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Off topic: Healthcare Needs Insurance Companies Like a Fish Needs a Bicycle

Great article in Freakonomics Nov 2011

Mentions a New England Journal of Medicine article which estimated 5.9 % of healthcare costs are due to insurance

This does not include

  • Cost of employees who fill and file insurance paperwork
  • Value of patients’ time spent talking to insurance companies
  • Medical procedures which are done because the insurance expects them to be done
  • Medical procedures done to minimize liability
  • Increase cost of drugs in US - some of which had been non-prescription, many others are far less expensive outside of the US

Cost of Health as a fraction of GDP has been rising very quickly in the US WikiPedia

Note that:

  • 95 cents of every 'Health Care" US dollar is spent on disease
  • The UK pays their doctors based on about 22 proactive actions the doctors do to PREVENT disease

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Notes from a nice book on the topic The Healing of America by T. R Reid 2009

Amazon has 157 rave reviews
Looks at 10+ countries way of providing health to ALL of the people
US has the worst of all of them – most expensive and least effective
Even the Swiss have private insurance – but not permitted to make a profit on basic coverage
French has electronic records card that the individual keeps
Most doctors in other countries make normal wages


  • admin cost are 1/5 that of the US
  • capitation fees – encourages proactive measures
  • NHS has many quality measures that they pay doctors by – and “best practices” awards up to $125,000 per year


  • average # of visits per year = 14.5 = 3X of the US
  • makes house calls. Generally just show up – not make an appointment
  • average length of stay in hospital 36 days (US 6 days)
  • health care cost is just 8% of GDP
  • has 3600 different health plans
  • pays insurance for unemployed or too poor
  • MRI used 3X as much as US – but machine is 1/10 the cost

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882 800px-Health_care_cost_rise.svg.png admin 13 Nov, 2011 17:54 63.79 Kb 599