I cannot tell you how obsessed I am with this chart.It shows exactly what is wrong with America’s conversation about health care.
Health Care Spending Around the World
On one level, you’ve seen this chart before.
It shows health care spending as a share of the economy of a bunch of countries.
There’s Germany and France and Japan and Canada — and oh! There’s America.
But now I want to add something you haven’t seen to this chart.
This is how much of that spending in each country is private and how much is public.
America’s Public and Private Spending
Here’s what’s amazing:
America’s government spending on health care — on programs like Medicaid, Medicare, and the VA — our versions of socialized medicine —
is about the same size as these other countries.
These countries where the government runs the whole health care system!
And then there’s our private spending.
It’s the private insurance system that makes health care in America so expensive.
The Myth of Private Efficiency
Conventional wisdom says that the government is more expensive than the private sector.
“It can’t say no. It’s corrupt, it’s inefficient, it’s slow.”
“If you want something done right, you give it to the private sector.”
That is what we hear in America all the time.
And yet here we are — with the biggest private sector spending the most.
Do Americans Use More Health Care?
If you look at the data on physician visits and hospital discharges, you can get rid of one theory.
Americans don’t consume more health care than people in these other countries.
We don’t go to the doctor more than the Germans or the Japanese.
In fact, we go to the doctor less.
The difference between us and them is that we pay more.
Every time we go to the doctor — for everything from an angioplasty to a hip replacement, from a c-section to a pain reliever —
in America, the price for the same procedure at the same hospital varies enormously depending on who is footing the bill.
Why Public Insurance Pays Less
The price for someone with public insurance like Medicare or Medicaid is often the lowest price.
These groups cover so many people that the government can demand lower prices from hospitals and doctors — and they get those lower prices.
If the doctors and hospitals say “No,” they lose a ton of business — all those people on Medicare, all those people on Medicaid.
The Private Insurance Problem
But there are hundreds of private insurance companies.
Each covers far fewer people than a Medicare or a Medicaid.
Each one has to negotiate prices, and hospitals and doctors are on their own.
And if you’re uninsured, you have even less leverage.
Nobody is negotiating on your behalf.
So you end up paying the highest price.
One study found that most hospitals charge uninsured patients four times as much as Medicare patients for an ER visit.
How Other Countries Handle Pricing
Other countries don’t have this problem.
Instead of every private insurance company negotiating with every health care provider, there’s just this big list.
The country — the central government — goes and says:
“If you want to sell to us, to all of our people, then here’s what you can charge for a checkup.
Here’s what you can charge for an MRI or a prescription for Lipitor.”
And so whether that bill goes to the heavily regulated private insurance companies in Germany or directly to the government like in the UK,
each country is telling the doctor, hospital, or drug company how much that bill will be.
And because the government controls access to all of the customers, it’s an offer that hospitals and doctors and pharmaceutical companies typically can’t refuse.
“I’m going to make him an offer he can’t refuse.”
Why the Consumer Model Fails America’s Health Care System
In America, the idea is that you’ll be a consumer.
That you’ll do what you do when you go to Best Buy and buy a television.
But that just doesn’t work in health care.
It doesn’t work because you often come and get health care when you’re unconscious, in an ambulance, when you’re scared, when it’s for your spouse or your child.
It is a time when you have the least bargaining power.
You are not usually capable of saying “No.”
You’re not knowledgeable enough to do it, not comfortable doing it, or not conscious enough to do it.
That’s why in other countries, the government is the person who can say “No” for you.
It can say, “No, that’s too expensive, you’re going to have to lower your price,” because they have that power.
The Push for Single-Payer Health Care
Anchor: A new push for single-payer health care right here in the U.S.
Demonstrator: “What do we want?”
Crowd: “Single-payer!”
Demonstrator: “When do we want it?”
Crowd: “Now!”
Anchor: California and others are saying maybe we should adopt the European model.
The Challenge of Reform
If we decided to create a single-payer system with one of these huge price lists in the U.S.,
there would be nothing to stop lobbying from hospitals, from doctors, from drug companies — and those prices would get influenced.
So we could end up with a single-payer system that is expensive — even as expensive as our current system.
It all depends on how much you negotiate down the prices.
And now, in America, these groups have so much power because they are so rich that it’s really hard to get them to bring down the prices.
This is the irony of American health care:
It’s so expensive that it’s become hard to make it cheaper.
All that money they make becomes political power.
Years and years of overpaying have created huge industries, and they have a lot of influence in Congress.
The Pain of Change
Under a single-payer system, if we did drive prices down, doctors and hospitals would be paid less than they are right now.
That might mean some of them close, some go out of business, or some move.
It would be really painful.
One person’s waste is another person’s essential service or local hospital or income.
Bernie Sanders’s Interim Plan
But single-payer isn’t an all-or-nothing choice.
There’s a really interesting section of Bernie Sanders’s Medicare-for-All bill where he lays out an interim plan.
It’s a plan he wants while he’s setting up his new single-payer system.
In that plan, he expands Medicare to cover vision and dental and opens it to nearly everyone — not just people 65 and older.
All kids go on Medicare automatically, and most adults can buy in.
That plan, on its own, wouldn’t get American health-care spending far down overnight,
but it would at least begin to recognize what we already know — and what most other countries already do:
That health care is one of those things the government can do cheaper and better than the private sector.
नमस्कार दोस्तों। मेरा नाम Yash Patel है और में पिछले 4 सालो से आपको सही जानकारी दे रहा हूं,Vacancy Xyz का Owner भी हूं, और Writers भी हूं, मैं इस साइट में Job, News,Tech, Finance और Auto मोबाइल की जानकारी देता हूं,जिसका Educational and Awareness Purpose है।
