High cost of cancer care in the U.S. doesn't reduce mortality rates:
While the U.S. spends twice as much on cancer care as the average high-income country, its cancer mortality rates are only slightly better than average, according to a new analysis by researchers at Yale University and Vassar College.
[...] The researchers found that national cancer care spending showed no relationship to population-level cancer mortality rates. "In other words, countries that spend more on cancer care do not necessarily have better cancer outcomes," said Chow.
[...] Smoking is the strongest risk factor for cancer mortality, and smoking rates have historically been lower in the United States, compared to other countries. When the researchers controlled for international variations in smoking rates, U.S. cancer mortality rates became no different than the average high-income country, with nine countries — Australia, Finland, Iceland, Japan, Korea, Luxembourg, Norway, Spain, and Switzerland — having lower smoking-adjusted cancer mortality than the United States.
[...] "The pattern of spending more and getting less is well-documented in the U.S. healthcare system; now we see it in cancer care, too," said co-author Elizabeth Bradley, president of Vassar College and professor of science, technology, and society. "Other countries and systems have much to teach the U.S. if we could be open to change."
Journal Reference:
Ryan D. Chow, Elizabeth H. Bradley, Cary P. Gross. Comparison of Cancer-Related Spending and Mortality Rates in the US vs 21 High-Income Countries, JAMA Health Forum. 2022;3(5):e221229. DOI:10.1001/jamahealthforum.2022.1229
(Score: 5, Insightful) by Booga1 on Sunday May 29 2022, @01:49PM (6 children)
The insurance setup we have in America today is ridiculously bad(but slightly better than it used to be). We pay twice as much as the rest of the world and get half as much for our money. Insurance companies drive up costs, deny legitimate claims, and require people to jump through hoops for basic care. A few years back, people who were afraid of insurance reform talked about "death panels" run by the government as if we didn't already have unaccountable corporate operated ones.
We need real insurance reform. It needs to be simplified to the point we can get rid of all the middle men that don't actually provide health care.
(Score: 0) by Anonymous Coward on Sunday May 29 2022, @04:05PM
Defense, education, healthcare, police, fire fighting and few other things are why countries exist. The point is to have a common basic services, so that everyone can consentrate on doing their jobs and living instead of everyone wasting resources and nerves trying to figure things out for themselves. Common good and so forth. There's already too much to handle in life.
I just can't understand the US mentality that those who have money should be able to buy their way around everything. Instead of trying to make the few get better education, for example, making the education better for everyone would benefit the whole society.
(Score: 3, Informative) by Anonymous Coward on Sunday May 29 2022, @11:42PM
Just look at the billing.
You get one from the facility (hospital). You get one(s) from the doctor(s). You get one from pharmacy. You get one from the lab. And then there are ones from "out-of-network" doctors/labs/god-knows-what.
Even from a hospital with employee doctors, the price for procedures varies wildly - makes haggling at middle eastern souks or indian bazzaar look like a child's play. This in a supposedly "developed country" on healthcare of all things, a basic necessity.
(Score: 3, Offtopic) by pdfernhout on Monday May 30 2022, @12:19AM
"The Healthiest, Anti-Cancer Foods: G-BOMBS"
https://www.drfuhrman.com/blog/62/the-healthiest-anti-cancer-foods-g-bombs [drfuhrman.com]
"G-BOMBS [Greens, Beans, Onions, Mushrooms, Berries, Seeds] is an acronym that you can use to remember the best anti-cancer, health-promoting foods on the planet. These are the foods that you should eat every day, making up a significant proportion of your diet. They are extremely effective at preventing chronic disease, including cancer and promoting health and longevity."
"The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes (Eat for Life)" by Joel Fuhrman
https://www.amazon.com/End-Diabetes-Live-Prevent-Reverse-ebook/dp/B0089LOG7U/ [amazon.com]
"The End of Heart Disease: The Eat to Live Plan to Prevent and Reverse Heart Disease (Eat for Life)" by Joel Fuhrman
https://www.amazon.com/gp/product/0062249363/ [amazon.com]
"Why Our Health Matters: A Vision of Medicine That Can Transform Our Future" by Andrew Weil
https://www.amazon.com/Why-Our-Health-Matters-Transform/dp/B004KAB3U2 [amazon.com]
"Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare" by Peter Goetsche
https://www.amazon.com/Deadly-Medicines-Organised-Crime-Healthcare/dp/1846198844/ [amazon.com]
"Deadly Psychiatry and Organised Denial" by Peter Goetsche
https://www.amazon.com/Deadly-Psychiatry-Organised-Denial-Gotzsche-ebook/dp/B014SO7GHS/ [amazon.com]
"Medical Nemesis: The Expropriation of Health" by Ivan Illich
https://www.amazon.com/Medical-Nemesis-Expropriation-Ivan-Illich/dp/0394712455 [amazon.com]
The proximate cause of so much ill health (both physical and mental) in the Western World:
https://tlc.ku.edu/ [ku.edu]
"We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life. (Stephen Ilardi, PhD)"
Which is why so many US Americans are "Fat, Sick & Nearly Dead" as shown by Joe Cross:
https://www.rebootwithjoe.com/watch-here/ [rebootwithjoe.com]
Spending more money on "sick" care generally does not make people "healthier". There is a difference. Sick care just makes people temporarily less sick. For example, mechanically unclogging an artery in the heart without other lifestyle changes leaves in place a situation where the artery will just clog up again through poor diet, and meanwhile other clogged arteries like in the brain and elsewhere will continue to get worse and cause other issues like mini-strokes until dietary changes are made.
And example of true "health" care via a Blue Zones initiative:
"Blue Zones Results: Albert Lea, MN"
https://www.bluezones.com/blue-zones-results-albert-lea-mn/ [bluezones.com]
"When Blue Zones and Blue Zones Project began working with Albert Lea in 2009 to transform its policies, places, and people, the focus was on helping people move naturally, eat wisely, connect, and have the right outlook—all of which can lead to living longer, better. To make transformation a reality, city leaders and the Blue Zones Project identified key opportunities for impact and sought pledges from businesses and residents. ..."
And some other examples of "Logical Miracles" collected and inspired by Dor Mullen:
https://www.amazon.com/Logical-Miracles-Second-edited-Mullen/dp/1975891430/ [amazon.com]
"Why is it so hard to eat right? What does it take to turn around the habits that keep us sick, fat and depressed? Logical Miracles is a collection of stories by people in The Suppers Programs who found their personal solutions by experimenting with whole food. In an environment of nonjudgment, we cook, taste and feel our way to health, and we forge new friendships based on healthy living."
More health ideas collected by me here:
https://github.com/pdfernhout/High-Performance-Organizations-Reading-List#health-and-wellness [github.com]
The biggest challenge of the 21st century: the irony of technologies of abundance used by scarcity-minded people.
(Score: 1, Touché) by Anonymous Coward on Monday May 30 2022, @03:17AM (2 children)
The rest of the world has solved this problem. Anyone arguing for private healthcare is on the take - hoping for a percentage of your bank balance and so what if you die.
(Score: 0) by Anonymous Coward on Monday May 30 2022, @03:35PM (1 child)
We'll never have it until we stop voting for the dems. The greens have plenty of planks for the identitarians too. You could trade the return of sodomy laws targeting only M/M sex acts for abortion and single-payer healthcare.
(Score: 1, Funny) by Anonymous Coward on Tuesday May 31 2022, @01:18AM
You forgot to take your medicine again, eh.
(Score: 5, Insightful) by Rosco P. Coltrane on Sunday May 29 2022, @02:11PM (11 children)
are totally unlated.
Healthcare providers in the US set the price to line their pockets and that of their pharmaceutical industry buddies. "Commie" European countries with taxpayer-funded healthcare systems set the price to maximize efficiency.
Free market baby! Your life's miseries are a greedy exec's next holiday on Grand Cayman!
(Score: 0) by Anonymous Coward on Sunday May 29 2022, @06:55PM
Still better than literal government death panels! Oh wait, insurance just uses actuarial tables, you don't even get a human to fuck you over.
(Score: 2) by unauthorized on Sunday May 29 2022, @09:39PM (2 children)
Man, I wish, constitutionally enshrining neoliberalism is a requirement for any member state of the EU and historically any remotely left society has faced vicious economic warfare or even literal warfare. The so-called commie countries are at best sucdem neoliberal states which face constant attacks against the mildest social programs. The Tories have been trying to kill the NHS in Britain for decades and even in places like Sweden you're starting to see calls for austerity as if shrinking your own economy is ever a good idea.
(Score: 5, Touché) by Michael on Sunday May 29 2022, @11:19PM (1 child)
Commie isn't short for communist. It's just the way republicans spell centrist (or how they spell moderate-right, depending how zealous they are), hence the quote marks.
(Score: 0) by Anonymous Coward on Tuesday May 31 2022, @10:18PM
You are arguing past yourself. Come up with a plan that will lower the taxes and we can talk. Until then saying "Well they spend less, so lets raise your taxes to spend less" is not going to work, because it is bullshit. I watch government waste money every day, and you want me to give more.
(Score: -1, Troll) by Anonymous Coward on Monday May 30 2022, @01:07AM (4 children)
"Commie" European countries with taxpayer-funded healthcare systems set the price to maximize efficiency.
^^Said parent
Well yes, but efficiency FOR WHOM?
If the govt is the payor, they maximize for THEIR OWN benefit. Keeping costs down means denying timely treatment in many cases (waiting 6 months for an MRI) because the govt doesn't want to "waste" money building those facilities. If you want treatment NOW or the most modern treatment, America is your place.
(Score: 3, Informative) by Anonymous Coward on Monday May 30 2022, @01:45AM
TFA says the data shows they have better health outcomes.
You are spreading FUD.
(Score: 2) by Opportunist on Monday May 30 2022, @10:26AM (2 children)
You can have an MRI without any medical reason and right now in Europe, too, exactly the same way you can have it in the US: Cough up the dough and whatever you want is yours.
(Score: 0) by Anonymous Coward on Monday May 30 2022, @06:57PM (1 child)
Exactly. It is not available in the socialist medical system. You have to escape it and go to the free market system if you want it.
(Score: 0) by Anonymous Coward on Monday May 30 2022, @09:31PM
At that point it isn't really medical care though. Not surprising that a medical system refuses to provide you with things that are not medical care.
(Score: 0) by Anonymous Coward on Monday May 30 2022, @03:29PM
It's not a "free market," which is part of the problem. It's deeply regulated and infested with middle-men (which consumers are basically required to use). The reason there is all the stuff going on behind the scenes is because consumers don't actually pay for their care. Imagine if your "car insurance" paid for normal maintenance and wear-and-tear. What would happen? Premiums would likely gradually rise, as oil filter companies start charging $100 per pop. You never see the cost directly, because you just pay your monthly premium... but you see these weird bills where the oil filter costs $250, but you get the "discount" with your insurance, so your service station only pays $100 for the filter... which really should cost $10, but there's no pressure in a closed market between third parties like that.
Now, what happens if you actually have to pay for oil filters yourself? Ah... suddenly you're putting pressure to bring costs down, as it directly costs you each time you go for the filter change. The oil filter manufacturers can no longer demand $100, just hoping it gets wrapped up in the monthly "premiums" that you don't think about.
It's the same scam cell-phone companies are running continuously these days. $800 phone "for free," but you have a $150/month bill for phone service. Huh?? And consumers just go along with it, because they think they're getting a "discount" and it's easier to charge someone a constant monthly fee rather than get them to suddenly shell out a few hundred dollars for an unexpected expense.
If most healthcare costs were paid out of pocket, people would shop around. I was on a high-deductible plan for several years and DID shop around. The same scan they'd charge $3000 for in the hospital network facility... guess what? I could get that scan done for $600 at an independent place a few miles away from me, and they even gave me a CD of the scan. But to get that savings, I had to make arrangements with my doctor to get a special approval notice that worked differently because it was outside the hospital network. Why should I bother doing that if I just pay a monthly premium and never see a cost difference??
So, one problem is that it's definitely NOT a "free market."
(Not that it should be. Personally... and this is just my own opinion -- I think we should have a single-payer system in the U.S., which would be so much more efficient. But what we have now is the worst of all possible worlds -- a semi-regulated industry where you're forced to pay a bunch of middlemen to do NOTHING useful other than skim their cut off the top... and meanwhile obscuring actual costs so that it leads to behind-the-scenes price-gauging that drives all costs upward.)_
(Score: 2) by DannyB on Tuesday May 31 2022, @09:17PM
Once they have your money, why worry about the mortality rate? That just doesn't make good business cents.
How often should I have my memory checked? I used to know but...
(Score: 2, Interesting) by pe1rxq on Sunday May 29 2022, @02:30PM (1 child)
The problem is using the wrong statistics: If the rich and lucky are the only ones spending money you should not take the average death rate (which includes the poor) as a measure of success.
(Score: 1, Informative) by Anonymous Coward on Monday May 30 2022, @02:14AM
> you should not take the average death rate (which includes the poor) as a measure of success.
... because poor people's lives don't matter.
The poor child who lost her mother to cancer because her mother was working poor-- not poor enough for medicaid or substantial ACA subsidies, but too poor to pay $750-$1250/mo insurance premiums* will undoubtedly disagree with you.
You are correct about one thing though, being poor in the US is a significant factor in the US's poor health outcomes, including higher rates of infant mortality compared to European nations. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/ [nih.gov]
*$1250/mo was what I paid last year for a "silver" plan, and $750/mo is what I currently pay for a "bronze" plan with too high a deductible/co-pays to be useful as anything other than a catastrophic plan (I was hospitalized in 2010 on a similar plan to this bronze plan, and paid $15,000 out of pocket for the event). Proper nationalized health care like practically every other country has, would cost less and cover more and have the same or better outcomes (we know this because of the zillion examples of state heathcare that costs less, covers more, and has better outcomes).
(Score: 2, Interesting) by Runaway1956 on Sunday May 29 2022, @02:35PM (3 children)
I think the moral of the story is, no matter how much money you throw at the problem, you're still mortal. Bill Gates is destined to the same fate as the village idiot - they're both going to die. George Soros will end up in a similar condition as the guy on death row.
Get used to the idea that something is going to get you. If not cancer, then heart disease, and if not that, COVID, or pneumonia, or . . .
If we could just get rid of the parasites, our quality of life would improve tremendously!!
Abortion is the number one killed of children in the United States.
(Score: 2, Interesting) by Anonymous Coward on Sunday May 29 2022, @05:33PM
So all the red states with regressive policies that prevent us making anything better while generating thousands of domestic terrorists that blame liberals for what Replublican politicians have done. Weird how you mention Gates and Soros, playing kkk bingo?
(Score: 4, Touché) by Gaaark on Sunday May 29 2022, @08:17PM
...some rando walking into a school with a fecking AR-1500000(b)(v2.3) and shooting while the cops cower outside....
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 2) by sjames on Sunday May 29 2022, @10:17PM
The parasites can be found mostly in the financial sector and in the C suites. Agreed that ridding ourselves of them could do wonders for healthcare.
(Score: 1, Insightful) by Anonymous Coward on Sunday May 29 2022, @04:24PM (3 children)
5 year survival rate is much higher in America. So cancer is jot cured but people live much longer with cancer in America.
America also subsidizes rnd with high domestic pricing and sells medicine in bulk at low cost to socialized systems like the NHS in the UK.
(Score: 0) by Anonymous Coward on Sunday May 29 2022, @06:28PM
Do you have a source for that statistic?
(Score: 5, Informative) by Anonymous Coward on Sunday May 29 2022, @10:13PM
The US subsidizes R&D through government grants. The single biggest budget item at a US pharmaceutical company is advertising. [apnews.com] Even in bulk, US drugs are much more expensive than generics. The only reason to buy them is because of patent protection. This is also why the US manufacturers sell mixed drugs, so the customer is forced to buy the second non-patented drug instead of a cheaper generic.
(Score: 0) by Anonymous Coward on Monday May 30 2022, @08:59AM
No. Virtually all of that is due to increased early detection. People don't live longer, they are just treated for longer because the cancer is found earlier.
Finding out you have lung cancer at 48 and being dead at 50 is, in my opinion, a better outcome than finding out you have lung cancer at 45 and being dead at 50.
(Score: 5, Insightful) by Barenflimski on Sunday May 29 2022, @06:36PM (8 children)
I've found the entire American system a systematic rip off and general failure.
We pay close to $20k for health insurance yearly.
Mental Health? Total joke. Not enough psychiatrists or psychologists. You can get anti-depressants though! Ugh.
General medicine? Need insurance you pay hundreds of dollars a month for to then pay $50 for a visit for a $3 script that costs you a $10 - $25 deductible.
Broken arm? $4k for your 3 $50 x-rays and your $10 roll of gauze and cast material.
Want to know how many times the local place has told me, "Yea, our doctors can't see you until next week, so just go to the Emergency room or Urgent Care." $500 bucks later, they tell you, "Yea, you need to see your primary care for this."
I've traveled a good bit and visited health systems in many other countries. Antibiotics are antibiotics. X-rays are x-rays. Covid tests are Covid tests. In America though, you pay 10x more for all of that, and usually wait longer.
Maybe it'll all be worth it when I'm laying in the hospital after a massive heart attack and they tell me that because I have insurance, my wife will only be charged the $12k deductible plus $10k for a coffin and burial.
For these prices and the total lack of service for the high prices we pay, you'd think the waiting rooms would be lined in gold and they'd have beverage service while you waited in them.
(Score: 0) by Anonymous Coward on Sunday May 29 2022, @06:52PM
This guy Murrihealths!
(Score: 3, Informative) by Gaaark on Sunday May 29 2022, @08:21PM (4 children)
Come to Canada: our beer is better too!
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 0) by Anonymous Coward on Sunday May 29 2022, @11:02PM (2 children)
Your industrial beer is the same as our industrial beer, but we kick your ass with the independent brewer beers.
(Score: 3, Informative) by Gaaark on Monday May 30 2022, @12:36AM (1 child)
Uhhhh.... we have craft brew too! Americans do NOT have that monopoly.
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: -1, Troll) by Anonymous Coward on Monday May 30 2022, @12:44AM
You canucks do have the monopoly on being passive-aggressive. When the yanks say canucks are "nice," we are being sarcastic - see, we are no good at sarcasm but canucks forced us to.
And your beers suck, just like ours.
(Score: 0) by Anonymous Coward on Monday May 30 2022, @01:03AM
Your beer sucks! [youtube.com]
(Score: 0) by Anonymous Coward on Sunday May 29 2022, @10:16PM
The gold trim and beverage service is in the corporate offices of the medical supply companies. Not just the drug companies, but medical equipment suppliers, too.
(Score: 1, Informative) by Anonymous Coward on Monday May 30 2022, @02:33AM
I was receiving a cocktail of expensive chemo drugs, and a cheap one. In the US, there was a shortage of the cheap one, because no pharmaceutical company wanted to make it because it had such a small profit margin. It was used to potentiate one of the other compounds in the cocktail making that other compound more effective. I only received it twice out of 12 treatments.
Fast forward a year and a half when I went onto a similar cocktail. An expensive patented version of the formerly cheap drug was available, but it was an extra $250 co-pay per treatment.
Cheap - leucovorin - https://www.oncolink.org/cancer-treatment/oncolink-rx/leucovorin-calcium-leucovorin-citrovorum-factor-folinic-acid [oncolink.org]
Patented - levoleukavorin - https://www.rxlist.com/levoleucovorin-drug.htm [rxlist.com]
The portion of the US capitalist financial system that sometimes happens to deliver health care is an unconscionable disaster.
(Score: 1, Interesting) by Anonymous Coward on Sunday May 29 2022, @08:22PM (10 children)
i am trying to find a argument line that says that free universal health care will overall benefit the "rich and lots to lose" people more then a Scagerely(?*) fleecing medical type industry.
i suppose, the argument goes like so: if you put Captn' Fleecing in charge, everybody will get fleeced (even the rich, tho they can afford it). but since only 1% would benefit and the rest would slowly just be considered "not worth it", the driver and case studies would then be limited to a small subset of the human population thus the research driver would be reduced or sink, thus hampering future medical discoveries?
The rich don't just pre-emtively finance medical research 'cause they might or might not get sink from a disease or other.
Captn' Fleecing would put more into his/her pocket then into the R&D lab then ... leading to being more rich but less solutions to buy (also less human resources).
(*) can't remember the correct name, but the guy would have made 1g of aspirin cost more then the same amount in gold.
(Score: 3, Interesting) by Gaaark on Monday May 30 2022, @12:47AM (3 children)
Posted this to SN before:
Governments used to do a lot of funding of 'free for all' medical research and the researchers used to share all their data so no one in the world was having to duplicate anything. Researchers could split into groups to research different things, different drugs.
Anyone with an interest could work on it or just do their own research while keeping tabs on what interested them in what someone else was doing.
Everyone benefited.
Now, corporate medical research is secret and duplicating waste is done by all for the benefit of the corporation: "First to patent".
Research should be done for the benefit of all and shared like it used to be, but won't because of lobby money.
Universal healthcare (and universal medicine (shared)) benefits everyone.
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 2) by Opportunist on Monday May 30 2022, @10:18AM (2 children)
The difference of a socialist and a capitalist healthcare system: Socialist means "patients come first", capitalist means "patents come first".
(Score: 0) by Anonymous Coward on Monday May 30 2022, @10:46PM (1 child)
No. In socialist medicine, the govt decides what medical care you are allowed to have: not the doctors, not you.
Granted, in America, we do not have a really free market system, as the insurance companies and the govt decide what they will pay for and at what rate, so that influences what care you receive, but not to the same extent as in a socialist system where the control is absolute. As others have mentioned, you are usually free to go outside the socialist medical system to a non-govt doctor to get the care you want or need, if you can afford it.
(Score: 0) by Anonymous Coward on Wednesday June 01 2022, @01:51AM
Today I learned that US healthcare is socialist and insurance companies are the fascist rulers of government.
Sadly you can not comprehend so you'll argue against universal healthcare so you can be overcharged and outright denied healthcare. Conservatives are silly.
(Score: 2) by stretch611 on Monday May 30 2022, @02:19AM (5 children)
In general, yes, this is true. Spending money up front and on preventative medical care is always cheaper.
The easiest example is with the poor who can't afford a doctor. When they have a problem they ignore it until it turns for the worse and any preventative care ends up being immediate emergency care that costs more and has a longer impact. It would be a lot cheaper to have paid the doctor to run the tests before it gets out of hand.
You may ask why insurance companies do this? Of course cheaper in the long run is not compelling to the wall st types that want to maximize profits now along with actuaries that say that xx% of people with that problem will be on a different insurer's policy tomorrow.
As for the rich... well, they are in general the wall st types and want to make their money today instead of tomorrow.
Now with 5 covid vaccine shots/boosters altering my DNA :P
(Score: 1) by khallow on Monday May 30 2022, @11:17AM (4 children)
You may ask why insurance companies do this? Of course cheaper in the long run is not compelling to the wall st types that want to maximize profits now along with actuaries that say that xx% of people with that problem will be on a different insurer's policy tomorrow.
People just don't get that when you pay someone to find expensive health care problem, particularly in the US where it's generally in the health care providers interest to find such problems, they will find expensive health care problems. In a world without conflict of interest, there's little point to dealing with problems that won't manifest, much less kill you, before you die of something else.
It's in the US insurance company's rational interests to hold off on most preventive care for that reason - because it generates more costs than it eliminates!
(Score: 0) by Anonymous Coward on Monday May 30 2022, @05:20PM (3 children)
> ... US insurance company's rational interests to hold off on most preventive care for that reason - because it generates more costs than it eliminates!
OK, so how do we turn this around? Seems like there must be a way to create a better incentive for the insurance companies? For example, sort out what kinds of preventative care actually do save money and improve outcomes for the whole health care system, by catching things like cancers before they get too large/invasive.
Bigger picture, I see the problems of the US health care system as a near-total lack of system thinking. And at the root I tend to blame the historical elevation of doctors (MDs) to semi-gods who "cure things"--with the result that many doctors (surgeons in particular) have a very elevated opinion of themselves. And thus are not interested in cooperating with anyone. Instead of coordinating between all the different moving parts, each part (insurance, hospitals, clinics, nurses, aides, administrators, regulators, etc, etc, as well as MDs) seems to only operate in their own interests. And most of these parts each have their own association and/or lobby, making sure that they get at least their piece of the money pie.
Would a reorganization of the system have a chance of improving both cost and outcomes? For example, what if we had multiple large competing health care companies, with each company vertically integrated and providing complete service *including* insurance. If companies competed for patients by offering all types of care, would that set up useful incentives? There would still need to be regulation, to make sure that the natural tendency of capitalists to strive for monopoly (buyouts, unfair competition, etc) was controlled. There needs to be enough of these vertically integrated companies to insure competition in all markets (but this may not be feasible in rural areas?)
(Score: 2, Insightful) by khallow on Monday May 30 2022, @11:08PM (2 children)
A simple fix on the insurer side would be to open the insurance company's decision making. A lot of the problems with insurance companies is not that they make selfish decisions, but that these selfish decisions are hidden from the customers of the business. So the insurer can screw over thousands of people with policy, but an individual customer can't know without some sort of costly court or regulatory discovery process who else is affected - and that process has to be justified first with multiple misdeeds.
Bad decisions rarely affect just one. Class action lawsuits are far from ideal, but they'll open bad insurers to massive liability, if people and their lawyers could figure out what systemic illegal acts were going on.
On the health care provider side, require honest billing. Again, due to the complexity and opacity of this process, you don't know how much you or your insurer owes until the bills stop coming. There's no other industry where I would just ignore the first bill because it's purely imaginary.
And then on the regulatory side, limit the demands on other parties. Insurance for a glaring example, should be about providing catastrophic health care, nothing else, unless the customer really wants it. Today a big part of the cost of insurance is paying for things the customer doesn't want or need, but it's mandated by some law or regulatory agency.
(Score: 0) by Anonymous Coward on Tuesday May 31 2022, @01:00AM (1 child)
> Insurance for a glaring example, should be about providing catastrophic health care,
This one makes sense to me, my Medicare Advantage program (BCBS) offers all sorts of silly wellness benefits that just seem like a way to keep more people employed. And I'm assuming that the people employed by BCBS are actually paid by the Feds, since this program costs me nothing extra.
One question though: How would you define a catastrophic health care event? Is it $1000? For many people in USA a thousand bucks is a lot of money to fork over all at one time. But for the software professionals here on SN, it's almost trivial--a day or two of work.
(Score: 1) by khallow on Tuesday May 31 2022, @03:58AM
How would the insuree define it? For me, I keep a certain amount around so the deductible should be smaller than that. And I need to protect against possible catastrophic depletion of my savings and assets from long term or expensive health care problems so the amount of the insurance needs to protect against that.
(Score: 1, Interesting) by Anonymous Coward on Sunday May 29 2022, @09:37PM (3 children)
U.S. health care costs so much because it is run for profit for the most part. Decisions about your life are based on how much it costs to keep you alive. If they can't squeeze every drop from your bank account then you are not worth it.
(Score: 2, Informative) by Anonymous Coward on Sunday May 29 2022, @10:17PM
It's not even the "for profit" part, it's that there are so many different players, and nearly all of the players feel like they are worth more than they are earning. Read this book (an easy read) as a start to seeing the whole of the healthcare industry,
https://www.google.com/books/edition/Health_Care_USA/AYVSAAAAQBAJ [google.com]
"Health Care USA" is required reading for many people studying to work in the field.
(Score: 4, Informative) by Anonymous Coward on Sunday May 29 2022, @10:24PM (1 child)
Cost is mostly irrelevant. It is about what they can charge.
https://khn.org/news/treating-a-scorpion-sting-100-in-mexico-or-12000-in-u-s/ [khn.org]
https://www.cbsnews.com/news/cure-for-womans-scorpion-sting-costs-83k/ [cbsnews.com]
(Score: 0) by Anonymous Coward on Monday May 30 2022, @05:26PM
> Cost is mostly irrelevant. It is about what they can charge.
Well, there might be a few other things involved! For example, there is no malpractice insurance in Mexico,
https://www.expatsinmexico.com/why-medical-costs-are-lower-in-mexico/ [expatsinmexico.com]
But that is a major cost for any health care related business in USA.
(Score: 3, Insightful) by Opportunist on Monday May 30 2022, @10:15AM
The healthcare system in the US is supposed to line pockets, not to cure people.
(Score: 2) by Thexalon on Monday May 30 2022, @11:00AM
The US has the worst health care system in the world if your goal is to keep as many people alive and healthy as possible. It has the best health care system in the world if your goal is to part patients with as much of their money as you possibly can while being completely indifferent as to whether it helps keep them alive and healthy.
And when it comes to the aftermath of getting treatment, I'd much rather deal with a ridiculously callous government "death panel" than I would an insurance rep whose job it is to find any excuse they can to deny paying my bill.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.