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kalap_ur | 5 months ago

I did a calculation once. US spends $4.9T on healthcare: $2T on personnel, $500B on non-acute drugs (ie OTC + prescribed) and $2.4T on something else. Germany spends $550B on healthcare: $430B on personnel, $80B on non-acute drugs and $31B on something else. My guess is that the "something else", which is non transparent, is actually private insurance jacking prices up.

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giantg2|5 months ago

Can you adjust those to for a per capita and CoL basis?

That something else could also be stuff like malpractice insurance, legal settlements, etc.

kalap_ur|4 months ago

There is no need. The personnel cost multiplier is 3.6x, the non-acute drug multiplier is 6.25x and the "something else" multiplier 77x. So we can debate that there are ~4x more people in the US and CoL is higher maybe by 0.5x turns, but there is no debate that the 77x shows something is awfully wrong.

My bet is the private insurance because we dont have transparent data on how much does the same procedure (broken down by personnel (doctor, nurse, admin), implied equipment amortization, rent, drugs) cost with and without insurance.

I could totally imagine that there are plus personnel expenses buried within the "something else", or acute drug prices, which are administered during an emergency at a hospital. But we don't know, because healthcare spending is a black box in the US.

mrguyorama|5 months ago

>That something else could also be stuff like malpractice insurance, legal settlements, etc.

This claim is regularly brought forth as why US healthcare is expensive and it just doesn't work.

First of all, are you aware Texas has fairly rigorous limits to rewards for Medical Malpractice suits? You can only get half a million dollars above what the malpractice cost you. There's also a two year statute of limitations from when you found out about the malpractice, and if you find out that your surgeon willfully fucked up your treatment more than 10 years after it happened, too bad, no case for you period.

Does Texas have cheaper healthcare than the rest of the country?

Nope.

Second, the primary cost of a medical malpractice suit is fixing the medical problem which is only a large number because medical care in the US is stupid expensive. Blaming the cost of healthcare on malpractice suits and insurance is putting the cart before the horse.

Meanwhile, most medical lawsuits never even come close to large sums.

When my sister was being born, the doctor broke her shoulder to get her unstuck. There is a correct way to do this, but he did it wrong and permanently disabled her. Turns out, he was literally not allowed to practice medicine in some states for doing exactly that to several other babies, and ended up doing exactly the same thing to another baby a few years later in the same town.

We got $10k. Permanent, life altering disability with no treatment or fix for outright malicious incompetence. My sister isn't supposed to be left handed, but she is.

$10k

If you've ever gotten upset about the McDonalds "hot coffee" lawsuit for example, you should be aware that the plaintiff originally was only asking for $20k to treat her fused labia and permanent damage. The court awarded significant damages because it was discovered that McDonalds had done this to multiple people and was purposefully keeping their coffee hotter than they were supposed to despite how it had directly harmed multiple people. They also ran a literal propaganda campaign to libel this woman that it was somehow her fault for not knowing the coffee was hot or something. You can bet they spent more than $20k on that. Oh, and the $2.7 million she got in punitive damages for McDonalds willfully contravening safety and helping melt her lady parts? It was specifically equal to 2 days of coffee sales. And then the judge said "no" and only gave her $600k. Then McDonalds appealed the case and settled privately.