Thursday, May 04, 2006

The worst health care that money can buy

The United States spends around 15% of its GDP on health care, more than anybody else in the world. So this ought to get us the bestest health care system ever, right?

Err, not so fast, me bucko! First of all, over 1/4th of that gets spent on administrative costs. Administrative costs range from 23% (at public and non-profit hospitals), to 33% (at private hospitals). As not-for-profit hospitals owned by doctor's groups and local community-minded citizens sold out to private hospital companies during the 1980's and 1990's, administrative costs thus soared -- we can estimate that privatization has raised health care costs by at least 10% (in inflation-adjusted terms) over the past 20 years. Remember, privatization of health care costs money, it doesn't save money. The whole notion of government being inefficient is just plain ridiculous -- at least for health care, government is 33% more efficient than private enterprise.

Next, there's the problem of the 1/5th of the population that doesn't have health insurance of any sort. They get the worst health care of any industrialized country. All of these people are working people -- if you're not working, you qualify for Medicaid insurance -- so you can't just say "tell them to get a job." they have jobs. Just not jobs that provide health insurance benefits. For them, we have the worst health care system in the world. Which is probably why the United States' infant mortality rates are similar to that of 3rd world countries -- the worst of any OECD country -- and why the U.S. lifespan is the worst of any OECD country. Our health care system just, on average, doesn't provide good care.

But what, you say, about those of us who do have health insurance? Ah, good question. Today we learn that Kaiser-Permanente is saving money on kidney transplants by, err, not giving kidney transplants. It seems they have the same philosophy towards medical care that the Valley Transit Authority has about mass transit -- i.e., that the best way to make a profit is to not provide what's being paid for. VTA gets a massive amount of taxes that are dedicated to transit (i.e., are not allowed to be spent on anything else), and has figured out that if you don't run buses and trains, all that tax money is pure "profit" for the VTA. Meaning that if I want to travel from downtown San Jose to Mountain View via VTA, it takes over an hour (as vs. 15 minutes by automobile) because they run their trains and buses on such a horrible schedule. It once took me two hours to get from Capital Expressway to Fair Oaks Station via VTA.

Now, one advantage of not providing the services that you pay for is that you can then charge less money. Which KP does. Which is why my employer provides KP insurance. It costs them less money. So I get on KP's web site to choose my personal physician and... WTF? Every single doctor accepting new patients has a medical degree from Third World U! Not a single one of them has a medical degree from a medical school that I'd trust with my health (i.e., an accredited medical school in an OECD nation). University of Iran? Chinese University of Alternative Treatment? Bangalor Technical School and Day Care Center? AGH! So now you get the other half of the equation. They pay their doctors so poorly that the only doctors they can get are graduates of 3rd-world diploma mills. WTF? I'm not gonna let a diploma-mill doctor be in charge of my treatment!

Except, apparently, I am.

Best medical care in the world? Yeah right. In some alternative universe where "best" means "lousy", maybe...

-- Badtux the Unmedicated Penguin

5 comments:

  1. Dude! Where you been? Wasn't able to find your site, and had de-blogrolled you. Let me go add you back on again. Good to 'see' ya, hope all's well.Others have asked about you, I'll be sure to let them know.

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  2. I have never undetstood the "Health Care" system in the U.S.! Doctors and Drug Companies have no incentive to make you well or find cures. How did this system end up this way. Doctor's do not profit if you are healthy, only if you are sick. If you are not sick, then they recommend unneeded surgery so they can make money from you. And think about if Drug companies found cures for diseases that their drugs are now treating, they wouldn't profit from treating your ailment. This is an evil of the capitalist society. If you are treated by a doctor, and he fails to make you better, you still have to pay him. If you have surgery that fails, and even if you die because the doctor was not successful in his procedure, the doctor still expects to get paid and will go after your estate to collect. There is something very, very wrong with this.

    Then if you have insurance to pay for all this expensive health care, the provider screws you by not providing the best they can get, but gets you some cheap alternative to save money.

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  3. It's all part of the con. Socialized medicine means you don't get your surgery. Social Security should be privatized. Welfare is an impossible system doomed to fail. Taking taxes from or imposing scaled penalties on the ultra rich means job loss. And all the countries successfully doing these things have been teetering on the brink of extinction since… forever.

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  4. Just proves this is a two tiered society - the rich, and the rest of us.

    Such purely American ideals!

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  5. Having worked in the medical field, I can tell you that if you don't have insurance, you can expect to fork over a pretty penny. One thing that insurance companies started doing, that they probably still do, is get a hospital to be their preferred hospital. Then, from the medical services, they take off a percentage that they do not have to pay. Patient still has to pay their deduct and co-pay. I guess the savings to the patient is, perhaps a smaller co-pay, but I think the insurance gets the better deal. One thing to think about is if you do have a once in a five-year-span hospital stay, with no insurance, ask the hospital to discount it or settle. Do some research. Go straight to the administrator or president and ask. Make a big noise. It can't hurt, and can sometimes get the bill cut down to a lower amount.

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