Trump signs order that aims to reveal real health care costs

[code1211]

In the UK the life expectancy is 80.54 years. In the US the life expectancy is 79.68 years.

A better comparison would be between Canada and the US because their cultures and life styles are so similar. In Canada the life expectancy is 81.76 years (and in the US it is still 79.68 years).

However, another metric is "Healthy Average Life Expectancy" and for the US that is a phenomenal 68.5 years while it is a mere 71.9 in the UK and a pitiful 73.2 in Canada.

Obviously the SOCIALIST MEDICAL SYSTEMS in Canada and the US are resulting in hundreds of thousands of people dying when they shouldn't (and when they wouldn't if those Socialist Monarchies were to adopt the vastly superior American model).

In the US, there are behaviors, traditions and customs as there are in both Canada and Britain.

The outcomes you're citing could be direct effects of the cause of the healthcare system or the outcomes could be mere correlations caused by other societal factors.

There could even be differences in the methodologies used to gather the information.

This is a very "messy" area in terms of gathering "apples to apples" kind of data.

 

[code1211]

True.

You might find "Canadian Hospital Rates" interesting. There is no column for "Insured Residents" - mainly because having a whole column of $0.00 looks rather silly. An "Un-Insured Resident" would be someone on a temporary residence permit (like a student or someone on a time limited work visa). [You might want to note that those are "inclusive" rates and that there are no additional charges for lab work, doctors, drugs, toilet paper, "kleenex", breakfast, lunch, dinner, snacks, disposable syringes, laundry, IV fluids, bandages, etc., etc., etc. like there are in many American hospitals.]

Does the information provided from the Canadian system enhance the ability of the residents to make informed choices in choosing their healthcare options for providers, facilities and procedures?

 

[code1211]

It will be quite some time, if ever, before that happens.

I have absolutely no idea how the regulations that evolve from the EO are going to look like.’’

Of course, since the transactions are usually between insurance companies and hospitals, and the patient has no say, or interest in them, it’s hard to figure out how to square the circle.

And since retail prices are only charged to the uninsured, it’s hard to see how that will be affected either.

However, the insurance industry’s warning is noteworthy. Particular in the face of the growing national trend to merge hospitals into regional chains, which in turn drive cost up in regional markets by creating health care monopolies.

In an industry where transparency is viewed as a threat and the tendency for each of the business entities in the higharchy of oligopolies is to compete for revenue share and thus drives costs up.

Since almost no consumers ever ask the price of health care, and are as likely as not to fail to understand (or even look at) the pricing that may be out there.

BTW, retail pricing is already required. That was a change made under the ACA.

Funny though, the pharma lobbyist who runs HHS for Trump managed to keep the drug companies insulated.

In the company for which I worked prior to retirement, the insurance coverage was administered by an outside insurance conglomerate, but was self funded.

One of the cost savings measures employed was to encourage the employees to "shop" for better deals by providing incentives to do so.

In the case of my former employer, driving many of the decision making processes down to the user level resulted in a reduction of liability to the corporation, out of pocket costs to the employees and services rendered by the doctors.

The key to reducing the costs of healthcare is to reduce the costs incurred in healthcare. Changing the level of premiums only changes the levels of premiums. Actual care may or may not be affected.

 

[TU Curmudgeon]

In the US, there are behaviors, traditions and customs as there are in both Canada and Britain.

True, irrelevant, but true.

The outcomes you're citing could be direct effects of the cause of the healthcare system or the outcomes could be mere correlations caused by other societal factors.

Again true. The fact, however, is that the data is what the data is. A statement that "A person in 'Country A' has a life expectancy of 79 years while a person in 'Country B' has a life expectancy of 81 years." means ONLY that a person in 'Country A' has a life expectancy that is two years shorter than that of a person in 'Country B' AND the REASON why that is the case is entirely irrelevant to the fact that it is true.

There could even be differences in the methodologies used to gather the information.

True, but since the WHO sets the criteria for ALL of the countries reporting, holding that out is pretty much either [a] grasping at straws, ignoring reality, or [c] both.

This is a very "messy" area in terms of gathering "apples to apples" kind of data.

If you have some evidence on that point, I will consider whether it is "messy" enough to actually account for the differences between Canada and the US (which are countries of roughly equivalent culture, language, socioeconomic makeup, education, and infrastructure). I will concede that it might well make a difference between the US and countries like Somalia, Central African Republic, Democratic Republic of the Congo, Burundi, Liberia, Niger, Malawi, and Mozambique.

 

[TU Curmudgeon]

Does the information provided from the Canadian system enhance the ability of the residents to make informed choices in choosing their healthcare options for providers, facilities and procedures?

Quite likely.

If the patient is going to pay 'Doctor A' $0.00 in order to obtain 'Service X' and they are going to pay 'Doctor B' $0.00 in order to obtain 'Service X' and they are going to pay 'Doctor C' $25,000 (of which they will be reimbursed $10,000 from their medical insurance plan) in order to obtain 'Service X', most Canadians can make an informed choice as to which is the better "financial decision" to make. I rather expect that most Americans could too.

On the other hand, if the patient is going to pay 'Hospital A' (10 minutes away) $0.00 for an ER visit, and they are going to pay 'Hospital B' (15 minutes away) $0.00 for an ER visit, and they are going to pay 'Hospital C' (45 minutes away) $0.00 for an ER visit, and they are going to pay 'Hospital D' (3 hours away) $0.00 for an ER visit, and they are going to pay 'Hospital USA' (30 minutes away) $2,000.00 (+ [+ {+ < + >}]) for an ER visit, most Canadians can make an informed choice as to which is the better "financial decision" to make. I rather expect that most Americans could too.

Doctors are almost all self-employed so the Canadian patient has complete freedom to chose between any of them (assuming that the doctor is accepting new patients) and can either have the doctor's bill paid by the medical insurance plan directly (according to the agreed fee schedule) or pay the doctor directly (and doctors are required to make it clear that they do NOT bill the medical insurance plan for ANY services) in which case the doctor can charge whatever they feel like charging and the patient will be reimbursed up to the agreed fee schedule rate for the doctor's services. I rather expect that most Canadians can decide which is the better "financial decision" in such cases (and I suspect that most Americans can too).

 

[code1211]

True, irrelevant, but true.



Again true. The fact, however, is that the data is what the data is. A statement that "A person in 'Country A' has a life expectancy of 79 years while a person in 'Country B' has a life expectancy of 81 years." means ONLY that a person in 'Country A' has a life expectancy that is two years shorter than that of a person in 'Country B' AND the REASON why that is the case is entirely irrelevant to the fact that it is true.



True, but since the WHO sets the criteria for ALL of the countries reporting, holding that out is pretty much either [a] grasping at straws, ignoring reality, or [c] both.



If you have some evidence on that point, I will consider whether it is "messy" enough to actually account for the differences between Canada and the US (which are countries of roughly equivalent culture, language, socioeconomic makeup, education, and infrastructure). I will concede that it might well make a difference between the US and countries like Somalia, Central African Republic, Democratic Republic of the Congo, Burundi, Liberia, Niger, Malawi, and Mozambique.

In Europe, there are countries that gather data on infant mortality but exclude infants dying for weights too low or other circumstances. The numbers recorded and reported as a result are lower.

Without standardized collection and reporting, standardized results are impossible.

Gun ownership, number of people owning cars, eating habits, BMI, exercise rates, and accidental deaths or deaths in warfare are also impacting factors that may or may not be helped by the local healthcare system.

Unless all factors are identical except the one that you are citing, the one you are citing may or may not be the important one.

In business, we used to try to identify the process to improve and the point in the process that was causing issues. Fixing anything else was less impactful than fixing the most important problem.

The example I used often was taking steps to cool down a room. Do anything you want, but if the house is on fire, the first thing to do is put out the fire. Anything else may have a marginal effect, but the room with flames consuming the furniture is still going to be too warm.

So, surveyed results regarding the outcomes may or may not be meaningful with correlation to the quality of healthcare. Costs for care are pretty much limited to the costs paid for care so the cost comparisons seem to be pretty "clean".

From what I've seen, the COST of American care is outrageous viewed either as a stand alone or compared to other systems.

 

[code1211]

Quite likely.

If the patient is going to pay 'Doctor A' $0.00 in order to obtain 'Service X' and they are going to pay 'Doctor B' $0.00 in order to obtain 'Service X' and they are going to pay 'Doctor C' $25,000 (of which they will be reimbursed $10,000 from their medical insurance plan) in order to obtain 'Service X', most Canadians can make an informed choice as to which is the better "financial decision" to make. I rather expect that most Americans could too.

On the other hand, if the patient is going to pay 'Hospital A' (10 minutes away) $0.00 for an ER visit, and they are going to pay 'Hospital B' (15 minutes away) $0.00 for an ER visit, and they are going to pay 'Hospital C' (45 minutes away) $0.00 for an ER visit, and they are going to pay 'Hospital D' (3 hours away) $0.00 for an ER visit, and they are going to pay 'Hospital USA' (30 minutes away) $2,000.00 (+ [+ {+ < + >}]) for an ER visit, most Canadians can make an informed choice as to which is the better "financial decision" to make. I rather expect that most Americans could too.

Doctors are almost all self-employed so the Canadian patient has complete freedom to chose between any of them (assuming that the doctor is accepting new patients) and can either have the doctor's bill paid by the medical insurance plan directly (according to the agreed fee schedule) or pay the doctor directly (and doctors are required to make it clear that they do NOT bill the medical insurance plan for ANY services) in which case the doctor can charge whatever they feel like charging and the patient will be reimbursed up to the agreed fee schedule rate for the doctor's services. I rather expect that most Canadians can decide which is the better "financial decision" in such cases (and I suspect that most Americans can too).

Alrighty!