Great article in Freakonomics Nov 2011
Mentions a New England Journal of Medicine article which estimated 5.9 % of healthcare costs are due to insurance
This does not include
- Cost of employees who fill and file insurance paperwork
- Value of patients’ time spent talking to insurance companies
- Medical procedures which are done because the insurance expects them to be done
- Medical procedures done to minimize liability
- Increase cost of drugs in US - some of which had been non-prescription, many others are far less expensive outside of the US
Cost of Health as a fraction of GDP has been rising very quickly in the US WikiPedia
Note that:
- 95 cents of every 'Health Care" US dollar is spent on disease
- The UK pays their doctors based on about 22 proactive actions the doctors do to PREVENT disease
- - - - - - -
Notes from a nice book on the topic The Healing of America by T. R Reid 2009
Amazon has 157 rave reviews
Looks at 10+ countries way of providing health to ALL of the people
US has the worst of all of them – most expensive and least effective
Even the Swiss have private insurance – but not permitted to make a profit on basic coverage
French has electronic records card that the individual keeps
Most doctors in other countries make normal wages
UK
- admin cost are 1/5 that of the US
- capitation fees – encourages proactive measures
- NHS has many quality measures that they pay doctors by – and “best practices” awards up to $125,000 per year
Japan
- average # of visits per year = 14.5 = 3X of the US
- makes house calls. Generally just show up – not make an appointment
- average length of stay in hospital 36 days (US 6 days)
- health care cost is just 8% of GDP
- has 3600 different health plans
- pays insurance for unemployed or too poor
- MRI used 3X as much as US – but machine is 1/10 the cost