puddleglum, the one thing you have right is that making the government pay for our current system is dead stupid. Our system is a ridiculous, overpriced, overcomplicated mess. The SYSTEM is what needs to be changed, not just who pays for it. The SYSTEM is why other countries pay half what we do for health care.
There are 50 systems out there that provide high quality health care far cheaper than ours, we need to understand why and apply those concepts to our own country.
So you’re happy paying more for your healthcare than you have to? How Democratic of you!
Hey, someone has to subsidize the French system by paying for all the health care R&D. How else can they get the same drugs we get for 1/3rd the cost?
The pharmaceutical companies in France (and virtually every other country) aren’t spending billions on marketing and advertising prescription medicines to consumers. That’s one way they get the same drugs for one third the cost.
Fifty percent of Roche’s revenue comes from the US compared to only 22% coming from all of Europe. Sanofi’s revenues are closer, but US revenues were 12 billion last year compared to 9 billion for Europe and 10 billion for the rest of the world. 57% of all new pharmaceuticals between 2000 and 2010 came from American pharmaceutical companies. It’s clear that American dollars are what is funding the pharmaceutical industry and I don’t think many people would argue with that.
The other way is, they negotiate as a large group. It ain’t rocket science, the bigger the amount you’re purchasing the better price you’re going to get. America has millions of separate, much, much smaller groups. Not by accident either, it insures much, much higher profits.
The two things combined, negotiating as a large group and no advertising costs, create a truly substantial savings.
Isn’t blaming countries who negotiate smarter something y’all should admire? Maybe America just needs a better deal maker?
Yeah, more of the profit comes from the US, that’s where they get to freely exploit a system they constructed to purposely maximize their take! Blaming people who built a smarter system is kinda silly.
I don’t think it’s so much negotiating as a large group as negotiating as a sovereign country. Guaranteed, we have insurers with far more customers than live in Iceland, but they don’t get the prices Iceland gets.
Part of it is because Americans are much more medicated; well, those who can afford it. Also, there are companies which make some medications available only in specific markets and if they can, one will be the US; I remember one instance where Novartis made one such med, specifically one which had to be taken for a week every year for the rest of the patient’s life, available only in India (1) and in the US (2).
And did Mylan’s research on epinephrine take place in the US? The US is where they came up with a price hike that would have gotten the racks taken out of museums and put back into service in pretty much any other country…
1: where the price was less than $500/year, and pretty much anybody could get it for nothing; one of the patients which they used in their publicity was a member of the Olympic Sailing Team who’d been diagnosed in India, traveled to the US for a second opinion and was getting it for free as he qualified based on his income.
3: where the price was 30K/year, period.
Also, he’s acting as if people in the United States are paying for their health care out of pocket, and if suddenly a third party started paying for it, everyone would start going to the doctor more often and getting more medical care, because now it’s free.
Except, dude, few people in the United States pays for medical care out of pocket, except for cosmetic surgery. Most people have health insurance, either through their job, or their spouse’s job, or their parent’s job, or from a government program. Or, they go to the emergency room with an injury, get treated, and then walk away because they have no money and no insurance and the emergency room can’t legally toss bleeding people into the gutter to die.
You already subsidize the disabled and the elderly through medicare and medicaid. You already subsidize former military through the VA. You already subsidize the destitute and the homeless and the judgement-proof through emergency room treatment.
YOU ALREADY PAY FOR THIS. The advantage to a systematic system is that we can replace the giant roulette wheel that’s spun every time you visit the doctor to see how much you’re going to pay–is it free? Is it a $10 co-pay? Is it $50,000?
We’re not talking about the government taking over health care. Private health care providers will still exist. We’re talking about the government taking over health insurance, not health care.
And if you’re upset because a government death panel is then going to refuse to pay for grandma’s toe fungus, why aren’t you upset when a private insurance death panel refuses to pay for grandma’s toe fungus?
The bottom line is that you’d rather pay more for worse coverage, if that means that certain people who don’t deserve it will get nothing. You’re like the Russian peasant who finds a genie’s lamp, and is upset to find that whatever he wishes for his neighbor will get twice as much, until he wishes to be beaten half to death.
As discussed in the other thread, “Medicare for all” is a nebulous term with a lot of different possible implementations, but it should be obvious that if the US achieved substantially the same health care system as Canada, that costs would be roughly the same. So the obstacles are political and should be recognized as such.
FTR, the health care systems in other countries – and speaking of Canada specifically – do not “limit access to specialists and expensive technology”. A patient is free to see any specialist he wants, but because patients are typically not qualified to know what specialist is appropriate, a referral is typically required for the first appointment – that isn’t a restriction. Insurance company restrictions, out-of-pocket costs, and the limitations of provider networks are real restrictions, and those are inherent in the US system, not single-payer. Nor are there restrictions on “expensive technology”. Everyone who needs an MRI or CT scan can get one in an appropriately timely fashion. What is absent is the profligate waste that exists in the US system, where provider fees are so outrageously inflated that these million-dollar machines and the staff to operate them can sit around idle.
If the Canadian experience isn’t relevant, why did you bring it up? But since you did bring it up, I thought it appropriate to point out the wonderful irony that it was liberal philosophy that led to this fiscal responsibility. This observation seems particularly relevant in a thread seeking to show that liberal policies would lead to the debacle of Venezuela.
I fail to see how it would bankrupt the government to take the money it is already spending on health care and use it more efficiently to provide health care for all. Even if one assumed a system so grossly inefficient that taxes had to be raised, I don’t see the problem with getting the same or better health care for half the cost but paying it in taxes instead of insurance premiums.
No. The gigantic fallacy here is assuming that Medicare for all or some type of single-payer UHC will pay for everything but nothing else will change. This is absolutely false. The simple facts are that the present health care system has more forms, paperwork, and bureaucracy to deal with it all than I’ve ever seen in my life, whereas in the single-payer system I’m familiar with I’ve never even seen a single form. The costs of this bureaucracy are estimated to be on the order of $500 billion a year. Providers not only have to pay for this overhead, they also have to endure losses from insurers and patients who don’t pay them. Under a reasonably implemented UHC system, providers won’t be swallowing losses – they’ll be enjoying unprecedented efficiency and be relieved of one of the most frustrating aspects of their profession. One of the complaints frequently heard from American doctors is that they didn’t go to medical school to learn how to argue with insurance bureaucrats.
They do? Not that I’ve noticed, unless this is another uniquely American phenomenon associated with aversion to government. What I’ve seen is that people don’t necessarily object to higher taxes, but they want to know what they’re getting for it. Better schools, better health care, safer and more pleasant communities, and sustainable fiscal policies with balanced budgets are all considered good reasons for paying taxes.
Nonsense. The costs won’t be the same, because Canada and the U.S. are not the same. For one thing, Canada free-rides somewhat on U.S. healthcare spending. Drugs are typically more expensive in the U.S. than in Canada, because Americans are on average richer than Canadians.
For an example of how intrinsic differences matter, consider education. The U.S spends significantly more per student on K-12 education than does Canada ($12,700 in 2014, vs $10,300 for Canada), but our students on average score much better on standardized tests and in measures such as graduation rates and college attendance. The OECD rankings has Canada ranked 10th in Math, and the U.S. is 41st, below the OECD average. Canada is 3rd in reading, and the U.S. is 24th. Canada is 7trh in science, and the U.S. is 25th.
If the differences always just come down to universal coverage or how much we spend, how do you explain this? Perhaps things as complex as a national education system or a national health care system can not be boiled down to something as simple as single payer vs market?
Our costs of living are very different as well. Large percentages of the U.S. population live in very expensive cities like New York, San Francisco, Los Angeles, etc. This drives up the salaries of doctors. The U.S. also has a fatter, less healthy population, more violence, and is different from Canada in many other ways that affect health care costs.
In addition, although many people think that UHC is more efficient because of economies of scale, it’s exactly the opposite. Economies of scale only apply to industries with high fixed costs but low marginal costs, such as manufacturing. Economies of scale happen because you can amortize the fixed costs over more sales. But service-based industries are not like that at all. Opening a new hospital also means adding bureaucracy at every level. Every new doctor requires just as much managerial expansion. In fact, centrally planned systems behave in the opposite fashion - the bigger they get, the more top-heavy and unwieldy they become, and the less responsive they are to regional or individual needs. This is why huge corporations eventually die - their bureaucracies can no longer manage the complexity and they make increasingly poor decisions.
Universal Health Care may on balance be better than the hodge-podge of legislation, subsidy, market and government that is the U.S. system, but making categorical statements about what will be cheaper are not warranted. It may turn out to be far more expensive. You won’t know until you run the experiment.
You do know that Canadians can’t always find family doctors? This is especially true in rural regions, but even in the cities. And even if you have one, getting an appointment can take weeks sometimes, and a referral to a specialist can take months.
We have another problem in Canada that’s not discussed much - the quality of our doctors is declining, especially in the rural areas. Because of our rigid fee schedules, it can be difficult to find doctors willing to work in rural areas for standard fees. The result is that Canada has gone fishing for doctors around the world, while not looking too closely at their history. We picked up quite a few from South Africa in the past decade. Some of these doctors are good, and some are terrible.
My mother died two years ago. About five years ago, she started feeling stomach pains. She went to her 80 year old small city doctor, who told her it was her gall bladder, and gave her some medicine. The medicine did nothing. She went back again, and told him she thought it was something else. He disagreed, and gave her a different medicine. This went on for two years, while her condition got worse.
Finally, she asked for a referral to a specialist. The closest one was in Edmonton, four and a half hours away. It took her four months to get an appointment. When she finally did, it took them a day to discover she had bowel cancer. They booked an appointment with a cancer specialist - a month away. Her condition continued to deteriorate. The Cancer specialist sent her to a radiologist - another month delay. By this time she was bedridden and had lost about 40 pounds and was very weak. The radiologist scheduled her for Chemo - in another three weeks. Finally the time came, she was checked into the hospital, and the attending doctor decided she was too weak for chemo or surgery. She was sent to a hospice to die, which she did about a month later.
My son plays violin, and was thinking of a career in music. Then he started getting numbness in his last two fingers, and we got him an appointment with a specialist. Because it was non-life threatening, he waited for three months to see someone - three months during which he could not practice either his violin or piano. We finally got in, and the doctor misdiagnosed him and told him it was just an RSI and he’d be fine if he just took it easy and rested his hand a bit more often. I was unhappy with that, because I worried that it was his Ulnar nerve (the symptoms matched exactly), and if untreated could result in permanent damage and end his music career. We asked for a referral to another doctor for a second opinion, and the first doctor blew his top. He finally agreed, but said it could take three or four months before the second doctor would contact us with an appointment.
We waited for four months. Nothing. So we called the original doctor’s office, and the secretary said that the referral was still sitting on his desk - he didn’t bother to send it, probably because he was mad that we dared question him. That’s the kind of thing you can do when you can’t be fired.
We eventually got my son in to the second specialist, where he quickly diagnosed him with an ulnar nerve issue, and it turned out that his ulnar nerve was now over 50% deteriorated. He was right on the line for needing surgery, but first the doctor decided to immobilize his arm, which eventually worked. But he had to give up the violin and stay only with piano. Had we just accepted the first doc’s snap diagnosis, my son would likely have permanent nerve damage in his hand and be unable to play and do other things.
My grandmother had to walk with a cane and be in excruciating pain for YEARS while on a waiting list for a knee replacement. Non-essential surgeries like knee and hip replacements can have very long waiting lists.
This is how it can go in Canada. Sometimes it goes smoothly and great. If you are a pregnant woman, you’ll generally get excellent care. If you are a smart, educated person who can work the system and who the doctor thinks is worth his time, you might get good care. But if you are poor and disadvantaged, or you look like a biker or some other low-life, you can expect indifferent care and sometimes outright rejection from the system.
I don’t know how waiting lists compare to how long you wait in the states, but you might like to read this: Waiting your turn-wait times for health care in Canada 2017. From that document, here are some tidbits:
So on average, AFTER you have had a referral from your family doctor, the average wait time until you actually start receiving treatment is 21.2 weeks, or a little over five months. That’s the average for the country. Some provinces are slightly better, some a lot worse. 2.9% of all Canadians are currently on a waiting list for medical treatment. How does that compare to the U.S.?
And notice that things are getting worse, not better. This is typical of government systems. When they first start out, everything is new and fresh. Everyone is trying hard. Politicians and the public are carefully watching.
But once the system is in place, rot starts to set in. Public unions prevent necessary reforms, the people in the system start to burn out, etc. You can see that in education, you can see it in health care (look at the Veteran’s administration in the States, for God’s sake. You even see it in large corporations or anywhere else where rigid bureaucracies form. They rot from the inside. In the free market, such corporations eventually die and are replaced - a process of constant renewal. In government, such systems can persist indefinitely. So even if Canada’s health care system is okay today, it was better five years ago, and it’s likely to be worse five years from now.
From the document above, “This year, Canadians could expect to wait 4.1 weeks for a computed tomography (CT) scan, 10.8 weeks for a magnetic resonance imaging (MRI) scan, and 3.9 weeks for an ultrasound.”
How does that compare to the U.S.? Do you on average have to wait two and a half months for an MRI? Maybe you do, but now you have the Canadian numbers to compare. And bear in mind that an MRI or CT scan has to be ordered by a specialist - who already took you 10-20 weeks to see.
So imagine: you feel a pain in your stomach. You decide to see your doctor. You wait two weeks for an appointment. Then your doctor refers you to a specialist. You go home and wait for a few months. Finally you get in to see the specialist, who orders an MRI. You go home and wait for two more months. Then you get the MRI, and it shows a problem. You go back to your specialist (maybe waiting another couple of weeks for a follow-up appointment), and he decides to book you in the hospital for surgery - in another two months. Is that comparable to what would happen in the U.S.? Because that seems like a pretty average outcome in Canada.
Another reason why Canada’s health care costs are lower is that we do not pay for extreme life-saving measures and many optional surgeries. If you want an artificial heart, or you want surgery to transition from male to female or vice versa, you’re traveling to the states to get it done. In fact, medical tourism from Canada to the U.S. is big business, because if you are wealthy and suspect you have cancer, you’re likely to pay for fast diagnosis and treatment in the U.S. rather than wait for months in Canada. Or if you need a hip replacement or a knee replacement and you are in agonizing pain, spending your life savings on U.S. surgery might be better than waiting five years for your ‘free’ surgery in Canada.
This is not a small thing. Last year, [url=63,000 Canadians left the country for medical treatment last year: Fraser Institute | CTV News]63,000 Canadians went to the U.S. for medical treatment. If our system is so great, why did 63,000 Canadians choose to pay out of pocket for American health care rather than waiting for ‘free’ Canadian health care?
This brings me to my biggest worry about universal health care - early adopters. In every industry, the wealthy pay for the innovations that eventually trickle down to everyone. We wouldn’t have airbags or stability control in cars today if Mercedes Benz couldn’t charge a premium to develop them. We wouldn’t have cheap personal computers if wealthy people in the 1980’s weren’t around to pay $5000 for an IBM PC with a hard drive. We might not have cell networks if there weren’t Gordon Geckos around willing to pay $1000/mo for a car phone. If we one day get cheap artificial hearts, it will be in part because millionaires paid for the early ones. If we get cheap access to space, it will be because billionaires and millionaires paid for rocket development when it was expensive.
If you make something universal and the government pays for it, you can bet that no one is going to approve $20 million dollars for an experimental artificial heart that might keep you alive for another year. But in a free market, rich people can spend that money, and eventually the technology matures, costs come down, and we all benefit. There’s a reason why the U.S. leads the world by far in medical research.
Oh, and one other thing - Canada’s government health care costs are somewhat lower because there are a lot of treatments the Canadian government doesn’t pay for. For example: prescription drugs, vaccinations, dentistry, optometry, podiatry, psychology, fertility treatments, gender assignment, cosmetic surgery, and a long list of other things. Many Canadians carry supplemental health insurance for these things - or go to the U.S. for them.
That doesn’t mean the forms aren’t there. While I was sitting in the hospital with my mother, I developed a headache. The little hospital pharmacy was closed, so I went to the front counter and asked the nurse if they had any Tylenol. Just plain over-the-counter Tylenol. Well… they couldn’t do it without a doctor ordering it, so they opened up a file on me. Then I had to get my heart checked, blood pressure, etc. Then the resident had to come and do the formal admission. Finally, after all that I was given a little manila envelope with four Tylenol tablets. I figure the cost to the system for those four tablets probably came to several hundred dollars. If their little hospital store had been open, I could have walked in and bought an entire bottle of the same thing for $5.
Look, you can organize a complex system like health care in two ways - one is to let the market order it. The other is to have a bureaucracy do it. There is no other way. And a national bureaucracy for health care is massive… When you have to micro-manage everything, there will be paperwork galore. It’s just that you don’t see it in Canada because it’s done behind the scenes. But as the husband of a health care professional, I can tell you that they spend one hell of a lot of time shuffling papers and justifying everything they do and every dollar they spend. There are no free lunches.
The problem with the U.S. is that they do neither - they pretend to have ‘free market’ health care, where in fact everything is still controlled by huge bureaucracies. A large chunk of health care (the elderly and the poor and veterans) already get single payer health care. Would you say that their outcomes are particularly good? if going to single payer will save so much money, how come Medicaid and Medicare cost so much? I believe the U.S. spends more per capita on Medicare alone than Canada spends to cover everyone. So why is your government health care so much worse?
Except that spending on health care, schools, and cities has been skyrocketing in the U.S., while the quality is decreasing. And when taxes are raised, governments tend to find a way to spend the money rather than paying down the deficit. People are starting to figure this out.
Sam, do you want to hear a long list of horror stories about medical care in the United States? Because I can guarantee you that for every horror story about Canadian health care, I could give you a hundred about American health care.
Like, you know, rather than having to wait for a month to see a doctor, lots of people just aren’t allowed to see doctors, period. Doctors are not for them, because they don’t have medical insurance.
Or the people who do have health insurance, and go get some routine treatment, and then get hit with bills for tens of thousands of dollars.
Or on and on.
Hey, you want better medical care in Canada? Doctors aren’t getting paid enough? Then you’re gonna have to pay more. But you don’t wanna pay more? OK. You think you’re going to pay less if you just pay for every medical treatment out of pocket?
My point was not that Canada was worse than the U.S. My point is that simplistic comparisons of complex systems are stupid - and more specifically, I was giving the actual numbers regarding wait times to counter Wolfpup’s assertions. My anecdotes were merely to point out the human cost of those long waits.
No health care system is going to be perfect. Because resources are scarce, any system you impose is going to have tradeoffs and costs. This is important to remind people of, because too many are running around claiming that socializing health care will result in lower costs and better care for all, with apparently no other tradeoffs. That’s nonsense.
It may be nonsense, but you’re going to need better anecdotes to prove it. Because what you just described is a fucking dream compared to US health care. Jesus, they gave you a free aspirin at the hospital! Do you have any idea how much that would cost someone in the US?
I didn’t say the costs would be identical. I said that if the US achieved substantially the same system as the Canadian provinces, one could expect costs to be roughly similar. The interesting thing about the education analogy is that despite some significant differences in how the systems are run, their fundamental structural similarity (taxpayer-funded public schools) results in costs that are remarkably similar, whereas US health care costs are a complete outlier, pretty much off the chart compared to Canada or any other country in the world.
And incidentally, touching more directly on the OP and the original subject of this thread, the reason Canadian students do so much better than American ones is the (socialistic) emphasis on equality across schools and equality of opportunity within them, including for immigrants, minorities, and the poor – and particularly with respect to equality of opportunity for the underprivileged, so that students’ test scores are not dragged down by a long tail of underachievers.
I don’t. Where did I try to make that point? Sounds like an irrelevant straw man.
In fact the point I’ve made several times, though not in this thread, is that for optimum flexibility UHC systems should be managed by the individual states under general federal guidelines, as they are in Canada by the provinces.
No, we know already. We know because UHC is far less costly than the US system in every single country in the world, without exception, and we know why. Because the staggering bureaucratic overhead has been eliminated, and because there is generally a central authority to regulate provider fees and services.
Everything that you’ve said here about availability of doctors, quality, etc. applies to the US, too, and in many cases the issues are worse. At least Canada doesn’t need to have charities like this one providing free medical care to its own poor citizens, something that should be considered a travesty in the richest country in the world.
I’m very sorry to hear about the health care issues you’ve described. But on the matter of misdiagnosis, you surely are not trying to imply that doctors made mistakes because they’re not paid enough, or because they’re paid by a public health care plan? If the argument is that the system discourages doctors from spending adequate time with their patients, I acknowledge that that can sometimes be the case, although fortunately that has not typically been my experience – but these stresses happen regardless of the system of health care coverage, and indeed may be even worse with private insurance. This is why in the US some practices have been moving to so-called concierge services, high-end medical clinics where the payment of high annual enrollment fees gets you access to a doctor who can give his wealthy patients much more personalized attention and referrals to the best specialists. This sort of exclusivity in my view takes health care in the wrong direction, making it even more money-focused and weakening the system for everybody else. But such is the mercenary nature of US health care. And it wouldn’t be necessary if people didn’t perceive problems with mainstream medical care.
This business of wait times is a tired old canard that is constantly being over-hyped and exaggerated. Medical need in my experience has always been competently triaged and (again, in my experience) when there are significant wait times it’s always been because it just doesn’t matter. For instance, you mention your grandmother being “in excruciating pain for YEARS while on a waiting list for a knee replacement”. I’m very sorry to hear that, but I simply don’t understand, again from own experiences, how that can happen. Joint problems due to age don’t typically arise suddenly, and if they arise due to some accident then they’re triaged as emergencies. A friend had a gradually developing knee problem, his doctor scheduled elective knee-replacement surgery which was done a month or two later (actually, sooner than he would have liked, as he wasn’t looking forward to it), and that was the end of it. He saw a slowly developing problem and had it dealt with in plenty of time. Had he fallen and broken something it would have been handled as an emergency. The system working as it should.
My experiences include acting as health care advocate for several elderly individuals, and I’ve never had issues with the timeliness or quality of their care. I’m not claiming the system is perfect, but I can’t think of any major issues, and I can think of some surprisingly positive ones, like the quality of home care that one of them received. One also needs to keep in mind with these horror stories about long waits for MRI or CT imaging that not only are waits bypassed for time-critical situations, but they only apply to outpatients. Once you’re in hospital all these resources are essentially instantly accessible.
In addition to what I said just above, I disagree with many of those assessments. The main reason that a lot of medical innovation comes from the US is that a lot of technical innovation in general comes from the US, and there is a lot of public and private research money around. Outside of sci-fi movies, it’s rarely because some billionaire funds an invention to let him live an extra month or year. The innovative technologies that Canada’s health care systems fund vary by province but the general requirement (at least in Ontario) is proven efficacy. If there is some procedure that is not available here, it’s probably still experimental or at least leading-edge and not yet mainstream, and available only in one or two places, perhaps research centers where it was developed. The few cases I’ve read about Canadian patients going to the US for medical treatment have involved such technology. In most cases the public health system will pay for it.
Moreover, as I’ve mentioned here and in the Medicare thread, a great deal of medical innovation comes from countries other than the US – the bulk of advanced diagnostic imaging technology, for instance. As cited there, only two out of the 10 top companies providing this technology are US based.
In any case, while I’m sorry that you had these bad experiences, if one were to extrapolate from them and assume they are typical, then one would assume that Canada’s health care system is dysfunctional and systemically broken. You are surely not trying to imply that this is the case, and it certainly disagrees with all of my extensive direct experiences over many years.
Much of this is wrong or misleading. Cosmetic surgery is covered if it’s medically necessary (for instance, due to an accident). It’s not covered if you’re getting it done for reasons of vanity. In Ontario where I live, vaccinations are covered. As of December, 2015, fertility treatments are covered under the Ontario Fertility Program. Gender assignment surgery is covered as of March, 2016.
Certain forms of dental surgery are covered, though not most routine dentistry. Psychology is not covered, but psychiatry is. Prescription drugs are covered for seniors over 65, for the poor, for everyone while in hospital, and in cases of certain rare specialized drugs. Generally speaking the things that are not covered are common minor items like prescription drugs and optometry (eyeglasses) for those of working age which have minimal costs and are usually covered by routine employer supplemental insurance. The public health plan likes to nickel-and-dime on trivia like that while paying unconditionally and in full for major procedures like major surgeries. Those are priorities that I can get on side with.
The first thing you’re describing there is the hospital internal bureaucracy involved in dispensing drugs. That’s completely irrelevant and has nothing to do with the bureaucracy involved in health care funding which is what I’m talking about.
Second, what you say about your health care professional spouse having to do paperwork doesn’t change the fact that American doctors and hospitals have to maintain significant staff to deal with accounts receivable and specifically with insurance companies which constitutes an enormous bureaucratic burden because of its volume and complexity, costing, as I said, an estimated $500 billion a year. Conversely, I can tell you for a fact that my family doctor has on staff just a receptionist and a nurse/assistant who never seems very busy. If there is a lot of paperwork to be done, nobody is doing it.
Because it has to work within a structurally broken system, including the fact of high provider costs and high provider overhead that it can’t do anything about. I am continually astounded by the staggering complexity of the Medicare system and its different “parts” and options compared to the simplicity of the single-payer system I’m accustomed to that simply pays for everything without question and no money changes hands between me and the health care provider.
I think you’re mischaracterizing. Mostly what they’re saying is “there are lots of other countries trying this, and every single one works out better than us in terms of medical outcomes, effectiveness of care and/or cost, so the evidence is pretty damn high those things would improve for us, too, if we just copied one.”
People who would argue with you, though, include those who have researched the issue.
US Pharmaceutical Innovation in an International Context
“Conclusions. Higher prescription drug spending in the United States does not disproportionately privilege domestic innovation, and many countries with drug price regulation were significant contributors to pharmaceutical innovation.”
It is true that pharmaceutical innovation generally happens in large developed nations. Among them, however, the US does not innovate more than its share. The US does spend far more money on it, but that is the case for every area of health care. That does not produce better results for the US.
If this is true, we need to change how much we overspend so the world’s pharma industry isn’t funded on the backs of Americans. That responsibility should be shared.
If this is not true, we need to change how much we overspend because it just goes into the pockets of investors, and we don’t even get the benefit of more research with our excess spending.
Medicare is already run by the government. It has more people as beneficiaries than the entire population of Canada.
A better explanation is the difference between average cost and marginal cost. Generally the American consumer pays the average cost of the medicine and foreigners pay closer to the marginal cost. Drugs cost about 2 billion dollars to come to market and many don’t sell at all. In order for them to be developed someone has to pay the average cost.
This is not true at all. Russia has government run health insurance, and infant mortality is higher, life expectancies are 10% shorter, there is more untreated mental illness, heart disease is worse, and cancer survival rates are much lower. The same is true for Mexico and Turkey. The cost is much less but the healthcare outcomes are much worse.
Five year survival rates for the 18 most common forms of cancer are highest in the US