The USA spend more public money than most of Europe, yet unlike most of Europe does not have universal, free at point of delivery healthcare.


Public and private expenditure on health
US dollars per capita, calculated using PPPs, 2003 or latest year available
[image from titania.sourceoecd.org too old to be available]

The US system is the most inefficient in the world. Spend the mosts, gets the least back

below av infant mortality.
Deaths per 1000 live births, 2003 or latest available year
[image from titania.sourceoecd.org too old to be available]

below av life expectancy.
[image from titania.sourceoecd.org too old to be available]

And for this shaite they pay 100% to 50% more than the rest of the developed world....

all graphs from the OECD.

/How could it get worse?

hillbillypharmacists POV.

The rising cost of healthcare is directly attributable to the sheer number of middlemen, their increasing profit margins, and the byzantine system by which we pay them. Of course, this is all fine if you buy into the theory that this is what the market will bear, people will find a way to pay if they want to, and that there is no tangible benefit to society as a whole to have a larger percentage of the populace healthy.

I don't buy into it. However, I don't think healthcare is a 'right', either. It is a luxury that we can afford to pay, if set up correctly.

There is a middle ground between for-profit corporate healthcare and fully socialized government healthcare. It upsets me to no end when any encroachment or regulation on insurance companies and pharmaceutical corporations is referred to as the beginning step towards communism. It isn't.

It is the government's duty to provide a conducive atmosphere for business to flourish, and one of the best ways to do this is to supply it with a larger pool of healthy workers. In order to do this, the corporations providing healthcare now may cease to exist in their present states. Too damn bad. And again- I'm not advocating government run healthcare- that would be madness.

I think that we should create non-profit businesses to replace drug manufacturing, research and development labs (which ironically are heavily funded by the NIH anyways, double bonus for drug companies who can make a profit on drugs they didn't pay to discover), and insurance companies (including malpractice insurance). These companies can compete among themselves for their patients and doctor clients, but the money they save by being efficient will be used how it should: lowering the price of the services provided and increasing the number of patients treated, instead of being pocketed by shareholders and executives. By doing this, our healthcare system will be able to provide the same care for a cheaper price, while still allowing the consumer to choose between plans (or none at all) all without that evil, evil government control.

This sort of thing has happened before in US history. In 1938, the government created Fannie Mae in order to make it easier for Americans to purchase homes. Considering the amount of taxpayer money that goes to subsidize various healthcare corporations, and research that is funded by NIH, plus Medicare and Medicaid, creating government-sponsored independent corporations whose entire goal is to treat as many people as possible as cheaply as possible (instead of making a profit) will actually lessen government's involvement in healthcare, not increase it.

But failing this fairly radical change, some simpler steps can be done to help matters. For example, creating non-profit drug companies that can directly compete with the for-profit companies instead of replacing them. For-profit companies receive public funds to pay R&D costs for many drugs, and then charge a profit to the consumer. This costs the taxpayers twice. This should not ever happen. Either public funding of R&D for for-profit corporations must be abolished and diverted to non-profit drug companies, or the for-profit corporations must sell those drugs at cost to the consumers.

Another problem is drug advertising, which is harmful and expensive. Advertising costs pharmaceutical corporations as much as double R&D. The consumers simply don't have enough information or education to make informed decisions about prescription drugs.

The medical community as a whole should practice evidence-based medicine, and allowing drugs to be peddled with pretty pictures and appeals to authority, instead of performance in clinical trials, is unprofessional and unhelpful. Moreover, the FDA is fraught with corporate interests, and those that run the FDA have a fundamental conflict of interest, because they can own stock in the companies whose products they approve or disapprove. Moreover, approximately half the FDA's budget for regulating the drug industry comes from the drug industry itself as fees to speed up the approval process. As a community, medical professionals should demand objectivity and squelch conflicts of interest.

/ I'm more of a Eurpean model fan myself