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Little out of pocket is not the problem I've noticed or it wouldn't be so expensive. Maybe too little out of pocket for a millionaire?
BTW, medical insurance is part of your 'out of pocket' expenses.
Obviously I am talking about the same level of care and the same type of system.
What country has the same level of care and system, with much lower costs?
What country has the same level of care and system, with much lower costs?
Only as of late. Some very affordable insurance premiums are coupled with much higher deductibles, aka catastrophic coverage. If one must pay for an "all you can eat" option then why not consume as many, and the most expensive, items available? The PPACA exchange premiums are based on (limited to?) your ability to pay with the balance of the bill picked up by Uncle Sucker. Folks use their homeowners, renters and auto insurance policies very rarely and premiums are more based on actuarial risk, like insurance should be, not used to cover routine maintenance costs and with a 3X premium cost limit for the highest risk (relative to the lowest risk).
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage. Next closest is spending 9.3% of GDP. And $3,000 less per capita. Do you think we have the best healthcare in the world? I don't.
List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage. Next closest is spending 9.3% of GDP. And $3,000 less per capita. Do you think we have the best healthcare in the world? I don't.
List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage.
In 2011, we were spending over 17% of our Gross Domestic Product on healthcare, dwarfing country #2 by a full 25% in dollars. And we are #1 in this percentage. Next closest is spending 9.3% of GDP. And $3,000 less per capita. Do you think we have the best healthcare in the world? I don't.
List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia
That doesn't tell us the whole story. What we need to keep in mind is that medical care is a superior good, which means that it is the type of good where consumers are willing to spend more as they get richer.
Luxury cars are a superior good. Luxury homes are a superior good. Canned Spam is, on the other hand, an inferior good. As people get richer, they're less and less willing to buy canned Spam.
The US is a rich country. Not all of us are rich of course, but when we look at the nation as a whole, then we're doing better than other nations.
To give an example. About a decade ago, Canada had 151 MRI machines and the US had 10,000. We'd have to get rid of 8,600 of our 10,000 to get down to their MRI/ per capital level. The point is that Americans like having all of this expensive technology available. We're not that much richer than Canadians, but Canadians also ration the access to their MRI machines and so can contain some costs. We don't have that same degree of rationing - Americans don't want to wait 3 months for an MRI scan and so this is why we have 10,000 machines and why we pay so much for medical care.
Quicker access costs money. Medical care being a superior good means that people are willing to pay. Now being willing to pay doesn't exactly translate into being happy to pay, it just means that given a choice between paying and getting the service or not paying and not getting the service, people will pay and bitch about it.
There's a difference between best healthcare and most access to healthcare. I'd argue that those who provide healthcare services in Canada are second to none - it's why many Canadian trained doctors, nurses, EMTs, etc. are actively recruited for higher paying positions throughout the US, particularly in the sunbelt/southern states.
That said, there's no doubt that even if you have the cash in hand, many services readily available in the US aren't available here in Canada or if they are, they aren't available in as timely a manner. Secondly, even though many medical breakthroughs initiate in Canada, many times more are discovered in the US where the financial incentive drives discovery. In addition, our government frequently funds healthcare services for patients to travel to the US for services needed quickly or that aren't available at all in Canada.
We here in Canada benefit greatly from the market driven medical services economy in the US.
Interesting, CJ. And you remind me of a good friend whose brother died of pancreatic cancer before his appointment for an MRI came up (or CAT scan, don't remember which). I made him feel better when I told him that his brother's pancreatic cancer was terminal. He hadn't known that. I don't know, though . . . maybe there's a lesson in that. His brother avoided grueling chemotherapy and was eased on his journey through hospice and a palliative care regime. Great Britain, by the way.
If medical insurance weren't a problem there wouldn't be a need for Obamacare. Even with higher deductibles the medical insurance costs have been extreme. If you have a $5000 deductible, in which case you almost don't need insurance, you still pay over $75-$150 a month.
When I was healthy in my 30's, I purchased a good PPO plan thru my employer for $12 a month in 2000 with a $500 deductible. It quickly after the next few years went up to $270 a month and $1500 deductible, which was cutting into my paycheck. The reasoning explained to us was that insurance companies weren't making enough money.
That said, there's no doubt that even if you have the cash in hand, many services readily available in the US aren't available here in Canada or if they are, they aren't available in as timely a manner.
In addition, our government frequently funds healthcare services for patients to travel to the US for services needed quickly or that aren't available at all in Canada.
Health>Medicine is not like shopping a car.[.....]
In contrast to Social Security, "Medicare is a real Nightmare," says Johnston. He says healthcare payments for Medicare recipients surpass the healthcare liabilities of 33 other countries in the Organisation for Economic Co-operation and Development (OECD), ALL of whom have Universal Healthcare.
He suggests that the U.S. adopt a single-payer healthcare system but admits it's unlikely to happen in the foreseeable future.
In the meantime, he suggests the U.S. switch from what he calls a "business model" focused on profits for insurers to a Service model like education and police.
"It would require a sea change of thinking," says Johnston, but "it's possible."
Johnston also suggests a national health service for older Americans that would help drive down the cost of healthcare. Doctors would be protected from the lawsuits that often threaten private practices and the service would end "defensive medicine" -- i.e. extra, and often expensive, tests.
Those additional tests—not the lawsuits—are what's largely driving healthcare costs higher, Johnston says."..
I agree - for me, if I ever become so sick or if I ever become less than self-sufficient, I sure hope we have laws in place that allow a doctor or other healthcare practioner to put me to sleep, forever - I want nothing less than what is available to the pets I've loved over the years.
Hence the Premier of Newfoundland flying to the US to have heart surgery instead of having it done by staff in a hospital in his own province. He knew that it would be terrible politics to jump the queue and get immediate heart surgery just because he was the Premier, so instead of waiting for months on a list, as the citizens of Newfoundland do, he paid for the surgery in the US and was treated immediately.
To offer service in a timely manner means that the entire medical system has to have the slack built into it to push people through with no back-ups in the pipeline. This also means that all of the capacity can't be used at 100% efficiency. To operate at less than 100% efficiency means that you're paying more for those underutilized assets.
British Columbia has a population of 4.4 million and the city of Spokane, WA has a population of 209,000. I have no clue how many hospitals BC has but whatever the number, every single one of those hospitals had their neonatal care units running at full capacity and a small American city had unused space in their neonatal care unit:
At least two premature Canadian babies sent to the United States when no bed was available for them at home are now stable enough to return to a British Columbia hospital. There's only one problem: There are no beds for them.
Consequently, the two infant girls will have to stay in the neonatal intensive-care unit at Deaconess Medical Center in Spokane, Wash., until a bed becomes available in B.C., said Patrice Sweeny, the hospital's assistant manager of the neonatal intensive-care unit.
"Bedline calls us every day," Ms. Sweeny said of the company, bcbedline, which locates emergency- and critical-care beds for B.C. citizens on behalf of doctors. "They have not had a bed yet. We're just waiting. But as soon as they have a bed, we'll send those babies back ... It's just a crisis up there."
Over the past six months, at least 40 patients from three provinces have found themselves smack in the middle of a medical drama. With no neonatal intensive-care beds available for the babies in Canada, provincial government officials were sent scrambling, trying to find care south of the border.
The babies' mothers, who have been sent abroad to Washington, Montana, Michigan and New York, were typically those who went into labour before 32 weeks gestation - at least two months early. Their babies require the highest level of neonatal intensive care, often needing a ventilator to assist breathing.
All too true - now, imagine if you were talking about a country of 330 or so million people all with equal access to all medical facilities and services, all funded through the federal and/or state governments. Not to say all people don't deserve, at some level, medical services they need to stay alive and live productive lives, but forcing everyone to have a stake in the system also incentivizes everyone to access the system causing shortages of supply.
Canada does a pretty good job with the system that they have but what Americans don't see is the drawbacks which the Canadians endure, and for many Canadians they don't even recognize that they're enduring the drawbacks.
A nightmare scenario for the US is to adopt a Canada-type system and to couple it the American public's consumption habits and expectations of performance with regards to a medical system. Being used to timely service and expecting that from a Single Payer System is just a non-starter.
Liberals were furious when Governor Palin accurately noted that ObamaCare was going to implement Death Panels. You need that feature if you're going to contain costs. These panels exist everywhere in the world where there is a single payer system. Someone has to have the authority to say "NO, we're not going to pay for that procedure because it doesn't make financial sense with regard to the benefits of extending life for X months that it produces."
Sweet Jaysus, back in the 90s Canadians took a number of kicks into their nads as Martin and Chretien fought the budget deficits by curtailing spending on Health Care. The costs to quality of life for medical patients, and the costs of deaths which could have been prevented if attended to either in a timely manner or under a laxer "Death Panel" formula, were quite real and Canadians endured that painful era. After seeing the Obama era unfold, I have no faith in American ability to endure hardship in the area of reduced medical spending and the lifestyle hardships that this would impose. This being the case, a move to UHC and SPS is very unwise.
What do you think, caused the Medical costs to become so astronomical?
Was it the nature of capitalism to extract as much profit from the value of a product, as possible. And of course, what amount would we not pay to be healthy? Is capitalism of this sort, taking an unfair advantage of our desire to not be physically miserable or dying?
Or is it the insurance companies that have gotten in between us and our providers, increasing the costs of service and medicines, by taking an absorbent share?
Do we factor in the Medicare, Medicaid provisions and non payers, as a source of increased prices, because of their discounted and written off income sources?
Is it the specialized facilities, medicines, equipment and cost of training the professionals of the field?
Could it be all of the above?
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