US spend massive and massive about of money on cancer research compared to Japan, South Korea, Singapore, China and Taiwan?

[nec209]

 

If you look this in China yuan cancer treatment cost it is yuan 21,000 for bladder cancer and yuan 39,527 for lung cancer and yuan 33,376 for stomach cancer.

That is yuan 21,000 is $2,863.95 and yuan 39,527 is $5,390.64 and yuan 33,376 is $4,551.77.

So if you covert much cheaper in US dollars and the most expensive lung cancer.

 

Average costs for cancer treatments in public hospitals in China in 2021, by type of cancer 

 

 

So if you look at that in China they not making much money of cancer treatment. Where in the US it like three times of buying car or more.

 

[CharonY]

17 minutes ago, LuckyR said:

The UK is an instructive model of the difference between private pay and public pay Healthcare. One can easily Google "wait time for joint replacement in UK" and learn the difference between the NHS and private pay. 

 

Basically there's no free lunch, you get what you pay for. 

It is not that easy, though. For example, Denmark has some of lowest wait for hip replacements and it is a single-payer system. Canada and UK are just below OECD17 average and Norway with Australia, with a mixed model have longer wait times.

For the US I have seen varying times (some median values exceed OECD averages, but I have not looked in detail at their data collection), plus the fact that folks not covered by insurance likely won't get one.

[LuckyR]

1 hour ago, CharonY said:

It is not that easy, though. For example, Denmark has some of lowest wait for hip replacements and it is a single-payer system. Canada and UK are just below OECD17 average and Norway with Australia, with a mixed model have longer wait times.

For the US I have seen varying times (some median values exceed OECD averages, but I have not looked in detail at their data collection), plus the fact that folks not covered by insurance likely won't get one.

Of course Denmark has lower wait times than the NHS. It has higher income and especially capital gains tax rates and a nominal Defense dept budget. It would be criminal if it didn't. You get what you pay for. It's not magic. 

 

That's why the UK is so instructive, private pay and the NHS are within the same economic system (unlike a Denmark/UK comparo). 

Edited Saturday at 07:45 PM by LuckyR

[swansont]

13 minutes ago, LuckyR said:

You get what you pay for.

*offer not available in the US

1 hour ago, nec209 said:

If you look this

Can you provide a link to where you got these infographs?

Also you should factor in the cost of living. 

[CharonY]

3 hours ago, LuckyR said:

Of course Denmark has lower wait times than the NHS. It has higher income and especially capital gains tax rates and a nominal Defense dept budget. It would be criminal if it didn't. You get what you pay for. It's not magic. 

 

That's why the UK is so instructive, private pay and the NHS are within the same economic system (unlike a Denmark/UK comparo). 

You can make that for any other comparison. IIRC private insurance is a top up from the regular insurance and is a tiny fraction. I.e. it is not just the additional funds, but because the public system takes care of much of the basics.

Also, the per capita expenditure for health in Denmark is lower than Norway, but as mentioned, has shorter wait times. Again, the issue is somewhat complicated and generally the US is the easiest to identify issues, as it has the largest discrepancy between cost vs outcome. Obviously, investment plays a role, but also how the system is set up.

[CharonY]

4 hours ago, nec209 said:

 

If you look this in China yuan cancer treatment cost it is yuan 21,000 for bladder cancer and yuan 39,527 for lung cancer and yuan 33,376 for stomach cancer.

That is yuan 21,000 is $2,863.95 and yuan 39,527 is $5,390.64 and yuan 33,376 is $4,551.77.

So if you covert much cheaper in US dollars and the most expensive lung cancer.

 

 

Average costs for cancer treatments in public hospitals in China in 2021, by type of cancer 

 

 

So if you look at that in China they not making much money of cancer treatment. Where in the US it like three times of buying car or more.

Direct comparisons are not really meaningful and comment about making money in health care often does not make a lot of sense. For example, is health care in China a for-profit system? Or does it aim to be revenue neutral? Are there mixed elements (e.g. private hospitals vs public hospitals)? What is the difference in salaries? What is the outcome? I.e., there are many factors to consider and especially if a health care system is designed to cover cost, rather than generate profits, you cannot really apply the idea of profit (i.e., making money) to the equation.

 

[LuckyR]

4 hours ago, swansont said:

*offer not available in the US

So in the US those who have (higher premium) "Cadillac" health plan coverage don't get faster, better healthcare than Medicaid? 

3 hours ago, CharonY said:

You can make that for any other comparison. IIRC private insurance is a top up from the regular insurance and is a tiny fraction. I.e. it is not just the additional funds, but because the public system takes care of much of the basics.

Also, the per capita expenditure for health in Denmark is lower than Norway, but as mentioned, has shorter wait times. Again, the issue is somewhat complicated and generally the US is the easiest to identify issues, as it has the largest discrepancy between cost vs outcome. Obviously, investment plays a role, but also how the system is set up.

We are in total agreement that when comparing different country's health systems, that how they're set up plays an important role. 

And I have heard nothing that discounts my assertion that all else being equal, that investing more resources leads to better care. 

[swansont]

51 minutes ago, LuckyR said:

So in the US those who have (higher premium) "Cadillac" health plan coverage don't get faster, better healthcare than Medicaid? 

I’m not sure how you make the leap to get to this from what I said.

I simply meant that the US pays the most for healthcare but does not have the best healthcare ( measured by life expectancy at birth, for example), by a fair margin. i.e. overall, they are not getting what they pay for.

[zapatos]

3 hours ago, LuckyR said:

So in the US those who have (higher premium) "Cadillac" health plan coverage don't get faster, better healthcare than Medicaid? 

No, not really. They may have to pay less out of pocket or something similar, but doctors do not look at insurance as they provide health care. Based on feedback today from both a doctor and a hospital administrator, doctors do not modify the way they treat a patient based on insurance (obviously exceptions may occur). In an OR the overall outcome may be worse for those without insurance (less follow-up, prescription issues, etc) but doctors do not, say, skip an x-ray for a patient without insurance, and administrators are not looking over the shoulders of doctors.

I have been on Medicare, Medicaid and  private insurance here in the US. I kept the same doctors and used the same hospitals as I transitioned through all three. My care was exactly the same in all cases. The only differences were that for me Medicaid was the cheapest, followed by Medicare, then private insurance the most expensive.

[LuckyR]

6 hours ago, swansont said:

I’m not sure how you make the leap to get to this from what I said.

I simply meant that the US pays the most for healthcare but does not have the best healthcare ( measured by life expectancy at birth, for example), by a fair margin. i.e. overall, they are not getting what they pay for.

You said that "you get what you pay for" doesn't apply to the US healthcare system. I showed that within the US system it does. However it turns out you were only referring to comparing what the US spends compared to what other countries spend. 

As it happens, if you took the patients that the US healthcare system has to treat (a cross section of Americans) and put them in, say Denmark's system, the cost of treating them would be more than what Denmark pays to treat Danes and their outcomes would be similar to US outcomes. Because it is an error to suppose that healthcare outcome differences in the West are due to heathcare "quality", rather they're due to what the patient brings to the table. Or to put it another way, Danes are, on average healthier up front, than the average American. Just one factoid to ponder: Denmark has less than half the obesity rate of the US.

4 hours ago, zapatos said:

No, not really. They may have to pay less out of pocket or something similar, but doctors do not look at insurance as they provide health care. Based on feedback today from both a doctor and a hospital administrator, doctors do not modify the way they treat a patient based on insurance (obviously exceptions may occur). In an OR the overall outcome may be worse for those without insurance (less follow-up, prescription issues, etc) but doctors do not, say, skip an x-ray for a patient without insurance, and administrators are not looking over the shoulders of doctors.

I have been on Medicare, Medicaid and  private insurance here in the US. I kept the same doctors and used the same hospitals as I transitioned through all three. My care was exactly the same in all cases. The only differences were that for me Medicaid was the cheapest, followed by Medicare, then private insurance the most expensive.

Several things.

First, I'm glad you personally have had great medical care across various insurance plans. Though your experience is anecdotal for the purposes of this thread.

Second, Medicare (generally for seniors) has a great reputation in the insurance world, thus I wasn't referring to that.

Medicaid (generally for low income folks) has many problems. Firstly, many docs don't accept it (as insurance) since it pays them sometimes below the cost of providing care. Second, the average denial rate of Medicaid managed care organizations is more than double that of Medicare.

Edited Sunday at 08:25 AM by LuckyR

[swansont]

4 hours ago, LuckyR said:

You said that "you get what you pay for" doesn't apply to the US healthcare system. I showed that within the US system it does. However it turns out you were only referring to comparing what the US spends compared to what other countries spend.

No, I also compared outcomes. The US spends more on healthcare by a significant margin, but this does not translate to the best life expectancy. We are not getting the outcome we should get, given what we pay.

Quote

As it happens, if you took the patients that the US healthcare system has to treat (a cross section of Americans) and put them in, say Denmark's system, the cost of treating them would be more than what Denmark pays to treat Danes and their outcomes would be similar to US outcomes. Because it is an error to suppose that healthcare outcome differences in the West are due to heathcare "quality", rather they're due to what the patient brings to the table. Or to put it another way, Danes are, on average healthier up front, than the average American. Just one factoid to ponder: Denmark has less than half the obesity rate of the US.

If you took Americans and transplanted them to Denmark they’d probably start e.g. biking more, because the Danes have better infrastructure to support that, and other elements that support healthy lifestyle that are deficient in the US. But not because we lack the money.

IOW, Danes are not inherently more healthy. It’s the system they live in.

9 hours ago, zapatos said:

No, not really. They may have to pay less out of pocket or something similar, but doctors do not look at insurance as they provide health care. Based on feedback today from both a doctor and a hospital administrator, doctors do not modify the way they treat a patient based on insurance (obviously exceptions may occur). In an OR the overall outcome may be worse for those without insurance (less follow-up, prescription issues, etc) but doctors do not, say, skip an x-ray for a patient without insurance, and administrators are not looking over the shoulders of doctors.

But patients might avoid treatment because they lack sufficient insurance, and don’t want to invite the crushing debt that they might incur.

[iNow]

There’s no “might” about it. Gemini summary below to the query “percent of US residents who avoid healthcare due to costs.” Supporting links available for each.

One such link here:  https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/

 

——

A significant number of Americans avoid or delay healthcare due to cost, including:

Uninsured adults

In 2023, 46% of uninsured adults skipped medical treatment due to cost. Uninsured adults are also less likely to have a primary care provider. 

Working-age adults

In 2023, 38% of working-age adults delayed or skipped healthcare due to cost. 

Adults with employer coverage

In 2023, 29% of adults with employer coverage delayed or skipped healthcare due to cost. 

Adults with marketplace or individual-market plans

In 2023, 37% of adults with marketplace or individual-market plans delayed or skipped healthcare due to cost. 

Adults with Medicaid

In 2023, 39% of adults with Medicaid delayed or skipped healthcare due to cost. 

Adults with Medicare

In 2023, 42% of adults with Medicare delayed or skipped healthcare due to cost

Edited Sunday at 02:03 PM by iNow

[zapatos]

6 hours ago, LuckyR said:

Firstly, many docs don't accept it (as insurance) since it pays them sometimes below the cost of providing care.

I don't need to see every doctor in the country, I only need to see a handful who are close to me. Every single health insurance plan in the country is not accepted by certain doctors. It is irrelevant that many docs don't accept Medicaid.

Where I had Medicaid you picked a Community Plan of your choice. There were Community Plans that covered every part of the state. Each Community Plan covered your needs for doctors, hospitals, drugs, urgent care, emergency care, etc. You could choose your own doctor in the plan or one would be assigned to you. The Community Plans (unlike other insurance) were incentivized to keep you healthy. When I signed up I was interviewed to discuss my mental health, whether or not I would need transportation to my doctor's appointments, was given patient information about existing conditions and was offered a gym membership, among other things. ALL at no cost to me. Not a dime. For my circumstances, Medicaid was the best insurance of the three.

Medicaid has its issues, but it is not the boogeyman as it is often portrayed. There are 50 versions of Medicaid; you cannot universally condemn them.

[LuckyR]

5 hours ago, swansont said:

No, I also compared outcomes. The US spends more on healthcare by a significant margin, but this does not translate to the best life expectancy. We are not getting the outcome we should get, given what we pay.

If you took Americans and transplanted them to Denmark they’d probably start e.g. biking more, because the Danes have better infrastructure to support that, and other elements that support healthy lifestyle that are deficient in the US. But not because we lack the money.

IOW, Danes are not inherently more healthy. It’s the system they live in. 

Yes you did (compare outcomes), alas doing so presupposes that levels of health are mainly influenced by Healthcare, whereas it is influenced much more (as you later acknowledged) by lifestyle choices/opportunities and genetics. Thus the high US expenditures reflect things like profit taking, the medicolegally caused "defensive" medicine and the higher acuity of their population. 

 

I agree that Americans in Denmark might improve their lifestyle choices but if so this only underscores the reality that the US Healthcare system is burdened with treating a more unhealthy population who are destined to 1) require more (and more expensive) care and 2) end up with worse outcomes, despite the extra expenditures. 

4 hours ago, zapatos said:

I don't need to see every doctor in the country, I only need to see a handful who are close to me. Every single health insurance plan in the country is not accepted by certain doctors. It is irrelevant that many docs don't accept Medicaid.

Where I had Medicaid you picked a Community Plan of your choice. There were Community Plans that covered every part of the state. Each Community Plan covered your needs for doctors, hospitals, drugs, urgent care, emergency care, etc. You could choose your own doctor in the plan or one would be assigned to you. The Community Plans (unlike other insurance) were incentivized to keep you healthy. When I signed up I was interviewed to discuss my mental health, whether or not I would need transportation to my doctor's appointments, was given patient information about existing conditions and was offered a gym membership, among other things. ALL at no cost to me. Not a dime. For my circumstances, Medicaid was the best insurance of the three.

Medicaid has its issues, but it is not the boogeyman as it is often portrayed. There are 50 versions of Medicaid; you cannot universally condemn them.

I apologize for being difficult to understand. I'm not "condemning" Medicaid, it does an incredibly tough job pretty darn well and IMO deserves better funding to do even better. My tangential comment was that better funding leads to faster care. 

[iNow]

2 hours ago, LuckyR said:

better funding leads to faster care. 

It doesn’t always though, not by definition, and you’ve already been provided counter examples 

[zapatos]

4 hours ago, LuckyR said:

My tangential comment was that better funding leads to faster care. 

Which applies to every health system, no?

4 hours ago, LuckyR said:

I apologize for being difficult to understand. I'm not "condemning" Medicaid, it does an incredibly tough job pretty darn well and IMO deserves better funding to do even better.

My fault. I'm clear now on what you were saying.

[LuckyR]

8 hours ago, zapatos said:

Which applies to every health system, no?

Yup, as said before, you get what you pay for (within the same system).

[CharonY]

8 hours ago, LuckyR said:

Yup, as said before, you get what you pay for (within the same system).

Well, that is also not necessarily true in the US, where in some cases you pay a lot for poor coverage. Of course one can extend the argument to all levels of the system (e.g., down to different plans within the same insurer), but I am not sure how useful of an argument that is.

I think the basic point is that quality of a health care system depends on funding, but is shaped by the overall system. I.e. some can suck up money without improving care, others are more efficient in some, but less in other areas.

Plus there are areas where additional funding even within a set system, does not necessarily improve care. One area where that has been found is related to health equity, where certain investments, such as in digital infrastructure, has inadvertently resulted in worse health results in already marginalized communities.

[iNow]

55 minutes ago, CharonY said:

not necessarily true in the US, where in some cases you pay a lot for poor coverage.
<...>
shaped by the overall system. I.e. some can suck up money without improving care
<...>
additional funding even within a set system, does not necessarily improve care.

QFT

[LuckyR]

52 minutes ago, CharonY said:

Well, that is also not necessarily true in the US, where in some cases you pay a lot for poor coverage. Of course one can extend the argument to all levels of the system (e.g., down to different plans within the same insurer), but I am not sure how useful of an argument that is.

I think the basic point is that quality of a health care system depends on funding, but is shaped by the overall system. I.e. some can suck up money without improving care, others are more efficient in some, but less in other areas.

Plus there are areas where additional funding even within a set system, does not necessarily improve care. One area where that has been found is related to health equity, where certain investments, such as in digital infrastructure, has inadvertently resulted in worse health results in already marginalized communities.

A pretty good demonstration of "what-about-ism". If you want to demonstrate that adding funding doesn't improve quality, I suppose you're prepared to show that cutting funding of Healthcare doesn't erode quality. Since the main expenditure of any Healthcare system is labor costs, having fewer, say nurses, in a hospital doesn't erode quality of care? Or replacing RNs with lower cost Nursing Assistants? 

[CharonY]

1 hour ago, LuckyR said:

A pretty good demonstration of "what-about-ism". If you want to demonstrate that adding funding doesn't improve quality, I suppose you're prepared to show that cutting funding of Healthcare doesn't erode quality. Since the main expenditure of any Healthcare system is labor costs, having fewer, say nurses, in a hospital doesn't erode quality of care? Or replacing RNs with lower cost Nursing Assistants? 

You are missing my point. I did not say that additional funding does not improve outcomes, but I did say that it is dependent on the area and system. Putting money into something does not automatically benefit the outcome. As already discussed, for-profit health units often have more income (i.e. funding) but apparently do not allocate it efficiently to improve health outcome (i.e. the ratio of funding to outcome is often worse than in publicly funded units, even within a mixed system).

There were a couple of studies on the US systems showing that e.g. privately owned hospitals and care homes had higher cost, but inconsistent outcomes, for example. I.e., more money did not result in hiring more nurses.

Another one is misguided investment. I mentioned digital infrastructure, where algorithms were intended to speed up care, prioritizing treatment and overall save cost. But there have been well-documented issues where certain marginalized groups were put on the back of the line for treatments. As a results, the folks needing care most got it last, resulting in a degradation of health care for certain folks. This health inequity has degraded overall public health outcomes. As I said, the system is complicated, and it is not just a matter of more or fewer nurses.

In fact, the issue is not only systemic, especially on the micro scale it can be very challenging to figure out how health care spending is best used. One highly cited publication a while back (it was JAMA paper, cannot recall the author) showed that higher spending (down to the per physician level) was not associated with better patient outcomes, for example. Again, a lot of challenges to maximize impact per investment and depending on circumstances more is not always better. Sometimes, it is wasted and is some rarer instances, harmful.

So as mentioned, you do not always get what you paid for, as depending on what you pay into, the money might not go into improving health care. But again, if your statement is just to say that if everything is held constant, having more money is generally better than having less- it is trivially true, but also does not address associated challenges.

[TheVat]

Arguably the biggest bang for the buck in the US would be a massive change in public nutrition and nutrition education.  At this point it would probably require a benign dictatorship to get many Americans to eat halfway decent meals.  Stern admonition from doctors doesn't work too well.  A lot of our healthcare system seems to consist of duct taping up the mess after people have spent years eating junk and avoiding non motorized transport.  (the months I spent in France were a real eye-opener - most  everyone is thinner, more personally capable of mobility, and there is a collective frowning upon junk food and snacking.  In Sweden, they had Lördagsgodis, which is where everyone only eats sweets on Saturday - again, unimaginable in the US!)

[swansont]

There’s also policy; we know that pollution causes health problems, and government policy sometimes works to undermine protections that could be put in place (by framing it as regulation inhibiting business)

There was a recent story about a community that got rid of fluoride in its drinking water and saw a significant spike in dental procedures within a few years. So policy definitely has an impact on health outcomes.

[CharonY]

5 hours ago, TheVat said:

Arguably the biggest bang for the buck in the US would be a massive change in public nutrition and nutrition education.  At this point it would probably require a benign dictatorship to get many Americans to eat halfway decent meals.  Stern admonition from doctors doesn't work too well.  A lot of our healthcare system seems to consist of duct taping up the mess after people have spent years eating junk and avoiding non motorized transport.  (the months I spent in France were a real eye-opener - most  everyone is thinner, more personally capable of mobility, and there is a collective frowning upon junk food and snacking.  In Sweden, they had Lördagsgodis, which is where everyone only eats sweets on Saturday - again, unimaginable in the US!)

One thing I noticed is that in US processed foods there is way more sugar than in Europe. Also portion sizes are off. Kids get used to that esrly on and sadly the trend is also invading other countries.

[Phi for All]

11 hours ago, CharonY said:

One thing I noticed is that in US processed foods there is way more sugar than in Europe. Also portion sizes are off. Kids get used to that esrly on and sadly the trend is also invading other countries.

I know the claims that emulsifiers are nutritionally inert, but there have been any studies on how they affect the processing of liquids consumed, and that they can cause cancer: https://pmc.ncbi.nlm.nih.gov/articles/PMC7961571/

It seems our bodies don't do well when trying to separate substances that normally don't form a stable mixture. Everything about emulsifiers seems to benefit the manufacturers and distributors and stores. The consumer only gets to shake things up less.