Almost all advanced countries, if not all, have national medical care. It is telling that in the debate over Obamacare, few looked at systems in other countries to see how well what worked. The reason seems to have been a mixture of the classic American arrogance and lack of interest in anything beyond the borders. Characteristically, discussion usually turned on the evils of socialism–for some reason, Europe is thought to be socialist–and who was going to make money.
The results are what one would expect. Study after study has shown that American health care is of poor quality compared with that of other First World nations, and way more expensive.
Recently I encountered a casual friend–he was dancing in a local club–whom I had not seen for a while. Where ya been, I asked? In Guadalajara for cardiac surgery, he said, double bypass and valve replacement. The replacement valve was from a pig so we made the mandatory jokes about did he say oink-oink, and parted.
Later, for the hell of it, I asked by email what it had cost. His response, verbatim, except for my conversions to dollars at 17 pesos to the dollar:
“The costs of my surgery were as follows:
330,000 pesos to the surgeon and his surgical team. $19,411
122,000 pesos to the hospital for eight days $7176
15,000 to the blood bank. $882
————-
467,000 total $27,470
The time frame was March 13 to March 21. The exchange rate around this time period was about 17.5 which would make the USD cost app. $27.000.”
Wondering what this would cost in the US, I googled around and found things like this:
“For patients not covered by health insurance, valve replacement surgery typically costs from about $80,000-$200,000 or more with an average, according to an American Heart Association report[1] , of $164,238, not including the doctor fee. A surgeon fee can add $5,000 or more to the final bill.”
This was only for the valve replacement. The price for a simple bypass in the US runs to $50,000 to $70,000 at the lower end. What the bypasses would add to the replacement, I don’t know, and shudder to think.
The huge difference in price between American and other care occurs in almost everything. For example, corneal transplant in the US:
“For patients who are not covered by health insurance, the average cost of surgery can range from $13,000 to $27,000 or more. According to the Agency for Healthcare Research and Quality[2] , a corneal transplant typically costs $13,119 when done as an ambulatory procedure and $27,705 when performed as an inpatient surgery.”
In Mexico, about $3000, according to my ophthalmologist, who does them constantly.
Why the prices? Several reasons offer themselves. Advanced countries–Mexico is not one–have less corruption than does the US, and a greater concern for the well-being of their people. In Europe, for example, this is obvious not just in medical care but in unemployment insurance, length of vacations, and public amenities. In Seville, among my favorite cities, sidewalks are very wide, bicycle lanes are actually usable, in intercity buses are clean and comfortable. In the US all of this would be regarded as hippy dippy or socialism or the malevolent workings of the nanny state.
I tell you, boys and girls, America is a collection of self-interested interests concerned with maximizing profits and nothing else. Hospitals are run for profit, with the result–surprise, surprise–that they charge what they can get away with. Compare Japan:
“Hospitals, by law, must be run as non-profit and be managed by physicians. For-profit corporations are not allowed to own or operate hospitals. Clinics must be owned and operated by physicians.”
Anybody want to take bets who gets better care at lower prices?
When national medical care is considered in America, nobody–so far as I am aware, anyway–thinks to look at other countries, see what they are doing, and ask, “Does it work?” To do so would make sense, and so is rejected out of hand, and anyway Americans apparently cannot conceive that other countries might do things well. Instead we hear about this that economic theory, and freedom, and what Adam Smith said about bypass surgery, and tyranny.
Invariably you hear of the pregnant woman in London who couldn’t see a doctor under national health care and had to giver herself a Caesarian with a chainsaw. These nightmares are offered as proof that national care doesn’t work. In fact the medical business lobbies to underfund national care, ensuring that it won’t work well. Then they talk about the evils of socialism.
Suppose we did make comparisons?
Military medical care is the obvious, available, and easily studied alternative to Obamacare. So far as I know, nobody thought of this. In the military you go to the hospital or clinic, show your ID card, get done whatever you need, and leave. Thank you, good day. No paperwork. No paperwork. No insurance forms, deductibles. receipts. No insurance companies trying to pay as little as possible, since that’s how they make money. The doctor doesn’t order a PET scan, three MRIs, and a DNA analysis of your grandmother’s dog to run up the bill.
Canada:
“Canadians strongly support the health system’s public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported “public solutions to make our public health care stronger.”[18][19] A Strategic Counsel survey found 91% of Canadians prefer their health care system instead of a U.S. style system.[20][21]”
From the taxpayer’s point of view, real national care involves no insurance companies. For this reason Congress, for sale to the highest bidder, will never consider such a system.
“The French health care system is one of universal health care largely financed by government national health insurance. In its 2000 assessment of world health care systems, the World Health Organization found that France provided the “close to best overall health care” in the world.[1] In 2011, France spent 11.6% of GDP on health care, or US $4,086 per capita,[2] a figure much higher than the average spent by countries in Europe but less than in the US.”
People who have used it–well, the three I know–love it.
The foregoing paragraphs by themselves do not justify a sweeping change of policy–but might they not suggest to our rulers the wisdom of at least looking at what other countries have done?
No.
Your comment about military healthcare is on target. I am not retired military, but do have a service connected disability, which puts me in a fairly high priority status. In the years I have been a VA patient, I have NEVER had a complaint about the medical treatment or service received. Some minor complaints from the admin side of the operation, but not the medical side. The only cost to me is my co-pay for my meds -$8.00 per month. Over the years of service I have talked with many of the doctors who have treated me. Several had left private medicine and joined the VA because the paperwork and insurance burdens had become so onerous that they had no time to practice medicine. I also note that the med center to which I am assigned is also a teaching hospital; however I do not know if that is the case at all VA centers.
Also, on a personal note, I recently (within the past couple of years) have undergone cataract surgery in both eyes. So has my wife, at her private opthalmologist’s hospital, covered by her expensive private insurance. My surgery has turned out great on both eyes. My wife’s, not so much. She has had problems with the resulting vision.
I am a retired AF vet and receive all of my healthcare from the VA. I receive very good care. I suspect that the quality of the care depends on which hospital you are assigned to and there are some very bad ones with bad management. Any hospital/clinic with bad management will give bad care. I am grateful for the VA so I didn’t have to go broke buying Obamacare.
State funded, single payer health care would have collapsed years ago if it wasn’t for the advent of technology advances in pharmaceuticals, diagnostics, and surgical techniques. This has allowed dramatic cuts to the cost of acute care, which is the focus of all health care systems. A rostering system has also been implemented in most, if not all, single payer systems. It works by paying doctors annual lump sums per patient on his roster.
Having said that, the writing is still on the wall as the boomer cohort, with all their lifestyle issues, could bankrupt the system.
The US private system is no better because it’s a monopoly racket, run by insurance companies and their hmo’s, protected by the state. What need’s to be done here, is to promote real free market based, health care, and the first step is for government to reform tort law, which would base civil suits on actual damages rather than fanciful payouts dreamed up by litigators. It would also help to rein in court costs, which makes it cheaper to settle than fight, no matter how spurious the suit.
The cost of liability insurance, to protect against malpractice, is one of the main reasons sole practitioners don’t exist anymore. Of course, the cost of this insurance is devised by the same industry that dominates the health industry.
Insurance dominates the industry as a result of government policies as far back as the WWII era that made it desirable as an untaxed and unregulated compensation to get around various wage laws.
https://www.zanebenefits.com/blog/part-1-the-history-of-u.s.-employer-provided-health-insurance-post-world-war-ii
Government initiates problems then makes them worse in an attempt to correct them.
“The cost of liability insurance, to protect against malpractice, is one of the main reasons sole practitioners don’t exist anymore. Of course, the cost of this insurance is devised by the same industry that dominates the health industry.”
I’m pretty sure that is not the case.Look at some of the states where they have implemented tort reform & see if malpractice premiums have really come down appreciably.
Three easy steps to making health care more affordable.
1) Free Market
2) Free Market
3) Free Market
” study has shown that American health care is of poor quality compared with that of other First World nations, and way more expensive.”
That’s why so many of them come here to get help instead of staying within their own systems.
Their systems, an example of their superiority: http://www.naturalnews.com/056214_socialized_medicine_gangrene_amputation.html
Here’s a healthcare option ( as opposed to sickcare ).
I work out at the gym about 4 times a week (and have for most of the last 40 years). I focus on major muscle groups two of those days – particularly the legs and butt. The other two are aerobic with a good bit of huffing and puffing.
I take no meds of any kind- NO MEDS!
I am now 74 years old and probably middle age. True, I do spend quite a bit on various supplements and I see a chiropractor a couple of times a month, for which Medicare will not reimburse.
It’s the Fram Oil Filter thing – pay me now or pay me later.
If you depend on doctors (AMA) for your health, you are screwed. They don’t make money if you are healthy. Hell, they define health as the absence of disease.
I have recovered from ACL tears in both knees. (I can now do deep squats with 150lbs, counting the bar). I have recovered from low thyroid. Both through supplementation and exercises and limited fasting.
I avoid as much of the junk as I can (like soft drinks) and go for the premium stuff like Dewar’s White Label and Knob Creek- every day!! Well, almost every day, along with Haagen-Dazs.
My Dad died of a heart attack at 46 and I guess that’s where it started for me.
So, take responsibility for your own health. Find out what works for you and don’t depend on people who want to cure symptoms rather than address root causes.
Anyone need a soapbox? I’m done with this one.
Purplefrog
Purplefrog: Congratulations. I’m serious. I’m the flip side of that coin. I’m 66, have been smoking cigarettes without quitting since 1962, I drink a bottle of smirnoff once a week and drink a 2 liter bottle of 7UP everyday. My father died in 2015 at the age of 95. My mother still lives in her own home at 92.
Right back atcha – congrats on the genetics. Clearly I don’t have that in my corner. At least Dad died quickly. The Smirnoff is probably what’s helping. 🙂
What a fucking joke: “Why the prices? Several reasons offer themselves. Advanced countries–Mexico is not one–have less corruption than does the US, and a greater concern for the well-being of their people. ”
The average yearly income in Mexico is $13,000. In the US $52,000. There’s a reason for the discrepancy in prices. And probably the Doctor was at least partially trained in the US, used drugs and techniques perfected in the US.
Agreed, the US foots the bills for medical discovery and the rest of the world reaps the benefits.
That has little to do with the price discrepancy and neither does “tort reform”. The cancer in our healthcare “system” is the insurance companies. They should be cut from the loop and prices would collapse by 90%.
I agree that eliminating monopolies would drive down costs (duh) but make no mistake: US companies loot our country for their own benefit on every front.
If we drive down the cost of healthcare in the US you WILL see an upswing in costs globally. They will never be quite as high as they are in the US, because they don’t want illegal generics to steal business, but shit would get more expensive for India/mexico etc.
I surely don’t want the same people who staff the DMV to be in charge of any part of my healthcare.
Once we watch the European democracies go broke from socialism (if they survive Islamic invasion long enough to do so), we will be able to assess the success of socialized medicine. Fred is watching socialized medicine fall from an airplane, currently suspended fifty feet above the ground and saying, “Looks good so far!”
You can’t look at a country’s medical system in isolation from its entire economy. The cost to educate healthcare workers, pay them and pay for the healthcare infrastructure is built into their overall taxation system. Most countries with national health systems have commensurately high (and then some) tax rates – and that’s without spending anything to speak of on defense and despite Americans subsidizing their pharmaceutical R & D by being gouged for drugs in the US. The fact that they get so much for “free” – medical care, education, public transportation isn’t unrelated to the fact that they live in small apartments and pay $9 a gallon for “petrol”. Per capital income is generally lower – other than oil rich Norway. You want the free healthcare of socialism but not the high unemployment and confiscatory tax rates? Sorry. Doesn’t work that way. I don’t see people sneaking into Mexico.
In the socialized countries the health care is essentially rationed, by having to wait for many procedures. Dental care isn’t the best either.
Thereis a HUGE discrepancy between what is charged, and what an insurer pays. The surgeons bill may be 10,000 bucks but the insurer likely will contractually pay 800 bucks and call it “paid in full”. So it’s horseshit to some degree to use the numbers that Fred uses. Most of the monies collected in premiums goes to middlemen, not providers.
I’m in favor of government sponsored (with premiums) catastrophic care insurance, and you pay out of pocket for routine care. Transparent pricing at all Dr. offices, hospitals and clinics, just like auto repair. No coverage for elective procedures. Buy your own insurance for those. Catastrophic premiums and OOP’s tied to income. Mandatory physical and blood work once a year from OOP. Premium surcharges for destructive behavior (obesity, smoking, alcohol and drug abuse). Eliminate Medicare, Medicaid and VA (except for injured vets) and employer based insurance. Basically eliminate insurance companies.
I believe Karl Denninger at Market-Ticker.org has written several articles that describe, in detail what the problem is here. Hint – massive collusion between many different entities that protect each others monopoly status. I have two phrases that would solve 80% of the Healthcare problem over night – 1. 15 USC Chapter 1 – ENFORCE THE DAMN LAW 2. Oklahoma Surgery Center – THE model for real, free market healthcare. Oh, and of course what purplefrog said about TAKING RESPONSIBILITY FOR YOUR OWN DAMN HEALTH. Go ahead and blame the food companies, but I can tell you this; if people learned to read a label, and care enough to not buy the garbage, personal sickness of all sorts would go down overnight as well. I see it as Darwinism, at least until the dopey liberals start sticking a gun to my head and forcing me to pay for it.
The real solution is free competition, free competition of prices, but that don’t hardly work if you are dealing with a cartel. Also, open up medical schools to greater enrollment and marginalize organizations that perpetuate licensing requirements, like the AMA, that restrict competition from others who want to enter their medical field.
Put the choice of medical care and who will perform that care back into the hand of the patient who must take the responsibility for his or her own healthcare. Let those who smoke cigarettes, do drugs, eat foolishly, drink excessively, and take unnecessary risks face the consequences of their debauched lifestyle instead of subsidizing bad behavior. Ya! I know it’s cruel. Did anyone ever tell you that it is a cruel world out there?
Homer, you’re stupid! Ya, I know, like totally. It would never happen as long as a lot of palms are being greased with a lot of moola. So we just have to wait for the system to collapse, which it will, but not before bankrupting the whole productive nation. But…you can beat ’em by staying healthy.
The healthcare business got corrupted in this country by businesses offering medical insurance to their employees. Yup! True! Companies used to give wage increases to their employees as the profits to the company increased. What happened is that companies realized that in lieu of pay increases, they could offer health insurance as a benefit. Health insurance was cheaper than outright pay increases which was a cost to the company, where as insurance was a deduction for the company. Insurance was cheap, until the working masses realized that since I have it, I might as well use it and use it they did. This increased the cost to the insurance companies and increased ‘demand’ for health services. It was a simple ‘supply and demand’ equation. As ‘demand’ increases and supply of medical service remains the same, prices go up, not only for insurance costs, but also the wages for those providing the medical services.
In the ’60’s’ and ’70’s’ companies got sticker shock to their bottom line. Like Soc Sec, where in the beginning 16 people paid in for everyone drawing down on it, today, we have 1 person paying in for every 16 people drawing down on it. It was great in the beginning, but a big, big headache now. Something had to be done and pronto. The companies thought, we can’t be giving all these healthcare moochers all our profits. They’re our profits not theirs.
Well, guess what? Big business decided to do what was in their best interest. That was–shift the healthcare costs on to the taxpayer and in the meanwhile keep the extra profits that they would have to pay for health insurance and not lower prices. A WIN-WIN!
So, dear readers, you’re paying for your healthcare, twice. Once when you accepted lower pay for health insurance and now when you’re paying for Obamacare, Medicaid, Part B, and Supplemental to Part B insurance. I guess, dear reader, you weren’t as smart as you thought. The best Con is when you don’t realized you’ve been Conned!
I was working near the Canadian border and staying in Canada. While I was there I made it a point to ask the locals what they thought of their health care system and how they would compare it to ours. There was not a single positive response given about their”s and most that were given described exactly the reasons in your article that are used for dismissing it as a viable option. They hated their’s.
In fact, they told me that if they needed care for a serious problem they would simply come to the US for it. They added that it was their hope that the US never adopted a system of socialized health care even remotely like their’s.
I also was going to go to work in the oil sands projects they had going. But, after speaking with them regarding the process I needed to go through to work there and the tax situation for me, it became clear that I could not afford to work there because the taxes would eat my reason for going.
60% of my income I believe is what they said. Then I would still have to pay taxes here!
Hey Ed,
I have a foolproof medical plan. Whenever I get sick all I do is call on the power of Jesus’ name and ask for healing, and voila, the power of His blood heals me. Every time.
I’m surprised you haven’t tried it.
Stucky,
I’m glad that works so well for you. But, since I walk in that healing continually I do not have to ask after I get sick. I just don’t get sick.
You do believe me…… Don’t you? 😀
Sorry, worked for a U.K. Bank for over a decade. No one who has a choice relies on the national health service. Long waits, poor service, they might take you quickly if it is life threatening but otherwise……
Talk to a lot of people in those countries, don’t rely on what someone with a bias tells you, including me.
My wife is from Germany,which has one of the natl. healthcare systems that is allegedly so great.The care is good but patients pay way more $ then it is believed.
I’m 35 yrs old and haven’t had a cold in years. I get some seasonal allergies and usually tough it out, or take an OTC. I haven’t had health insurance since I quit my job and started my own business. When I DID have health insurance the cost jumped as soon as ObammyCare was passed and even more after it was implemented. I only used it for myself once after being bit by a brown recluse spider. The emergency room at Jackson Memorial in Miami had me fill out some paperwork. An hour later and a student took my vitals. 3 hrs into my wait- with bums and gang bangers filling the waiting room as well, free place for them to sleep- I said “I’m leaving and I’m not paying you for anything.” Jackson Memorial healthcare immediately sent me a bill for +$300… for a student to take my vitals and I NEVER saw a doctor. I ended up going home and using my benchmade knife to cut out most of bite. Thanks Obamacare!