USA Healthcare Facts

In 2003, of the roughly 3,900 nonfederal, short-term, acute care general hospitals in the United States, the majority—about 62 percent—were nonprofit. The rest included government hospitals (20 percent) and for-profit hospitals (18 percent). In exchange for tax-exemptions, estimated to total $12.6 billion in 2002, nonprofit hospitals are expected to provide community benefits.

Percent of national health expenditures for prescription drugs: 9.8% (2014)

Many health insurance companies are nonprofits including some of the state Blue Cross organizations. see: Google search for percent non profit health insurance.

It's Surprising How Few Countries Have National, Single Payer, Health Care Systems


It is surprising how little, expensive healthcare contributes to health. See here. (by expensive I mean beyond vaccinations and antibiotics).

Do Americans spend more money on the health care of the poor than the rich?

Ratio of mean health care spending in richest quintile to mean health care spending in poorest quintile, 
For the United States, as reported, that ratio is 0.884 for ages 25-64, and for 65 and up the ratio has two varying estimates, from 0.87 to 0.9.

Trust and Cost Disease

I have been wondering if loss of trust is a significant driver of our rapidly increasing spending for schooling and medical care. Spending is increasing rapidly and yet the teachers and MD's are less happy with their jobs and the patients are not happier with the service. See here.

We don't trust the teachers as much as we used to and so we test more and regiment them more. We don't trust MD's and so we build rules and bureaucracy to regiment them. Part of that is inevitable in a 3rd party payer system but it might be increased by this international competition. All the stories that tell us how poorly the USA does on PISA and life expectancy as compared to the other developed countries when there are many non schooling non health care things that effect PISA scores and life expectancy.

BTW As far as schooling goes, does PISA really test anything important? On PPP GDP per capita USA Ranked 6th, 44% more than Finland, maybe the Finns should change their schools to look more like ours? Maybe the PISA tests are too close to an IQ test tell us much about the quality of our schools.

On Paul Romer's Idea of Charter Cities

Paul Romer's Idea of Charter Cities

We should lead by example and make Brownsville or Detroit charter cities. The current residents would keep their US citizenship but newcomers would need a passport and VISA to get into the rest of the USA.

 

A lot of capital is going to waste in Detroit. we would people to fill Detroit, but most voters don't want more immigrants and they know that you cann't keep people in the area that you want. I have heard that programs that bring in immigrant MD's to places like Iowa have a problem with them moving. 

But I don't see anyone taking this up, such is nationalism. So Paul Romer should understand that it is unlikely to be accepted elsewhere. Argentina might be the best bet because they seem to have an open boarders policy now. 

Is High US Health Care Spending, Quite Well Explained by its High Material Standard of Living

High US health care spending is quite well explained by its high material standard of living

Scientific American:Opioid Addiction Is a Huge Problem, but Pain Prescriptions Are Not the Cause

Scientific American: Opioid Addiction Is a Huge Problem, but Pain Prescriptions Are Not the Cause

These epidemics seem to come and go. It may be that people see the damage and stay away  from drugs until enough time has passed the lesson is lost.

How much would single-payer healthcare cost in the USA?

Someone asked me: How much would single-payer healthcare cost in the USA?

My answer:

It could be very cheap, but political realty makes me think it would cost about what is spend now.
There is a lot of evidence that we are overtreated (Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer: Shannon Brownlee: 9781582345796: Amazon.com: Books The Last Well Person: How to Stay Well Despite the Health-Care System: Nortin M. Hadler: 9780773532540: Amazon.com: Books Cut Medicine in Half Hanson on Health | EconTalk | Library of Economics and Liberty) but since the people over 65 are already covered and are politically active I think they will prevent us from doing what the NHS in the UL does and what they do the Netherlands.
To illustrate the point that absent politics you could implement single payer for cheap” Since probably 90% of the benefit of heath care comes from vaccination you could just cover them and say you have single payer. Further much of the rest of the benefit comes from trauma care, infant care and drugs (about 20% of health care by cost.)
Another thing that could be done to limit costs would be to squeeze providers like they do in Japan and Canada but with healthcare being up to 18 of the US economy the providers here are pretty powerful politically.
Another problem in the US is that states do most medical regulation so the Fed. Gov. paying for more creates a bad incentive: Before the Federal Government Starts to Pay for Even More Healthcare (expanded)
Here is an interesting article about the rise in medical costs: https://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/
One additional thing to keep in mind is that health insurance premiums are motivation to work more in the taxed economy (rather than for in family consumption) but taxes are an incentive to not work in the taxed economy, mostly wives of good earners way the 2 alternatives and act on them.
BTW most countries do not have single payer but something like the PPACA but with a public option, Canada does though.
Very tough to tax another 9% of GDP (the Gov. already spends about half of medical care spending).

Considerations On Cost Disease

Considerations On Cost Disease

Maybe it is because, we used to trust teachers and MD’s, now we want Government to watch them closely, and maybe that is caused by this international competition in PISA test and in life expectancy. Even though schooling above some low quality base does little to drive up PISA test scores and health care does little to drive up life expectancy.