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

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

UK

• 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

Japan

• 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