How Overpriced is US Health Insurance? Posted on April 29, 2012 by Yves Smith This chart says it all. The medical-industrial complex and American policymakers should be ashamed. Hat tip Business Insider. 000636 Post navigation ← Links 4/28/12 Matt Stoller: Obama as Neoliberal Ideologue → Subscribe to Post Comments 116 comments Cameron Mulder April 29, 2012 at 3:29 am I have very mixed feelings about this chart in that it gets an important point across but is misleading. Since the policy environments are drastically different between nations it is hard to make an apples to apples type comparison on health insurance costs. Now even when you are able to do that you would see that the USA is by far the most expensive. I am curious when an enterprising foreign health insurance company will start offering some type of health coverage to US residents that will pay for medical tourism for expensive procedures. Carla April 29, 2012 at 9:34 am “I am curious when an enterprising foreign health insurance company will start offering some type of health coverage to US residents that will pay for medical tourism for expensive procedures.” I will start planning my aneurysm now, and advise family members to carefully schedule their car accidents. This could be the answer! james April 29, 2012 at 12:56 pm way to miss the point carla lol chris April 29, 2012 at 8:54 pm reading for comprehension could spare you a lot of embarrassment, carla. Susan the other April 29, 2012 at 2:27 pm I am more curious as to when our medical monopoly will allow foreign clinics and hospitals to practice here. We need some serious insourcing of outsourced services. And over the counter, but licensed, preparations from the old pharmacopoeia, should be instituted yestereday. We have the most pathetic medicine in the history of the world. And it is as expensive as it is pathetic. wunsacon April 29, 2012 at 3:32 pm >> Since the policy environments are drastically different between nations it is hard to make an apples to apples type comparison on health insurance costs. Cameron, how is this not an apples-to-apples comparison on health insurance costs? Sure, the policy environment affects the cost. Isn’t that the point of this comparison? Are you proposing a “better” comparison would strip out the increases due to the policy environment? Then what would we be comparing? To clear up my misunderstanding, please elaborate. Thanks. Stephen Nightingale April 29, 2012 at 5:47 pm Wunsa, I somewhat agree with Cameron. While a straight dollars to dollars comparison is illuminating, it needs to be normalized against average personal income (too much corporate profit involved to use ‘GDP per person’), and also needs to include a few outcome comparisons: average lifespan and child deaths before 1 y.o. would be good for starters. Health outcomes for the bottom 50% would be good to know too. I still don’t think it will make the US look anything remotely good. It certainly won’t be any good advertisement for ‘American Exceptionalism’. Procopius April 29, 2012 at 11:09 pm Well, at the very least they should be expressed in Purchasing Power Parity terms. Are they? Or are they expressed at exchange-rate conversion terms? I’m sorry to say I don’t know how to do the conversion myself. Also, I remember years ago The Economist used to give periodic listings of their “Big Mac Index,” which used the price of a Big Mac in every country to compare their currency values. For example, here in Thailand a Big Mac costs 55 Thai Baht, currently about $1.79 at last weeks exchange rate. What is the price in the U.S. right now? Does The Economist still publish that? By the way, Thailand is a great destination for “medical tourism,” for medical procedures that are non-emergency in nature. We have a couple of hospitals that are virtually luxury hotels, where things like hip replacement surgery cost about a third as much as the U.S. genauer April 29, 2012 at 5:10 am data for Germany are highly misleading. A standard package is 2 x 7.5% (half employer/employee each) on up to 6000 $ / month. With an income of 4000 $ / month you pay 15%*4000 $ *12 month = 7200 $ / year bmeisen April 29, 2012 at 4:03 pm Model used 25 – 35 yr olds. While I agree that the figure for Germany is dubious, from the standpoint of private insurers 25-35 yr olds are cheap, especially if you factor out services that the basic American coverage excludes and that are included in basic German coverage, e.g. dental. For gesetzliche KV, the German “public” health scheme, the solidarity principle mandates relatively uniform pricing across age groups along the lines that you indicate i.e. 15% of gross wages, “split” evenly between employer and employee. Per capita income in Germany is about $38k so the average premium would be $5700 of which an employee would “feel” $2850. For this price our average German gets full medical, basic dental, most prescription, basic optomitry, some of various forms of therapy, some chiro, all of long-term convalescence beyond 42 days, (and I believe all of the legendary kur, which is a doctor mandated pause). I am gesetzlich and have no complaints. John F. Opie April 30, 2012 at 10:54 am Auch ich bin gesetzlich versichert (Barmer-GEK), allerdings freiwillig. The number published for Germany is for the lowest income group, i.e. it is the price charged for those whose incomes mean that they are the least able to pay. You cannot chose to pay this little if you earn more: the prices increase according to your ability to pay, up to a legal maximum which is, as has been stated, around $7200/year that the employee carries. That takes is, of course, to be greater than the US average share. That average of $2850 is more appropriate. Of course, the real problem here is that in virtually all the countries involved, you are comparing apples to oranges to baseballs to copper ingots. Nice try. Oh, and of course when dealing with health care: tort reform! Remove the ability to sue at will when the outcome is not to your liking and insurance premiums for doctors will go down, reducing their costs (which must be recovered via higher fees), unnecessary testing is eliminated (usually done for purely due diligence reasons because the insurance companies insuring the doctors insist on it) and you get the lawyers out of the pricing picture. Manchmal könnte aber die Welt von deutschen Wesen wohl genesen…zumindest funktioniert die ges.KV leidlich gut! :-) Phoenix Rising May 1, 2012 at 12:45 am Here in Colorado we already have tort reform – no help for our medical insurance rates, though. We also have insurance companies based in other states selling policies here – no help from that Republican proposal, either. (Of course, what the people behind these ideas really mean by these two proposals is that we allow insurance companies to operate by the lowest standard offered by any state, and suffer no legal complications for the resultant sub-standard care. That’s not how it’s sold, but it’s what someone wanted when they came up with the ideas.) Peter April 29, 2012 at 5:18 am No premium in the province of Canada that I live in. alex April 29, 2012 at 10:28 am The whole article is so brief and imprecise that I have no idea what they mean by premiums. As you point out in your province (be helpful if you mentioned which one) there is no premium. Similarly in the UK there is no premium for the NHS. If they’re talking about total costs per capita then the ratios are too big. Heck, they don’t even mention whether they’re using exchange rates or PPP to convert to USD. Furthermore, percentage of GDP is a better measure since so much of medical costs are labor costs. The cost of medical care in the US vs. other developed countries is obscene, but this article does little to make the point in a clear and objective way. Sharon April 29, 2012 at 1:44 pm Most Canadians will pay for insurance if they are planning a trip to the US. Perhaps they have based it on that I’m not sure. Jose L Campos April 29, 2012 at 5:29 am Yes we are very expensive. But our hospitals are connected with enormous parking structures that we demand because otherwise we would have to walk some distance. Our hospitals have atriums with tropical plants, two or three different restaurants with a luxurious space within which to eat. Every one of us wants a room for ourselves. There is a cloud of advisers, psychologists, grief counsellors, PR gals. The surgical interventions multiply after the multiplication of diagnostic procedures. The cost of the necessary equipment is immense. Then there is the profit system. My cataract extractions were said to cost $19000 whereas my wife’s seven thousand. My operation was done in a for profit enterprise whose existence was mentioned obliquely to me. I realized what the word for profit meant when I saw the bill. But at that moment I paid nothing. I have been paying for years and will continue until the final medical ictus overwhelms me. Then in order to prolong my sufferings a few days colossal sums will be spent, and by colossal sums I mean the fruitless labor of a medical establishment. CB April 29, 2012 at 8:06 am What hospital palace is that? Nothing like that around here for us 99 percenters. Maybe there are some super lux facilities discretely tucked into spots I’m not aware of. I’m trying to think of a public hospital facility here but nothing is coming to mind, they’re all private. Where is this place? Thorstein April 29, 2012 at 8:46 am Not to worry, CB. A hospital palace will be coming soon to a suburb near you. Dayton, Ohio isn’t exactly the country club of the 1%, but the hospitals here are building les Versailles off every suburban interstate exit ramp. Even the “not-for-profit” hospitals are putting in Les Bon “Pains” One local insurer-hospital consortium even built a football field-cum-sports-medicine-clinic next to the local high school with a sign that read “No Tax Dollars Spent Building This Facility”. No, just our premium dollars. One pays one’s taxes to either one’s local elected officials or to the multinational nobility. Lucy April 29, 2012 at 9:32 am “No Tax Dollars Spent Building This Facility”. No, just our premium dollars. One pays one’s taxes to either one’s local elected officials or to the multinational nobility.” Good point. Mary April 29, 2012 at 10:15 am Dayton here also. This tally misses the cross subsidies of development tax breaks, property tax forgiveness, subsidies to physician training, subsidies to procedure and drug r&d, subsidies to home health care services — in every country. Fact is there is so much government expenditure, nobody know what what the overhead actually is, or consequently , actual costs. However, profit is an interesting marker, if unreliable. Notice that insurance companies never have a bad year. Carla April 29, 2012 at 9:35 am Gosh, I never thought of the parking angle! rps April 29, 2012 at 11:08 am The combined net income of the 50 largest nonprofit hospitals jumped nearly eight-fold to $4.27 billion between 2001 and 2006. According to Greenchange: Nonprofits which account for a majority of U.S. hospitals, are faring even better than their for-profit counterparts: 77% of the 2,033 U.S. nonprofit hospitals are in the black, while just 61% of for-profit hospitals are profitable, according to the AHD data…… Flush with cash, non-profit Northwestern Memorial Hospital in Chicago has rebuilt its entire campus since 1999 at a cost of more than $1 billion. In October, it opened a new women’s hospital that features marble in the lobby, birthing rooms with flat-screen televisions, 1,000 works of art and a roof topped with 10,000 square feet of gardens. In 2006, Northwestern Memorial’s former chief executive officer, Gary Mecklenburg, received a $16.4 million payout. Reporter, Bruce Japsen of the Chicago New Cooperative wrote, “For the year 2007, Northwestern Memorial HealthCare showed charity cases as 1.85 percent of its $1.18 billion in net patient revenue.” Non-profit hospitals are exempt from local, state, and federal taxes, receive subsidies, freebies, and ride on the wave of taxpayer supported services while property taxes rise to cover loss NPO property revenue since they don’t pay property taxes. In fact, they profit from medicare and other state and federal healthcare incentives. Another rigged casino at the taxpayers expense. Klassy! April 29, 2012 at 11:12 am Indeed. MyLessThanPrimeBeef April 29, 2012 at 2:04 pm After paying out $16 million, I would imagine there is no profit left I think it’s morally superior to work at a non profit. Susan the other April 29, 2012 at 2:37 pm This means that instead of taking a dividend in money, you invest and agree to take a dividend in social improvement. Or in this specific case, medical improvement. chitown2020 April 29, 2012 at 5:40 am I don’t want Obamacare. I want a choice. I have a son with a pre-existing condition and I couldn’t even afford Obamacare. The price of healthcare is the problem. The price of healthcare is a disgrace. They are hogs. Pokey April 29, 2012 at 10:17 am That’s confusing. It suggests that existing law pejoratively called Obamacare denies “a choice,” but adds that chitown2020 can’t afford preexisting condition coverage anyway. The only hope, therefore, is national healthcare that eliminates the 30+% of each healthcare $ extracted by insurance parasites. But that does not sound like a choice. Here’s the choice: stop lying about current law and your circumstances, or make more money. chitown2020 April 29, 2012 at 2:42 pm That is a typical troll response you piece of crud. Make more money huh..? That is your answer for $1.2 QUADRILLION DOLLARS IN UNSUSTAINABLE DEBT FRAUD COMMITTED BY THE GLOBALIST CROOKS THAT HAS DESTROYED THE ECONOMY..? They intentionally caused this mess to create their TOTALITARIAN REGIME..THE CROOKS NEED TO WRITE A CHECK TO EACH AND EVERY AMERICAN CITIZEN THAT THEY ROBBED…THEN I WONT HAVE A PROBLEM AFFORDING HEALTHCARE THAT I ALREADY PAID FOR ANYWAY…YOU SOCIALIST…COMMIE SCUMBAG. psychoanalystus April 29, 2012 at 5:11 pm Hey, how about the U.S. first writing a check to every citizen of a country where it: 1. Bombed relentlessly, 2. Sent economic hitmen to plunder, 3. Unleashed locusts (a.k.a. IMF, WorldBank) to enslave, 4. Assassinated democratically-elected leaders, 5. Maintained brutal dictators in power, etc, etc. Here’s a very short list: The entire South America, most of Africa, the entire Eastern Europe, The entire Middle East, Russia, South-East Asia. And now you can add Greece, Ireland, Spain, Portugal, and others to be announced shortly (hint: Italy, France, Austria, the UK). That’s where the West’s former prosperity came from: stealing from others. However, the rest of the world has wised up, which is why the West (including America) is now canibalizing itself. That’s why I suggested emigration to you below. Meanwhile, read some history, will ya… chitown2020 April 29, 2012 at 5:21 pm PSYCHOANYLYSTUS…I know they used THE AMERICAN PEOPLES WEALTH and labor to carry out these crimes. THEREFORE….We The People are THE FIRST LIEN HOLDERS…LEARN YOUR HISTORY YOU GLOBALIST SWINDLING FRAUDSTER! Christophe April 29, 2012 at 7:25 pm Yves, The above overcapitalizing, undereducated poster is adding nothing to the thread. In fact, he is detracting from it. Referring to the commenter who urged him to “make more money” as a socialist commie scumbag betrays considerable confusion about political forms. Hurling “globalist swindling fraudster” at a well-reasoned response to his ravings of entitlement and betrayal seems to misjudge the boundary between truth and lies. Please consider limiting his damage for all our sakes. enouf April 29, 2012 at 5:27 pm porateCommieCapitalistPigs (the reigning CCCP) are the real scumbags as you mention; think of kerMitt RomperRoom Bankster who steals wealth/equity from the working class through Bain Capital techniques; and he and his minions revel in glee for doing so. I guess i just take offense to people generalizing the terms commie, etc.. when in reality all MegaMultinational Corps are; a) Unlawful b) Socialist c) Communist d) Theives e) Fraudulent f) Immoral …. shall i continue? ;-) Love p.s. I’m truly sorry to hear about your Son’s pre-existing condition and hope and pray he gets the care he needs. enouf April 29, 2012 at 5:32 pm awe snap; a) I meant to reply to Chitown2020 b) the capital ‘C’ is missing as first letter in comment c) to continue … Corruption, Greed, Fraud is rewarded in this culture of Systemic Treason. These Global Multinational Terrorists have no loyalty to any nation state, they only care that a ‘Police State’ exists to oppress (even peaceful) dissidents. Love chitown2020 April 29, 2012 at 5:35 pm Enouf…I agree that those are their sneaky weapons of choice they use to rob us. Thank You for your kind words regarding my son and caring about others. Susan the other April 29, 2012 at 2:40 pm They aren’t just hogs eating up the slop. They are intentional hogs sucking all of the money out of the system that would otherwise be used for improvement and effective, cost effective improvement. chitown2020 April 29, 2012 at 2:56 pm I agree. psychoanalystus April 29, 2012 at 5:54 pm Hey Chi, What leanholder nonsense are you talking about? Any claims for reparations that the American people might have had over the policies of the government were canceled out when millions of morons began shouting “USA! USA! USA!” while American bombs were killing innocent women and children across the world (e.g., just today, at least three people have been killed as US drones struck a girls’ school building in northwestern Pakistan). And hey, I am sorry to hear about your son. Like I said, unless you make 150K in America to afford decent health insurance, perhaps you should swallow your oversized American pride and move to a saner place, like Argentina. And don’t forget to brush up on history, will ya. How about you start with a few books by Howard Zinn, Chalmers Johnson, and Morris Berman. And, by all means, why don’t you burn all those Glenn Beck books you’ve been wasting your son’s medication money on. And get a grip on your anger, will ya. You look kinda ridiculous shouting like that. chitown2020 April 29, 2012 at 6:38 pm Psychoanalysus…I am not proud of what America has become. I don’t blame the hard working American people who were too trusting and were swindled. I don’t remember voting for any wars, tax payer funded bailouts, tax loopholes for the biggest corps, the Patriot act, NDAA. the U.S. TAX PAYERS funding Wall Streets derivative scams, the repeal of Glass – Steagal, a repeal of the uptick rule, Obamacare and so on. chitown2020 April 29, 2012 at 7:00 pm Psychoanylysus…I think you express a Globalist view and expect the American people to pay for the crimes of the Globalists. I refuse. I refuse to be back down or leave the land WE THE PEOPLE…FOUNDED, BUILT, FUNDED, FOUGHT AND DIED FOR AND PAID FOR. I demand our stolen wealth be returned…….FULL RESTITUTION…I refuse to be bankrupted under the guise of reparations for the crimes and sins of the Globalist scum. So you go ahead and let them steal and spread your wealth around into their overseas bank accounts under the guise of lies and you can hand them your freedom on a silver platter. chitown2020 April 29, 2012 at 7:20 pm Make the criminals who gave the orders to commit these horrors pay. I despise war and violence towards any living thing. I just saw a commercial on CNN for http://www.theyarebankruptingamerica.org…... psychoanalystus April 29, 2012 at 7:20 pm Chi, The American people did vote for this tyranny. I voted for Obummer 3 years ago. I was taken in by his hope/can bullshit. I should have instead researched who was financing his campaign (try Crown family, biggest warmongers in the country). But still, it would not have made any difference. It is simply game over for the USA as a republic and a democracy. We are, at this point, identical to the Roman Empire in the 4th century. Anybody who still has some sense is making plans to leave America, before it becomes too late. The world will go on, even after America sinks into its own version of the Dark Ages, just like the Roman Empire did when it collapsed. The sun will still shine in Asia, South America, and other places, just that it won’t shine anymore in America. People with pre-existing conditions, such as your son, will still be cared for unconditionally in other parts of the world, just that they won’t be cared for in America. This is reality, my friend. It is high time for contingency plans. Here is a great clip with Gonzalo Lira that might be of interest to you (the segment of interest begins at minute 11:00): http://www.youtube.com/watch?v=ctXKWcO5vg8 chitown2020 April 29, 2012 at 7:27 pm Psychoanalysus…I voted for McCain and he is no better. He helped draft the most fascist parts of the NDAA.. I agree we have to wake up and unify. psychoanalystus April 29, 2012 at 4:54 pm “I have a son with a pre-existing condition and I couldn’t even afford Obamacare.” Maybe you should consider emigration. I’m not kidding. enouf April 29, 2012 at 5:40 pm I’m not sure where this “emigrating” concept from you comes from, but here’s my take; If anyone does not like their Unalienable Rights (and free exercise thereof) , they are more than welcome to emigrate (from the USA) elsewhere Love psychoanalystus April 29, 2012 at 6:34 pm What “Unalienable Rights”? NDAA, HR0347, and whatever creepy “executive order” Obummer may have signed this weekend, have completely done away with any “unalienable rights” the American people once enjoyed. America is officially a fascist state, and the Constitution and the Bill of Rights are null and void at this point. Get used to it—it’s reality. And, many Americans are already emigrating, my friend. Many more are trying to secure a second passport, in order to be able to leave once full-blown fascism takes hold. Expect that once this ponzy economy runs out of ink for the money printing presses. Right now, wise Americans are making contingency plans for the safety of their families. To think that at this point the fascist military dictatorship that is being assembled is avoidable is equivalent to living in a delusional fantasy (a.k.a. “American Dream”). Here are a few articles of interest: http://thinkprogress.org/justice/2012/04/24/469950/more-mexicans-are-now-leaving-the-us-than-entering/?mobile=nc http://www.huffingtonpost.com/2009/09/20/young-americans-going-to-_n_292818.html chitown2020 April 29, 2012 at 6:41 pm The people did not vote for any of that tyranny. The pokiticians are abusing everything. Kiste April 29, 2012 at 6:34 am The German numbers are flat out wrong. I’m assuming that whoever made this chart took the maximum premium of roughly EUR 600, converted to to USD and missed the fact that it’s a monthly premium. Of course, it’s not even that simple, since not everyone pays the maximum. If the German numbers are wrong, other numbers are probably wrong, too. This one’s for the trash can. Funny that “Deutsche Bank” is the source… bmeisen April 29, 2012 at 4:20 pm DB Global Markets research team!?! I guess it depends on how they calculated the basic US plan and then how they modified plans available in other countries. Maybe from the private insurer standpoint US basic level services provided to the average 25-35 yr old in Germany may cost less than $800. gregg April 29, 2012 at 7:55 am In our experience, the numbers for the US and Canada are correct. We had 2 kids attend university in Canada, one in Ontario and 1 in BC. The University Health Insurance Plan (UHIP) in Ontario was approximately $700 and coverage mirrors the provincial Ontario Health Insurance Plan for residents. In BC the rates were even cheaper. Our third kid graduated in 2007, pre-Obamacare and she would have required an individual BC/BS policy that was $5000 back then! She got a job before her very expensive university insurance expired. We are self-employed and have a high deductible plan — it costs over $8000/year with an $11,000 deductible. They pay most times, but it is not uncommon to have claims hung up for months on end, even when things were pre-approved, wasting hours of our time in phone menu hell and on hold. Obviously middle income people simply cannot afford health insurance if they are not covered at work. Obamacare, with its mandate, is simply a tool to keep the private insurance industry afloat. It would have collapsed in the absence of Obamacare. We are hopeful the SCOTUS throws the mandate out and the system does eventually collapse. Apparently that will be the only way single-payer can come about. enouf April 29, 2012 at 5:53 pm You have a better chance of having the BigBanks broken up into their constituent parts .. lmao In tandem, BigAgri + BigPharma + BigBanks (et al) == Facism and plutocracy with totalitarianism tendencies ;-) (that’s just the short list) We (as sovereigns) really need to reclaim our endowed unalienable rights and disband the boogeyman; For-Profit entities will never do it themselves: we allow for treatment (after the fact) as opposed to promoting prevention, we allow GMOs to be unlabeled as such, we allow the Police State to disband organic growers.. see farmwars.info, nongmoproject.org, foodworldorder.blogspot.com, naturalnews.com Love Lou P April 29, 2012 at 8:07 am I’ve lived in Germany since 1996 – the absolute minimum German premium (e.g. for welfare recipients) is at the very minimum ca. 120 Euros/month = ca. $160/mth = $1920/year. Still noticeably cheaper than the US, but also much higher than the published figure. However, here in Germany, as far as I know there is no “minimum” health care coverage – all coverage is quite complete (incl. all doctor’s visits, tests, all meds provided for a small fee (usually 5 Euros), etc.), so you really can’t compare it to US (or other foreign) coverage which, at least according to the chart, is only “bare minimum”. Personally, I’m curious what is provided by Chinese or Indian health insurance – if it’s comparable to/better than/worse than US bare minimum coverage. I’m sure that health care costs in the US are ridiculously high, and much needs to be done to change the system. Sadly, the chart lacks truly comparable figures/information, so it isn’t really useful towards advancing a serious discussion. Ep3 April 29, 2012 at 8:17 am Kudos yves in this chart! jake chase April 29, 2012 at 8:27 am There are so many aspects to the health care problem, one of which is running to doctors at every opportunity and swallowing their prescriptions hook, line and sinker. As a nation we have been brainwashed to ignore an axiomatic medical principle: the body heals itself. I have watched quite a few of my own “medical conditions” disappear on their own during the past fifteen years, including alternating dvt in both legs, for which a variety of doctors prescribed elevation of the limb, coumaden and daily blood monitoring, all of which I learned to ignore after four months of no progress and increasing sedentary disability. Only when I ignored the condition and returned to activity did I get better. I have been ignoring medicine ever since and have never felt better. Of course, anecdotal evidence proves nothing, nor does the fact that the two smartest doctors I have ever known agree with me that ignoring medical advice can be the best treatment as often as not. For some reason we cannot comprehend the extent to which organized medicine is an extractive industry on the lines of finance, real estate and insurance. Naturally, the Fear Factor is uppermost. At age sixty-nine I understand that something will ultimately kill me. I am determined that it will not be medicine. Joel3000 April 29, 2012 at 10:01 am Indeed. Doctors are rarely much more than naive drug pushers nowadays. Clive April 29, 2012 at 8:32 am Hi Yves Yes, sorry to agree with the naysayers above but this table should be interpreted with extreme caution. In the UK, the private medical costs NEVER include Accident and Emergency room cover. This is picked up by the National Health Service (NHS). The NHS is lauded as “free at the point of use” which of course it is. Unfortunately the Tax and National Insurance (mandatory) bill is huge. If you strip out the element of NHS payment from your tax payments and add it to an — optional — private medical insurance premium the total is almost as eye-wateringly bad as the US. Of course, if you’re happy to play the NHS lottery with your health, you can avoid having to hand over any money to the rent seekers who doll themselves up as the caring sharing private operators. Anyhow, I’m ranting on my pet peeve here, the point is that the table isn’t a direct read across from one country to another. Three cheers for highlighting this important issue (but a small hiss for the skewed data). alex April 29, 2012 at 10:40 am Clive: If you strip out the element of NHS payment from your tax payments and add it to an — optional — private medical insurance premium the total is almost as eye-wateringly bad as the US. Not even close. In the UK the total healthcare bill is around 9%/GDP and around 18%/GDP in the US. That’s 2:1. If you want to convert both bills to USD (or GBP) then the ration is even higher, as the US has a higher GDP/capita, whether measured by exchange rate or PPP. You may complain about the high costs of your healthcare, but it’s nothing compared to the US. Clive April 29, 2012 at 12:33 pm Hi alex You might be in danger of falling into the bogus accounting trap which — in terms of NHS finances approaches Greece levels of brushing stuff under the carpet. The hidden and unfunded liabilities are considerable and don’t get included in the oft-quoted NHS annual budget. For FY 2011/12 it is around £106 billion which is really just revenue expenditure. This as you say is c. 9 to 10% GDP BUT: * The Private Finanance Initiative shell game (where most of the capital budget is hidden) is currently £45 billion and isn’t consolidated in the NHS’s “balance sheet” at all * The unfunded NHS staff pension liability is £61 billion. Don’t even get me started on the costs of the funded part, which is simply merged in with the rest of the public sector pensions costs (and no, it doesn’t appear in the £106 billion budget). * The estate (property) costs don’t even come close to being presented on a commercial basis; the depreciation policy is a joke * No allowance is made for third sector contributions to NHS shortfalls. I do not know the exact figure, I doubt anyone does but if my involvement in trying to patch up a (very small) part of the system where the NHS lets down its patients is anything to go by and is replicated on a broader basis this is a significant “hidden” cost. A vast amount of goodwill keeps things sort-of stable. Goodness knows what the result would be if consultants, patient groups and volunteers said we’re not playing any more. Please don’t get me wrong — the NHS has the potential to be far and away the best system of providing healthcare and the model it represents is clearly a winner. But accounting gimmicks mask a serious underfunding. That was why I pointed out that the figures in Yves’ table were a bit bogus. And again, you’re absolutely right in pointing out that the inefficiencies which “market mechanisms” bring into the mix are at best wasted money and at worst cover for outright fraud. But that simply indicates that a magical-thinking mindset about the NHS type of system being perfect and not prone to political and ecconomic bad influence is a little naieve. In and of itself, it needs additional safeguarding — which no-one has quite figured out how to implement from what I can tell. Regards Clive Citii Owl April 29, 2012 at 8:58 am We had lived in Taiwan for the last 10 year, Taiwan has a “National Health Plan” which we individually paid around 35USD per month per person( This premium is considered medium high in the approx. range of 20-45USD; and that includes everyone from no income housewife/elderly/child to high income millionaire as it is calculated based on you or the income earner’s income level). Most major surgeries are included with some expenses but not exobitant but still a lot of people with low income and with long-term illness have hard time to pay …because it is still too much a burden.. The point is that the government needs to figure out the best affordable medical and health system to take care of all residents. :) chris April 29, 2012 at 9:52 am I was on a visit to TW and came down with hives / stomach problems. I was dreading going to the doctor because of the cost, but doctor visit including getting my prescription filled was $25 US. At that point I realized how badly we were getting screwed. A foreigner in America would have been charged in the thousands for the same services. Dan April 29, 2012 at 8:59 am I wonder where they get that data. My annual cobra premium is on the order of $24K ($2082/mo). We are stuck on cobra being between jobs as my wife was denied even though never any issues. Best case it would have been $7200/yr without pregnancy coverage – which didn’t want anyway. Phoenix Rising May 1, 2012 at 12:56 am It’s for “most basic” insurance, whatever that is – and it’s probably for a group basic plan rate, as most people who are insured in this country are covered by a group plan. You’re paying for what is likely better than “most basic”, and at the COBRA-inflated rate. Be lucky you’re not paying as a self-employed person, assuming you could even get coverage that way. LucyLulu April 29, 2012 at 9:18 am Over-treatment in the U.S. — Annual healthcare costs have now exceeded $8000 per capita in the U.S., much of it for unnecessary or even harmful care, and it isn’t defensive medicine driving it all, or even most of it. In the four years following the introduction of a $1.5 million robot to assist in prostate surgery the number of surgeries increased by 50%, despite a decrease in the incidence of cancer. Somebody’s gotta pay for those robots. From the Chicago Tribune back in February: He cites estimates that about $800 billion – or nearly one-third of all healthcare spending – is wasted in unnecessary diagnostic tests, procedures and extra days in the hospital. Treatment guidelines will help curb overuse, but Gruber and others would prefer the government set them. “I don’t trust professional societies to do it because that’s how they make money – by doing tests and procedures,” said MIT healthcare economist Dr. Jonathan Gruber. …..snip The Centers for Disease Control and Prevention recommends three tests to find polyps or diagnose colorectal cancer: a stool test, once a year; a flexible sigmoidoscopy once every five years; or a colonoscopy every 10 years. Each test can be performed alone or in combination. The American Cancer Society’s Brawley said the $10 stool test has been shown to save lives, but in the United States, the $3,000 colonoscopy is mostly commonly used. “Everyone is getting the expensive test, even though the cheaper test is better. But the cheaper test involves stool and no one can make money off of it,” Brawley said. http://www.chicagotribune.com/health/sns-rt-us-overtreatmenttre81f0uf-20120216,0,499074.story Literary Critic April 29, 2012 at 11:35 am To quote the Simpson’s Space Aliens: “We Have Learned All We Can From Anal Probing” enouf April 29, 2012 at 6:09 pm But the cheaper test involves stool and no one can make money off of it,” Brawley said. Now take that statement and apply it to all the Toxic Waste the Banksters (and their minions) have pooped all over the world, ..then tell us how false that statement is ;-) Love Sharon April 29, 2012 at 10:41 pm You said it best. In 2002 I found out I had a BRCA mutation. Then a breakthrough in diagnostics called proteomics. The first test was Ovacheck and I immediately signed up for the study. This test is non-invasive and only requires a drop of blood. I was excited, no more expensive scans. Ten years later you can get the test in Europe and Japan but not in the US. Want to know why? The FDA decided to regulate it as a medical device. I think they were protecting the revenues of pharma. Here’s a link to the Congressional testimony. http://www.correlogic.com/approach/index.php http://www.correlogic.com/newsandevents/congressional.php By the way they have a blood test for colon cancer that will also be delayed for a decade or two while the medical industrial complex can make money from the colonoscopy. chitown2020 April 30, 2012 at 12:02 am My friend almost died at age 50 from a colonoscopy when the physician tore his colon. My aunt had her colon torn from a colonoscopy and was too old to recover so the hospital euthanized her in the hospital hospice floor. The nurses were bitches up there and were obviously covering stuff up for the doctors negligence. Did you know if the doctor “thinks” you will die in 6 mos the doctor can send hospice in to kill you. If you have a Dr who is a family member you can do in your old pain in the arse relatives legally with hospice. I was a witness to the horror. Didn’t they jail Kevorkian..? He was a saint compared to what these dirty bees do. They drug you…and then starve you to death. I despise these jerks. Klassy! April 30, 2012 at 11:26 am Euthanize? What are you talking about? I’m sorry, but you seem very misinformed about hospice. Also, the 6 month diagnosis is the criteria to receive hospice services. It is often extended or sometimes people do so much better under hospice care they are no longer eligible for the services. Nobody is “euthanized”. There are even people that still remain a full code under hospice care! Klassy! April 30, 2012 at 11:31 am By the way– the real problem here may be that your aunt underwent a colonoscopy and she was “too old to recover”. If she is “too old to recover” should she have been getting a colonoscopy? There is always a risk, and what would they have done if she was found to have cancer– do you think the surgery would have been a good choice for her? Or suppose she just had some polyps removed. What exactly would be the point? Would these polyps really kill her or would she just die from them. Klassy! April 30, 2012 at 11:32 am sorry, meant “with them”. chitown2020 April 30, 2012 at 11:47 pm Klassy….I witnessed first hand what hospice does. I would rather take a cyanide pill. Yes my aunt was to old to tolerate a colonoscopy. The doctor should have taken a less invasive course of action. chitown2020 May 1, 2012 at 12:00 am Everyone should Google search what hospice does. The people who euthanized my Grandparents came out of Saint Johns hospital. They drugged my Grandpa with a strong psychotic med. I dumped the cocktail down the drain. The nurse was livid with me. My son witnessed this. My niece is a RN and said what they were doing was wrong. After they drugged him into a coma they administered more drugs until he died. My Grandfather begged for his life. He lost. There was nothing I could do because of his depression over the loss of his wife of 70 years he was depressed and my relatives said he was nuts so they had power of attorney. It was like an episode of Tales From The Crypt. They have to live with themselves now and I don’t think they are doing so well. My aunt now says the house is haunted. I wont go there any more. The Dr. Who ordered in hospice is now dealing with his mothers Alzheimer’s disease. darms April 30, 2012 at 11:33 pm I have gotten colonoscopies due to several attacks of diverticulitis and one attack of diverticulosus. I agree that less expensive tests are good for cancer screenings but don’t think they’re all that good for conditions like mine. Charles Wheeler April 29, 2012 at 9:21 am In the UK healthcare is averaging around 9% GDP c/w France 11.5% & US approaching 18%. Because the NHS has provided universal, comprehensive care irrespective of income it has also had the effect of dampening demand for private healthcare – lowering the cost of private insurance. Historically, the NHS was taking around 7% GDP before the introduction of the ‘internal market’ 6% of which went in admin. – now around 12%. The current govt is aiming to raise private sector provision to 49%, introducing co-payment and forcing people into private sector by starving the NHS of funds on the grounds of ‘austerity’. It’s no coincidence that the health secretary’s private office received ‘donations’ from private health companies, while many Tory MPs have associations in the private health sector. So it seems that the UK has decided to ditch one of the most efficient methods of providing healthcare in favour of one of the least. Otto April 29, 2012 at 9:28 am It is pretty amazing that this post generates a long series of comments without anyone actually putting their finger on the factors that are involved in driving the costs of the American medical treatment system sky high. The main problem is that there are several subsets in the medical treatment system that vigorously work to extract maximum profit at every twist and turn, from pharmaceuticals to medical equipment makers, from employer consultants to insurance companies, all the way down to specialists who perform procedures with questionable outcomes. In terms of responsibilities and overall planning, our system is fossilized as each professional essentially operates independently with minimal communication and coordination with others. Comprehensive systems, like Kaiser Permanente, for instance, are often stymied by a legal system that discourages total comprehensive health care. Our national government is gridlocked as part of the government is bought and paid for by many of the groups that extract profits from the medical care arena. As part of the governmental gridlock we have a public amazingly ill informed, and so we get commenters who “have a pre-existing condition and hate ObamaCare and want a choice” and are totally oblivious to the fact that the Obama initiative was in fact the only legislation that would give him or her a choice, and that without the Obama initiative there would be no choice because nothing would be available for someone with a pre-existing condition. And we have other commenters who happily suggest that the best medical care is to let the body heal itself. When that commenter goes into a diabetic coma, I will recommend that we stand back and just let them heal themselves. But to provide a more serious response, there are many physicians and surgeons out there who are conservative in their treatment choices and recommend physical therapy rather than surgery; or recommend waiting rather than intervening. The real problem is that these recommendations result in less income for the physician, a terrible problem that we have tried to address with capitation and HMOs. The resultant waves of howls of protest and screams of death panels have forced a retrenchment from these initiatives, in part because they limit the profit that can be extracted from the medical care arena by the industry subgroups. And so the feeding frenzy continues. Lucy April 29, 2012 at 9:56 am “…we get commenters who “have a pre-existing condition and hate ObamaCare and want a choice” and are totally oblivious to the fact that the Obama initiative was in fact the only legislation that would give him or her a choice…” In my experience it is the employer that chooses what health insurance I may have, and the insurance company that chooses what doctors I may see. Sharon April 29, 2012 at 9:57 pm Lucy, we have demonized the insurance companies and for the most part they probably deserved it. But I wish to the stars that I had not jumped through the hoops my insurance company made me jump through to get MRIs ten years ago with gadolinium based contrasting agents. I believe my insurance company knew how toxic the GBCAs were and couldn’t say anything. I’ll bet they know a heck of a lot more than we give them credit for but pharma has us so brainwashed that we love to hate the insurance companies and we love to take their toxic treatments, scans and drugs. Going forward and in a highly regulated environment I hope that we can look to them to keep us safe by keeping an eye on pharma, an internal control if you will. And why will they do this? Because the healthier their premium payers are the longer they will be in business. I think Obama was playing chess, he may have known that this was the only way to control pharma and stop the poisoning of American citizens. chitown2020 April 29, 2012 at 11:09 pm Sorry Lucy…pre-existing conditions are still unaffordable for the majority of Americans on top of the outrageous premiums for the rest of the family. A radio show host told me to look into Medicaid..! What an answer…! I don’t want a hand out… I want affordable healthcare.. an extra $1500.00 a month or more for a pre-existing condition is not the solution. The only reason we have this problem is the Well Fargo pulled our small business credit line for NO REASON… After 25 years of never being late on a bill the put us out of business… and into fraudclosure. We have had a huge loss of income trying to rebuild our business and lost our healthcare coverage. That is why we have a pre-existing condition problem… But beware…if you lose your healthcare insurance…THEY WILL MANUFACTURE A PRE EXISTING CONDITION….They will call your doctor and give them the third degree and demand to see your records…too many sore throats or a pulled ground muscle……pre-existing condition.. chitown2020 April 29, 2012 at 11:13 pm I meant pulled groin muscle…Not just that but they will not insure individual family members. Don’t think this is not manufactured..They want us to beg for Obamacare..Screw them. chitown2020 April 29, 2012 at 11:17 pm I just want to add that my family doctor told me the insurance co, BLUE CROSS/BLUE SHIELD, scared him….! Blazer April 29, 2012 at 2:43 pm Obamacare is the worst capitulation prior to the AG settlement. An assembledge of insurance companies and the Heritage Foundation. The best we can get argument is tiresome – I think the chart shows this very clearly. Other countries are vastly superior. But with servants like Max Baucus who arrested Doctors that dared to mention single payer, and a media that celebrated idiocy, their can be no mention – it’s taboo ya see. Alas, have no fear – Their could be a consensus of “protect profits” and “it’s the best we can do” from the USSC, which will guarantee Ofraudcare. Observer April 29, 2012 at 4:24 pm From within the healthcare industry, my perspective is that profit motive has ruined healthcare in the US. Publicly traded corporations now own multiple hospitals, nursing home facilities, home health care agencies and staffing agencies. Because it’s all they know how to do, corporate executives try to apply models developed for widget manufacturing to the service of delivering healthcare. In one example that will remain unnamed, stock is $6 per share and corporate executives can cash in $15 options while promising shareholders more profit every quarter. The money has to come from somewhere, so staffing and supplies get cut to make assets look temporarily profitable for a sale. The cycle starts over again under the corporation that buys the asset. The result is continually increasing cost and continually decreasing quality. Economic interests also dictate to whom the service is provided. Due to demographics and Medicare, more and more users of healthcare services are elderly. They get expensive procedures and require lots of testing. Physicians, following the money, choose specializations instead of good old general family care. This results in a shortage of family practices, making longer waiting times for an appointment and increasing the cost for that visit. Meanwhile, healthcare corporations employ more and more staff workers on an “as needed” basis (called PRN) to avoid paying benefits to their workforce. Thus the people providing the actual care may have no healthcare coverage themselves. Need I go on? The profit-motivated American system is hopelessly intertwined and hopelessly broken. ECON April 29, 2012 at 5:52 pm Well said, Otto. Kudos to you. I note J. Wennberg book “Tracking Medicine: A Researcher’s Quest To Understand Health Care”. It reinforces the view that sustainable system will require not only so-called “free market system” of insurance and real reform but fundamental changes in way that medicine and health system is organized, delivered and paid for. Given the ownership of government and courts by corporations and Wall St, I bet against reform success in health care. Sharon April 29, 2012 at 9:44 pm Otto, Your post echoes my thoughts on healthcare. I would like to add that the medical industrial complex poisons with impunity and even when they are fined it is far less than the billions they have already made in profits. The misery they inflict on families cannot be overstated. And when their products, treatments, scans or drugs fail which is usually, only those closest to death can sue. Even then the Daubert standard applies which for all intents and purposes means if you cannot prove that the product caused your illness you are out of luck and cannot sue. And then you must get a doctor to diagnose that the product caused your injury – good luck with that, they are so in bed with pharmaceutical companies that if they want to work again they will let the patient suffer or die before they will help them. My point is this, who pays for the faulty products? It is rarely the manufacturer. It is either the government, the premium payer, insurance companies or the largest self-insured employers. And I can guarantee you they have a clue what is causing all these diseases, from autism to fibromyalgia but they are unable to say anything and so the poisoning of the patient population continues unabated. With the implementation of the Affordable Care Act (ACA) the patient population may get some relief for many different reasons. For example, if premiums continue to rise the payers of the premiums are going to start questioning why the premiums are so high. And they are going to find out the reason is because the pharmaceutical companies and medical device and equipment manufacturers are poisoning the patient population and you healthy Joe have to pay for this. Another hopeful result of the ACA is that the insurance companies are incentivized to keep us healthy and so are the largest employers that self-insure because their profits depend on keeping healthcare costs manageable. Twenty of the largest employers have formed a consortium and you can bet they know the number one reason we are sick – that’s right pharma poisoning. And I’m not quite sure but I believe insurance companies are going to be able to deny treatment if efficacy of that treatment has not been proved. That’s hard to prove when your product kills or maims people that have it. Managing Director, Capitalist Collections, Ltd. April 30, 2012 at 7:34 am Insurers have no more incentive to deny coverage now than they did before. All Obamacare does is foist an unaffordable tax on the healthy to socialize care for the unhealthy. They will f*** you back in a heartbeat. Wise up. Phoenix Rising May 1, 2012 at 1:03 am “All Obamacare does is foist an unaffordable tax on the healthy to socialize care for the unhealthy.” Welcome to the concept of insurance. darms April 30, 2012 at 11:36 pm Yeah, I know of at least two families who were finally able to get health insurance under Obamacare because of a family member’s pre-exisiting condition no insurer would touch. Glen April 29, 2012 at 10:01 am Good to know the USA still leads the world at something even if it’s getting financially fucked by our “healthcare” system. Go Team USA! Eureka Springs April 29, 2012 at 10:23 am All facts suggest the US is double to near triple the costs of rest of the developed world for the worst health stats from cradle to grave. What always amazes me is how many people make excuses for this. Even the most ardent avocates – health care should be a human right with single payer… are just trying get us to compete with the last place position in terms of care/costs. We are sooo far down the rabbit hole. For dawg sakes, can’t we just insist health care be established as a human right first and foremost? It’s the only humane, civilized thing to do. Stop making excuses. Donebenson April 29, 2012 at 11:24 am I don’t know about the accuracy of other country’s figures, but the $200 a year amount for South Africa is very misleading. As a permanent resident, I have an ‘executive’ policy for which I pay in excess of $600 a month, and my wife has a different policy for which she pays well over $300 per month. So, our medical insurance costs amount to about $1000 per month for just 2 people. For the great majority of the population [80-85%] health insurance is free, but the quality of the care is generally quite poor [long waiting lines, and frequent lack of drugs and qualified medical personnel]. So, perhaps the ‘average’ amount paid for all people living in South Africa may approach only a few hundred dollars, but it is a meaningless figure, as no one living in the U.S. would put up with the quality of care under the ‘free’ care system. Eureka Springs April 29, 2012 at 12:05 pm 50 million Americans… would love to know the meaning of care. Even more would love to know what care means without bankrupting them. In the US tens of millions fear “care” more then we fear infection, growing tumors, effects of diabetes, pain, rotting teeth, legal blindness and so on. All of this is worse than debt. briansays April 29, 2012 at 12:07 pm have read that 13-20 percent overhead for the private cabal is expected and tolerated that much of every premium dollar goes to noncare whereas medicare runs at 6 percent overhead this is why we were sold out on the public option the house bill had it it was striped out due specically to senators who would not fight for it and obama who went along as usual none republican blanche lincoln max baucus joe lieberman (the senator from aetena and cigna) ben nelson (former insurance commissioner of nebraska and insurance executive) otherwise the votes were there and your mandate would have included a public option to control costs cali is flirting with a ballot proposition to require regulatory approval for rate increases just like we have had for auto insurance for years medical tourism is a growing option if you read the travel sites it looks like thailand is developing a first world medical care system and has achieved it for many services meanwhile i just received a 13 percent increase in my individual policy no medical problems just me retired early high deductible they are now trying to increase the percentage of cost you can agree pay for after the deductible to create the illusion of choice a racket sanctioned and approved by a bought government Gil Gamesh April 29, 2012 at 12:22 pm Wow. We’re number 1. Universal health care, a basic human right, in a single payer system,imagine that. At this juncture, as remote a prospect as ever. river April 29, 2012 at 12:55 pm It seems like the medical industrial complex has the following problems: 1) High cost and complicated payment system through a private insurance system. If you are uninsured, the hospitals and doctors have a higher fee schedule for you, just to rub it in. 2) For profit pharmaceutical companies that perform all kinds of tricks to make the most profit out of their medical treatments (television advertising, slight modifications to keep their patents intact, keep branding on the tips of the tongue of physicians). As best as I can figure, the high prices of drugs in the US subsidizes the development of drugs for all of the industrialized nations. 3) Country club style medical facilities. Note that a parking garage isn’t exactly an expensive structure to create, and with complaints that my dad (with bad feet) has about our local country club hospital being so big that you have to walk 1/4 mile from a parking lot to get in to visit his brothers and sisters, wouldn’t be that bad of an expense. But the building itself has all kinds of needless expenses. This is just a symptom of not having any pricing pressure. 4) Extraction by the medical practitioners. Basically, the doctor’s and nurses are overpaid. Again, another sympom of not having any pricing pressure. We have too many specialists. Doctors have become business men. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande 5) End of life care is messed up and too expensive. Observer April 29, 2012 at 5:04 pm Doctors, yes. But I can assure you that, at $20 an hour, nurses are not overpaid. At the same time that they provide actual care, they see their paychecks deducted every month for their patient’s Medicare and Medicaid insurance, yet many nurses have no health insurance coverage themselves, or pay an ever increasing share of the coverage their employers are offering. Ironically, folks who work in healthcare have the worst coverage of all. Lyle April 29, 2012 at 11:12 pm Note that one of the perceived upgrades all private rooms actually makes sense from an infection spreading point of view. If you share a room, infections can spread, also staff are less likley to wash hands then if in distinct rooms. Also privacy rules require it. kris April 29, 2012 at 1:39 pm This is quite misleading and I don’t understand why doesn’t anybody understand that Canada and Europe have limits on medical care spending. In Canada is 11% of GDP, not a cent more.Anything has to be stuffed within the 11%, otherwise cuts or lower quality service, or …..go to USA and pay for additional services. In USA, there’s no GDP % limit, hence people choose or are forced to pay more, but they get more since there is not limit. No system is better or worse, it’s what people choose. Medical care is not like a mechanism or a car that can be fixed. It is simply not fixable. If death were fixable, then medical care would be fixable. El Guapo April 29, 2012 at 2:05 pm This post is compete fucking gibberish. What are you talking about? kris April 29, 2012 at 2:21 pm Do you have an argument, because what you said it’s quite easy and makes for no debate. Blazer April 29, 2012 at 2:33 pm You have no point, other then your non-sensical scratch. kris April 29, 2012 at 2:38 pm Ok. No debate = boredom. PQS April 29, 2012 at 1:54 pm Lots of good points here, and yes, I agree that the chart is misleading. I haven’t paid $5K a year for years. More like $8K or more for ever-higher deductibles. (Such a contemptible word.) It seems to me that the No. 1 problem with private health insurance is the very fact that it IS insurance – it isn’t health care, and it is just middleman, rentier expense. The difference between a non-profit health insurance premium and a for-profit can be twice as much – I’ve seen the numbers myself: $1800/mo for premiums for two adults versus $900 for basically the same coverage. One is a non-profit co-op with their own doctors and hospitals. Fancy advertising, executive salaries, and that huge phone bank of people whose entire mission is to AVOID PAYMENT is expensive on the for-profit side! The No. 2 problem is that there is way too much incentive for over-treatment. I’ve seen some pretty outrageous crap in the Medicare system, courtesy of elderly relatives: 80 year olds still getting mammograms, hospital stays for endless testing for no real reason, etc. All because the providers know they’ll get compensated because it’s Medicare. There is zero incentive to manage costs. I believe Obamacare had some tentative steps in that direction, but this is a cultural change that will have to occure – it isn’t going to happen quickly. Maybe a decade or more. And I know when you ask a provider how much something costs, they just look at you strangely. It doesn’t even come into their minds, and they wonder why it is in YOUR mind. Someone mentioned medical tourism – both Canada and now Mexico have UHC. Maybe they ought to consider taking Americans for cash on the barrelhead. It seems to be the only thing we have to offer anymore. MyLessThanPrimeBeef April 29, 2012 at 2:13 pm Sometimes a product could be not overpriced but I could afford it. For example, they could double the price if a burger and I csn still handle it as I eat one every one year or so. From my own experience I dont know if it’s over priced but I can less afford health insurance with each passing day. MyLessThanPrimeBeef April 29, 2012 at 2:17 pm Sometimes we have to think out of the box. How about we train more barefoot doctors? The Barefoot Doctors Corps? Two year service and your student debt is completely forgiven. JohnB April 29, 2012 at 2:43 pm Netherlands: 115 Euro’s a month, no co-pay, no deductables. psychoanalystus April 29, 2012 at 5:29 pm Just curious, how is capitalism working out these days for you, kids?…LOL ECON April 29, 2012 at 6:03 pm Referring to medical tourism….why not just export health care (Singapore, eh?) as manufacturing has been done. psychoanalystus April 29, 2012 at 6:54 pm Medical tourism is already a booming industry. At one point I too was thinking of starting a dental tourism business, so I researched the topic. Americans would typically save about 80% of the costs, and get far better care than what is normally available in America. In 2000, the World Health Organization rated the US health care system to be #37 (just behind Costa Rica’s and 2 spots ahead of Cuba’s). Also, Colombia, Morocco, Chile, Slovenia, Dominica, Greece, and Oman were all rated much better than the US. That was in 2000. Today, I’d guess America is number 156, just after Zimbabwe. And, by the way, Singapore was rated as number 6. http://www.photius.com/rankings/healthranks.html The American medical system is a criminal scam, a mafia operation. Anybody who thinks otherwise should seriously consider cutting back their daily intake of FoxNews to no more than 10 hours. John F. Opie April 30, 2012 at 11:09 am Of course, medical tourism has one major downside: if something goes south, you can’t sue, because no other country has let the lawyers set up the health care industry for their own benefit. No one has mentioned the need for tort reform. Remove the necessity for very high cost malpractice insurance for doctors and practicioners and you’ll see their costs decline, reducing the need to increase fees everytime the insurance company has to settle a case for multi-millions out of court because it was cheaper than running it through the court system and spending years fighting court cases because someone doesn’t like how something turned out. Remove the necessity for extensive due-diligence testing when treating a patient as well: those tests are mandated by the malpractice insurance coverage industry, not because the doctors think it is necessary. A little common sense would go a long, long way to reform the US health care system. However, given the massive preponderance of lawyers in health care management and the asymmetric advantage of litigants in the US court system – tort lawyers can drive pretty much anyone out of business if they feel like it – this is unlikely. It remains the 500 lb gorilla in the room that nobody, but nobody is talking about. Don Levit April 29, 2012 at 6:45 pm Median household income; $50,000 Average family group premium: $13,000 I think we have reached our limit of this medical expense bubble. We need the not-for-profits to do what they were encouraged to do back in 1986, with the passage of 501(m): distinguish themselves from the for-profits by offering unique products and services. Blue Cross and Blue Shield lost its federal tax-exempt status, primarily because it had evolved into its for-profit competitors. It has been 26 years, and has any not-for-profit insurer taken advantage of 501(m) to set themselves apart from their for-profit competitors? Don Levit Anon April 29, 2012 at 7:36 pm I have only visited seven out of 17 countries on that list, and only have have first-hand experience of a couple of medical systems not that of my home country, thank god, but the figures that really leap out are for China (1%) and Singapore (2%). If neoliberal paragon Singapore is delivering private healthcare at 2% of US cost, what is the justification in “free market” terms of the enormous gouging of patients in the current US system? And if China, which I understand is not providing much traditional socialized medical coverage these days, also has a system capable of delivering care at 1% of US cost, what gives? Many countries such ss India and China also have strong indigenous medical traditions that also probably contribute to keeping health costs down overall. In those countries, there’s also a strong tendency to look to diet and exercise not only as preventatives, but also as first-line treatment responses to poor health; often, medication is only taken as a last resort. (Traditional Chinese herbal preparations are so disgusting for the most part that, in my experience, you have to be very seriously ill to consider taking them at all.) And the health problems prevalent in the US (obesity, diabetes, heart conditions, cancer = tend to be chronic, not acute) are not necessarily replicated in the rest of the world, which I imagine also skews health coverage costs somewhat. psychoanalystus April 29, 2012 at 8:44 pm Over the past few years China has been building a massive socialized health care infrastructure that is aiming to deliver free local health services to 99% of the population. It is comprised of a massive network of clinics and small hospitals. So China has socialized medicine. I have had experience with the socialized health care systems of Eastern Europe (former communist nations), all of which provide adequate services to 100% of their population with no insurance premiums. Because these nations are in the EU, the treatment plans are the same as those in Western Europe, they use the same drugs and procedures, and treatments for major illness (i.e., cancer) are usually initiated without delay. There isn’t much “traditional” medicine in Eastern Europe – the treatments are usually similar to those in the US. The only problem is that these nations have been under vicious and sustained attack by foreign neoliberal agencies such as the IMF, World Bank, and the European Commission that have been demanding massive cuts in health care expenditures and privatizations, which have led to a serious decline in the quality of these systems. These demands are being made in order to pay foreign banks, by the way. So there has been a chronic shortage of funds and equipment in Eastern Europe, not to mention that doctor salaries are ridiculously low. However, I believe people in Eastern Europe are not going to take this lying down. A few months ago people in Romania protested violently when their neoliberal president attempted to privatize their emergency medical system. He backed down, and a new prime minister was chosen, however, the very next day, the demon from the IMF that goes by the name of Jeffrey Sachs, flew in from Washington and demanded that austerity programs continue unabated in Romania, this to the dismay of the entire Romanian nation. But I think people like Jeffrey Sachs forget how the Romanians handled their last dictator. I believe the people in Eastern Europe are far tougher than the Greeks. The Greeks have lost their fight, and are now doomed. But I don’t think Eastern Europeans, who fought against and defeated the evils of communism are going to let the EU and the Washington Consensus destroy their countries and their lives much further. Anon May 2, 2012 at 8:43 pm I hope you are right about Eastern Europe and China, but a lot of the post-Eastern bloc states are in terrible trouble economically, for example, Latvia. In the UK, socialized medicine is coming under an horrific assault. Basically, an attempt to move to a US-style system, with many US private health providers already contracted in without the public really being aware of how far it’s already gone. Vampires, the lot of them, but nothing that a little sunlight on the matter won’t sort. Matt Franko April 29, 2012 at 9:04 pm The reports I have seen have the healthcare industry at 15% of Gdp. 0.15 * 15T = 2.25T Divided by 300M US Citizens = $7500 per capita per year. No one is paying that. Must mean that the balance is being paid by govt via deficit spending to get it down to the $5k+ paid in the US Perhaps other country’s use their deficit spending to reduce the premiums to their populations by more than the US does. This is a political decision. resp, Phoenix Rising May 1, 2012 at 1:24 am Matt, Medicare and Medicaid patients do in fact make up a large portion of this figure – along with a number of people covered under high-risk plans or self-employment insurance rates. In 2008, Medicare cost an average of $9100 per beneficiary, with 46m beneficiaries – more than 15% of the population. Similarly, the elderly and disabled covered under Medicaid cost more than $12,000 per year per beneficiary. Medicare notes that most of that premium is spent covering the beneficiary’s last year of life. psychoanalystus April 29, 2012 at 9:19 pm Chitown2020, I posted here, because the thread above was getting a bit too cluttered. I, along with several other rational observers of current events, believe it is too late to unify. It is simply too late. OWS has lost in the most pathetic way, and there is no other alternative. History stands witness that no nation or empire that faced similar problems as we are today were able to overcome them. On the contrary, the decisions and leaders that were chosen were the kind that only expedited the collapse. It is simply game over for the United States as we once knew it. Even if people unite, as you say, what can they do? Just look at the gigantic police and security state that America has become. There is nothing that anybody can do. There will be no revolution. It is over. It is only “Hunger Games” for the foreseeable future, for many decades to come. There will be no New Deal, no repeal of Citizens United or NDAA. There will be no scaling back of the prison-industrial complex–on the contrary, it will be expanded. The war machine will be expanded, and everything will be sacrificed for it: Social Security, Medicare, public education, middle class. Everything will be sacrificed so that wars can continued 30 or 40 years from now in God knows what unheard of nation on the other side of the planet. This is the new America. And there is nothing that can be done to change this. There will be no last-minute saving rabbit pulled out of the hat. No Hollywood-style Superman will save this nation. And make no mistake, this is no accident. It is the plan of the globalists that you mention. They won. One reason why nothing can be done is because the American people really are too hopelessly brainwashed and dumbed down at this point. This is one of the most uneducated and uninformed nation in the world. It is a lobotomized nation. Just look around. This is America, my friend. All they want is to trample each other to death over a pair of Nikes on Black Friday morning, to get high, to get laid, to hallucinate in front of their Facebook page and to text on their smartphone. It is a nation that has its head firmly inserted into Kim Kardasian’s oversized butt. It is a nation that has never known the concept of community, so how can anybody unite. On the contrary, as things deteriorate, the place will likely become more and more vicious and more individualistic. Fortunately, the rest of the world is not like this. chitown2020 April 29, 2012 at 9:57 pm Psychoanalystus…It is true there is real evil in this world trying to distract mankind from the truth. I believe the truth is being revealed for a reason that we dont fully understand. We have to have faith. Comments are closed. Tip Jar Please Donate or Subscribe!