US Not Getting Its Money's Worth On Healthcare

[RedScare]

Business Roundtable Report

Americans spend $2.4 trillion a year on health care. The Business Roundtable report says Americans in 2006 spent $1,928 per capita on health care, at least two-and-a-half times more per person than any other advanced country.

In a different twist, the report took those costs and factored benefits into the equation.

It compares statistics on life expectancy, death rates and even cholesterol readings and blood pressures. The health measures are factored together with costs into a 100-point "value" scale. That hasn't been done before, the authors said.

The results are not encouraging.

The United States is 23 points behind five leading economic competitors: Canada, Japan, Germany, the United Kingdom and France. The five nations cover all their citizens, and though their systems differ, in each country the government plays a much larger role than in the U.S.

The cost-benefit disparity is even wider

[sevfiv]

Fwiw, it really creeps me out that my health insurance is being traded on the NYSE..

[jb4647]

Business Roundtable Report

Not a real encouraging report. While many of us have claimed that the money spent on healthcare while leaving 15% not covered is a flawed system, this report says we're not even getting our money's worth for the healthcare we pay for.

They say a Conservative is a liberal who's been mugged. I say a liberal is a conservative who gets sick and realizes his/her health insurance is inadequte.

The older I get the more suspicious of any scheme whereby you pay a monthly fee for years and then expect it to kick in when you acutally need to use it. It's like anything, once they've cashed your check in advance, they screw you.

I for one am tired of getting those little envelopes in the mail stating that "X isn't covered becasue of such and such." What the hell am I paying $300-$400 a month in premiums for???

[Jax]

When people criticize the Canadian system, I always tell them that it depends on what you care more about - convenience or saving lives.

In Canada you might have to wait a bit longer to get treated, but statistically less people die of treatable diseases than they do here, and it costs less per capita to provide that quality of care.

Here, you might wait less time for treatment if you have enough money to pay for it, but the mortality rate is statistically higher.

What that tells me is that here in the USA we have high convenience at the expense of higher mortality.

In Canada, even though you might need to wait in line sometimes, that waiting doesn't lead to a statistically higher mortality rate (ie: if it's a life and death matter, you get to skip ahead in line, if it's something that can wait, you might have to wait so that people with more critical conditions can be treated first).

Ideally, you need to balance convenience and mortality.

Personally, I value life more than convenience, but I know some people may disagree.

Strangely, it seems that most people who are content with our health system as it is are more concerned with saving the "lives" of fertilized eggs than full fledged people.

[jb4647]

When people criticize the Canadian system, I always tell them that it depends on what you care more about - convenience or saving lives.

In Canada you might have to wait a bit longer to get treated, but statistically less people die of treatable diseases than they do here, and it costs less per capita to provide that quality of care.

Here, you might wait less time for treatment if you have enough money to pay for it, but the mortality rate is statistically higher.

What that tells me is that here in the USA we have high convenience at the expense of higher mortality.

In Canada, even though you might need to wait in line sometimes, that waiting doesn't lead to a statistically higher mortality rate (ie: if it's a life and death matter, you get to skip ahead in line, if it's something that can wait, you might have to wait so that people with more critical conditions can be treated first).

Ideally, you need to balance convenience and mortality.

Personally, I value life more than convenience, but I know some people may disagree.

Strangely, it seems that most people who are content with our health system as it is are more concerned with saving the "lives" of fertilized eggs than full fledged people.

Great point. You always here the Canadian Health Care system attacked for "rationing" and long waits but that's exactly what happens here in our HMO/PPO-dominated system as well. I can't tell you how many times I've called to make an appointment with a specialist and was told that the earliest I could see them was a 2 months or more. If you do get "squeezed in" to see them, you wind up waiting in the waiting room for hours reading year-old magazines.

I used to think our health care delivery system was the best when I was in my 20's and never used it. The older I get, the more I find myself using our HMO/PPO dominated health care delivery system and I'm finding all sorts of flaws.

The US has the most advanced medical skills/knowledge in the world. Its the ACCESS to all of that medical know-now that's the problem.....unless you have loads of $$

[cnote]

When people criticize the Canadian system, I always tell them that it depends on what you care more about - convenience or saving lives.

In Canada you might have to wait a bit longer to get treated, but statistically less people die of treatable diseases than they do here, and it costs less per capita to provide that quality of care.

Here, you might wait less time for treatment if you have enough money to pay for it, but the mortality rate is statistically higher.

What that tells me is that here in the USA we have high convenience at the expense of higher mortality.

In Canada, even though you might need to wait in line sometimes, that waiting doesn't lead to a statistically higher mortality rate (ie: if it's a life and death matter, you get to skip ahead in line, if it's something that can wait, you might have to wait so that people with more critical conditions can be treated first).

Ideally, you need to balance convenience and mortality.

Personally, I value life more than convenience, but I know some people may disagree.

Strangely, it seems that most people who are content with our health system as it is are more concerned with saving the "lives" of fertilized eggs than full fledged people.

I constantly hear my friends harp that all our healthcare problems would be solved if we were more like Canada, but I don't think you can fully make that argument. There are too many factors that go into healthcare and mortality/fertility rates (lifestyle, culture, demographics) to say a Socialist healthcare system would have the same impact it does in Canada (saving lives as you put it).

Also, there is the impact that other socialist systems Canada has that result in a reduced population living in poverty.

Canada has much lower obesity rates and a much smaller population of smokers, is that because they have universal healthcare? No, that is a cultural/lifestyle difference that greatly impacts the amount of deaths from heart disease in that country.

You also have the impact of Hispanic immigrants in the United States. And all these points do not even address the age of the populations in the two countries (did Canada have a baby boom?), which I have never analyzed but would impact healthcare a great deal.

I am not saying that our system is perfect, or even the best, but I am not sold on nationalization for us either.

[sevfiv]

I am all for going non-profit in some way. Most insurance providers are companies just like any other publicly traded one where profit must be maximized and shareholders pleased. I think it is highly unethical.

Jax - what is it like dealing with prescription medication in the Canadian system?

I do benefit greatly from paying my copay instead of the full price of medicine (about $80/month to keep me alive vs. a retail price of about $300).

My employer does, however pay for a large percentage of my monthly premiums..

[crunchtastic]

wait, you might have to wait so that people with more critical conditions can be treated first).

Ideally, you need to balance convenience and mortality.

Personally, I value life more than convenience, but I know some people may disagree.

lol Jax, you crazy Canadian socialist!!

Despite the fact that global statistics like the report above routinely disprove us, Americans cling to this notion of government bad/private enterprise good when comes to healthcare. Healthcare is not a right, it is a product. At this very moment, corporately-funded doctors are probably busy revising the cholesterol guidelines down yet again so that pharma can sell more Lipitor, etc. before their patent rights run out. And when they sell you the Lipitor, you get the added gift of a 'pre-existing condition' going down on your record. Which means that the insurance cartel charges you more for less coverage.

It's the American way. Maximum profit taking for all! As long as you're not the guy who has a heart attack when he can't afford to go to the doctor or pay for his meds after he gets laid off, because can't afford COBRA, because his-preexisting condition means his rate is $500 a month.

[jb4647]

[quote name='sevfiv' date='Thursday, March 12th, 2009 @ 12:59pm' post='311804'

My employer does, however pay for a large percentage of my monthly premiums..

Just wait, your percentage will increase over time. Mine has since the late 90's. All of ours have.

[barracuda]

I think everyone can agree that people deserve access to affordable healthcare. I believe part of the problem with our current system is that a market-driven approach does not work well when weighed against the best interests of patients.

Pharmaceutical companies are driven solely by profit. This works great in most industries, as competition eventually drives down the cost of goods. But the goal for a pharmaceutical company is to develop blockbuster drugs that have the greatest chance of huge profits. This means patent-protected drugs that nobody else can sell until the patent expires, guaranteeing the drugs will be expensive and out of reach for many. It also means drugs that require subscription-like use to ensure recurring income for the company. These companies are not interested in curing diseases - that would not provide the sustainable long-term income. They simply want to help with side affects so you are buying their products for life.

It's also in the best interest of health insurance companies to weigh the numbers and essentially put a value on human life. It is beneficial to the bottom line if they don't approve expensive procedures if they can get away with it. You have to read the fine print in your insurance plan to find this out. The part I find bizarre is the way health insurance plans don't seem to emphasize prevention. Maybe it's because patients change insurance providers too frequently, but it would seem to be in their best interests as an industry to encourage and pay for reasonable expenses related to prevention, but many times this isn't the case.

What happens when people can't afford health care is they wait until the problem becomes severe, then they end up going to the emergency room, thus incurring the highest possible cost for their health care. This simply gets passed onto those of us who have insurance plans.

Edited March 12, 2009 by barracuda

[KinkaidAlum]

Our health care system is a joke. I am not sure why so many people defend it or make up excuses for it (Canada is healthier because they don't get as many Mexicans up there????)... WTF.

And, last time I checked, we don't have many freedoms here. I mean, do you really get to choose your doctor or do you have to choose one that accepts your plan? Do you really get quality care or do you wait months for an opening and then get maybe 10 minutes of face time with the actual doctor if you are lucky? Are you really told all of your options for treatment or are pharms forced on you because your doctor enjoyed an all-expense paid trip to the Bahamas on Proctor's dime?

[Jax]

I agree that Canada's system is probably not perfect for the USA. Any healthcare system that we implement here needs to be catered specifically to our own needs and problems. I'm just saying that there's a lot we can learn from Canada's system. I hate it how some people are so quick to criticize Canada's healthcare system - even people who have never been to Canada or experienced Canadian healthcare (!!). Of course it's not perfect but it works better than the American system does in terms of reducing unnecessary deaths. It might be less convenient overall, but it's better at saving lives and to me that is what is important.

If we want to improve our own system, the best way to start is to look at successful healthcare systems in other countries and try to learn from them and develop our own solutions.

I guess the problem with trying to learn from other countries is that virtually every other healthcare system in the world has socialist elements to it, and that word will always generate resistance from certain people, even if it's the best way to improve our system. I am expecting to hear somebody say that if we move towards a public health system, we'll be on the "slippery slope to communism". That was basically Bush's excuse for not expanding Children's healthcare even when congress (including many Republicans) approved of it.

What I'd like to see is pragmatism overcome ideology here. Let's do what works the best for the greatest number of people, and let's base our decisions on empirical data not on what some political party's preconceived notion of how it should be.

As far as prescription drugs go, all I can say is that they seem to be cheaper in Canada. I don't personally use any prescription drugs, but my girlfriend had to transfer a prescription from Canada to here (on Baylor's healthcare insurance plan) and it costs her about twice as much per month.

Edited March 12, 2009 by Jax

[20thStDad]

The part I find bizarre is the way health insurance plans don't seem to emphasize prevention. Maybe it's because patients change insurance providers too frequently, but it would seem to be in their best interests as an industry to encourage and pay for reasonable expenses related to prevention, but many times this isn't the case.

The only thing I really like about the plan we just switched to this year is that preventive care is 100% paid for, there's not even a copay. I think more companies will go toward this. Of course at the same time the cost of non-preventive care will go up.

I have never felt like I get my money's worth out of our health plan. I don't know how anyone could. But that's what you're stuck with, the alternative costs 10 times as much.

I'm not sure socializing it will make anything better, but changes to the way it's run and regulated can only help. What possible way could there be for drug companies to be non-profit? The talent in America, by and large, goes where the money is. If that goes away it will put a huge dent in research and progress. And if socialized it would be riddled with bureaucracy and very average people, just like every other government department.

[Jax]

did Canada have a baby boom

Yes.

I know the USA has a higher obesity rate than Canada, but I think the smoking rate is similar.

http://www.nationmaster.com/graph/hea_dai_...h-daily-smokers

[crunchtastic]

And, last time I checked, we don't have many freedoms here. I mean, do you really get to choose your doctor or do you have to choose one that accepts your plan? Do you really get quality care or do you wait months for an opening and then get maybe 10 minutes of face time with the actual doctor if you are lucky?

Ooooh, major beef of mine.

I have the freedom to make 3 different appointments with an ob-gyn, over a time span of 3 months, only to get them cancelled because a far more profitable c-section was scheduled for the day of my appointment. So I'm looking for a new doctor, and the cycle starts all over. My plan is to find someone who doesn't do obstetrics, but there aren't many. There's no money in providing preventative care (unless you're the lab processing the bloodwork). I wish there was a better network of nurse practitioners and PAs for routine doctor visit stuff.

[sevfiv]

And, last time I checked, we don't have many freedoms here. I mean, do you really get to choose your doctor or do you have to choose one that accepts your plan? Do you really get quality care or do you wait months for an opening and then get maybe 10 minutes of face time with the actual doctor if you are lucky? Are you really told all of your options for treatment or are pharms forced on you because your doctor enjoyed an all-expense paid trip to the Bahamas on Proctor's dime?

True - I have to go to someone in network, I have to get a referral for a specialist, and I always see a PA or an NP instead of the doctor for wait reasons..

The only thing I really like about the plan we just switched to this year is that preventive care is 100% paid for, there's not even a copay. I think more companies will go toward this. Of course at the same time the cost of non-preventive care will go up.

At my previous job, we had United Healthcare (the best insurance I have had) - two dental cleanings and one well-woman exam per year were copay-free..

What possible way could there be for drug companies to be non-profit? The talent in America, by and large, goes where the money is. If that goes away it will put a huge dent in research and progress. And if socialized it would be riddled with bureaucracy and very average people, just like every other government department.

I agree about that, but what about insurance companies?

If we want to improve our own system, the best way to start is to look at successful healthcare systems in other countries and try to learn from them and develop our own solutions.

True - I need to get around to watching this:

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

As far as prescription drugs go, all I can say is that they seem to be cheaper in Canada. I don't personally use any prescription drugs, but my girlfriend had to transfer a prescription from Canada to here (on Baylor's healthcare insurance plan) and it costs her about twice as much per month.

Ah...now that I think about it, I know of several Americans who mail-order prescription from Canada..

[memebag]

True - I need to get around to watching this:

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Everyone needs to watch that.

[cnote]

Yes.

I know the USA has a higher obesity rate than Canada, but I think the smoking rate is similar.

http://www.nationmaster.com/graph/hea_dai_...h-daily-smokers

I will try to find the article I was reading that said the smoking rate in the US was much higher, but I did find a study by the WHO that actually said the smoking rate in Canada was higher, but that US citizens consumed more cigarrettes per person per year...

WHO study

[cnote]

Our health care system is a joke. I am not sure why so many people defend it or make up excuses for it (Canada is healthier because they don't get as many Mexicans up there????)... WTF.

And, last time I checked, we don't have many freedoms here. I mean, do you really get to choose your doctor or do you have to choose one that accepts your plan? Do you really get quality care or do you wait months for an opening and then get maybe 10 minutes of face time with the actual doctor if you are lucky? Are you really told all of your options for treatment or are pharms forced on you because your doctor enjoyed an all-expense paid trip to the Bahamas on Proctor's dime?

If you are referring to my post and that is all you took from it, maybe you should read it again...And yes, uninsured illegal immigrants are a huge burden on our healthcare system and in our emergency rooms, especially here in Texas.

I will agree that the obscene profits of the pharmaceutical industry stand out, and the whole doctor-rep relationship is a little suspect, but I think that could be solved with reform, rather than overhauling the entire system.

Let

[20thStDad]

I agree about that, but what about insurance companies?

I haven't put a lot of thought into it, I would need to in order to get my head around that idea. But really it's less insurance than glorified administration, which government can be very capable of doing. If "premiums" were taken directly out of taxes like social security that would seem to be easier than dealing with the uninsured masses. Then again how do you account for dependents, etc. I'm sure there are plans that outline all the details, but like I said I haven't gotten into it.

[HtownWxBoy]

When people criticize the Canadian system, I always tell them that it depends on what you care more about - convenience or saving lives.

In Canada you might have to wait a bit longer to get treated, but statistically less people die of treatable diseases than they do here, and it costs less per capita to provide that quality of care.

Here, you might wait less time for treatment if you have enough money to pay for it, but the mortality rate is statistically higher.

What that tells me is that here in the USA we have high convenience at the expense of higher mortality.

In Canada, even though you might need to wait in line sometimes, that waiting doesn't lead to a statistically higher mortality rate (ie: if it's a life and death matter, you get to skip ahead in line, if it's something that can wait, you might have to wait so that people with more critical conditions can be treated first).

Ideally, you need to balance convenience and mortality.

Personally, I value life more than convenience, but I know some people may disagree.

Strangely, it seems that most people who are content with our health system as it is are more concerned with saving the "lives" of fertilized eggs than full fledged people.

One of my best friends from college (who is an American) moved to Canada a few years ago with his boyfriend who is Canadian. He (my American friend) says it's worth paying the higher taxes to get the health care they have. Now that's just his one opinion... others may feel differently.

[sabasushi]

[quote name='sevfiv' date='Thursday, March 12th, 2009 @ 12:59pm' post='311804'

My employer does, however pay for a large percentage of my monthly premiums..

Just wait, your percentage will increase over time. Mine has since the late 90's. All of ours have.

If you think your employer-subsidiarized premiums are high, try self-insurance -- trust me, it ain't cheap. And you'de be amazed at all sorts of reasons that insurance companies would give for not insuring you, no matter how healthy you are....like deafness. (Yes, I know this is supposed to be illegal, but we're talking about health insurance companies here....modern-day mafias.)

I'm kinda of undecided about universal health care. For one thing, I'm skeptic that the US government would run such a program efficiently. After all, people aren't exactly raving about Medicare. (When my father was alive, he carried a private insurance in addition to Medicare because he thought Medicare wasn't good enough.) But on the other hand, our healthcare system, as it is now, is pretty screwed up -- for one thing, Americans are bascially using heatlh insurance as poor man's socialized medicine. I mean, 30 years ago or more, health insurance was something you got for major emergencies, but nowdays, people expect health insurance to pay for *everything*, such as birth control.

[sevfiv]

Just wait, your percentage will increase over time. Mine has since the late 90's. All of ours have.

You're probably right. Just checked though, and I'm grateful - 84% of my premiums are paid by my employer as of right now (and geez...my quite average health insurance costs quite a lot)..