# Reformers' Claims Just Don't Add Up \[health care\] **URL:** \ **Category:** Great Debates\ **Created:** [July 20, 2009, 10:40am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607 "2009-07-20T10:40:02Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![hobscrk777](https://avatars.discourse-cdn.com/v4/letter/h/a6a055/32.png) [@hobscrk777](https://boards.straightdope.com/u/hobscrk777)\ **Post date:** [July 21, 2009, 4:22am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/61 "2009-07-21T04:22:43Z")
> [@Isamu](#): > > And this is one thing I don’t understand about the resistance to a UC system. It actually makes planning your life a lot easier when you don’t have to prepare for unknowable expenses. None of us know what illnesses might happen to us. You’re forgetting, of course, that the diehard Republicans _know_ that they won’t have a catastrophic illness. After all, they’re responsible. If one of the plebians has outrageous medical costs, well, he/she obviously didn’t plan very well. ---
**Author:** ![furt](https://avatars.discourse-cdn.com/v4/letter/f/439d5e/32.png) [@furt](https://boards.straightdope.com/u/furt)\ **Post date:** [July 21, 2009, 9:06am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/62 "2009-07-21T09:06:25Z")
> [@Czarcasm](#): > > No, and neither does it mean that the right-wing slanderers and rumormongers are suddenly saints. > Or did you really think the old “Never mind what is happening here-look over _there!_” ploy was actually going to work here? Silly me, I was sort of hoping for debate on the merits of the issue, not ad hominem “you can’t believe anything from people who don’t vote like you.” Was a time that sort of thing was discouraged around here. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [July 21, 2009, 1:36pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/63 "2009-07-21T13:36:14Z")
> [@Whack-a-Mole](#): > > Yes, it is true that not all preventative treatments are effective. Yes it is true that politicians like to overstate (or understate depending on their inclination) how much may be gained via preventative treatments. > > It is also true that preventative medicine can indeed provide substantial cost savings. The trick is separating the effective tests/treatments from the ineffective tests/treatments. For instance screening everyone in the US for Malaria is arguably a poor use of resources. A lot of cost for little to no benefit. You keep switching back and forth as regards to what the discussion is about. To be clear, I made two separate points in my initial post here (#22). 1. that the argument that Voyager (& you) put forth in favor of preventive care being cost effective is flawed. And 2. (identified by the words “in addition to the above …”) that there are those who say preventive is sometimes bad for health _in addition to_ being not cost effective. You had never heard of the latter argument, and assumed it was idiotic so you responded by mocking it. I pointed to several sources that gave expert opinions backing it up, upon which you weaseled by pretending I had argued that individual people who feel symptoms should not have them checked out. And now, when I point this out, you turn around and start talking about cost effectiveness. Yes, that’s nice (more below) but that’s not what this particular exchange - and the words you quoted and replied to - is about. > [@](#): > > Again, it is for the medical profession to sort these out and we need an economic incentive to find the useful treatments and downplay the not so useful ones. Right now your doctor may as well test you for anything and everything. Why not? If you are insured it’s not your dime. > > The incentives are all out of whack. As mentioned add in suing your doctor and the incentive is for the doctor to take a cover-their-ass approach. > > This does not argue against preventative treatment. Pointing to one thing and saying, “See? That doesn’t work!” is missing the bigger picture. Some things do work. Hopefully any new system would stress the importance of the effective treatments. Clearly our _current_ system is not doing this effectively so arguing for keeping it is absurd. It is clearly broken in some fundamental ways. Operative word here is “hopefully”. But it’s naive, IMO, to create massive government programs and uproot a system and create a new one based on the notion that “hopefully” a new system will be better. Unless you have concrete reason to think that it will be better, that’s a foolish way to do things. So far I’ve not heard anything that would suggest that it would be better as regards to be ing more discerning, and frankly past experience does not suggest that politicians will be more discerning about what works and what doesn’t than insurance companies. One thing that would help is tort reform, which might address the defensive medicine issue that you noted. But that is not part of the current effort and for the most part, the people leading the charge on the current health reform issue are opposed to meaningful tort reform. [I’ll throw you one bone, and note that preventive medicine will be more cost effective under a single payer system than under an employer/insurance system. But that still doesn’t mean it will be effective, on the whole, for reasons noted.] ---
**Author:** ![Mr.Duality](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mr.duality/32/4098_2.png) [@Mr.Duality](https://boards.straightdope.com/u/Mr.Duality)\ **Post date:** [July 21, 2009, 2:27pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/64 "2009-07-21T14:27:05Z")
> [@athelas](#): > > :rolleyes:If you read my post, you’d realize that it is the _interpretation_ of the statistics by drive-by posts like yours that is flawed. So are you going to explain how European demographics have anything to do with the USA’s poor showing in life expectancy and infant death rates? Hmph. I thought not. I’ll help you out just a little bit. The obesity epidemic in the US could account for _some_ of the life expectancy data, but not all of it. I see no accounting for the infant mortality rates other than quality of care. As someone else wrote above, the more salient issue is that we in the US are paying twice as much per capita as they do in other industrialized nations. ---
**Author:** ![cosmosdan](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@cosmosdan](https://boards.straightdope.com/u/cosmosdan)\ **Post date:** [July 21, 2009, 2:45pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/65 "2009-07-21T14:45:51Z")
> [@furt](#): > > Silly me, I was sort of hoping for debate on the merits of the issue, not ad hominem “you can’t believe anything from people who don’t vote like you.” Was a time that sort of thing was discouraged around here. You’re invited to show the numbers being used by the arguments against UHC are accurate. It has nothing to do with how they vote. It has to do with having a track record of honest discussion or dishonest political spin. At some point the dishonest BS deserves dismissal until they can demonstrate a change in attitude, concern about the actual issue and solving serious problems rather than lying for a political agenda. That goes for both parties. Find a conservative with a track record of honesty and I’ll examine their arguments. In fact, I’m interested in George Will’s take on the subject. It’s[here](http://newsbusters.org/blogs/noel-sheppard/2009/06/14/george-will-tells-dirty-little-secrets-universal-healthcare) [here](http://www.washingtonpost.com/wp-dyn/content/article/2009/06/26/AR2009062603457.html) [and here](http://townhall.com/columnists/GeorgeWill/2009/01/01/if_you_think_health_care_is_expensive) I don’t always agree with Will but I usually trust him to give an intelligent honest take on an issue. It seems the repetitive mantra of the 50 million uninsured is a deceptive representation of the details. Still, my limited understanding is that it isn’t just about those with no insurance. It’s also about those who can barely afford the insurance they have and those who are one medical emergency away from being buried in debt. It’s also about insurance companies increasing their profits by denying coverage or dumping patients with preexisting conditions. I find it entirely believable that this admin is steering us toward a single payer system and is using this as a first step. What I’d like to see is a good argument against that. One that clearly shows it’s a horrible idea and there’s an better way that is demonstrated by evidence. Will does mention an experiment by Secretary of HHS Mike Leavitt that sounded interesting. In the last link he explains that Leavitt implemented a program of competitive bidding for certain expensive equipment. It showed promise until the equipment vendors got congress to repeal it. Personally I don’t trust the Dems in congress much more than I trust the GOP members when it comes to making an honest informed argument. That makes it even more frustrating and the job of trying to be accurately informed even harder. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [July 21, 2009, 2:53pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/66 "2009-07-21T14:53:11Z")
> [@Fotheringay-Phipps](#): > > Operative word here is “hopefully”. But it’s naive, IMO, to create massive government programs and uproot a system and create a new one based on the notion that “hopefully” a new system will be better. Unless you have concrete reason to think that it will be better, that’s a foolish way to do things. So far I’ve not heard anything that would suggest that it would be better as regards to be ing more discerning, and frankly past experience does not suggest that politicians will be more discerning about what works and what doesn’t than insurance companies. Here is the problem. You buy into republican talking points so much, are so in agreement with the party of “no” you seem willing to let the status quo remain despite its profound short comings. Here, I’ll give you a Republican Senator’s view on this. A senator who was once a physician as well (technically still is I think). > [@](#): > > “Old approaches are failing us today. They lead to costs that are growing too fast; we all know that. They lead to access that is uneven. They lead to enormous quality chasms that exist today. And these old approaches have no chance of addressing the new challenges of 2014.” > > “Indeed,” he said, “I would argue that the status quo of health care delivery in this country is unacceptable today. It will further deteriorate unless the care sector of 2004 is radically transformed, is re-created.” > > SOURCE: [Bill Frist, Senator(R) Tennessee](http://www.washingtonpost.com/wp-dyn/articles/A50500-2004Jul14.html) Leave _insurance_ companies as the arbiters of proper health care decisions? That is putting the fox in charge of the hen house. More from that article: > [@](#): > > The United States spends almost 15 percent of its income on health care, far more than other advanced countries. That’s about $5,540 a year for every man, woman and child. > > Costs are rising four times as fast as wages. One informed estimate places the cost of employer-sponsored health care coverage for the average family at $14,500 in 2006, just two years from now. > > The Census Bureau found last year that almost 44 million Americans had gone without health insurance for the previous year. That number has been increasing by roughly 2 million a year. Families USA, a consumer group, says that almost 82 million people, one out of three below age 65, were uninsured at some point during 2002-03, most of them for at least nine months. > > Frist also talked about the “inefficiency” of the system, noting that “according to a recent Rand study, patients received recommended care about only half the time for conditions such as my own specialty of heart disease, as well as diabetes.” > > SOURCE: [http://www.washingtonpost.com/wp-dyn/articles/A50500-2004Jul14.html](http://www.washingtonpost.com/wp-dyn/articles/A50500-2004Jul14.html) These are economy breaking issues. They are dragging the whole country down and are simply unsustainable. People seem to think the new system will be making us pay for something we don’t pay for now because our employers pick up most of the insurance bill. That is incredibly short sighted. As costs rise companies decrease coverage, place more cost burden on employees, refuse to hire new employees because they are too expensive or go bankrupt because they cannot compete while bearing such costs. The insurance companies have been piloting this ship for decades and they have us pointed squarely at a big honking ice berg. We can certainly debate what fixes are best and which aren’t but it absolutely needs fixing. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [July 21, 2009, 3:07pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/67 "2009-07-21T15:07:00Z")
> [@Mr.Duality](#): > > I’ll help you out just a little bit. The obesity epidemic in the US could account for _some_ of the life expectancy data, but not all of it. I see no accounting for the infant mortality rates other than quality of care. You might want to look a little more closely. [The obesity epidemic also accounts for some of the infant mortality rate.](http://www.reuters.com/article/healthNews/idUSTRE50T5WH20090130) Another reason is that the US often reports as a live birth an infant that dies within twenty-four hours of birth, while other countries would report that as a stillbirth ([cite](http://findarticles.com/p/articles/mi_m0795/is_n4_v13/ai_13359858/pg_2/?tag=content;col1)). Regards, Shodan ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [July 21, 2009, 3:15pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/68 "2009-07-21T15:15:04Z")
> [@Whack-a-Mole](#): > > Here is the problem. > > You buy into republican talking points so much, are so in agreement with the party of “no” you seem willing to let the status quo remain despite its profound short comings. No, that’s not the problem. Here is the real problem. The problem is that I made specific points relating to a narrow issue - the value of preventive care - and you are ignorant about these matters, but feel free to respond forcefully based on the vague notion that anything that supports your broader position must be true and anything that undermines it must be bad. As part of your general mindset, you feel free to repeatedly misrepresent what I’ve said. Apparently to your mentality, anyone who disagrees with any particular argument in support of A is obviously in support of every argument in support of B, and you can attack them on that basis, and if that gets you off the hook from having to defend what you actually said, all the better. So for those keeping score at home, contrary to whack-a-mole’s claims, the following are things that I’ve not said or implied anywhere in this thread [ul] [li]someone who has symptoms of an illness should refrain from seeing a doctor[/li][li]the status quo is OK.[/li][/ul] What I _have_ said, again, is [ul] [li]the argument that Voyager (& whack-a-mole) put forth in favor of preventive care being cost effective is flawed.[/li][li]that there are experts who say preventive care is sometimes bad for health _in addition_ to being not cost effective.[/li][/ul] If you have anything substantive to say about either of these issues, feel free. Otherwise we are done. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [July 21, 2009, 3:33pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/69 "2009-07-21T15:33:04Z")
> [@Fotheringay-Phipps](#): > > Otherwise we are done. Thank Og! Your persistent personal attacks are tiresome not to mention against board rules. ---
**Author:** ![athelas](https://avatars.discourse-cdn.com/v4/letter/a/5e9695/32.png) [@athelas](https://boards.straightdope.com/u/athelas)\ **Post date:** [July 21, 2009, 3:45pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/70 "2009-07-21T15:45:11Z")
> [@Whack-a-Mole](#): > > These are economy breaking issues. They are dragging the whole country down and are simply unsustainable. So what I’m hearing is: 1. Healthcare costs are ruining the economy. 2. We need to spend MORE money to cover the uninsured. What’s unsaid, is the proof that (2) will fix (1). In fact there have already been strong arguments against it. So why don’t you sit down and supply an actual argument? ---
**Author:** ![furt](https://avatars.discourse-cdn.com/v4/letter/f/439d5e/32.png) [@furt](https://boards.straightdope.com/u/furt)\ **Post date:** [July 21, 2009, 4:08pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/71 "2009-07-21T16:08:40Z")
> [@cosmosdan](#): > > You’re invited to show the numbers being used by the arguments against UHC are accurate. I’ll leave that to the OP. Sorry, don’t have time to get into a detailed debate this week. > [@](#): > > It has nothing to do with how they vote. It has to do with having a track record of honest discussion or dishonest political spin. At some point the dishonest BS deserves dismissal until they can demonstrate a change in attitude, concern about the actual issue and solving serious problems rather than lying for a political agenda. > > That goes for both parties. I agree. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [July 21, 2009, 4:14pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/72 "2009-07-21T16:14:52Z")
> [@athelas](#): > > So what I’m hearing is: > > 1. Healthcare costs are ruining the economy. > 2. We need to spend MORE money to cover the uninsured. > > What’s unsaid, is the proof that (2) will fix (1). In fact there have already been strong arguments against it. So why don’t you sit down and supply an actual argument? Explain how it will be more expensive. Have you considered other costs to the system? For instance, medical costs are the biggest cause of bankruptcy in the US. Explain how it is you think we are not already currently paying for the uninsured? The US spends far more on health care than any other country I can think of. 17% of GDP and rising. That is in comparison to other countries that provided universal health care which we currently do not provide. For that we get worse results. In what world do you see that as sustainable? There may well be an initial spike as you provide coverage to everyone. Overall though it is about flattening the dramatic upward trend in medical costs in this country. > [@](#): > > Health spending is rising faster than incomes in most developed countries, which raises questions about how these countries will pay for future health care needs. The issue may be particularly acute in the United States, which not only spends much more per capita on health care than any other country, but which also has had one of the fastest growth rates in health spending among developed countries. Despite this higher level of spending, the United States does not achieve better outcomes on many important health measures. > > SOURCE: [http://www.kff.org/insurance/snapshot/chcm010307oth.cfm](http://www.kff.org/insurance/snapshot/chcm010307oth.cfm) > [@](#): > > Total medical care expenditures among all of the uninsured in 2004 (including both those without coverage for all or part of the year) are almost $125 billion. > > \ > > A third of the medical costs for the uninsured are uncompensated. > > \ > > The primary source of funding for uncompensated care is government dollars. Projected federal, state, and local spending available to pay for the care of the uninsured in 2004 is $34.6 billion—about 85% of the total uncompensated care bill. > > \ > > The annual economic value of foregone health among the 40 million uninsured in 2000 has been estimated to be between $65 and $130 billion in that year.3 If the middle of that range ($97.5 billion) is inflated to 2004 dollars, the annual economic value of the foregone health of those 40 million uninsured increases to $103 billion—a sum considerably larger than the $48 billion in increased costs of expanding coverage to all of them. > > \ > > The new dollars would constitute less than 3% of total personal health care spending in this country. > > The $48 billion would increase the share of GDP going to health care by 0.4%. > > SOURCE: [http://www.kff.org/uninsured/upload/The-Cost-of-Care-for-the-Uninsured-What-Do-We-Spend-Who-Pays-and-What-Would-Full-Coverage-Add-to-Medical-Spending.pdf](http://www.kff.org/uninsured/upload/The-Cost-of-Care-for-the-Uninsured-What-Do-We-Spend-Who-Pays-and-What-Would-Full-Coverage-Add-to-Medical-Spending.pdf) (PDF) ---
**Author:** ![athelas](https://avatars.discourse-cdn.com/v4/letter/a/5e9695/32.png) [@athelas](https://boards.straightdope.com/u/athelas)\ **Post date:** [July 21, 2009, 4:23pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/73 "2009-07-21T16:23:57Z")
The Democrats’ House plan is focused on maximizing coverage while doing very little of that cost control that the Dems talked about. “The increasing cost of healthcare” is now a reason to OPPOSE this plan. > [@](#): > > On closer inspection, the fiscal impact appears even larger. The CBO projection implies that full implementation would not occur until 2015. The average net cost per year of the five full implementation years (2015-2019) is $172 billion. And finally, costs rise swiftly within that five year period, from $141 billion in 2015 to $202 billion in 2019–roughly 9 percent per year, compounded. > > The Massachusetts-style reform template that is shaping proposals in both the House and Senate has the virtue of making the costs of near-universal coverage more transparent than did the Clinton-era approach. In the coming months, Congress, the White House, and the American people will have to decide whether they can live with legislation that focuses so heavily on coverage while giving such short shrift to meaningful cost control. Now explain how this will save us money. No vague “things are bad now” posturing. Explain how your idea will make this better. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 21, 2009, 4:28pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/74 "2009-07-21T16:28:33Z")
It’s a revelation to see the GOP and its partisans express such concern about the cost of government programs and the value of limiting the deficit. Warms my cockles, it does. Now, if they only had some sort of alternative to offer … ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [July 21, 2009, 4:28pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/75 "2009-07-21T16:28:51Z")
> [@Whack-a-Mole](#): > > For instance, medical costs are the biggest cause of bankruptcy in the US. Cite for this (note most are insured and employed in decent jobs). Not sure how you quantify all the costs involved with this but I think it is safe to say it is expensive to the country and an overall Bad Thing[sup]tm[/sup]. > [@](#): > > Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001. > > SOURCE: [Medical Bankruptcy in the United States, 2007: Results of a National Study](http://www.amjmed.com/article/PIIS0002934309004045/abstract) (The American Journal of Medicine) ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [July 21, 2009, 4:36pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/76 "2009-07-21T16:36:27Z")
> [@athelas](#): > > No vague “things are bad now” posturing. Explain how your idea will make this better. I provided you numbers just above your post that cite the costs of the uninsured today and the cost to insure them in the future. That falls short of your number to fully recoup the loss but then does not take into account such costs as bankruptcy and all the other social ills that attend families in financial upheaval. I am also curious if the extra costs assume the massive inefficiencies that currently exist within our system or try to account for a more streamlined system. Administrative costs of health care in the US are frankly absurd. > [@](#): > > In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada’s national health insurance program had overhead of 1.3 percent; the overhead among Canada’s private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers’ administrative costs were far lower in Canada. > > Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations’ figures exclude insurance-industry personnel.) > > Conclusions The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system. > > SOURCE: [Costs of Health Care Administration in the United States and Canada](http://content.nejm.org/cgi/content/short/349/8/768) (New England Journal of Medicine) ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [July 21, 2009, 4:37pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/77 "2009-07-21T16:37:55Z")
I’m a little saddened that someone who had to barter for dental services would think our system is hunky dory. What if the dentist didn’t need computer services? What if a particular patient doesn’t engage in a trade that physicians or dentists will never have need of? Arguing that because you did something everyone else should too is pretty poor support for a given position, especially when the issue at hand is a basic necessity and your specific circumstances include something atypical, like trading computer services for healthcare. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [July 21, 2009, 4:45pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/78 "2009-07-21T16:45:29Z")
> [@Whack-a-Mole](#): > > Administrative costs of health care in the US are frankly absurd. Another cite (and honestly, does anyone know if projected costs assume new efficiencies or assume current wasteful spending…I really do not know): > [@](#): > > The United States spends nearly 40 percent more on health care per capita than its G.D.P. per capita would predict. Given the sheer magnitude of the estimated excess spending, it is fair to ask American health care providers what extra benefits the American people receive in return for this enormous extra spending. > > \ > > One thing Americans do buy with this extra spending is an administrative overhead load that is huge by international standards. The McKinsey Global Institute estimated that excess spending on “health administration and insurance” accounted for as much as 21 percent of the estimated total excess spending ($477 billion in 2003). Brought forward, that 21 percent of excess spending on administration would amount to about $120 billion in 2006 and about $150 billion in 2008. It would have been more than enough to finance universal health insurance this year. > > The McKinsey team estimated that about 85 percent of this excess administrative overhead can be attributed to the highly complex private health insurance system in the United States. Product design, underwriting and marketing account for about two-thirds of that total. The remaining 15 percent was attributed to public payers that are not saddled with the high cost of product design, medical underwriting and marketing, and that therefore spend a far smaller fraction of their total spending on administration. > > SOURCE: [Why Does U.S. Health Care Cost So Much? (Part II: Indefensible Administrative Costs) - The New York Times](http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/) ---
**Author:** ![intention](https://avatars.discourse-cdn.com/v4/letter/i/e95f7d/32.png) [@intention](https://boards.straightdope.com/u/intention)\ **Post date:** [July 21, 2009, 5:12pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/79 "2009-07-21T17:12:11Z")
Before y’all start pillorying the insurance companies, consider the following figures from [NPR](http://www.npr.org/news/specials/healthcare/healthcare_profiles.html): **PER CAPITA HEALTH CARE EXPENDITURES** ```auto Country, Total Spending, Gov't Spending United States, $6,402 , $2,884 France, $3,374 , $2,693 Germany, $3,673 , $2,518 United Kingdom, $2,723 , $2,371 Netherlands, $3,580 , $1,733 Switzerland, $4,177 , $2,493 Japan, $2,358 , $1,927 ``` The surprising thing to me was that the US Government spends more per capita on health care than the government of any of the other countries shown. I would never, ever have guessed that. This indicates to me that we are getting ripped off, but not by the insurance companies as everyone claims. The problem is that we’re not getting anything like the value per dollar from our government expenditures that we should be getting. And this, in turn, definitely suggests that while health care reform is desperately needed, insurance reform is not the main necessity. The problem is … wait for it … US government inefficiency. Color me surprised. Given our horrible record in getting value for government money, shifting more of the burden onto the government might not be the best plan for health care reform. If we got the same bang for our governmental buck that the other countries get, we wouldn’t need insurance reform, it would be paid for already. Just sayin’ … PS - the other oddity? In the US, 55% of the health care tab is picked up directly by the consumer. In the Netherlands, 52% of the health care tab is picked up directly by the consumer, and in Switzerland, it’s 40% … so they’re not that much different than we are. I wouldn’t have guessed that either. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 21, 2009, 5:17pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/80 "2009-07-21T17:17:32Z")
> [@Hentor\_the\_Barbarian](#): > > I’m a little saddened that someone who had to barter for dental services would think our system is hunky dory. Haven’t you heard? Our health care system is the envy of the world! It MUST be true; it gets repeated often enough. [Previous page](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607.md?page=3) [Next page](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607.md?page=5)