Health Costs inflated by old, fat and stupid people.

[ananda]

A loss of standards would result in different less acceptable costs. So you need a bureaucracy and administration to organise a system of health care. There are also economies of scale in such a model and with standardisation. But there are continual questions to be made about administrative decisions and system plans and what can be done to improve them. Clearly the clearer structures and organisation of the European health care systems compare very favourably with the chaos in the American system which duplicates programmes in the name of choice and free market competition and whose base inefficiency costs twice as much.

The problem arises when different people hold different standards.

 

[Nithavela]

My personal suggestion would be to kill everyone. That should drive health care costs down.

 

[mindlight]

The problem arises when different people hold different standards.

Hence one of the questions in my OP. How do we decide on what standards and who to enforce them?

 

[ananda]

Hence one of the questions in my OP. How do we decide on what standards and who to enforce them?

The most reasonable answer is that everyone gets to decide for him or herself based on their own individual standards, needs, wants, and desires.

 

[mindlight]

The most reasonable answer is that everyone gets to decide for him or herself based on their own individual standards, needs, wants, and desires.

If the individual is the arbiter then the main question is whether they will also pay for that care. If the answer is yes then the rich will be cared for and the poor not. If the answer is no then the individual will always choose the best care regardless of cost. So either way the system does not work. The first because it fails to provide comprehensive care. The second because the cost escalation will quickly become unaffordable.

In practice there has to be some kind of common insurance scheme we all pay into making health care affordable for all. But how that is managed and held to account for costs and treatment decisions is the crucial question.

Individualism is the curse of the American system not its salvation and explains why it costs twice as much while failing to provide comprehensive care.

 

[ananda]

If the individual is the arbiter then the main question is whether they will also pay for that care. If the answer is yes then the rich will be cared for and the poor not. If the answer is no then the individual will always choose the best care regardless of cost. So either way the system does not work. The first because it fails to provide comprehensive care. The second because the cost escalation will quickly become unaffordable.

In practice there has to be some kind of common insurance scheme we all pay into making health care affordable for all. But how that is managed and held to account for costs and treatment decisions is the crucial question.

Individualism is the curse of the American system not its salvation and explains why it costs twice as much while failing to provide comprehensive care.

"Health care" cannot be made "affordable to all" until we reconcile what you mean by "health" and "care" and why those definitions should apply to everyone.

 

[mindlight]

"Health care" cannot be made "affordable to all" until we reconcile what you mean by "health" and "care" and why those definitions should apply to everyone.

It is a mark of a civilized country that it takes care of its own.

But. I agree the definition of what is health and care is crucial in order to establish what should be generally available and what should be a matter of personal choice and private payment.

Health for example is not just physical but also mental. Regarding comprehensive care it cannot include cosmetic surgery or nonessential treatments. It should not include abortion at the taxpayers expense either. It must also consider what is possible with the resources available and this may rule out some kinds of expensive drugs or treatments. Doctors should mainly save or prolong lives where that is practical and affordable. But there is a discussion to be had about the extent to which public free health care must maximize quality of life. A broken arm should be fixed but other more expensive treatments that might improve life quality might not be for instance.

Ultimately the body that decides the scope of supported health requirements and the limits of what is affordable needs to be publically accountable and its decisions must be transparent and reviewable.

Any extra care requirements should be the decision of individuals ,paid for by them directly, through more expensive insurance arrangements, or as a result of charity.

Guarding the financial limits and scope of treatment of what constitutes comprehensive care is the essential problem here.

 

[lismore]

T A more balanced population with more babies and immigrants would address part of this imbalance.

Stop abortion!

 

[Bob Crowley]

I sometimes wonder why Americans are so hung up about "socialism" when it comes to health care. It almost seems to be an obsession with them, despite the fact that "socialised" European health systems have been outperforming the American system for decades.

Some years ago, a friend of mine was an architect with the state government here. He was sent on an overseas trip to check out hospitals in Western Europe and the USA, not doubt to see what we could copy or modify here.

Unfortunately he had a stroke himself not long after his return, and hasn't been able to work since. One of those things - as somebody remarked above, no one knows who is going to draw the short or long straw. One of those unfair ironies life throws at you sometimes - sent to check out hospitals to see what we could possibly learn from them, and he was in a hospital himself a couple of weeks later.

He did state though he found the German and Dutch systems seemed to be the best, but he wasn't very impressed with the American system.

I suppose the German and Dutch tend to do what they're told by their relevant authorities, but they're also efficient.

On a personal note, somebody I know went to the US with her husband some years ago for a holiday. He had cancer before they left, and they knew that, although to look at him you would not have known it. Sadly he had a heart attack in Las Vegas and died after 3 days intensive care in a hospital there. His wife said she nearly died herself when she got the bill - $30,000 for 3 days!

Not as bad as another couple where the wife's baby arrived prematurely en route home from England to Australia. She had the baby in Abu Dhabi at about the same time the financial crisis hit. They ended up seeking help from a charity, and she commented, "I don't know how we're ever going to pay it off!" I had no idea of the cost, but I found out later through the grapevine that you could buy a house in Brisbane, Australia, for what it would cost you to have a baby in Abu Dhabi.

No doubt the free market advocates of health care would say this is a great and wonderful thing. Great for the medical staff and the shareholders maybe.

But I don't think so. We've got a "socialised" medical system in Australia via Medicare and other public funding, and overall it works pretty well, abuses notwithstanding. I'd hate to see the American style system adopted here.

 

[JCFantasy23]

I sometimes wonder why Americans are so hung up about "socialism" when it comes to health care. It almost seems to be an obsession with them, despite the fact that "socialised" European health systems have been outperforming the American system for decades.

I know, so many people are stronger supporters of keeping our system, which to me is horrible. Several think it will raise taxes, but I argue there is no way the taxes would raise enough to be even a fourth what we pay now for our own medical. Some of the wealthiest money makers here are pharmaceutical companies and insurance companies, which tells me the reason right there.

 

[mindlight]

I know, so many people are stronger supporters of keeping our system, which to me is horrible. Several think it will raise taxes, but I argue there is no way the taxes would raise enough to be even a fourth what we pay now for our own medical. Some of the wealthiest money makers here are pharmaceutical companies and insurance companies, which tells me the reason right there.

Agreed there are deeper cultural issues here at the moment and solutions to the essential problems of cost inflation and comprehensive care would have to address the full range of these.

 

[mindlight]

Good time to revisit this thread since these are the people dying in the current Pandemic

 

[lismore]

1) So what in your opinion can be done to reduce health care costs in Europe?

IMHO Health care costs should not be reduced.

But there are things that should. The amount of money spent on wars should be reduced. The amount of money squandered in sports and sports betting should be reduced to nil, paying some people millions of pounds to kick a ball when many people are starving in the world is degrading.

Give the money squandered on nuclear weapons, sports, booze, drugs etc to the old and the sick.

God Bless