Infrastructure Reforms

[rj40]

There is a yearly comparison of European healthcare systems. Austria is usually among the top performers. The comparison considers all these factors and more.
I think I posted it on this board before.
Austrias is among the most expensive of the (mostly) public healthcare systems. It is still significantly cheaper though than the US option (measured in percent of the GDP). Noone ever goes bankrupt here because of their medical bills. Availability is great, wait times are short, copays are less than in the US (if there are any at all). People here have the option for an additional private insurance that covers certain cosmetic procedures (like porcellain dentail crowns instead of the standard fillings), alternative medicine treatment and it gives you things like a single bed room in hospitals (normally the bed rooms are for 6 people) or the choice if lying in a private sanatorium instead of a hospital (the doctor of your choice will perform the surgery there then, instead of the general hospital). There is worries about whether the doctor, clinic, or pharmacy accepts your insurance. You can go anywhere and have full coverage.
So basically they save money on things that are merely for personal comfort, but not on things that affect outcome.

Thanks. I'll look this up.
Now, you may have already covered this above, but to what do you attribute the trouble in Geece? What is Austria doing that Greece did not? I cannot keep track of everything above, so I am asking for a synopsis of what you think.

[Skipjack]

Greece is a completely different story and that has nothing to do with the healthcare system itself, but rather other aspects of their social system, plus the fact that they are a bunch of lazy ass bastards

[Skipjack]

Does there need to be a huge private healthcare system somewhere in the world to fund innovation and investment in order for public healthcare systems to leverage off of?

Ohhh, the great myth of the "free rider". The poor US is paying the research and we evil socialists are benefiting of it and that is why we can be cheaper. This is of course nonsense. The cost of pharmaceuticals and therapies only makes 20% of the cost of the US healthcare system. Where are the other 30% coming from that it costs more than Austrias (and that would assume that the medication in Austria is essentially free compared to the US)?

[rj40]

Greece is a completely different story and that has nothing to do with the healthcare system itself, but rather other aspects of their social system, plus the fact that they are a bunch of lazy ass bastards

Point taken.


What are your views on the problems in Greece? Many people in the American south, where I live, cannot see a difference. Health care vs welfare vs. whatever. What, in your opinion, has Greece done wrong?

[Skipjack]

Greece did so many things wrong, I dont even know where to begin. Corruption, spending money they did not have on things they did not need. Not spending money on things that they should have spent them on (e.g. infrastructure). Lying about that. Making false promises to the people. IIRC, their retirement age is the lowest in the union and I think that Austrias which is MUCH higher is too low.
Letting their cultural heritage decay. Letting their infra structure decay. Letting their tourist locations decay. Everything there is at last 30 years old and noone cared to invest into keeping things going, when they had the money to do so. Noone wants to spend their vacation in a dirty, filthy country with the shit swimming around in the sea by a dirty filthy 30 year old hotel. Compare that to turkey which is NOT in the EU and thus NOT benefiting from the EU money. There the sea is clean, the hotels are new and they all have water cleansing facilities. They actually care for the cultural heritage they have (lots of greek and turkish heritage there).
Just to give a few examples that come to my mind right now, without even doing some digging.
All that has nothing to do with the healthcare system, which IIRC is not even that great there (same aged condition as everything else there).

[rj40]

Wow. What do you REALLY think?



What do you think about Obamacare? Step in the right direction?

How far is it from the Austrian system?

Thanks for all is. Very interesting.

[Skipjack]

Obamacare is a very small step in the right direction. It is what congress left of the original plan (which was better), expecting that Obama would never sign it into law. He did it anyway (probably hoping to fix the shortcomings later). Obamacare allows me to live here with a preexisting condition and all that. It is good for the US, because I brought all my know how and I am a net tax payer...
In any case it is VERY different from the Austrian system and probably as far as it gets. Not that the Austrian system is flawless (and I would change a lot about it too). So being different is not necessarily a bad thing.

[seedload]

Does there need to be a huge private healthcare system somewhere in the world to fund innovation and investment in order for public healthcare systems to leverage off of?

Ohhh, the great myth of the "free rider". The poor US is paying the research and we evil socialists are benefiting of it and that is why we can be cheaper. This is of course nonsense. The cost of pharmaceuticals and therapies only makes 20% of the cost of the US healthcare system. Where are the other 30% coming from that it costs more than Austrias (and that would assume that the medication in Austria is essentially free compared to thie US)?

Just to be clear, I dont really think "poor US" about anything.

I just believe that if there is no free market, and demand is controlled with price fixing, then eventually the state will need to take control of supply.

[seedload]

Does there need to be a huge private healthcare system somewhere in the world to fund innovation and investment in order for public healthcare systems to leverage off of?

Ohhh, the great myth of the "free rider". The poor US is paying the research and we evil socialists are benefiting of it and that is why we can be cheaper. This is of course nonsense. The cost of pharmaceuticals and therapies only makes 20% of the cost of the US healthcare system. Where are the other 30% coming from that it costs more than Austrias (and that would assume that the medication in Austria is essentially free compared to thie US)?

Just to be clear, I dont really think "poor US" about anything.

I just believe that if there is no free market, and demand is controlled with price fixing, then eventually the state will need to take control of supply.

[Skipjack]

I just believe that if there is no free market, and demand is controlled with price fixing, then eventually the state will need to take control of supply.

Why do you think that? You do not understand how this works. The doctors decide the treatment. In some very expensive cases your physician has to get a certain (non life saving procedure) signed off on by a special doctor (Chefarzt) who is there to represent the government. They are basically there to provide a second opinion in some cases. In almost all cases they will side with the physician. Sometimes they will suggest a generic product instead of the brand, but only of the generic product has been certified (even certified to be compatible with other prescribed medicine). Whenever that happens there is usually a resulting quarrel between the chamber of medical doctors and the social insurance and then they argue for a few months and then things go back to how they were... I dont know of a single instance where any patient had an inferior treatment as a result of this.
Heck, I think that they even go waaaay to far at time with what they are paying for (e.g. boob implants for a girl that claimed to have psychological problems due to her small breasts).
Luckily these things are rare. So they do not make that huge of a factor in the overall cost, but still... It is one of the things that I have been critizising about the system.
Anyway, when a new treatment is certified in Austria, the government negotiates a deal with the provider for how much this can cost and that is what it costs. That does not lower the quality of the treatment in any way, nor does it mean that the provider will loose money. They just cant go overboard with what they are charging (like thousands for an operating room for a few hours). In addition patients always have a private option (which they have to pay for via a second private insurance, or out of their own pocket). Patients usually use that for better rooms and some alternative treatments like accupuncture homeopathy and other nonsense that is generally not approved nor certified by the medical establishment in Austria anyway.
So I do not quite understand why you get to the conclusion that the government has to take over control of the supply? Thre supply is the same here as it is anywhere else in the world. The government just does the negotiation instead of the individual doctor/hospital, etc.

[Teahive]

But you miss the main point. The persons who ought to be making health care decisions are the patient and the doctor.

At what point, do you think, should insurance come in?

Insurance should be for emergency / unpredictable situations. Universal health care should not be universal health insurance. Somehow they have become one and the same inside the USA, it's more profitable that way for the gatekeepers.

Many medical issues are unpredictable, but I suppose that's not a problem as long as cost is reasonably low. An insurance with voluntary excess would make patients interested in searching for best value treatment while protecting them from bankruptcy on a streak of bad luck.

Due to the demand being infinite the government rightly should set the price on the most common procedures / medications.

That's not really how it works in a market with healthy competition, though (no pun intended). As competitors try to beat each other's offer, the price would come down.

Demand is only infinite in immediately life-threatening conditions. Even for a procedure that could extend a patient's life expectancy from six months to a year, the patient could prefer six months in relative wealth to a year in poverty. A further problem with emergencies is that there's no opportunity for negotiation.

However, the medical market has a high barrier of entry, and it is very hard for patients to assess what they actually need. Which makes it a flawed market.

[Skipjack]

In Austria they have discovered that it is cheaper to pay for people to have frequent checkups and preventative treatments than to treat them in case of a catastrophic event. We also have quite extensive rehab programmes after such events to prevent a reoccurence and to give people the best recovery (so they can be productive again afterwards).
By paying ONLY for a catastropic event, you are sacrificing all of this and you might actually end up paying more in the end.
Just saying.

[paperburn1]

In Austria they have discovered that it is cheaper to pay for people to have frequent checkups and preventative treatments than to treat them in case of a catastrophic event. We also have quite extensive rehab programmes after such events to prevent a reoccurence and to give people the best recovery (so they can be productive again afterwards).
By paying ONLY for a catastropic event, you are sacrificing all of this and you might actually end up paying more in the end.
Just saying.

Just in from my company. we now have the Boone group for insurance to better sure you in the upcoming future.. Just in from the Boone group. Due to the cost of insurance increase with the new legislation we are taking your lifetime max of two million dollars and reducing it 15000 dollars. Personal limits are now 5000 per year. Wellness year limits are 150 dollars. prescription drugs limits to 500 dollars a year and prescriptions from dentist are not covered It goes on and on. For the same price to the employee of 7000 dollars a year we get one tenth of the coverage.
They then say "We are required by law to inform you that this does not meet the new health care standards and applied for a one year exemption and received that exemption from the regulatory department. We understand that this may not meet your needs and will help you find other health care at your own cost if possible."
Bottom line it cost more, the Boone group kicks back to the company the saving with the sub standard insurance reaping them a one year windfall of approximately 200 million dollars. and its all legal under the new Obama care laws.

[paperburn1]

In Austria they have discovered that it is cheaper to pay for people to have frequent checkups and preventative treatments than to treat them in case of a catastrophic event. We also have quite extensive rehab programmes after such events to prevent a reoccurence and to give people the best recovery (so they can be productive again afterwards).
By paying ONLY for a catastropic event, you are sacrificing all of this and you might actually end up paying more in the end.
Just saying.

Just in from my company. we now have the Boone group for insurance to better sure you in the upcoming future.. Just in from the Boone group. Due to the cost of insurance increase with the new legislation we are taking your lifetime max of two million dollars and reducing it 15000 dollars. Personal limits are now 5000 per year. Wellness year limits are 150 dollars. prescription drugs limits to 500 dollars a year and prescriptions from dentist are not covered It goes on and on. For the same price to the employee of 7000 dollars a year we get one tenth of the coverage.
They then say "We are required by law to inform you that this does not meet the new health care standards and applied for a one year exemption and received that exemption from the regulatory department. We understand that this may not meet your needs and will help you find other health care at your own cost if possible."
Bottom line it cost more, the Boone group kicks back to the company the saving with the sub standard insurance reaping them a one year windfall of approximately 200 million dollars. and its all legal under the new Obama care laws.

Final kick in the nuts, upper management is still cover under the old plan.

[ladajo]

Welcome to socialized medicine. This is part of the reason why private clinics are alive and well in the promised lands of Socialized Medicine.

It is all a bunch of crap to get those with to pay for those without. IT also provides those without with zero(even negative) incentive to become net contributors to society. A death spiral, as demonstrated by Europe, and now the U.S. and others.

'Eventually, you run out of other people's money.'