- cross-posted to:
- [email protected]
- cross-posted to:
- [email protected]
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The market has solved it.
You just don’t realize what the market has solved for. It didn’t solve the problem of expensive healthcare, it solved the problem of how to maximize profits for the wealthy.
That’s what people don’t understand about “the market”. What you think it’s doing isn’t what it’s actually doing.
Yup, the free market and health care are not compatible because the free market works on principles of supply and demand. But when you have a limited resource that people will literally pay anything for (their health) - well you can see where the problem is.
If the free market had any real competitors, the problem would genuinely solve itself in favor of the consumer. We see this with any new tech where a bunch of new firms try to win customers by any means necessary in those first few years.
The problem as always is: where are the competitors after X years, and are these “competitors” actually competing anymore?
The solution as always is: regulate. Ensure competition. Ensure cartels aren’t price fixing. But no one wants to hear that
The streaming market has tons of competition. So then why are prices endlessly rising and content being removed and the value being made worse with ads?
The video game market also has tons of companies in it, and yet most of them are making the experience worse with ads and service-based games.
I’m so old I used to install my games on 5 1/2" floppies. I dispise how the video game market changed from an ownership model to service-based and micro transactions models that are popular today. Don’t even get me started on mobile games. What I have noticed is that I am paying almost the same price for a video game today as I was 30 years ago. A game that I paid approximately $75 for in 1994 I should be paying approximately $150.00 for a new release today. Yet I’m still paying $75 for a game, they have to be making up that difference somewhere. Now the tools needed to make a game have had an enormous impact on reducing costs, and there’s a whole bunch of other economic stuff I’m ignoring. Regardless, it’s still kind of amazing the price of games hasn’t inflated.
I want to hear it. I want to hear it in my music. My daily discussions. My podcasts. On my television. In my social media. I cannot hear it enough. It’s gives a joyous and wonderful feeling.
I’m not sure if you’re replying to right comment
I have an honors minor in medical humanities and took several medical policy courses. We looked at this exact graph from previous years as well as several other huge sets of data/graphs/studies and anything else related to insurance you can imagine. Insurance is not a standard market commodity and does not follow the same trend or logic. The only way you can lower premiums in insurance is by reducing the risk in the pool, or increasing the pool size to dilute the risk. This is either increasing the total pool size by increasing premiums, getting more people, or being selective about who joins the risk pool. The third one was what was called “preexisting conditions” and kept high cost people from entering the risk pool and draining the funds. This got banned and increased premiums. By increasing competition you end up splitting up the pools, making everyone’s premiums go up. This happened multiple times post ACA after the GOP started stripping out the funding and safeguards to prevent this. More and more competition opened up with artificially low premiums being subsidized by federal dollars, but then when the subsidies ended the premiums started jumping. Then when the premiums were jumping, new companies opened up to make more competition advertising lower rates, but then further fractured to pool sizes, leading to premiums skyrocketing. If you look back just 10 years ago there was a 3-5 year stretch of premiums increasing almost 30% year after year. It was due to all the competition opening up every year. This is why single payer systems have the lowest rates. If you have even one private company monopoly with a regulated cap on profits you would still end up with lower premiums. Then, if this single paying company was nationalized to take out the profit making middle man, the premiums are that much lower because your risk is spread across a massive pool. More competition in insurance makes the problem worse. I would agree with your stronger regulation though. There is a lot that can be done there.
Thanks for your insight!
By the time the system has consolidated enough that there is little effective competition, those companies have also become so large that they can lobby for regulatory capture. It’s not zero regulation, but rather a form of regulation that solidifies their position while still providing the same shitty service they always have.
Regulation won’t work. The system is too far gone.
What other tools are there for ensuring a fair market? Government intervention seems like the only avenue
Stop expecting politians to be the source of change. The results will be lackluster, at best.
have you tried not voting for thieves porn stars and real estate developers? Maybe get someone in who could possibly know what they’re talking about
Yes. Since that clearly doesn’t work, what’s next?
Everybody knows this. You don’t have to state it so pretentiously like you’re the only jerk who knows it. It’s been said on the internet billions of times for 2 decades at least.
I N N O V A T I O N Doctors in the US spend about 25% of their time dealing with insurance companies
In Germany the adminstrative effort including documentation is at 50%.
It’s pretty disconcerting that we’re the second worst after the US.
Sure. But the graphic is very much cherry picked. There is plenty of space between the US and Germany: https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
What surprises me is the high rank of Australia!
- Infrastructure in Australia is unfavorable… like the US (thin emc network vs. helicopters in Germany that are super common, Germany is a dense country, everywhere hospitals… Australia a desert with some coast. Like US.)
- Australians are basically US americans of the south (think food: originally british, cannot be healthy, no good car manufacturers, afraid of foreigners…)
- Everything is trying to kill you in Australia!
What the heck are they doing?
But maybe the Germans can learn from the Australians something. Germany‘s System is such a inefficient mess… just the administrative effort to maintain dozens of public health care insurances… crazy!
I don’t understand the points of this post.
Australia is very urbanised with the vast majority of the country clinging to the coastal rim. The interior of the country is vastly unpopulated.
Australia has a much better health outcomes than the US. Our fast food culture, although not great, cannot be compared to Americans.
The ‘everything can kill you’ thing is a meme. Yes, we have tons of venomous creatures but as we mostly live in the cities the rare deaths cause headlines and are not common place. Plus we don’t experience mass shootings every week, let alone single gun deaths.
The single biggest benefit for Australian life expectancy is socialised medicine. It’s not perfect, and insurance is encouraged, but a poor person in need of major medical intervention has almost identical access to health care as a fully insured person, and mostly with no financial outlay. In fact, an insured person may lie side-by-side in a hospital bed next to an uninsured person getting the same treatment.
Medical insurance is not tied to employment.
All this is under threat. Conservatives are attacking our health system and underfunding it. It is only a matter of time before we start tracking downwards like the US. The secret to a longer life expectancy is government regulation and social responsibility, a healthy personal lifestyle and not feeding the corporate medical parasites that sit between the patient and the required healthcare.
Point is, Australia pays less and gets more. while being -culturally- a “western” country (unlike Japan). Somewhat similar in many ways to Germany and the US.
Being a rich country seems not to be the only reason for high life expectancy. See comparatively low scores of Germany and the US. And to me it is puzzling how Australia, of all countries, ended so far at the top.
Public healthcare is available in Germany too… and on a small scale, basically in the US now too… Still, both suck hard and Australia excels. Tied insurance to a job is utmost stupid and unfair. Point well taken! Good job Australia! But this is the same in Germany.
@[email protected] did a great job explaining some aspects!
Thanks for the effort. Not everything tries to kill you Australians either in reality? Was just playing around with some cliches… to underscore that I know nothing about Australia. The term ‘fast food culture’ is awesome. And surely you are able to compare pears with apples.
‘Government Regulation’ alone seems not be too important here, as all compared countries have many regulations in place. Especially also the US with their FDA. Typically, for the good, regulations increase cost for something to achieve something. Here ‘Drug and medical device safety’. And that public healthcare is a requirement is agreed upon by all of us. But these are not all aspects.
And for some reason Japanese are even better, even if they spend lives working all day while eating raw fish… don’t tell me now that this is not the entire truth either! (Having a healthy fast food culture eating sushi may help them too!)
Any good example for a corporate medical parasite? I’d like to dig deeper. I mean, do you mean ‘Pharma-Industry’ or Health Care insurance here? Any specific case? In Germany public health insurance is not really ‘evil’ it is just a huge bulky inefficient mess… And US Pfizer is of course a big corporation making billions. But they also brought us a pretty good COVID vaccine, pretty fast (with the help of a small company in Germany). IMHO Billions well deserved - in this single case.
I can’t compare the US or German situation in any depth because I’m neither American nor German. Like you I can only go by appearances when viewing the other. I think that big pharma has got you guys around the balls to a larger extent. For instance, insulin medication has never been expensive over here and we have a thing called the Pharmaceutical Benefits Scheme (PBS) that lets Australians get necessary prescribed medicines without paying full price. The scheme began in 1948. Some medicines which costs thousands in the US are subsidised to the tune of about $10 a month here. That is the extreme end, but drug subsidy is a thing and is tax payer funded.
As to why other rich western countries don’t do as well, I’m not sure. I speculate that social policies probably have a great deal to do with it. The US seems to treat socialised anything with a degree of contempt, at least according to the horror stories we hear about. You know, patients without sufficient insurance being refused treatment or massive bill shock after an operation. I’m sufficiently ignorant about this matter to be confident about the detail.
All I can say is that something structural is at work that might explain why the Aussie medical experience is better, and I doubt that it’s better or different fast food.
To add to @[email protected] 's points, Australia isn’t afraid of foreigners, it has very high migration. You might be confused because of the government’s reprehensible treatment of asylum seekers. Yes it was colonised by England, but internally, diversity is the most celebrated aspect of Australia.
Australia has been dubbed ‘the lucky country’ because despite a lack of smarts (manufacturing and other value added economic activity), we’ve always been able to dig things out of the ground and sell it (coal, wood, gas, food, gold…). Though Australia never developed a serious manufacturing sector, it has pivoted to a service economy instead, with that sector’s highest export being higher education.
The lessons to learn from Australia is be rich, be on the other side of the world away from the world wars, and have high welfare spending (plenty of room for improvement though).
I don’t know about much diversity is celebrated in Australia. I have cousins who grew up in NSW and eventually migrated to the UK, which they said had a marketed improvement in how they were treated. (N=2)
Australians are basically US americans of the south (think food: originally british, cannot be healthy, no good car manufacturers, afraid of foreigners…)
They’re really more like Canadians than Americans, although I’ve heard it said that New Zealand more accurately fills that role
https://ourworldindata.org/us-life-expectancy-low
The life expectancy in the US is also dragged down by other factors. The US is a huge outlier in several other aspects:
- Higher death rates from smoking, obesity, homicides, opioid overdoses, suicides, road accidents, and infant deaths, compared to other countries.
- Additionally, deeper poverty, economic inequality.
It could just be that the US has way more vices per capita than other countries.
Is this a good comparison? Feels like we’re missing all of the US administration, insurance is just a part of it.
Barely, but doctors here in Germany are always complaining about difficulties they have with insurances. Especially the dozens of different public insurances. System here is an unconsolidated mess. Apart from having optional private insurance.
Like my doctor working on treatment and not being buried with administrative tasks.
Those seem like two radically different things. Documentation is extremely important for doctors. That’s not the same as dealing with insurance companies.
That seems low
I think some areas bring down the curve (ER etc, maybe). It might be like 50% for GPs, idk
My doctor has added a few extra checks to visits so it can be billed to the insurance company as a general checkup, and not the specific thing I came in for that would bill at a much higher rate. I appreciate him doing that, but he shouldn’t have to.
The best part is that it’s only State spendings, people in the USA also pay for private insurance individually!
Americans essentially pay for our insurance 4 times.
we pay more tax dollars per patient than ay other country
We pay hundreds per person per month in insurance premiums
We pay all healthcare expenses until we hit our annual deductible
We they pay a co-pay percentage after all treatment beyond the deductible.
Everyone knows it’s a broken system, but people are adamant that anything else would be communism or would make you lose an election.
The people worried about “losing an election” are paid by the people who profit from the broken system. The communism fear is a strawman that liberals use to excuse their worthless party.
Wait the life expectancy in the US is that low?!
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I’m guessing the target goal is whatever they set retirement age to be.
(Yes, I realize they want to eliminate retirement entirely.)
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That’s average. So if you have a lot of money and are spending it to raise the average cost, you probably live as long or longer than the other countries. On the other hand, the poors have a live expectancy that much lower to average it out. So call it 70 for the poors and 82 for the rich.
…how did the line come about? How did they determine what the life expectancy would have been with less expenditure per capita?
My guess is that this was a gif at some point and the line is historical data
Definitely, you can see some lines in the top left zigzagging back left, which would not be possible if each was a function of the x-axis. In fact, both axes are a function of the hidden z-axis, which is time and comes in discrete yearly steps, the latest of which (2021) is highlighted.
At least one of those lines goes back on itself at some point, so my assumption is that it’s tracking where each country has been over time.
Ooh good catch. That makes sense. Not sure I would call this beautiful, especially without any way to tell how much time has passed, but fair enough
I think the line might be historical data?
But… from when? Surely expenditure hasn’t gone up linearly with time
Yeah something is weird about this graph.
Health expense in what timeframe? Monthly, yearly?
If i had to guess, i would say this graph just shows the average yearly health expense of people that died at age X
So people that spend more money on their health, live longer. If thats the whole message this is the most boring graph ever.
If the US line is true, it shows that people there get much less value out of the money they spend on their health.
My guess is that the line tracks what the life expectancy was when the expenditure per capita was that much? Might have to dig into their source to get more details.
There is a minimum amount which is likely the least some people spent on their health. So there is no interpolation I can see.
That doesn’t make sense unless this was personal expenditure, which it doesn’t seem to be
Yeah, but think of all that value generated for shareholders in America: What’s a few million dead people compared to profit?
That, and half of the system is designed to discard people that are no long useful for the machine, unless of course they’re wealthy or have a wealthy benefactor.
High life expentancy is communism tho
Abolish private health insurance corporations. The middlemen are bleeding us fuckin dry.
This makes complete sense as getting you to pay more for less is what private businesses are all about.
I think it’s clear from the graph that USA is doing it right and the rest of the world needs to smarten up!
/s
We can do better. There’s still empty pixels on the right to fill.
I would really like to know how this graph was generated, because some expenditure per capita values have three different corresponding life expectancy values. Just look at Spain for example.
I assumed each line represents time, so Spain’s values fluctuated some
One could poke around on those sources: https://population.un.org/wpp/Graphs/DemographicProfiles/Line/1832
https://www.oecd.org/els/health-systems/health-data.htm
My understanding is that the largest part of expenditures on health is generally at end of life, at least in developed countries, rather than spending a smaller amount on disease prevention earlier in life, which would be expected to have a larger effect on morbidity and mortality.
EEAGLI looks to be some sort of marketing/ PR firm. shrug
Yes this is a huge problem. Keeping people healthy instead of mitigating the obvious consequences of their unhealthy life
Also, smaller people live longer.
in case you’ve not gotten the memo, the entire world has been telling you for more than fifty years that under your shitty model you pay more for worse results.
It doesn’t take a genius to see how retarded the way you’re doing things is.
Retarded? You obviously don’t understand that it is working perfectly and exactly as intended. Only, it is not a system to maintain the health of the average citizen, it is instead a system to siphon as much wealth from the regular people as possible towards the few corporate entities who managed to buy themselves the monopoly to exploit the poorer castes and drain any poor fuck who needs medical assistance dry for all they’re worth.
The average American is prey, but there are enough reserves of these human resources to simply not care that it’s either bankruptcy or death in the average case of a medical emergency.
Cool, can the stupid meme “security is why the US has no free healthcare” finally die?
Only if you keep reminding people that Medicare for All would be cheaper than our current system.
Thanks USA, for fucking up so hard the rest of us can slack off on improvement because you’re pulling the average so far out.
