Meanwhile, the crime that is U.S. healthcare continues
by David Atkins
Elizabeth Rosenthal at the New York Times takes another distressing look at what passes for the United States healthcare system. Here's a chart:
And here's one particularly poignant bit from Rosenthal's piece:
Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories — and often by a huge margin.
Americans pay, on average, about four times as much for a hip replacement as patients in Switzerland or France and more than three times as much for a Caesarean section as those in New Zealand or Britain. The average price for Nasonex, a common nasal spray for allergies, is $108 in the United States compared with $21 in Spain. The costs of hospital stays here are about triple those in other developed countries, even though they last no longer, according to a recent report by the Commonwealth Fund, a foundation that studies health policy.
While the United States medical system is famous for drugs costing hundreds of thousands of dollars and heroic care at the end of life, it turns out that a more significant factor in the nation’s $2.7 trillion annual health care bill may not be the use of extraordinary services, but the high price tag of ordinary ones. “The U.S. just pays providers of health care much more for everything,” said Tom Sackville, chief executive of the health plans federation and a former British health minister.
Why?
A major factor behind the high costs is that the United States, unique among industrialized nations, does not generally regulate or intervene in medical pricing, aside from setting payment rates for Medicare and Medicaid, the government programs for older people and the poor. Many other countries deliver health care on a private fee-for-service basis, as does much of the American health care system, but they set rates as if health care were a public utility or negotiate fees with providers and insurers nationwide, for example.
“In the U.S., we like to consider health care a free market,” said Dr. David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama. ”But it is a very weird market, riddled with market failures.”
There is no such thing a free market in healthcare. It's a service that everyone needs at some point, that no one can do without, that has a dramatic impact on society's collective well-being, that is almost impossible to "shop around" for, and that has opaque pricing. The notion that there could ever even in a libertarian dystopia be anything like a free market in healthcare is ludicrous.
The Affordable Care Act has made some improvements to the system, but it's still barbaric. But try telling that to all the Americans who have never spent any time outside the U.S. and believe Jesus Christ wrote the Constitution. To them and the people they send to Congress, we're still #1 in everything and the "liberal New York Times" won't do a thing to change their minds.
The only way out of this mess is for states where such provincial people are heavily outnumbered to create single-payer systems and show the rest of the country it can be done here, too.
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