This always comes up in threads about universal healthcare-- that the US pays “X” times more than <insert industrialized country here>.
So, let’s break it down and let’s use Canada as our example. Americans and Canadians are probably more alike than Americans and Europeans. Let’s get passed the statements about X billion dollars a year or Y percent of GDP. I’ve seen claims from those on the left that it’s mostly overhead payed to for-profit insurance companies. I’ve heard from the right that it’s because a few rich people pay enormous amounts for care that isn’t available elsewhere and that skews the average. Or, I’ve heard that 80% (or some such figure) of a person’s healthcare dollars are spent in the last 6 months of life (again, or some such figure).
Who is paying for what and where do our healthcare dollars go (in both countries)? I’ve been lining up some reading on this subject, but I thought maybe I’d throw this out in GQ and see if I could get some quick answers. I purposely didn’t put this in GD because I’d really like to stick to facts-- if it gets too politically charges, though, I have no problem if it ends up there.
The Canadian government is tasked to provide health care to all it’s population, so it’s polices are geared to buying in bulk and having care before stuff gets really bad.
The American government isn’t mandated to provide coverage for it’s population, so no mass quantity savings, preventive care for only some, and the politicians get contributions from the insurance companies and pharmaceutical companies to side with them making a hefty profit. They federal government has killed programs that states tried to run to provide drugs for less money. You can bet the pharmaceutical interests pressured for that.
Interesting. Wikipedia never ceases to amaze me. But that article is not well written, and has all kinds of warning about its neutrality. And when I read this:
I went: :eek: , but then I went to citation #58 which contradicted the claim it was supposed to support:
I don’t trust it. I’m often distrustful of articles that are shorter than their discussion pages-- tells you people are arguing a lot about what is being posted there.
The medical system in the US is a business and you get what you pay for, ergo a better standard of treatment - if you can afford it or your company covers you.
I have no problem saying American health is most probably the best in the world.
I would dread having to go NHS with anthing serious, however bowel removal and quad by-pass aside. Getting a prescription for £6.90 a pop is kind of nice.
The only downside, aside from mortal dread of hospitals is the tax clobber.
Look on the bright side, at 300M population and growing the US could never sustain a NHS anyhoo.
Be thankful for the quality services you have.
The socialist in me thinks of the poor people who have no cover, then I think that’s America’s problem and not mine.
Get a job, Cancer Boy!
I can’t answer the question in one gulp, but for the United States, at least, here are some good statistics from the Department of Health and Human Services that show who is spending the money and what they’re spending it on. Note that insurance overhead (both government and private) accounts for less than 10% of total spending, so even if every insurance company worked pro bono we’d still be well ahead of Canada.
In the end, the answer always seems to be that stuff in the United States costs more. Our doctors, nurses, hospital stays, medical equipment, and drugs are all more expensive than they are anyplace else. We don’t consume more of them, we just pay more for what we do consume. I don’t know why this is so.
Someone please correct me if I’m wrong, but my understanding of his ruling was that the Supreme Court ruled that such a ban is unconstitutional only if the government doesn’t offer timely access to the same service.
One of the problems with the US system is that, increasingly, even those with health insurance are being refused needed treatment in some cases. This is the main point of Michael Moore’s film Sicko. So, it’s not quite as simple as “you get what you pay for”.
If I’m reading the table here correctly (and if the numbers themselves are valid - I’ll try to verify the sources):
[ul]
[li]In the US, the per capita health expenditure is $5711, of which 44.6% (i.e. $2547) is paid via the government.[/li][li]In the UK, the per capita health expenditure is $2428, of which 85.7% (i.e. $2081) is paid via the government.[/li][/ul]So, on average, a US resident has a greater health-related “tax clobber” than does his/her UK counterpart. Insurance premiums are on top of that, of course.
Why should that be the case? [Not trying to be snarky - I’m generally curious what you believe the cutoff point is.]. If there is some reason that a 300 million US-NHS would be impossible to run, it could be administered at the State level, but with the bargaining power (for drug prices, etc) of the full 300 million.
Not just the impoverished; plenty of those with “pre-existing conditions” (such as myself) are also denied health insurance coverage.
But if you’re continuously covered, you can’t be denied coverage for pre-existing conditions. Also most group policies (employer sponsored) allow for such as a condition of their contracts (at least my employer’s insurance works that way).
The uninsured in the USA are still insured. They won’t be denied life-saving services due to their inability to pay. My own uninsured mother is going through all of this right now, and is quite depressed at the mounting bills she’ll never, ever be able to pay. She’s gotten all required treatments anyway, though.
Of course those live-saving services would likely be preventable if the uninsured had access to preventative care, so in the long run we’re all paying extra to subsidize the chronically uninsured.
As to Canadian health care, it’s not uncommon for those who are able to pay to get instant treatment outside of Canada where private medical care is readily available, such as in the United States.
It’s interesting that a lot of the pharmacists that I run into over here (being right across the river) have a very distinctive Ontario accent. They much prefer the salaries that the free market can bear. On the other hand, we have state governors promoting the idea of importing Canadian drugs.
Get a job cancer boy is exactly how it works out in this country. My friend that died of leukemia had to work all messed up until two months before her death. At the same time another employee with severe fibromyalgia worked for over a year almost unable to move. She went to work some place else. I worked three years hardly able to get about, and for a full time job only managed 24 hours a week. Finally at the point of complete physical collapse, I had to go on medical leave losing the all important insurance after about 10 months. It’s a shitty system in this country.
The biggest most abundant structures built in the last few decades is the insurance buildings. They went up everywhere.
You don’t get all the service you need once you can’t pay. I have experience with that. You may like to say that, but it doesn’t always happen.
Frankly, I think those numbers are manipulated. If Britons (and other Europeans, and Canadians) pay so little for healthcare, then why are their taxes so high? Where does all that money go?
Still, there’s no question that Americans pay a lot for healthcare. I blame obesity. Americans are the fattest people on earth, and we’ve known for a long time that this is unhealthy. It’s only logical that this would be reflected in our heathcare costs.
On similar lines, it seems like a lot of people in the biomed field (drug researchers, etc.) are recent European immigrants.
Except pharmacies are all private outfits in Canada. It’s a free market. Selling prescription drugs isn’t a part of the public health care system. So why would they flee from one free market to another?
I think the flu shots are a good example of why we pay more than Canada. Canada orders what will be needed from the manufacture. The manufacturer doesn’t have to eat the cost of unsold vaccine. The Canadian government gets a great price. In the USA all the places that offer shots, order separate and pay many times the Canadian price. We have shortages in the fall, because the manufacture has to eat any that aren’t used, and many don’t make it anymore.
Yeah, but the drugs are price controlled, meaning that the margins are less, meaning that pharmacists can’t be paid as much. Either that or it’s the tax benefit of not working in Canada, but why the high preponderance of Canadians? Or maybe I’m totally wrong and its selective recall, although with all of the Canadians I know and work with it’s odd that my distorted perception would be limited to pharmacists. ::shrug::
But the dispensing fee is where the pharmacy makes most of its money. The job of the pharmacist isn’t any different, and in any event, I think you might be grossly overestimating the difference in drug prices.
I’m not sure what state you’re in but it could simply be that Ontario pumps out a lot of pharmacists.
It is simple to me. One of my friends is a contractor. Her company offered medical insurance where they pay 0% of the cost, but it is still cheaper as it’s a Group rate.
Now imagine where the entire fucking Nation is not only* one Group,* but there’s only one insurance company. The Group rate gets that much cheaper.
We could have had Universal Healthcare here in the USA, but Americans are very wedded to the idea of “I want my same old Doctor”. Trying to add that into the plan just pushed it over the edge.
As long as a good number of us insist on “I want my same old Doctor”, we will not have Universal healthcare. It’s as simple as that, and MM can go get a colonoscopy- with a sewer pipe.
It’s been said before on these boards, but in the Canadian system, no one is mandated to go to any doctor. You get to choose whichever practitioner has space for patients. I don’t know how this idea got started that you can’t choose your doctor here. There’s really no connection between that and the lack of Universal coverage.
It’s not easy comparing overall tax rates between countries. However, the OECD has produced a spreadsheet(450kB .XLS file) comparing income taxes for various countries, for each year from 2000-2006. For each country, four income levels are compared (67%, 100%, 133%, and 167% of the average). The totals include national (i.e. Federal in the US), local (e.g. State in the US), and SS contributions. Here are the numbers for the “100% of average” incomes (column E on the spreadsheet) for 2006:
[ul]
[li]Canada: 32.1%[/li][li]UK: 33.9%[/li][li]US: 28.9%[/li][/ul]I wouldn’t say that the income tax rates of Canada and the UK are that much higher than the US. [By comparison, France has an equivalent tax total of 50.2%, mainly due to higher Social Security contribution than the others listed above.]
Of course, taxation involves more than just Income Tax. Canada has GST, the EU (including the UK) has VAT, and many goods cost much more in Europe than in the US – some of the differences (e.g. gasoline / petrol) can be accounted for by the higher tax rates on those goods. [On the other hand, the amount of petrol bought every year by the average Brit is a lot less than the gasoline bought by the average American. Shorter distances, more efficient vehicles.]
Many countries with higher tax rates than the US have more generous social services (unemployment benefits, sick leave, child care, etc) and greater investment in public infrastructure (e.g public transit). This all costs money, of course; nationalized health care is not the only difference between the various countries. Plus, of course, the US spends a much greater percentage of GDP on the military than do other countries.
In the US, changing jobs often means a change in insurance company, which may mean that “my same old Doctor” is no longer an option with the new plan (or, in some cases is “an option” but a much more expensive one).
