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Why Are American Health Care Costs So High

Good morning hank, it's tuesday.I want to talk today about why healthcare costs in the united states are so phenomenally, fascinatingly expensive, but first i have to blow your mind alright, so you've probably heard that the reason that people enjoy free healthcare in australia and the uk and canada, etc, etc is that they pay higher taxes.That money then goes into a big pot and is used to pay for people's healthcare, but in fact, in the us, we spend more tax money per capita on healthcare than germany, australia, the uk,.

Or canada.That's right hank you pay more in taxes for healthcare than you would if you were british, and in exchange for those taxes, you get no healthcare.In fact, only about 28 of americans get their health insurance through government funded programs, mostly poor people, old people, and congresspeople.But as you can see in this graph our private healthcare spending most americans are privately insured through their employers is way higher than anywhere else in the world.In total, the us currently spends about 18 of its gross domestic product on healthcare costs.

Australia by comparison 9.Why is this well because everything costs more, which seems obvious, but apparently isn't, because every article you read is like oh it's because of malpractice insurance or it's because we're obese or we go to the too much or people are prescribed too many medications.Well, not really.It's because everything costs more.A hip replacement in belgium costs $13,000.In the us it's often over $100,000.Colonoscopies average over $1100 a piece in the us in switzerland they're $655.And on average a month of the drug lipitor will cost you $124 if you live.

In the us.If you live in new zealand $7.Now we are alsonot to bragricher than all of these countries, so it makes sense that we should spend a little more on healthcare.But we don't spend a little more.We spend a ton more.And vitally, we don't get anything for that money, which means we are essentially paying people to dig holes and then fill those holes back up.Like we don't live longerin fact we're 33rd in life expectancyand in everything from asthma to cancer, according to one recent nonpartisan study, american healthcare outcomes are not notably superior..

So why are we spending all of this money for nothing well first, let's discuss some of the problems that are not actually problems.For instance, the problem is not socalled overutilization the idea that americans go to the more and get more tests and spend more time in hospitals.We know this because americans actually go to the less than europeans and spend much less time in hospitals, although to be fair, you can stay in a dutch hospital for seven nights for what it costs to stay in an american hospital for one night, so no wonder we're hesitant.

Also it is not because we're sicker than other people.Everyone likes to blame obesity on our rising healthcare costs, but yeah, no.That argument is just not supported by data.For one thing, disease prevalence does not affect healthcare costs that much.And for another thing, while we do have more obesity in the united states, which sometimes leads to health problems, we have fewer smokers and less alcohol consumption really apparently yes.So that saves us a little money, and if you compare us to like the british or the.

French, in the end it's probably a wash.Hank, the truth, as usual, is complex.Like, there are obvious inefficiencies in our healthcare system.For instance, not everyone has insurance.If you don't have insurance, you still get healthcare, but you're responsible for paying for that healthcare, which often you can't do, so you end up going bankrupt.That sucks for you, obviously, because you're bankrupt, but it also sucks for the rest of us because we have to pay not only for your care, but also for all the money the hospital spent trying to get you to pay for your care.Also.

The only options available to uninsured people are usually the most expensive options, like emergency rooms, which is just bananas.But those inefficiencies are hard to measure.Fortunately, there are things we can measure.So like i said before, because the us is one of the richest countries in the world, you would expect us to pay a little more for healthcare than most people.The question is, when do we pay more than you would expect us to pay, and that turns out to be pretty interesting.Let's start with malpractice and socalled defensive medicine.The idea here is that.

s are scared of huge malpractice suits so they order a lot of unnecessary tests in order to, like, cover their butts.That does contribute to our healthcare costs, like there are more mri and ct scans in the us than anywhere else.However, there are a bunch of states like texas that have passed tort reform to limit malpractice suits, and in those states healthcare costs have dropped by an average of a whopping 0.1.The biggest estimates for the total costs of defensive medicine put it at around 55 billion dollars, which.

Is a lot of money, but only 2 of our total healthcare costs.Another smallish factor s and to a lesser extent, nurses are paid more in the us than they are in other countries, and by my possiblyfaulty math we end up spending about 75 billion dollars more than you would expect us to there.And then we have the cost of insurance and administration costs, like paperwork and marketing and negotiating prices.That's about 90 billion dollars more than you would expect us to spend.We spend about $100 billion more than you would expect on drugs, not so much because.

We take more of them, but because the ones we take cost more per pill.Okay, and now for the big one.I'm gonna lump inpatient and outpatient care together, because in the us we do a lot of things as outpatient procedures, like gallbladder surgeries, that are often inpatient procedures in other hospitals.We're just gonna make a big ball gestures.That big ball is $500 billion more than what you would expect given the size of our economy.Per year.Why because in the united states we do not negotiate as aggressively as other countries do with.

Healthcare providers and drug manufacturers and medical device makers.So like in the uk the government goes out to all the people who make artificial hips and says one of you is going to get to make a crapton of fake hips for everybody who is covered by the nhs here in the united kingdom.But you better make sure your hips are safe, and you better make sure that they are cheap, because otherwise we're going to give our business to a different company.And then all the fake hip companies are motivated to offer really low prices because.

It's a really huge contract.Like think if your company got to put hips inside of everyone in england and scotland and wales and northern ireland i guess not everyone.Just the people who need hips.But in the us we don't have any of that centralized negotiation, so we don't have as much leverage.The only big exception is medicare, the governmentfunded healthcare for old people, which, not coincidentally, always gets the lowest prices.So basically, hank, in the united states, providers charge whatever they think they can get away with, and they can get away with a lot, because it's really difficult to put.

A price on, like, not dying.This is a phenomenon called inelastic demand, like if you tell me that this drug will save my life costs $7 a month, i will pay you $7 a month for it.If you tell me that it costs $124 a month, i will find a way to find $124 a month to pay for it.You can't negotiate effectively on your own behalf for healthcare services because you need them.And not like you need a macbook air or the new season of sherlock,.

But actual, physical need i guess it is like the new season of sherlock.So basically, hank, until and unless we can negotiate as effectively with the people providing healthcare as australians and british people do, us healthcare costs will continue to rise faster than anywhere else in the world and we won't get better healthcare outcomes.Hank, i know this tutorial is long, although it could have been much longer, but i am so tired of people offering up simple explanations for what's wrong with our healthcare system.They say oh, it's malpractice, or it's s who must also be businesspeople or.

it's insurance companies or it's insane rules for who can get insurance.It's drug companies, it's government bureaucracy, it's an inability to negotiate prices.Yes, yes, yes, yes, and yes! it is all of those things and more! it is not a simple problem, there will not be a simple solution, but it is probably the biggest single drag on the american economy and it's vital that we grapple with it meaningfully instead of just treating healthcare costs as political theatre.So i hope i've at least introduced the complexity of the problem.I've put some thoroughly nonpartisan.

Allon4 in Philadelphia PA Susans Full Story By Design Dental Implant Center

My former dentist, who i adore, had given me some options about implants and they were oneatatime and i would be without a tooth for a whole year for each tooth that was going to be put in my mouth, and to me that wasn't an option.I'm 58 years old, i don't have 100 years left so i wanted my smile back as fast as possible.A friend of mine actually a client of mine's husband came here, and i saw some befores and heard some stories and was quite interested and came to discover what it was about.I was extremely frightened,.

Yes, and i remember them explaining to me.I thought, of course i'm going to be a nightmare, and what if my gums or bones didn't accept something he goes well, there's always plan b, and they have a second option, so i was so comfortable.I'm actually on a program that is interestfree for 2 years, and it's not even a year yet and it's almost paid off.The s are great, they make me laugh.I think i make them laugh you never know what's going to come out of my mouth so i have the whole place going. Thaler well,.

He's always happy, kind of like me.He first isked if there was any concerns as he wheels up on his little stool there, and the girls usually have everything set and ready, and we chat for a minute, and it's wonderful.It's really like, he does do the business part first to make sure there's no complaints or issues that i may have.So i prepared for 3 days and had somebody come stay with me because i live alone and took off of work, and honestly, it was fun.I mean after i slept it off the first day, i had lots of ice cream.

Dental Implants in Philadelphia PA Elizabeths Full Story By Design Dental Implant Center

My name is elizabeth and i live in philadelphia and at this point i am at by design dental.I had a severe dental situation.As a child i lost five or six molars.The molars were not replaced and as a result i had empty space on my right side and as a result the top teeth fell into the empty space, which means in time the top teeth were eventually touching my bottom gum.The right side of my mouth was useless let's say for fifty years.I could.

Not eat there.I had to eat on the left side.I knew as time went on that something would have to be done about it, but i guess i just waited until it was critical.My dentist kept saying elizabeth, you're going to have to do something about this.Since my work would have been so extensive, he recommended me to Mogyoros and his staff.Since Mogyoros had done thousands of these he felt more confident that Mogyoros would do a fine job and i must say he did.

I visited Mogyoros' office and the staff was very competent and knowledgeable.All of my questions were answered.I was still scared and as a result, i really delayed the process for a year.My situation did not get better and so a year later it was worse.I made up my mind to go back to Mogyoros' office.I did so and made arrangements to have the procedure done.I must say when i visited Mogyoros' office i was shocked.It didn't look, smell or feel like a dentist's office.Sometimes you go to the dentist and.

You feel intimidated right away.You hear the drills, you smell the medications that are being administered to other patients.You don't get thaqt feeling at all in this office.It was very relaxed and i felt good about going to the dentist.The staff took me back and answered my questions and filled me in step by step of what would happen.I was concerned about how long it would take.Is this going to take a year or six months they said no, 100 days.I was shocked because i did not want to walk.

Around looking snaggle toothed or unattractive and as a result, i made arrangements to have the procedure done.We had more than one session as a conference, but when we made up our mind to have the procedure done, i came in one morning.The staff took me back and the procedure was done in several hours.Would you believe they fed me i could eat right after the procedure and by that afternoon by the time i left if you did not know that i had dental work done, if i didn't tell you, you wouldn't have known.

I thought it would be a horror story.I thought it would be painful and scary.I'm not going to say i wasn't nervous because i was, but i kept waiting for that painful visit.I would go to the dentist and it never happened.When i would go for my checkups, they were very kind, careful, asked me how i felt, any problems.Everything went fine.I must say it went faster and smoother than i had expected and they continue to map my progress.I can call any time i want.I haven't had any problems really.I've been very satisfied with the results.

That i have.When i tell my friends what i've done, they can't believe it.When i go to work, my manager says elizabeth, when are you going to have your permanents and i said they're in.She said that was fast.Less than three months and i'm done and when i come to the office and i see patients waiting, i'll say to them who is the patient and they'll tell me who it is and i'll just say don't worry.You'll be fine.I try to be encouraging to others that i see waiting in the office.

I would certainly recommend this to anyone.The fact that it was all under one roof was a great relief to me because otherwise i would have to go back and forth from one dentist to the other, one for the implants and one for the prosthetics.The fact that it was all under one roof was such a relief because running back and forth from dentist to dentist would have been very stressful.I appreciated that.The staff, they all knew my case and worked with me and answered my questions.I'm very pleased.

Prior to having my dental procedure, knowing that my teeth were out of line and not being able to eat properly, knowing when i smiled others could see the fact that this side of my mouth was hanging, even though they would never say anything, i had seen the same situation in the mouths of other people.It doesn't add to your confidence.In fact it lessens your confidence.It makes you want to smile less.Very self conscious.When i would take my pictures, i would always take the pictures or tutorial and always be self conscious about.

That side of my mouth where the teeth were hanging.It was a very uncomfortable situation.It makes you lose your confidence really so you don't smile as much as you would or as large as you would like to because you think that other people are staring at your smile.Smiles make a very big impression.First impressions last a very long time.I like people and i like for people to like me, even though it's not a matter of looks, but i would like to present the best image that i could and the fact that my smile was not healthy, i didn't.

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