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INTERNATIONAL: Health care costs, and not just here!

I spent rather more than I’d like of my Thursday night writing a piece I promised ABCNews for their week-long series on the health care system that starts Sunday. As I was finishing up I saw this. It’s not exactly what I was writing about, but it’s not far away—Medical costs push 78 million Asians into poverty

International health experts have estimated that 78 million more Asians than previously thought are living in poverty because of healthcare costs. Many people in Asian countries do not have health insurance and pay for doctor bills and medical treatments. But the out-of-pocket health expenses they incur are not included in conventional estimates of poverty.When researchers deducted the medical costs from total household resources in 11 Asian countries, millions more people fell below the internationally accepted poverty threshold of $1 per head per day. "If you allow for direct out-of-pocket healthcare payments, there are another 78 million counted as poor," said Dr Eddy van Doorslaer, a health economist at Erasmus University in the Netherlands who headed the research team."We calculated that an additional 2.7 percent of the population under study ended up with less than $1 a per day after they had paid for healthcare." The figures, which are reported in the Lancet medical journal on Friday, are based on information from national expenditure surveys of what people spend on medical care in the various countries. The researchers extrapolated the national, representative samples to cover the entire population. Overall the study showed the prevalence of poverty was 14 percent higher than other estimates that did not include out-of-pocket healthcare costs.

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General Electric ServisiHealth TourismDoug Gerkebourne2yJack E. Lohman Recent comment authors
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General Electric Servisi
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I have learned to trust the government players more than the corporate CEOs that would run the system you envision, Barry. The CEO has but one goal: to maximize profits and his own personal wealth. The government can screw up and send us screaming to the politicians, but they won’t kiss you off like private industry will. I’ve been very happy with my social security and Medicare; even more so than the companies I’ve investments in. I simply don’t understand the concerns expressed over a Medicare-for-all system.

Health Tourism
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Let’s just make healthcare free!”
As P. J. O’Rourke famously said: If you think healthcare is expensive now, wait until it’s free!

John Fembup
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John Fembup

“(and no, John, I am not going to search for the source, but if you read http://www.pnhp.org I suspect you’ll find it.)”

Oh, yeah . . . PNHP.

Well, THAT certainly explains Jack’s views.

Jack E. Lohman
Guest

Here are a bunch of single-payer FAQs
http://www.pnhp.org/facts/single_payer_resources.php

Jack E. Lohman
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New studies show that more *Canadian* physicians are going back home than are heading south (and no, John, I am not going to search for the source, but if you read http://www.pnhp.org I suspect you’ll find it.)

John Fembup
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John Fembup

“John. Jeez I thought you read my blog. Go read this and weep about the fact that on the crossborder issue at least Jack is completely right.” Matt, thanks for the info (I had not started reading your blog in 2003, if that matters). Learning never makes me “weep”. BTW, the information you post does note the presence of a net in-migration of Canadian physicians to the US, marginally larger than an out-migration of US physicians to Canada. Overall, the net is negligible. That is important information, and alters the point of view I had taken from widespread media reports… Read more »

Jack E. Lohman
Guest

I have learned to trust the government players more than the corporate CEOs that would run the system you envision, Barry. The CEO has but one goal: to maximize profits and his own personal wealth. The government can screw up and send us screaming to the politicians, but they won’t kiss you off like private industry will. I’ve been very happy with my social security and Medicare; even more so than the companies I’ve investments in. I simply don’t understand the concerns expressed over a Medicare-for-all system. But all of this discussion is for naught. We are headed for an… Read more »

Barry Carol
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Barry Carol

Jack — The issue of covering the uninsured is one of how to achieve universal healthcare. Some (including you) want a single payer system while others favor building on the current system. The issue I raised is an analytical one that purports to measure and compare quality across countries using metrics like life expectancy and infant mortality. I am suggesting that there are many factors that impact on these metrics that have nothing to do with the quality of the healthcare system. As for the uninsured, figures I’ve seen suggest that about one-third are eligible for Medicaid but have not… Read more »

Jack E. Lohman
Guest

But Barry, all of your arguments are just “excuses” for not fixing our current system. Matthew and others are 100% correct that practice variations can cause rather than correct medical problems. But rather than eliminating the health care system because of it, which we have essentially done to 45 million Americans, we must fix that system with a national IT solution (God forbid we allow Medicare or the VA do it, no matter that they are the best equipped to do so. Let’s outsource it to Halliburton or Boeing.) You and I agree that a national database will solve many… Read more »

Barry Carol
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Barry Carol

Jack — In debating how to potentially restructure 16% of our economy, it is extremely important to insure that the analysis is complete and not overly simplistic. Take, for example, the issue of life expectancy, which only varies by a couple of years among most of the major industrialized countries. You said (correctly) that Japanese people have higher life expectancy even though more of them smoke. It could be due to a healthier diet and/or genetic factors. It would be incorrect and inappropriate to attribute it completely to better healthcare. People from lower socio-economic groups tend to die sooner than… Read more »

Jack E. Lohman
Guest

Barry, since Matthew hasn’t responded yet I’ll throw my two cents in, but overall I just think you are grabbing at straws to save a doomed system. >>> “1. Infant mortality statistics.” It doesn’t really matter that we are larger or more diverse, these are per-capita numbers. Canadian teenagers are typically poorer than those in the US but are not deterred from prenatal care. That is a positive. >>> “2. Life expectancy.” Japanese are heavier smokers but live two years longer than us, probably having more to do with diet than anything else. >>> “3. Canadians have more doctor visits… Read more »

Doug Gerke
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Doug Gerke

In the course of my work I’ve had occasion to familiarize myself with a number of health systems around the world on a superficial basis. Based on this work experience I think it’s fair to say: 1)most countries are grappling with health care costs rising well above the rate of inflation, wealthy nations more so. 2)There is no “free system,” nor is there an “Asian” system. There is rather a lot of variety though most countries attempt to offer universal health care. The Netherlands for one has an interesting blend of private and public provisions. 3) The Canadian system is… Read more »

Barry Carol
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Barry Carol

Matthew, Since you are a healthcare expert, could you please speak to the relevance and validity of some of the following metrics the purport to show that U.S. healthcare is lower in quality than numerous other countries despite higher costs: 1. Infant mortality statistics. The U.S. is a much larger and more diverse country than others. Such issues as poor teenagers who become pregnant may not get adequate care because they don’t go for checkups consistently even though they are usually covered by Medicaid or have access to clinics. In some of our rural areas, there may an inadequate supply… Read more »

Jack E. Lohman
Guest

John,
If the best you can do is send someone running to document their sources for a simple remark, believe what you will. If you are denying that “big bucks” would attract physicians to the US, so be it. That ANY physicians are leaving the US for Canada should be enough to concern you. That you would totally ignore the preceding comparison for such a mundane post tells me you simply want to believe what you want to believe. So do it.

Matthew Holt
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Matthew Holt

John. Jeez I thought you read my blog. Go read this and weep about the fact that on the crossborder issue at least Jack is completely right.