Why is America spending more on healthcare per capita than Denmark?

[Deuce]

I didn't notice anyone bringing up lawsuits. Sorry, but if a patient off the street getting charity care, can sue a doctor for malpractice, when what the doctor was attempting to save an individual's life, I can see how our healthcare costs can be astronomical. When a family of a grandma of 85 can sue a hospital if she dies on the operating table then that is why medical costs are so high. When doctors think they are God and can charge whatever they wish, that is why medical costs are so high.

While malpractice lawsuits are a significant issue, that's just a small piece of the pie.

 

[LittleNipper]

While malpractice lawsuits are a significant issue, that's just a small piece of the pie.

Pieces ADD UP. All Doctors do pay extremely high rates for malpractice insurance. They do pass this on to those they serve.

 

[Manc Skipper]

Except when you can't afford it.

Or your insurance company tells you you reached your lifetime maximum.

 

[Harshaw]

If the transport cost falls on the patient, then it can't be distance that's pushing up healthcare costs.

This is silly. It pushes up costs; who pays for it is irrelevant to the fact that it pushes up costs.

 

[jaeger19]

If the transport cost falls on the patient, then it can't be distance that's pushing up healthcare costs.

Yeah.. no.

You are missing the big picture.

These communities (4 of about 5 thousand a piece) live three or more hours from a large population center.

Three or more hours from healthcare in this country is not generally acceptable. So there is a small hospital in the central community that serves these 4 communities. It has an emergency department with a full complement of diagnostic equipment (MRI, CT, X ray, Ultrasound etc.), It has a 10 hospital beds, therapy, an outpatient clinic and two surgical suites for less complicated surgeries (emergency c sections, ORIF ETC).

that facility adds to the cost of healthcare.. since if those roughly 20 thousand people did not live in their rural communities.. but lived instead in the large population center.. there would be no need for an extra facility. the existing facilities in the population center can easily handle the healthcare for another 20 thousand people. That's because of the economy of scale.

That's why area makes a difference. Providing healthcare in a smaller area is more efficient (requires less facilities).. than providing healthcare to a much larger area (where people are more spread out and require more facilities to have access to healthcare).

 

[jaeger19]

Pieces ADD UP. All Doctors do pay extremely high rates for malpractice insurance. They do pass this on to those they serve.

Actually the real price tag is in the defensive medicine that's practiced (though a good portion of that would continue as well regardless of malpractice since I don't want to have a pissed off patient in any case)...

But you have a point that malpractice does have a cost and these costs add up.

now here is something that many don't know.. in other countries.. they bear the cost of malpractice as well... however, because many other countries have public systems that handle malpractice it doesn't get factored into their "cost of healthcare".. in all likelihood that money is in another column.

where here.. it is factored into what it costs. just like education for healthcare providers.

 

[Manc Skipper]

"In all likelihood" it comes out of the same pot, therefore it's counted.

The NHS Litigation Authority, which provides indemnity cover for legal claims against the health service, has set aside £26.1bn to cover outstanding liabilities, equivalent to almost a quarter of the £113bn annual health budget: £1.6bn was paid out last year.

https://www.ft.com/content/f4da10f6-a255-11e4-9630-00144feab7de

 

[joG]

As we all know, the US does not have universal healthcare; rather it has healthcare companies. Denmark on the other hand does have universal healthcare and here's the best part: it spends less per capita than the US.

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

The US spends the most per capita when it comes to healthcare, surpassing even countries which have universal healthcare.

So here's the question: What is the extra money going to specifically?

Have you ever deaggregated the numbers? Actually the US social programs do spend more per beneficiary on the poor and elderly than Germany, while Americans consume about the same amount again from private funds. What are we talking about?

But, one thing is clear. Germany rations medical care and many applications come online in the US long before they are legalized in Germany.

 

[joG]

Cancer cost me tens of thousands of dollars (certain treatments wasn't covered by my insurance),and I am rich.I can't imagine how rough it is for the poor.

You have poor insurance. The insurance company paid everything, when my father had cancer.

 

[joG]

America spends more per capita than everybody, not just Denmark.

The real question is, how much of it is necessary and how it would impact medical innovation, were we to curtal the spending in various ways.

 

[Manc Skipper]

Denmark spends just under ten per cent of GDP on health, and covers everyone, including visiting EU citizens.
America spends nearly twice that, half of which is publicly funded, and still doesn't cover everyone, let alone foreigners.

 

[jaeger19]

Denmark spends just under ten per cent of GDP on health, and covers everyone, including visiting EU citizens.
America spends nearly twice that, half of which is publicly funded, and still doesn't cover everyone, let alone foreigners.

Yep..

having been in Europe.. and the US...

I greatly prefer the US system,. I get to choose who I go to.. what procedures are best for me.. get more covered.. and have less wait times for those procedures than in great Britain.. or Canada..

France? hmmm.. not sure..

but Great Britain and Canada...? Vastly prefer the US...

 

[Gimmesometruth]

Actually the real price tag is in the defensive medicine that's practiced (though a good portion of that would continue as well regardless of malpractice since I don't want to have a pissed off patient in any case)...

But you have a point that malpractice does have a cost and these costs add up.

now here is something that many don't know.. in other countries.. they bear the cost of malpractice as well... however, because many other countries have public systems that handle malpractice it doesn't get factored into their "cost of healthcare".. in all likelihood that money is in another column.

where here.. it is factored into what it costs. just like education for healthcare providers.

Some were dubious when I told them that McAllen was the country’s most expensive place for health care. I gave them the spending data from Medicare. In 1992, in the McAllen market, the average cost per Medicare enrollee was $4,891, almost exactly the national average. But since then, year after year, McAllen’s health costs have grown faster than any other market in the country, ultimately soaring by more than ten thousand dollars per person.

“Maybe the service is better here,” the cardiologist suggested. People can be seen faster and get their tests more readily, he said.

Others were skeptical. “I don’t think that explains the costs he’s talking about,” the general surgeon said.

“It’s malpractice,” a family physician who had practiced here for thirty-three years said.

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted.

“Come on,” the general surgeon finally said. “We all know these arguments are bull****. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

The surgeon came to McAllen in the mid-nineties, and since then, he said, “the way to practice medicine has changed completely. Before, it was about how to do a good job. Now it is about ‘How much will you benefit?’ “
The Cost Conundrum - The New Yorker

 

[Casper]

Let's see, when a hospital charges $10 for an aspirin and the same for all their services and products that might have something to do with high costs.

 

[jaeger19]

Some were dubious when I told them that McAllen was the country’s most expensive place for health care. I gave them the spending data from Medicare. In 1992, in the McAllen market, the average cost per Medicare enrollee was $4,891, almost exactly the national average. But since then, year after year, McAllen’s health costs have grown faster than any other market in the country, ultimately soaring by more than ten thousand dollars per person.

“Maybe the service is better here,” the cardiologist suggested. People can be seen faster and get their tests more readily, he said.

Others were skeptical. “I don’t think that explains the costs he’s talking about,” the general surgeon said.

“It’s malpractice,” a family physician who had practiced here for thirty-three years said.

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted.

“Come on,” the general surgeon finally said. “We all know these arguments are bull****. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

The surgeon came to McAllen in the mid-nineties, and since then, he said, “the way to practice medicine has changed completely. Before, it was about how to do a good job. Now it is about ‘How much will you benefit?’ “
The Cost Conundrum - The New Yorker

Yawn.... do you have a point somewhere in there.?

I suppose you don't think any other countries medical providers care about profit?

 

[Gimmesometruth]

Yawn.... do you have a point somewhere in there.?

I suppose you don't think any other countries medical providers care about profit?

The point was: Malpractice is not the problem, overutilization is.

The tell, your tell, is the avoidance, the feigned ignoring of the obvious when smacked between the eyes.

 

[jaeger19]

The point was: Malpractice is not the problem, overutilization is.

The tell, your tell, is the avoidance, the feigned ignoring of the obvious when smacked between the eyes.

Actually.. malpractice is a problem,,,. just not the only problem.

What you fail to realize that "one" of the reasons for over utilization.. is defensive medicine.. which is quite possibly and actually probably one of the reasons that the incidence of lawsuits was "practically zero"

Patients that think you are doing everything for them.. are unlikely to sue... particularly in a red state.

The problem with you is that you are so busy trying to find something to argue with me.. you fail to educate yourself..

 

[Lord of Planar]

The major difference is that the US "system" is entirely market oriented. Not only is it for profit throughout, it also has an insurance middleman who takes profit too.

Spending on health broadly reflects life expectancy around the world, except for one country.

Because it is a profit system, there are people to sue... How many single payer plans award people multiple millions from lawsuits?

We also have excessive regulations, which add to the cost.

 

[Lord of Planar]

The point was: Malpractice is not the problem, overutilization is.

They both are.

Don't forget where providers go out of their way with excessive tests to protect prom lawsuits.

 

[Gimmesometruth]

Actually.. malpractice is a problem,,,. just not the only problem.

What you fail to realize that "one" of the reasons for over utilization.. is defensive medicine.. which is quite possibly and actually probably one of the reasons that the incidence of lawsuits was "practically zero"

Patients that think you are doing everything for them.. are unlikely to sue... particularly in a red state.

The problem with you is that you are so busy trying to find something to argue with me.. you fail to educate yourself..

False, as the Texass example shows, even with caps on malpractice that has caused cases to drop to near zero, overutilization still exists, ergo the argument "overutilization is a defense against malpractice" has no basis. HC costs in Texass have increased at the same rate as the rest of the nation even with malpractice out of the equation.

You are provided with "education" material, you fail to comprehend it, or even read it.

 

[jaeger19]

False, as the Texass example shows, even with caps on malpractice that has caused cases to drop to near zero, overutilization still exists, ergo the argument "overutilization is a defense against malpractice" has no basis. HC costs in Texass have increased at the same rate as the rest of the nation even with malpractice out of the equation.

You are provided with "education" material, you fail to comprehend it, or even read it.

Nope.. correct.

First.. the caps on malpractice didn't really cause cases to drop to zero. I don't know texas specifically.. but most states that passed malpractice caps.. were states that ALREADY had low lawsuits (one of the reasons that such legislation could get passed in the first place.)...

Second. as pointed out.. having lower lawsuits is more likely the result of defensive medicine.. which is a form of over utilization.

Sorry.. but you simple weren't able to comprehend my prior post.

 

[Gimmesometruth]

Nope.. correct.

First.. the caps on malpractice didn't really cause cases to drop to zero. I don't know texas specifically.. but most states that passed malpractice caps.. were states that ALREADY had low lawsuits (one of the reasons that such legislation could get passed in the first place.)...

Well, if they have "low lawsuits" (which as per usual you won't document) as a result of caps on malpractice, then it would follow that costs should drop for 2 reasons, Dr's dont need as much coverage, and overutilization would not be required. You can't document anything to show one way or the other that your argument holds, I have already shown what the case is in Texass.

Second. as pointed out.. having lower lawsuits is more likely the result of defensive medicine.. which is a form of over utilization.

Then you can show that the rates (risk) has declined, which then causes lower MI costs....but you won't....you won't even read, let alone supply documentation.

Sorry.. but you simple weren't able to comprehend my prior post.

I comprehended fine both yer argument and yer lack of evidence....and yer inability to read....yer still ignorant about Texass even with it spoon fed to you.

 

[Gimmesometruth]

I don't know texas specifically..

Open wide, here comes the airplane....

Studies: Texas Tort Reform Has Had No Effect on Physician Supply, Lowering Costs « D Healthcare Daily

 

[jaeger19]

Well, if they have "low lawsuits" (which as per usual you won't document) as a result of caps on malpractice, then it would follow that costs should drop for 2 reasons, Dr's dont need as much coverage, and overutilization would not be required. You can't document anything to show one way or the other that your argument holds, I have already shown what the case is in Texass.

Then you can show that the rates (risk) has declined, which then causes lower MI costs....but you won't....you won't even read, let alone supply documentation.

I comprehended fine both yer argument and yer lack of evidence....and yer inability to read....yer still ignorant about Texass even with it spoon fed to you.

Lets see..

1. no and no.

Costs won't drop because the cost of care is based on what insurance companies pay. Not on any one decrease in malpractice insurance. Lets say my malpractice insurance triples. So what? What the insurance company pays doesn't change one dang bit.

2. No because if medical providers are overutilizing services to prevent lawsuits.. and its perceived that its working.. they aren't going to stop because lawsuits are down. they are going to continue whats perceived to be working.

3. Well you just pointed out that the risk had declined.. that lawsuits were almost zero.

4. Nope.. but you keep telling yourself that.

 

[jaeger19]

Open wide, here comes the airplane....

Studies: Texas Tort Reform Has Had No Effect on Physician Supply, Lowering Costs « D Healthcare Daily

thanks... see.. I guess I did know texas. Since this is exactly what I had said happened in other states that had tort reform.

thanks for supporting what I said Gimme.