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American Healthcare

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    JaxsonRaineposted 4 years ago

    Alright, I'm tired of debating healthcare. I'm just going to give some information for everyone.

    The US leads the world in obesity rates, and obese people pay $1,500+ per year more than non-obese.

    The US leads(or nearly) the world in diabetes rates. Diabetics spend 2.3 times as much on healthcare than non-diabetics.

    The US pays double the price for branded prescription drugs compared with Europe. Europe uses price controls, and pharmaceutical companies lose money on drugs they sell there. They make their profit by jacking up the price in America.

    Surgeons, Doctors, and Nurses earn approximately double in the US compared to the OECD average.

    Traffic accident mortality rates in the US are double the OECD average, and total accident rates are triple.

    The 'overpayment' of Americans on healthcare for each category are as follows:
    Obesity: $95 billion
    Diabetes: $115 billion
    Prescriptions: $125 billion
    Salaries: $220 billion+
    Traffic: $100 billion

    Or $2,100 per person.

    Interestingly, in 2006 the US was only $1900 per capita above the trend line for spending across countries. I just thought, maybe, some of you might be interested in the real reasons why US healthcare costs more than it 'should'.


    On top of that, the US enjoys some of the best healthcare in the world. Here are some examples.

    2 months or longer to see a specialist(%)
    AUS    CAN    UK    US
    29    42    33    10

    Average length of stay(days)
    AUS    CAN    UK    US
    6    7.2    7.5    5.6

    6 months or longer for elective surgery(%)
    AUS    CAN    UK    US
    9    14    15    4

    No blood pressure check within past year(%)
    AUS    CAN    UK    US
    19    20    33    12

    No pap test within past three years(%)
    AUS    CAN    UK    US
    20    23    22    10

    Dead from cancer within 5 years(%)
    AUS    CAN    UK    US
    31.7    29.5    48    26.2

    More than 30 minute wait in ER(%)
    AUS    CAN    UK    US
    67    80    74    66

    More than 4 hour wait in ER(%)
    AUS    CAN    UK    US
    16    31    4    13

    1. Paul Wingert profile image78
      Paul Wingertposted 4 years ago in reply to this

      Then how come we come in at #37 in the workd healthcare ratings?

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        JaxsonRaineposted 4 years ago in reply to this

        Because the WHO attributes less than 25% of its ranking to the outcome provided by a healthcare system.

        I mean, seriously, who cares about the results?

        1. PrettyPanther profile image85
          PrettyPantherposted 4 years ago in reply to this

          Jaxson, can you provide a source for that?  Based on my limited checking, I don't see this statement as being accurate.

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            JaxsonRaineposted 4 years ago in reply to this

            Yeah, I can provide sources for everything I say, because I base everything I say on sources. I don't automatically provide them because it's a pain to provide dozens of sources for every topic, when people on these forums constantly show preference for 3rd-party sources over primary-source data.

            http://en.wikipedia.org/wiki/World_Heal … ethodology

            Primary source: www.who.int/whr/2000/en/whr00_en.pdf

            50% is based on life expectancy. 25% on the actual figure and 25% on life expectancy distribution. Neither figure accounts for the causes of life expectancy. The US is the highest in the world, or nearly so, for accidental deaths, homicides, obesity, diabetes, and cancer, to name a few. Life expectancy doesn't compare the efficacy of treatment, it just assumes that better treatment means higher life expectancy, and that each country has the same incidence of diseases.

            25% is based on 'fair financial contribution'. They consider public money to be better than private money. So if the government taxes you $100 to pay for healthcare, that's good. If you pay $100 out of your own paycheck, that's bad. The don't account for incidence of diseases either. The US leads in obesity rates worldwide, and an obese person averages $1500/year more in health expenses. Again, they assume that every country is on equal footing for incidence.

            The last 25% is based on speed of service, privacy, and 'quality of amenities'.

            There isn't a single statistic they use that actually compares outcome of treatment country to to country. Probably because there have been very few studies that do that, and none that cover all WHO members. My 25% figure is actually being generous, as 0% of the ranking is directly related to the outcome of treatment. 50%(life expectancy) is indirectly related.

            1. Josak profile image60
              Josakposted 4 years ago in reply to this

              It's important to provide the sources because as we saw the other day sometimes those sources are horribly unreliable (which is understandable) but the source is essential to the validity of the data.

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                JaxsonRaineposted 4 years ago in reply to this

                Yes, Josak, you countered one of my sources, one time, without providing your own source. Ironic, isn't it?

                As I said, I'd be happy to discuss the OECD's response to that study, but they haven't made it available online, it's in a $50 book.

                The fact remains, life-expectancy figures don't adjust for incidence of diseases, homicides, or accidents.

                Every person who dies before their time in the US in an accident(28,000 more per year than if we were at the OECD average) is counted as a failure of the healthcare system.

                So don't talk to me about sources Josak. The best you ever do is a news article. People on this forum constantly ignore my original sources, or call them lies, because they don't agree with what a NYTimes article or a BBC article said.

            2. PrettyPanther profile image85
              PrettyPantherposted 4 years ago in reply to this

              As a purely practical matter, it would be nearly impossible to directly analyze the outcome of treatment, don't you think?  Would you measure the outcome of all treatments, from a minor skin rash to lung cancer?  Do all nations keep these statistics, and would their recordkeeping methods be comparable? 

              I fail to see how it could be done.  The absence of this particular measure does not mean that the other measures that were used are invalid.

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                JaxsonRaineposted 4 years ago in reply to this

                Right, it is impractical.

                So what do people do? They take the WHO report from 2000(getting pretty outdated at this point), and pretend that it actually does a good job of ranking countries.

                In other words, in the absence of good data, let's pretend that crap data is good data.

                Not all nations keep statistics, not all nations measure statistics in the same way. It really can't be done at this point.

                The absence of this particular measure doesn't make the WHO report good. You can't say 'Well, we can't actually say which healthcare systems are better at treating illness, so we'll just base which one is best on everything except for how good of a job it actuallly does.' The WHO report just doesn't work.

        2. Ralph Deeds profile image68
          Ralph Deedsposted 4 years ago in reply to this

          The WHO results data are bottom line results including mortality for people who get health care and those for various reasons, mainly poverty, denials by insurance companies for preexisting conditions, people who are laid off and lose their coverage, etc. That's the only accurate way to evaluate a country's health care system. Mayo, Cleveland Clinic and Sloan Kettering may well be the best in the world, but not many Americans get that kind of care.

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            JaxsonRaineposted 4 years ago in reply to this

            Counting people who die in car accidents and are murdered as failings of the healthcare system is not a good measure.

            Thinking that a country with twice as many obese people per capita should have the same results and same costs is simply lunacy.

            The WHO results don't look at ANY bottom-line results. The closest thing they look at is life expectancy, and I've clearly pointed out, several times, how that is a poor measure to use.

            To try and use that measure, you have to agree with some on this forum that the US has high diabetes rates, high obesity rates, high cancer rates, because of poor healthcare not stopping citizens from stuffing their faces with grease, fat, sugar, preservatives, aspartame, pink slime(ammonia), etc etc etc.

      2. Ralph Deeds profile image68
        Ralph Deedsposted 4 years ago in reply to this

        Because health care in the U.S. is quite good for the people who can afford it. It is lousy for the uninsured and poor who suffer from malnutrition, lack of good prenatal care, pediatric care and adult preventive care. Basically, poverty and mal-distribution of income are what drags the U.S. down compared to other advanced countries.

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          JaxsonRaineposted 4 years ago in reply to this

          It's because the WHO attributes less than 25% of their ranking to the actual health outcome of a healthcare system.

          Yeah, we could do better at getting everyone covered, but still our system gets the best results in many categories, and all the finger-pointing at pharmaceutical companies, insurance companies, and doctors completely misses the real issue.

  2. John Holden profile image61
    John Holdenposted 4 years ago

    http://www.pharmatimes.com/article/12-0 … study.aspx

    I was looking for support for your claim that the drug companies lose money on sales in Europe, not surprisingly, I couldn't find any such support.

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      JaxsonRaineposted 4 years ago in reply to this

      It's basic math. Pharma companies can only charge half the price in Europe they charge in America. The average profit margin for a pharma company is 15%.

      PharmCoA has a 15% profit margin. Half of their revenue comes from the US selling each pill for $1. Half of their revenue comes from Europe selling each pill for $0.50.

      That would mean they sold twice as many pills in Europe than the US.

      50 pills in US for $50
      100 pills in Europe for $50

      Total sales = $100
      15% profit margin means expenses were $87.
      $87 to make 150 pills means each pill costs $0.58

      Every pill sold in Europe loses them $0.08.

      That's the current situation.

      1. John Holden profile image61
        John Holdenposted 4 years ago in reply to this

        Do you really believe that they would sell drugs at a loss?

        Whilst governments might be able to control the prices that they sell at, there is no mechanism that I know of that enables them to force companies to sell goods if the company does not want to.

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          JaxsonRaineposted 4 years ago in reply to this

          Ok, you explain how a company can sell half of its drugs at $1 and half at $0.50, end up with a 15% profit margin, and still make a profit on the drugs sold for half price.

          If half their revenue come from the US, it's not possible. I already showed that, they would lose 9% on each pill.

          If 1/3 of their revenue come from the US you get:


          50 pills in US for $50
          200 pills in Europe for $100

          Total sales = $150
          15% profit margin means expenses were $130.
          $130 to make 250 pills means each pill costs $0.52

          Every pill sold in Europe loses them $0.02.

          Still losing almost 4% per unit.

          So tell me, how are they making money selling drugs for half price, when thier profit margin is only 15%?

          1. PrettyPanther profile image85
            PrettyPantherposted 4 years ago in reply to this

            I could be wrong about this because I haven't looked into it recently, but I believe that drug companies spend massive amounts of money on direct-to-consumer advertising in the US.  I don't think this is allowed in Europe. 

            Smart people, those Europeans.

            1. John Holden profile image61
              John Holdenposted 4 years ago in reply to this

              You're not wrong.

            2. 0
              JaxsonRaineposted 4 years ago in reply to this

              Depending on the company, advertising can account for up to 15% of the discrepancy in prices. It's not even close to the majority of the reason for the differences in price.

              It's plain and simple. We wouldn't have all the drug R&D that we do if America payed prices similar to the rest of the world.

              1. PrettyPanther profile image85
                PrettyPantherposted 4 years ago in reply to this

                This source says that pharmaceutical companies spend almost twice as much on direct-to-consumer marketing in the U.S. as they do on R & D. 

                http://www.csa.com/discoveryguides/direct/review2.php

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                  JaxsonRaineposted 4 years ago in reply to this

                  Ok, according to that article pharmaceutical companies spent 4.2 billion on direct-to-consumer advertising and 7.2 billion on advertising to physicians.

                  I'll just take it that those figures are correct. PhRMA reports that in the same year, PhRMA members spent $39.9 billion on R&D, and that figure doesn't include spending by pharmaceutical companies that aren't members.

                  So pharmaceutical companies actually spend less than 10% on DTC advertising as on R&D.

                  www.phrma.org/sites/default/files/.../p … _final.pdf

          2. John Holden profile image61
            John Holdenposted 4 years ago in reply to this

            Actually more like 20% which is far more than any other type of company makes!

            And that is of course after the money spent on R&D(!) advertising, salaries dividends etc etc.

          3. wilderness profile image96
            wildernessposted 4 years ago in reply to this

            It's been some time since I looked at it, but one big answer used to be that the large majority of R&D for drugs was done in the US.  Very little was being developed in Europe.

            The real cost of a drug isn't in the raw materials or production of that little pill; it is in the R&D.  No research, no costs.  No costs, no losses.

            1. John Holden profile image61
              John Holdenposted 4 years ago in reply to this

              But there is much evidence that the drug companies don't pay the lions share of R&D.

              1. 0
                JaxsonRaineposted 4 years ago in reply to this

                John, you keep trying to make that point, and it doesn't matter what the percentages are. It only matters what the dollar figures are.

                If a corporation pays $1 billion to develop a new drug, they need to charge enough for that drug to at least make up for that cost. Otherwise, they won't be able to continue doing research.

                1. John Holden profile image61
                  John Holdenposted 4 years ago in reply to this

                  If, if, if, but they don't.

                  1. 0
                    JaxsonRaineposted 4 years ago in reply to this

                    According to PhRMA it cost $1.3 billion in 2005 for a company to bring one new drug to market.

                    Your old source is absolutely false. If companies only spent $50-$100 million to bring a drug to market, then why isn't Pfizer bringing 10 to 20 new drugs to market every year with their nearly $10 billion in R&D spending?

            2. 0
              JaxsonRaineposted 4 years ago in reply to this

              Yeah, Celgene, the company John was painting as some evil, money-grubbing group earlier, spends 40% of their GROSS revenues on R&D every year.

              There are a lot of international companies that do research. They just get their funding for it by charging higher prices in the US. There's really no difference in where the company is based, they can still fund R&D with sales here.

              1. PrettyPanther profile image85
                PrettyPantherposted 4 years ago in reply to this

                Do you have a source for that?  Based on what I've seen so far, I'm not sure that is accurate.

                1. 0
                  JaxsonRaineposted 4 years ago in reply to this

                  Source for which part? That Celgene spends 40% of gross income on R&D?

                  Look at their annual reports.
                  http://ir.celgene.com/phoenix.zhtml?c=1 … ortsAnnual
                  http://ir.celgene.com/phoenix.zhtml?c=1 … ualArchive

                  Recently they have spent between 30 and 40%. Earlier in the 2000s they spent upwards of 65%+, and they spent over 100% in 1999.

                  Or were you asking about companies getting their funding for R&D from the US?

                  1. PrettyPanther profile image85
                    PrettyPantherposted 4 years ago in reply to this

                    I just wanted to see where you were getting your figures.  You tend to throw out a lot of facts and numbers without substantiating them.

                    Yes, drug companies spend a disproportionately large portion of their revenues on R&D.  One could argue that this is not necessarily a good thing.  Many new drugs are nearly identical to already existing drugs and work no better and have about the same level of side effects.  How many anti-depressant drugs do we need, anyway?  Drug companies want to make money, so they will create something "new" (even if it isn't really new in the way it works or any more effective) and market it as the next great treatment for depression, high blood pressure, diabetes, or whatever. 

                    There is a reason people in the U.S. are the biggest consumers of prescription drugs and that reason is the massive amount of money spent on advertising by big pharma, both directly to consumers and to doctors.

            3. Ralph Deeds profile image68
              Ralph Deedsposted 4 years ago in reply to this

              That's true, but the drug companies aren't bearing all the cost of R&D. Much is subsidized by the federal government and done at universities.

              1. 0
                JaxsonRaineposted 4 years ago in reply to this

                Without the spending on R&D by PhRMA companies in the US, there would be 311 less drugs introduced to the market during the period 2004-2010.

                PhRMA companies spent $311 billion over that period, with an average cost to market 1 drug of $1 billion. No, they don't bear all the cost, but without them, we wouldn't have nearly the number of lifesaving and improving drugs that we currently do.

              2. wilderness profile image96
                wildernessposted 4 years ago in reply to this

                As far as a company is concerned, it doesn't matter how much the govt. or anyone else puts into the R&D, only what the company spends. 

                Your statement may be, and probably is, true.  It just doesn't change the fact that companies spend enormous sums to bring a drug to market and those funds must be re-couped by charging high prices for the drug.

                1. Ralph Deeds profile image68
                  Ralph Deedsposted 4 years ago in reply to this

                  American drug companies have developed many effective and even miraculous drugs. But several of them have paid billions in fines for fraud, unapproved off-label promotion and marketing, and failing to report harmful side effects. Until recently they have been bribing doctors and medical school professors for biased research and delivering speeches written by the drug companies at expensive resorts where doctors are invited to hear sales pitches about drugs. Until recently when I visited my doctor's office around noon box lunches for the entire staff were delivered courtesy of drug company sales people.

                  1. wilderness profile image96
                    wildernessposted 4 years ago in reply to this

                    You are correct - drug companies spend money on advertising and not all follow the law.  Not all companies are ethical and not all researchers in any one company are ethical, either.

                    Does that mean that much of the cost of a drug is not in R&D?  Or are you simply basing drug companies for being like all the other companies out there in regards to promotion and ethics?

    2. 0
      JaxsonRaineposted 4 years ago in reply to this

      By the way, your article talks about how Americans spend double on drugs.

      It's because we don't create artificial price ceilings. Be thankful we don't, or the whole world would have less life-saving drugs.

      1. John Holden profile image61
        John Holdenposted 4 years ago in reply to this

        Oh rubbish!

        And how many of the grossly overpriced drugs are life saving?

        1. 0
          JaxsonRaineposted 4 years ago in reply to this

          Grossly overpriced?

          How are companies going to spend billions coming up with these drugs if they don't charge high prices?

          Again, if America followed the rest of the world, pharma. companies wouldn't have the money they need to do R&D. You should be thankful.

          You can try to dismiss drugs, but they do save lives.

          1. John Holden profile image61
            John Holdenposted 4 years ago in reply to this

            "The proof is in the pudding with the case of Thalidomide, a drug that was banned for decades before being brought back with publicly funded research. In the mid-1990s, Dr. Bart Barlogie, who runs the Myeloma Institute for Research and Therapy in Little Rock, Arkansas, found that Thalidomide could dramatically reverse the course of multiple myeloma, a life-threatening blood disorder. In 1999, he published his study results in the New England Journal of Medicine. Shortly thereafter, use of the drug was expanded from being completely banned to being used to treat leprosy and childhood leukemia. Dr. Barlogie’s study was primarily funded by the National Cancer Institute and American government grants. But the drug company was the one to profit.

            In response to Dr. Barlogie’s groundbreaking research, Celgene, the manufacturer of Thalidomide, dramatically hiked prices. Before the research was published, Celgene was charging $400 for a month’s supply of the drug. Within six years, it was charging $3,600 per month, an increase of 900 percent!"

            http://www.rxrights.org/your-thoughts/w … ally-going

            1. 0
              JaxsonRaineposted 4 years ago in reply to this

              Celgene said that when Thalomid was being used only for AIDS patients, they kept the price lower to make it accessible. When it began being used for other uses, they charged more.

              Is that wrong? Everything works off of supply and demand, it's not necessarily bad to charge more for something that more people need.

              In 1998, Celgene(evil people) were spending X working on 13 new product to treat cancer, AIDS, RAS, Chron's, and ADHD.

              2 years later, they were working on 27 new products. I guess it's bad for them to spend their money trying to find cures and treatments for horrible diseases, right?

              Funny, they are clearly such a bad corporation. Never mind the fact that from 1998 through 2000, they lost $102 million dollars, and spent $124 million dollars on R&D. Clearly they were just laughing all the way to the bank.

  3. Uninvited Writer profile image84
    Uninvited Writerposted 4 years ago

    Where did you pull these stats from?

    Constantly insisting the US is better than every other country over and over again becomes very annoying to the large number of people on this site who are not American and have actually experienced these things... Kind of arrogant actually.

    1. 0
      JaxsonRaineposted 4 years ago in reply to this

      Stats came from the CDC, OECD, WHO, among others.

      All I did is explain why American healthcare is more expensive per capita, and what that extra expense gets us.

      Conversely, it annoys me when people say American healthcare is bad compared to other countries, when it's not true. It also annoys me that other countries use price controls on drugs and make America effectively pay for all private drug R&D.

  4. John Holden profile image61
    John Holdenposted 4 years ago

    Actually Jaxson, claiming that health care is more expensive than elsewhere because Americans are less healthy is not a defence of your health care system, quite the opposite!

    1. 0
      JaxsonRaineposted 4 years ago in reply to this

      Healthcare is not the cause of obesity and diabetes. It's not the cause of accidents and homicides.

      Americans are more obese and diabetic because of lifestyle and diet, not because of poor healthcare.

      1. John Holden profile image61
        John Holdenposted 4 years ago in reply to this

        But note, the term is "health care" not illness care!

        Health care is not just about putting people right when they fail, it's about preventing them from failing in the first place.

        Americans are more obese and more likely to suffer diabetes precisely because health care is letting them down.

        Remember the Chinese doctors who only got paid when their patients were well, a sick patient and they did not get paid.

        1. 0
          JaxsonRaineposted 4 years ago in reply to this

          Americans are diabetic because we are more sedentary and eat worse foods. There really isn't any preventative care that you can do to stop people from killing themselves.

          It's our education and society as a whole letting people down. Healthcare doesn't stop people from eating McDonalds while watching sitcoms every night.

          1. John Holden profile image61
            John Holdenposted 4 years ago in reply to this

            No, it can't stop people doing anything but it can educate them as to the risks.

            1. 0
              JaxsonRaineposted 4 years ago in reply to this

              Come on, that's a pretty lame argument. People don't know that eating fatty/sugary diets and living a sedentary lifestyle is bad for them?

              If you want to put blame on people for obesity rates in America, blame Americans for what they do, and blame the government for claiming that genetically modified foods are safe, aspartame and other sweeteners are safe, ammonia-treated foods are safe, etc.

              It's not a reflection of healthcare how a population eats.

        2. Ralph Deeds profile image68
          Ralph Deedsposted 4 years ago in reply to this

          Jaxon Raine, Mittens and the GOP are more interested in wealth care than in health care.

          Claims that U.S. health care is okay are not factual. Cost increases are eating up the economy at an unsustainable rate because drug companies, for profit hospitals and doctors and parasitical health care insurance companies are ripping the rest of us off and doing all they can to block reform.

          1. 0
            JaxsonRaineposted 4 years ago in reply to this

            Ugh. Did you actually look at my first post? Our higher-than-average healthcare has more to do with our accident rates and high rates of obesity and diabetes than the 'predator' drug companies, doctors, hospitals, and insurance companies.

            For profit is not a bad thing. The desire for wealth, mixed with competition in a free market, creates efficiencies and innovation.

            In 2004, Silverstein, Brouwers, and Wolff found that if the OECD removed price controls on pharmaceutical companies, there would be an additional $17-$22 billion per year for Research and Development, leading to 10-13 new compounds on the market per year.

            It's sad. 50-60% of the increase in life expectancy for cancer patients is attributed to new developments in drugs. Over the course of a decade, mortality rates attributable to cardiovascular disease fell 28%. The AIDS-related mortality rate dropped 75% since 1995.

            Doctors charge more in America because of the cost of their tuition and because of the cost of medical malpractice insurance. They aren't ripping us off.

            Insurance companies contribute 4%.

  5. Wayne Brown profile image87
    Wayne Brownposted 4 years ago

    Did they bother to publish any figures on "medical litigation" or the cost of defending against it...a huge factor in rising medical costs in the USA?  Certainly obesity, diabetes, and other such medical conditions bear serious concern but a top notch medical industry can only treat the ravages of such conditions as opposed to eliminating them for many of these conditions are driven by mindsets, diet, exercise and activity levels. While the medical industry can attempt to educate, that educational process can easily be counterbalanced by ignorance and/or apathy which is easy enough to find in the USA today even among the educated. Companies across the nation are attempting "wellness awareness" programs while waging focused attacks on the killer diseases such as cancer, heart issues, and diabetes.  All this is being done to try to hold costs to a flatter curve over time. Employees have a vested interest and a potential reward in participating, both in the healthy aspects and in terms of reaping some extra financial benefits but still they persist in their old ways and these programs are currently struggling in many instances. There is an underlying message here that screams for Americans to become personally responsible and accountable to themselves for their health as opposed to looking for some entity to pick up the tab for their shortcomings and downstream damage as a potential solution to the problem. Here again, we attempt to treat the effect rather than the cause. WB

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      JaxsonRaineposted 4 years ago in reply to this

      I haven't been able to find any studies about the total cost of malpractice insurance, but I did find that in Florida insurance premiums run from 20k to over $100k per year.

      But, you can indirectly get that information by looking at physician salaries, as it is figured in to what they charge. Physicians, surgeons, nurses, they all make about twice as much as their European counterparts.

      Sadly, Americans just don't seem to care. 30-40k people die in car accidents every year, but who cares? I still need to shave/change/read the newspaper and talk on the phone while changing the radio station while I'm driving.

      I wonder what Progressive's 'Snapshot' program would do to healthcare. Your insurance company tracks your diet, activity levels, BMI, cholesterol, etc etc etc, and gives discounts if you perform well smile

      1. Ralph Deeds profile image68
        Ralph Deedsposted 4 years ago in reply to this

        "Certainly obesity, diabetes, and other such medical conditions bear serious concern but a top notch medical industry can only treat the ravages of such conditions as opposed to eliminating them for many of these conditions are driven by mindsets, diet, exercise and activity levels."

        People who are treated primarily in emergency rooms for health crises don't get much advice on ailments due to diet and alcohol. I recall reading somewhere that 5% of the people account for 50% of health care costs. An experiment that focuses a special team approach on this 5%, in NJ I think has produced good results.

  6. startupninja profile image61
    startupninjaposted 4 years ago

    @JaxonRaine - your idea of basic math is precisely that BASIC... your lack of knowledge and ability to understand pharma business practices and accounting, or BASIC statistical analysis formulae, are only surpassed by your lack of critical thinking.
    In countries with highly functioning healthcare systems, a higher degree of importance is attributed to prevention than to treatment for one SIMPLE economic reason... It is cheaper to prevent diabetes than to treat it... same goes for every single preventable disease, which is why babies are vaccinated for a variety of diseases shortly after birth.
    John Holden is right by saying that pharma companies never sell at a loss, even in Europe... the difference between the market and pharmacy cost of drugs in the UK for example is not due to price controls, but rather due to subsidies of drugs, where the insurance covers the difference, and the pharma companies still make their profit margin only not on the back of patients, but through a pooling of resources... the cost of healthcare is lower by 5-8 percentage points of GDP.
    I have one suggestion, educate yourself thoroughly, before assuming you are familiar with a subject matter.

    1. 0
      JaxsonRaineposted 4 years ago in reply to this

      Hey startup. Forgive me, in a forum like this it's best not to make things too complicated. If you want to go over balance sheets of pharmaceutical companies, compare sales from continent to continent, and delve deeply into the varying rules, regulations, taxes, and subsidies across dozens of nations, then feel free.

      But I can tell you, nobody here is going to read what you post if you do that. I've tried being precise before, it gets no response here. I even offered to walk Ralph here through GE's financial statements to show him their tax liability, but he said it was too complex(only fit for accountants) and stuck to his news article that claimed differently.

      I know it is more complicated than what I have put forward, but not really by much. Some countries will force a US pharmaceutical company to export their drugs directly at a reduced price. In that instance, my math stands up perfectly. If you make 15% profit, and half your sales are at half the price of the other half, you can't turn a profit on the half-priced goods.

      Now, they do it because technically they still make a profit on those goods, when you only consider the cost to produce and distribute. However, the R&D costs that went into making that drug aren't made back there, they are made back in America where they can charge full price.

      That's why they sell drugs overseas 'at a loss'. Technically it's profit, effectively it's loss, but it still helps the bottom line so they can use American money to pay for the R&D for the next drug.

      Did you know that the US has the highest levels of 'preventative' screenings? True story.

      Screenings aren't preventative. They are diagnostic. You can get a screening and have the doctor say 'Junior, you need to watch your diet or you'll end up being obese', but it doesn't do any good if the person doesn't do anything about it. Americans are bad about diet and lifestyle, which is why we are the most obese.

      We have good preventative care in the US, sadly we also have a lot of people slowly killing themselves with diet and lifestyle, and that puts a huge burden on the entire system.

      Actually, the UK uses the Pharmaceutical Price Regulation Scheme to, you got it, regulate the price of pharmaceuticals.

      Now, PPRS has changed a lot over the years. Companies can price how they want, unless they will make more than X number of pounds, or more than X% return on capital. Then, of course, there are the other 100 pages of regulations, and individual agreements between pharma companies and the DoH.

      The net effect of all of this, as of 2004, was that pharmaceutical companies could charge $0.50 on the dollar for branded drugs in the UK. No government or insurance company was subsidizing the difference.

  7. secularist10 profile image89
    secularist10posted 4 years ago

    Healthcare, like any other good, comes down to supply and demand. Clearly, the demand for healthcare is much greater in the US (because of unhealthy lifestyles that lead to poor health outcomes).

    The supply of healthcare is also problematic, from the exorbitant costs to become a doctor, to the cockeyed health insurance system.

    Healthcare is reflective of the larger socioeconomic system in industrialized countries. Europeans, being more egalitarian in their outlook, have developed a system that serves everyone at a more or less decent level. The US, less egalitarian, valuing more risk taking, rewarding winners and punishing losers much more, provides the best healthcare in the world for those who can afford it. Those who cannot afford it are out of luck.

    This helps to explain why the US, despite hosting the most advanced healthcare developments, nevertheless performs poorly on life expectancy, teen pregnancy and other measures of societal health. The system is skewed so that the bulk of the total benefits go to the top. Europe takes benefits from the top and redistributes them across the social classes.

    1. 0
      JaxsonRaineposted 4 years ago in reply to this

      Right. Why can't people understand this? We have high healthcare costs because we're obese, diabetic, cancerous people. We aren't obese, diabetic, cancerous people because of poor healthcare.

      And I would argue that the insurance companies would be a lot better if the government would simply allow them to operate on free market principles. There are thousands and thousands(I think over 9000) regulations on insurance companies tellling them what they have to cover, from preventative care, to accupressure treatments. Add to that the fact that companies can't compete across state lines, and you can see the problem.

      IF insurance companies were allowed to compete with each other, they would be driven to reduce costs and increase efficiencies in order to compete for customers. Just as every other product or service, competition lowers prices.

      That being said, insurance companies aren't really the problem... they only add a few percent to the total cost of healthcare.

      1. secularist10 profile image89
        secularist10posted 4 years ago in reply to this

        I certainly agree that health insurers must be allowed to compete across state lines and similar pro-competition measures. There are a number of states where a single health insurance company controls 70% or more of the market.

        Nevertheless, the government has a significant role in the actual health of the people. Subsidizing junk food and penalizing the consumption of healthy food are a major example. Eliminating recess, gym class, and pushing soda in schools are others. Inadequate support for public transportation is another, as is viewing drug use as a criminal issue rather than a public health issue (which would lead to less prison time and more treatment options).

        I don't support Bloomberg's push to outright ban certain sizes of drinks, but I do support efforts to tax junk food and sodas as a temporary measure to affect consumption patterns.

      2. Ralph Deeds profile image68
        Ralph Deedsposted 4 years ago in reply to this

        "We aren't obese, diabetic, cancerous people because of poor healthcare."

        That's not entirely true. Many doctors quickly prescribe pills without bothering to suggest an improved diet and regular exercise as a preferable alternative to deal with a medical problem.

        "That being said, insurance companies aren't really the problem... they only add a few percent to the total cost of healthcare."

        A number of Michiganders are getting refunds from companies whose administrative costs exceeded 20% of total costs including benefits paid. Health care insurance companies are already competing to see who can collect the most premiums and avoid paying out benefits. They are parasites which add no necessary value to the health care system. The U.S. is alone among advanced countries to figure this out and to adopt a single payer system. The most logical approach would have been to phase in Medicare coverage for everyone over a period of years, beginning with pre-natal care, care for children and so forth until everyone was covered. Unfortunately this wasn't politically feasible thanks to the insurance and drug companies.

        1. 0
          JaxsonRaineposted 4 years ago in reply to this

          Haha, true, but I would put just as much blame on the patient as the doctor. Americans prefer a quick fix, they don't want to do the work. Even if the quick fix doesn't really work and might cause itchiness, rash, dizziness, heart attack, leprosy, increased urge to gamble, or death.

          1. PrettyPanther profile image85
            PrettyPantherposted 4 years ago in reply to this

            I agree with you; however, many doctors are complicit in offering that quick fix.  I recently went to a new doctor (I moved to a different state) for a recurring shoulder problem resulting from an old rotator cuff injury.  He started writing a prescription for Meloxicam.  My previous doctor would send me to physical therapy and that always cured it, so I asked for physical therapy instead of the drug.  He looked surprised, then went on to say that physical therapy doesn't always help.  I asked him, does the drug always help?  He said "you have a point."

            1. John Holden profile image61
              John Holdenposted 4 years ago in reply to this

              Reminds me of a visit to my doctor many years ago. As he started to write out a prescription he said "these'll clear it up in about a week" I asked him how long it would take to clear up if I didn't take the prescription. He tapped his pen on the desk, stared at the ceiling and finally looked at me and said "about 7 days"!

  8. aware profile image70
    awareposted 4 years ago

    I read many a post.
    then fell sick from numbers.
    It occurred to me then .
    That money  is the problem .
    We should do away with it!

  9. aware profile image70
    awareposted 4 years ago

    That's four fives.
    And a six.
    Two threes.
    One.

  10. Ralph Deeds profile image68
    Ralph Deedsposted 4 years ago

    Corporate corruption is growing, public confidence declining--

    http://www.nytimes.com/2012/07/11/busin … ef=economy

 
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