Don’t Do It Like the Japanese
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The Washington Post this weekend ran an interesting but rather mixed-up report on the Japanese health care system and whether something like it could, or should, be adopted in America. The Japanese live longer than Americans, their health care system costs less, and they have full choice of doctors. What’s not to like?
Well, there’s this: “Statistics show that the Japanese are much less likely to have heart attacks than people in the United States, but that when they do, their chance of dying is twice as high.”
A lot more than just the quality of medical care goes into longevity. Violent crime and war, for example, tend to drive down the average life span, and the U.S. has more of both. Diet and demographics are also important, of course. An apples-to-apples comparison such as how patients in each country fare after heart surgery suggests that the Japanese medical system isn’t nearly as good as the lede of this WaPo article would like us to believe.
I’m afraid you are never going to an apples-to-apples comparison to other countries because they are in fact different countries.
So a smart person tries to find the characteristic of the different system and tries unifying principles on what works.
Do they look at the number of doctors per 100k? Most places that have lower prices have higher number of doctors per 100k population…duh.
Hospitalization cost less when there are more hospitals and beds.
So this entire discussion is pointless until we get a new banking system working so we can start building the basic infrastructure and training the people needed to deliver the care.
Want to fix health? Here’s how?
1. Kill the Fed. End the War (now there’s some real savings!).
2. Build 2000 Hospitals and train 1 million new doctors nurses, PAs, and medical equipment technicians.
3. Ban HMOs, Repeal the HMO Act of 1973 and Medicare part D.
4. Replace HMOs and Insurance with non-profits under Hill-Burton standards.
5.Break up the Cartels and end Corporate protectionism.
Do these 5 things and the problem is solved but don’t expect anything from the District of Criminals.
(1) is quite nice, but then you lose me.
Since our present facilities are not overcrowded, (2) is designed to bring down prices, apparently, but supply exceeding demand only pushes prices down when the profit motive is in play. I hardly think your new non-profits (4) will compete to make money, and the desire to make money is the only reason why supply pushes prices down. Empty beds and (inferior new) doctors alone won’t do it. My saying that is the closest thing in economics to a scientific fact. Your combination of (2) and (4) is quite actually the same as an attempt to make ice melt by lowering the temperature. You can’t get there from here.
I’d like to see the cartels broken up, and it would be better if the system weren’t controlled by self-protecting corporations. It might even be good if some incentives were set up to push more hospitals into the non-profit sector. But there is no way that raising supply will automatically lower prices in the absence of for-profit competition. If there were ten thousand times as many pickles on the market tomorrow as there are today, but none of the people selling them had any incentive to move them, the result would be that prices stay the same.
@Septeus7 – I agree. Well said.
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http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
Life Expectancy – 84 yrs
Province of mainland China (Macau)
Life Expectancy – 82 yrs
Andorra, Japan
Life Expectancy – 81 yrs
Singapore, San Marino, Province of mainland China (Hong Kong)
Life Expectancy – 80 yrs
Gibraltar, France, Switzerland, Sweden, Australia, Iceland, Canada
Life Expectancy – 79 yrs
Italy, Monaco, Lichtenstein, Spain, Norway, Israel, Greece, Austria, Malta, Netherlands, South Korea, Luxemborg
Life Expectancy – 78 yrs
New Zealand, Germany, Belguim, United Kingdom, European Union, Finland, Jordan, Puerto Rico, Bosnia/Herzegovina, Bermuda, Saint Helena, United States
with 145 countries below the US
World average is 65.8 years
THERE IS NO WEIGHTING for AUTOMOBILE DEATHS, MILITARY DEATHS, RACIAL DIFFERENCES
The United Nations says that each country was responsible for reporting it’s own statistics, and the collection methods may have been different from country to country.
LIBERALS WILL TELL YOU it is ASSUMED that the differences in life expectancy is due ENTIRELY to HEALTH CARE.
So when you are told that the US has bad health care, because 44 countries have a better life expectancy, remember:
Liars use statistics. Fools believe them.
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10 most populous Countries in the world:
Country, Population, UN Ranking in Life Expectancy
1 People’s Republic of China 1,332,100,000 (Ranks #103 life expectancy)
2 India 1,166,980,000 (Ranks #145 life expectancy)
3 United States 307,026,000 (Ranks #45 life expectancy)
4 Indonesia 230,781,846 (Ranks #135 life expectancy)
5 Brazil 191,608,000 (Ranks #114 life expectancy)
6 Pakistan 167,038,500 (Ranks #164 life expectancy)
7 Bangladesh 162,221,000 (Ranks #167 life expectancy)
8 Nigeria 154,729,000 (Ranks #204 life expectancy)
9 Russia 141,868,000 (Ranks #157 life expectancy)
Thanks, Mr Swartz.
So in terms of size, our peers countries would be Indonesia, Brazil, and Pakistan? Are there any life expectancy numbers for Europe as a whole? The total population may make Europe a peer area as well.
Quote MattSwartz: Since our present facilities are not overcrowded, (2) is designed to bring down prices, apparently, but supply exceeding demand only pushes prices down when the profit motive is in play.
You are wrong there is massive overcrowding and the number of beds per 1000 has been dropping since the 1970s from 4.5 beds per 1000 to now 3 per 1000. In the 1970s we had over 7000 public hospitals now we have less than 4800. The number of health care workers has dropped from 200 per 100,000 to now less than 150 per 100,000.
See http://www.shepscenter.unc.edu/research_programs/rural_program/maps.html#cah.
and http://www.larouchepub.com/eiw/public/2009/2009_10-19/2009_10-19/2009-11/pdf/54-57_3611.pdf
This take down of the health care infrastructure mirrors the take of US domestic industrial capacity per capita. What economist preaching to us about “free trade” and the “new economy” didn’t mention that is that without a first world industry you can’t have first world medical care.
Quote from MattSwartz: “I hardly think your new non-profits (4) will compete to make money, and the desire to make money is the only reason why supply pushes prices down. Empty beds and (inferior new) doctors alone won’t do it. My saying that is the closest thing in economics to a scientific fact.”
Unfortunately, your so-called scientific fact completely ignores all real history and experience. Under Hilton-Burton we build hospitals and trained lots of doctors and nurses and surprise, surprise the cost went down, access went up, and health statistics improved, and many disease where eliminated.
Only when the idiot Nixon forced everyone off the non-profit public hospital system onto the “free market” make-profits-by-cost-cutting HMO system did prices start going through the roof.
You are also wrong about the profit motive as the Swiss reform of their system to a non-profit system has proved. They still compete for customers even though by law they cannot make profit from basic care and surprising the economists the Swiss private health insurance companies are now better off as non-profits than they were under the for-profit system because they now invest in actual physical capital (to get customers) rather monetary “capital” and their stock value.
The value of health care is in the providing of physically effective service not stock prices or money “capital.” The only moral profit in health care one serves the health of the patient not the wallet.
In fact and I’m going all Distributist but all industries could benefit if they switched from business models from making money to providing physically meaningful services and products because the only real profits in a human action are ones that have physically measurable benefits to other humans regardless of monetary value of that action in a market says. Every smart investor knows never ever to listen to the market cause when the market says get in you get out and when market says get out you get in because the market made of 99% pork and pigs get slaughtered.
The truth is that only people that only interested “money profits” are crooks and in my idea of a free market they don’t exist.
Quote from MattSwartz: It might even be good if some incentives were set up to push more hospitals into the non-profit sector.
That was exactly what the Hill-Burton standard was until Nixon while listening to ChicagoBoy followers of economic crackpot Milton Friedmen decided that was “Govmint inference with the free market.” Hill-Burton, in the tradition of FDR reforms, required every hospital receiving state funds to provide a certain amount of free care and thus we had charity hospitals.
Swartz: But there is no way that raising supply will automatically lower prices in the absence of for-profit competition.
If you mean by “for-profit” money then you are totally wrong. The profit in medicine isn’t determined by the prices a doctor or hospital can charge but by the value of service provided to the patient. Increasing supply by definition increases profits because in health care demand takes care of itself because we are mortal and somewhat fail creatures and thus more care provide the more profit for everyone.
You fail to understand the difference between commodity economics and service economics. Health care is a service not a commodity and therefore all market dynamics that apply to commodities (i.e. products of labor) do not apply to a service (labor). Most Austrians make this mistake and treat labor like’s a commodity rather than people because health care is labor so an increase in the supply of labor while demand remains constant or rises will result in lower prices and because the demand for health care will always remain constant because it is non-voluntary necessity (like going to court) and therefore any increase in supply will lower prices QED.
Think of it this way, imagine how cheap health care would be if we produced doctors like we do lawyers. It would be unbelievable.