John Moore – Appreciate your balanced comments. In my own post about the great flaws of the US system, I omitted the archaic, byzantine paperwork that adds cost and inefficiencies other advanced nations have moved past – and the screwing of those denied or without insurance having to pay 5 to 10 times more.
In another discussion in a different forum, the latter topic was brought up. This practice of charging uninsured “top price” while saying big insurers and government wards (welfare mommas, prisoners, illegals, seniors on Medicare) get huge discounts was defended as fine and proper by certain free market ideologues.
Their rationale is that if individual citizens denied insurance by the jobs they do or a pre-existing condition are “too lazy” to negotiate their own discount schedule for a range of maladies they might one day have in the future – well, then they deserve to pay 5-10 times more and be bankrupted. I thought that stance was ludicrous, the idea that an individual is responsible to visit hospital billing dept and personally negotiate and argue with an employee and the lawyer from Hospital Legal for “best rates”. Spend a few days there, getting prices for 500 diseases, all possible hospital charges,600 possible tests, and prices on 3800 possible drugs or disposable med devices used?
Then hit all the doctors offices to negotiate deals for anything you might, but likely not, possibly come down with?
I called the hospital in my medium-sized city – the only hospital within 45 miles – to ask how many uninsured individuals have attempted to negotiate their possible future prices down to less than 5-10 times more than insured and gov’t wards get. They referred me to legal…which explained that they had institutional contracts agreeing to rates, but absolutely no provision for individuals to negotiate..
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On the matter of only the US system avoids “socialism” while “innovating”…thus is better even if 50% more in cost and leading to lower life expectancy in part because 1/6th of workers do not get employee benefits –than those “inferior foreigner ways”…..
A Japanese associate who also had worked in Singapore and the Netherlands which were roughly similar explained that their health care system is universal insurance but private sector care. 6-7 large insurance companies are obligated to to cover all (no cherry-picking, no denial for pre-existing conditions), workers are obligated to be covered by payroll deduction, people who can’t work or are unemployed have gov’t pay the premiums if they cannot afford to.
He said that the private companies have to compete for people nationally, insurance is not crazy-quilted by differing prefecture law and regs (A Prefecture is like a US State). QA is built into the process and quality of patient care is examined by independent gov’t inspectors and benchmarked against how foreign nations do. Goals are set, and those private medical providers that are the most efficient and innovative get more profit.
He also said that he believed (his brother is a MD) that Japan does as much R&D as the US does per capita into drugs (All the big pharma outfits have R&D facilities in Japan and India), basic cancer research,develop new drugs, and as much or more med research papers and drug patents, per capita.
