# Why is healthcare cheaper in nations with UHC? **URL:** \ **Category:** Great Debates\ **Created:** [October 25, 2012, 4:46pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840 "2012-10-25T16:46:39Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [October 30, 2012, 5:19pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/81 "2012-10-30T17:19:55Z")
**Sitnam** , I think you completely missed the point. The question was not “why the out-of-pocket expenses are lower”, but “why the per-capita costs are lower (in straight conversion dollars, usually even more considering PPP)”. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 30, 2012, 6:19pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/82 "2012-10-30T18:19:18Z")
> [@amarone](#): > > I will not be shy about naming names; your experience is very similar to mine with United Healthcare (were they taking the piss when they chose to abbreviate their name to UHC?). My wife (before we were married) had similar issues with them. > > By talking to colleagues we discovered that they routinely rejected the first claim each year on the grounds that the customer “might have other insurance”. I think it strongly depends on who is buying the insurance. Blue Cross (under whatever name they are using now) used to do this to me all the time. Not just once - repeatedly until I called them up and yelled at them. Then my very large company dumped their sorry ass and we went with UHC who has never done it. So, not only is it that those with money get decent healthcare in the US, those with clout don’t get screwed over by their insurance companies even when they have healthcare. I’d much rather deal with Motor Vehicles workers than insurance company workers - I’ve found them to be far more competent and polite. ---
**Author:** ![amarone](https://avatars.discourse-cdn.com/v4/letter/a/e0b2c6/32.png) [@amarone](https://boards.straightdope.com/u/amarone)\ **Post date:** [October 30, 2012, 9:24pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/83 "2012-10-30T21:24:41Z")
> [@Voyager](#): > > I think it strongly depends on who is buying the insurance. Blue Cross (under whatever name they are using now) used to do this to me all the time. Not just once - repeatedly until I called them up and yelled at them. Then my very large company dumped their sorry ass and we went with UHC who has never done it. Funnily enough, I was the person in charge at our small company. I dumped UHC and changed to BC/BS of GA, who were much better. These companies obviously vary from region to region. J.D. Power has survey results. In Georgia’s region, UHC ranks better than BC/BS. In South-Central, BC/BS of Alabama is number 1 and UHC comes last. I am with BC/BS of AL now. Mind you, we are about to have a fight over a $1,000 claim that they rejected a couple of months ago for no obvious reason. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [October 31, 2012, 11:41am UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/84 "2012-10-31T11:41:59Z")
> [@Sam\_Stone](#): > > The last few posts are dancing around one of the major reasons health care costs are lower in countries with UHC, but no one wants to come right out and say it. So I will: > > Health care costs are lower in some of these countries because health care is _rationed_. Well, yes, nowhere is there an infinite supply of healthcare. However, the fact is, rationing is **far more severe in the US than in any other developed country**. This is because, as pointed out, in the US healthcare is prioritized by the ability to pay for insurance/treatment. In other countries it is prioritized by medical need. This in itself makes the US rationing harsher by a very large margin. To a US citizen, the difference can appear _vast_. People from other nations speak of healthcare as “free”. Because they’ve never thought of healthcare as something that might be scarce. That is quite revealing. Meanwhile, in the US, millions of citizens do not have access to healthcare, or are underinsured. The difference in rationing is enormous. Actually allocating resources on the basis of the medical needs of the entire population also goes some way to explaing the greater efficiency of UHC systems. Futhermore…the US system employs 250% of the medical staff other nations do, has 600 000 employees in the medical insurance business that many other nations do not, and runs a large number of health care subsidizing organizations in parallell, duplicating each others work. And you’re sayiong the countries with none of these, providing health care to all their citizens, and where people live longer, in better health, are cheaper because they ration treatment? Do you see that that makes absolutly no sense? > [@Sam\_Stone](#): > > It’s very easy to control health care costs if you simply cap fees to doctors, set up health boards to determine who will or will not get treatments, declare some expensive treatments to be off limits, etc. Many of these countries have a doctor shortage because they don’t pay enough, and the doctor shortage then becomes a very politically expedient way of rationing care. If there just aren’t enough doctors to treat everyone, then a politician didn’t have to deny treatment. Who sets up health boards to determine who will or will not get treatments, declare some expensive treatments to be off limits? I’d really like some substantiations of this. As for the doctor shortage…seriously, where do you get this stuff? _[The US is number 53 in number of physicians per population](http://www.globalhealthfacts.org/data/topic/map.aspx?ind=74#table)_. Third from the bottom in the western world. Only Canada and Japan has fewer. > [@Sam\_Stone](#): > > You won’t see this reflected that much in statistics regarding cancer survivability, or even in lifespan statistics, because life-saving treatments aren’t the ones that are rationed in most cases. It’s the ‘quality of life’ treatments that get the axe. How very fortunate that we have measures in public health to gauge the efficiency of a countrys “_Quality of Life_” health care. We normally use [HALE](http://www.who.int/whr/2003/en/Annex4-en.pdf)s. "Health-adjusted life expectancy ". Or sometimes [DALY](http://gamapserver.who.int/gho/interactive_charts/mbd/as_daly_rates/atlas.html)s. HALE estimates the number of healthy years an individual is expected to live at birth by subtracting the years of ill health – weighted according to severity – from overall life expectancy. By moving beyond mortality data, HALE is meant to measure not just how long people live, but the quality of their health through their lives. DALY means “Disability Adjusted Life Year” and means the number of years lost to ill health, disability or early death. As you can see from the links, the United States trails most of the developed world in both stats. > [@Sam\_Stone](#): > > Will Americans accept a half-year wait for heart surgery? Will they accept a multi-year wait for joint replacements? As the population ages, these surgeries will become more in demand, and therefore the lists will grow longer. Americans at the moment accept longer waits than most systems in studies. [While normally beating Canada](http://www.commonwealthfund.org/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx?page=all) for timliness and access, the US does not otherwise place well in this area. > [@Sam\_Stone](#): > > Oh, there’s another big reason why we control health costs - because of the waiting lists, we offload a lot of patients to the United States. People mortgage their homes and cash in their retirement savings to get painful, debilitating conditions treated in the U.S. when they can’t get it done here. That offloads a lot of our costs off the system, and it doesn’t show up in our health care cost stats because the money isn’t spent in Canada. Um…no?[Just no](http://content.healthaffairs.org/content/21/3/19.long). > [@Sam\_Stone](#): > > One other way we help the system work: We privatize it. Canada actually spends less government money per person on health care than does the U.S. Something Canada has in common with the UK, France, Germany, Japan etc. It is an illustration of how out-of-control US healthcare costs are. Just the government programs cost more than provideing healthcare for the entire population would. > [@Sam\_Stone](#): > > Another way other countries contain costs is because they refuse to do extremely expensive medical treatments. Um…what? We do the same treatments as the US, they are just cheaper. > [@Sam\_Stone](#): > > The U.S. innovates in health care in large part because it has a private system that can offload the costs of new treatments on ‘early adopters’ - wealthy people who are willing to pay for cutting-edge medicine. Eventually the costs come down and those treatments benefit all of us, but take away the ability of wealthy people to pay for their own health care, and you’ll cut off a major source of funding for innovation. The major source of funding for research in the US is the government, through the NHI. Medical research profit calculations normally do not include any “early adopters” profits. Its all about wheter a product can sell. If it can, it’ll normally stay on the market for so long that the early adopters are not a big factor. Inasfar as the US consumption gets special treatment it is that you can push drugs which are less medically effective there, since you can market drugs, not just rely on the judgemet of physicians. > [@Sam\_Stone](#): > > Yeah, you’d think that’s how it would work. But it really doesn’t. Tell me - if a sports star blows out a knee, do you really think he’s going to go on an NHS waiting list behind grandma? Yes, obviously. How do you think it’d work? You go on triage in the public system, or pay for a private treatment. How else do you think it’d work? > [@Sam\_Stone](#): > > Private orthopedic surgery is allowed in the UK? In Canada it isn’t. So normal people who want it done quickly go to the States. Somehow, sports stars get instant access. It is allowed in every other developed country. > [@Sam\_Stone](#): > > Of course health care is a scarce resource. No one is arguing otherwise. The question is, what is the most efficient way to provide health care services to the public? One side argues that the free market is, overall, the best way to ensure that health care resources are utilized optimally. The other side believes that the industry must be ‘managed’ by a bureaucracy and the resources doled out by technocrats, who can be trusted to be fairer than the market in determining who should have access. > > That’s the debate. No one is promising a utopia. I don’t think that is the debate. You seem to be leaving out that orthodox economic theory indicates that healthcare is not a commodity fit for a free market, and that every bit of real-world experience backs that up. Its not much of a debate, to be honest. Sam, I need to ask you something: Where do you get this stuff from? Because you’re not just repeating common myths like Canadian use of US healthcare facilities. Some of the stuff you’re presenting as facts, like the US number of of physicians, comparative medical rationing, and the amount of quality of life treatments provided are not just wrong, they are demonstraby **exactly the opposite of how things are in the real world.** And thats…peculiar. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [October 31, 2012, 6:07pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/85 "2012-10-31T18:07:33Z")
> [@Wesley\_Clark](#): > > The Japanese visit the doctor far more than Americans and still pay a lot less. > > [Japanese Pay Less for More Health Care : NPR](http://www.npr.org/templates/story/story.php?storyId=89626309) > > Health care costs here weren’t too bad compared to other countries, but they exploded starting in the 80s. I don’t know why. > > [Lean Enterprise Institute | Learn Lean Thinking & Practice](http://www.lean.org/images/shook_hcchart.gif) I think that might coincide with better, life extending, more expensive heart and cancer treatments. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [October 31, 2012, 6:12pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/86 "2012-10-31T18:12:18Z")
> [@Sam\_Stone](#): > > The last few posts are dancing around one of the major reasons health care costs are lower in countries with UHC, but no one wants to come right out and say it. So I will: > > Health care costs are lower in some of these countries because health care is _rationed_. … All goods are rationed. Most of them are rationed based purely on ability to pay. IMO, healthcare and education are two things that should not be rationed purely on that basis. Would you trade Canada’s health care system for the US health care system, warts and all? Which system do you think would have more defectors to the other system from current users? ---
**Author:** ![elbows](https://avatars.discourse-cdn.com/v4/letter/e/b3f665/32.png) [@elbows](https://boards.straightdope.com/u/elbows)\ **Post date:** [October 31, 2012, 6:35pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/87 "2012-10-31T18:35:52Z")
The only time, the Canadian populace, comes close to the passion reflected in the popular American slogan, “…from my cold dead hands!”, is when talking of healthcare. Politician’s all tread very carefully, believe me. ---
**Author:** ![What\_the](https://avatars.discourse-cdn.com/v4/letter/w/f4b2a3/32.png) [@What\_the](https://boards.straightdope.com/u/What_the)\ **Post date:** [November 1, 2012, 3:45pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/88 "2012-11-01T15:45:45Z")
> [@Damuri\_Ajashi](#): > > The answers aren’t all that complex, the reason its an issue is because there is a portion of the population that takes issue with everything from evolution to global warming why should a partisan issue like UHC be any less susceptible to partisan opposition. Oftentimes what they really take issue is with those who think that the government can solve everything and should take care of everyone whether or not they can or should take care of themselves. To answer the question… it easy to have a lower price if you can set a lower price and not worry too much about the supply or quality. Plus you can shift admin costs away from insurance companies to a government bureaucracy. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [November 1, 2012, 4:16pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/89 "2012-11-01T16:16:51Z")
> [@Sam\_Stone](#): > > Private orthopedic surgery is allowed in the UK? Why on earth shouldn’t it be? Very often surgery is done by the same surgeons in the same hospital as the NHS. The fees go in part to the hospital which benefits NHS patients. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [November 1, 2012, 6:22pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/90 "2012-11-01T18:22:36Z")
> [@What\_the](#): > > Oftentimes what they really take issue is with those who think that the government can solve everything and should take care of everyone whether or not they can or should take care of themselves. > > To answer the question… it easy to have a lower price if you can set a lower price and not worry too much about the supply or quality. Plus you can shift admin costs away from insurance companies to a government bureaucracy. Small government pro-business forces have been denying science for a long time. From the effects of smoking, asbestos, lead paint, leaded gasoline, DDT, the Ozone layer, acid rain, seat belts, etc. Of course ultra-liberals do much of the same when they try to make us all live like the Amish but noone takes them seriously. There is a lot of money spent to inject doubt into the debate on global warming or UHC, just like there was a lot of money spent to inject doubt into the debate on the effects of smoking. UHC doesn’t have to set a market price. If people don’t like UHC, they can buy private insurance. Noone forces pharmaceutical companies to accept the lowest bidder for their products. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [November 1, 2012, 6:23pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/91 "2012-11-01T18:23:47Z")
> [@Quartz](#): > > Why on earth shouldn’t it be? Very often surgery is done by the same surgeons in the same hospital as the NHS. The fees go in part to the hospital which benefits NHS patients. If a private school system can coexist alongside a public school system, I don’t see why a private health insurance market cannot coexist alongside a UHC system. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [November 1, 2012, 7:32pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/92 "2012-11-01T19:32:04Z")
> [@drew870mitchell](#): > > I think you missed the point - it’s the _insurance_ industry in the US which employs 500,000 people. If we went to UHC most of these positions could be straight-up eliminated. That’s a cost savings for the US healthcare system. Surely you didn’t think the entire country had only 0.5 million healthcare employees. Do you think they will just find the next job that comes along? Or is the tax payer going to get stuck with an additional 500,000 people on unemployment? ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [November 1, 2012, 8:35pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/93 "2012-11-01T20:35:56Z")
> [@Kearsen](#): > > Do you think they will just find the next job that comes along? Or is the tax payer going to get stuck with an additional 500,000 people on unemployment? This is not a logical argument for keeping people employed. I mean, what happened to all the employees of buggy-whip factories? What about all those folks who made zepplins? If they have no function anymore, then yes, they will have to re-train. I don’t think you’re moving to UHC over the next week, so there will be some time for that. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [November 1, 2012, 9:40pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/94 "2012-11-01T21:40:14Z")
> [@What\_the](#): > > To answer the question… it easy to have a lower price if you can set a lower price and not worry too much about the supply or quality. Plus you can shift admin costs away from insurance companies to a government bureaucracy. Didn’t we just establish that\* both\* supply and quality is higher in the UHC coutries? And that bureaucracy is far bigger in the US, there is simply far more to have a bureaucracy about when you add in billing. ---
**Author:** ![sisu](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@sisu](https://boards.straightdope.com/u/sisu)\ **Post date:** [November 1, 2012, 11:02pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/95 "2012-11-01T23:02:04Z")
> [@Leaffan](#): > > Because it’s a not-for-profit industry. Physicians have standard costs set by the government. Not really, in Australia a doctor can charge we he/she likes but the customer only gets a certain rebate back from Medicare. So the rebate is set not the fee, it does help keep doctors’ fees down as there is a benchmark set. When I see the doctor for a short 15min visit this is normally 100% covered by Medicare. We have a combination of private and public care here and some people rely only on Medicare, I use a bit of both. I think part of it is the profit motive, most of our private hospitals are run as NFP. So careful and constrained government intervention on rates combined with a generally healthy population keeps our costs down. ---
**Author:** ![sisu](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@sisu](https://boards.straightdope.com/u/sisu)\ **Post date:** [November 1, 2012, 11:09pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/96 "2012-11-01T23:09:49Z")
Oh yes one I did forget is that in Australia we are not litigious society and as such malpractice insurance is relativity cheap, this certainly keeps costs down a lot! ---
**Author:** ![Leaffan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leaffan/32/299_2.png) [@Leaffan](https://boards.straightdope.com/u/Leaffan)\ **Post date:** [November 2, 2012, 12:45am UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/97 "2012-11-02T00:45:38Z")
> [@sisu](#): > > Not really, in Australia a doctor can charge we he/she likes but the customer only gets a certain rebate back from Medicare. So the rebate is set not the fee, it does help keep doctors’ fees down as there is a benchmark set. When I see the doctor for a short 15min visit this is normally 100% covered by Medicare. > > We have a combination of private and public care here and some people rely only on Medicare, I use a bit of both. > > I think part of it is the profit motive, most of our private hospitals are run as NFP. > > So careful and constrained government intervention on rates combined with a generally healthy population keeps our costs down. That is a reasonable compromise that I can legitimately see Canada moving towards at some point, but health-care in general is a sacred cow in Canada. Any attempt to modify or privatize is certain political suicide for some reason. People just cannot grasp the enormous costs as the baby-boomers age and that the remaining worker bees need to fund the program. A private/public option would relieve a lot of stress on the system. ---
**Author:** ![sisu](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@sisu](https://boards.straightdope.com/u/sisu)\ **Post date:** [November 2, 2012, 12:59am UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/98 "2012-11-02T00:59:42Z")
> [@Leaffan](#): > > People just cannot grasp the enormous costs as the baby-boomers age and that the remaining worker bees need to fund the program. > > A private/public option would relieve a lot of stress on the system. Yeah the ageing population is often cited as the reason for a lot of changes in Australia such as health care and also superannuation [retirement saving]. The private/public also allows private companies to spend money on high capital intensive new equipment etc without increasing government spending. Hey it’s not prefect but no one goes bankrupt in Australia due to health costs. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [November 2, 2012, 10:22am UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/99 "2012-11-02T10:22:30Z")
> [@zoid](#): > > This is a HUGE problem. Adequate preventive care for everyone would save this country big bucks. Well, no. The single most expensive thing we can do as a society is keep everyone healthy, although it would save insurance companies a boatload. Medical care is the most expensive at each end of life. Let’s consider the elderly. A healthy elderly person hitting 65 might live for another quarter century. The healthier they are when they hit retirement, the more they are going to cost. They are going to collect SS longer and from a medical standpoint, they are going to cost a fortune because they healthier they are the more stuff they are going to need replaced as it wears out. The hips and knees will go eventually. Joint replacements. The vasculature is going to wear out. Stroke care. The heart valves will slowly wear out. Aortic valve replacement. And so on. Right now, we think nothing of replacing joints and valves in 80 year olds who are otherwise healthy, precisely because they are healthy. Then there’s cancer. When it shows up, we are going to pull out all the stops when you are healthy and let you die if you aren’t healthy enough to go through treatment (or the treatment will kill you more easily). Cancer shows up more the older you get… When it does come time for you to check out, a basically healthy individual takes a long time to die, dies incrementally and dies expensively. You’d be amazed at how long a healthy elderly person can hang on with a respirator in the ICU, or after a debilitating stroke as long as the rest of the body is healthy. All of these costs are now shifted from the insurance company–which got the person to Medicare in a healthy an robust state–to the government, which is stuck with this healthy person who requires huge quantities of healthcare money between the time they retire healthy and dwindle away. We need to smoke hard and die young, from an economic standpoint–at least, from the standpoint of costing the common fund money. The costs of that smoker (if they aren’t polite enough to work hard and drop dead from an unexpected heart attack) are passed along to an insurance company, which can adjust its premiums accordingly. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [November 2, 2012, 2:16pm UTC](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840/100 "2012-11-02T14:16:45Z")
> [@Chief\_Pedant](#): > > A healthy elderly person hitting 65 might live for another quarter century. The healthier they are when they hit retirement, the more they are going to cost. They are going to collect SS longer and from a medical standpoint, they are going to cost a fortune because they healthier they are the more stuff they are going to need replaced as it wears out. The hips and knees will go eventually. Joint replacements. The vasculature is going to wear out. Stroke care. The heart valves will slowly wear out. Aortic valve replacement. And so on. > > Right now, we think nothing of replacing joints and valves in 80 year olds who are otherwise healthy, precisely because they are healthy. Because they are healthy, but perhaps not healthy enough. People who get to 90 with the health level of my maternal grandparents cost more in Tumms for the doctors than in actual healthcare for the oldsters… those two happened to hit a combination of the genetic lottery with good healthcare and good food growing up, but still; the assumption that everybody is going to need “replacement surgery” is somewhat farfetched. I’d like to see some actual stats. [Previous page](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840.md?page=4) [Next page](https://boards.straightdope.com/t/why-is-healthcare-cheaper-in-nations-with-uhc/638840.md?page=6)