It’s not that either. US health plans generally offered free annual physicals voluntarily, and under the ACA are now required to.
The obesity rates in places like new Zealand or Australia are comparable to the US, only a minor difference. Per capita, the US has fewer smokers than France or Japan and the US is near. The bottom of smokers per capita in oecd nations, I think only two wealthy nations have fewer smokers, the rest have more than we do (sometimes double the rates). Despite it those countries spend half what we do on health care.
The reason we spend more on health care is our system is designed to be expensive. An mri costs $1000 here but $98 in Japan. A hip replacement is 41k here and 7k in Spain. Japan could prescribe five times more mris than we do and still cost less than us.
Also I don’t know if healthy living reduces medical expenses. Preventative care is a mixed bag for cost savings. Some studies finds it saves money, some say no difference, some say it costs more. People will still get sick and die with optimum lifestyles, so I am not sure. I can’t find the study, but I saw a short article once saying that healthy 65 year olds cost the Medicare system more than the sick ones over the course of a lifetime.
No, that not good. Bad.
NICE doesn’t “deny” drugs, it simply doesn’t make it compulsory for NHS organisations to fund them, if prescribed. De facto, this makes it unlikely the NHS will cover them, admittedly, but it doesn’t mean they can’t be had if someone comes up with the money- which is as I understand it the situation in the USA.
But don’t your private insurance companies rule out coverage, sometimes after the treatment? And aren’t insurance premiums predicated on complex actuarial calculations of, you know, putting numbers on people’s lives?
It’s all about pooling risk and contributions, in all systems. The question is, which is the most effective way to do so, who decides, and on what criteria?
The NHS leaves as much as possible - who gets which treatment and when - to the judgement of the clinical professionals within their overall budget limits. Those are set by government, with all the public political debate about that, and about the practical consequences of those decisions (where should the hospitals and clinics be, how many doctors and nurses do we need, or - for a current example - how can doctors’ contracts be amended to extend the availability of non-emergency services without working them into the ground?). It strikes me as a lot less opaque and complicated, and more open to democratic decision-making than the kinds of things I’ve seen described here and on other US messageboards.
What the graph illustrates is that the imprimatur of small government Ronald Reagan rebuilt trust in government despite his insistence we not be dependent on it. He’s not a great example of why small-government conservatives are destroying trust in government. Nor is Bush, Sr. I concede Jr. was trash.
Aww, that’s just a personal attack. You can do better to explain why R&D into medical technology won’t decline if we go to single-payer (which it obviously would as newer technology/pharmaceuticals become less profitable).
The difference would be made up by government grants to universities and other research facilities. The idea that pharmaceutical research must be market-driven is absurd.
We’re making personal attacks because you’re saying stupid things.
Well, we got Viagra now, see we can stop looking.
The US is a world leader in medical R&D, making up 45% of the worlds spending.
However as I said, about 40% of that spending is public which wouldn’t be affected.
Of the $70 billion in private/industry R&D, even if it drops by 10-20 billion we could easily recoup that with the money saved from having a cheaper health care system in the form of subsides for private R&D (tax credits, subsidies, grants, awards, etc).
Assume industry R&D drops by $20 billion if we changed our health system to be 1.5 trillion a year cheaper. Even if you had to recoup the entire cost via public funds, spending an extra $20 billion to save 1.5 trillion is a good deal.
ISTM that even picking the entire $70B and letting the private sector take their ball and go home, should they be so inclined, would be a bargain, if it saves $1.5T.
nm
Since American conservatives are wholly unable to convince Europeans and others who live under a form of single payer system that they’d be better off under an American style system, I don’t see how they can argue that this country moving towards that model makes us worse off. I just don’t.
If a single payer system forbids drug marketing, like in Europe we’d have plenty for R&D, We would get to enjoy fewer ads warning us of the dangers of toenail fungus though.
In addition, a lot of advances on drugs today come from startups which get bought by Big Pharma if they come up with something good. Nothing wrong with that model, but the founders of these companies are still going to make a fortune if they succeed, and so innovation should continue.
Do you have a cite for that tort reform comment? It’s not been the experience in Canada.
Nobody sues anybody in Canada, that’s rude!
I’ve not read the thread; just chiming in to ask:
How can any sentient American pay the slightest regard to anything Trump or Carson says? 
They’re just the clowns sent out pre-show to get the audience in the mood to laugh at the headliners. Nobody here has any interest in what Clothahump or Shodan says, why make an exception for Trump or Carson?
Yes, yes, I know they’re leading the polls but that just shows what a joke Republiopathy has become. (I won’t rule out that some billionaire is secretly prodding their campaigns along, giggling in hope that they will help cause Republiopathy to implode.)
How about we abolish Ben Carson and Donald Trump and replace them with sane candidates?
We get those too, and plenty for indigestion, hay fever, cold and flu remedies and so on, in their due seasons. I suspect there is less TV advertising overall anyway, and certainly no advertising of prescription-only medicines (though occasionally disguised adverts for “information services” about particular conditions, but here too I think the advertising industry regulates itself quite tightly). It may be, too, that the old attitude of trusting the doctor interacts with the NHS’s position as the dominant customer for prescription-only medicines (which means they try to hold prices down) to reduce the likelihood of such advertising having much success for the pharma companies.
Okay. Abolish RW Media and stop growing generations of people who are afraid and misinformed, and the problem should clear up in 20-40 years.