4 ms·

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

by Dilpil 17y ago

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.
- mblakele 17y ago
  I think it's an exaggeration to say that "In most countries in the western world, except for the United States, and recently Canada, medical care is available for free." That is only true for non-zero values of "free". http://wikileaks.org/leak/crs/RL34175.pdf http://wikileaks.org/leak/crs/RL34175.pdf (Congressional Research Service RL34175) figure 1, "Health Care Spending Per Capita, 2004", shows that every country in the report spends some private money on health care. You yourself spent $5 to replace your lost pharmaceuticals in Spain, didn't you? Table 1 shows that health care in Spain is 71% public money. Figure 21 shows out-of-pocket expenses per capita: Spain averages almost 24%, and the US just over 13% - of course, the spending in the US is 3x Spain, so that's really about $488 in Spain vs $793 in the US. Oh, and while it's a common error to think that the US Constitution enshrines the right to "life, liberty, and the pursuit of happiness", it does not. That phrase is from the Declaration of Independence, which has no legal standing.
  - jamesbritt 17y ago
    'I think it's an exaggeration to say that "In most countries in the western world, except for the United States, and recently Canada, medical care is available for free." That is only true for non-zero values of "free".' Lately, when I read something that refers to this or that as being "free", I mentally replace "free" with "no one gets a bill" and "no one gets paid", and see if it still makes sense.
- gkv 17y ago
  ""The government should pay for them!" They said." Where, pray tel, does government get the money? From us of course.
mblakele 17y ago
There's some data in http://wikileaks.org/leak/crs/RL34175.pdf http://wikileaks.org/leak/crs/RL34175.pdf (Congressional Research Service RL34175): "Figure 15. Practicing Physicians per 1,000 Population, 2004". But I don't think this metric alone can explain cost differences. For example, the average of the countries sampled is 3.0, with western Europe in the 3.3-4.2 range. The United States comes in at 2.4 - but tied with Finland and above New Zealand (2.2), Canada (2.1), and Japan (2.0). Also, figure 14 shows that the Netherlands (3.6 practicing physicians per 1000) pays its specialists even more than the United States does. At the same time (2004) the Netherlands spent about $3000 per capita, while the US spent $6100 (table 1). The best story is told in table 4 (CRS-28). Of the $3500 per capita difference between the US and OECD median, the largest single delta is labeled "outpatient care" ($1941). Next are "inpatient care" at $575; "health administration and insurance" at $400; "pharmaceuticals" at $345. I find the administration costs shocking: we spend about 8% of our health care budget on administration, while the OECD median is closer to 2%. This seems to come directly from a heterogeneous mix of private and public spending: according to the CRS Luxembourg has similar spending and a similar mix of health care plans. But this is a very complex subject. The cost differences are likely attributable to a number of causes, from malpractice suits driving extra tests to weak market forces between insurers and providers (and between providers and consumers). The US may also be paying for overcapacity in order to reduce wait times for procedures. I see two alternatives: either find a way to strengthen the market forces and improve the legal framework so that the market can control its own costs (no existing example); or convert to a single-payer system (eg, NHS in the UK) so that the single payer can control costs.

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

by 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.

mblakele 17y ago
I think it's an exaggeration to say that "In most countries in the western world, except for the United States, and recently Canada, medical care is available for free." That is only true for non-zero values of "free". http://wikileaks.org/leak/crs/RL34175.pdf http://wikileaks.org/leak/crs/RL34175.pdf (Congressional Research Service RL34175) figure 1, "Health Care Spending Per Capita, 2004", shows that every country in the report spends some private money on health care. You yourself spent $5 to replace your lost pharmaceuticals in Spain, didn't you? Table 1 shows that health care in Spain is 71% public money. Figure 21 shows out-of-pocket expenses per capita: Spain averages almost 24%, and the US just over 13% - of course, the spending in the US is 3x Spain, so that's really about $488 in Spain vs $793 in the US. Oh, and while it's a common error to think that the US Constitution enshrines the right to "life, liberty, and the pursuit of happiness", it does not. That phrase is from the Declaration of Independence, which has no legal standing.
- jamesbritt 17y ago
  'I think it's an exaggeration to say that "In most countries in the western world, except for the United States, and recently Canada, medical care is available for free." That is only true for non-zero values of "free".' Lately, when I read something that refers to this or that as being "free", I mentally replace "free" with "no one gets a bill" and "no one gets paid", and see if it still makes sense.
gkv 17y ago
""The government should pay for them!" They said." Where, pray tel, does government get the money? From us of course.

mblakele 17y ago

There's some data in http://wikileaks.org/leak/crs/RL34175.pdf http://wikileaks.org/leak/crs/RL34175.pdf (Congressional Research Service RL34175): "Figure 15. Practicing Physicians per 1,000 Population, 2004". But I don't think this metric alone can explain cost differences. For example, the average of the countries sampled is 3.0, with western Europe in the 3.3-4.2 range. The United States comes in at 2.4 - but tied with Finland and above New Zealand (2.2), Canada (2.1), and Japan (2.0). Also, figure 14 shows that the Netherlands (3.6 practicing physicians per 1000) pays its specialists even more than the United States does. At the same time (2004) the Netherlands spent about $3000 per capita, while the US spent $6100 (table 1). The best story is told in table 4 (CRS-28). Of the $3500 per capita difference between the US and OECD median, the largest single delta is labeled "outpatient care" ($1941). Next are "inpatient care" at $575; "health administration and insurance" at $400; "pharmaceuticals" at $345. I find the administration costs shocking: we spend about 8% of our health care budget on administration, while the OECD median is closer to 2%. This seems to come directly from a heterogeneous mix of private and public spending: according to the CRS Luxembourg has similar spending and a similar mix of health care plans. But this is a very complex subject. The cost differences are likely attributable to a number of causes, from malpractice suits driving extra tests to weak market forces between insurers and providers (and between providers and consumers). The US may also be paying for overcapacity in order to reduce wait times for procedures. I see two alternatives: either find a way to strengthen the market forces and improve the legal framework so that the market can control its own costs (no existing example); or convert to a single-payer system (eg, NHS in the UK) so that the single payer can control costs.