patrick.net

This ought to be good...

So what does create free markets and lowers health care costs?

You could fit everything you know about economics on the head of a pin.

Competition creates high quality and low prices. Monopolies in either the private sector and of the public sector result in low quality, bad management, set pricing, fraud, and other ills.

The power of single paying:

Let's take an example of how these low costs work. In Denver, where I live, if you get an MRI of your neck region it's $1,200, and the doctor we visited in Japan says he gets $98 for an MRI. So how do you do that?

Well, in 2002 the government says that the MRIs, we are paying too much, so in order to be within the total budget, we will cut them by 35 percent.

If I'm a doctor, why don't I say, "I'm not going to do them; it's not enough money"?

You forgot that we have only one payment system. So if you want to do your MRIs, unless you can get private-pay patients, which is almost impossible in Japan, you go out of business. ...

Siemens and other makers of these machines pay kickbacks to hospitals to adopt the machines - and I suspect that insurance companies have interesting relationships with lab, MRI, etc. providers.

First off, NPR is hardly an unbiased source. It's an extremely liberal source. Second, unless we have upfront pricing, there is no free market in health care. I offer Lasek Surgery as an example of something in the medical field where it's a free market and the costs have come down over the years.

zzyzzx says

First off, NPR is hardly an unbiased source. It's an extremely liberal source. Second, unless we have upfront pricing, there is no free market in health care. I offer Lasek Surgery as an example of something in the medical field where it's a free market and the costs have come down over the years.

The person being interviewed is Japan's Top Health Economist explaining how Japan's system works: Government, Companies and Employees pay equal thirds a set premium, and all costs are negotiated down to the last degree by government for ALL providers. They pay by each square inch of stitches, regardless of what hospital or doctor performed it.

There will never be upfront pricing in the USA. Insurance Companies, Doctors, and Hospitals regard medical pricing as something secretive, the basis of their strategy and power.

While NPR could ask leading questions, there's absolutely no doubt when it comes to better outcomes at nearly half the cost, Japan KO's America's system in round one.

thunderlips11 says

absolutely no doubt when it comes to outcomes and costs, Japan KO's America's system in round one.

Splain me?

Read the link. Japan spends about 8% of GDP on health care, we spend about 16%. Pretty much every major health indicator in Japan is superior to that of the US. From Surgery Outcomes to Cancer Death Rates.

You'll go on to read that in the year before the interview took place - I guess 2006 - Japan's health care spending went up one tenth of one percent: 0.1%. Despite an aging and demographic situation much worse than the United States.

Think of all the brokers that don't need to be paid a commission... all the accounting work to adjust between upteen different insurance plans offered by an assortment of different insurance companies... the reduced need for marketing.

And, the percentage of private hospitals in Japan is higher than in the USA.

thunderlips11 says

Read the link. Japan spends about 8% of GDP on health care, we spend about 16%. Pretty much every major health indicator in Japan is superior to that of the US. From Surgery Outcomes to Cancer Death Rates.

It's not all healthcare. Japanese eat better.

thunderlips11 says

The power of single paying:

Yep, capitalism isn't the only system that has markets, free or otherwise, or commerce.

Lemon socialist Obamneycare raises costs even further, as every promised cost reduction either proves either illusory to begin with or gets repealed, predictably:

"A push now under way in Congress to defer or repeal the so-called Cadillac tax is the biggest legislative threat the Affordable Care Act has faced in the past five years. And, weirdly, the lawmakers to blame are Democrats," Orszag wrote in a Bloomberg View column.
***
"Economists and deficit hawks favor the Cadillac tax, as it is projected to raise revenue and lower overall health costs. But it is reviled by just about everyone else — especially labor unions, which represent a major Democratic constituency. It has crept into the presidential campaign, as both top Democratic contenders — Clinton and Sen. Bernie Sanders (I-Vermont) — have called for its repeal.""

The legislation was never about improving public health nor reducing costs. It was always about enabling the entrenched players to hijack the reformers' momentum and channel it into further revenue maximization. Life expectancy has stagnated for three years, while costs have continued to increase higher than anywhere else on earth, including scores of countries where people live longer. (Formerly dozens of countries had longer lives and lower costs, now scores of countries do.) "One side gets the music, the other side gets the action."

They have in effect a government plan. The better idea would be to get government out of healthcare. The problems we have are from the government being in healthcare through medicare and now the ACA and through pharmaceuticals. Additionally by not allowing interstate competition. Z mentioned Lasek which is an example of the free market at work. Someone else mentioned monopoly, monopolies ONLY exist through government.

indigenous says

Someone else mentioned monopoly, monopolies ONLY exist through government.

Tell that to De Beers.

Dan8267 says

Tell that to De Beers.

They had the monopoly through cronyism in the GOVERNMENT , & BTW they don't have one anymore.

De Beers is a private cartel, not a government imposed one like the phone or cable companies. If you are trying to make the point that big business bribes government and corrupts it, then, true to that.

No if you read up on it De Beers built their monopoly by holding a monopoly on the mines through the local governments.

zzyzzx says

I offer Lasek Surgery as an example of something in the medical field where it's a free market and the costs have come down over the years.

Really? That's not what the lasik institute says. Average cost today is 2500 per eye, not much if any less than 1990's when first approved. Prices have actually been steadily rising for the last 10 years. http://www.lasik.com/articles/how-much-is-lasik/ https://www.qualsight.com/how-much-is-lasik http://www.drmotwani.com/lasik-explained/ It's a good myth though. I would think by now you would know that advertised price and actual cost aren't always the same thing.

There is an interesting company out there called vitals smartshopper which will shop around for the best price and get you a kickback from the insurance company if you go with a cheaper procedure. Only in a couple states so far. https://www.vitalssmartshopper.com/Login?ReturnUrl=%2F