biochem wrote:namelessfly wrote:The point is that the US already had an extremely effective healthcare system based on employer financed insurance with Medicaire to insure the high risk elderly and Medicaid to fund the indigent. I myself was enrolled in a government organized high risk insurance pool. Itcost me $1,000 per month for a high deductible, but I had insurance.
You´re kidding right?
US healthcare system runs at about twice the cost, with roughly similar average quality to the system here.
TWICE the cost. With a low end of quality that is depressingly poor
Pre-Obamacare about 85% of the population was insured.
Looking at averages is misleading to the situation. The USA has some of the best medical care in the world for those who can afford it i.e. the insured 85% plus rich foreigners who pay out of pocket. For the 15% uninsured we have some of the worst healthcare in the developed world. When looking at averages you are lumping the 2 groups together and the 15% pulls down the average of the rest.
A similar situation is seen with costs. That 2x cost is driven by a tiny percentage of patients that cost absolutely horrendous amounts to treat: very premature babies, people in their last year of life etc etc.
So if you are developing a policy and you look at averages as a guide you will diagnose the WRONG problems with the system, which is part of the problem with Obamacare. Diagnosing the quality problem correctly, 85% have excellent quality care, 15% have poor quality care leads to a logical conclusion of leave the 85% alone fix things for the 15%. But Obamacare made the mistake of trying to fix the whole system instead of focusing on the problem area. As a result, this boondoggle more people have been harmed than helped. Personally, my family now has worse insurance for a lot more money - so we are in the harmed category.
On the costs side it is customary to treat here where other countries do not. And those tiny percentage of cases drive a large amount of the unnecessary costs. The reasons are complex: legal (Doctors don't want to be sued), emotional on the part of families, religious, etc. And because the reasons are complex there isn't a simple solution. However, there are things that could help. Tort reform would be a good place to start. Of course that would require congress to quit taking so many bribes (sorry campaign contributions) from the trial lawyers association.Withfew exceptions, the only people who had no insurance at all were illegal aliens.
That´s not what statistics say.
You're correct here. That 15% does not include illegal aliens. However illegal aliens without insurance are a significant cost driver in border states. Perhaps the US government should just add up the per country expenses we get stuck with and send a bill to their home countries. But somehow I doubt most of them would pay it.A big expense for our systems is the high cost of drugs until the patents run out (sorry Biochem but I disagree strongly with you on this). Sure they have to recoup their development costs and turn a decent profit for shareholders, but deliberately charging twenty times production costs for a life saving drug right up to the patent expiry, which costs the lives of many poor people internationally is inexcusable.
I'll agree the drug companies are run by sociopaths. Unfortunately no one else has been successful in developing drugs. The sociopaths are in it for the money and if they don't get the money, they'll invest in something else and let the drug companies go bankrupt. This is in fact what is happening. The ROI (return on investment) isn't what it used to be considering the risks they are taking and so they are getting out.
Pharmaceutical companies are downsizing R&D with a chainsaw. You don't really see it yet because they still have drugs in the pipelines but they are drastically cutting R&D.
And to make it worse innovative new drugs cost a lot more to develop and are exponentially more difficult to develop so fewer and fewer of the new drugs are truly innovative.
Bill Gates is spending a lot of money trying to cure malaria and TB but even he doesn't have enough money to replace the greedy sociopaths. In any case if you can come up with a way to get R&D done in this high risk environment without the sociopaths, great. But in the short term we may be stuck with them.
That's definitely a big concern. The pharmacology companies spend hundreds of millions to billions of $ to try and develop new drugs and procedures, and most of them fail to pan out, so there's that money being lost. Those companies cannot just keep throwing money at the problem without finding a way to replace it, and since many countries out a price cap on what companies can charge for their products (the newer stuff costing a hell of a lot just to develop), they are -severely- constrained in recouping their losses, and these companies have to make a profit to keep running in order to fund new research (and these companies, hate them or not, do better research than the government), prices for drugs in the US, which doesn't have price caps for the most part, are higher since the US is the only place the companies can recoup their R&D expenditures.