Healthcare Education and Q&A Thread

Thanks for lending us your expertise Schneed. It is often remarked that the United States spends more per person than any other country in the world on healthcare yet gets less, consistently ranking near the bottom of major industrialized countries in independent international surveys. First of all, do you think these rankings are fair? Second, do you think it would be possible to expand coverage to the unininsured without substantially increasing taxes or cutting other government spending? It seems that other countries are able to get more coverage for considerably less money.

Finally, I know that you have been critical of Obama's healthcare proposals in the past. Does this mean you advocate the status quo? If not, what specific changes would you like to see implemented by congress?

If I'm correct I think my buddy said he pays 85,000 a year for malpractice ins. and it might have been even more than that.

Thanks for lending us your expertise Schneed. It is often remarked that the United States spends more per person than any other country in the world on healthcare yet gets less, consistently ranking near the bottom of major industrialized countries in independent international surveys. First of all, do you think these rankings are fair? Second, do you think it would be possible to expand coverage to the unininsured without substantially increasing taxes or cutting other government spending? It seems that other countries are able to get more coverage for considerably less money.

Finally, I know that you have been critical of Obama's healthcare proposals in the past. Does this mean you advocate the status quo? If not, what specific changes would you like to see implemented by congress?

Cost-wise, a few things in particular separate us from other countries:

Malpractice
Other countries don't allow civil suits to result in large payments to victims of malpractice. Hence our docs pay a ton more in malpractice premiums than do docs in other countries.

Cost of Living
Cost of living in the US is way higher than most industrialized nations. Since healthcare is so labor-intensive, it is unfair to compare per-capita spending on healthcare from one country to another without adjusting for cost of living or wage index.

I'd like to see the surveys you're speaking to be able to comment further as to their fairness. I'd be particularly interested to see how they're determining that we "get less." Does that mean we have shorter lifespans? How the heck do you measure that?

We have shorter lifespans because we're fat, not because our healthcare sucks!

Here's a pretty detailed analysis of the WHO's most recent survey (from a few years ago, which ranked us 37th). PR-2000-43/ WORLD HEALTH ORGANIZATION : ASSESSES THE WORLD'S HEALTH SYSTEMS (http://www.photius.com/rankings/who_world_health_ranks.html) Looking online it seems like a lot of people have criticized the methodology of this particular ranking, so I'd be interested to hear your take.

Your first observation makes sense but I can't find any information online suggesting that the US has a high cost of living relative to other industrialized nations. Are you sure about this? Speaking anecdotally, it has been my experience from traveling that the cost of living - or at least the cost of things I buy like food and beer - is way higher in other industrialized countries than the US, and I am including Japan, Germany, France, England, Spain, and the Netherlands on this list. Speaking from experience I can tell you that Japan is significantly higher than the US pretty much anyway you measure it. Most information online ranks cities instead of countries (usually putting NYC around 20th in the world) but here's one I found ranking countries across several categories, with the US being pretty average in every category Cost of Living Index By Country (http://www.numbeo.com/cost-of-living/rankings_by_country.jsp)

So anyway, while cost of living might explain how Colombia ranks higher than us, unless I'm missing something I really don't think it's true that the US has a high cost of living relative to the EU and the most developed Asian countries.

you say other countries do not allow civil settlements in doctors error. what happens in those countries when mistakes are made?

you say other countries do not allow civil settlements in doctors error. what happens in those countries when mistakes are made?

Don't know, I guess that would be a legal question. I wonder if any lawyer types know what the deal is in other countries.

Here's a pretty detailed analysis of the WHO's most recent survey (from a few years ago, which ranked us 37th). PR-2000-43/ WORLD HEALTH ORGANIZATION : ASSESSES THE WORLD'S HEALTH SYSTEMS (http://www.photius.com/rankings/who_world_health_ranks.html) Looking online it seems like a lot of people have criticized the methodology of this particular ranking, so I'd be interested to hear your take.

Your first observation makes sense but I can't find any information online suggesting that the US has a high cost of living relative to other industrialized nations. Are you sure about this? Speaking anecdotally, it has been my experience from traveling that the cost of living - or at least the cost of things I buy like food and beer - is way higher in other industrialized countries than the US, and I am including Japan, Germany, France, England, Spain, and the Netherlands on this list. Speaking from experience I can tell you that Japan is significantly higher than the US pretty much anyway you measure it. Most information online ranks cities instead of countries (usually putting NYC around 20th in the world) but here's one I found ranking countries across several categories, with the US being pretty average in every category Cost of Living Index By Country (http://www.numbeo.com/cost-of-living/rankings_by_country.jsp)

So anyway, while cost of living might explain how Colombia ranks higher than us, unless I'm missing something I really don't think it's true that the US has a high cost of living relative to the EU and the most developed Asian countries.

I'll take a close look at that survey and weigh in.

On cost of living, the question really is what to doctors and nurses get paid in those other countries. I am under the impression it's less, though admittedly I'm not certain; I know a lot more about our healthcare system than I do that of other nations.

If I'm correct I think my buddy said he pays 85,000 a year for malpractice ins. and it might have been even more than that.

Wow. I wonder if that's the average, or if your buddy has a habit of amputating the wrong limbs.

Wow. I wonder if that's the average, or if your buddy has a habit of amputating the wrong limbs.
MY buddy said he has only been sued once and he admitted that in that case he did make a mistake but that was like 8 years ago. He is the guy they call in to put you back together after a bad accident and he also has a practice which specializes in sports injuries. He does the emergency type stuff because he likes that type of work and he jokes by saying motor cycle riders paid for his house.

MY buddy said he has only been sued once and he admitted that in that case he did make a mistake but that was like 8 years ago. He is the guy they call in to put you back together after a bad accident and he also has a practice which specializes in sports injuries. He does the emergency type stuff because he likes that type of work and he jokes by saying motor cycle riders paid for his house.

Sounds like an Orthopedic Surgeon. They suffer one of the higher malpractice premium rates, probably second highest to obstetricians.

Our Orthopedic Surgeons get paid about $350,000 plus incentives, and then the Medical School pays for their malpractice coverage, about $60-$70K per doc on average. $85K does not sound unreasonable, the only reason our medical school docs have a lower premium is because they're getting a "group rate" of sorts.

Obstetricians deal with about $100K apiece.

Malpractice costs aren't some buzzword or hot button issue; it's a serious problem.