Healthcare In the US of A

[Truth OT]

It's the costs people!!!

http://www.statehealthfacts.org/profileind.jsp?cmprgn=45&cat=5&rgn=1&sub=68

The average cost of hospital stay per inpatient day in the USA as of 2010 was $1910.
The cost of staying a night at a five star hotel, getting a couple's spa treatment and a gourmet dinner for 2, $829 (on the expensive side, a person could probably do this for $600 in some places).

Regardless, why is it that hospital stays cost sooooooo much? For those of you that say it's because hospitals are gready capitalist oranizations trying to profit off of the poor health and misfortune of sick people; how do you explain the fact that non profit hospitals and goverment run hospitals daily costs average about $1,827 here in the US? In addition, why are hospital stays more expensive in Washington, Massachusetts, and California than in places Mississippi, North Carolina, and Minnesota?

Historicaly, the profit margin of hospitals falls below 4% annually and we must realize that hospitals’ ability to hold operating profits is an important focus whether we like it or not. Ideally, they want to keep these profits predictable and relatively steady over the longer term. Their ability to do so is tied to their capacity to control expenses to match fluctuations in revenues. We have to understand that it is not realistic to think that hospitals can all operate at a loss and we still as potential patients can expect to have access to the quality care we feel we need.

healthcare.thomsonreuters.com/.../HospOperatingTrendsQuarterlyMa...
Between the third quarters of 2005 and 2010, U.S. hospitals saw non-labor expenses (which include pharmaceuticals, professional fees, and maintenance of and additions to plant and capital, including technology), increase nearly 20%. On the other hand, labor expenses, (which include salaries and benefits for physicians, nurses, technicians, and numerous other personnel) which represent a greater portion of total costs, grew by 8%.  If hospitals could better control non-labor expenses like supply chain and physician preference items, as well as labor expenses such as employee salaries and and the cost of insuring their employees, they could enjoy substantial savings and pass those along to the insurers and patients that have to pay for care. But how can they control these costs? That is the question that needs to be answered because only when it is properly addressed can we, the consumer expect our costs to go down.

When comparing US healthcare costs to those overseas, in many ways the comparison cannot be done fairly. Overseas, wage rates and other labor costs are lower therefore overall hospital expenses are lower. Doctors earn substantially less than comparable physicians in the United States (maybe that's why many doctors in the US come here from abroad to practice). Median nurses' salaries are one-fifth to one-twentieth of those in the United States and the wages of unskilled and semiskilled labor, such as janitors and orderlies, are also much less elsewhere than in the US. Because of this, the prices those hospitals can afford to charge is substantially less thanwhat is charged in the USA. Botom line, these lower labor costs make it much less expensive to build and operate hospitals in other countries. 

Also, malpractice litigation costs are also lower in other countries than in the United States.  Compare American physicians in some specialties having to pay more than $100,000 annually for a liability insurance policy, while a physician in Thailand or you name the other nation, can spend less than $6,000 per year.  Also, malpractice awards overseas are far lower than in the United States and harder to come by. Overseas hospitals have fewer cost-increasing regulations and cross-subsidies than the USA. An example of a cross subsidy is when a US hospital will have ER services and maybe do heart procedures as well. The cross subsidation allows then to run the ER at a loss and make up for that loss by marking up the heart procedures. That is one of the reasons why specialty treatment in the US is outragiously high.
There are also fewer regulations overseas. Some would say excessive health care regulations in the USA prevent American hospitals from making the sort of collaborative arrangements many international hospitals use. Facilities abroad can structure physicians' compensation to create financial incentives for the doctors to provide efficient care, whereas American hospitals usually cannot.  The reason:  Physician compensation arrangements in American hospitals cannot violate the Stark (anti-kickback) laws. http://www.ncpa.org/pub/st304?pg=5

[nogodsforme]

That is why some US people are going for surgery in Argentina, South Africa or India-- medical tourism.

That's assuming you can afford all the travel and medical expenses out of pocket right? How much does it have to cost in the us for a procedure in order for this to be cost effective for this?

According to the wikipedia site, http://en.wikipedia.org/wiki/Medical_tourism#Employer-sponsored_health_care_in_the_US
a coronary bypass operation in Thailand cost $12,000 versus $100,000 in the US. Even if you tack on another 5,000 bucks for airfare, hotel, food and followup care, you are still way below the US cost.

Still, most people don't have 12,000 extra bucks lying around for surgery, even if it is a fraction of the higher cost. But corporations are very interested. Evidently there are health insurance companies that are promoting this to their corporate enrollees as a way to cut costs. That is a worry, because sending you to Singapore or Costa Rica for your treatment may someday become a requirement, not an option. (That is, as long as we keep the for-profit lousy, over-priced health care system we have now.)

The same article said that there are ten times as many US people seeking treatment in other countries (including Canada and Mexico) as foreigners coming here for health care --around 750,000 compared to around 75,000. So much for the argument that "we have the best care in the world and everyone wants to come here to use our health system".

Most of that used to be elective like plastic surgery. But more of it is serious life and death stuff like open heart surgery and liver transplants. I am nervous about people who don't know a language or a culture submitting to that.[1] 

1.	I had excellent dental work done in a Latin American country, but a friend nearly died from infection after a tummy tuck overseas.

[Truth OT]

The same article said that there are ten times as many US people seeking treatment in other countries (including Canada and Mexico) as foreigners coming here for health care --around 750,000 compared to around 75,000. So much for the argument that "we have the best care in the world and everyone wants to come here to use our health system".

The argument is not whether the US has the best healthcare system in the world, instead it revolves around the idea that the best doctors and facilities are US based. We do not have the world's best system, but we very likely (and by a longshot at that), have the best collection of medical professionals and facilities in the world.
The foreigners that come here are of the wealthy variety because they can afford to pay the high costs charged in the States. That should say something about what the world thinks of the quality of care offered here. We will always export more care than we import as long as our costs are exponentially higher than cost abroad.

(That is, as long as we keep the for-profit lousy, over-priced health care system we have now.)

My question to all those that are against a for profit health system is this: Is there a such thing as a fully not for profit health system, and if so, where is it?

We are looking at only one side of the coin and then allowing that single side to help us format the entirety of our opinions on the matter of healthcare in the USA. That ain't gettin' us nowhere!

The other side of the coin reveals to us the FACT that the healthcare providers we love to hate have costs they must pay to be operational and they cannot remain operational if they are in the red bringing in less that what they spend, and they have top spend a lot. That spending translates into higher costs for us. Because of that fact, it is in OUR BEST INTERESTS to be advocates of the medical care providers having less of a cost burden.

It frustrates me that the perception of many appears to be that a single payer system is a panacea for the US healthcare crisis when in fact it does NOTHING to fix the major problem of cost. Due to the costs of medical care in the US, even if we had a single payer system, it could NOT cover the cost of care for the entire citizenry. We need lower costs AND a LOT more money on healthcare to spend if we are to be able to effectively offer coverage for all.

[Nam]

I don't mind if hospitals are for profit. But it shouldn't cost me, or anyone, over $3,000 for 6 hours, especially since all they did was withdraw some blood, and processed it to find out what was wrong with me. And, in the end: they didn't. I was referred to a FREE clinic the next day to see a specialist. They knew I barely could pay, at the time, why didn't they suggest the free-clinic before? Hell, why wasn't such a place known to exist except for certain people? Why keep such information away from those "less fortunate"? So, they'll be in debt, literally, to them? What profit is there in that but in their own pockets. Luckily that hospital was bought by the government[1] recently so, perhaps it won't be so bad in the future...doubtful but who knows...

-Nam

1.	state government

[nogodsforme]

http://www.cnn.com/2012/06/28/health/countries-health-care/index.html

This article compares the US with several other countries from around the world that have made universal health care a priority.

They include Brazil, Moldova, Thailand and believe it or not, Rwanda. When poverty-stricken Rwanda is dedicating its scarce resources to give all their people health care, while the US is saying we can't afford it because we can't ask the wealthy to pay a bit more in taxes, it makes me want to weep in shame.

[nogodsforme]

http://prescriptions.blogs.nytimes.com/2009/09/29/health-care-abroad-germany/

Here is an amazing interview with a German expert about health care. It will make you furious if you are in the US. Germany has outstanding universal health care. They cover illegal immigrants, because they are human beings living in the country. Shocking.

Also, read the comments from US people living in Germany. They love the health care in Europe and can't imagine going back to the US system. One person said she would not have to worry about health care costs as long as she stayed away from the US. Another US expat got sick here, and was charged an astronomical amount, which the German system still paid for!

Maybe I should brush up on my German just in case of a Rawmoney win....achtung baby.

[Nam]

I lived in Stuttgart for a couple of years...perhaps I should go back. And, I have a basic understanding of German.

-Nam

[Truth OT]

If the government is to be involved in healthcare, I wish that government would begin its involvement by mandating that hospitals, ERs, and all healthcare facilities make their procedures' pricing public and readily accessible to the public so that we can at least shop around in situations allow for us to do so.

It's reDAMNdiculous that in the same state, a procedure like an appendectomy can range in cost from $1500 to $165,000 without complications! As a potential patient/medical service consumer I should be able to have my driver, be it my wife or an ambulance driver, take me to the facility of my choosing that's capable and most affordable.

PUBLICIZE the damn pricing please!

[nogodsforme]

If the government is to be involved in healthcare, I wish that government would begin its involvement by mandating that hospitals, ERs, and all healthcare facilities make their procedures' pricing public and readily accessible to the public so that we can at least shop around in situations allow for us to do so.

It's reDAMNdiculous that in the same state, a procedure like an appendectomy can range in cost from $1500 to $165,000 without complications! As a potential patient/medical service consumer I should be able to have my driver, be it my wife or an ambulance driver, take me to the facility of my choosing that's capable and most affordable.

PUBLICIZE the damn pricing please!

That seems like a good idea at first. But when are you in the position to shop around for health care services? If it is elective and you can live without it, sure. You can plan ahead and take your time researching your options.

Shop around for your nose job. The best plastic surgeons in the business will charge you up the yingyang. But you aren't Madonna, so who cares if you get your nose done by some less skilled hack, and you look funny. Probably not life threatening (although anytime you go under anesthesia and have someone cut into you it is potentially life threatening.) Be sure to read that release form.

You might even be willing to shop around for your vasectomy.....what could go wrong? Maybe you can go in with a buddy and get done at the same time on a two for one coupon.

But are you really going to shop around and choose a heart surgery or brain surgery for your child based on who offers it cheapest? Is that the criteria you are going to use? And, when you are on your way for an appendectomy, believe me, cost is the last thing on your mind. You are going to die in excruciating agony. You, or your loved ones, will sign over your house to the hospital under those conditions.

That is why for-profit health care should be illegal. We are not talking about where to get an oil change or who has the best deal on a set of car tires. If you make a mistake and choose wrong, you can at worse, buy another car.

This is life and death stuff they are effing with here. I don't want posted prices unless the prices are the same everywhere. Because I don't want poor people trying to save money by going to the cheap doc. Or waiting for a markdown sale.

[Truth OT]

That seems like a good idea at first. But when are you in the position to shop around for health care services? If it is elective and you can live without it, sure. You can plan ahead and take your time researching your options.

Shop around for your nose job. The best plastic surgeons in the business will charge you up the yingyang. But you aren't Madonna, so who cares if you get your nose done by some less skilled hack, and you look funny. Probably not life threatening (although anytime you go under anesthesia and have someone cut into you it is potentially life threatening.) Be sure to read that release form.

You might even be willing to shop around for your vasectomy.....what could go wrong? Maybe you can go in with a buddy and get done at the same time on a two for one coupon.

But are you really going to shop around and choose a heart surgery or brain surgery for your child based on who offers it cheapest? Is that the criteria you are going to use? And, when you are on your way for an appendectomy, believe me, cost is the last thing on your mind. You are going to die in excruciating agony. You, or your loved ones, will sign over your house to the hospital under those conditions.

That is why for-profit health care should be illegal. We are not talking about where to get an oil change or who has the best deal on a set of car tires. If you make a mistake and choose wrong, you can at worse, buy another car.

This is life and death stuff they are effing with here. I don't want posted prices unless the prices are the same everywhere. Because I don't want poor people trying to save money by going to the cheap doc. Or waiting for a markdown sale.

I believe you're overlooking somethings. Readily available pricing information isn't about when an emergency or need arises, it's about keeping the public informed and thereby making the service providers know that they are being watched and compared. Them knowing that the public has this information will put pressure on the facilities to be more competitively priced. In addition to that, we must not assume that higher costs equals better care. Shopping for a better price doesn't mean one is sacrificing quality of care.

[nogodsforme]

But how do we evaluate the quality of care, aside from price? We are not all medical experts, so we are largely at the mercy of medical providers. Just as we are not all master mechanics, and are at the mercy of repair shops. People get ripped off all the time when they get their cars repaired. And a car is replaceable. But we know that the cheapest repair shops are not always the best.

I agree that if the hospitals posted their prices it might provide an incentive to lower costs-- and we would have a better idea of what exactly we are paying for. But doesn't that already happen with Medicare?  The government only reimburses the provider x amount for y service.

If we all were just allowed to buy into Medicare at any age, instead of waiting until 65, we would already have the cost problem taken care of. And the system would be solvent forever because younger and healthier people cost far less to care for then the elderly. Spreading the costs around would make the entire system cheaper. We could even afford to include poor people, some of whom are young and healthy, for very low cost or for free. We might even be able to raise the reimbursements to primary care docs, etc. And Medicare has a lower overhead because they don't spend on expensive marketing or fancy perks for their executives. It's a win-win-win.

But for the handful of people making millions off of the sick, it's a lose-lose-lose. That is why they spend millions to tell us that universal or single payer won't work, is socialism, is evil, that death panels with kill grandma, etc. Meanwhile the insurance companies deny care and  kill grandma and grandson and everyone else every day.

[Nick]

There was a guy in a town near me who was killed by being hit by a train.  My uncle knew him.  He thinks the guy drove in front of the train on purpose.  He was in his 80s and in pretty bad health.  He thinks he was tired of all the medical run around.  Makes you wonder at what level one might consider something like that? 

[Truth OT]

But how do we evaluate the quality of care, aside from price? We are not all medical experts, so we are largely at the mercy of medical providers. Just as we are not all master mechanics, and are at the mercy of repair shops. People get ripped off all the time when they get their cars repaired. And a car is replaceable. But we know that the cheapest repair shops are not always the best.

I wouldn't disagree with anything you said above. As non-medical lay people, we are at the mercy of the licensed experts that work in the medical facilities we use. That is the case whether or not they publicize the cost of common medical procedures.

I agree that if the hospitals posted their prices it might provide an incentive to lower costs-- and we would have a better idea of what exactly we are paying for. But doesn't that already happen with Medicare?  The government only reimburses the provider x amount for y service.

It's a fairly common practice in countries like Japan to in effect place caps on what can be charges for healthcare services. Many nations can get away with this while all nations cannot, and there lies the problem. America, or specifically the US healthcare market and other open market healthcare countries make it possible for SOME nations to benefit from, finance, and afford a single payer system or similar systems with government mandated price control mechanisms.

If we all were just allowed to buy into Medicare at any age, instead of waiting until 65, we would already have the cost problem taken care of. And the system would be solvent forever because younger and healthier people cost far less to care for then the elderly. Spreading the costs around would make the entire system cheaper. We could even afford to include poor people, some of whom are young and healthy, for very low cost or for free. We might even be able to raise the reimbursements to primary care docs, etc. And Medicare has a lower overhead because they don't spend on expensive marketing or fancy perks for their executives. It's a win-win-win.

But for the handful of people making millions off of the sick, it's a lose-lose-lose. That is why they spend millions to tell us that universal or single payer won't work, is socialism, is evil, that death panels with kill grandma, etc. Meanwhile the insurance companies deny care and  kill grandma and grandson and everyone else every day.

If we were to eliminate big insurance from healthcare, healthcare costs by all indications would be lessoned somewhat. That would not address the crux of the cost problem we have in America though. Medical facilities still must pay for a medical staff, pay for legal coverage and representation, pay taxes, pay for the latest equipment and technology, etc., all things that get factored into what we pay for our healthcare. If we are to have a national system like medicare available to all persons, how much would that cost and where would the revenue come from?

[Gohavesomefun]

As a none US resident, I hope you don't mind me passing comment. To say what I think of the US Health Care system from my external perspective, I am forced to ask another question, which is what is the responsibilities of an elected government? Would the most basic of things not to be to care for the physical and mental health of it's country? In the light of terminal conditions, it is inhumane to suggest that anyone must pay for treatment that could prolong, even cure illness or otherwise certainly face death. This is a collapse of the basic idea of why there is a government in the first place; for the people.

[nogodsforme]

It has been many years since I was doing public policy analysis, but what I remember was that the cost per person covered would be quite a bit less than what it costs to run Medicare per patient now. This is because it is very expensive to care for sick elderly people. But the government still does that way cheaper than if it was done by the private sector. The private sector must make a profit. They do this by either denying care or charging higher prices. The government does not have to squeeze a profit out.

It would cost less than what most people are paying for crappy health insurance. We would not have to cover free riders--the uninsured who get sick and cannot pay. Nobody would lose thier house to medical bills. And you would be guaranteed care.

The providers would actually get paid, perhaps less than now. But still, they would not have to waste hours every day begging insurance companies to pay up. Or employ an entire office just to sift through different companies' insurance documents and requirements. They might actually end up making more money under a universal plan.

Remember, when thinking about costs, we almost can't lose by changing to a single payer or other universal coverage plan. We currently pay more than any other country in the world. And we get less.

[Truth OT]

As a none US resident, ..........................I am forced to ask another question, which is what is the responsibilities of an elected government? Would the most basic of things not to be to care for the physical and mental health of it's country?
This is a collapse of the basic idea of why there is a government in the first place; for the people.

That's the big point of contention my friend. There's a great divide as it pertains to what the role of government is and should be. Some, including the founders of the US felt that government's responsibility extended only to defending and protecting the freedom of the individuals that make up the populace. 

[Truth OT]

Remember, when thinking about costs, we almost can't lose by changing to a single payer or other universal coverage plan. We currently pay more than any other country in the world. And we get less.

Indeed, we do pay more and oftentimes do so for less in return. We know the primary reasons for this is due to the cost US medical care providers incur. These costs are passed along to the consumers. How do we rectify this is the question we MUST answer.

[Death over Life]

That's the big point of contention my friend. There's a great divide as it pertains to what the role of government is and should be. Some, including the founders of the US felt that government's responsibility extended only to defending and protecting the freedom of the individuals that make up the populace.

Bolding mine. Please provide evidence for such statement.

Don't forget that being healthy is a requirement for "life, liberty, and pursuit of happiness", which is what government is supposed to provide for us, as per the Constitution. So, yes, the government should and needs to be involved in healthcare.

Indeed, we do pay more and oftentimes do so for less in return. We know the primary reasons for this is due to the cost US medical care providers incur. These costs are passed along to the consumers. How do we rectify this is the question we MUST answer.

It's been mentioned over and over and over, but a single payer healthcare system similar to Canada and much of Europe IS the answer, and Obama's Affordable Care Act is a step in the right direction, although I'd rather go with Jill Stein's approach and just do the single payer system and be done with it. I really wish that 3rd parties in the US had an actual shot at getting elected.

[Truth OT]

That's the big point of contention my friend. There's a great divide as it pertains to what the role of government is and should be. Some, including the founders of the US felt that government's responsibility extended only to defending and protecting the freedom of the individuals that make up the populace.

Bolding mine. Please provide evidence for such statement.

I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.

My reading of history convinces me that most bad government results from too much government.

A wise and frugal Government, which shall restrain men from injuring one another, which shall leave them otherwise free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned. This is the sum of good government, and this is necessary to close the circlue of our felicities.
Thomas Jefferson
http://www.brainyquote.com/quotes/authors/t/thomas_jefferson.html

Don't forget that being healthy is a requirement for "life, liberty, and pursuit of happiness", which is what government is supposed to provide for us, as per the Constitution. So, yes, the government should and needs to be involved in healthcare.

Rationalize much?
The DOI states that government's role is to protect individuals inalienable human rights from that which would threaten the rights you mentioned.

It's been mentioned over and over and over, but a single payer healthcare system similar to Canada and much of Europe IS the answer, and Obama's Affordable Care Act is a step in the right direction, although I'd rather go with Jill Stein's approach and just do the single payer system and be done with it. I really wish that 3rd parties in the US had an actual shot at getting elected.

A single payer system will reduce the salaries of those employed in US healthcare; how?
Will it reduce the costs HC providers pay for legal costs, medical equipment, and other technology?

I am so with you on 3rd parties. Too much entrenched power resides in the 2 parties. We need to free ourselves.

[Death over Life]

I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.

My reading of history convinces me that most bad government results from too much government.

A wise and frugal Government, which shall restrain men from injuring one another, which shall leave them otherwise free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned. This is the sum of good government, and this is necessary to close the circlue of our felicities.
Thomas Jefferson
http://www.brainyquote.com/quotes/authors/t/thomas_jefferson.html

So, only 1 founding father. It is something though. Now don’t get me wrong, I like the quotes myself, but these are just snippets at best. In order to more properly understand what Jefferson was talking about, we need to have context involved within the timeframe when Thomas made these quotes. If we just cherry-pick, I’m also going to at least post this from your own link:

Our greatest happiness does not depend on the condition of life in which chance has placed us, but is always the result of a good conscience, good health, occupation, and freedom in all just pursuits.

The care of human life and happiness, and not their destruction, is the first and only object of good government.

So, it looks like Thomas Jefferson has mentioned something we both can use for both of our causes.

Rationalize much?

How so?

The DOI states that government's role is to protect individuals inalienable human rights from that which would threaten the rights you mentioned.

So, how is improving the quality of life threatening the unalienable human rights of life, liberty, and pursuit of happiness? This is starting to remind me of the whole 2nd Amendment rights vs. gun control fiasco.

A single payer system will reduce the salaries of those employed in US healthcare; how?
Will it reduce the costs HC providers pay for legal costs, medical equipment, and other technology?

I don’t quite understand the 1st question. Are you asking how a single payer system will reduce the salaries of those employed in US healthcare? If this isn’t the question, you will need to reword it.

As for the 2nd question, it kind of goes into what Quesi has already talked about. If we do comparisons between the US and the rest of the entire world on healthcare costs, we waste so much within medical, and in addition, we pay around 3 times more than any of the other countries. A big part of this is because our Medical Industry as is, is privatized, so it’s all about profits, just like our prison systems. As Quesi said, government isn’t about making a profit, it’s about proving services to the people. That alone will help lower costs, and now since people can’t be denied due to pre-existing conditions, everybody will be putting money into it instead of everybody covering somebody else’s tab with higher premiums.

And don’t forget to, it’s far cheaper if we have everybody go get checked out by a doctor instead of telling them to go to the emergency room. Forcing to many patients to go to the emergency room as is, is part of why our healthcare is outrageous. Under NO circumstances, by law, is anybody to be denied to the emergency room, so why should we reject what would be a far more cheap and life-saving alternative?

If we were to stop forcing people to the emergency rooms, and to cut back on wasting so much medical supplies, and weren’t all about the profits, I guarantee you, our prices will be similar to the rest of the world, and the best and most affordable healthcare systems are single payer. I can’t give all the nit-picky details about how it works, but I’m hoping this overall generalization will be good enough.

I am so with you on 3rd parties. Too much entrenched power resides in the 2 parties. We need to free ourselves.

It’s part of why Europe as a whole is so much better than US. They have their dems/libs and cons/repubs, but they also have a labor party, a libertarian, a green, a socialist, and so many other parties, but they all have equal grounds to be elected, unlike here where it’s Dem or Pub. There is no room for Libertarians or Green Parties here.

Europe has choice, US has ultimatums.

[Truth OT]

A single payer system will reduce the salaries of those employed in US healthcare; how?
Will it reduce the costs HC providers pay for legal costs, medical equipment, and other technology?

I don’t quite understand the 1st question. Are you asking how a single payer system will reduce the salaries of those employed in US healthcare? If this isn’t the question, you will need to reword it.

You've got it. That's exactly what I'm asking.

As for the 2nd question, it kind of goes into what Quesi has already talked about. If we do comparisons between the US and the rest of the entire world on healthcare costs, we waste so much within medical, and in addition, we pay around 3 times more than any of the other countries. A big part of this is because our Medical Industry as is, is privatized, so it’s all about profits, just like our prison systems. As Quesi said, government isn’t about making a profit, it’s about proving services to the people. That alone will help lower costs, and now since people can’t be denied due to pre-existing conditions, everybody will be putting money into it instead of everybody covering somebody else’s tab with higher premiums.

There's no arguing the bolded part above. We pay more for the same and often for even less than do patients in other countries. Where I disagree with you is the 'WHY'. Many assume that we pay more because of privatization, but what the facts reveal is that our medical providers foot a bigger bill than their foreign peers and they then pass those costs along to us, the medical consumer. The big 'profiteeres' in medicine are the doctors, the drug companies, and the science & technology firms that develop innovation that benefits the world. The only real way to reduce our costs is to have other nations foot the bill that we have been footing as it relates to the doctors, the drug companies, and the science & technology firms, or for those groups to have their success ad profits drastically reduced. If US doctors (nurses and all medical staff) get paid substantially less, drug companies had caps placed on how much they could charge in the US, and Science & Tech firms ability to make a profit off of the US medical industry was encumbered, then we would reasonably expect to see reduced HC costs. If that were to happen, how would that effect the medical profession and the innovation of drug and Sci & Tech companies?

[Nick]

What kind of health care did they have back then?  Leaches and some quack with a saw to remove limbs?  Health care should be a basic right and any advanced country should see to it that all of their citizens are covered.  What is gov for if not to take care of those it seves?

[Truth OT]

Health care should be a basic right and any advanced country should see to it that all of their citizens are covered.  What is gov for if not to take care of those it seves?

We step out on a limb when we make that claim not having the foresight to consider the unintended consequences of acting on such thinking. We must not forget that the only reason modern, quality, advanced HC is available is because we have scientists, doctors, other medical staff working to make our health better and our world a better place to live. They expect to be compensated for their efforts and hard work. Like it or not, the free market economies in this world, namely America, provides these needed workers with the incentive to do what they do. If our government takes steps to reduce the incentives for people to go into these lines of work, then ultimately what good does that do for the citizen's rights to life, liberty, and the pursuit of happiness this government was set up to protect?

[Nick]

If not to care for its citizens then what good is it?  I guess death panels for those unable to pay will need to be set up.

[nogodsforme]

TOT, why do you keep assuming that nobody but the good 'ol US of A has scientists? If the US stops giving the world all that wonderful free science, where oh where would those poor science-deprived people be?

Germany, Japan, England, the Netherlands, France, Australia, China, Canada, Brazil, India and South Africa, among many other countries, have research universities, pharmaceutical companies and highly skilled medical practitioners. You can live very well in many countries and be treated by local physicians and never touch a US drug or medicine. Basic primary care does not require a lot of US high tech.

The world is not sitting around, going "When is the US going to invent something that will cure malaria, or diabetes or cancer?" People are doing research all over the place and a lot of it is subsidized by their own governments. Incidentally, a lot of the R and D done in the US is at public universities by low-paid graduate students and professors, not by some mythical millionaire genius like Tony Stark.

Even some of the research in private labs is paid for with government money from the CDC and the NSF. Very little basic research is undertaken by for-profit labs, for obvious reasons: they want to make money. So they just tweak a drug that already exists to do something else, like designing a lower dose aspirin to prevent heart attacks. That is not expensive trail-blazing research.

So, no, without having private for-profit companies overcharging the US population, the entire world's medical care would not disappear. If you go to many other countries you find medicines from Germany and France. Funny how we can't buy that stuff in the free market US. In fact, Indian, South African and other companies are blocked by US trade regulations from providing their lower-cost but effective alternatives to the US market.

But even if it was true that we had all the scientists, why should we pay for the world's drug research when it denies us the medical care we need?

[screwtape]

But even if it was true that we had all the scientists, why should we pay for the world's drug research when it denies us the medical care we need?

Shouldn't it be the other way around?  If we do the research, shouldn't we get the hometown discount?

[Truth OT]

TOT, why do you keep assuming that nobody but the good 'ol US of A has scientists? If the US stops giving the world all that wonderful free science, where oh where would those poor science-deprived people be?

Germany, Japan, England, the Netherlands, France, Australia, China, Canada, Brazil, India and South Africa, among many other countries, have research universities, pharmaceutical companies and highly skilled medical practitioners. You can live very well in many countries and be treated by local physicians and never touch a US drug or medicine. Basic primary care does not require a lot of US high tech.

I never said the US has a monopoly on science or innovation. I simply brought to light the fact that the US does the heavy lifting as it pertains to the world’s biotech R&D as well as incentivizing medical workers and professionals. Each year, we test more potential new medicines than the rest of the world combined, our doctors and nurses make higher incomes, and the medical industry here has more price increasing regulation to deal with than do other nations.

The world is not sitting around, going "When is the US going to invent something that will cure malaria, or diabetes or cancer?" People are doing research all over the place and a lot of it is subsidized by their own governments. Incidentally, a lot of the R and D done in the US is at public universities by low-paid graduate students and professors, not by some mythical millionaire genius like Tony Stark.

But the world does recognize the benefits provided by the US system.
 

Tom Sackville, who served in Margaret Thatcher’s government and now directs the IFHP is quoted as saying that the situation the US is in is "a good deal for residents of other countries." He believes that the USA's high spending makes medical innovation more profitable and therefore more likely which in turns leads to better worldwide healthcare. According to him, "We (the rest of the world) end up with the benefits of your investment,” Sackville says. “You’re subsidizing the rest of the world by doing the front-end research.”

If US healthcare facilities were charged what healthcare facilities abroad are charged for technology and labor; what effect would that have on other countries ability to control costs and keep prices lower than US pricing?

[Truth OT]

But even if it was true that we had all the scientists, why should we pay for the world's drug research when it denies us the medical care we need?

Shouldn't it be the other way around?  If we do the research, shouldn't we get the hometown discount?

The perceived and perhaps even the real wealth of the US population is a major factor in why we get charged more. The companies know we not only can but will pay.

[Chronos]

In many states there are already set prices for certain types of health care, typically common problems, and those prices are made available to the public but probably not in a form that anyone would recognize.

In Maryland, the Maryland Health Care Commission (MHCC) sets acceptable rates for various types of charges made to the public for services provided. These prices are listed in a guide using the Diagnosis Related Group (DRG) method. This system was sponsored by Medicare (and is likely still used by Medicare) but was also adopted by some states -- infamously in New York and New Jersey -- to control the costs of health care. Instead of nickle-and-diming a hospital on every charge for every service or supply, great or small, the DRG system averaged all the charges typically made and allowed payments based on the average. The enticement for the hospital was to get the patient out of the hospital for a lower cost than the payment allowed by the DRG method.

Regardless, the public doesn't know this information exists and wouldn't know how to interpret it if they did. Although I believe more information makes for better consumers, the issue of health care is so complex that this information doesn't improve the choices of patients, prospective or current. Those choices have to be decided by smaller groups of citizens (the commissions) who are better educated and experienced in the field to help decide on the prices of health care.