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Making health care affordable to all is a big political issue in many countries. What do you think is the best way to achieve this?


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If it was easy, every country would have already done it.

Often "affordable" trumps speedy. That's the hard part that nobody seems to have solved. Just ask the people waiting 6 months for cataract surgery http://www.cbc.ca/news/canada/calgary/alberta-cataract-wait-time-cihi-report-1.3514209 or even longer for hip replacements http://www.telegraph.co.uk/news/2016/12/31/nhs-rationing-hip-replacement-patients-needlessly-suffering/ .

Table 4 here: http://www.healthpolicyjrnl.com/article/S0168-8510(13)00175-9/fulltext#tbl0005 shows some interesting data. Seems that waiting at least 25 and sometimes 90 days for most non-critical care is necessary.

Couldn't find data for Japan, but my searches were in English.

Is expensive and fast better? I wouldn't know. It was relatively cheap for me prior to the ACA/Obamacare. Since 2014 (pre-ACA), our monthly insurance costs have almost tripled with a 50% higher deductible and the insurance company we used before has left our region.

I feel that part of what the USA does for the world is pay higher health costs to subsidize medical research. I'm sure other places do as well, but when there is a 10,000x cost differential between a drug sold in the USA and the same drug sold in India, I have to believe some of that added cost is good for the world.

Wish I had an easy answer.

-5 ( +1 / -6 )

theFuJAN. 15, 2017 - 08:53AM JST If it was easy, every country would have already done it.

For several decades, most industrialized countries apart from the US have done it.

I feel that part of what the USA does for the world is pay higher health costs to subsidize medical research. I'm sure other places do as well, but when there is a 10,000x cost differential between a drug sold in the USA and the same drug sold in India, I have to believe some of that added cost is good for the world.

You "feel" it, but that doesn't necessarily make it true. The higher price of drugs in America isn't because drug countries set a price point they need to make and mark up US prices to offset low prices elsewhere, they're high because the US doesn't negotiate with pharma companies to keep prices low. So they gouge when they can for no other reason than that they can.

We cannot just assume all of that revenue from price-gouging the American public automatically goes into R&D, though we've heard supporters of the pharma and insurance industries make that argument for decades. The fact is, American drug companies employ tactics that simply aren't used in the rest of the world. In how many other countries do drug makers put ads on TV telling people to "ask your doctor if [Insert buzzword drug name here] is right for you"? I've never seen those sorts of commercials elsewhere. Why would I? Normal people under functioning health care systems don't go running to their doctor to ask for extra medicine, but in the US apparently that's a profitable strategy. Drug makers in the US also pay sales reps to push their meds on doctors, sometimes employing ethically dubious methods to bribe them to sell more product. All these ads and salespeople and sneaky tricks to sell more drugs cost money.

6 ( +7 / -1 )

Years ago an international assessment of the public health system in Japan found it pretty good for overall coverage and preventative health but inconsistent on attending to individual needs. Regular checks for kids up to leaving school or beyond, and for public servants, is good though tending to be rudimentary (for example no respiration testing). But bottom line is they treat first and worry about paying later

Public and private systems in tandem, such as Australia (where everyone pays from income, more or less free treatment in public hospitals but pay sometimes a lot in private), work well but there is not so egalitarian. But it is subject to shift in government policy as to how economical it is (eg. when charges of 3-6,000 yen just to see a doctor before the drugs and treatments are the periodic norm, people start clogging up emergency rooms in public hospitals where there is usually no charge, causing extra delays etc.). Stopping people without adequate insurance is fairly new and people generally dread the drift towards a US model.

Pay as one can is scary these days. For instance travel insurance companies tend to keep special extra rates for people traveling to the US. The insurance and litigation cultures in the US are a big downer, regardless of any cutting edge knowhow and technology.

5 ( +5 / -0 )

Preventive health education, nationwide mandatory health insurance, strict prescription drug guidelines.

Most of all ban corporate campaign contribution towards national elections. This is the worst of the worst.

1 ( +3 / -2 )

Canada's system isn't so bad. Not perfect, but no country's health system is free of criticism.

2 ( +3 / -1 )

Easy -- a national health service modeled on ALL THE SUCCESSFUL ONES throughout the world.

2 ( +2 / -0 )

There is a saying in the USA about health care :

If you think health care is expensive today, just wait until it is free.

-5 ( +0 / -5 )

How can you give something to everybody AND make it cheap and high quality at the same time?

Impossible. Pick two.

Politicians (and their obedient journalists) have been lying to us for so long everybody now believes the lie.

-1 ( +1 / -2 )

Devalue it.

I think it was either Molly Ivins or Ann Coulter who pointed out in a few articles that the medical industry (specifically the American Medical Association, a kind of doctor's union) and medical eduction (the medical schools) combine to artificially constrain access to medical degrees and medical positions.

This is to their advantage, it keeps jobs and jobholders in their industry scarce and allows them to charge a lot.

The stated excuse is that they need this stuff (80-hour-plus workweeks for interns, high admission standards and low admission rates, requiring students to obtain an undergraduate degree before permitting access to medical school) to breed the supermen or demigods necessary to administer health care.

Also, with all the medical institutes sitting around, they should be able to combine and make autodoc diagnosis programs and machines, and standard procedures to be followed for all conditions. After these are distributed costs should drop drastically. When you call the weekend triage nurse, she'll walk you through a diagnosis and then make a recommendation as to whether you should keep your kid at home and nurse them there or take them to the ER. She might call the doctor if her flowchart or training says to at some point.

People seem confused about the relation of business to productivity, at least there are tons of complaints on JT boards about how unproductive their fellow salarymen are. The primary purpose of every actor in the system is to maximize their benefit. If working harder gets your deadlines done sooner, a consequence is that pink slips may come sooner. Even the managers may not want deadlines finished sooner. The medical industry isn't immune to these kinds of non-apparent goals. Neither is government. So don't expect much.

-1 ( +1 / -2 )

cut down on military spending. we should spend less money killing each other and more to heal each other.

3 ( +5 / -2 )

If you think health care is expensive today, just wait until it is free

The 5th highest infant mortality rate among 34 OECD countries is a brutal and compelling reason for the world's richest country to get its healthcare act together.


3 ( +4 / -1 )

The world's richest country is: Qatar. I don't know much about their healthcare system or infant mortality rates. https://www.gfmag.com/global-data/economic-data/richest-countries-in-the-world?page=12 or http://www.mapsofworld.com/world-top-ten/world-top-ten-richest-countries-map.html if you prefer maps. Qatar and the USA have similar IMR according to this: http://www.indexmundi.com/map/?v=29 ; I am missing the point.

Just found this: http://www-tc.pbs.org/prod-media/newshour/photos/2012/10/02/US_spends_much_more_on_health_than_what_might_be_expected_1_slideshow.jpg

USA devotes ....

17.6 percent of GDP in 2010 — to health than any other country. The Netherlands is the next highest, at 12 percent of GDP, and the average among OECD countries was almost half that of the U.S., at 9.5 percent of GDP.

I'm starting to be convinced there are better answers since the USA is spending much more per-person than every other country out there. People earning a living in the for-profit parts of health care industry will need to find other jobs. That will greatly impact the economy. Guess it needs to happen.

0 ( +2 / -2 )

Copy Japan's system.

-2 ( +1 / -3 )

Japan system is the best that I've ever been a part of.

0 ( +2 / -2 )

The world's richest country is: Qatar.

GDP wealth of a small nation vs total wealth of the US. Really?

I don't know much about their... infant mortality rates.

I'll read that as:

"Couldn't care less: I want to opine and emote, not understand!" (evidence: previous post's List_of_countries_by_infant_mortality_rate)

3 ( +4 / -1 )

I would ask that you read what was written. Please. If I "couldn't care less" (your words, not mine) then I wouldn't have posted.

Facts speak for themselves. Google "world's richest country" What is the result?

Just trying to understand, share my opinion, and get some other points of view from commentators here. That was the topic. Yes?

0 ( +0 / -0 )

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