Re: Why Are American Health Care Costs So High?

Re: Why Are American Health Care Costs So High?

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M Riippa says:

its all about the money in US

lee brondum says:

What about the French system the gov pay half of costs and people pay the
rest out of pocket and they have the best health care in the world

vicente reyes says:
SJK299 says:

Summed up: greed and money hungry scammers.

ReaiityCk says:

Private Health Insurance monopolies in the United States have long colluded
illegally to fix prices nation wide and typically cost 38% or 38 cents of
every $ spent providing heath care for doing nothing more than acting as
unnecessary middleman between patients and health care providers.

Until the ACA was recently implemented private health insurance
corporations frequently gamed the system by canceling insurance policies
the moment someone got sick and filed a claim or routinely overcharged or
denied millions of people health insurance due to what they claimed was a
pre-existing condition. I got news for you, getting old is a pre-existing

A single payer non-profit system like Medicare is the most efficient and
cost only 5% or 5 cents of each health care $ to administer. Both health
care providers and patients all agree it works well and EVERYONE is
covered. My husband just qualified for Medicare. He’s had to go to the
hospital several times since and we have had nothing but perfectly good
experiences with Medicare. Single payer health insurance is a no brainer
for anyone who understands the issue. 

OldRangeRat says:

3rd payer plus no/little regulation equals more over all scams.

ross atkinson says:

Europe has low price controls

Im british and the government pays the equivalent of 15 dollars for a 2
dollar medication
They use flat rates not price controls
Also they set the rates for years ie pay 20 dollars for something for 10
years thus as price falls cost rises due to rates still being 20 dollars

And finally many dont pay tax thus free rider concept emerges

Richard Wagner says:

So we’ve got the worst of both worlds. We don’t have the price controls of
Europe, nor do we have the competition of a market, and therefore, nothing
to keep costs down. That’s the mistake we often make.

codylramey says:

Finally something from you that sounds at least a little sensible. The
problem with your solution is that it still leaves poor people out in the
cold. With things like laser eye surgery, that is an elective surgery that
is not needed to live. So the market is able to bring down the prices
because people can very easily just not get the surgery thus lowering the
demand for it and driving down prices. But with many many other aspects of
the healthcare field you dont have the choice not to get the services,
whether it be surgery or drugs or whatever, so you will either have to find
a way to get the money or die. Thus the demand will stay the same and the
prices, while they may drop, will not drop to an affordable rate for the
average person.

When medicine first became as effective in saving lives as it is now we
had the system you are talking about in place. People still couldnt afford
it. Thus Blue Cross Blue Shield (im pretty sure I have the right company)
decided to get a group of people (i believe it was a group of public
workers) to pool their money together and when one of them got sick they
would be able to draw from that pool and pay for their bills no questions
asked, no copays, no deductibles. Everyone paid the same amount into the
pool and when you got sick your bill was just paid. This system worked and
they expanded to allow anyone to pay into the pool not just the public
workers. Age, or preexisting conditions didnt matter. People wernt dropped
after getting sick. This was the first example of health insurance in
America. When other companies saw this they decided they wanted in on it,
but they wanted to make a profit. So they took all of the healthiest people
from Blue cross and offered them coverage at a lower rate. Those people of
course took their deal but it left Blue Cross with all of the sick people
that were apart of the system. So to compete Blue cross had to start
dropping those people so they could lower their rates and attract the
healthy ppl back. This is where the shit storm in our health care system

But i do like that you want to get rid of the insurance companies. I mean
its common since that they are apart of the problem that is the
skyrocketing healthcare costs in America. They are making a profit, that
profit comes from the American people’s pockets and goes to them not back
to the American people. That fact alone raises prices. There are many other
reasons why insurance companies contribute to the high prices of healthcare
but that is the most obvious one.

What you said about the problems with European healthcare of course was
bullshit, but i dont want to go into that. Anyway this was deff. one of
your more respectable videos. Not respectable of course, its still shit,
but its better. 

William Aycock says:

You’re assuming the average person isn’t living from paycheck to paycheck.
I am, and if there were more burden on me, I simply wouldn’t be able to

Thecluelessbassist says:

but how do you make more out of pocket payments? It seems like you would
have to the government to force insurance companies to stop?

Mikey Mike Mikey says:

Urm in case this guy doesn’t know Europe isn’t one nation, each country
runs very autonomously. So saying European healthcare is like X compared
to US means nothing bacause it varies so much, although maybe jhon started
it and he carried it on. Nevertheless most countries in Europe don’t
control price of the *products* they simply cap the expenditure, this
means the hospitals and medical practices must look for the best price to
help the most patients. And our waiting lists are normally longer because
the sytem allows more people to get treated not just the middle classes and
The good thing is that in Europe medical practices are being reshaped,
nurses now play a bigger role, and rather than use a over paid GP a nurse
can see if you have a very common infection of something, rather than the
american solution where this person just sits at home, becuase they have to
pay to go in, until it gets so bad it requires more expensive treatment.

Brad Williams says:

Clear and true! The people like John Green who claim that health care is
special because it is a life-or-death issue with “inelastic demand” are
somehow forgetting that thing which is even more necessary to bodily
survival: food — and how we have an abundance of cheap food in the US, no
thanks to the government. It did not take agencies “negotiating” with
“providers” to get 99 cent cheeseburgers on the menu, it took a marketplace
of free individuals.

mrandrewv says:

1. You cannot refer to a government negotiating low prices as a “price

It’s a negotiation just like any other. The government is no more forcing
suppliers to offer low prices than a car saleswoman is forcing someone to
buy a car.

This is a strawman argument.

And btw why are you comfortable with businesses using their massive size to
get a advantage at the bargaining table but as soon as it’s a government
that’s doing the bargaining it’s suddenly a bad thing?

Careful, your ideology is showing.

2. The bottom line is this: there isn’t a single privatised healthcare
system on the planet that works. There has never been one and I doubt there
will ever be one.

Why prop up a flawed system instead of switching to the European model that
demonstrably works better?

Wateenkut Zooi says:

Shortages and waiting lines? Waiting lines? I never heard of that before.
If I have a health problem I call my family/personal doctor (4 – 7 doctors,
9 -15 assistants per 1000 people). He will come to my house if needed. He
will subscribe medicines or ask my permission to sent my case to a
specialist. Health-insurance companies only know your id number. Hospitals
and personal doctors will keep in contact with you and each other to keep
health records up to date.

chgarciaro says:

At least in Austria, you don’t usually have to wait “months” for a given
treatment, this is particularly true when you need a critical treatment
(e.g. those related to cancer ), in those cases the treatment is given
almost immediately. In some cases, however, you might have go to a bigger
city if you live in a small one. There is the myth that “socialized” health
care is of low quality. For what I’ve seen in here Austria, that is not

TheAznsenzation says:

It’s easy to use laser eye surgery as a model for out of pocket services
being a more ideal scenario than having third party payment systems. But
laser eye surgery is different from other medical services. When it comes
to laser eye surgery, i can do my research ahead of time to see which
doctor is better and less costly as a result of me having more time to do
this research, since laser eye surgery isn’t immediately necessary, and not
having laser eye surgery is always an option because of alternatives i.e.
glasses contacts. If i have a sudden illness or i need immediate medical
attention, I don’t have the time to compare doctors or hospitals and as a
result, doctors and hospitals can price gouge and can sign off for
treatments that are not necessarily beneficial since there is virtually no
competition. This is why we have insurance. It’s a counterweight to the
risk of having to pay exorbitant amounts of money when you least expect it.
It’s why people buy car insurance, or house insurance. 

John Andrew says:

The US does have (contrary to what some in the comments are saying) price
controls on Medicare & Medicaid, it’s called the SGR. It hasn’t done much
to control the runaway costs of those govt-run health care programs, but it
has caused doctors to flee those programs in droves.

djkenny says:

Out of pocket is an awful idea. No one could get basic care, get sick, not
afford that care. Nothing is sustainable about out of pocket. Not everyone
could afford it. Only the very well off. 

Charlie Murphy says:

The British NHS is the second most efficient health service in the world
according to dollars spent per life saved. Also, everyone gets coverage;
treatment is free at the point of use; and if anyone doesn’t like it, they
are free to go private.

The USA was the least efficient, spending more per life saved than any of
the other countries.

Dinesh Kudtarkar says:

U sir are very smart!

Alan Kelch says:

The freer the market place the cheaper and better the product and service.
I have yet to find any example that disproves this.

Kyle Towers says:

You make some good points but ignore or gloss over counterarguments. Worst
of all is your dependence upon generalizations, what you “believe”, and
even anecdotes, in the near total absence of data. This is how propaganda
is done, but not how reasoned debate is done.

For example, your anecdote about someone with insurance paying out of
pocket and saving money is surely an aberration among the many examples of
people without insurance being charged many times the insured price. I can
provide anecdotes, too.

Perhaps the most egregious omission was that of the costs of an insurance
based system. You are likely aware that the ACA requires insurers to spend
a minimum of 80% of premiums on care. Many plans have had expense ratios
far beyond 20% and in many markets, you can be guaranteed that they will
asymptotically approach 20% with the ACA in force.

Therefore, there is an immediate 20% taken off the top in an insurance
based system. However, anyone paying attention during an office visit
surely realizes that a significant fraction of the staff hours are expended
on dealing with insurance in one way or another. So what is the total
built-in disadvantage? 35%? 40%?

That you never mentioned this factor reveals you to be either naively
repeating ideas taken from ideologically approved sources as “received
wisdom” or simply being a deceptive partisan shill.

Nyah Notrealname says:

What a clown. Oooh…let’s fix the medical system by making the sick pay
for it individually. Glad I’m paying taxes for our price-controlled
government provided medical system you selfish twit. Lasik eye surgery and
life-saving procedures are two completely different things you selfish,
greedy fool.

George Ramram says:

How can we EFFICENTLY help the poor or disabled with their outrageous
costs? How can the cost of a surgery to remove a tumour or parasite from a
poor person? Denying them care is inhumane. So… whats the soloutoion?
Make them pay full price? Then that will only make them poorer.

bullpcp says:

One reason the rest of the world can pay so little is that we pay so much.
Much of the profit that healthcare corporations make, whether you are in
the US or not, come from the US. You can’t ague that the US pays more for
healthcare in the world and simultaneously argue that the majority of
profit doesn’t come from the US. Since most healthcare profit is 10% or
less the ramifications should be obvious.

Craig Flanick says:

He could be right on some of his points, however he doesn’t quantify
anything at all, period. There is no substantive data mentioned at all.
When he starts talking about “healthcare outcomes”, he’s literally making
up his own definition for the term. If you look at what most of academia
and the rest of the world uses to determine outcomes (infant mortality
rate, average life expectancy, etc… etc…) he makes the arbitrary
distinction that these measurements aren’t good enough, because the numbers
contradict his thesis. I agree that competition could drive down costs of
a lot of the system, and you are starting to see that more and more with
people flying to other states for cheaper procedures, however healthcare is
not just your average commodity and parts are so specialized you’ll never
see any real competition period.

Josh Perry says:

The system that you’re describing would be fine for elective surgury’s but
you don’t have time to “shop around” when you need immediate care. If you
do have the time to shop around the best and cheapest doctors may be on the
other side of the country. I don’t pretend to have the answer, but I do not
think your system wold work for most of the country.

Dror Kronstein says:

But why do the insurance companies do not lower the price by bargaining
themselves? It may be a third party payer system but insurance companies
still have an incentive to lower prices to reduce premiums, don’t they?
Also, wouldn’t the same reasoning about collective bargaining (by European
countries) be the same reasoning as with large insurance companies in the
US? What am I missing?

MrJoeRedford says:

saying that health insurance should only cover “catatrophic” diseases etc.
is exactely why the US healthcare system is so ineffective and costly. By
not covering basic stuff like controlls and präventive medicine people wait
until their respective disease gets much worse until it becomes a
“catastrophic” disease or whatever, which in return generates huge costs
for health insurances. 

Kyle Chandler says:

First, I think this theory greatly marginalizes the effect on high medical
care costs on the costs of premiums. We may not feel the cost of the entire
care, but we certainly feel it in raised premiums. Second, it also does not
take into account deductibles and coinsurance, which people aren’t blind
to. Third, it assumes that an average American would make the conscious
decision to save X money every month and use that for more minor procedures
when they weren’t paying required premiums.

João Paulo Borges says:

Discussions short version: market rules don’t apply in a scenario which the
demand cant wait/choose!

In most (severe ones) cases, you don’t have the choice to deny the health
care system offering about your demand.

Then, everything you says is sharply correct, but only from a theoretical

K Burgoyne says:

Let us talk bout how the REAL world works, rather than your arbitrarily
invented and self-serving notion.

The reason healthcare is so expensive is incredibly simple. It has a very
high inelasticity of demand. People are practically as undesirous to do
without healthcare as they are to do without water. Your intermediate payer
argument implies there is an unwillingness of the intermediate payer to
control costs, and therefore an unwillingness of the intermediate payers to
compete for business between each other based on price. That would imply a
failure of the free market in the intermediate payer arena.

If everyone had the same high inelasticity of demand for visiting
Disneyland, accompanied by persistent propaganda that load balancing queues
are evil, then it is incredibly simple to predict that Disneyland ticket
prices would immediately start skyrocketing. Just for starters, Disney
would need to recover the costs of building six redundant Haunted Mansions
so that there would be no queues in the summer, but the redundant mansions
would sit wastefully idle in the winter. The “load balancing queues
propaganda” thereby creating artificial inefficiencies that the current
free market Disneyland avoids by relying upon highly efficient load
balancing queues.

It is an absolute requirement of free market economics that some portion of
consumers must and will go unserved. That is the mechanism by which a
supplier seeks the most profit. The intersection of the demand/supply curve
is NOT where the most consumers are being served. The intersection is at
the point where the supplier has maximized profits — which means NOT
serving consumers at the low end. That is why no free market serves
everyone. That is why Apple does not sell an iPhone to everyone in the

Therefore the social question is NOT based on economics but on ethics.
Whether a society believes that healthcare should be delivered on the basis
of maximized profits, or on the basis of profits balanced with need. Should
water be distributed solely on the basis of maximized profits or of need.
Society has made the decision that water, at least, should be distributed
based more on need than profit.

Bruce True says:

Less third party payer => lower costs. Makes sense, but how do we also
provide for those of little or no means is the problem. How do you provide
universal or near universal access, but controls costs at the same time.
One of the European models seems the most logical to me.

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