Free market ideology doesn’t work for health care

/free-market-ideology-doesnt-work-health

  • The best health care system in the world? Nonsense!
    http://www.publicintegrity.org/2015/06/01/17426/best-health-care-system-world-nonsense

    To understand how foolish we are, let’s consider the war of words that recently erupted between health insurers and drug companies.

    First, though, let’s take a look at a new study that compares how much Americans pay for prescription medication compared to what folks in a few other industrialized countries pay.

    The study, released last week by the Kaiser Permanente Institute for Health Policy, showed that pharmaceutical spending in the U.S. per capita had reached $1,010 in 2012. The next highest spender was Germany at $668 per capita. Australia came in at $558.

    Am I the only one who finds it more than a little upsetting that the Germans spend 66 percent of what we spend for drugs and the Aussies spend just 55 percent?

    As the Kaiser researchers point out, those countries’ citizens get a much better deal on their meds because their federal governments have policies in place to regulate drug prices. And those nations are not alone. Every other country in the developed world has instituted some kind of price control mechanism. Except, of course, the United States.

    Kaiser’s numbers are consistent with those from a 2013 analysis by the 34-member Organization for Economic Cooperation and Development (OECD), which showed that Americans spend 40 percent more on drugs than the next highest spender, Canada.

    As PBS pointed out last year in a report on drug prices around the world, government agencies in other countries set limits on how much they (and their citizens) will pay drug makers for their various products.

    “By contrast,” as PBS further pointed out, “in the U.S., insurers typically accept the price set by the makers for each drug, especially when there is no competition in a therapeutic area, and then cover the cost with high copayments.” (Emphasis mine.)

    PBS nailed it. American insurance companies are essentially powerless when it comes to negotiating prices with Big Pharma, just as they are becoming increasingly powerless in controlling the cost of hospital care and physician services. The way insurers continue to make money is not by doing a good job for their customers but by constantly shifting more of the cost of care to those customers.

    If we were paying close enough attention to what insurers were saying during the health care reform debate, we would have realized that they are, for all practical purposes, impotent when it comes to holding down costs. All we had to do was read between the lines.

    #santé #etats-Unis #

    • Free market ideology doesn’t work for health care
      http://www.publicintegrity.org/2015/06/08/17460/free-market-ideology-doesnt-work-health-care

      In my column last week I suggested that one of the reasons Americans tolerate paying so much more for health care than citizens of any other country — and getting less to show for it — is our gullibility. We’ve been far too willing to believe the self-serving propaganda we’ve been fed for decades by health insurers and pharmaceutical companies and every other part of the medical-industrial complex, a term New England Journal of Medicine editor Arnold Relman coined 35 years ago to describe the uniquely American health care system.

      One of the other reasons we tolerate unreasonably high health care costs is gullibility’s close and symbiotic relative: blind adherence to ideology. By this I mean the belief that the free market — the invisible hand Adam Smith wrote about more than two centuries ago and that many Americans hold as a nonnegotiable tenet of faith — can work as well in health care as it can in other sectors of the economy.

      While the free market is alive and well in the world’s other developed countries, leaders in every one of them, including conservatives, decided years ago that health care is different, that letting the unfettered invisible hand work its magic in health care not only doesn’t create the unintended social benefits Smith wrote about, it all too often creates unintended, seemingly intractable, social problems.