A) Call it even for health outcomes if you'd like, we could argue the numbers regarding demographics, lifestyle and all that until the cows come home, but health in Canada/UK/France/Japan definitely isn't materially worse. So for the sake of argument let's just call it even, except we're spending several times as much. (we actually spend more gov't money on healthcare per capita than many companies with socialized medicine, in addition to private sector spending -- that's how broken our system is).
B) Regarding doctors wages, I'm not really talking about "poorer" countries unless you'd call western europe, canada, japan "poorer". If they make significantly less in those countries than here.. sure, fine. Given that we don't offer cheap schooling like those countries there might be a limit to how low we can go, though.
C) Top 5% of income != doctors, necessarily. And the money we're wasting, a tiny percentage of that is going into doctors' pockets. Most of it is just plain pissed away, and a lot goes to insurance company profits. Doctor salaries are pretty far down on that list, so I don't think I was proposing drastically lowering their salaries, no.
Ok, fine. So we are in agreement that health outcomes are roughly even.
Insurance companies don't make much in the way of profits. Those greedy pigs have profit margins roughly the same as home improvement stores, textile-apparel clothing and slightly less than packaging and containers. (And keep in mind, this was a good year for them. They all raised prices significantly in anticipation of Obamacare.)
You simply won't get much money by soaking insurance companies.
The main thing you need to do to reduce spending is to get people to consume less medicine. That was the conclusion of another (very good) series of articles on the same blog - we spend more on health care because we consume more (in particular, outpatient care).
>Those greedy pigs have profit margins roughly the same as home improvement stores, textile-apparel clothing and slightly less than packaging and containers.
Except all of those things involve moving stuff around. Insurance is just bit flipping in the banks when you get down to it, paperwork at the absolute worst. They should be able to manage way lower margins, they're moving money on paper instead of goods. But they don't, because they're an entrenched industry which puts less competitive pressure on them.
However you're right in that soaking the insurance companies won't make up the gap. We need to get smarter and be more efficient. As a first step, why don't we just the other 6 members of the G7, since they deliver equivalent outcomes for much cheaper? I'm not a healthcare expert but the topline numbers say it all. Healthcare's killing us on all aspects of everyone's budget. There could still be a role for insurance companies, there is in europe.. let's just do what works.
Profit margins are not generally dependent on the weight of the stuff you are moving around. It is mostly based on risk and competitiveness. Risk increases profit margin (see: software companies, drug companies), while competitiveness reduces it (see: retail).
If there were no competitive pressure, why didn't insurance companies raise prices a lot higher? That's what ISPs did, resulting in a profit margin of 28%.
As for copying the G7, which of the other 6 members of the G7 do you propose copying? And how will imposing their system in the US prevent the overuse of medical services?
Do you think that Americans will say "our health care system is now just like France, maybe I better act like a Frenchman and not run to the doctor because I have the sniffles?"
> Insurance companies don't make much in the way of profits. Those greedy pigs have profit margins roughly the same as home improvement stores, textile-apparel clothing and slightly less than packaging and containers.
And, their total profit plus executive salaries is a small fraction of the amount of admitted Medicare fraud.
I mention medicare because it's supposedly more efficient, but that's based solely comparing their cost to cut a check to the "overhead" of private health insurance companies.
Note that folks who have disputes with medicare are less likely to win than folks who have disputes with private health insurance companies.
IIRC, the total profit by private healthcare companies was less than $10B in 2009 and the executive salaries total was under $1B. You've said that the 2010 numbers are somewhat better.
B) Regarding doctors wages, I'm not really talking about "poorer" countries unless you'd call western europe, canada, japan "poorer". If they make significantly less in those countries than here.. sure, fine. Given that we don't offer cheap schooling like those countries there might be a limit to how low we can go, though.
C) Top 5% of income != doctors, necessarily. And the money we're wasting, a tiny percentage of that is going into doctors' pockets. Most of it is just plain pissed away, and a lot goes to insurance company profits. Doctor salaries are pretty far down on that list, so I don't think I was proposing drastically lowering their salaries, no.