For a lot of reasons, Healthcare is different than some of the other markets that we usually talk about. you will probably not shop around for the hospital with the best prices if you’re having a heart attack. At the same time, a hospital emergency room is not going to wait for your credit card to go through before they treat you. It would help if you had it at absolutely unexpected times. Going to the emergency room can be pretty expensive, and therefore the need for health insurance, whether it be private or public.
Private insurers periodically collect money paid by individuals or their employers in the form of premiums. Public insurance programs collect money from taxpayers. You might have heard that some countries provide “free” healthcare, but it is not free. They’re paying for it, either directly, through insurers or taxes.
Access, cost, and quality are the three criteria based on which economists evaluate the effectiveness of a healthcare system. According to the census bureau in 2021 11.4% of Americans did not have health insurance coverage. The vast majority get insurance through their employer and the rest buy individual plans. About a third of Americans had health insurance through taxpayer-funded government insurance plans.
People without insurance tend to be somewhat younger, earn less and be more racially diverse when compared with the general population. Because Medicare covers people below or near the poverty line, the uninsured are usually not completely destitute. They often work part-time or low-wage jobs. If an uninsured person gets sick or gets hit by a bus, they can easily get stuck with a six-figure medical bill. These unpaid medical expenses drive up costs for everybody.
The US spends the same share of GDP just on Medicare as most countries spend to cover their entire populations. So why does the US spend more than other countries? Some argue that it’s due to the high quality of care per person. Since insurance companies, rather than patients pay providers, patients may want more care, like tests, procedures, and treatments than necessary. It will be like an all-you-can-test buffet. An experiment a few years ago found that requiring patients to pay for a portion of their healthcare costs deters them from overconsuming healthcare.
That is one reason that in the US, many insurance plans have deductibles, a form of cost sharing where the patient is required to pay a part of the cost before the insurance kicks in. many economists say prices are also a problem. insurers pay between $100 and $300 for an MRI in most other countries. In the US, the prices are around $1500. You can go down the list of treatments and procedures and in nearly every case, US providers are being paid 3,4, or 5 times more. This is because the US needs a unified system that can aggressively negotiate with doctors, pharmaceutical companies, and other providers.
So which problem is driving healthcare costs? quantity? price? Administrative costs? When you dig into the numbers, the US consumes a significantly high quantity of tests and treatments per person. But it is not radically higher than other countries. Likewise, the US administrative costs are also higher since many counties reduce their billing paperwork with a universal insurer. US providers are paid much higher prices than their counterparts in other countries; this can be where most of the difference comes from.
The Obamacare policy has reduced the number of Americans without insurance. So, access seems to have improved. The affordable care act also has provisions meant to deal with the costs. In the end, the economic debate over healthcare is a lot like the debate over topics such as price controls, climate change, inequality, etc. So, this is a part of the American healthcare system, which is weird and expensive, and necessary.
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