>Add to your list of reasons why this could be so: "because we can" --
>how much of the "shitload" of money that gets spent on "health care" in
>the US would you say is, well, optional? Is it easier or harder to get
>discretionary health care (if you [and your insurance company] can
>afford it) in the US than in, say, Canada? At the other end of the
>spectrum, how much of these costs are for extreme care? Here's an
>interesting statistic, I doubt it's anomolous: In Tennessee's "TennCare"
>Medicare program, about 150,000 of the 1.3M covered people account for
>the majority of the spending -- and they have 5 or more simultaneous
>chronic illnesses.
Jordan, a lot of health care economists have studied this stuff to death. The US scores poorly on almost every outcome measure - for which life expectancy and infant mortality are very good proxies - despite spending massive amounts of money. Almost every aspect of health spending in the US is inflated - drugs cost more, machines cost more, docs earn more. And our administrative structure, with scads of private insurers watching over scads of providers, is horrendously inefficient, a rathole for money. We spend more public money (Medicare and Medicaid mostly) on health care than most other countries' grand total of public and private spending (and they have universal coverage).
And talk about meaningless stats - of course a disproportionate amount of health spending is going to be on the sickest people. Most expenditures on fire departments go towards buildings on fire too. The real questions are: do we have more such multiply chronics (because of poverty or lack of basic care) and do we spend more on taking care of them? I'm sure the answer to the latter is yes, but I don't know about the former.
There's just no rational economic defense of the US health care system. It's a disaster.
Doug