The graphs embedded above are from a document prepared by the International Federation of Health Plans, an organization for insurance industry personnel in several countries.
These data are discussed in an article by Ezra Klein at the Washington Post, with a link to a pdf containing these charts and many more.
These are VERY misleading.
ReplyDeleteFirst: The "range" on the US price only is a bit of a trick. It makes the US price look very large. What is the range in other countries? Also what do they mean by average/low end? By definition the average is not the low end. I would like to see standard deviations around the mean.
Second: These prices are not normalized to % of GDP.
Third: There is no information on the methodology used to generate these numbers (might be why each graph says "for illustrative purposes only" which Klein cuts out in his article but can be seen here or in the original set that he links to)
This is definitely the biggest problem. Do the graphs account for only out of pocket expenses for the consumer? Do they account for the fact that the comparison countries subsidize these prices with tax money? This is not a trivial point either considering Germany, for example, has a mean income tax of over 50% compared to the US below 30%.
Now these do not mean that we don't have a cost problem with health care but they certainly don't mean we do. These graphs are very sensational but not very convincing. There are also many other confounding factors such as wait times for treatment, quality of care, etc. which can be debated endlessly.
Bottom line is that pretty much ever single person in those other countries is covered by health care and not subjected to life crushing bills. Whereas we in the U.S. leave millions uninsured and others bankrupt. 'nuff said.
ReplyDelete@A. Fisher - I'm not exactly disagreeing with you, but I guess I don't understand why health care costs should be "normalized to % of GDP."
ReplyDeleteIt would seem to me (I'm no expert) that such a normalization would be used to compare whether a given country as a whole is spending appropriate amounts on healthcare. But it doesn't address the question of how much the individual has to pay to care.
If you want to normalize these data, I would think they would be adjusted according to average household or individual income for persons in each country.
@the first post: 50% plus tax rate in Germany is bollocks.
ReplyDeletehttp://de.wikipedia.org/wiki/Einkommensteuer_(Deutschland)
It went below 50% in 2000 and even with the 'Solidaritaetszuschlag' (which is meant to be used to have the eastern part of Germany brought en par with the western one) it maxxes out at around 48%.
and your question about the 'range': There is none. The doctors have list prices for anything they do, the only thing you can do to pay extra is if you go to the hospital and want a single room and treatment by the head of the department.
Since you are forced by law to have health insurance, there is just no going broke because of medical emergencies. Depending on your contract, you might have to pay up to a certain threshold by yourself (it is cumulative for the whole year), after that threshold it is covered by the insurance.
As a last note: 'Regular' treatment is covered, if you want extra-flamboyant stuff, there is cutoffs. An example would be glasses. I had mine made with extra light glass, and de-mirrored (less reflection, don't know the exact english term) and took a rather cheap frame, alltogether it was about 150 Euro.
If you go for a gucci frame that is 600 euro alone, it will of course not be fully covered. I would have to check my insurance conditions, but I believe they pay up to 300 euro for your glasses or so.
same anon again: the 'mean' income tax of over 50 percent is an even bigger lie. The first almost 8000 Euro of income are not taxed at all, after that it starts at 14% and progresses to 42 % and then 45 if you make more than about half a mil. If you earn less than that half mil, thanks to the progression of the tax rate, your actual tax rate will be 35%.
ReplyDeleteActually, there is quite a range of, for example, physician or hospital prices even on a 'fixed schedule' as different insurances arrange for steep discounts for many things; however, the uninsured, who usually can least afford it, are usually billed the full freight.
ReplyDeleteThe Dutch situation is similar to the German, as far as I can see, and here, too, tax rates are progressive up to 52%. But that's including social security, and in the US there are additional state and federal taxes and I understand your real estate taxes are much higher than ours. Read Going Dutch - How I Learned to Love the European Welfare State (NYT) and see that the average US citizen also pays around 50% of her income in taxes. Without the benefits.
ReplyDeleteIs there a chart showing relative malpractice insurance premiums?
ReplyDeleteThis should include the amount a veterinarian charges for the same procedure...stitching a human costs about ten times as much as a cat (the cat got general anesthesia, I had to make do with local) and a cat pacemaker is about 1/50 the cost of that for a human.
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