America's Health Care
Research essay I did on America's health care problems. Constructive criticism welcome and appreciated.
America's Health Care: Plans, Policies, and Profits
H.L. Mencken claimed that there is a “simple, elegant, and wrong" solution for every problem (Tanner "Universal Healthcare..."). Today that solution appears to be providing universal health care ( Read more... )
America's Health Care: Plans, Policies, and Profits
H.L. Mencken claimed that there is a “simple, elegant, and wrong" solution for every problem (Tanner "Universal Healthcare..."). Today that solution appears to be providing universal health care ( Read more... )
My claim here was that the demand for health care, be it high, low, or in the middle, comes from sick people, at least the vast majority of the demand does. The segment of health services that are elective, for example botox, responds to price in the way you describe. But not the segment that concerns, say, ear infections. The demand for health services related to ear infections is at all times exactly equal to the number of people with ear infections at the time. Driver's licenses are an example I think you'll understand. If you change the fee for a driver's license, the exact same number of people will stand in line to get one as before. The only reason someone would not come to the hospital when sick is if they were actually prevented from it, for example by the threat of personal bankruptcy. Private health services are an excellent way to provide elective services, such as botox. Making them public would increase demand. But general practice? No way. Whether the provider is public or private, the demand is the same, and that has been shown in the statistics you will find from the health ministries in some of the countries you are listing, if you have the considerable patience it takes to wade through all that stuff.
What factors are you wanting to consider other than lifespan? Dental care in the UK is known to be inferior, due to an oddly downgraded importance people ascribe to the profession there. But in Canada, France, Germany, and Japan, dental care is very good. It costs roughly 1/2 as much to see a dentist for a cleaning in Canada, on average, as it does in the US. That is for the normal, run-of-the-mill procedure, not for fancy elective stuff.
I've personally had the opportunity (misfortune?) to compare health service cost and delivery in Canada, the USA, the UK, Germany, and France. I got great service in the US, but I am also rich and I paid a lot for it.
Whether you tax citizens to pay for public health care, or you require them to (a) get private insurance, or (b) pay out of pocket, the citizens do pay for it. The question is whether the citizens pay more via the public system, or via private systems. Statistically speaking, the cost of health care is lower for citizens when general services are provided through a public option than otherwise. That is, the Canadian government pays less for a GP visit in Canada than an insurance company or a private citizen pays for the same visit in the US. The difference is not small. Although the public option requires government oversight, hence bureaucracy costs above the cost of treatment, the private system also requires oversight, bureaucracy costs, and hopefully, profit. There is not much evidence that large firms are more cost-effectively run than government agencies, and there is some evidence that they are run less cost-effectively. Your statements about small firms being highly efficient are quite true, but private health management groups and insurance companies are anything but small and lean.
You say you couldn't find good data in support of the public option. I'll ask one of my assistants who liaises with our political contacts to look some data up. I'm curious about the numbers, now, too.
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The first report (http://www.youtube.com/watch?v=refrYKq9tZQ) cites that the life expectancy statistics is missing a few factors: Americans are more likely to die in car accidents, five times more likely to be murdered.
Costs are higher in the United States because the insurance industry has an unregulated oligopoly that stifles competition. This article (http://news.cincinnati.com/apps/pbcs.dll/article?AID=/AB/20090808/NEWS01/908090348/) claims that health insurers have acquired monopolies "in dozens of markets." I think an investigation into anticompetitive practices should be made.
I couldn't find very reliable data in support of the public option, but that would be wonderful of your assistant. BTW, an assistant who liaises with political contacts -- what on earth is your profession?
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So the story the raw data tells us is this: already the US covers about half of all health expenditures, but does so much less efficiently than France does. A health care reform in the United States that simply copied the French model would reduce the burden on citizens (including insurance and non-essential care) from 1/2 to 1/5 of the costs, and would reduce government costs by up to 25% the current government costs.
http://www.who.int/whosis/en/index.html
This is just one of many sources of data you might look at.
By the way, murders are a vanishingly small proportion of causes of death. The tsunami in Asia a few years ago affected the death statistics much more profoundly--for Europeans. So you are more likely to die of a tsunami in 2005 while on vacation that to die of murder.
Accidents are a substantial cause of death, but not the most substantial by a long shot. And the different in EU and US accidental death rates is not very statistically significant, according to data from the CDC and the EU. You can google "cause of death" to find stats that confirm this, although slogging through the math is a bit tiresome.
Actually, it is worth mentioning that causes of death vary dramatically based on age and income. Car accidents affect 20 year olds much more than heart disease, which is the overall leading cause of death.
Also, this little snippet I think is very important. It is on the European Public Health Alliance page (http://www.epha.org/a/2352) and I quote:
The data are analysed and gathered per disease and not per risk factors. Only 7 risk factors are responsible for most of the burden of diseases, They are largely preventable and well known: high blood pressure, tobacco use, harmful and hazardous alcohol use, high cholesterol, being overweight, low fruit and vegetable intake and physical inactivity.
A much better health reform than anything under consideration would therefore focus on prevention, with respect to these seven major root causes of bad health and death. In my opinion, having low cost access to GPs and nurses, where those professionals were trained to give advice related to reducing these seven risk factors, would immensely unburden the health care system in the medium and long run, and would reduce the need for highly specialized, expensive post-disease treatment, reducing all around health care costs. Four nurse appointments a year, for forty years, might cost a total of $16,000. A single case where heart surgery is required can cost a hundred thousand dollars and more, not even including lost productivity.
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