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DesideriScuri -> RE: US Health Care Costs (11/22/2014 1:35:51 PM)
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ORIGINAL: freedomdwarf1
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ORIGINAL: DesideriScuri
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ORIGINAL: freedomdwarf1
I have given you many examples in the past where costs are directly driven DOWN by socially-funded healthcare.
Not just rising much slower.... actually and physically lower costs per item than a privately funded system.
You just refuse to see the numbers game and insist on proof.
Where have you shown any examples where costs have dropped? It's not just about the cost of an MRI machine for the NHS vs. the cost of an MRI machine for a private UK hospital. If that was all there was to it, then profits at medical equipment manufacturers in the US would be massive (which would be a signal to the Market and there would be a massive influx of competitors to fight for those profits). Why would a medical device maker sell to government at such a low price, compared to private hospitals? Wouldn't that be gouging the private company? Or, could it be, that the private companies are having to pay such a high rate to make up for the well-below-cost price for the government? What happens when there isn't a customer to pay that high rate anymore?
I gave you just ONE example of where costs were physically driven down by utilising the fiscal muscle power of a nation-wide spending budget over that of a private single hospital.
Now apply that logic to everything across the board - and that is where savings are made.
The equipment manufacturers still make shitloads of profits even from such deals as the scanner I quoted.
They just have a unit-price drop but sell many more units.
It's the scale of numbers and is just how supermarkets manage to maintain profits and sell the individual items at a lower price than a local kwik-e-mart.
You don't seem to grasp that concept too well.
Yeah, I do. I just find it hard to believe there is going to be profit in $8k. Even if $8k was the cost of production, you're trumpeting them charging a 175% markup on their goods. That certainly doesn't sound fair, now, does it?
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ORIGINAL: DesideriScuri
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Just look at the graph you posted.
All examples of socially-funded single-payer systems cost MUCH less than the US system of private insurance.
There is your proof.
Nobody can provide explicit individual invoices which seem to be your only acceptance of "proof".
Every country typically buys the same sort of equipment, the same pills, pays for hospitals and staff and GP's and services..... yada yada yada.
Yet they are all at a lower cost PPP than the US private insurance system.
It is proof by example... lots of examples. But you won't accept that.
Bullshit. I'm not asking for individual invoices at all. What was spending in the UK in the years prior to the NHS? What was it in the years immediately after? I've looked, and I admit I can't find that data. I can't find it for Italy, Germany, Australia, either. So, please, do show me where costs have dropped.
So what "proof" are you specifically wanting??
There is plenty of proof by example in many OECD socially-funded healthcare systems.
It seems you are asking for the impossible.
Our NHS was founded in 1944. And like many other countries, figures aren't available for that period so there cannot be any direct before/after comparison.
And again, like many other countries, our single-payer systems have evolved to meet the demands over the decades; so figures for that aren't usually available except for more recent years where spending has been analyzed more closely.
So, you don't have any proof (because the data wasn't recorded) that costs drop. Got it. Thanks for the honesty.
When were records kept? 1980? If so, there should be proof in Australia's switch over...
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ORIGINAL: DesideriScuri
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And let me reiterate just one simple example that I gave a year or so ago.
Two local hospitals, one is part of our NHS (socially funded healthcare), the other is run by Bupa (private insurance a.k.a US system).
Both wanted a new scanner priced at $22k each.
Bupa hospital said it was too expensive and didn't buy one.
NHS hospital bought one for just $8k because the NHS used it's fiscal muscle and negotiated the deal and price but for a number of NHS hospitals, including our local one.
So..... total cost to our NHS hospital was $8k (and $8k for all the others that wanted one). That is by far cheaper than the $22k price tag for individual hospitals to purchase.
A direct saving of $14k for just that one item.
Private patients: don't have the new scanner despite the high insurance premiums they pay.
NHS patients: pay far less and have the new scanner.
See how that works??
And that is just one example amongst many others that I have given you in the past.
Why was Bupa's price so much higher? I know you probably won't know the answer to this, but I do wonder what the actual cost of the scanners was to make. How much was made/lost?
Bupa's price was much higher because they had no buying clout to negotiate a lower price.
Quite simply, that was the market price of a single machine.
I have no idea how many machines were negotiated for the NHS other than there were a good few more than a single unit.
It's just like buying in bulk but on a bigger scale.
Again, horseshit. If you buy 1M units, it still costs X to make. You won't be able to drop the price below X for very long before you have to close your doors. Bulk buying or not. If you sell at a loss, making it up in the number of units only makes it worse.
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I'll give you another example: cutlery for the hospital. One single set is priced at £8 (about $13). Buy 200 sets and they cost only £5 per set (that would be enough for 200 patients and no spares). For a 750 bed hospital, one set for each patient and one set being washed/cleaned etc, makes a total of 1,500 sets of cutlery minimum. Unit price is now dropped to £3.50 per set but to get that level of discount, you need to buy more than 1,000 sets in a single order.
For a single (largish) hospital, that is doable. For a small hospital or recovery clinic, probably not.
Now multiply that by over 200 NHS hospitals. That amounts to 300,000 sets of cutlery in a single order made by the NHS as a single purchasing body. And for that sort of order level, that unit price drops even further to less than £3 per set.
So, for a direct comparison, a small privately funded 50-bed hospital, it would cost them £8 per set for the cutlery because it would be uneconomical to buy the minimum 200-set order to get the discount.
The NHS buys a bare minimum of 300,000 sets at less than £3 per set.
See where the money is actually saved??
All the NHS hospitals, including those little tiny rural hospitals, get their cutlery at less than £3 per set but the private hospital is paying £8 a set.
It's a numbers game across the board and vast savings are also made across the board.
You can't seem to grasp how this works.
You grasp little about me.
Any whining about greed with regards to your medical device manufacturers? No?
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