Skyhigh prices of everything make US healthcare the worlds most expensive

first_img Xoxarle 3 4 I worked and am now retired from the U.S. health care industry. The waste is astounding! Care received is marginal. Accrediting bodies try to self-police but fail. Physicians gather for national meetings at the Ritz-Carlton and obscene venues such as Gaylord Resorts, where exotic food and booze flows behind closed accounting systems hiding their cost. tjt77 America spends twice as much on health as 10 other rich countries, due to the high cost of everything from prescriptions to doctors Report infullview Report Share on Twitter Report Share on Twitter Show 4 more replies Share Reply sammy3110 3 4 1 2 3 4 Share 1 2 Report That’s being a bit optimistic. The Republican party has blocked any attempt to rein in healthcare costs — you only have to look at the Medicare Part D mandate to see how their thinking works. You could say that the GoP is, among other things, the epitome of the Medical-Industrial complex. You’re also being a bit optimistic about the tax bill. The bill itself was a bit rushed so its only relatively recently that people have started to figure out the effects of some of the provisions. One that will affect ordinary people is that most aren’t getting a tax cut – it was minimal, anyway – but the revised withholding rules won’t make up for the loss in dependent allowances. (The IRS, among others, still can’t figure out the pass-through rules.) Still, I have to admire you for keeping the faith….. 6 7 Share on Twitter Support The Guardian Facebook Share on Facebook Share Reply 1 Facebook Share on Twitter Report Share on LinkedIn Xoxarle Share on Twitter Massaniello Share on Facebook Xoxarle Reply 14 Mar 2018 4:27 14 Mar 2018 1:20 3 14 Mar 2018 4:57 25 BuckUpButtercup imsoboredwiththeusa 1 2 Reply collapsed Unions have fought for a decent wage, not for gouging sick people. unthreaded Facebook Share Manahmanah wrkerbe 14 Mar 2018 1:56 Share on Twitter Report Share on Twitter I always wonder where they get the data on physician wages. My husband and I have an independent family practice in a small town and don’t make $130,000/year between us. It’s probably the big hospital chains that give out the big salaries. PepperoniPizza Twitter Share on Facebook Facebook Facebook Reply | Pick Report PepperoniPizza Share 14 Mar 2018 1:21 6 7 Share on Twitter There are very well set up systems which prevent physicians getting kickbacks. Any gift or anything linked to a dollar value is strictly regulated and prevented. If the guidelines are not followed multi million dollar fines can and are levied. We were at a bms brunch with free coffee and cheesecake today and doctors were being told to report that value. 8 9 Here’s a link for you to the NYT in-depth series Paying Until It Hurts: Once you educate yourself about the deceptions and greed practised by doctors, in addition to all the other bad actors (hospitals, drug companies, insurers), you’ll learn to distrust and despise them too. Here’s an especially distastful example of the kind of tricks doctors get up to: Share Share on Twitter Twitter 14 Mar 2018 1:17 Comments 354 Share BuckUpButtercup Share on Twitter Twitter Twitter Reply Share Facebook Reply Reply 14 Mar 2018 2:48 Twitter Report Share Aseoria 14 Mar 2018 2:56 Share on Facebook Yeah, I wondered about that too. In our city, the largest in the state, primary care docs top out around $160,000. The starting salary for residents is less than what many nurses make. Then add the burden of huge, monthly student loan payments to all that. And keep in mind that many people get their day-to-day care from nurse practitioners or physician assistants, who get paid much less. Twitter It was pretty shameful to single out doctors when the real money is made by the executives who have nothing to do with caring for the publics health.You cant watch TV for 20 minutes without seeing a prescription drug commercial telling you to go talk to the “overpaid” doctors. Take a look at what big pharma pays its top executives and you’ll find a shameful distribution of loads of money to people who have little to no impact on the healthcare of our citizens. Share on Facebook 10 11 Aseoria Reply 11 12 recommendations The way to cut costs is to eliminate insurers (useless middlemen with outsized admin overheads and complex billing systems), open up supply of doctors, have government set caps on drug prices, stop politicians corruptly taking bribes to extend generic protections, eliminate med school debt for doctors, curb excesses of hospital corporations and their opaque charge sheets, end hospital regional monopolies, bring all citizens under Medicare umbrella with it’s low admin overheads and negotiated pricing. End advertising of drugs on TV, end the drug reps bribery of doctors, end financial incentives for over-medicating and overuse of diagnostic scans, give poor people access to preventative care so they don’t need to use expensive ER as first point of contact for when trivial issues become severe. End the deceptive labeling of in-network vs out-network, end provider to insurer deal-making. Twitter Facebook 14 Mar 2018 2:57 14 Mar 2018 2:28 14 Mar 2018 2:13 | Pick A_Fortunate_One Share on WhatsApp I worked in the US health “care” system for the better part of a decade. It’s not the doctors salaries that are inflated. It’s the executives and administrators, many of whom have never treated a single patient in their lives, that need to be culled and reined in. Or, jettisoned entirely. Also, the administrative costs through a labyrinthian bureaucracy of insurance companies, the competitive marketing costs, and astronomical pharmaceutical inflation needs to be on the chopping block as well. Not doctors salaries. Health care should be ran by scientific based and objective panels of doctors and specialists, not these greedy fux anyway. Twitter Share on Facebook Report The only way I see to cut costs would be to fire nurses, raise the deductables, reduce coverage and kick lazy entitled sponges out of the program. That should do it, no? 7 8 ID5586613 | Pick “So private sector “efficiency” is 2.5 to 8 times LESS efficient than other countries.” No, American doctors earn much more than doctors elsewhere. That’s all. Don’t feel badly just because the NHS pays a pittance. It’s based on supply and demand, not efficiency. Effectiveness rather than socialism. See? 13 14 UnstableGenius Share on Facebook Twitter Share 19 20 Sky-high prices of everything make US healthcare the world’s most expensive Share HiramsMaxim Share on Twitter Facebook Share on Twitter Well, malpractice is a business expense. I suppose it depends on whether it is paid by the Doctor, or by the healthcare organisation. One way or another, it is the insurance companies who pay it (and thus is priced into premiums.) Yes, we spend a HUGE amount of public money on healthcare. And, like so much of our spending, it is not done with any eye to efficiency. As long as the argument is over national health or nothing, the two Parties can continue to fund raise over the issue, without having to actually do anything. And, like abortion and gun laws, nothing will change, because the issues are more valuable as differentiators to politicians, then they are as problems to be solved. Share on Facebook Reply Report | Pick | Pick Share HiramsMaxim The AMA does not lobby to keep the supply of doctors low. New medical schools are opening all over the country. The bottleneck in producing new doctors are the number of residency positions. Those are funded by the federal government, who has not allocated much money to expand them. Report 0 1 TettyBlaBla 6 7 Share on Twitter ralbin Twitter Report Report Share on Twitter Show 1 more reply Facebook Twitter Share Facebook Share 14 Mar 2018 2:36 Sorry there was an error. Please try again later. If the problem persists, please contact Userhelp Share Report PepperoniPizza Share on Twitter Share on Twitter Facebook David Betterton 14 Mar 2018 1:10 Reply Report Facebook Remember 1980? That’s when almost all health insurers went for-profit (Thanks, Ronnie!). The rest is the odious history of obscenely paid execs, with thousands upon thousands denied adequate care and condemned to death as the collateral damage. It’s all about money, not humans. BankruptoCleptoCasinoCapitalism (BCCC) meets BankruptoCleptoCasinoCommunism (BCCC) in what unites them both, opposites as they may be: Organized Irresponsibility. Communism imploded due to the decades-long rot eating it from within (with Ronnie and JPII giving it a wee little tap to make it fall a tiny bit sooner, but certainly not to be credited with the system’s downfall – that was entirely its very own doing). The BCCCapitalism we suffocate under today will soon do the same. Get your two Charlies, Dickens and Marx, out again: they are, again, surprisingly accurate these days. “Ill fares the land/To hastening ills a prey/Where wealth accumulates/But men decay” (Oliver Goldsmith, The Deserted Village, 1770). Share on Twitter Peter Davis Share Share more infant deaths than any other country Really folks you have been proven wrong on this leftie talking point, how many times? Order by oldest Report 0 1 Facebook 1 2 ewmbrsfca Share on Facebook Report Share on Twitter Share doc_doom sammy3110 Facebook HiramsMaxim Show 8 more replies Report Report PepperoniPizza jjustad 14 Mar 2018 1:49 14 Mar 2018 2:36 ID5586613 JillTheSaint Share Share on Twitter William Anthony | Pick 12 13 In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives. Report 14 Mar 2018 2:55 infullview Xoxarle Twitter 14 Mar 2018 1:09 Reply Twitter Show 5 more replies Facebook dturkey Facebook Report 14 Mar 2018 3:40 Since you’re here… Share Thomas1178 Twitter | Pick PepperoniPizza UnstableGenius Facebook | Pick | Pick Share | Pick Share on Facebook Twitter Share on Facebook 14 Mar 2018 3:22 States consider bringing prescription drugs from Canada to US as costs soar Twitter Share on Twitter Twitter 3 4 Share on Facebook Twitter Share on Facebook | Pick Facebook Reply Banking reform is a second term item after reelection in 2020. infullview You will get a notice from Medicare telling how much, if any, you still owe the provider after Medicare pays. It will either be zero or an arbitrary amount much lower than what the provider’s full bill is. Wait a bit. Or go online and look at your Medicare account to see recent charge/payment/balance activity. Only pay what Medicare says you have to pay. As for your medicine charges under your Part D or “Advantage” plan, you really don’t have to deal with the insurance company at all. Just pay what the pharmacy charges you. Make sure your pharmacy is on the long list of approved pharmacies. They’ll collect the balance from your insurance company without you being involved. Not so hard. Certainly not so hard that one would want Universal when the Medicare and drug premiums are so much lower than they would be with that. I realize you already know he went to prison. I’m just saying that one has to be caught breaking the law, and that’s why more don’t go to prison. They can get rich without breaking the law. Reply 3 4 Reply Share on Facebook Share Share on Facebook | Pick Share Report Catherine_the_decent Twitter 0 1 The nominal cost of becoming a doctor is $1m in training and lost wages. Public US college costs are comparable with British costs (Instate university of Arizona fees are less than Loughborough’s and UofA does have a decent medical school). So how do you cut that $1m cost, without lowering requirements? Anyone with the intelligence to become a doctor could earn more in other professions. Share Facebook Share on Facebook Facebook Share on Twitter Recent attempts to reform American healthcare have assigned blame for the high cost of care to nearly every sector – from drug companies to hospitals to health insurers. However, a co-author of the new study said those arguments ignore the “800-pound gorilla”: sky-high prices everywhere. “Most countries get to lower prices one of two ways: they either have a very strong price setter, usually a government agency, or more efficient markets,” said Dr Ashish Jha, co-author of the study by researchers at Harvard’s TH Chan School of Public Health. “The US has figured out how to do the worst of both.”In the study, America was compared to 10 other countries: the United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands and Switzerland. Researchers used 98 indicators to compare countries across seven areas: general spending, population health, structural capacity, utilization, pharmaceuticals, access and quality and equity. The majority of the data came from international organizations, such as the Organization for Economic Cooperation and Development. What researchers found was not a single sector with high prices, but that every sector had extraordinary price tags. For example, the average salary for a general practice physician in the other countries was between $86,607 and $154,126. In the US, the average salary was $218,173. Per capita spending for prescription drugs in other nations ranged from $466 to $939. In the US, per capita spending was $1,443. The US also spends more on administrative costs. Other nations spend between 1%-3% to administer their health plans. Administrative costs are 8% of total health spending in the US. This results in US health costs that, as a percentage of gross domestic product, are nearly double that of other nations. In 2016, the US spent 17.8% of GDP, compared to 9.6%-12.4% in other countries. At the same time, America often had the worst population health outcomes, and worst overall health coverage. The US ranked last in life expectancy; had the worst maternal mortality rates (nearly triple that of the United Kingdom); more infant deaths than any other country, and a high rate of low birth weight babies. Report Report Share on Facebook Catherine_the_decent Twitter 14 Mar 2018 5:43 Share Facebook Share Twitter Share on Twitter Report | Pick Share Peter Davis Share on Twitter Catherine_the_decent Reply Thomas1178 Public US college costs are comparable with British costs Share on Facebook Part of Obamacare was to set a minimum limit on how much of premiums had to be spent on healthcare. Do you have informed opinion if malpractice counts as healthcare- does that need breaking out ? Share on Facebook 2 Reply Facebook Share on Facebook Report Share on Facebook Reply Share on Facebook Show 5 more replies 5 6 Easy–you make medical education free to the student, and cut doctors’ fees. Share Share wrkerbe Read more 14 Mar 2018 4:55 | Pick Share | Pick 14 Mar 2018 1:30 Share on Twitter Twitter Share Share on Facebook BrooklynNonHipster Indeed. I thank my lucky stars everyday! Twitter Reply 6 7 Reply Aseoria Report Share on Twitter Worth also remembering that single-payer, or Medicare For All, had a comfortable 70% approval rating from repeated polling. Tue 13 Mar 2018 16.29 EDT Before the Affordable Care Act passed our household was spending about 28% of annual cash flow in the form of early withdrawals from retirement accounts (which was considered to be around median in my area and very high in non-coastal states). At the time we were purchasing individual coverage. We did some financial modeling based on proposed changes to Medicare, including rising annual premiums, additional Medicare taxes on retirement income (taxing our income while we earn and again when we retrieve it from after tax savings put into IRAs as there was a low limit to what could be saved pre-tax), ever-increasing co-pays, ever-increasing deductibles, and the prescription medication donut hole where nothing was covered after token expenses (considering massive inflation in drug prices) and came to the conclusion that medical expenses would take roughly 70% of cash flow in retirement. Even with what remains of ACA today I will not be eligible for Medicare for a number of years, my individual health insurance premium presently runs more than rent for a 2 bedroom apartment in the midwest and it is anticipated that premiums will go up in my state by 19% next year due to the removal of the individual mandate and decision by many who do not have employer or taxpayer funded coverage (whether elderly or impoverished) will skip having insurance altogether, leaving only people who have a history of seeing medical professionals for their existing health issues. If you would like to point a finger, it can be directed to Richard M. Nixon and the HMO Act of 1973. While originally intended to curb medical inflation and provide comprehensive and more equitable and accessible health care, buried deep within this act was the repeal of all requirements that health care providers and insurance companies be service providers (non-profit). The Act launched the familiar annual circus called Open Enrollment and has since been amended six times, with the latest being HIPAA in 1996. 2 3 Report 14 Mar 2018 3:20 14 Mar 2018 2:26 Share on Twitter PepperoniPizza Facebook Share on Facebook Twitter 7 8 Reply Is it true that almost 75% of care facilities and clinics in the NHS are understaffed due to lack of decent pay to attract doctors? Surely your low pay would still attract the best and brightest, simply because they are loyal and patriotic, no? Surely it is simply a coincidence that many doctors in the USA today speak with decidedly British accents? A recent headline in a British newspaper: “NHS doctors warn medical care is deteriorating as nearly 75% report staffing shortages on wardsGovernment told to get a grip on funding and workload pressures which are making NHS jobs unsustainable” jjustad Share on Facebook 14 Mar 2018 2:35 Reply Share on Twitter Share on Twitter Twitter “Ronnie” didn’t take office until 1981. Are you sure you’ve got your analysis right? Share on Facebook | Pick but the article didn’t single them out, the article said that high prices across the board are the drivers of inflated health costs in the United States. Administration, drug prices, medical school cost, doctor compensation etc. All of it, together. I blame selfish, single-issue voters who shoot themselves (and their neighbors) in the foot every time. There are places in the US where doctors and dentists give free clinics for the homeless, I have seen it in Oregon. 11 12 0 1 Share 2 3 Share on Twitter Twitter 14 Mar 2018 1:22 Twitter Reply | Pick Share on Facebook Facebook Share on Twitter 8 9 14 Mar 2018 4:27 This article is more than 1 year old Report Share PepperoniPizza Share on Facebook Share on Twitter Share JillTheSaint 7 8 Share on Twitter Twitter 1 2 Facebook 14 Mar 2018 9:18 US healthcare Share on Facebook Share on Facebook DBINSF Share Share ewmbrsfca Reply 14 Mar 2018 2:37 Close report comment form Twitter BuckUpButtercup LabRat99 Reply Ten years ago the minimum wage for M.D.’s not at the top of the class was 30KUS, today it is not uncommon for specialist such as heart surgeons to make 2 to 3 million US. Those earnings do not show up as wages, since all M.D.’s are allowed to incorporate as not for profit corporations onder their personal name, so-call small business in America. Allegiance to the Hippocratic Oath as set aside years ago…. | Pick Reply Share on Twitter Share 14 Mar 2018 20:50 US healthcare Share on Facebook Xoxarle Report Facebook Report Reply Share on Facebook PepperoniPizza Remember 1980? That’s when almost all health insurers went for-profit (Thanks, Ronnie!). Facebook Twitter Share on Twitter Janeinma BrooklynNonHipster America really missed out on a chance at Medicare for all when they elected that completely insane president Dump. The Millenial generation will implement American universal healthcare as soon as the current lack of healthcare speeds the demise of all the old people who continue to vote for republicans. “Allegiance to the Hippocratic Oath as set aside years ago….” Does the Oath say anything at all about salaries? Beuler? Beuler…? For over a century, doctors with the AMA have fought against universal healthcare simply because they want to set the costs. And it’s been great for them, and a death sentence for millions of other Americans. Share on Twitter Reply Share Share Share on Facebook Share on Twitter | Pick Report Share on Facebook This article is more than 1 year old PepperoniPizza 4 5 Share Reply Share on Twitter | Pick Report So private sector “efficiency” is 2.5 to 8 times LESS efficient than other countries. Need to broadcast that to the trumpeters (dun intended) of private health care. Report Share on Twitter | Pick dopamineboy PepperoniPizza Share on Twitter Share on Twitter Report Share on Twitter Administrative costs in the US are just 8% of the total, as reported here. The administrators may be overpaid, but paying them nothing would reduce health care costs by less than ten percent, and our health care costs are more than twice other nations for worse outcomes. The major problem are the salaries, the drug costs and the system (each doctor completely independent of the others with no team work or responsibility). Share on Facebook Reply Wrong. Address the banking system, in predatory student loan practices with crippling interest rates. Bingo – opens up availability for thousands of potential doctors and nurses to actually pursue careers in health care, education necessary for our aging society, and affordability in working in these fields without exorbitant interest rates applied to student loans (due and payable upon day of certification). GOP loves to espouse the trickle-down theory of economics, much of which proven to be, at best, questionable in terms of actual application, and at worst blatantly whitewashing of the reality – corp.’s, including banks & lending org.’s, keep the realized savings for shareholders v employees or end-use consumers. Facebook | Pick Report Right back at you. True they need an order from a doctor but the actual MRI to my knowledge can be done by a tech with little to no experience and license. I stand by my “shithole” state comment! 2 3 14 Mar 2018 2:45 The United States spends twice as much on healthcare as 10 other high-income nations, driven by the high price of everything from prescription drugs to doctors’ salaries, a new study in the Journal of the American Medical Association finds. 14 Mar 2018 3:29 Reply Xoxarle Reply Reply Share on Facebook 9 10 Reuse this content,View all comments > doc_doom Sign in or create your Guardian account to recommend a comment PLDD Next item on the MAGA agenda – root and branch reform of the completely corrupt US medical-industrial complex right after the Repubs win the midterm elections. Key goals: remove financial incentives for over-billing and over-prescribing; major crackdown on opioid manufacturers; etc. [By the way, a huge first step in the right direction would have already been taken had it not been for McStain’s betrayal in the Senate vote last year.] The implementation of these policies will engineer a rapid and visible improvement in the way health care works for ordinary Americans (sort of like all the salary increases that came through immediately after the tax cuts), thus ensuring the Donald’s re-election in 2020. Share on Twitter DBINSF Share Manahmanah Facebook Facebook Twitter 14 Mar 2018 2:48 28 29 14 Mar 2018 4:24 All riosalsero Share on Facebook DBINSF Reply ID5586613 Share 4 Report Twitter 1 2 Catherine_the_decent Report Twitter TettyBlaBla Report Report Share on Twitter Share on Facebook 2 Share on Facebook Reply Share Twitter | Pick Report 2miners Share on Twitter 3 4 Reply wrkerbe Reply Report Reply 14 Mar 2018 2:41 Janeinma Twitter Share on Twitter Share Reply Report 1 2 | Pick expanded Twitter Share on Facebook Twitter Share on Twitter TettyBlaBla JillTheSaint Speedsquare Thomas1178 14 Mar 2018 1:42 3 4 Share on Facebook 14 Mar 2018 0:54 0 1 14 Mar 2018 5:21 50 Facebook Share on Twitter Share Report Reply 14 Mar 2018 1:56 Share on Facebook Twitter imsoboredwiththeusa 14 Mar 2018 2:09 Share on Facebook Share on Facebook Facebook Twitter Facebook LabRat99 First published on Tue 13 Mar 2018 12.21 EDT 2 3 Share on Twitter Needed an MRI last year and didn’t know if it was going to be approved so I got prices in advance in case I had to pay. The prices ranged from $700.00 at a dedicated MRI stand alone facility all the way up to $8000. At a major hospital in Boston. All providers were licensed by state of Massachusetts. Unlike Alabama, Oklahoma, Missouri and Arkansas where no one is licensed and anyone can do an MRI. I would call these “shithole” states in the United States. Finally got approval but opened my eyes to wasteful and extravagant medical spending in US. If insurance companies really wanted to save the patient money and lower premiums wouldn’t they pay for a limo to pick up the patient, deliver them to the $700. MRI facility. Then return the patient in a limo back home. Also maybe throw in a gourmet dinner and show to show appreciation for going to $700. MRI facility! They probably would save about $6500. Each patient. Mary B Share on Facebook | Pick Share on Twitter Share on Facebook Share on Twitter | Pick Share on Twitter Share 14 Mar 2018 2:32 Share on Facebook | Pick 0 1 You don’t know that many do you- intelligent well that depends – I have met more than my fair share and you are not convincing me to change my mind Share on Facebook Aseoria 16 17 Facebook andyfu | Pick Twitter Share on Facebook Peter Davis While pharmaceutical costs are indeed a major driver, physician fees are not. They make up only about 10-12% of the total cost of healthcare, so even if you cut doctors fees by 25%, you’re still not going to put a dent in the cost of healthcare. The authors are disingenuous in their attempt to vilify U.S. physicians by comparing salaries to those of countries with socialized medicine. First, in most if not all of those countries, medical school is no-cost to students. U.S. medical students today will graduate with $250-300,000 in medical school debt. Second, malpractice claims are a fraction of those in this country, and are paid out by the government. Here, doctors can spend $100,000 a year of their own money on professional liability insurance. And greedy lawyers will sue for just about anything. Third, physicians in many of those countries get generous government pensions upon retirement. Here, most doctors must save and invest their own money in order to save enough to retire. Increase salaries for U.S. physicians offset those facts. Lastly, administrative burdens are enormous here, and cost the system billions while adding nothing to patient care. Look at this graph of the growth of administrators and physicians from 1970 to 2009. An that’s just administrators, which doesn’t include the volumes of mind-numbing paperwork and pointless regulations that waste time, money and resources. So sorry, this is a poor study and even worse conclusion. Are healthcare costs worse here than elsewhere? Yes. But not for the reasons the authors claim. | Pick | Pick Xoxarle Share on Facebook Facebook Sometimes hospitals send bills out to the patient without even checking who has the responsibility for payment. You will need to spend a lot of time on the phone – that’s the way it is. Facebook Report Twitter Report Report Show 1 more reply 2miners Report Reply David Betterton Share PepperoniPizza Report Share Share on Facebook I live in the US and recently turned 65. I am now on Medicare, plus I have an “advantage” program from a private insurance company called Aetna. I recently went in for minor treatment and discovered that I’m now dealing with three different bureaucracies: the local hospital, Medicare, and Aetna. None of which are in touch with the other. All of which are billing me and expecting me to handle the coordination of coverage. It’s this infuriating bureaucratic nightmare of having to deal with, in my case, three different billing entities that is also costing the US so much every year. It’s wasteful, pointless, and ridiculous. Time for single payer universal health coverage for all. Facebook Twitter Share on Twitter 14 Mar 2018 2:55 Share Report 14 Mar 2018 3:07 Facebook Twitter Share on Facebook Ms. Glenza needs to re-read this article and the several associated commentaries. Physician costs are not a driver of cost differences between the US and comparison nations. Its correct that physician income is significantly higher in the US but the US has a significantly smaller number of physicians per capita and these 2 effects almost completely cancel each other out. The four primary causes of cost differential between the US and these industrialized nations are:1) Drug Costs; 2) Procedure Costs; 3) Imaging Costs; 4) Administrative Costs. The comment by Dr. Jha about efficient markets is somewhat misleading. Presumably, he is referring to things like insurance markets in Germany and the Netherlands. These are highly regulated markets – the results of considerable state intervention. Efficiency in this domain requires strong state intervention. A final editorial comment. Left of center American politicians would love to the conversation about costs suggested by Dr. Jha. Its the right that is the obstacle. | Pick Report Twittercenter_img Share PepperoniPizza | Pick Share | Pick | Pick Jessica Glenza in New York Twitter William Anthony Share Share on Twitter Report Share on Twitter Reply Lead exposure may be linked to 412,000 premature US deaths yearly, study says Reply Twitter 3 4 lullu616 … we have a small favour to ask. The Guardian will engage with the most critical issues of our time – from the escalating climate catastrophe to widespread inequality to the influence of big tech on our lives. 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Every reader contribution, big or small, is so valuable. Support The Guardian from as little as $1 – and it only takes a minute. Thank you. | Pick Facebook Facebook Reply 14 Mar 2018 5:08 | Pick Don Martin Show 1 more reply Health 14 Mar 2018 2:03 Facebook Share on Facebook Twitter | Pick Share on Facebook Twitter 0 1 Reply Share on Facebook | Pick Share on Messenger Setting up a system of healthcare as a ‘for profit business’ is in itself ‘inhuman’ and hence open to a multitude of ‘conflicts of interest’ .. the primary power in this system, lies between insurance companies and drug suppliers. Insurance companies negotiate significantly lower prices than private individuals are billed.. hence we have billing practices to counter the ‘shortfall’:- an overnight stay own the average hospital bed in a ‘communal ward’ costs more than full private suite at a prestigious hotel..(why?) a simple 5 min procedure that would be billed at $120 in an ‘urgent care clinic’ is often billed at $1,000 in a hospital. (why?) . like the US political systems.. its is terminally corrupt, due to something that saner nations have deemed a ‘given right’ being sold to Americans as a ‘for profit’ business, which as a ‘consumer’ one has to pay for. Question on fairness and sanity :- What percentage of ones income should be put aside for ‘healthcare’ ? and how can one be expected to pay $2,000 per month for ‘health insurance’ when earning an average of $ 15 per hour ? how any sane person can find this highly discriminatory system even ‘acceptable’, let alone ‘viable’ defies rational logic and sanity. It should be seen for what it is :- A national disgrace. Share on Twitter Xoxarle 14 Mar 2018 1:38 | Pick Share via Email Reply Share on Twitter 14 Mar 2018 2:01 Twitter Reply Share Just 90% of Americans have health insurance, leaving about 27 million people without access to healthcare.Photograph: Peter Byrne/PA Share on Facebook Share on Facebook 3 4 Share Reply 14 Mar 2018 5:05 Report 0 1 4 Reply 1 2 Facebook DBINSF Share on Twitter Share Fire your private company and get another. Do the Trump thing. I am on Medicare and have secondary insurance and never ever see a bill until its all paid. I pay just a $30 co pay most visits and thats it. Sorry, I’ll use my sarcasm font next time. Reply 12 13 Share on Twitter Show 25 Share Martin Shkreli DID go to jail. Why do you say the industry is not being policed? The only thing is, you have to break the law first. You can’t simply outrage the British with your business plan. “Shkreli was convicted of two counts of securities fraud and one count of conspiring to commit securities fraud in August 2017, and was sentenced in March 2018 to seven years in federal prison and to $7.4 million in fines.” (Wikipedia) And from a recent Guardian story: Twitter Share on Facebook Xoxarle 14 Mar 2018 6:12 Socialistic systems of healthcare delivery outperform US for-profit system, often at a fraction of the cost. They are demonstrably more efficient and effective, and no patient has to either self-deny treatment due to cost (as many insured Americans do who can’t afford out-of-pocket costs) or go bankrupt due to billing. To see an example of how British doctors live comfortably, see movie Sicko. In addition to getting paid well for their work, they get the satisfaction of knowing they are not working as part of a system that seeks to destroy patients with excessive medical bills, as the US system does. Share on Twitter Facebook Share on Twitter There’re plenty of people like that in this world, just not in US Share on Facebook Share on Twitter Facebook Share on Facebook Reply 15 16 Reply Share on Twitter 14 Mar 2018 1:12 Twitter | Pick Share on Twitter Studies of why infant mortality is markedly worse in the USA than other equivalent first world countries point to out of pocket costs and doctor treatment of minorities as significant factors. Expectant mothers with inadequate or lacking insurance are hesitant to get help for risk factors during pregnancies, and doctors often overlook them, or provide inadequate post-natal care. Shares998998 Share on Twitter Twitter | Pick Share on Twitter cterryr2 Massaniello Report Thomas1178 3 4 BuckUpButtercup 15 Mar 2018 2:53 2 3 Report Share on Facebook Facebook | Pick Report Catherine_the_decent wrkerbe 11 12 UnstableGenius Report Reply 14 Mar 2018 1:20 5 6 Facebook Reply 14 Mar 2018 16:11 | Pick Reply 14 Mar 2018 1:40 | Pick Share on Twitter 3 4 Reply Reply Facebook Share on Facebook Share 14 15 Report Facebook Facebook Twitter tjt77 14 Mar 2018 2:27 Reply DBINSF | Pick 6 7 Share on Facebook Reply Twitter Share on Facebook | Pick 14 Mar 2018 1:21 I like to believe that there are people in the world who want to help sick and/or injured people without regard to monetary compensation. At least I sometimes ponder this in my weaker moments. And there are probably even a few such people in the US. Facebook “It’s not the doctors salaries that are inflated.” Said the doctor. Even though the study indicates that US doctors get about TWICE the average of the other countries in the study. Welcome to America, land of the free, home of the greedy. Share on Facebook Share Report Share on Twitter Share on Facebook Facebook Even with such systems in place this practice still exists today. The unethical ones are just better at getting away with it. It is self reporting. Reply Share on Facebook Share Report BuckUpButtercup 14 Mar 2018 0:55 dturkey Obamacare amounts to a $T subsidy to the for-profit healthcare industry, and doesn’t even include a public option. Put that into your anti-Trump repertoire and see how it works. | Pick 0 1 6 7 Share Reply | Pick Twitter | Pick Share on Twitter Thomas1178 Report Facebook Share via Email Reply the simple answer is this :- Taxpayer funded healthcare openly available for all in the USA. Who’s leadership priorities are completely out of whack and need to be exposed for what they are..we need some smarts,real honesty and common sense applied:- firstly cut out the B.S. If we can fund perpetual wars and have several thousand military bases throughout the globe.. then we have sufficient funding that would promote some REAL and genuine ‘freedom’ for everyone within and visiting in the the form of healthcare for all..regardless of ‘means to pay’..If very other civilized democracy can do it..what is preventing the USA form getting on board, other than gross hypocrisy and the continual promotion of ignorance and fear ? SharpeyShuffle Share on Facebook In some of the European countries a doctor’s pay is only commiserate with his professional level of training when compared with similar other professions. Not in the States. But the real problem is the insurance middleman. The first four years of Obamacare they had to pay back subscribers because they extracted too large a percentage of the premium and federal financed pie. By giving young subscribers an opt-out choice the Exchanges are going to fall of their own weight (another conservative time bomb). Now I hear the senior drug loopholes (reducing cost) are going the way of the dodo bird. And our mortality and morbidity rates will again sore. Share Don Martin 2 3 Reply Facebook | Pick Report Twitter Yes. Twitter Share on Twitter Facebook UnstableGenius sammy – there are, and many more than what would be assumed by the broad brushstroke of ‘doctors (and nurses) have inappropriate salaries’ mindset. Reality; the cost of education necessary for reaching title of M.D. or Accredited Nurse, is literally tens of thousands of dollars, if not (in case of M.D.) hundreds of thousands. Contemporarily speaking, virtually NO M.D is now Board certified without crippling loans with immediate payoff plan that begins the minute of graduation. Share on Twitter Share on Facebook Facebook Report Reply Share Topics Facebook Share Reply Facebook Lisa German Twitter David Betterton Facebook 8 9 | Pick Twitter Share on Twitter doc_doom Share on Twitter Share Facebook 1 2 Email (optional) Share 1 2 Report Reply comments (354)Sign in or create your Guardian account to join the discussion. 14 Mar 2018 2:38 4 5 Share on Twitter | Pick Twitter Reply Reply 14 Mar 2018 3:33 53 54 | Pick 2miners Share on Facebook 14 Mar 2018 4:23 Maybe. Obamacare certainly raised the deductibles so high that the working poor could no longer get care. Dunno about the sponges. Republicans think the sponges are the people who are on Medicaid and not paying. But I don’t call those people sponges. I just call them poor fellow Americans. Share William Anthony Reply Share on Twitter 14 Mar 2018 0:47 Paul Jordan @JessicaGlenza | Pick UnstableGenius Report JillTheSaint Peter Davis Share on Facebook 27 28 Share on Facebook Facebook 0 1 Share | Pick Facebook Share on Facebook 4 5 | Pick This is what you get when you have unbridled greed in the pharma business more people like Martin Shkreli need ot go to jail. 1 example does not make this true in general. I believe if you did a proper comparison you would find that you are wrong. Facebook Share You’re exactly right about admin costs. I had a healthcare business and changes in Medicare documentation requirements forced me to triple my billing and funding staff while causing the order process to go from 30 to 90 days. BrooklynNonHipster 14 Mar 2018 8:31 Share on Facebook Share Share on Twitter 11 12 | Pick Report it says first do no harm. Bankrupting your patients, pretty much harm. 14 Mar 2018 2:06 Twitter | Pick Twitter Share on Twitter Show 13 more replies | Pick Threads collapsed Twitter dturkey 14 Mar 2018 4:50 Share Show 10 more replies JillTheSaint Reply Show 32 more replies Report Obama could have pushed for single-payer, at a time when Dems controlled the legislature (both houses). He was opposed by blue-dog democrats from red states, and powerful legislators like Lieberman and Evan Bayh who had spouses earning millions from the for-profit providers. What we got instead was the ACA (Obamacare) that addressed some of the most egregious failings of the then system (pre-existing refusal, lifetime limits, kids on parents policy until age 26, etc.) but left the entire hideous edifice in tact, with it’s neo-racketeering posture. His legacy is being systematically dismantled by “Dump” and the Republicans in Congress, and eventually there will be nothing left. 14 Mar 2018 2:10 Xoxarle 7 8 14 Mar 2018 2:30 Twitter Twitter Facebook Catherine_the_decent 14 Mar 2018 1:12 130 in a small town- guess what you are doing better than most Twitter 2 3 7 8 Twitter Facebook Share on Twitter | Pick Report Twitter Please select Personal abuse Off topic Legal issue Trolling Hate speech Offensive/Threatening language Copyright Spam Other Xoxarle Share PepperoniPizza Share on Facebook Share on Twitter Twitter Reply Reply Share on Facebook Reply Share on Pinterest The real problem is …. everyone. Hospitals, doctors, insurers and pharmas. All of them working together to shaft patients and prevent legislators from legislating the public interest. Americans get the worst treatment at shockingly high prices, most of it carefully hidden from scrutiny. Share Xoxarle Share Report Twitter Facebook 14 Mar 2018 2:31 1 2 Share on Facebook those ware per month! Share on Twitter Twitter Facebook Report Why are all the comparisons (except Japan) to small, mostly European countries? Yes, doctor salaries are high. Also high is [malpractice insurance]( I work in a part of IT that deals with hospitals. I can absolutely confirm that administrative costs are huge. It is not a simple issue. But, I absolutely concur with the quote,” “Most countries get to lower prices one of two ways: they either have a very strong price setter, usually a government agency, or more efficient markets. The US has figured out how to do the worst of both.” I do, however, think that this is far more complex than a NHS or nothing choice. There are many other models out there that would be a better fit for the US. The German public/private model seems to be one that could work well. Facebook Share news 7 8 Report 4 5 | Pick Share on Facebook Share 2 3 Report Twitter tjt77 | Pick 11 12 14 Mar 2018 1:28 Lisa German Report 14 Mar 2018 2:21 Facebook 14 Mar 2018 2:05 High malpractice insurance fees are a consequence of a very litigious society and the rewards a person can extract for suing for anything. I also understand specialists and hospitals over test patients to ensure noting is missed just to cover against lawsuits. Maybe curtailing the ability to take legal action for anything could result in lowering health cost for the US…? Report dturkey Report sammy3110 | Pick This is due to rampant illegal immigration from high risk countries. People often have unheard of diseases and are malnourished as well. Look for German and UK stats to follow suit soon. the U.S. needs to start keeping more detailed stats on whose babies are dying. Open borders has affected many other things (such as literacy and high crime) as well. It’s hard to keep up with so many people. But we must try harder. Facebook JillTheSaint Reply Share LabRat99 | Pick Facebook Twitter Report Reply 7 8 Twitter 14 Mar 2018 3:15 Facebook 14 Mar 2018 1:58 Reply Share on Twitter While there are no doubt bad actors in medicine, I don’t think that vast majority of doctors are unethical. The situation cited by the Times doesn’t paint the bigger picture, as hospital operations are complicated logistically and financially. It’s not uncommon for other practitioners to participate in the care of the patient. Certainly the charges by the neurosurgeon are egregious and indefensible. Twitter Share on Twitter Share on Facebook 14 Mar 2018 2:02 Reply 14 Mar 2018 0:54 Reply Facebook Reply ” Unlike Alabama, Oklahoma, Missouri and Arkansas where no one is licensed and anyone can do an MR” I haven’t read the state statues in the states in question, but would be shocked if someone was able to obtain a MRI examination without referral from a licensed physician. It is highly unlikely that “anyone can do an MRI” In those states. In other words, I think you’re full of fecal material. Report Facebook Janeinma Reason (optional) Twitter Show 1 more reply Show 3 more replies Report Lisa German Facebook newest | Pick Share on Twitter 14 Mar 2018 8:27 14 Mar 2018 5:36 Reply | Pick 3 4 ralbin Show 5 more replies Report | Pick Share on Twitter Facebook Show 3 more replies 14 Mar 2018 1:14 martinusher Facebook 16 Mar 2018 11:27 Facebook Report Reply | Pick Report Share on Facebook Report | Pick Share | Pick 14 Mar 2018 2:37 14 Mar 2018 2:41 Share on Facebook Twitter RK1111 Twitter Show 3 more replies Report Show 3 more replies Share on Facebook Report 14 Mar 2018 2:51 Reply Here’s some required reading for you if you are going to opine on the subject of infant mortality rates: Despite its lavish spending, the United States has one of the highest rates of both infant and maternal death among industrialized nations, although the fact that poor and uninsured women and those whose insurance does not cover childbirth have trouble getting or paying for prenatal care contributes to those figures. 14 Mar 2018 6:05 Twitter Yeah i just thought the doctors were paid more at a reasonable income compared to the others. And if the others pay is deemed reasonable then doctors are sorely underpaid.Some of the most overpaid are the national news anchors – they want no part of retiring when getting paid like this. Share on Twitter Reply No, if you’re going to point fingers, point them directly at the US Congress, which is full of corrupt money grubbers from both parties, who would rather take bribes from insurance and pharmaceutical companies than provide affordable, single payer health care to all citizens. Report Mary B Xoxarle Twitter Report Share on Facebook Report Share chloe9020 Reply Facebook 9 10 | Pick Twitter | Pick Report Show 15 more replies Facebook Share Share Share on Twitter 14 Mar 2018 3:37 Only about 30% of US physicians–probably less by now–belong to the AMA. There are tons more medical schools, and students, than there have ever been in the US, and there are increasingly large numbers of nurse practitioners and physician assistants being minted as well. I do not believe that physician salaries are predicated on the shortage of clinicians. It appears to have more to do with the massive profits being generated by the big hospital systems, with the assistance of federal and state governments, which pay far more for patients being seen in hospital systems than they do for patients being seen in independent outpatient clinics. Share on Facebook 6 7 | Pick Reply Facebook | Pick ewmbrsfca Share on Twitter Share Facebook Twitter Total insurance company CEO earnings amount to an average of $20 million (median of $11 million) per CEO per year. A vast majority of pay is in the form of vested stock. Since CEO compensation is stock based, they are encouraged to A) run up prices, sell more prescription medicine, etc. to drive up profitsB) deny care to those most in need The US does not have a healthcare system. It has instead a small class of immoral parasites profiting from death. Facebook Share on Twitter 35 36 Reply Share on Twitter Share 0 1 Reply Catherine_the_decent America is about Business. That includes healthcare. (Do not do business with Americans. Do not go to America. Do not buy stuff made by American companies. And avoid American Bacon.) Share | Pick Facebook | Pick Facebook Aseoria sammy3110 Report this makes sense, with the connection of course being that the government in some cases is legally forbidden from negotiating lower prices even the case of Medicare, where they should have tremendous bargaining power. there are so many lobbies with a vested interest in keeping prices high, from big pharma to the AMA, to medical schools, and no single lobby representing patients opposed to them. Twitter 5 6 Share on Facebook As with any broad brushstroke fear-flaming rhetoric, ID558’s comment is without basis of facts and choosing instead to form opinion with little actual statistics in support. “…Do not do business with Americans. Do not go to America. Do not buy stuff made by American companies…”; please enlighten the reader as to why ALL American ‘stuff’ is inappropriate for purchase, as well as ALL travel (presumably both leisure as well as required by work), business, and laughably, bacon, is lumped into one large and convenient bin. Share on Twitter Share Share on Facebook | Pick oldest | Pick Reply Report Facebook ID5586613 Share on Twitter | Pick Capitalism is anti-human. It’s greed and division. It’s everything bad. We deserve this for allowing Capitalism to run wild. Murder by greed. | Pick “For over a century, doctors with the AMA have fought against universal healthcare simply because they want to set the costs.” For over a century, labor unions have fought against employers simply because they want to set the price of labor costs to the employer. People want to earn as much as they can. It’s a human thing. Share 24 25 Share on Twitter | Pick Facebook 14 Mar 2018 1:23 Facebook 100 William Anthony Share on Facebook Correction: America is about greed. It’s our number one value, and often the only value. Show 5 more replies | Pick | Pick Share on Facebook 2 3 Twitter Share on Facebook Share Share 14 Mar 2018 3:14 Loading comments… Trouble loading? 10 11 | Pick Facebook Share Lisa German Elephantmoth Reply 14 Mar 2018 2:27 | Pick 4 5 Share on Facebook RK1111 14 Mar 2018 5:19 Other countries had universal, or near universal, health insurance rates. The US ranked last. Just 90% of Americans have health insurance, leaving about 27 million people without access to healthcare. Jha said whether the US moves toward more private healthcare, as advocated by Republicans, or to single-payer healthcare, as advocated by liberal Democrats, price tags on all American health services need to be addressed.“I’m happy to move in either direction that will allow for lower prices, but right now we’re not even having that debate,” said Jha. “We’re fighting over all sorts of other things.” The study’s possible weaknesses include comparability of data, with different countries having “modest” differences in data collection. Twitter 14 Mar 2018 2:57 6 7 Share | Pick Share on Twitter Share Report The AMA lobbies to keep doctor supply low so demand is high. Hence salaries are high. Doctors are not exempt from the corruption and racketeering in every sector of the healthcare chain. They are an integral part of it. L Ar AMA supported the Affordable Care Act FFS &Unions negotiate a master labor agreement with industry that protects workers. But you tell your story anyway you like it. 14 Mar 2018 4:34 Share Twitter | Pick | Pick Twitter Just don’t get old or get Cancer in your lovely Nannystate. PepperoniPizza Twitter | Pick i’m fairly sure he/she didn’t mean all at once on the stroke of midnight, but rather that’s when the transition began… Facebook Share on Facebook Reply Facebook Manahmanah Share on Facebook 14 Mar 2018 7:01 Twitter Report | Pick Are you a troll? The corruption in the health care industry is breathtaking. Ask any Big Pharma sales rep off the record and the stories will curdle your blood. Read more Share on Twitter 7 8 Facebook 3 You’re lucky to get advanced pricing. The system mostly relies on patients being ignorant of costs, so that they can be ambushed on the back end. Last year my wife and I tried to shop around for a procedure, and neither the insurer, nor doctors, nor hospitals could give us a definitive answer. We suspect the reason why isn’t ignorance but greed, and the inbuilt complexity that enables greed. Twitter Share on Facebook Reply | Pick Doctors 1 Twitter View more commentslast_img

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