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willcipriano | on: Stargate Project: SoftBank, OpenAI, Oracle, MGX to build data centers
Every other nation on earth somehow finds a way to deal with that. Given the US is 48th in life expectancy[0] behind all these other nations that spend much less, that explanation doesn't seem to hold much water.

[0]https://www.worldometers.info/demographics/life-expectancy/

whimsicalism | parent
> Every other nation on earth somehow finds a way to deal with that.

well not every other nation, but i know what you mean.

other nations are much better at managing overutilization by denying care where it is not needed. the US insurance system shields people from cost and encourages overutilization due to a number of stupid policy choices (aka refusal to have 'death panels' like in Canada/UK but also refusal to do away with massive publicly subsidy for health expenditure).

for a personal story, my parents basically get free MRIs from the state for little reason whereas people I know have to pay an arm and a leg for MRIs because their insurance is worse. at minimum, we could at least also make my parents have to pay an arm and leg for useless MRIs and doctors would stop encouraging them or lose patients.

willcipriano | root | parent
MRIs only cost that much in the US[0](2015 prices: $1,145 in America and $138 in Switzerland), everything is inexplicably ten fold more expensive here. That more expensive care doesn't result in ten fold better outcomes as all the health measures you can find indicate. That's the root of the problem and the thing is no politician[1] is really willing to address it and they don't really cover it clearly on the news[2], I wonder why?

[0]https://www.vox.com/2014/9/4/6104533/the-125-percent-solutio...

[1]https://www.opensecrets.org/federal-lobbying/industries/summ...

[2]https://www.fiercepharma.com/marketing/hey-big-spenders-phar...

s1artibartfast | root | parent | next
Correct, you have identified the problem. Prices are high because there is no agent in the US system looking to allocate spending on the basis of cost and health returns. The closest we come is the much hated insurance denials.
willcipriano | root | parent | next
Its likely true that more procedures are performed and more prescriptions written, but why are those procedures and prescriptions many times more expensive?

Economies of scale should make them cheaper. An MRI machine and technician that sits there unused half the day has to charge more per visit than one used all day long. Have too many customers? Get more machines and techs, now the MRI manufacturer is making more units, offering volume discounts...

Rationing of care doesn't explain why the individual units of care are themselves much more expensive. Compare inhaler prices in Canada vs the US, $10 in Canada $100 here[0], that isn't because too many of them are given out. It's theft.

Addendum: Further, the young and healthy ration their care quite a bit under the current system, they are taxed too heavily (to pay for the care of the elderly) to afford it for themselves so they go without.

[0]https://www.usnews.com/news/healthiest-communities/articles/...

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whimsicalism | root | parent
yes, precisely my point
whimsicalism | root | parent
the overutilization story is what explains this, you cannot simply walk into Switzerland and say "I want an MRI here is my $138", but that is essentially what you can do (delta a bit of doctor shopping) in the US. there also is a lot of bad price transparency in the US so the listed price is not the price ended up paying, again this is due to the problem I identified above about shielding costs.
mrguyorama | root | parent
When's the last time you tried that here in the US?

It's like when people claim that other countries have worse medical systems because they have to wait, as if my friend didn't just wait 2 months for a simple injection recently, and my mom isn't waiting 2 weeks for an MRI after a stroke.

The vast majority of people who insist we have the greatest healthcare don't even go to the doctor's regularly. Because they were raised in a system where going to the doctor is something you have to weigh the cost of! We have worse medical outcomes simply because people wait until a cheap situation turns into a shitty and painful and expensive situation.

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