What makes the US Health Care System so expensive

[jducoeur]

Thanks to mindways for the pointer to this fascinating blog series on the topic of health care, and the real (or at least, apparent) reasons why it is expensive.

It's a bit long -- ten modest-length blog posts, each on the separate topic -- but well worth reading. The underlying principle is that, in almost every other developed country, there is a roughly consistent ratio of medical spending to GDP; based on that, we would expect the US to spend more on health care than everybody else, since we're richer. But in fact, we spend *vastly* more than that curve would indicate -- we're way out of line, and don't appear to get better health care as a result. (The series is very much from an economics POV, but avoids complex jargon: it's pretty easy to understand his points.)

Rather than go after a single easy bogeyman, the series goes into serious, principled detail: it examines where the money is actually going, and how much extra the US is paying compared to other countries in that respect. Towards the end, he spends a post knocking down the usual easy culprits, arguing that they mostly don't appear to be primary contributors to the problem. (Indeed, it's impossible to miss the way that politics is distorting the argument, when you compare his numbers to what gets hyped in the media.) Overall, he eschews easy answers -- indeed, the main point of the series is that the entire system is pretty well screwed up, and there likely is no single easy answer to the problem. The result is an implicit call for serious root-and-branch reform that re-examines the way we do business -- he doesn't say that in quite as many words, but he really doesn't have to.

Refreshing stuff, even if the conclusions are a bit depressing. This area of policy is so dominated by people promoting dogmatic arguments and snake-oil fixes (some of which, I'll admit, I've tended to buy into) that it's rather bracing to see an examination that is driven as strictly as possible by what the actual numbers seem to say. You can validly argue with the interpretation of some of the details -- in particular, I think it's worth deeper examination of how some of the parts interact -- but it at least provides a good basis for that argument...

Comments

[tpau]

the FDA, for all its uses and regulations and safety... is often the reason drugs cost a fuckton of money. it is just too freaken expensive to get fda approval. sigh

[baron-steffan.livejournal.com]

That's entirely true, but my point in posting this was that life in colchicine-land was just fine, thenk-yew, without the trumped-up "concerns" in the blatantly spin-doctored press releases. Colcrys is colchicine, pure and simple, and now you get to spend about ten times as much for it as you did before. Yes, the approval process is expensive, but do you really suppose that entirely accounts for the price increase? No, it doesn't. It can't possibly. The price is what it is because it CAN BE. Yes, they were aided and abetted by an "initiative" at FDA to get grandfathered drugs through the Process (so expect a lot more of this crap in the near future). But the bottom line is that if you need colchicine, you now have to have to go to Colcrys to get it, and they get to charge whatever the hell they want. So they do. That's their motivation, not any concern for the public safety, which was not in danger and has not been improved one iota by this. And anyone who buys into their press releases probably still believes that cigarettes are good for asthma.

[tpau]

well, nicotene is supposed to be a bronchodialator :P but i see your point