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The United States spends $2.5 trillion a year on health care, more than any other rich nation, and yet has poorer outcomes. About $700 billion is wasted each ye

by pj 17y ago

The United States spends $2.5 trillion a year on health care, more than any other rich nation, and yet has poorer outcomes. About $700 billion is wasted each year. The reason is simple: Artificial controls on supply and demand of medical professionals: http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm I can't count the number of friends I have had who applied to medical school and were denied entry due to insufficient seats. There are vastly more individuals qualified to be doctors, many I would much prefer to have as doctors than I have had in the past, but with these artificial limits on supply - governed by the AMA itself - there will always be a shortage of medical care and high medical care costs. Furthermore, the healthcare industry lobbies congress to prevent individuals for caring for their own health. We cannot for example buy our own insulin without first getting a prescription from a doctor. We cannot get our own blood tests or request our own CAT scans. We are forced, by law, to visit a doctor before we can manage our own health. As long as doctors are the gatekeepers to health and the supply of doctors is limited by doctors themselves, there will continue to be healthcare problems in the United States. Our society has pitted the doctor in a competitive role against the patient through litigious means and pharmaceutical industry pressure on doctors to overprescribe unnecessary medications. It's a horrible situation, but the solution isn't difficult to implement for anyone except the medical industry itself. They don't want to lose the power and control they have over every single life in America. Visit most countries outside the U.S., Canada, and the UK and you can walk into nearly any pharmacy and purchase the drugs you need to survive, cure disease, and prevent pregnancy for a tiny fraction of the cost Americans pay and without the time delay of a doctor's appointment or the added cost of the doctor's visit itself. And healthcare for the average citizen is higher in these countries. Infant mortality is lower and people live longer.

Dilpil 17y ago
I've always suspected this was part of the reason. How different are these sorts of things in countries with lower costs?
- pj 17y ago
  In most countries in the western world, except for the United States, and recently Canada, medical care is available for free. In Spain for example, women can get birth control pills without a prescription. They visit the doctor, not because they have to, but because they know the doctor can offer them expert advice. There is still the option to pay for a private doctor if you want to. There are sometimes longer wait times for public doctors vs. private doctors, on the order of weeks, but if you've ever made an appointment for a specialist anywhere in the United States, you know that wait times can be months! Not only that, but HMO's require two doctors visits to see a specialist -- the first to get a referal, the second to actually see the doctor. Even if the patient knows the patient needs to see a specialist. Most GP's simply do not have the experience to treat complicated diseases -- this is not a problem in itself, there should always be specialists, as there are DBA's, UI designers, and language specialists in computer programming. When I was traveling in Europe, my backpack was stolen, along with my presecription medications -- this happens frequently actually. I was distraught that I would have to return home to get more medicine, however, I walked into a pharmacy and without even speaking the same language, managed to get the right pills and dose for $5, compared to the $40 it costs without insurance in the U.S. and $15 with insurance. Needless to say, before returning home, I stocked up! My Spanish friends were appalled that in the United States I had to pay for these drugs at all. "The government should pay for them!" They said. Another story: An American friend of mine who was studying in Spain relayed a story to me of a time she fell and hit her head and had to get stitches. She went to the hospital. She didn't have insurance. She wasn't Spanish. She was afraid the bill would be astronomical. After she was stitched up, she asked the staff where she had to go to pay and how much it was going to cost and they LAUGHED! They laughed at her for thinking she had to pay for such care. In other countries, medical care is thought to be a basic human right. In the USA, we have the right to life, liberty, and the pursuit of happiness. In most western countries, citizens have the right to life, liberty, the pursuit of happiness, and health. I believe our country will be much better off if we simply remove from our minds the constant worry of health related issues. If we know we can be cared for, if we don't have to worry about insurance and doctors appointments and the costs required to just stay alive, our creativity can flourish. Another story, one of my friends, whose father was a doctor in new orleans spoke of a patient with diabetes who was having problems with her feet. Diabetics can lose their feet if they aren't careful. Medicare only allowed her 11 doctor visits a year. She needed another visit though because her feet were getting bad. The doctor had to deny her visit because medicare wouldn't cover it. Due to inadequate treatment, treatment that could have fixed the problem with her feet -- her feet had to be amputated -- because medicare wouldn't pay for the visit. As you can imagine, her medical care costs were then much higher than had she simply had the preventative care she needed. This friend of mine was one denied entry into medical school and she was absolutely brilliant and had been shot in the leg, so she really understood the value of doctors. I think the health care situation in the United States is much worse than Americans know. Those who make the policies have plenty of medical care. The politicians and the doctors get all the medical care they need. Politicians don't travel around the world and see the conditions of average citizens in elsewhere, so they don't know the full impact of the policies they create. It's a horrible state of affairs in the United States. It's abominable really. It is perhaps the worst part of life in the United States relative to the rest of the world and the desire for power and financial gain is at the root of it.
martythemaniak 17y ago
We pay a fraction of the cost Americans for drugs because our governments aren't as owned by the pharmaceutical companies as the US government is. They're called price controls and they work pretty well, maybe someday the US will wake up to that fact. And of course, blaming the AMA and doctors is another great diversion. The same professional association exists in Canada and other countries, yet our health care expenditures are under control. Like price controls on drugs, it is the kowtowing to free-market ideology over practical policies that work that gets Americans a shitter health care product for nearly twice the cost.
- helveticaman 17y ago
  >And of course, blaming the AMA and doctors is another great diversion. Seems like a reasonable cause for problems. Sure, on an individual level they're not evil, but put them in a huge association with the second-highest lobbying expenditure of any group in the country.
- pj 17y ago
  I actually believe a free market would go a long way to helping correct the problems with our health care system -- even without the government providing that care. In a free market, there would be more doctors and therefore more clinics. When the supply goes up, the costs go down. But I do agree that pharmas have way more power than they should. The problem is that healthcare in the US is not a free market. Where do you live, if you don't mind me asking?
- bokonist 17y ago
  The same professional association exists in Canada and other countries, yet our health care expenditures are under control. Well, then we could also blame James Madison. The U.S. is one of the few countries to have a Congress, and the Congressional design is very prone to policy capture by factions.
- TriinT 17y ago
  "The same professional association exists in Canada and other countries, yet our health care expenditures are under control." Many times, the costs are not under control, they are hidden. I come from Europe, and in my homecountry the AMA-like lobby is powerful too. The reason why the health care expenditure seems to be under control is that health care is subsidized by the state. You pay for it with the highest sales tax in Europe. No free lunch, right?
gibsonf1 17y ago
A very interesting point which I don't see mentioned often, is what was our health care system like before the massive government intervention of Medicare and Medicaid? The good old days prior to that, I even remember doctors making house calls. But seriously, given that the government already controls completely 50% of the health industry and has onerous regulations on the rest, wouldn't the idea that perhaps it is the government intervention itself causing the problem an idea that would be given some credence? There seems to be an oft-repeating and equally destructive pattern of government causing a problem, then trying to solve it by increasing government intervention.
- aristus 17y ago
  Government intervention did not kill the housecall. :) Specialization and mechanization did: there was less money in general practice than podiatry and fancy machines. The same thing happened to car mechanics a little later, leading to the joke about the mechanic and the doctor: "Doc, why did you have to get so much school to be a Doc?" "Well, because I repair very complicated machines." "So do I! And you only have to worry about one make and two models!"

by pj 17y ago

Dilpil 17y ago

I've always suspected this was part of the reason. How different are these sorts of things in countries with lower costs?

pj 17y ago
In most countries in the western world, except for the United States, and recently Canada, medical care is available for free. In Spain for example, women can get birth control pills without a prescription. They visit the doctor, not because they have to, but because they know the doctor can offer them expert advice. There is still the option to pay for a private doctor if you want to. There are sometimes longer wait times for public doctors vs. private doctors, on the order of weeks, but if you've ever made an appointment for a specialist anywhere in the United States, you know that wait times can be months! Not only that, but HMO's require two doctors visits to see a specialist -- the first to get a referal, the second to actually see the doctor. Even if the patient knows the patient needs to see a specialist. Most GP's simply do not have the experience to treat complicated diseases -- this is not a problem in itself, there should always be specialists, as there are DBA's, UI designers, and language specialists in computer programming. When I was traveling in Europe, my backpack was stolen, along with my presecription medications -- this happens frequently actually. I was distraught that I would have to return home to get more medicine, however, I walked into a pharmacy and without even speaking the same language, managed to get the right pills and dose for $5, compared to the $40 it costs without insurance in the U.S. and $15 with insurance. Needless to say, before returning home, I stocked up! My Spanish friends were appalled that in the United States I had to pay for these drugs at all. "The government should pay for them!" They said. Another story: An American friend of mine who was studying in Spain relayed a story to me of a time she fell and hit her head and had to get stitches. She went to the hospital. She didn't have insurance. She wasn't Spanish. She was afraid the bill would be astronomical. After she was stitched up, she asked the staff where she had to go to pay and how much it was going to cost and they LAUGHED! They laughed at her for thinking she had to pay for such care. In other countries, medical care is thought to be a basic human right. In the USA, we have the right to life, liberty, and the pursuit of happiness. In most western countries, citizens have the right to life, liberty, the pursuit of happiness, and health. I believe our country will be much better off if we simply remove from our minds the constant worry of health related issues. If we know we can be cared for, if we don't have to worry about insurance and doctors appointments and the costs required to just stay alive, our creativity can flourish. Another story, one of my friends, whose father was a doctor in new orleans spoke of a patient with diabetes who was having problems with her feet. Diabetics can lose their feet if they aren't careful. Medicare only allowed her 11 doctor visits a year. She needed another visit though because her feet were getting bad. The doctor had to deny her visit because medicare wouldn't cover it. Due to inadequate treatment, treatment that could have fixed the problem with her feet -- her feet had to be amputated -- because medicare wouldn't pay for the visit. As you can imagine, her medical care costs were then much higher than had she simply had the preventative care she needed. This friend of mine was one denied entry into medical school and she was absolutely brilliant and had been shot in the leg, so she really understood the value of doctors. I think the health care situation in the United States is much worse than Americans know. Those who make the policies have plenty of medical care. The politicians and the doctors get all the medical care they need. Politicians don't travel around the world and see the conditions of average citizens in elsewhere, so they don't know the full impact of the policies they create. It's a horrible state of affairs in the United States. It's abominable really. It is perhaps the worst part of life in the United States relative to the rest of the world and the desire for power and financial gain is at the root of it.

martythemaniak 17y ago

We pay a fraction of the cost Americans for drugs because our governments aren't as owned by the pharmaceutical companies as the US government is. They're called price controls and they work pretty well, maybe someday the US will wake up to that fact. And of course, blaming the AMA and doctors is another great diversion. The same professional association exists in Canada and other countries, yet our health care expenditures are under control. Like price controls on drugs, it is the kowtowing to free-market ideology over practical policies that work that gets Americans a shitter health care product for nearly twice the cost.

helveticaman 17y ago
>And of course, blaming the AMA and doctors is another great diversion. Seems like a reasonable cause for problems. Sure, on an individual level they're not evil, but put them in a huge association with the second-highest lobbying expenditure of any group in the country.
pj 17y ago
I actually believe a free market would go a long way to helping correct the problems with our health care system -- even without the government providing that care. In a free market, there would be more doctors and therefore more clinics. When the supply goes up, the costs go down. But I do agree that pharmas have way more power than they should. The problem is that healthcare in the US is not a free market. Where do you live, if you don't mind me asking?
bokonist 17y ago
The same professional association exists in Canada and other countries, yet our health care expenditures are under control. Well, then we could also blame James Madison. The U.S. is one of the few countries to have a Congress, and the Congressional design is very prone to policy capture by factions.
TriinT 17y ago
"The same professional association exists in Canada and other countries, yet our health care expenditures are under control." Many times, the costs are not under control, they are hidden. I come from Europe, and in my homecountry the AMA-like lobby is powerful too. The reason why the health care expenditure seems to be under control is that health care is subsidized by the state. You pay for it with the highest sales tax in Europe. No free lunch, right?

gibsonf1 17y ago

A very interesting point which I don't see mentioned often, is what was our health care system like before the massive government intervention of Medicare and Medicaid? The good old days prior to that, I even remember doctors making house calls. But seriously, given that the government already controls completely 50% of the health industry and has onerous regulations on the rest, wouldn't the idea that perhaps it is the government intervention itself causing the problem an idea that would be given some credence? There seems to be an oft-repeating and equally destructive pattern of government causing a problem, then trying to solve it by increasing government intervention.

aristus 17y ago
Government intervention did not kill the housecall. :) Specialization and mechanization did: there was less money in general practice than podiatry and fancy machines. The same thing happened to car mechanics a little later, leading to the joke about the mechanic and the doctor: "Doc, why did you have to get so much school to be a Doc?" "Well, because I repair very complicated machines." "So do I! And you only have to worry about one make and two models!"