5 ms·
Relevant: the US spends double the amount of other countries on healthcare, yet has a life expectancy 3 years shorter. https://ourworldindata.org/us-life-expec
by danuker 4y ago
Relevant: the US spends double the amount of other countries on healthcare, yet has a life expectancy 3 years shorter.
https://ourworldindata.org/us-life-expectancy-low https://ourworldindata.org/us-life-expectancy-low
- Cthulhu_ 4y agoLet the market decide!11! Mark Cuban's project of selling off-brand medication for cheap is great - insurance companies don't want to work with them, but if said insurance companies still require their customers to pay for medication and that project is even cheaper than that, they'll get competed out of the market. Also that free market thing is a lie, it's in the medical industry's interest to keep prices high and to not have competition / undercutting happen.
- bambax 4y ago> insurance companies don't want to work with them I'm not familiar with the peculiarities of the US healthcare system, but why wouldn't insurance companies work with off-brand medications? If it costs less it's good for them, no?
- freeone3000 4y agoMedical insurer's profits are limited to a percentage of their gross income, so, more expensive medications and procedures are preferred to less expensive ones in order to preserve overall income.
- danuker 4y agoWell, there's a perverse incentive!
- bambax 4y agoAh... Thanks... Unintended consequences strike again.
- kuu 4y agoNot so sure it is unintended...
- willcipriano 4y agoThis predicable outcome was either on purpose or the nation is ran by a cabal of people with severe cognitive impairment. What's better?
- sokoloff 4y agoPorque no los dos? (Why can’t it be both?)
- gambiting 4y agoI don't understand. If you pay $5000 a year for your medical insurance, but it paid $10k for your medication, how have they made money? If they could purchase the same medication for $2000 instead, surely it would be more profitable for them?
- closewith 4y agoPart of the U.S Affordable Care Act is the so-called 80/20 rule, which limits profit margins to 20%. Therefore, the greater the overall healthcare spend by insurance companies, the greater the allowable profit.
- thaumasiotes 4y ago> If they could purchase the same medication for $2000 instead, surely it would be more profitable for them? If the 60% profit margin is illegally high, then no, it's worse. They'd be better off paying more money for the same thing.
- giantg2 4y agoVerticle Integration. For example, CVS Caremark is my insurance. They force me to get most medication through CVS or their mail order service.
- api 4y agoWow what a perverse incentive.
- formerkrogemp 4y agoNo, they're required to spend at a minimum 85% of the money they receive from premiums on healthcare or healthcare quality improvement. As the price of medical procedures goes up, so does the 15% amount that they're allowed to keep and so too do the premiums rise to increase their income.
- nradov 4y agoWhile the Affordable Care Act (Obamacare) did introduce a minimum medical loss ratio, insurers still have a strong incentive to hold down costs by encouraging use of cheaper generic medication so that they can offer lower prices to plan purchasers. Most medical insurance is purchased by employers and other group buyers, and they look closely at costs. In most cases, physicians have to obtain specific approval in order for more expensive medications to be covered.
- spaetzleesser 4y agoMy impression is that they mainly focus on pushing costs to the patient in the form of higher and higher deductibles.
- nradov 4y agoWho is "they"? Medical insurance companies don't really set deductibles. They offer a menu of options to customers (mainly large employers) and let them pick. Insurers are happy to offer plans with zero deductible, but the premiums will be higher. This is all based on actuarial calculations; insurers generally don't make any more profit on high-deductible plans. If you think your deductible is too high then complain to your employer. There is a tax incentive at work here as well. Individuals enrolled in high-deductible health plans (HDHP) can often receive a federal income tax break, so you have to factor that in when calculating your net cost.
- spaetzleesser 4y agoThe configuration of your health insurance is negotiated between insurance and employer. It seems pretty obvious that they are setting things up in a way that’s good for them.
- nradov 4y agoYou don't seem to understand how that negotiation works. Higher deductibles aren't good for medical insurers. In terms of insurer profit margin, higher deductibles are neutral to slightly negative. It's the employer (customer) who has complete control over deductibles. That is the reality of how the market works. Deductibles are generally going higher because healthcare providers and pharmaceutical companies raise prices every year, and because we have an increasingly unhealthy population that demands more services. Insurers try to hold down those increases but with limited success, so they pass those costs on to their customers (employers), and those customers in turn pass on the higher costs to their employees.
- evandijk70 4y agoExactly - in the Netherlands we have the reverse problem - if a generic drug exists, some insurance companies will only reimburse that drug. In some cases that leads to problems. One example was a generic drug where some patients were allergic to the excipients in the generic drug.
- basisword 4y ago>> Mark Cuban's project of selling off-brand medication for cheap is great It's great and going to help a lot of people. But it's still not cheap compared to a lot of other countries which either provide free medication or medication for a fixed fee per item (usually around $10-20, varies by country).
- arethuza 4y agoAs someone who lives in a country where medication is "free", I always like to clarify that "free" in these kinds of contexts means "free at the point of delivery" - we're all perfectly aware that they are paid using money from taxpayers.
- hobs 4y agoWho have an insanely better price anyway because of their negotiating power as a nation instead of an individual payee.
- vidarh 4y agoIt's not just negotiating power, but that they're actually allowed to negotiate. E.g. Medicare has a substantially higher demand for drugs than most single payer universal healthcare systems due to a combination of number of people covered plus covering mostly older, more expensive, patients. It's larger than the UK's NHS for example. But Medicare is subject to various legal restrictions on their ability to negotiate the best prices possible, while the NHS can use whatever leverage it pleases.
- arethuza 4y agoWhy would any government legislate to prevent a government run medical provider from negotiating with suppliers?
- vidarh 4y agoThe excuse is that they're concerned about it distorting the market. So instead they're distorting it by ensuring one of the bigger customers of pharma companies won't try to get the best prices possible...
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- 21723 4y agoOur healthcare system is an absolute travesty for the poor, but it's pretty lousy even for people who can afford care. I know plenty of people with 7- and 8-figure net worth, people who have connections to the medical system, who've still received substandard care. It's at the point where no one's winning.
- clinicalcurious 4y agoWhich healthcare system are you referring to? US? Or another country? Honest question. I am also curious to understand if European, UK and Asian healthcare systems suffer from substandard care problem.
- donatj 4y agoConsidering our diet, exercise and demographics I think that’s surprisingly decent regardless.
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- ChrisRR 4y agoWho could've expected a country that glamourises gluttony would have a shorter life expectancy?
- ncmncm 4y agoThat is not why we are sick. We are sick because practically everything pushed on us is pumped full of sugar.
- ellopoppit 4y agoSugar biochemically induces gluttony and laziness
- ncmncm 4y agoSugar causes excess uric acid in the blood, which causes type 2 diabetes and high blood pressure, among a dozen other ills. And, does not reduce hunger like real food. On a choice between fat and sugar, always choose fat. To be precise: sugar without enough fiber causes illness. With enough fiber, as is provided by all fruit except grapes, sugar absorption is delayed long enough that intestinal bacteria get to eat most of it. Keep your intestinal bacteria fed; if not, they eat you.