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As I review social media the angst over health care costs and insurance is apparent. Americans don’t like premiums, out of pocket costs, insurance companies or anyone interfering with their health care. Most people have no clue about the relationship between premiums, deductibles and out of pocket costs. One goes down the others must go up.
Americans want any and all services paid without question and they want it all “free.”
That’s quite a wish list. Oh yes, they also don’t want anything remotely looking like socialized medicine which some call Medicare.
I always found it amazing how money spent on health care is always viewed as very different than the same amount of money spent on just about anything else. I learned this well from decades managing health plans and dealing with people.
Just think of the tens of thousands of fans spending small fortunes to attend the World Cup matches. It’s $250 just to take the train from NYC a few miles to the NJ stadium. Fugatabout what they spend on tickets, etc.
Then I imagine their reaction if a pharmacist told them the Rx copay was $250. The Rx may save their life, but it’s unaffordable. The soccer match gives then pleasure and is affordable even if it is on credit.
I don’t have an answer, I don’t know what Americans want or expect possible when paying for healthcare. However, I suspect what people may want is to hide all costs in taxes so when it comes to receiving healthcare, it will be “free” like in other countries. Good luck getting anyone to admit that though.
FYI The average net profit margin for health insurance companies 5-6% – among the lowest industry and if you took the compensation of the CEO of the largest insurer and allocated it to policyholders premiums it equals less than a dollar each.
So, any ideas? What do we Americans want when it comes to paying for our healthcare?
“If you think health care is expensive now, wait until you see what it costs when it’s free.” — P.J. O’Rourke, American political satirist and author
It’s interesting nobody has mentioned the massive amount of dollars spent on advertising new, expensive drugs. I believe the U.S. is the only country which allows advertising for prescription drugs. The same drugs sold in the U.S. for big dollars are a lot cheaper in other countries.
Harry, you’ve hit on one of my pet peeves, I hate those commercials. I truly don’t know how the cost impacts prices. I do know there are many other factors that cause the discrepancy among prices.
Richard? Your thoughts?
What do I want? I want America to be a country where nobody goes bankrupt or has to sell their home because of medical bills.
I want America to be a country where everybody has access to basic health care, where you don’t meet families whose 5-year-olds haven’t had a medical checkup since they were born because they don’t have insurance or there aren’t any doctors around.
I want America to be one of the safest countries in the world to give birth. Not ranked 54th in infant mortality behind places like Latvia and Serbia. Not three or five or ten times the maternal mortality rate of other developed nations.
And I don’t want anybody to tell me we can’t afford it when we spend more on national defense than the next six countries in the world combined, while having no enemies on our borders.
As you know, it’s complicated and so very misunderstood. Regarding infant mortality. Access to pre natal care is a big factor, but so is lifestyle, including obesity.
Bankruptcy does occur of course, but more often than not health care expenses are listed as one factor among others in bankruptcy, not the primary cause. But seeing healthcare listed affects the narrative.
It’s not a matter of affording it and certainly not additional tax dollars. We could implement a form of Medicare for all by diverting current employer spending, government tax dollars (Medicare and Medicaid, etc.) and individual current spending on premiums and out of pocket spending.
Now mention that to people and see the reaction😱. I’m amazed that 60+ million of us get our healthcare paid for by Medicare quite easily and accessible, but trying to extent the concept to everyone turns it into socialized medicine- which it is not?
Medical expenses are listed as the primary cause of two-thirds of US household bankruptcies. Sources for that statistic are multiple.
And the politicians enacting the cuts to Medicaid and the ACA and eliminating the HHS programs targeting infant and maternal mortality ((the Maternal and Child Health Bureau and the Pregnancy Risk Assessment Monitoring System) all cited various versions of “America can’t afford it” as the reason.
Part of the problem is that we have a mixed system. Medicare often does not reimburse enough to cover DR and hospital expenses, so they have to charge more to other patients to make up for it. Primary care Drs limit the number Medicare patients they will take on because they lose money on them. My wife’s DR moved away and we cannot find another DR who will take her on.
Years ago, the government put a wage and price controls on businesses. One of the results was that employers got around the law by offering like health insurance instead of higher salaries to attract employees. This created yet another tier that gave some people a big advantage, hurting others. If everyone was in the same boat and all the insurers had to compete for customers, prices would come down.
What strikes me is that the U.S. spends about 17% of GDP on healthcare, versus roughly 10%–12% in countries like the Netherlands, Germany, Belgium, and the Scandinavian nations.
Yet our health outcomes are often no better—and sometimes worse. The question isn’t whether we’re spending enough, but why we’re spending so much more for comparatively poor results.
If we could even partially reclaim that extra 5%–7% of GDP, we could fund many of the social programs that today seem unaffordable.
Mark, agreed, I have pondered this issue before. According to Wikipedia, US spends US$13,473 per capita each year, and Australia US$6,980. Yet Australia has life expectancy approximately 4 years longer than the US.
Surely the fact that spend per capita is nearly double, but life expectancy is lower, is a sign of some major inefficiencies.
You have to be careful looking at health outcomes. Our health care quality is fine. Many of the outcome comparisons are affected by population and lifestyle differences. And of course millions with limited access to care. We are the most obese country in the world outside of a few Pacific islands. High infant death rates are not because of quality, but access and parent lifestyles.
Other countries accept as normal waiting times and other limitations. Americas think more care and faster care and often duplicate care is always better. It isn’t. Compare the number of MRI scanners in the U.S. They have to be used to pay for them. Only Greece has more per 100,000 population. Ireland has less than half the U.S. Some countries a third. I can drive to six major hospitals in 20 minutes or less. That may not be efficient.
I have traveled with my children as preteens and later as young adults in Germany and Japan. On one occasion our son required an outpatient visit for a serious infection. Our daughter had an emergency room visit for a serious health condition. In both instances, medical services were relatively prompt (< 1 hr wait) and inexpensive. Prescribed meds were also inexpensive and the health concerns were resolved. I contrast that with the forms, billing, EOB statements, and coverage reviews we all – well most of us – experience in the US. The US spends more per capita on health care than other nations. Yet, our health outcomes – think infant mortality – are sub par for developed nations.
I think R. Quinn’s post highlights the lack of good healthcare education among the general public. As Quinn noted in another thread on this site, in retirement and as we age, our health and making the most of our time are extremely valuable. I think many would exchange taxes for healthcare for unanticipated expenses that can wreck individual and family finances.
Quinn’s post highlights the lack of good healthcare education. I totally agree, but would add that we individuals need to eat better and exercise more.
The other day I had my first Jersey Mike’s Philly Sub and a bag of chips. It was sooooooo good, but probably a lousy choice for my health. But the good news is, I just had a great workout at Planet Fittness!
Well duh, Dick, I want my taxes to pay all my health care costs….. Just don’t raise my taxes🥴
I think a few million people agree with you. I think you are on to something. 😱