Friday, July 11, 2014
Why Do American Health Care Costs Seem to Be Twice What They Are in Other Industrial Countries with Socialized Medicine? (first of all it has been socialized here with medicare and medicade) Tort Lawyer Fun certainly Helps
Why Do American Health Care Costs Seem to Be Twice What They Are in Other Industrial Countries with Socialized Medicine? Governments Control Their Own Statistics. Hidden Unseen Costs Don't Have to Be Added In. Private Health Care Has Substantial Direct Tax Costs Paid by the Consumer. Governments Often Spend More on Pumping Out Information Than Doing Much of Anything Else Lex Loeb Contributor Network . The US health care system is not a system but a lot of different systems coupled together for the sake of comparison with nationalized health care programs in other countries. Our health care system only can be judged as a system based on government programs already in place which include Medicare and Medicaid, Otherwise it is not a system but multiple systems that have to be judged separately. The data showing that the USA is one of the least efficient "systems" with costs more than double places like Germany and France are rigging the data for the purpose intended which is to introduce more government control of the US heath care as a positive excuse for doing so. Before just believing the statistics there are somethings you should know about how the statistics for comparison are generated. In countries with nationalized health care systems there are massive office buildings filled with bureaucrats paid exclusively to generate statistical information and to paint the happiest face on all the various programs that they run. Here in the USA we have the same sort of government where propaganda is generated constantly to justify getting more and more government funding. Here in the people's republic of Oregon we have a saying that there are no government workers just government employees. Whole offices do nothing much more than generate flattering propaganda of all the good their agency does for the state and community always with little to show for it. The services they say they are providing are often availble to the public for fees that should make people wonder why they also require government funding in the first place. When these agencies actually need to do actual work they necessarily go out and subcontract that work to companies and people who do actual work because government employees don't really do work. Maybe you have noticed that happening in your state too or in Washington DC? In Europe, Canada and elsewhere you can see much more of the same thing. Governments do take the time to fabricate the statistical data they need to justify their continued existence. Every Nationalize program and agency around the world is going to self justify it's existence. You see it with Pemex the national Oil company of Mexico which bills it self as essential to the Mexican economy but really just benefits insiders and operates so inefficiently that it may even be draining the countries resources. National health care systems never publish any statistics that are going to be overly self critical nor are they going to put an unhappy face on anything they do. Have you seen your local public school system's claims of success? Here in the People's Republic of Portland, Oregon, Public schools say they don't have enough money with almost $15,000 per year per student and graduating only 60% of students with that much money in the system is acceptable. The schools are always out of money and they are doing their best but they need more money is always the message. Private schools that cost substantially less per student per year are graduating a larger percentage of student, getting better overall test scores and costing parents out of pocket money on top of what they already pay to keep the public school mess in business. You really think that if that happens in our public schools that it is not happening in nationalized health care systems? It is and when nationalized health care comes to the USA it will be just as bad or worse because government funding needs to be constant and then all government agencies want to grow their size and funding just like the public school systems do. When you see the cost and effectiveness of state run health care plans in places like Cuba exceeding the USA beware you are seeing a government assessment of itself and it is extremely flattering. Unfortunately for the Cuban people their health care system is embedded in a system that controls everything in their economy. Castro has used his medical care system as a propaganda tool for ever while in office and it comes at significant expense elsewhere in the economy. The fact that food is rationed and most people only have beans and rice to eat is absolutely a cost not included in the government's statistics showing their health care system is cost effective. The Cuban system is also not a fair comparison because most Cubans can't just get on a plane and go elsewhere to make comparisons. In Europe there are lots of hidden costs not added into the government statics. Their showcase government health care systems are much more expensive than advertised because taxes are generally higher. We don't have income taxes and VAT taxes together. European Estate taxes are higher, Property transfer taxes, protectionist food taxes and excessive fuel taxes lower standards of living and consumption in major ways compared to the USA which ultimately are costs that go to pay for their supposedly better health care systems. So when Germany or France say they only pay 7 or 8 percent of their GDP on health care compared to 15 percent in the USA, it is not the whole cost story. Lingering high unemployment in much of Europe is one of the direct costs that no government statistician is adding in. It is a substantial cost of their government having a class of unemployed people as high as 20% of the population that could be working nonworking but at least having free health care services. The high unemployment in Europe should be a multiplying factor in the statistics but is no where to be seen in the official analysis. European health care cost probably exceed US health care costs by a substantial factor once all costs of government are added in the mix. It is true that it is hard to qualify perpetual high unemployment as a monetary cost but that does not mean that it should not at least be a major foot note in the data. In The USA health care is expensive. Very expensive. Most people are clueless why it is so expensive and that is because we also have hidden costs and these costs are exclusively something we can blame on government because our government makes money off of our health care system. Having worked for a medical health care company I know exactly how government made all the services our company provided cost substantially more for patients than they had to. The company, like all us companies in a certain income bracket has to pay income taxes, The effective rate of taxation I remember having been 45% at one point. The company was paying this to the government in quarterly payments for employees before paying them. Services to patients thus cost them approximately 45% more than they had to be. A $200 bill to a patient or their insurance company thus would be $110 if the government were not collecting what is $90 Tax on it. That is still going on in the USA and one might wonder why government just does not make the medical profession and health care equipment and supply companies tax free instead of trying to nationalize it if they really want to get costs to come down? The fact of the mater is that if you go to a hospital for a heart by pass and you see a bill for $160,000 to you or your insurance company you maybe paying a hidden tax on that service of $72,000 to your government in taxes paid on every level of the health care food chain. You cannot blame the insurance companies for these high added tax costs. Government is responsible for not making health care tax free the same way state governments exempt necessities from their sales tax liabilities. If the hospital could bill for a tax free 88,000 for the heart by pass hospitalization instead of $160,000 then the insurance companies would necessarily be able to charge less. There are other hidden health care costs that government is responsible for . You cannot walk into a doctors office in America where a doctor or the hospital / system he or she works for is not paying a substantial annual fee for liability insurance. American seem to agree that there should be a way to get compensation for medical malpractice but there is no reason why lawyers should be cut into the deal and be able to get a 50% or more contingency fee. The compensation mostly comes from the insurance companies and if it goes to the lawyers that does not benefit the people supposedly harmed. Congress could act immediately to limit contingency fees to 20% of any settlement to help stop forcing the American health care system to pass on these costs to patients and their health care plan companies. Congress would never hear of cutting hidden costs like these. Anyone dealing with contingency fee attorneys know they only like to take the easy cases and don't necessarily work very many hours to get 50% of a settlement and most are settled without ever going to court and attorneys are making money representing the defendants all paid for by all patients. Congress could come up with a no fault compensation system to completely dump the lawyers from the equation because now we have enough data to show what the cost of every malpractice claim actually is after legal costs for over 40 years. The government could just set the rates of compensation and then have a process that determines whether there was any malpractice at all by a panel of professional medical people not trial lawyers and paid expert witnesses. It would save up to 20 percent of many health care bills but that is not what congress wants to do to. Attorneys get an automatic cut of everything you pay for you health care services. The attorneys believe that all the dollars collected for medical liability insurance ultimately belongs to them and there is never enough to pay them and keep the insurance companies in business so the price just keeps going up. Doctors are forced to settle even when there is no malpractice because the courts are run by the same attorneys as a means of income protection for their profession. What do those costs have to do with your health care? They make it considerably more expensive because it not only adds the liability insurance but it adds defensive medicine you end up paying for because lawyers have set medical standards in court that are not very often very scientific but failure to preform defensive medicine will make liability costs rise so doctors are forced to do the unnecessary. Make an appointment with an attorney instead of a doctor if you want to make money going to a hospital. Once you take the hidden cost of US health care out of the US health care then the costs are lower than in socialized medical systems around the world. Once you take the bureaucratic spin out of foreign nationalized programs and stop comparing apples to oranges, the US medical systems are better more effective and probably the best in the world with more choices for patients. Nationalizing or having a public option is nonsense as a way to get costs down because the system still is not a tax free system. Government can set the basic costs per service as a percentage that would be tax free to doctors and hospitals to immediately limit health care costs here but they don't want to because they are collecting huge revenues for what is 15-25 percent of our economy form the rich doctors, rich insurance companies and rich drug companies. Unfortunately it is the rich American patients who are really paying out as much as 45% of their health care dollars so big government can cut itself in to that money. The problem is that those income taxes do not just go to our health care system. No- they go into the general fund. When you pay 45%, I pay it now myself for my medical care, it goes to social security, the pentagon, to the department of agriculture, to The FDA and to a minimal percentage to health care programs. Did you know that your health care costs are paying for the war in Iraq among other things just because your doctor is passing on his income taxes to you the patient? Our government wants to expand it's power and not cut those taxes when you look at their plans to add taxes on top of these for their various public program ideas. Congress and the president are not being honest about the real approach to instantly lowering health care costs by making these services tax free. One way to do it nationwide is just to eliminated the existing income tax and replace it with a general consumption tax that exempts all medical goods and services providers with set parameters of what can be charged and anything over that subject to consumption taxes over that including maybe some elective services and treatments. That would help the entire economy. Another way to cut cost is to change the liability malpractice system which is entirely government controlled and to create a board of review for malpractice claims with set pay out rates so that insurance companies can lower liability insurance rats ultimately paid for by patients but charged to doctors and clinics. It really makes no sense to charge patients 35 -45 percent taxes because the income tax does not exempt the necessity of health care. Faced with the idea that rich doctors, insurance companies and hospitals might get richer because they are no longer subject to these taxes seems like less of a concern that I have to $200 at a clinic for a service that really just costs $110 without all the taxes added in. I think I would prefer to pick my rich doctor instead of being assigned one by a government bureaucracy that runs the way public schools do. Other proposals to cut medical cost allow drug and equipment manufacturers to go to the patent office to agree to lower costs of their products in exchange for extending the time they keep their patents . This makes sense because the USA has the competitive advantage in Research and Development and we are forced to deal with OPEC cartels to pay more for stupid commodities but then force our companies with natural competitive advantage to give away their patents to the world after too few years of protection. Congress talks about saving US industry and manufacturing but they are too stupid to do the obvious when it comes to the best proprietary technology this country has by not allowing patent extension just even based on keeping the USA competitive. The US patent office is the king of patent offices around the world and it is not a bad thing that foreigners should also have longer proprietary patent protection if they too lower initial costs to consumers. .