Why does America spend so much more per capita on healthcare than countries with universal healthcare?
Three reasons …The U.S. healthcare system is largely for-profit (even though many healthcare facilities/providers use a non or no-profit designation — that’s really just a tax designation for IRS reporting purposes).The U.S. healthcare system is based on a fee-for-service model. When tied to “for-profit,” this means more services = more revenue/profits. Fee-for-service pricing is universally common, but not when it’s tied (as it is uniquely in the U.S.) to #1 above — and #3 below.The U.S. healthcare system stands alone as being designed around “selective health coverage.” All the other industrialized countries use a system of “universal health coverage.” The U.S. selects or “tiers” coverage by …Age (twice — 26 & 65)Income (Medicaid)EmploymentMilitary Service (VA)Heritage (Indian Health Services)UninsuredIn combination (as evidenced by this next chart), it creates a system that winds up being both a global embarrassment AND a perpetual national crisis.We could change this. We should change this, but Lawrence Lessig nailed it with this quote:You know, when Bernie was talking about single-payer healthcare people rolled their eyes. Not because it was a bad idea, but because there’s no chance to get single-payer healthcare in a world where money dominates the influence of how politicians think about these issues.Now, we don’t have to implement a single-payer system. In fact, I’m not convinced a single payer system is a good cultural fit, but our decades long battle with actuarial math is unwinnable. In the end, universal health coverage is inevitable. Not for any political reason, but because it’s the most efficient economically — and the most equitable.Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death. Martin Luther King, Jr. — March, 1966The reason we argue, fuss and fight over healthcare reform (like Obamacare) isn’t because it doesn’t work, but because it jeopardizes the status quo — a status quo that’s built on enormous revenue and profits.How many businesses do you know that want to cut their revenue in half? That’s why the healthcare industry won’t change the healthcare industry. Rick Scott — Florida Governor
Why should America have Universal Health Care?
AHHH!! Again there's jj_33_6 with his carbon copy answer. I've seen this EXACT same response over a dozen times on all sorts of topics. Seriously, look at this guy's list of responses. Same thing over and over. And this isn't the first time I've pointed it out. Probably won't be the last either. But to answer the question. There are all sorts of reasons why the US should have Universal Health Care of some level. I think it is a citizen's basic right to have some sort of basic health care needs taken care of. If the government can protect us, govern us and set rules that affect all aspects of our lives why the heck can't they also help take care for our health? Not only that, but when a segment of the population has no coverage they tend to wait for things to get really bad before seeking health care. This can make things worse by letting a condition get to the point where it is not treatable, or at least not treatable cheaply. And before people start thinking I'm preaching for socialized medicine, I'm not. The source of funding can have absolutely nothing to do with who is in control of the system. It is possible to have a privatized health system that is funding publicly, not privately. The cons of universal health care. Increased wait times, can be considered unfair to healthy tax payers, unequal access can still exist, coverage is typically not 100% (unless you want health care to be about 50% of GDP), etc. Pros: keeping all people with a certain level of health helps the economy by reducing sick days, by not providing 100% coverage healthcare expenditures can be kept to appropriate levels (just having health insurance increase utilization, it's called moral hazard. if someone is 100% for all care they can seek care when they really shouldn't be, it's not efficient use of limited resources), universal healthcare systems have been associated with higher life expectency, etc. Universal healthcare has it's pros and cons just like everything else. It's all about trade offs.
How good is the Indian healthcare system?
For a question so broad and so important, my brief answer is definitely not going to do any justice. Nevertheless.Indian healthcare system has its strengths, as well as its challenges. For the extremely diverse population set, there is healthcare offering at every level, right from the expensive tertiary branded hospitals, to alternate medicines at the grassroot, for instance ayurveda. Doctors in India treat far higher number of patients than the doctors in the developed markets. And therefore, like-for-like experience and background, Indian doctors clearly have a far richer experience. That said, it has its own challenges. The system is fairly broken. Fewer doctors than what should be. Fewer clinics, hospital beds, and accredited facilities - infact far lower than what is required in India. The healthcare information is not properly structured and stored, and therefore, we are not quite learning from our past. Infact, in several ways, doctors and healthcare providers must be reinventing the wheel by trying similar treatments, without knowing their probabilities of success and failure.The key challenge from what I see is that incentives are not linked with outcomes. Doctors and Hospitals get paid for quantity of work. Patients benefit from quality. Insurance penetration is fairly limited, and therefore, there is no particular scrutiny on the treatments and expenditures.Overall, several challenges remain. And therefore several opportunities exist as well. We at The Healthy Billion™ are trying to tap into a subset of these opportunities, and hopefully make some difference to the Indian healthcare system.
For all you Canadians out there..How is your medical care?
I think it is pretty good personally. I am a mother of three children. I am grateful they are pretty healthy. We do have a family doctor, but she works 2 hours away. We can always go to an afterhours clinic if we need to. That actually is quite a pain because the line-up waiting to get in it is huge and outside. When they finally unlock the door and let everyone in, they usually lock it up again and tell everyone else, sorry, it's full and the doctor can only see this many patients in the two hours the clinic is open. This is incredibly difficult for sick people and seniors and for parents with tiny children to have to be waiting outside in the winter weather for an hour or more to see a doctor. Now, I usually go to the emerg with the kids when it's bad weather so I can avoid this. But it's because there isn't enough doctors around for all the citizens. If we had more doctors the care would be easier to come by. The ones that are working are so stressed out and over worked. I really appreciate the ones that are still at it. The ones I've been to are great. I am happy that anyone here in Canada can see a doctor for free. That is good. You just may have to wait a while to see them.
What evidence exists that the economy fixes itself without government or monetary policy intervention?
There isn't any evidence. A purely free market will eventually self destruct as participation in said market recedes when the flow of money is upset for any reason (hence recession). Unless someone in the market steps forward to risk their own capital to fight the contraction, it only continues to contract. This is why governments now have economic and monetary policies ... because no free market will correct itself. There's too much money to be made from an economy on a downward spiral.