
Government debt swells as choices get harder - gibsonf1
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2009/05/24/MN2B17PDPL.DTL
======
pj
_The United States spends $2.5 trillion a year on health care, more than any
other rich nation, and yet has poorer outcomes. About $700 billion is wasted
each year._

The reason is simple: Artificial controls on supply and demand of medical
professionals: <http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm>

I can't count the number of friends I have had who applied to medical school
and were denied entry due to insufficient seats. There are vastly more
individuals qualified to be doctors, many I would much prefer to have as
doctors than I have had in the past, but with these artificial limits on
supply - governed by the AMA itself - there will always be a shortage of
medical care and high medical care costs.

Furthermore, the healthcare industry lobbies congress to prevent individuals
for caring for their own health. We cannot for example buy our own insulin
without first getting a prescription from a doctor. We cannot get our own
blood tests or request our own CAT scans. We are forced, by law, to visit a
doctor before we can manage our own health.

As long as doctors are the gatekeepers to health and the supply of doctors is
limited by doctors themselves, there will continue to be healthcare problems
in the United States.

Our society has pitted the doctor in a competitive role against the patient
through litigious means and pharmaceutical industry pressure on doctors to
overprescribe unnecessary medications.

It's a horrible situation, but the solution isn't difficult to implement for
anyone except the medical industry itself. They don't want to lose the power
and control they have over every single life in America.

Visit most countries outside the U.S., Canada, and the UK and you can walk
into nearly any pharmacy and purchase the drugs you need to survive, cure
disease, and prevent pregnancy for a tiny fraction of the cost Americans pay
and without the time delay of a doctor's appointment or the added cost of the
doctor's visit itself. And healthcare for the average citizen is higher in
these countries. Infant mortality is lower and people live longer.

~~~
martythemaniak
We pay a fraction of the cost Americans for drugs because our governments
aren't as owned by the pharmaceutical companies as the US government is.
They're called price controls and they work pretty well, maybe someday the US
will wake up to that fact.

And of course, blaming the AMA and doctors is another great diversion. The
same professional association exists in Canada and other countries, yet our
health care expenditures are under control. Like price controls on drugs, it
is the kowtowing to free-market ideology over practical policies that work
that gets Americans a shitter health care product for nearly twice the cost.

~~~
TriinT
_"The same professional association exists in Canada and other countries, yet
our health care expenditures are under control."_

Many times, the costs are not under control, they are hidden. I come from
Europe, and in my homecountry the AMA-like lobby is powerful too. The reason
why the health care expenditure seems to be under control is that health care
is subsidized by the state. You pay for it with the highest sales tax in
Europe. No free lunch, right?

~~~
martythemaniak
Statistics on healthcare expenditures as a percentage of GDP are freely
available around the net. Have a look. The US spends _substantially_ more than
European countries and gets worse results.

If you add up what you pay for healthcare in taxes, and what the average
American spends in taxes and private insurance, you'll find you spend far
less. Your high VAT is likely needed because of any other number of government
programs not available in the US.

~~~
TriinT
I am aware that the U.S. spends way too much money in health care and gets
less than brilliant results. I will never understand how that is possible...

------
jpcx01
Not a problem. Lets just pass 1 more stimulus plan (to make it a trifecta) and
then implement national health care. Because we all know the best way to lower
prices is increase demand.

No doubt this problem is going to catch the country completely by surprise in
the next 3-5 years. Paul Krugman will be shocked, just shocked, that the
government is out of money.

~~~
DanielBMarkham
In the immortal words of Monty Python during the killer rabbit incident: "run
away!"

I blame myself as a partial culprit.

Boy was I a sucker. Even though I am an independent, I have picked a party to
vote for based on which one I thought would keep spending under control. I
used logic, reason, historical trends, etc.

Boy was I a sucker.

Seems like each side is playing "who can run the biggest debt up" game. One
bunch takes it to new levels, and the next bunch tries to outdo the first. Not
only is the slope of the equation bad, the first derivative is bad too.

I honestly don't see a political way out of this. For the first time, I wrote
a letter to my senator and asked him to do what he could about spending. Don't
make a scene, I said, and don't play politics with this. Just try to do the
right thing.

In reply I got a form letter with a political speech in there about how he's
such a great guy for voting for such great bills.

sigh

~~~
TomOfTTB
As a Californian I think there is a political way out. Calfiornia has gone
down the road that the U.S. is headed down so you can sort of see the results.

Basically what has happened here is that conservatives who believed in small
government lost out to liberals who promised the government would solve
everything. Those conservatives then becamse "social conservatives" and
started focusing on a bunch of hedge issues while promising to spend as much
as the liberals (which is basically where the U.S. is now). Now we're out of
money and those "social conservatives" are now turning back into "fiscal
conservatives" because the public has finally started to realize spending like
there's no tomorrow doesn't work.

For the record I think there's one more step here where liberals start to
become more fiscally conservative and focus on ideals that don't cost anything
to change like gun control. Think Clinton era liberalism. But that's just my
opinion.

So really the political answer to the problems the U.S. now has is to get into
enough financial trouble to give political cover to those politicians who
would propose spending cuts.

------
forinti
Obama should call Castro for tips on running a health care system on a
shoestring. Just kidding, sort of.

------
hooande
It's probably worth noting that the US also currently has the highest GDP of
any country in history. While our debt is catastrophically high, we also
produce more per person than any nation our size.

~~~
halo
It's difficult to judge. The US has the highest GDP, but it's also the largest
western country in terms of population, which makes direct comparison
difficult.

It does not have the highest GDP per capita (see
[http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nom...](http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nominal%29_per_capita)
and
[http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP...](http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP%29_per_capita)).

~~~
lliiffee
The only country above the US that isn't an oil exporter is Luxembourg, which
has a population about %0.1 of the US-- its basically a single, medium/small
city. I bet if Beverly Hills became its own country, the per capita GDP would
also be impressive!

------
martythemaniak
The solution is marvellously simple:

"But the larger problem, as in California, is that the public also recoils
from spending cuts and tax increases"

The American public needs to stop acting like a bunch of petulant, whiny
children and start paying up.

