patrick.net

http://www.post-gazette.com/nation/2009/12/13/U-S-health-care-costs-for-the-aged-are-sky-high/stories/200912130214?pgpageversion=pgevoke

Why do you think the US spends so much more on the senior citizens with Medicare (socialized government healthcare) compared to the other countries below that have socialized government healthcare?

On the other hand, Americans' risk of dying in later years is lower than that in many European nations whose health care systems are being touted by some as a model for the United States.

Looking only at deaths caused by disease, Dr. Fischbeck's analysis shows that American men have a survival advantage over men in Western Europe that increases steadily after age 65. American women gain a similar advantage starting later, at about age 80.

Putting it another way, if Americans died from diseases at the same rate as people in the Netherlands, for instance, there would be 60,000 more male deaths and 14,000 more female deaths in the United States -- all coming after age 70 -- his tables show.

A notable exception is France, which has much lower disease-related death rates than America throughout the lifespan. If Americans died at the French rate, his figures show, there would be 76,000 fewer male deaths and 242,000 fewer female deaths.

Still, Americans fare better than most Western Europeans in the latter part of the Medicare years. Dr. Fischbeck said it's important to keep that in mind as Congress winds its way toward a final health care reform bill.

"These numbers show there's something really unusual going on here," he said. "Congress is talking about reducing Medicare payments into the future, but if it's thinking about that without the possible impacts on survivability, that's only one side of the argument."

12

Patrick 2017 Mar 26, 5:27pm

These Democrats just voted against Bernie's amendment to reduce prescription drug prices. They are traitors to the 99% and need to be primaried: Bennett, Booker, Cantwell, Carper, Casey, Coons, Donnelly, Heinrich, Heitkamp, Menendez, Murray, Tester, Warner.

Thanks for calling out the names of the traitors!

13

MisdemeanorRebel 2017 Mar 26, 6:02pm

Booker and Menendez have lots of Rx behind them, all along US 1 and 287.

14

Patrick 2017 Mar 26, 6:06pm

A notable exception is France, which has much lower disease-related death rates than America throughout the lifespan.

It's the red wine.

Might be cheaper and more cost effective than Medicare to buy every adult a bottle of red wine every 2 to 3 days.

15 bob2356 2017 Mar 26, 7:03pm

Blurtman says

Bernie would have allowed

Ya really think so?? Bernie hasn't got shit done in Congress in 20 years...

Just like Paul Ryan who has gotten something like 2 bills he wrote passed in 18 years.

16 bob2356 2017 Mar 26, 7:09pm

On the other hand, Americans' risk of dying in later years is lower than that in many European nations whose health care systems are being touted by some as a model for the United States.

I wonder why you didn't put up the rest of the article where other researchers question the benefits?

I notice the term "disease" isn't defined. I would say a big part of that is the extensive treatment of people in terminal stages of diseases. They get strung along, at a very high cost, until they die of a heart attack or stroke. Europeans make much higher use of hospice.

17

Dan8267 2017 Mar 26, 7:09pm

rando says

Might be cheaper and more cost effective than Medicare to buy every adult a bottle of red wine every 2 to 3 days.

Or you could eat fruit and get the same health benefits. It's not like it's the alcohol that makes it healthy.

18 bob2356 2017 Mar 26, 7:10pm

bob2356 says

Paul Ryan

This thread was about Paul Ryan???? Gee, I must have missed that.

You brought up the subject of how effective people were in congress.

19 bob2356 2017 Mar 26, 7:57pm

bob2356 says

You brought up the subject of how effective people were in congress.

No, I brought up how effective BERNIE was in Congress.... Please try and keep up!!

Yep, more effective than the speaker of the house. Glad you brought that up.

20

marcus 2017 Mar 26, 9:10pm

Once you figure that out or answer it honestly, you'll know why giving "Medicare for All" won't work in OUR country.

A better question from my view is, since on average probably 95% (or more) of the dollars spent per person on health care in their lives happens when they are over 65, and most of that is covered by medicare, how in the hell can we account for people having to pay often over 10K per year insure their families with high deductible major medical when they are younger ?

I don't see the logic in your point at all. I'm sure you're response will be something like "that's becasue I'm a dumb dumb poopy head" (or something equally childish). But I'm serious.

YEs health care is way too costly in America and of course since it's so costly, the amount spent per person when we are older which is when they deal with end of life type heath care, is ridiculously high.

But it's extremely hard to imagine that if done right, single payer wouldn't bring costs down. There is some fraud and abuse that has to be watched, and then there will also be the issue of supplemental policies, and how they might lead to inflated prices and markets splitting to serve different segments of society.

But it's no no brainer, and it's not really "socialized medicine." It's single payer, which means one insurance company run by the government, payed for the same way medicare is funded now.

21

marcus 2017 Mar 26, 9:16pm

I was hoping you would explain this. How do you explain it ?

Once you figure that out or answer it honestly, you'll know why giving "Medicare for All" won't work in OUR country.

22

marcus 2017 Mar 26, 9:33pm

MY view is that most of us now pay something like 10K per year or more (or our employer does) for health insurance and only need maybe $1k per year or much less in actual health care. Why not pool the catastrophic risk (sometimes called 'major medical') part of our health care needs along with all of the old people, in medicare. And then buy cheap "supplemental policies" to cover going to the doctor for the sniffles, or a cist removal, or whatever ?

What happens when that same out-of-control system is implemented for 320 million?

Currently, everyone yes everyone that deals with end of life extreme health issues such as extended cancer, heart bypass surgery, kidney dialysis, and many types of extremely expensive life extension therapies are covered by and these are largely paid for with the medicare system. That is unless they are fortunate to just be healthy until they are 93, and then die in their sleep. IT's not the health care that the healthy 68 year old receives that drives up your graph. You might note that it starts spiking up well before medicare kicks in. Sure it accelerates later, but that coincides with the distribution of end of life care. Some make it into their 80s or later before they have serious health problems, but some start having a fair amount of serious and expensive problems way sooner. Far more people are starting to have expensive health care needs at 62 then at 52 or 42.

That's what drives up your graph. It's not about medicare. If it were about medicare, you wouldn't see so much of a spike before 65.

23

marcus 2017 Mar 26, 9:47pm

Why does OUR country ramp up??

Because we pay a lot more for health care, and most of the health care we receive occurs when we are old.

That's really not that complicated.

It may be true that medicare has not been effective at keeping costs down or even partly the cause of allowing it to be as expensive as it is. Our senior also buy supplemental policies that allow them to buy premium care. I'm not suggesting that i reforms might not be needed, but it's a good place to start.

I think your graph actually argues the opposite way, if it's understood. Such a small percentage of our major medical (catastrophic cost) health care occurs before the age of 60 (which is what your graph shows), that it's absurd that everyone is paying as much as they do for health insurance when they are young, with small probability of needing the super expensive kind of care.

24 bob2356 2017 Mar 26, 9:49pm

That graph is for the SAME age brackets in the different countries, so all the senior citizens should be experiencing the same medical issues as they age. Why does OUR country ramp up??

Because other countries don't spent huge sums of money extending death. People in other countries get palliative care to be comfortable. That's a cultural issue, not a health care system issue.

25

marcus 2017 Mar 26, 9:55pm

Ahhh... finally...

You could understand my point of view if you wanted to.

Also, Bob is largely right, but it doesn't mean that it's not also true that more people have diabetes and heart disease here than in most of those countries, and yes we pay way more for all types of treatments here than there. That's still true, and I don't think he was denying it.

26 bob2356 2017 Mar 26, 9:57pm

bob2356 says

Because other countries don't spent huge sums of money extending death.

Except the chart ramps up WAY before the average life expectancy today, sorry, please try again...

Apparently you don't understand the term AVERAGE life expectancy.

27

marcus 2017 Mar 26, 9:58pm

Ironman says

Ahhh... finally...

You could understand my point of view if you wanted to.

marcus says

also true that more people have diabetes and heart disease

So, that only starts in people AFTER 65, that's your argument for the ramp up??? Really??

Maybe I was wrong about you understanding. What was I thinking ?

28

marcus 2017 Mar 26, 10:04pm

Ironman says

Why does OUR country ramp up??

Because we pay a lot more for health care, and most of the health care we receive occurs when we are old.

That's really not that complicated.

And the ramp up starts way before 65.

If you weren't so hung up on the adversarial confrontational aspect of conversation/debate you might actually learn something. And you might be able to lose when you are wrong, more gracefully. But then that's not really what trolling is about is it.

29 bob2356 2017 Mar 26, 10:11pm

They just live longer than us...

This is relevant how? Your original chart is spending by age. Trouble with math concepts again.

So lets try something simpler. if average age is 74 and someone dies at 94 then what age does someone else have to die for the average to work out? It's ok to use fingers and toes. OMG it's before 65. How did that happen?

30 MMR 2017 Mar 26, 10:20pm

rando says

Thanks for calling out the names of the traitors!

Both of the senators from NJ, including "Stanford carpetbagger" Cory booker

31

marcus 2017 Mar 26, 10:23pm

http://www.helpage.org/global-agewatch/population-ageing-data/life-expectancy-at-60/

They just live longer than us..

I wonder how much of that can be attributed to poverty in this country, that is dietary habits of our poor, lack of health care, murder rates, etc.

The difference shrinks some at 60, but those poor folks with less health care and other factors working against them are still in there. So I reckon expecting 85 at 60 in America if you're middle class is not that far out of line (as an average that is) .

32 bob2356 2017 Mar 26, 10:38pm

bob2356 says

How did that happen?

You posting straw men again... it's typical... when you lose an argument too...

You said

"Ironman says

marcus says

also true that more people have diabetes and heart disease

So, that only starts in people AFTER 65, that's your argument for the ramp up??? Really??

What straw man do you see? You say that people that die at 50 or 55 or 60, yes people do have to die before 65 to make the average work (sorry to drag you into the idea of math, I know it always baffles you), don't get heart disease or disabilities or cancer or other expensive chronic conditions? Sorry but yes they do. The 2 leading causes of death 50-59 are heart disease and cancer.

Yet another imaginary smack down for ironbrain.

33

marcus 2017 Mar 26, 10:39pm

The reason is Medicare, patients don't give a crap what the costs are and doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare. What ever the doctor "orders" is what's done. No price checks, no questions, no nothing.

I don't know the exact extent to which that's true. But to the extent it is true, I think we both (boomers) know that with our generation that's going to have to be dealt with, becasue it's a demographic bubble, and it simply is not sustainable.

But that's beside the point of our discussion. Old people almost always need some very expensive "major medical" treatments, procedures, therapies or whatever. Where as younger people usually don't. I don't believe pooling just the high risk and also the low probability major medical people (below age 65) into the pool covered by medicare would cost nearly what we are paying for it now through insurance companies. But this would be just for the major medical part of their coverage.

I don't believe anything you have said here provides the slightest evidence that I'm wrong.

34

marcus 2017 Mar 26, 10:43pm

The reason is Medicare

Then how do you explain the sharp rise before 65 ? Sure it's not as high as later ages, but neither is the amount of health care being delivered.

35 missing 2017 Mar 26, 11:09pm

doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare.

I have lived in two countries with universal health care where doctors order whatever procedures they think are necessary and they don't get turned down.

36 bob2356 2017 Mar 26, 11:16pm

. I don't believe pooling just the high risk and also the low probability major medical people into the pool covered by medicare would cost nearly what we are paying for it now through insurance companies.

You have any peer reviewed research on that? Otherwise it's just a stab in the dark.

I'm against medicare for all because the medicare system has many of the same expensive problems are insurance companies. Especially bill by procedure which has so many conflicts of interest and costs so much to operate. Using for profit hospitals/labs/imiging centers/ etc. socking a profit onto every single item and procedure is a problem also.

Why medicare for "all" anyway? Most people get insurance through work. The original point of ACA was to cover the uninsured, not to reduce costs of health care. It became a very expensive, convoluted way to go about it. It would have been much simpler and far cheaper to tack a piggy back health system onto the VA. The uninsured could pay pro rated based on income. With so many years of data the actuarial info would be childâ€™s play to calculate. The VA model eliminates almost all the problems with medicare. Doctors are employees, not billing by each thing they do. There is no incentive for tacking on extra tests or visits or for committing fraud. There is no expensive billing system since doctors are salaried. There is no profit on anything, it goes at cost. Which is heavily negotiated with vendors, including drugs. There would be no cost to planning. Everything is already up and running, it would just have to be expanded. Expansion could have been incremental done in step with the amount of people signing up.

Yes the VA has had problems come up. It's a huge system and any huge system is going to have problem spots pop up.

Never going to happen now ACA is running. The insurance companies and hospitals would never allow the competition.

37

anotheraccount 2017 Mar 26, 11:22pm

I'm against medicare for all because the medicare system has many of the same expensive problems are insurance companies

Bernie and Elizabeth sometimes forget about costs. Agree VA is much closer to a good vision of single payer than Medicare for all.

38 bob2356 2017 Mar 26, 11:23pm

The reason is Medicare, patients don't give a crap what the costs are and doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare. What ever the doctor "orders" is what's done. No price checks, no questions, no nothing.

That's crap and if you don't know it then you don't belong in this discussion. Medicare denies claims all the time. Google medicare deny claims and see how many hits you get.

39

marcus 2017 Mar 27, 12:01am

You have any peer reviewed research on that?

No. But it should be easy enough to look at Canada, Australia and France as fairly clear evidence of how it would work. You're advocating something more along the lines of the british model . One would think that being the last ones in the first world to implement Universal health care, we should be able to learn from the mistakes of others, as well as our own (with medicare).

Would you want to eventually move all the medicare people onto this VA model making it the model for a universal health care system here ?

That seems insane to me in terms of the magnitude of the disruptive transition, where as the main disruption with medicare for all would be to the insurance industry, which you have either way. I believe that Canada, France and Australia prove that it can be done. IT would be far easier to get doctors on board for this than it would be to make such a radical shift to entrenched systems in which they become employees of the state.

40 bob2356 2017 Mar 27, 5:38am

Would you want to eventually move all the medicare people onto this VA model making it the model for a universal health care system here ?

You didn't pay attention. I said that the VA model should have been used for people who didn't have health insurance instead of the aca abortion. That was right after I said most people have insurance through work. There is zero disruption, everyone with insurance continues on just as they are. Everyone without insurance would have a way to get a basic level of health care.

But it should be easy enough to look at Canada, Australia and France as fairly clear evidence of how it would work. You're advocating something more along the lines of the british model

What I'm advocating is like the Beveridge Model with public doctors and hospitals. But I'm only advocating it for people who don't have health care to provide a basic safety net and people would pay on a means tested basis with taxes being a subsidy for the shortfall. The NIH (which is terribly implemented) is the Beveridge model but so is Spain, Scandinavia, New Zealand. and Hong Kong.

You are mish moshing together the other two other big types of health systems. The The Bismarck Model found in Germany, of course, France, Belgium, the Netherlands, Japan, and Switzerland which has non profit health insurance plans with everyone covered using private doctors and hospitals. The National Health Insurance Model in Canada, Taiwan and South Korea has private doctors and hospitals with a government run insurance plan.

Funny you picked Canada, France, and Australia. I lived in Canada for almost 2 years and I am a permanent resident of both France and Australia. I have seen the ins and outs of all three of the countries health systems. They all work pretty well no matter what the people who have never travelled further than their state fair say. I'm a NZ citizen and have the ability to say the Beveridge model can also work well if well implemented.

There is zero chance any of the systems will be implemented in the US on a national basis. You are pissing in the wind if you think it will. There is far too many wealthy investors and highly paid executives making far too much money with far too much influence on the political system for that to ever happen.

41

zzyzzx 2017 Mar 27, 5:48am

Yet still another Democrat proposal that does nothing to control the costs.

42 bob2356 2017 Mar 27, 6:02am

zzyzzx says

Yet still another Democrat proposal that does nothing to control the costs.

When will you be presenting your comprehensive plan to control the costs that would be voted through congress? The republican's in congress had 7 years and came up with zero.

I'm not a democrat and it would be far cheaper to do what I propose than the ACA has been.

Oh I forgot, you never present anything but pictures and cartoons. Like the kids when they were 4.

43 Blurtman 2017 Mar 27, 7:51am

So, are you saying that's exclusive to the US, and none of the aging population in Spain, Sweden, UK and Germany experience the same medical issues, and that's why they spend so much less?

The article from which the graphic derives says that the elderly in these countries don't live as long as in the USA, perhaps due to the increased spending on medical care in the USA. Are you suggesting we let the elderly die, when their lives can be extended by existing technology?

"Looking only at deaths caused by disease, Dr. Fischbeck's analysis shows that American men have a survival advantage over men in Western Europe that increases steadily after age 65. American women gain a similar advantage starting later, at about age 80.

Putting it another way, if Americans died from diseases at the same rate as people in the Netherlands, for instance, there would be 60,000 more male deaths and 14,000 more female deaths in the United States -- all coming after age 70 -- his tables show"

44

marcus 2017 Mar 27, 7:52am

There is far too many wealthy investors and highly paid executives making far too much money with far too much influence on the political system for that to ever happen.

I think it will happen eventually. What might drive it is the realization on the part of the corporate world that it will benefit their bottom line, transferring some of the cost away from them. It would probably be cost effective for them in terms of addressing cost increases, to shift the payment for health care over to people's medicare contribution and just pay them more instead. Salaries and health care are both pre tax expenses, but it shifts the concern about increasing health care costs to the government.

45 bob2356 2017 Mar 27, 7:59am

The article from which the graphic derives says that the elderly in these countries don't live as long as in the USA, perhaps due to the increased spending on medical care in the USA. Are you suggesting we let the elderly die, when their lives can be extended by existing technology?

The article is totally lacking any explanation of methodology. When I see weasel words like "looking only at deaths caused by disease" it's a big flag that things are being manipulated. How do you reconcile shorter life spans in the US with people surviving longer?

46 Blurtman 2017 Mar 27, 8:11am

So why is treatment costs 4X in the US for similar treatments and conditions that old people get treated for?

Why assume that the elderly in the other countries are receiving the same treatment?

47 anonymous 2017 Mar 27, 8:11am

Most old people develop the same medical conditions as they age.

-------------

False

48 Blurtman 2017 Mar 27, 8:12am

How do you reconcile shorter life spans in the US with people surviving longer?

Don't know. Opioid addiction might account for some of that. Also perhaps deaths from heart attacks due to obesity and related conditions. You have to make it the hospital alive to rack up expensive treatment costs. It is conceivable that less folks in the USA die before they become elderly.

49 bob2356 2017 Mar 27, 8:16am