Why Do We Spend So Much on Healthcare?Read more at location 1230
Note: Gli usa spendono di + x avere -? E' vero il contrario Costo sociale e costo all' utenza Costi occulti: attesa Contare le risorse a parità di risultato Outcomes: cancro e speranza di vita. Resta comunque assodato che gli stili di vita siano i fattori + influenti Non c' è gran differenza tra governo e assicurazioni (regolamentate) La grande convergenza Ricetta: 1. HSA 2. assicurazione che rimborsa ai costi standard Edit
United States spends far more than any other country and enjoys mediocre health outcomes.Read more at location 1524
When you and I buy something, the cost to us is the price we pay for it. But that is not necessarily true for society as a whole. The social cost of something may be a whole lot more or a whole lot less than what people actually spend on it,Read more at location 1538
As previously noted, in the United States and throughout the developed world, the market for medical care has been so systematically suppressed that no one ever sees a real price for anything.Read more at location 1540
To make matters worse, other countries are more aggressive than we are at shifting costs and hiding costs.Read more at location 1545
In Greece, patients spend nearly as much on bribes and other informal payments as they do on formal costs such as insurance co-pays.Read more at location 1548
One way to pay doctors is to pay market prices—whatever fees are necessary to induce them to voluntarily provide medical services. Another way is to draft them and pay them little more than a minimum wage—as the government has done in the past in times of war. Obviously, the second method involves a lot lower spending figure. But to economists, the social cost is the same in both cases.Read more at location 1550
The reason? To economists, the social cost of having one more man or woman become a doctor is the next best use of that person's talents. Instead of becoming a doctor, the pre-med student might have become an engineer, say, or an architect. So what society as a whole must give up in order to have one more doctor is the loss of the engineeringRead more at location 1553
This cost, called opportunity cost, is independent of how much doctors actually get paid.Read more at location 1556
The opportunity cost of a hospital, for example, is the value of a commercial office building or some other use to which those same resources could be put.Read more at location 1558
there is another way to assess the cost of healthcare. We can count up the real resources being used.Read more at location 1560
On this score, the United States looks really good.58 As Table 5.1 (from the latest OECD report59) shows, the United States has fewer doctors, fewer physician visits, fewer hospital beds, fewer hospital stays, and less time in the hospital than the OECD average.Read more at location 1562
the only area where we spend more is on technology (MRI and CT scans, for example), as shown in Table 5.2Read more at location 1565
Almost a decade ago, Mark Pauly, a professor of healthcare management at the University of Pennsylvania's Wharton School, estimated the cost of healthcare across different countries based on the use of labor (doctors, nurses, etc.) alone.60 The finding: the United States spends a lot less than such northern European countries as Iceland, Sweden, and Norway and even less than Germany and France.Read more at location 1569
What about outcomes? Do we get more and better care for the resources we devote? Here the evidence is mixed.Read more at location 1572
five-year cancer survival rates. The United States basically leads the world.Read more at location 1575
Studies show almost no relationship between aggregate spending on health and population mortality.Read more at location 1576
Nonetheless, life expectancy statistics are a favorite of the critics, since Americans don't score very high.Read more at location 1577
Interestingly, one study found that if you remove outcomes that doctors have almost no impact on—death from fatal injuries (car accidents, violent crime, etc.)—US life expectancy jumps from No. 19 in the world to No. 1,Read more at location 1578
The general consensus of the literature, however, is that there is virtually no relationship between total healthcare spending and life expectancy across countries.Read more at location 1583
What the Right and the Left Don't Understand About Healthcare in Other CountriesRead more at location 1590
the belief that other healthcare systems are radically different from our own. They aren't.Read more at location 1592
Take the United States and Canada. I would say that the healthcare systems of these two countries are 80 percent the same. In both countries, third-party payers pay the vast majority of medical expenses.Read more at location 1596
in Canada, government is the third-party payer, whereas in the United States, about half of all spending is private. The mistake is assuming that there is a substantial difference between public and private insurance in the United States. There isn't. As we have seen, Medicare in the United States is managed almost everywhere by private contractors, and much of Medicaid is privately managed as well.Read more at location 1600
one out of every four Medicare enrollees and a substantial majority of Medicaid enrollees are enrolled in private health plans, even though government is paying the bill.Read more at location 1603
private insurance in the United States is so heavily regulated that there is no important difference between the public and the private sector.Read more at location 1605
There is far more difference within US healthcare than there is difference between the US and other countries.Read more at location 1612
People on the left and right who are prone to stress the differences between US healthcare and the healthcare of other countries invariably ignore the 80 percent commonality and focus on the remaining 20 percent. On the left, the focus is usually on the ways we appear to be worse; on the right, the focus is usually on the ways we appear to be better. But even here the differences are narrowing, and I expect that trend will continue.Read more at location 1616
Another way in which people get misled is in assuming that differences in health outcomes are mainly due to how the medical bills are paid. Yet, differences in health outcomes are far more related to lifestyle, culture, and personal behavior.Read more at location 1629
we know a lot more than you may think we know about how to reduce healthcare spending.Read more at location 1637
there are techniques that will work. If we employ them, it appears that we could reduce US healthcare spending per capita to about the same level as the average developed country, in nominal terms. But wait a minute. In making this claim, aren't I guilty of the same “fatal conceit” that I warned against? How do I know what will work? Actually, I don't know. What I do know is that certain kinds of incentives motivate others to find out what works for them.Read more at location 1639
Let patients pay for all routine primary care and all diagnostic screening tests from a Health Savings Account that they own and control.Read more at location 1643
domestic medical tourism—with the third party paying only what the care would cost at low-cost, high-quality facilities and with the patients paying all the additional costs if they choose to seek care from other facilities.Read more at location 1646
WhyRead more at location 1849
Note: Quando conti i non assicurati, tieni conto che: 1. molti nn sono cittadini americani (specie immigrati illegali) 2. molti possono permettersi l' assicurazione 3. molti hanno diritto a medicaid ma non si iscrivono 4. un nn assicurato americano riceve + servizi di un assicurato canadese Edit
conventional wisdom in health policy: access to healthcare is determined by price,Read more at location 1850
one of every three uninsured people in this country is eligible for a government programRead more at location 1939
A RAND report on expanding Medicaid coverage in Oregon turned up some positive effects.29Read more at location 4099
However, economist Robin Hanson points out that about two-thirds of these effects occurred after being accepted into the program, before any care was actually received.Read more at location
