The problem is not how we pay but what we are paying

This graph (click here for a larger version), taken from the National Geographic, shows how various countries rank in terms of dollars spent on health care per person, average number of doctor visits per year, and average life expectancy. At first I didn’t understand it; I thought that the maybe the original graph excluded the United States and that it had been ineptly pencilled in. Then I saw the problem—our expenditures are nearly twice that of the country in second place (Switzerland), and more than three times the average. Yet our life expectancy is in the middle of the pack, and number of doctor visits at the bottom.

Again I make my tired old point: as long as health care costs are spiraling out of control, it doesn’t really matter what mechanism we use to pay them.

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One thought on “The problem is not how we pay but what we are paying

  1. Again I make my tired old point: as long as health care costs are spiraling out of control, it doesn’t really matter what mechanism we use to pay them.

    But to what extent are costs spiraling out of control because of the mechanism we use to pay for them.

    The costs are hidden and obscured in the current system.

    There are anti-competitive aspects to the system.

    How much of the current system is bureaucracy dedicated to trying to deny payments, and other activities that are not part of other possible mechanisms?

    How much is a matter of “penny wise and pound foolish”? Someone is out of a job and out of insurance, so they don’t get the preventive care or maintenance care they need. So a small amount of money is saved now (out of their own pocket) and a large but avoidable amount spent later (emergency room, or medicare, etc., depending on when and how their condition deterioriates).

    We’re personally coming up against the madness of the current health insurance system, so it’s a subject that I have a harder time than usual being very objective about. I recently spent some time with a friend who is a health care provider in Switzerland at the moment, and who had a lot to say about the way that system works from both the point of view of a patient and the pov of a provider. And the article you posted from Reason about our system vs. the French system was very interesting too. A lot of what keeps the costs down has to do with the way services are paid.

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