# Relatively Price of Health Care **URL:** \ **Category:** Great Debates\ **Created:** [June 10, 2006, 5:34pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218 "2006-06-10T17:34:34Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 10, 2006, 5:34pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/1 "2006-06-10T17:34:34Z")
[This thread](http://boards.straightdope.com/sdmb/showthread.php?t=375186) made me recall a previous time when I decided to look up the state of health care in the US, to find out that per person, the US spends **eight** times the amount of money as the UK (for instance) and yet has a lower life expectancy. So, I just went to look it up and see what that reason was, with the following page coming up: [This](http://www.cmwf.org/Publications/publications_show.htm?doc_id=283969) So, I don’t know if they’re right or not. I’ve done no more research on the subject than turning up a single source. But certainly of the three options they present, the third does sound the most believable. (That is, that the cost of health care is higher there.) So, my question is: Is higher cost of health care in the US the reason for the greater spending? And if so, why does it cost so much in the US? Perhaps, our pharmaceutical corporations are involved in significantly more research than other nations’? I’ve no idea. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 10, 2006, 6:10pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/2 "2006-06-10T18:10:01Z")
The British are healthier than us at everything. [http://www.medicalnewstoday.com/healthnews.php?newsid=42717](http://www.medicalnewstoday.com/healthnews.php?newsid=42717) The British Are Much Healthier Than The Americans Here are some figures showing the incidence of some diseases: Diabetes USA - 12.5% UK - 6.1% High Blood Pressure USA - 42.4% UK - 33.8% Heart Disease USA - 15.1% UK - 9.6% Cancer USA - 9.5% UK - 5.5% Lung Disease USA - 8.1% UK - 6.3% Stroke USA - 3.8% UK - 2.3% Heart Attack USA - 5.5% UK - 4% Here are the supposed reasons – Britain has a universal health care system which is free for everyone. The USA has a patchwork of public and private healthcare. However, this study looked at well-off white residents - in both countries, all the people studied had good access to health care. – The USA has a bigger obesity/overweight problem than the UK does. The obesity/overweight problem has been present in the USA for longer than in the UK. – The British are more physically active than the Americans. People walk and cycle more in Britain than in America. The British also use public transport more. – Americans eat more junk food than the British do. – American food portions are much bigger than British ones. American portions are three times the size of a portion in the 1970s. – Americans are not addressing the underlying problems of obesity as much as the British are. Americans are treating the symptoms of obesity, rather than the reasons for it. However, it must be pointed out that the British are getting fatter and people complain not enough is being done to address the reasons for rising obesity levels in Britain. – Americans suffer from higher levels of stress than the British do. I’m sure there is more to it than that though. Its not pharma research. That is only $40 billion a year [http://www.phrma.org/news\_room/press\_releases/r%26d\_investments\_by\_america�s\_pharmaceutical\_research\_companies\_nears\_record\_%2440\_billion\_in\_2005/](http://www.phrma.org/news_room/press_releases/r%26d_investments_by_america%92s_pharmaceutical_research_companies_nears_record_%2440_billion_in_2005/) One of the reasons for higher spending is that we don’t have a single payer system, and we end up spending hundreds of billions on overhead that other countries don’t have to spend. Anothe reason is that in the US people put off medical care due to lack of affordability, which just means they have to get medical care later and that it is more expensive. So instead of getting some $30 pills a person doesn’t do that and has to get a $3000 operation a year later. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 10, 2006, 6:15pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/3 "2006-06-10T18:15:54Z")
> [@Wesley Clark](#): > > Anothe reason is that in the US people put off medical care due to lack of affordability, which just means they have to get medical care later and that it is more expensive. So instead of getting some $30 pills a person doesn’t do that and has to get a $3000 operation a year later. This sounds realistic. So then what are the British and all countries doing which causes preventative medicine over reactionary, such that their prices haven’t spiraled up as well? ---
**Author:** ![Alessan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alessan/32/465_2.png) [@Alessan](https://boards.straightdope.com/u/Alessan)\ **Post date:** [June 10, 2006, 7:10pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/4 "2006-06-10T19:10:32Z")
> [@Sage Rat](#): > > This sounds realistic. So then what are the British and all countries doing which causes preventative medicine over reactionary, such that their prices haven’t spiraled up as well? If they feel bad they go see a doctor. Pay a $2 deductable, get a check-up, and if they need a prescription pay $8 for pills. At least, that’s what I did last month when I had an ear infection. The antibiotics fixed it up in about 4 days. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 10, 2006, 7:23pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/5 "2006-06-10T19:23:48Z")
Yes, but why don’t Americans? It’s a circular argument to say that Americans don’t go to the doctor for a checkup because it is too expensive, but that it is expensive because people don’t go for a checkup. So assuming the price to be the cause, then at one either medicine cost more in the US for some Other Reason X, or that something Other Reason Y caused people to not go for checkups, or that other countries did Some Magic Thing Z which caused people to go for checkups and thus lowered their bill. X, Y, or Z? ---
**Author:** ![chappachula](https://avatars.discourse-cdn.com/v4/letter/c/d2c977/32.png) [@chappachula](https://boards.straightdope.com/u/chappachula)\ **Post date:** [June 10, 2006, 8:03pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/6 "2006-06-10T20:03:49Z")
> [@Alessan](#): > > If they feel bad they go see a doctor. **Pay a $2 deductable** what… $2? Wow, you have a terrible system over there! In my country, the doctor visit is totally _free_. (Unless I go to the walk-in clinic between 6:00 pm and midnight—then I have to pay $15.) When I tell this to Americans, they usually respond by saying , “yeah but we get to choose our own doctor, and you don’t.” Even people who are bankrupted by the system seem to think that it’s the best in the world. They seem to prefer not getting any medical care at all , rather than being required to get it from a doctor who they didn’t choose. I dont see any hope for changing the system in America. Most college-educated people (who have access to the political system ) are satisfied with it-- they get decent coverage from their jobs.And the poorer people don’t have the political clout to change anything. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 10, 2006, 8:25pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/7 "2006-06-10T20:25:08Z")
Not sure what that had to do with the topic… ---
**Author:** ![David\_Simmons](https://avatars.discourse-cdn.com/v4/letter/d/9de053/32.png) [@David\_Simmons](https://boards.straightdope.com/u/David_Simmons)\ **Post date:** [June 10, 2006, 8:48pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/8 "2006-06-10T20:48:31Z")
You have struck a nerve. For several years now I’ve had an irregular heart rate and a few incidents of atrial fibrillation. Just last Wednesday I went to the emergency room because of the third occurance, in three days, of a mild chest pain. I had an exceedingly high pulse rate which they managed to slow down and the ER doctor was about to let me go home when he got the results of a blood test that showed an elevated level of a cardiac enzyme that might indicate some damage. So they suggested a trip to the heart hospital in Bakersfield to which I agreed. A medical helicopter trip, an ambulance trip and there I was in their ER. Thursday I had an angiogram which showed no damage and in fact an exceedingly healthy heart which seems to have some unknown electrical problems which they are going to try first to control with medication. In any case, to get to the subject of costs, of course I haven’t gotten any reports yet but my WAG right now it will be in the $30,000 area. Fortunately I have Medicare and good insurance besides. If medicine doesn’t do the job then a defibrillator of some sort will be implanted and that will probably be another $30,000. As to why such high cost I have no input but them are the conditions what prevail. I don’t think I’m really worth what I’m costing the rest of you in the US. ---
**Author:** ![U\_Retard](https://avatars.discourse-cdn.com/v4/letter/u/7feea3/32.png) [@U\_Retard](https://boards.straightdope.com/u/U_Retard)\ **Post date:** [June 10, 2006, 9:08pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/9 "2006-06-10T21:08:51Z")
The US is the only industrialized nation without universal healthcare, and the effects are deadly–quite literally.[ul][li][Lack of health insurance coverage causes 18,000 unnecessary American deaths a year](http://www.citypages.com/databank/26/1264/article12985.asp). (That’s six times the number of people killed on 9/11.) (NYT, Jan. 12, 2005.)[/li][li]The World Health Organization “ranked the countries of the world in terms of overall health performance, and the U.S. [was]…37th.” In the fairness of health care, we’re 54th. (The European Dream, pp.79-80)[/li][li][Half the bankruptcies in this country are due to health care costs](http://www.house.gov/mcdermott/sp040304a.shtml). (Rep. Jim McDermott, March 4, 2004)[/li][li]In 1960, [the U.S. was ranked 13th in life expectancy for women; in 1995, it had slipped to 20th](http://www.pslgroup.com/dg/448d6.htm). (Anderson, OECD, Nov. 11, 1997)[/li][li]In 1960, the U.S. was ranked 17th in life expectancy for men; in 1995, that position had dropped to 21st. (Anderson, OECD, Nov. 11, 1997)[/li][li]Between 1990 and 1995 the infant mortality rate in the U.S. declined to 8.0 per 1,000 live births but this still left the U.S. at 23 out of 29 industrialized countries because other countries had shown more rapid improvement in reducing infant mortality. (Anderson, OECD, Nov. 11, 1997)[/li][li][Now] [the United States is 41st in the world in infant mortality](http://www.citypages.com/databank/26/1264/article12985.asp). Cuba scores higher (NYT, Jan. 12, 2005).[/ul]…Which surprises me considering how much the US spends on healthcare.[/li] [quote="[P\S\L Group] ([http://main.pslgroup.com/psl.nsf/html/about\_us.html](http://main.pslgroup.com/psl.nsf/html/about_us.html))"]"[[The US] spends more resources [on healthcare] than any other industrialized nation by a wide margin](http://www.pslgroup.com/dg/448d6.htm)," said study author Gerard Anderson, PhD, professor of health policy and management at Johns Hopkins School of Public Health.[ul][li]In 1996 the U.S. spent 14.2 percent of its gross domestic product (GDP) on health care. The next closest country was Germany with 10.5 percent.[/li][li]The U.S. also spent the most per capita on health care in that year with $3,708 US spent per person on health care services, followed by Switzerland with spending of $2,412 US.[/li][li]Of all the G7 countries (U.S., France, Germany, Japan, Great Britain, Canada and Italy) only the U.S. has not achieved nearly universal publicly mandated health insurance coverage.[/li][li]In 1995 only the U.S. had less than half of its population eligible for publicly-mandated health insurance.[/ul][/li][/quote] That’s why Americans want universal healthcare. > [@CNN.com](#): > > **Americans want universal health coverage, group says** > Thursday, June 8, 2006 > > WASHINGTON (AP) – The federal government should guarantee that all Americans have basic health insurance coverage, says a committee set up by Congress to find out what people want when it comes to health care. > > “[Assuring health care is a shared social responsibility](http://www.cnn.com/2006/HEALTH/06/07/universal.coverage.ap/index.html),” says the interim report of the Citizens’ Health Care Working Group, a 14-member committee that went to 50 communities and heard from 23,000 people. Rule by Majority?? > [@CNN.com](#): > > Sen. Ron Wyden, D-Oregon, said he and Sen. Orrin Hatch, R-Utah, came up with the idea for establishing a group that would work outside of Washington to find out what Americans want. He said they were tired of years of gridlock on health care issues. > > “[We decided, let’s try something else. Let’s go to the public and give them a chance, not in terms of writing a bill, but let them provide a kind of general roadmap](http://www.cnn.com/2006/HEALTH/06/07/universal.coverage.ap/index.html) where the country ought to head,” Wyden said. Letting the public provide a kind of general roadmap is radical thinking in the U$ where public opinion is often sharply opposed to public policy. As of Saturday, June 10, 2006, 1:43pm (EST, GMT -5): > [@CNN.com QuickVote](#): > > **Would you support government-guaranteed health care for all Americans?** > Yes: 21350 votes, 80% > No: 5380 votes, 20% > Total: 26730 votes (To view the poll go [here](http://www.cnn.com/2006/HEALTH/06/07/universal.coverage.ap/index.html) and click “View Results” under QUICKVOTE.) That mainstream media would actually publish such a report is very encouraging. Usually, the corporate media shies away from airing ideas of a social democratic nature. Yet this “news” is old. Americans have wanted universal health care for a long time. Not only do we want it, we’re willing to pay higher taxes to get it! > [@PBS](#): > > But a recent survey conducted by the American Hospital Association showed that some Americans said they would be willing to pay higher taxes. > > “[Nearly seven in ten respondents go so far as indicating they would be willing to pay more in federal taxes to assure that every American citizen has health care coverage](http://www.pbs.org/newshour/extra/features/jan-june04/uninsured_1-19.html),” said AHA President Dick Davidson. The survey, randomly polled 800 registered voters across the country. Fear not, my fiscally conservative friends. Thanks to unbelievably gross inefficiencies in existing private health care, you won’t need to pay more since single-payer health care yields greater value. > [@Jim McDermott on Mar. 4](#): > > The United States spent $1.6 trillion on health care in 2003. That is an average of $4,900 per person for the entire country. [The average of the next 29 industrialized countries is less than half that amount, about $2,100 per person](http://www.house.gov/mcdermott/sp040304a.shtml). Switzerland, at number two, spends $3,106. That is $1,800 less per year per person than the United States. Every one of these countries has universal health insurance except us. > … > > At the present time, government at all levels already finances 60 percent of all the health care spending in this country. That is over $2,600 per person. Remember, the international average is $2,100 per person so we are already spending enough. If we were tight-fisted, we could have that kind of a system. > … > > The Bush administration has endorsed and even funded universal health insurance. The thing is, the President’s universal health insurance program is for the people of Iraq, not anything for the 44 million [uninsured] Americans. What? You don’t trust a politician? 😉 Here’s a newer analysis from the same OECD quoted above. > [@The Commonwealth Fund](#): > > The latest data from the Organization for Economic Cooperation and Development (OECD), which compare trends among 30 industrialized countries, show that [the U.S. spent $5,267 per capita on health care in 2002—53 percent more than [Switzerland, the next-highest-spending country, and 140 percent more than the median OECD country].](http://www.cmwf.org/Publications/publications_show.htm?doc_id=283969). > … > > The authors also compared health spending in OECD countries with waiting lists to spending in those without lists. “Health spending in the twelve countries with waiting lists averaged $2,366 per capita,” the authors say, "while in the seven countries without waiting lists, it averaged $2,696—both much less than U.S. spending of $5,267 per capita. > … > > **Conclusions** > If litigation and waiting lists cannot explain higher U.S. health spending, then what factors are responsible? Part of the difference can be attributed to higher U.S. incomes and cost of living. But the principal factor, say the authors, is higher medical care prices. Not only do they make health care unaffordable for many Americans, the extra dollars spent are not yielding demonstrably better quality of care or patient satisfaction. “Future U.S. policies should focus on the prices paid for health services,” the authors say, “and on improving the quality of those services.” The solution is universal healthcare because it’s more efficient, it yields better results in foreign countries, and it’s preferred by overwhelming majorities here in the U$. However, the purchased politicians ignore the concept of democracy and subordinate to big business. Complicit in the attack on freedom and democracy is corporate media who rarely represent the majority. > [@Noam Chomsky](#): > > [Majorities (often large, depending on how questions are asked) think the government should guarantee health care to the population](http://blogs.zmag.org/ee_links/privatization_of_services_the_free_market_democracy) – even that it is a high-ranking “moral issue” (far above those trumpeted in the doctrinal system). It’s no secret that the US has far and away the most inefficient health care system in the industrial world, with far higher costs and among the poorest outcomes. It’s hardly coincidental that it is the only system that is privatized to such an extent, therefore introducing massive bureaucracy, supervision, paper work, subordination to big pharma, and other factors that raise costs and reduce performance. ---
**Author:** ![Least\_Original\_User\_Name\_Ever](https://avatars.discourse-cdn.com/v4/letter/l/e480ec/32.png) [@Least\_Original\_User\_Name\_Ever](https://boards.straightdope.com/u/Least_Original_User_Name_Ever)\ **Post date:** [June 10, 2006, 9:24pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/10 "2006-06-10T21:24:17Z")
I view this much like the tax system in America. There are people getting rich and benefitting by how the system is now, otherwise, the system would never be how it is now. If they were to overhaul it, fix it, and close up the loopholes and make it so it has no loopholes, the people in control would not like it. If they are to fix one of them, it’ll be different and universal, but the loopholes available to the ownership class will be that much larger for them, I predict. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 10, 2006, 10:21pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/11 "2006-06-10T22:21:45Z")
_taps pencil on desk_ On topic please. If you want to berate the lack of universal health care, the Pit is there for you. And if you want to debate why there should or shouldn’t be one, then you are free to start another thread. This thread is about the amazingly large price difference between American health care and elsewhere. ---
**Author:** ![David\_Simmons](https://avatars.discourse-cdn.com/v4/letter/d/9de053/32.png) [@David\_Simmons](https://boards.straightdope.com/u/David_Simmons)\ **Post date:** [June 10, 2006, 10:46pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/12 "2006-06-10T22:46:38Z")
> [@Sage Rat](#): > > _taps pencil on desk_ On topic please. > > If you want to berate the lack of universal health care, the Pit is there for you. And if you want to debate why there should or shouldn’t be one, then you are free to start another thread. This thread is about the amazingly large price difference between American health care and elsewhere. I think the argument is that universal health care results in a lot better preventive maintainance and brings down the price of health care for a nation as a whole. That seems to be the gist of the citation of British vs. US disease rates, Britain having and the US not having universal coverage. The idea that our system has a superiority in that “we can chose our own doctors” is just silly. As a matter of fact we can only choose from among the doctors in our locale and can only really choose if we can afford it. It’s generally conceded that the military gets pretty good health care and they can’t choose _their_ doctor. However, health care is available at the first sign of trouble which, again, results in a lot better preventive maintainance which in turn reduces the high expense of conditions that are allowed to persist. On the other hand many in the US can’t, in fact, choose their doctor. People who don’t have medical insurance and go to the ER can’t choose their doctor and there seem to be many of them in the US. We seem to have selected the worst of all possible worlds. Not very good health care on the average but with a relatively small, select group getting exceedingly wealthy in the health care business. Three cheers for the red, white and blue. ---
**Author:** ![Happy\_Clam](https://avatars.discourse-cdn.com/v4/letter/h/3bc359/32.png) [@Happy\_Clam](https://boards.straightdope.com/u/Happy_Clam)\ **Post date:** [June 10, 2006, 10:52pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/13 "2006-06-10T22:52:34Z")
Also, I don’t know if anyone has touched on it, but the system of private/public provision of healthcare is grossly inefficient, particuarly because of the large number of civil servants who need to spend time calculating (for example) tax breaks for companies based on their health insurance, or whatever. This is a cost that simply doesn’t exist in majority-publicly-funded systems like the UK. I’ll see if I can dig up the March issue of the Lancet, which had an article on precisely this issue- why does America pay so much for such shit healthcare? ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 11, 2006, 12:14am UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/14 "2006-06-11T00:14:14Z")
> [@David Simmons](#): > > I think the argument is that universal health care results in a lot better preventive maintainance and brings down the price of health care for a nation as a whole. That seems to be the gist of the citation of British vs. US disease rates, Britain having and the US not having universal coverage. That doesn’t make much sense. If you have health care you go to the doctor. Whether that is paid for by your taxes or by your employer doesn’t effect when you choose to go in to see the doctor. At current something like 90% of Americans have health care. Unless the other 10% of everyone are somehow walking into hospitals just as they get diagnosed with major, surgery requiring illnesses and then being treated for it even though they don’t have coverage, and thus racking up enough cost to outweigh everyone else so significantly… Seems odd to say that we’re letting people die because they aren’t covered, then say that we’re spending all this money because we’re saving the people who aren’t covered. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 11, 2006, 12:18am UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/15 "2006-06-11T00:18:18Z")
> [@Happy Clam](#): > > Also, I don’t know if anyone has touched on it, but the system of private/public provision of healthcare is grossly inefficient, particuarly because of the large number of civil servants who need to spend time calculating (for example) tax breaks for companies based on their health insurance, or whatever. This is a cost that simply doesn’t exist in majority-publicly-funded systems like the UK. I’ll see if I can dig up the March issue of the Lancet, which had an article on precisely this issue- why does America pay so much for such shit healthcare? I can envision that being true, but still paying the wages of a couple hundred or even thousand accountants doesn’t seem likely to double or more a number that is in the trillions. ---
**Author:** ![Alessan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alessan/32/465_2.png) [@Alessan](https://boards.straightdope.com/u/Alessan)\ **Post date:** [June 11, 2006, 5:04am UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/16 "2006-06-11T05:04:50Z")
> [@chappachula](#): > > what… $2? > Wow, you have a terrible system over there! In my country, the doctor visit is totally _free_. (Unless I go to the walk-in clinic between 6:00 pm and midnight—then I have to pay $15.) > > When I tell this to Americans, they usually respond by saying , “yeah but we get to choose our own doctor, and you don’t.” Even people who are bankrupted by the system seem to think that it’s the best in the world. They seem to prefer not getting any medical care at all , rather than being required to get it from a doctor who they didn’t choose. Ah, but I CAN choose my own doctor. If it’s something urgent I’ll call the Maccabi hotline and they’ll see who has open appointments later that day, but nothing stops me from calling any doctor I want and seeing where he or she can fit me it. That’s what I do with my son’s paediatrician - I’d never take him to see anyone else. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 11, 2006, 8:11am UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/17 "2006-06-11T08:11:56Z")
> [@chappachula](#): > > When I tell this to Americans, they usually respond by saying , “yeah but we get to choose our own doctor, and you don’t.” Even people who are bankrupted by the system seem to think that it’s the best in the world. They seem to prefer not getting any medical care at all , rather than being required to get it from a doctor who they didn’t choose. The sad part is those same americans have no problem with depending on an employer to give them healthcare and then depending on a PPO to tell them which doctor they can go to. Insurance companies limit your choice of doctors too. Sorry that was off topic, but I had to say it. Back to the topic. It seems that inefficiency in our multi payer system and a lack of preventative medicine are the major contributors. So is a lack of government buying power. We don’t buy things like medicine in bulk by using government bargening power like other countries do. So we pay more for medicine, I have no idea if that fact applies to other healthcare goods & services though. you seem to feel it is expensive because we avoid checkups, and we avoid checkups because it is expensive. The problem is checkups are a small part of healthcare. People don’t avoid the doctor thinking it’ll be more expensive, but that can eventually happen. People may avoid the $30 checkup and the $60/month in pills but they may end up facing the $2000 hospital bed bill and $6000 surgery bill because of it. Just the fact that we aren’t as healthy as other people is still another major issue. if you look at the brit vs. US statistics, we are less healthy here. The same goes for US vs. Canada [http://www.livescience.com/humanbiology/060530\_health\_canada.html](http://www.livescience.com/humanbiology/060530_health_canada.html) The new study found that 6.7 percent of Americans and 4.7 percent of Canadians reported having diabetes; 18.3 percent and 13.9 percent, respectively, reported having high blood pressure; and 17.9 percent and 16.0 percent said they had arthritis. About 21 percent of Americans said they were obese, compared with 15 percent of Canadians. And about 13.5 percent of the Americans admitted to a sedentary lifestyle, versus 6.5 percent of Canadians. However, more Canadians were smokers—19 percent, compared with about 17 percent of Americans. The reasons for the health discrepency aren’t totally known. Lifestyle and lack of universal access seem to be the major reasons. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 11, 2006, 8:26am UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/18 "2006-06-11T08:26:49Z")
Also sage rat you are using actual spending per capita, you aren’t using % of GDP spending. That is somewhat relevant as a bigger economy will have higher wages. I don’t know how/if that applies to US vs Europe though but in Thailand you can get heart surgery for $5000, and it costs $50,000 here because Thailands economy is smaller. So the size of the economy and median income may play a role. If median and average income are lower, people can’t afford to pay as much and the market changes to reflect that. Healthcare that is just as high quality as US healthcare costs 5-10x less in Thailand and India, but only because those economies are smaller. > **[OECD Observer](https://www.oecd-ilibrary.org/economics/oecd-observer_15615529)** > > The OECD Observer online archive takes you on a journey through half a century of public policy and world progress. > Since November 1962, the OECD’s experts and leading guests offer insights on the questions facing our member countries with concise... The US spent 15% of GDP on healthcare in 2003, Canada 10% and the UK 8%. I don’t know how relavant that is to the issue, but as a % of all of our economy the discrepency isn’t nearly as strong as it is per capita. The real figure for the UK is 2-3x as much, not 8x as much spending. This PDF file was interesting, but just restates what others here have already said. [http://dll.umaine.edu/ble/U.S.%20HCweb.pdf](http://dll.umaine.edu/ble/U.S.%20HCweb.pdf) It is due to a multi layered private system and a lack of preventitive medicine. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 11, 2006, 11:31am UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/19 "2006-06-11T11:31:08Z")
> [@Wesley Clark](#): > > So is a lack of government buying power. We don’t buy things like medicine in bulk by using government bargening power like other countries do. So we pay more for medicine, I have no idea if that fact applies to other healthcare goods & services though. Makes sense. > [@](#): > > a lack of preventative medicine are the major contributors. […] you seem to feel it is expensive because we avoid checkups You seem to be addressing preventative medicine and checkups as separate things. I’m not sure how that works (?) ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [June 11, 2006, 1:38pm UTC](https://boards.straightdope.com/t/relatively-price-of-health-care/360218/20 "2006-06-11T13:38:13Z")
> [@Sage Rat](#): > > [This thread](http://boards.straightdope.com/sdmb/showthread.php?t=375186) made me recall a previous time when I decided to look up the state of health care in the US, to find out that per person, the US spends **eight** times the amount of money as the UK (for instance) and yet has a lower life expectancy. So, I just went to look it up and see what that reason was,. I don’t know about life expectancy, but regarding costs, this has been debated many times and there seem to be a large number of different reasons : - Much higher admnistrative costs for medical practitioners, due to the multiplicity of insurances, with different forms, guaranteees, etc… -Higher litigation insurance costs for doctors, hospitals, etc… -Lack of economy of scale for insurance coverage. Higher admninistrative cost of it. -Profits of private insurance companies, obviously -Insufficient preventive care -Lack of coverage for a significant part of the population, resulting in people delaying visits and eventually in higher costs to treat an aggravated condition or an overall poorer health. -Over-equipment of hospitals, due to concurence between them in major population centers, that has to be paid for one way or another. By using said equipment more than necessary, or by billing its use for more than necessary. -Profits of private hospitals. -Much more costly examinations prescribed, some of them costly than generally considered necessary in european countries. -Higher cost of drugs. -Plainly : significantly higher income of doctors. [Next page](https://boards.straightdope.com/t/relatively-price-of-health-care/360218.md?page=2)