Why Does the U.S. Spend So Much on Healthcare? High, High Prices. 

Keep in mind that higher prices lead to innovation. Like the 4x hike in price for insulin leading to diabetics paying 4x as much for a century old drug. Gotta love that innovation.

"Don't forget to bill to the highest acuity of care." - med billing dept.

I once got an earbud stuck in my ear. Went around looking for someone with tweezers to get it out but couldn't find anybody. Went to the ER, didn't even need to check in. They used forceps right behind the desk. $1200

Yep, it's hard to admit that you're not the best at everything in the world when you've been thinking you're the best at everything in the world for a long time. My deductible for single coverage going from $250 in 2010 to $1750 in 2018 (and that's because my employer is pitching in $1250, otherwise it would be $3000) is something that I strongly believe could have been avoided. Face it, healthcare costs in the US are out of control, which they would be without the ACA too, and there is no legitimate way to justify these costs, no matter what anyone says.

Too many middle men, too many fat cats taking the cream!!

you make great videos that I enjoy watching. I have given this video a thumbs up, as well as the other videos that I see of yours. I'm also already subbed to you. Kudos again to you for these videos.

This topic can be broken down in so many ways and looked at by so many angles. Thanks for sending my mind racing like always :)

Really love the videos! Can you do a video on All Payer rate setting? It seems really interesting and not many people know about it. Maybe you could start a series on different state level healthcare systems, similar to your international playlist.

Thank you doctor for another video. John Green also had a good video about that subject. It's good that you keep up to date on the research even if it is still the same results (I only mention that because many comments seem baffled at why we need to discuss it). If it keeps being advertized that the higher US costs is due to other reasons like overuse but is indeed not true like you have shown here, it is indeed important to report it. I'm Canadian but have many disabled friends in the US so I like to stay informed. Thanks again!

Love this!

Well done.

This was refreshing. I think everyone intuitively understands that Americans are charged more for the same health (barring possible effects related to intensity of care) but this shows that analytically.

The graphic was misleading. I was expecting a comparison with other countries. And in the US, the most overpriced care is catching babies--and we get poorer outcomes as a result. Of all the developed countries the US had the highest rate of mothers dying after a birth--that has increased steadily in the last three decades. Our cesarean rate is way to high (1 in 3 instead of the 1 in 20 since constant baby monitoring during labor was made standard practice in the US--a practice that has been well-proven to cause more harm than good--but, hey, you get to bill for it and possibly a cesarean surgery as well.)

Greed is the reason why prices have gone so much up. I remember about 10-12 yrs a go when the most expensive insurance from some employers was about $400 a month with like $500 single or $1000 family deductible and was covering lot of services at 100% rate and now those insurance offers do not exist anymore with those employers. I had to turn down the insurance from my company because it would cost $500 a month with $6000 deductible and even after deductible it covers only 70% of services done and only if you stay in their network,so if i get sick or require medical procedure and i happen to be somewhere else other than my state those numbers are even more ridiculous. Shame on them,insurance companies,hospitals and US government for not regulating those prices

Me: Why are healthcare prices so high in the US? Google: 1000 articles explaining that American healthcare is so expensive because they have high prices. No shit google. What is causing the high prices? Anyone have any useful source on this?

Has any study attempted to see if there is a correlation between the rate and amount in which insurance companies pay out and the rise in prices? I have seen anecdotal evidence from Surgeons and Doctors that for certain procedures, insurance companies pay out so rarely that the few times they do has to cover the times they don't. To keep costs covered the hospitals have had to raise rates. Also since you decided to attach the providers over the pricing, did you look at reports on hospital's margins? Are they cash cows or are they sinking ships?

The American system is based on some bedrock beliefs that drive costs up: It's always better to do something than it is to do nothing and expensive care is always better than cheaper care. Neither of these is true. It's often better to do nothing and cheaper care is often as good or better than the most expensive care. If we can accept that reality, and impose price controls, American health care would be cheaper and better.

I know quite a few medical techs in various diagnostics fields. I asked one, "How many of the scans that you perform would you consider medically necessary? He said, "Less than 40%", going on to explain the private practice was deliberately milking the insurance companies for higher earnings and to pay for the high dollar equipment his practice purchased related to the scans. Conflict of Interest at its finest.

Considering the fact that health outcomes in America rank 51st among industrialized countries, I'd say this corporation is headed for bankruptcy. You didn't mention the fact that hospitals negotiate prices with third-party payers, and with a 50% reduction in fees, hospitals raise their prices by 50%. This might account for some of the increase. The fact that a third party has their hand out in each healthcare encounter might also play a role.

Is there evidence to suggest that a significant amount of higher medical prices are due factors other than just cost disease?

Could you please make the red text on the thumbnail not go to the bottom in the future? Looks like I have already watched three-quarters of the video.

“You’re not entitled to other people’s labor!” *But when you call the cops or the fire department you expect them to show up.* “I don’t want to pay for other people’s healthcare!” *But you’re fine paying for roads, schools, libraries, and social security?* “Everything should be privatized! We shouldn’t even be entitled to the services of the police!” *If we had to pay for police services out of pocket there would be chaos. Those who couldn’t afford to call the cops would be preyed upon. I didn’t know you were ok with rampant chaos and private police.*

I love you

The next time I have to go to the ER (because I can't afford to pay a doctor), I'm not bringing any ID and I'm using a false name and address. I figure the $3k I spent last time for an xray and ibuprofen should cover at least a few future visits.

The lifestyle in the USA is vastly different from Western Europe. Americans are completely sedentary. Their diets are different. Americans drive automobiles for trips less than 800 meters.

My dad is always telling me that health care is more expensive in the US because we have the ‘best’ health care. Meaning the quality of care and the innovation are better here than in countries where there is universal health care because Dr.’s are not incentivize in other countries to innovate or make better treatments for things. Is there any truth to that?

The largest driver of health- care costs at point- of - service is a rather small percentage of the population over- using a large percentage of the services and procedures.

Interesting video, but again it misses why prices have risen so high. Where I lived we have a county hospital. In its annual report is breaks down revenue by source and patient type, Medicare / Medicaid , private insurance or cash payer. This hospital gets 70% of its revenue from only 42% from one source. 24% of revenue comes 52% of the patients and the remaining 6% comes from just 6% of patients. It's fairly obvious that 6% are paying cash. Between Medicare/ Medicaid or private insurance which is the main source of revenue? It's Medicare/Medicaid. On top of that the hospital provided nearly 267 million in free charity care and still managed a 50 million profit. What has driven cost is that Medicare Medicaid have gone from paying pennies on the dollar to actually determining all reimbursements. The problem is that those reimbursements are exceeding actually cost of care. For example, Medicare states that a c section should be reimbursed at 14k. My private insurance negiotated rate was 31% of the Medicare approved amount. Every seen those back and knee brace commercials for seniors on TV? Medicare will reimburse those company's over $1200 for it while private insurance less than $280. So unless your willing to reform Medicare and Medicaid, healthcare will continue to increase in cost

Please consider discussing the Ketogenic Diet.

Its The Corruption.

And in other news, water is wet

20 seconds into First time watching Channel....... “No surprise to those who regularly watch Healthcare Triage.....” 😬

Replace "prices" with "charges". Price is just a number. Charge points to the process the price was set - who is requesting the price and how they do it.

There are two things that can bring down prices, and only two. Increased supply, or decreased demand. Everyone in healthcare knows this, and does whatever is possible to limit supply (from other people) and maximize demand. Government contributes by adding regulations, or monopolies sometimes, to further limit supply. State governments especially limit supply by imposing huge regulations on insurance companies. The only solution to the rising cost of care is to pay attention to these issues. You can personally contribute by shopping for outpatient services.

HEALTH CARE : Europe vs America WHATS IN IT FOR THE GOVERNMENTs and THE PATIENTS and why EUROPE WINS European system costs 11% of GDP against 19% in the USA EU HEALTH CARE IS ALL INCLUDED THE USA NOT & WHY SO COMPLICATED??? USA life expectancy is 42th in the world on the world ratings. WHATS IN IT FOR THE EU PATIENT? If you pay taxes, as an individual, and contribute to the central government “POT” (the community POT of money). You are covered for all treatment, hospital costs, surgery, drugs, implants, chemo, post op therapies, cost of prescribed drugs, specialist and normal GP doctors bills, specialist bills etc etc. (There are some small exceptions.) You dont have to look at the small print of coverage. Its all included, pocket your credit card.. you dont need it. You dont have to pay in advance NO Paperwork The system is rated as better than the American system as nobody is excluded and the system covers 99% of all patient needs. THE EUROPEAN SYSTEM: HOW IT WORKS: All european health systems are government run and are simple systems . It is a central, run by the govenment covering all healthcare needs for the population and is non profit , universal, and also internationally recognised between all EU countries. The EU underlying system is through fiscal residency of a person, (ie you pay into the employment tax system of the country you live and into health system, if you are registered or unemployed you are covered) Simply put, each person pays into the THE GOVENMENT POT as a % of individual pay packet contributions where you are employed Importantly even if you are unemployed, but registered, you control illegal immigration. Illegals get no benefits, unless humanitarian emergency. Importantly you are still covered. you as a patient get equal rights and coverage across Europe. The EU system is state run, and covers everyone, from birth to death and costs half of the USA system. Therefore in the USA a % of the health cost is based on profit to be paid out in dividends. Additionallly not all people in the USA are covered, (approximately 15%) Its a Bum deal for Americans. It costs 8-9% of GDP more than Europe HOW IT IS MANAGED: In America USA, the health system is profit run for the most part and privately handled. Patient care is secondary to profit for 50% of coverage. The European state (country) is the employer of all health staff, doctors, nurses, etc. Central government then covers the hospitals costs through a system which keeps the hospitals covered for the expenses of each patient. If we compare the EU to the USA structure in terms of cost to GDP, Europe average 11% of GDP to the USA 20% of GDP, (2019) with the EU at 99% coverage and with improved life expectancy rate, compared to the USA. Central Government in each country collects the money through the taxes you pay as a citizen, and redistributes it (generally) to regions ,hospitals, and doctors etc which then distributes the funds to the health system used by the patient. The Government also allows the private sector to operate under the public system, to build hospitals, run them privately. Each country allows this in different rules, like Germany/UK/France etc. They are then licence them to operate by the government. But importantly, the patient who pays to the state contributions through his salary, has equal rights to access all hospitals. 10-15 % of the EU health system is private If you wish to pay an additional supplement to the state system, you are allowed to do this into to the private scheme on top of your mandatory state payments so you get private health care coverage. But you cannot opt out of the central system or add to it. Most of people dont have the means or desire to pay private insurance policies. So the state system is better for them. WHATS THE BENEFIT Basically the EU system covers 99% of people and costs the half of the USA system. In addition to this, with the EU system, if you pay contributions to the health system in the UK or France, you can have full medical care in other countries , Germany, Italy, Hungary or any other of the 27 states etc. If you lose your job, you will still be covered. you just pay less to the system as unemployment reimbusement to you is less, so you pay less, but the more you earn at work, the more you contribute to the central system. Its based on % of earnings. These European systems are based on the old and original UK system, The National Health Service, abbreviated to NHS, was launched by the then Minister of Health in Attlee's post-war government, Aneurin Bevan, at the Park Hospital in Manchester. Aneurin Bevan, Minister of Health, on the first day of the National Health Service, 5 July 1948 at Park Hospital, Davyhulme, near Manchester. THE REAL ISSUE 1. EU Health is non political, non profit, more efficient and cheaper that the USA system, 2. BETTER in many ways, as the patient is first, and health has no “profit COST”. 3. It reduces the cost to the Government. (11% against the USA 20% per year GDP) 4. Its not fragmented. Its coverage is national, and for all. 5. If you are REGISTERED as a TAX payer, you have no problems. 6. If you are clandestine, then you get some emergency humanitarian services only. Thus the authorities know who you are and send you home after. Thanks for the comments!!!!

Y'all are getting robbed.

I think you're on the right track by looking for the cause of higher spending. So what makes prices higher? Let's see if there is mention of reliance upon third party payers or restrictions on supply or even discussion of IP law....nope. I'm quite disappointed that you instead immediately turn to price fixing. I realize that economics isn't your strong suit, but c'mon dude....as a doctor you should be looking to treat the cause and not the symptoms. Not only that but the evidence consistently shows that price controls don't work. They always come with unintended consequences.

Solution in a word: capitalism

in a word, capitalism

Why does being healthy have a cost in the US? Were people healthy before modern healthcare? How do you stay healthy without accruing debt? These questions are rhetorical. "Good health" costs because we destroy the clean food, water, and air we have for free, at a cost..

I hope to see you mention that price controls have failed in many states like Maryland and that price controls in foreign countries leave Americans to subsidize the difference. Furthermore, I hope to see mention of incentives of third party payers causing price increases. A $20 flu shot with cash turns into a $400+ insurance charge. I'll see if this episode is economically literate. reason.com/archives/2013/03/20/why-price-controls-wont-fix-american-hea#comment

Democrats and socialists that's what happened.... #MakeAmericaGreatAgain where is ronald when you want him??