Inefficiency Hurts U.S. In Ranking of Health
- Thread starter Bill Mattocks
- Start date
Rush and several other local radio shows reported on a story about a medicare provided wheelchair. A guy needed one for his wife so he applied to medicare. He was told that they would not buy him a wheel chair until they, medicare, had rented one for, I think 13 months. At that point they could justify the expense and pay for the wheel chair. The total cost of renting the wheel chair 850.00 dollars. Actual cost of the wheel chair, 350.00 dollars. The guy, realizing how stupid renting the chair through medicare was, stopped renting it and, out of his own pocket he purchased it. I sooo can't wait till we are all forced into government run healthcare.
Bruno@MT
Senior Master
Without going into the discussion of private vs socialized (it works for many other countries, so don't blame national healthcar for the ineptness of your government), it is fairly easy to see that an X amount of care is needed, costing Y amount of money.
The Y amount is what we would collectively pay through social taxing. Outisde of the providers and the materials, noone is benefiting from the giving of care.
In the US, extra money needs to be paid for massive profits of the insurance companies (A), as well as insurance of all providers against malpractice (B), as well as lawyer fees for all disputes (C), as well as penalties which are just charged back to the users (D) as well as all the personall involved solely in running the papermill of this entire structure (E).
So you end up paying not just Y, but Y + A + B + C + D + E.
The Y amount is what we would collectively pay through social taxing. Outisde of the providers and the materials, noone is benefiting from the giving of care.
In the US, extra money needs to be paid for massive profits of the insurance companies (A), as well as insurance of all providers against malpractice (B), as well as lawyer fees for all disputes (C), as well as penalties which are just charged back to the users (D) as well as all the personall involved solely in running the papermill of this entire structure (E).
So you end up paying not just Y, but Y + A + B + C + D + E.
The problem, as I see it, is that "Y" does not take into account some very important issues.
Countries such as Canada and France mandate costs of medical innovations such as drugs. For instance, if you want to have your drug used in such countries, you can only sell it in that country for $X. That means that someone else, somewhere, must pay for the costs of development, research, and testing for that drug. Due to the fact that the cost of those drugs can't be shared equitably amongst selling countries, the country where there are no price controls pays the lions share.
This is especially exacerbated since most medical innovation come from at least in part, the United States. According to the 2004 "Economic Report to the President", eight of the last ten most important medical innovations were developed at least in part in the United States (with one being of indeterminate origin and the other being Switzerland).
The top five hospitals in the U.S. conduct more clinical trials then in all of the hospitals in any single other country. In only five of the last 34 did a scientist in the United States not win or share in the Nobel Prize for Medicine or Physiology.
The point of all this is to say that these developments cost money, and not just in profits for medical companies. Money which other countries refuse to pay an equal share in, and therefore the costs of these burdens are laid at the feet of the American health care consumer.
These cost also are considering that the B, C, D and E issues which you brought up are also not paid for by those of non-American countries.
OP
OP
I do not take issue with the notion that the federal government runs some things very badly and inefficiently, nor with the general notion that private industry tends to act it its own best interests, which include behaving with an eye to efficiency and cost-effectiveness. These are basic general facts; I accept them.
However, the issue with health care is more complicated than that.
First, there are two types of inefficiency at play here. Inefficiency in terms of not doing work or doing work badly, and inefficiency in the form of bureaucratic regulations.
When we're talking about pure efficiency, we can easily see that private industry is or does generally greatly exceed government operations in terms of efficiency and cost.
However, private industry, if utterly unregulated, would be so 'efficient' with health care that profit would be the main driver of the industry; patient care would suffer. This is clear from the very nature of regulation of the health care industry; abuses were seen to exist to the detriment of citizens, and regulations were put in place in an attempt to address those abuses. What is good for stockholders is not necessarily (and probably not) good for patients.
When government regulation enters the scene, bureaucratic inefficiencies come with it. These will exist whether the ultimate dispenser of medical service is private or government-run.
I work in an industry that is both private and heavily government-regulated, although it is not the health care industry. As a technician, I prefer to simply do the work I am assigned, work that benefits the customer and ultimately contributes to both better products and less expensive products. However, the regulation that exists requires that any changes I make be approved by many layers of management, that established processes exist to ensure that changes I make won't cause downstream unforeseen problems, that everyone who might be impacted by any changes I make be informed and given the chance to raise objections if required.
It is frustrating. It is painful. It is slow. It is expensive. I spend weeks preparing for changes that take minutes to implement. I fill out paperwork, I take online certification in how to fill out that paperwork. I attend meetings. I explain my requested changes over and over again to different layers of management from two different companies. I am subject to termination for not filling out the right forms or filling them out correctly, even if the technical work I do is without flaw.
I can easily see how this applies to the health care industry. Especially when the government is applying standards and regulations upon multiple layers of private industries, from the health care providers to the hospitals to the drug and device manufacturers to the insurers to the employers.
With that in mind, I am not entirely certain that the government would be LESS efficient if applying those regulations to itself as opposed to a network of private companies. But I have no proof of this; I am merely unsure.
However, the issue with health care is more complicated than that.
First, there are two types of inefficiency at play here. Inefficiency in terms of not doing work or doing work badly, and inefficiency in the form of bureaucratic regulations.
When we're talking about pure efficiency, we can easily see that private industry is or does generally greatly exceed government operations in terms of efficiency and cost.
However, private industry, if utterly unregulated, would be so 'efficient' with health care that profit would be the main driver of the industry; patient care would suffer. This is clear from the very nature of regulation of the health care industry; abuses were seen to exist to the detriment of citizens, and regulations were put in place in an attempt to address those abuses. What is good for stockholders is not necessarily (and probably not) good for patients.
When government regulation enters the scene, bureaucratic inefficiencies come with it. These will exist whether the ultimate dispenser of medical service is private or government-run.
I work in an industry that is both private and heavily government-regulated, although it is not the health care industry. As a technician, I prefer to simply do the work I am assigned, work that benefits the customer and ultimately contributes to both better products and less expensive products. However, the regulation that exists requires that any changes I make be approved by many layers of management, that established processes exist to ensure that changes I make won't cause downstream unforeseen problems, that everyone who might be impacted by any changes I make be informed and given the chance to raise objections if required.
It is frustrating. It is painful. It is slow. It is expensive. I spend weeks preparing for changes that take minutes to implement. I fill out paperwork, I take online certification in how to fill out that paperwork. I attend meetings. I explain my requested changes over and over again to different layers of management from two different companies. I am subject to termination for not filling out the right forms or filling them out correctly, even if the technical work I do is without flaw.
I can easily see how this applies to the health care industry. Especially when the government is applying standards and regulations upon multiple layers of private industries, from the health care providers to the hospitals to the drug and device manufacturers to the insurers to the employers.
With that in mind, I am not entirely certain that the government would be LESS efficient if applying those regulations to itself as opposed to a network of private companies. But I have no proof of this; I am merely unsure.
Empty Hands
Senior Master
Not in the healthcare field. Medicare has a lower overhead than the private insurance industry average. Remember, private companies can have lots and lots of regulations and layers of bureaucracy as well. For instance, entire departments exist in every insurance company to find ways to deny claims. That's money that isn't going towards healthcare.
OP
OP
I said that. Read more. Sorry it was lengthy.
Bruno@MT
Senior Master
Yes and no.
Yes, what you say is true to some degree, but no, NO company is forced to sell their drugs below cost or even at cost. And I know this for sure because I work for a pharma company which makes some highly specialized meds, and I know what out treatments cost in countries like Belgium, France and Canada. I cannot share the numbers, but definitely not cheap or below cost.
Because contrary to what you believe, no company is forced to sell their drugs on our market. So if they couldn't turn a profit or break even in our countries... they simply wouldn't even try.
Additionally, looking at 'Y' I also inlclude things like taking X rays, an MRI, getting stitches, ...
