented, supported 5 regional healthcare exchanges. Even in our little corner of the problem space, there was so much room for improvement. Alas, most of it was prevented, because our participants were competitors, so the incentives were all wrong. A single payer system (or rough equivalent) completely moot most of those roadblocks.
  - deleted 7y ago
    [deleted]

ineedasername 7y ago

The Canadian comparison had nothing to do with my comment, or the GP post to which I replied. I cited a cost, and provided the source for it. You're assuming I was in some way affirming the other conclusions of that article: I was not, and did not consider them one way or another. The GP comment was about rising administrative costs. I gave the source & amount of those costs. That was all. I otherwise agree with you: administrative costs are not the prime culprit in understanding why US costs are so high.