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The problem is that the same healthcare service costs a lot more in America than it does anywhere else in the world. It's understandable if the surgery that onl

by zhyder 17y ago

The problem is that the same healthcare service costs a lot more in America than it does anywhere else in the world. It's understandable if the surgery that only 4 surgeons in the world can do costs a lot, but relatively routine/commoditized stuff shouldn't cost more than in other developed countries.

kjn 17y ago
The other problem is that despite spending significantly more than any other nation, measures of health care (i.e preventable deaths, access to health care) rank the US well behind other first world nations. The interview largely ignores that concern, and focuses instead on the strawman of absolute cost.
- cwan 17y ago
  Unfortunately the debate usually isn't as black and white all the time given that there are a number of metrics like survival rates following heart attacks or cancer detection/treatment where the US is very much ahead of other first world nations. Absolute cost is far from a strawman in this issue given that the basic argument for reform (as they've proposed - since I think a lot of people are for reform including Dean Kamen), is that the US healthcare system as it is now is too expensive and ergo a significant barrier to access. Others like Kamen make the point that by restricting absolute costs, innovation will drop because the incentives for innovating drop.
kznewman 17y ago
This seems intuitive and if its true that the cost is ONLY for that service and not ALSO for the superior research and development, then I would agree. I don’t know for sure but my hope would be that at least some relatively routine/commoditized stuff is higher in America to pay for things that aren’t being done in other places. In any case Dean Kamen makes some great points about moving beyond fear based legislation.
mrkurt 17y ago
I've only ever seen statistics that compare the aggregate cost of health care relative to aggregate outcomes in the US vs other countries. Do you have more details on the delta between pricing for specific services? It's generally very difficult to compare the cost of specific services in any meaningful way. For instance, many countries institute price controls on medication, cutting the cost of some prescriptions to 30% of what they'd cost in the US. However, some of these drugs were developed in the US based on US patent law and with the assumption of a certain amount of profit from US consumers. A price control in Canada is effectively subsidized by US consumers of a given drug, in lots of cases. A great deal of the costs we pay come as a result of artificial scarcity of both drugs and medical services. The result of legislation, fears of malpractice, and prescription requirements mean that treating a simple sinus infection (which I can diagnose reasonably well myself) costs ~$150 or so after the doctor visit and trip to the pharmacy. There are a great many ways to attack that scarcity, but we're not really considering them (unfortunately). Dean Kamen has a good point. The level of medical care we can provide to people is both insane and insanely expensive. High prices are rationing. What we need to do is attack the high prices that are artificially inflated.
- asmithmd1 17y ago
  "A price control in Canada is effectively subsidized by US consumers of a given drug" I think that is the crux of his point, if the US didn't have these crazy high prices - then the drug would not have been developed. I liked this quote: "Every drug that's made is a gift from one generation to the next because, while it may be expensive now, it goes off patent and your kids will have it essentially for free." The high cost in the US is paying for the R&D that makes the drug possible
  - blasdel 17y ago
    The drug companies spend almost nothing on R&D, not compared to what they spend on consumer advertising, marketing to doctors, regulatory compliance, lobbying, civil defense lawyering, and patent lawyering.
    - 17y ago
ncarlson 17y ago
Health care is just like any other product or service. It will be sold at market prices.
- abstractbill 17y ago
  Health care is not just like any other product or service. It's impossible to predict when you'll need it, and how much of it you'll need. When you really need it, you'll pay any price for it, even if that means spending every penny you have and then going heavily into debt. I can't think of a single other product or service that behaves quite like that.

by zhyder 17y ago

kjn 17y ago

The other problem is that despite spending significantly more than any other nation, measures of health care (i.e preventable deaths, access to health care) rank the US well behind other first world nations. The interview largely ignores that concern, and focuses instead on the strawman of absolute cost.

cwan 17y ago
Unfortunately the debate usually isn't as black and white all the time given that there are a number of metrics like survival rates following heart attacks or cancer detection/treatment where the US is very much ahead of other first world nations. Absolute cost is far from a strawman in this issue given that the basic argument for reform (as they've proposed - since I think a lot of people are for reform including Dean Kamen), is that the US healthcare system as it is now is too expensive and ergo a significant barrier to access. Others like Kamen make the point that by restricting absolute costs, innovation will drop because the incentives for innovating drop.

kznewman 17y ago

This seems intuitive and if its true that the cost is ONLY for that service and not ALSO for the superior research and development, then I would agree. I don’t know for sure but my hope would be that at least some relatively routine/commoditized stuff is higher in America to pay for things that aren’t being done in other places. In any case Dean Kamen makes some great points about moving beyond fear based legislation.

mrkurt 17y ago

I've only ever seen statistics that compare the aggregate cost of health care relative to aggregate outcomes in the US vs other countries. Do you have more details on the delta between pricing for specific services? It's generally very difficult to compare the cost of specific services in any meaningful way. For instance, many countries institute price controls on medication, cutting the cost of some prescriptions to 30% of what they'd cost in the US. However, some of these drugs were developed in the US based on US patent law and with the assumption of a certain amount of profit from US consumers. A price control in Canada is effectively subsidized by US consumers of a given drug, in lots of cases. A great deal of the costs we pay come as a result of artificial scarcity of both drugs and medical services. The result of legislation, fears of malpractice, and prescription requirements mean that treating a simple sinus infection (which I can diagnose reasonably well myself) costs ~$150 or so after the doctor visit and trip to the pharmacy. There are a great many ways to attack that scarcity, but we're not really considering them (unfortunately). Dean Kamen has a good point. The level of medical care we can provide to people is both insane and insanely expensive. High prices are rationing. What we need to do is attack the high prices that are artificially inflated.

asmithmd1 17y ago
"A price control in Canada is effectively subsidized by US consumers of a given drug" I think that is the crux of his point, if the US didn't have these crazy high prices - then the drug would not have been developed. I liked this quote: "Every drug that's made is a gift from one generation to the next because, while it may be expensive now, it goes off patent and your kids will have it essentially for free." The high cost in the US is paying for the R&D that makes the drug possible
- blasdel 17y ago
  The drug companies spend almost nothing on R&D, not compared to what they spend on consumer advertising, marketing to doctors, regulatory compliance, lobbying, civil defense lawyering, and patent lawyering.
  - 17y ago

ncarlson 17y ago

Health care is just like any other product or service. It will be sold at market prices.

abstractbill 17y ago
Health care is not just like any other product or service. It's impossible to predict when you'll need it, and how much of it you'll need. When you really need it, you'll pay any price for it, even if that means spending every penny you have and then going heavily into debt. I can't think of a single other product or service that behaves quite like that.