Health Care Costs

Most of the European health care systems provide about the same care as the US at about half the cost.   This is extraordinary when you think about it, especially because  we in the US pride ourselves on innovation and cost effectiveness.    What’s up with this?    Still not at all clear to me, but I think a major part of our problem is our … freedom to choose combined with our political spending craziness.   When you ask people about allocating risks they tend to very foolishly think we should have “no risks” or at the least always be working to reduce risks.    This is not rational – we should actually be increasing some risks in our health care system when this increase in risk would lower the costs.    For example rather than spending a huge sum on care for a patient in a coma with a very low chance of recovery we should allocate the money to improving inner city ambulance service times.      These types of decisions should be  practical / institutional / cost driven and not left to stressed individuals in hospital settings as we tend to do in USA.      It’ll take a lot more research to figure out the answer to my question however, which is how in the heck we can spend so much to get the same outcomes!

Here’s a nice article from Kaiser about the spiralling costs of US care, indicating that half the costs are now from hospital care:

In France the pharmacy can prescribe antibiotics and other medications from easy to diagnose conditions.    This is a great cost innovation and I’m looking into why we don’t do this here, forcing patients to involve a high cost doctor when this is not needed at all for many ailments.

Europe versus USA

One of the things that always strikes me during travel is how insulated we are in the USA from the rest of the world. Some of this is geographical – ie the USA is a huge country and folks don’t often move across national borders unless you are in the handful of cities that border Mexico or Canada. But even then the interactions are not like those in Europe where folks seem to maintain a sense of national identity as well as a mutual European identity. Not to suggest Europe does not have it’s share of problems, rather I just think it’s interesting to see a group of countries interacting so effectively and cooperatively with respect to so many things (Currency, trains, trade, border controls, etc, etc). However I think our isolation in the USA is more cultural and historical than geographical. As the key global power since WWII, it’s been far too easy to ignore how interconnected the world has become, and how impossible it is to isolate ourselves economically, militarily, and culturally. Finding the best (and free) Wifi at the Burger King in Munich, we sat watching Musit TV clips which were about half German rock stars and half USA. All over we’d hear the radios playing US pop and rock, and I was struck by how despite all the US economic and military presence all over the world, arguably the most powerful part of globalization is … US pop culture.

 …. to be continued …

(the Europe trip coverage will mostly be here:

Hello UK, and welcome to the bail out club…

I’m not seeing enough about the 500 billion pound UK Bailout (that’s $865 Billion US) on US Financial news.

That’s more than our USA bail out despite the fact that our economy dwarfs that of the UK.  Probably a sign that here in the US we are in for massively more bail out spending before the financial bloodbath is over.

The scale of this measure suggests to me what the markets already seemed to know – the situation is worse than we’ve been told.

So, market activity remains jittery and unhappy even though we’ve now got a massive global bailout in progress with the global .5 rate cut combined with 700 billion here and 865 billion there and the large global rate cut.  Gee whiz, pretty soon this could add up to real money.

I’m uncertain about this but I think the only remaining certainty is uncertainty, and that’s … for sure!