Bill's Notes

[Bill, July 3, 2007]
Medical care costs
A lot of blogs have been talking about medical-care costs. I have to admit I'm totally at sea. I don't know why costs have gone up, don't understand, really, the causes of the problem. I'm also concerned about the politicization of the debate, which makes it difficult to get the facts.

People have talked about the French or Canadian or British system, and I'm open to any solutions. But there can't be a solution unless we understand what our problems are.

Totally confused, I am.
Rob2 (mail) (www):
The following is an interesting read, Canadians live longer and spend less on health care. This seems to debunk Chris's assertion that Canada is better at letting nature cull the old, since we would then presumably live longer.

That said, I don't really understand the problems either.
7.3.2007 2:56pm
Paul Burgess (www):
No, I don't understand it either. All I know is, the health care industry [sic] is majorly messed up; and, being in good health, I have the luxury of steering clear of doctors and not becoming part of that dysfunction.

Though I'm sure they'd love to turn me (and my health insurance) into a lucrative cash cow: "Here, let's amputate your right arm, and see if that might help your test numbers a bit. Oh, and here are some more prescription drugs for you, expensive, dangerous, dubiously effective; but profitable to us."
7.4.2007 8:22am
Bill (mail) (www):
The answer appears to be: Don't get sick, ever. Or have great health insurance paid by your company (the government is even better), and then don't ever need an operation ... especially don't get sick with something that's indeterminate -- insurance will dispute it. When you get sick, get sick normally ... otherwise, the bureaucracy will get confused. Or at least that's my take.
7.4.2007 10:32am
Chris (mail) (www):
First off, cross-country statistics are always a bit hard. For example, there's the classic infant-mortality problem, where apparently we try to save infants that most other countries mark down as miscarriages. So those deaths go onto our infant mortality statistics (and drive up our costs), while not affecting other countries' infant mortality statistics.

Also, there's the problem of separating out medical care from lifestyle and culture. We live higher stress lives here in the US, and there are all sorts of weird aspects to our food, which is also vastly cheaper than food is (often) in europe. How do you separate those out?

And that's assuming that the medical statistics are accurate. When comparing against countries like Cuba that's a completely laughable assertion, but I'd also like to point out that the people in favor of centralized medicine are generally also the people who believe that governments lie all the time. Is Canada and France really as forthcoming as possible about the downsides to their care? How can we ever even find out?

(Also, there's the question about who pays for drug research, who pays for expensive experimental procedures before they're done often enough to be cheaper standard procedures, etc.)

There's also standards-of-care issues; as I gather in countries with socialized medicine you have no recourse if doctors do a bad job, so they don't have to care what you think, so they don't have to run every test and spend a lot of their time on you. One of the benefits of not having to care about what the customer thinks is that you don't have to waste time making the customer happy. (Since I suspect that doctors will generally do a decent job just for reasons of morality, removing customer satisfaction will make them more efficient without — in most cases — significantly reducing the quality of care.)

Also, europeans are probably more used to death, old age, and suffering, so they don't worry so much about it and don't spend so much money to make old people's lives more comfortable or longer. Since most medical care doesn't do much of anything anyway (let's be realistic here; for the most part the body heals itself, and our main advances have been hygene, antibiotics, pain killers and some surgeries, with most everything else yielding only minor statistical benefits. Those things only apply in some cases), people expecting less of medicine will make it cheaper without substantially changing the results. Some things doctors can really help you with -- quite a lot the best that they can do is serve as extremely expensive psychological comfort that you've done everything that you can do.
7.4.2007 12:38pm

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