The Cost of Health Insurance Around the World!

This is actually a pretty interesting chart that I posted above but am highlighting here so people don't miss it. It clearly lays out yearly per-person costs for coverage, average number of doctor visits per year, and life expectancy at birth for about 20 countries, clearly sourced and attractively prepared for you by the nice people at National Geographic.

infoporn

 

I'll be first to suggest that we don't have the absolute best health care system in the world. I don't know how we'd measure it for a start. I would state that it is adequate and pretty good and on a personal level, having needed it lately it's excellent. But that's a highly subjective view, others may have had crap experiences. Maybe I was just lucky.

I think the Health Insurance Act of 1973 is actually the Act that established what was known as Medibank which then became Medicare, but I'll have a look shortly.

Frankly I don't know how much the 1.5% raises and if it's sufficient for Medicare. I would think it isn't, but not sure. I did make the point that we pay the levy plus regular tax. I'm not suggesting that the two be discounted. Tax is tax is tax and the 1.5% is tax. So my tax bill is $X plus the 1.5%.

 

On the legislation. It seems as if the Health Insurance Act 1973, assented to in 1974, is the establishing legislation for our national health care programme. Not sure if you're familiar with the Westminster style of legislation but the initial act is given a long and short title. The short title usually states the first year it came into force, in this case 1973 and sometimes it will include the latest amendments. So if the Act in question was put before the parliament in 1973 and the the last amendments were this year then the short title would be The Health Insurance Act 1973-2012. There is a bit of a problem with Commonwealth legislation, it's bloody massive and since I'm used to the state legislation form I do find the Commonwealth one a bit difficult to plough through. However I think I have it correctly.

There is a link here - http://www.comlaw.gov.au/Details/C2004A00101 - if you check that page you will see links on the right to the latest version. Again that can be a bit confusing. The current Act usually consolidates all amendments from, in this case the establishing year of 1973 right up to the latest amendments. The Commonwealth has a bloody annoying habit of having bits of spinoff legislation from the original Act though. Our telecommunications legislation is a thorough dog's breakfast like that, but we're not discussing that, thankfully.

 

Yes it is. I reckon I've paid so much tax over 42 years of working that the buggers owe me a ride in the back of an F-18 (with a sick bag of course). I know my tax bill is $X plus 1.5% but the distinction in marking 1.5% of my taxation is designed to make me think, "oh well, at least they're not pissing it all away completely". I think it works. But I am aware that it is still a tax payment.

 

That is an interesting chart and those are stark differences. Before we hand over custodianship of our healthcare to our government perhaps we should consider if their results will match that of other governments. Consider Medicaid. In 2004 there were 46 million people enrolled at a cost of $295 billion dollars, or $6,413 per person. According to your chart that is more than twice what the average Australian pays. So you say that something needs to be done about our healthcare system in this country and I say, yes. If you say that we should have the government administer healthcare in this country, I have to say please, no. I have zero faith that our government can properly administer universal health care without lining the pockets of corrupt corporations and in turn their own.

 

I've only lived here in the US for a decade, but the more I think and talk about it the more I hear the opinion that we're too stupid here to implement a system that 20 or 30 other countries have been using for generations.

It might work nicely in other countries but we would screw it up here. Is that what you're saying? How is it that the legendary American Exceptionalism suddenly has an exemption when it comes to government? I think we can do it here and possibly we could do it better than everyone else if people weren't so taken in by such transparent lies from the very people with an interest in keeping things the way they are.

I can't tell if you're skeptical of the figures in the chart or not. There are a million other ways to find the same data if you're unconvinced but for what it's worth I can tell you that the numbers are a good representation of what I paid in Canada, the UK, and France.

 

More or less. In your 10 years in this country have you found the US federal government to be competent? Or have you found them to make brash and irresponsible decisions? Just compare the cost per person on Medicaid ($6,413) vs the cost for a private insurance plan as listed in the OP ($5429). These are the people that are supposed to solve our healthcare problems?

 

You've got me there. Maybe we do get the government we deserve.

 

I think that may be the case with all of us. I have spent a little time in the US, and while I find Americans friendly, and generous, and helpful, I also find them (a) largely ignorant of, and (b) uninterested in, what happens in other societies (unless an American President, or the US military is involved). I believe this to stem from the sense of exceptionalism most Americans seem to enjoy. When you have been told, from the time you could understand words, that you live in the best of all possible societies, and that your societal values, laws, and form of governance, are intrinsically superior to those anywhere else - why would you be interested in examining their ways of doing things? Add to that an inherent fear of just about everything - from Communism, to Muslims, to any innocuous stranger on the street - let alone 'foreigners', allied to a virulent Judeo-Christian religiosity, and you do not have a society which is quick to embrace 'foreign' ideas and ways of doing things. A fearful, heavily armed, religious nationalist, is perhaps not the subject most amenable to change from without.

When Americans realise that they are simply a part of the world, and not 'the shining city on the hill' sent by God to put the world right, some of this may change. But I am not holding my breath.

 

Looks to me like you've also worked out North Korea Leo. I never could figure out why those poor dumb bastards put up with the Kims. Now I understand.

 

Strange, Ron Paul was saying that our insurance premiums go up because of government involvement but all those countries where government completely in charge of health care have lower cost. Somebody is lying, either statistics of Ron Paul....

 

He isn't really lying. He is living in the past where doctors used to trade services for chickens, and when communities mattered. He is also an ideologue, so his world view must conform to what he believes not on just evidence.

 

Do you know where I can get live chicken in Manhattan? I need to go to dentist next week.

 

What i find strange with the usa with the exceptionalism issue. The usa is a melting pot made up of happy or unhappy citizens depending how view it. Who moved to the america to start a new life.

Now, they are people. The same people like anywhere else in the world. But something in the usa society, steming from their history causes the population to mirror and mask the nazis in the building to the ww2, ie the 1930s.

The belief in a superior people, a master race or as the americans put it. Their exceptionalism. The extreme nationalism quite evident on this forum.

I have never understood clearly how it formed. Many theories floating around though. The bitterness of the wars against uk/europe prompting an american seperation clearly seen to this day. The usa slave era. that mentality has never left them and perhaps the most obvious. An entire nation made up of people whose forfathers were overwhelmed with hated at their families in the 'old world' causing the pre mentioned wars to their independance and in the process this view to exceptionalism.

 

How is that exceptional that those who were prosecuted in Europe came to North America and butchered millions of indians?

 

That is the usa myth isn't it. That feeds into this exceptionalism view. That your forfathers were somehow martyers who were unjustly treated in europe.

Which is certaintly not true when delve in to history. Many were criminals, terrorists if use todays wording. They would be described now as rioters and trouble makers and not these political activisits in the usa version they are made out to be.

Regarding the indians. I also never understood why the americans after they gained independance carried on slaughering the indians.

 

Comparisons to Nazis, modern day North Korea, terrorists...You boys are laying it on pretty thick. Any more cliches that you want to throw out? Nobody has mentioned Stalinist Russia yet? Working your way up to that? Maybe hit it after touching on a Mussolini comparison, or Pol Pot?

The topic went from healthcare being relatively expensive in the US in 2012 to some type of BS mass psychoanalysis and stereotyping of an entire nation replete with racial superiority conspiracies and rehashes of centuries old history.

 

Well this is a forum and with such loose rule sets. Every topic can leap into something different. Very few stay the course to the original OP story.

Although i was on a journey of historical reflection. To enlighten not just myself but maybe shed a light on some historical misgivings.

 

It's not unique, and has its roots firmly in the 'old world' - there's been a long history of such thinking in Europe (especially in the former Imperial powers), and it still persists in some sections of society, although probably not to the wide extent that it seems to in the US. Personally I suspect the reason it is still relatively common in the USA is simply the size of the place, and the fact there is so much actually within the US that there's relatively little need for most people to bother thinking about the outside world. Couple that with obvious military power (it's a big place, so has a big army!) and commercial power (US companies have a huge 'home market' to exploit, so can be comparatively vast companies with huge resources to call on before they even venture out into international markets - there's no comparable capitalist home market on the planet, and that gives them a huge advantage internationally) and it's easy to see why people fall into the trap of thinking that the influence the US can exert on the world must be because they are somehow 'the best', and that 'everyone wants to be like them'. Fewer people in other countries (in 'the west' at least) tend to think like that simply because the countries are smaller, so the populations are inevitably far less able to become isolated from one another, and they have to be more internationalist in their thinking in the modern world. That's not a criticism of the US or its people - I just think it's an inevitable result of the way things are.

Add to that a relative lack of knowledge about what life is really like elsewhere on a day to day basis, and how things really work there, because of that relative population isolation, fuelled by a corporate structure controlling the media that has a vested financial interest in maintaining the current system (so doesn't want to give too much positive information about possible alternatives) and also has immense effective influence over politics, and it's not that hard to see why so many have a perception that their healthcare system must just be the best way of doing it (because it seems to work pretty well most of the time, whereas the 'evidence' they see from abroad is often about where their systems haven't been performing perfectly, as no system does, including the one in the US), and that all other systems in other countries must therefore be somehow 'inferior'.

The reality is that all systems have their advantages and disadvantages, and their successes and failings, and the US system is no different in that. There are flaws in their model, but it shouldn't be assumed by others that that means the system is necessarily 'failing' overall, but at the same time people in the US shouldn't assume inherent superiority or a lack of possible better alternatives, and shouldn't attempt to dismiss the simple fact that, whatever it's failings or successes, the US system is by far the most expensive in the world, and isn't providing a standard of care that is prolonging the average lives of US citizens compared with others around the developed world. To my mind, that surely has to mean that it is worth looking at what is going on elsewhere and seeing if there is something that can be learned, even if it only means working to improve the workings of the current system, its coverage and results, and its cost-effectiveness, rather than wholesale change to a completely different system (which may not necessarily be fully scaleable up to work in practise for the entire US anyway).

Complacency is the biggest danger in all of this, and unfortunately the aforementioned 'exceptionalism' and assumed inherent superiority that seems to be such a relatively widely held opinion is something that is only likely to breed exactly that.

 

Sorry people in the rest of the developed world.

In Ameirca, an MD is a license to get (*)(*)(*)(*)ing rich.

Take that away, and we won't have health care in this country becuase no one in their right mind enters the health profession except for the money. It is the most thankless job in America.

 

According to this graphic, Mexico (the other country without UHC) looks great - lowest cost and one of the largest positive slopes. But I don't think 'average life expectancy at birth' is a very good measure for quality of health care or the delivery of health care. There are a lot of variables at work and simplistic graphics don't shed much light on the real problems.

 

I don't know the background or context of the Ron Paul comment, but I think his point is that when reimbursement is kept artificially low by the government (e.g. Medicare and Medicaid fee schedules), the cost burden is shifted to people with private insurance policies. Countries with UHC wouldn't typically experience this phenomenon as government and private insurance tend to overlap less.

So in the US, we not only pay taxes to support Medicare and Medicaid, but those of us paying for private insurance (individuals and employers) end up subsidizing the government programs indirectly though higher premiums as costs are shifted to private insurers.

 

Dialysis may be a bad example - patients with End Stage Renal Disease (ESRD) automatically qualify for SS Disability and Medicare after 3 months. Over 80% of dialysis patients are Medicare primary, and Medicare reimbursement doesn't cover costs. So how do dialysis providers stay in business? They shift those costs to commercial insurers. In some cases commercial insurers pay more than 5-10x the Medicare reimbursement rate for dialysis treatments. So while it may appear that Medicare is cheaper, dialysis providers would simply close up shop if 100% of patients were paying the government mandated rates.

 

The same is true in most place, I would imagine. Doctors in the UK NHS are very well paid professionals, and if they also carry out private work (which they can do alongside their NHS work), especially at specialist/consultant levels, they can also become very wealthy. This survey of the top paid jobs in the UK from last year:
http://www.guardian.co.uk/money/2011/nov/25/highest-paid-jobs-uk-2011
puts medical practitioners second only the chief executives of major organisations. While that survey admits to being imprefect in some ways, some of those imperfections of missed out earnings will aply to some of the doctors, and although there may be addional earning potential for some at the very top in the USA to become exceedingly, hugely rich with the extra opportunities of getting involved in the insurance business and so on (although some of those opportunities do exist in the UK to, of course), any assumption that doctors in the UK are somehow poorly paid would be absolutely incorrect. Becoming a doctor in the UK absolutely is a license to become very, very well paid indeed.

 

Have you forgotten your own 'ignorant barbarian' European roots?