Healthcare Reform

[BigRedBuster]

 

[funhusker]

3 minutes ago, BigRedBuster said:

 

I wonder how much of a role preventative care plays.   I’d wager that it is a huge reason.

 

People with crappy insurance, or no insurance don’t go to the doctor until they absolutely have to in the US. That and our diets and lifestyles suck in comparison.

 

US doctors are like a manager trying to field a MLB team with only access to old, fat, drunk slow pitch softball players…

[BigRedBuster]

40 minutes ago, funhusker said:

I wonder how much of a role preventative care plays.   I’d wager that it is a huge reason.

 

People with crappy insurance, or no insurance don’t go to the doctor until they absolutely have to in the US. That and our diets and lifestyles suck in comparison.

 

US doctors are like a manager trying to field a MLB team with only access to old, fat, drunk slow pitch softball players…

It's a huge part of it.

 

Problem is, Americans are conditioned to not go to the Dr because it costs so much.  So, even some people with insurance don't see Drs for preventative care either.

[Archy1221]

1 hour ago, BigRedBuster said:

 

What constitutes Health Care System Performance?  I don’t see the qualifiers for performance in the graph 

[deedsker]

1 hour ago, Archy1221 said:

What constitutes Health Care System Performance?  I don’t see the qualifiers for performance in the graph 

https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly

[Archy1221]

32 minutes ago, deedsker said:

https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly

Thanks for the link.  Not a big fan of cross country survey data, and could’t find information on infant mortality.  Many countries classify this differently which affects the overall rate.  Innovation and end of life care costs are not broken down either for each country.  Most expenditures occur during the final few years of a persons life.  
 

I don’t put much stock into this.  

[deedsker]

16 minutes ago, Archy1221 said:

Thanks for the link.  Not a big fan of cross country survey data, and could’t find information on infant mortality.  Many countries classify this differently which affects the overall rate.  Innovation and end of life care costs are not broken down either for each country.  Most expenditures occur during the final few years of a persons life.  
 

I don’t put much stock into this.  

I wouldn't throw the baby out with the bath water.

 

https://www.rand.org/pubs/research_reports/RRA788-1.html

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/

 

We pay more for drugs and procedures and social/economic structures limit the US ability for care shortly after birth (i.e leave from work).

[Archy1221]

6 hours ago, deedsker said:

I wouldn't throw the baby out with the bath water.

 

https://www.rand.org/pubs/research_reports/RRA788-1.html

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/

 

We pay more for drugs and procedures and social/economic structures limit the US ability for care shortly after birth (i.e leave from work).

We pay more because we subsidize the rest of the world.  Get Most Favored Nationa pricing passes and you would no longer see those other countries mooching off us.  Either they would raise their prices or drugs would quite being sold there.  
 

The US would also see a drop, but keep in mind, over 90% of US prescriptions are already filled generic.  

 

From ncbi 

 

While the US IMR disadvantage is widely discussed and quantitatively important, the determinants of this disadvantage are not well understood, hindering policy efforts.² A key constraint on past research has been the lack of comparable micro-datasets across countries. 

 

Cross-country comparisons of aggregate infant mortality rates provide very limited insight, for two reasons. First, a well-recognized problem is that countries vary in their reporting of births near the threshold of viability. Such reporting differences may generate misleading comparisons of how infant mortality varies across countries. 
 

 specifically, in an unrestricted sample the US has much higher neonatal mortality than any of the European comparisons we analyze (World Health Organization, 2006), whereas our comparably-reported sample suggests that differences in reporting could be driving nearly all of that pattern.

 

just a few things I have previously brought up when talking  IMR across different countries. 

[deedsker]

9 minutes ago, Archy1221 said:

We pay more because we subsidize the rest of the world.  

I would say we subsidize CEO’s, but it doesn’t matter what it is. We pay too much. 

[Archy1221]

10 hours ago, deedsker said:

I would say we subsidize CEO’s, but it doesn’t matter what it is. We pay too much. 

Much of a CEO’s big payouts are in the form of stock options which are peanuts in the grand scheme of the overall drug cost. 
 

our healthcare system could use some reform and get some costs driven down, but for anyone to say we have the worlds worst healthcare system (for wealthy countries I should add) is just being silly and trying to drive some political narratives towards single payer 

[deedsker]

41 minutes ago, Archy1221 said:

Much of a CEO’s big payouts are in the form of stock options which are peanuts in the grand scheme of the overall drug cost. 

They seem to have some incentives.

 

https://www.npr.org/sections/health-shots/2019/12/31/792617538/a-decade-marked-by-outrage-over-drug-prices#:~:text=The man was Martin Shkreli,helped define the past decade.

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The man was Martin Shkreli, the former CEO of Turing Pharmaceuticals, who was called before Cummings' committee in February 2016. After hiking the price of an old drug for parasitic infections to $750 a pill from $13.50, Shkreli became the poster boy for pharmaceutical greed that helped define the past decade.

 

 

https://www.fiercehealthcare.com/payer/ceo-pay-2017-342-million-unitedhealth-molina-cigna-aetna

 

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In some instances, realized compensation is as much as three times the total compensation reported by the company. Such is the case for new UnitedHealth Group CEO David Wichmann, who was paid more than $83 million in 2017, thanks to $58.8 million in exercised options.

 

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All together, CEOs at the nation’s largest insurance companies earned $342.6 million in 2017, with the highest-paid executive bringing home $83.2 million, more than 1,400 times what the average employee brought home. 

 

https://www.beckershospitalreview.com/compensation-issues/18-highest-paid-ceos-in-healthcare.html

 

Quote

Here are the 18 healthcare CEOs that made the highest paid list, in order of total compensation in 2020. 

1. Michael Neidorff (Centene) — $24.96 million 

2. Alex Gorsky (Johnson & Johnson) — $23.14 million 

3. Richard A. Gonzalez (AbbVie) — $21.78 million 

4. David M. Cordani (Cigna) — $19.74 million 

5. Albert Bourla (Pfizer) — $19.67 million 

6. Giovanni Caforio (Bristol-Myers Squibb) — $19.56 million 

7. Daniel O'Day (Gilead Sciences) — $18.99 million 

8. Samuel Hazen (HCA Healthcare) — $18.13 million 

9. David Ricks (Eli Lilly) — $17.82 million 

10. Joseph Zubretsky (Molina Healthcare) — $17.81 million 

 

If this is peanuts, then please, just give me peanuts.

 

[BigRedBuster]

CEO pay always gets brought out as the boogie man in conversations like this.  Believe me, I think pay of CEOs of public companies is out of hand.  But, their pay is not the reason why drugs are so expensive.  

 

Drugs are expensive because of a very complicated system we have.  Most Americans really don't care what drugs cost because they go through insurance companies.  The ones that get screwed are the ones with bad insurance or no insurance at all.  But, when the public goes and gets a drug for a $10 co-pay, they don't give two s#!ts what the insurance company is actually paying for the drug.  And....it rarely gets thought about when people/companies pay premiums.  On top of that, most Americans get their insurance through their employer and don't pay the premiums....or they are subsidies somewhat by the employer.  Insurance companies really don't care what they pay because they just pass that expense on to the employer who is paying the premiums

 

It's a stupid and corrupt system that needs to change.

[deedsker]

7 minutes ago, BigRedBuster said:

CEO pay always gets brought out as the boogie man in conversations like this.  Believe me, I think pay of CEOs of public companies is out of hand.  But, their pay is not the reason why drugs are so expensive.  

 

Drugs are expensive because of a very complicated system we have.  Most Americans really don't care what drugs cost because they go through insurance companies.  The ones that get screwed are the ones with bad insurance or no insurance at all.  But, when the public goes and gets a drug for a $10 co-pay, they don't give two s#!ts what the insurance company is actually paying for the drug.  And....it rarely gets thought about when people/companies pay premiums.  On top of that, most Americans get their insurance through their employer and don't pay the premiums....or they are subsidies somewhat by the employer.  Insurance companies really don't care what they pay because they just pass that expense on to the employer who is paying the premiums

 

It's a stupid and corrupt system that needs to change.

Correct. Decoupling employment and insurance would be the big reason the US pays so much more than other nations. The second piece would be the negotiating power of a nation of 330 million people versus pockets of a hundred to a thousand people.

 

CEO pay just gives you some incite on who is winning the games being played.

[RedDenver]

U.S. life spans, which have fallen behind those in Europe, are telling us something important about American society.

Quote

Before the 1990s, average life expectancy in the U.S. was not much different than it was in Germany, the United Kingdom, or France. But since the 1990s, American life spans started falling significantly behind those in similarly wealthy European countries.

 

According to a new working paper released by the National Bureau of Economic Research, Americans now die earlier than their European counterparts, no matter what age you’re looking at. Compared with Europeans, American babies are more likely to die before they turn 5, American teens are more likely to die before they turn 20, and American adults are more likely to die before they turn 65. At every age, living in the United States carries a higher risk of mortality. This is America’s unsung death penalty, and it adds up. Average life expectancy surged above 80 years old in just about every Western European country in the 2010s, including Portugal, Spain, France, Italy, Germany, the U.K., Denmark, and Switzerland. In the U.S., by contrast, the average life span has never exceeded 79—and now it’s just taken a historic tumble.

 

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Infants in the U.S. are considerably more likely to die in the poorest counties than in the richest counties, and this is true for both Black and white babies. Black teenagers in the poorest U.S. areas are roughly twice as likely to die before they turn 20, compared with those in the richest U.S. counties. In Europe, by contrast, the mortality rate for teenagers in the richest and poorest areas is exactly the same—12 deaths per 100,000. In America, the problem is not just that poverty is higher; it’s that the effect of poverty on longevity is greater too.

 

Second, even rich Europeans are outliving rich Americans.

 

[Archy1221]

2 hours ago, RedDenver said:

U.S. life spans, which have fallen behind those in Europe, are telling us something important about American society.

 

 

The story doesn’t really give a reasoning behind their conclusions except we have higher incidents of heart disease (terrible diets) and cancer.  Along with higher gun deaths and total car deaths (rates per mile aren’t different).