The cost of healthcare

by Richard on August 15, 2009

Atrios gives a fun fact about US government health spending

Fun fact the media never tells you: as a % of GDP, the US has greater public expenditures on health care than the UK does. Not total expenditures, we know that. Public expenditures. More big government health care in the US than the UK.

Here’s another fun fact. If you’re earning the average wage in Britain reckon you’ll be paying about £5000 a year in income tax and National Insurance. Call it $7500. Someone in my circumstances (wife, 2 kiddies, all non-smokers) can buy a very comprehensive health insurance policy for £250 a month: £3000 a year. Can we call it $4500?

That means that I could have the NHS and private medical insurance for about $12000.

I was reading the other day that a typical family pays $12800 for medical insurance in the USA.

I just thought I’d mention it.

Update: Dave Faulkner has a great post taking up cudgels for the NHS

{ 5 comments… read them below or add one }

1

dh 08.17.09 at 1:48 am

Richard, I don’t know where you get your facts but the average family does NOT pay an average per year of $12,800 for medical coverage. Much of the premium is paid for by the employer and the cost is WAY lower than what you are saying due to the pooling of the group of all of the employees in the plan.

Well also people with cancer have longer life spans than in other nations. Also one fails to see that our health care dollars would be even higher than it currently is if we had the NHS system. Also one fails to recognize that there are no limits on punitive damages. If we had tort reform there would be lower government expenditures and premiums for health professionals for insurance to cover law suits would go down making the overall health care cost for government LOWER. So yes it does cost a little more but we have no lines and have no rationing of service.

2

Richard 08.17.09 at 7:25 am

Sorry DH. I got it wrong. The average annual premium for family coverage is $12680, not $12800. My bad. It’s irrelevant that much of this is paid by the employer, not the individual — especially since you’ve argued elsewhere that the cost of healthcare should be taken into account when comparing wages across national boundaries.

Comparing cancer survival rates isn’t ever so simple. Comparing life expectancy is easier. That would be 79 in the UK, 78 in the US. Infant mortality is easy to compare too: 4.85 deaths per 1000 live births in the UK, 6.26 in the US. Considering that your spending on healthcare is vastly more than ours, I reckon we come out of it pretty well.

No lines? I’m not sure that’s true

There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.”

Similarly, no rationing? Get real - every system operates some kind of rationing.

3

Beth 08.17.09 at 10:02 am

Wow. Same-day appointments are the norm here, right? All I have to do is ring my surgery in the morning and find out when they have space. If they have no free appointments, a doctor rings me back to check out whether I need to be seen as an emergency patient.

The NHS has a lot of problems, sure, but still - it pays for the five different drugs I have to take long-term, has fixed my broken left foot and, then, my broken right foot, stopped me dying from appendicitis, removed my agonising wisdom teeth, all that good stuff. And without costing me or my family anything except a flat rate for prescription medicine (which is not charged in Wales, or in England for those on a low income.) I’d like to see it better funded, and get rid of the ridiculously inflated bureaucracy. But I’d still rather this than any other healthcare system in the world.

4

Richard 08.17.09 at 3:26 pm

The pdf of that Commonwealth Fund report is here. It contains some really fascinating information, and puts DH’s claims about waiting and rationing in some perspective. There are areas where the US significantly outperforms Britain: waiting times for non-urgent or elective surgery, and waiting times to see a specialist. (I strongly suspect that this will include non-urgent cases) But overall, these data present the NHS pretty favourably compared with the USA. Of course, it’s a 4 yr old report, so things could have changed a bit in either direction.

5

J 08.18.09 at 2:17 pm

I hope you don’t mind me pulling a comment from the “Controversy” thread into this one, but your post is pertinent to it. You said:

“I prefer a health system that’s funded through taxation, but I understand that isn’t so in the US”

I’m not so sure that’s true - we need to distinguish between financing and control. I suspect a proposal for an $X000 federal tax credit to buy health insurance would be extremely popular in the US. The same concept applied to schools has been wildly popular - across the political spectrum - where it’s been tried (with parents, not public school employees).

What people in the US don’t like is the idea of a (non-elected) goverment employee making decisions about coverage. There’s a core cultural difference between the US and basically every other country I’ve been exposed to that doesn’t get discussed much in this type of debate, involving the issue of trust and confidence.

It’s been my observation in most countries I’ve spent any time in or dealing with that working in the public sector is at least a moderately prestigious occupation. In the US, on the other hand, while line employees of government agencies are frequently held in fairly high esteem ( firefighters, teachers, etc), staff employment with the government is extremely low prestige, with people in those occupations broadly regarded by the public as lazy and incompetent. If they run the TV series “Seinfeld” over there, the Newman character is pretty representative of the US view of public sector employees (ironic, as Newman is a line employee).

If Obama were to propose a subsidy for private health insurance, even if it was paid for with an increase in social security or medicare taxes, the debate would be over regulation of insurance plans, not whether or not the subsidy would pass. But people in the US do not trust the government to run an insurance plan itself, and are going to oppose one that appears to have the objective of killing off private insurance.

“why, if it is against the law, does discussion about payment before treatment in the Emergency Room appear to be so widespread”

The law doesn’t say they can’t ask for payment, only that they can’t deny treatment.

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