Average income for a craftsman in 1958 was around $4500 annually. Today it is around $60,000. Adjusted for inflation that bill is around $1500. Additionally, the standard of care is better today. Assume that improved technology increases the cost by a factor of 10, so call it $15,000 total.
According to Parent’s Magazine the average out of pocket cost for an uncomplicated vaginal birth is $5,591. The total cost (including the the portion insurance pays) is $14,768. So, maybe it did not go up as much as it seems.
This assumption is unfounded. Where does this factor of ten come from?
Out-of-pocket cost is irrelevant. The hospital bill is for the total cost. Costs outside of out-of-pocket still have to be paid by someone: indirectly by the patient through taxes and insurance premiums.
The US healthcare system is broken. It is well-established that the cost of healthcare has greatly outstripped general inflation. The technological improvements have not resulted in dramatically improved results. Furthermore, the US has the most expensive healthcare in the world without correspondingly best results. Since you are still at Ricochet, you can read my post on this topic from 2017 with statistics to back this up. Quoting myself for the benefit of those who cannot follow this link:
The US is an outlier in healthcare costs, by almost a factor of two, while delivering comparable or inferior results.
…
US performance is generally comparable to, or poorer than, countries that spend much less. I could not find any significant health metric in which the US excelled over other first-world countries.
Some commenters felt offended by these facts about the US healthcare system. Normies defend the system because they think it is free-market, whereas it is quite the opposite: dominated by government funding and regulation. Obamacare made it worse but it was already terrible.
Of course, if we went back maybe only about 200 years, the out of pocket cost for a regular birth was approximately zero … and about 2/3 of women survived the experience.
Big difference between then and now is that our ancestors were not plagued by a surfeit of lawyers, hovering around like vultures waiting to enrich themselves by suing doctors & hospitals – and thereby driving the costs of medicine in the US far above other countries. There probably was not even such a plague of lawyers in 1956. Let’s hope Elon Musk notices.
And other commentors are so set in their opinions they reject any evidence that contradicts it. I was surprised when I ran the numbers and got the result I did. I expected to see it much higher than inflation.
The vice of Obamacare and the modern medical system is more the time delays it injects in the process. You play Mother May I until it is too late for medical intervention to help. That was certainly the case with my wife and her cancer. It took so long to clear all the paperwork hurdles before she got treated, it had spread irrevocably.
And that is the real problem. The lawyers.
You are ignoring the inflationary effects of Medicare and Medicaid.
Did you know half of all pregancies in USA are covered by Medicaid?
Why are taxpayers paying for half of all pregnancies? If a woman is too poor to afford her own health insurance, we should abort not facilitate her pregnancies
Edit: since 1965 there has been an over reliance on third party payment and the third party has been the federal government
This paragraph contains zero justification for the factor 10. Why not make it 100? Those MRI machines are so cool! Then the argument is that the price is 10 times cheaper today than it was in 1956. What a bargain! You can get any answer you want via this approach.
The way to make a more meaningful and objective valuation is to show improvement in results. Expensive technology per se is useless if it does not produce better outcomes. For that, I refer you to the piece I linked, wherein the cost of medical care in various countries is compared to outcomes. Did you bother to read it? It’s chock-full of data, not conjecture.
Says the person who provided zero basis for his arbitrary choice of numbers. There was no evidence to reject. Random conjectures are not evidence. I came to my conclusions honestly, I.e., by following the data rather than by backing into a pleasing result.
The sad truth, exemplified by the 1956 medical bill, is that care was affordable enough in the mid 20th century that people were often able to pay the entire cost without insurance. The US spends a greater fraction of GDP on healthcare than any other developed country while not obtaining better results. It’s an outlier.
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The data show that other countries do it better. We don’t have to live this way.
As the old saying goes – There are lies, damned lies, statistics, and government statistics. Do other countries really handle their medical systems better?
There has been discussion in the past that – for example – the US’s statistically poorer performance on neo-natal survival is partly due to trying to save marginal babies instead of counting them as still births (which some other countries do).
On the anecdotal level, we know that the flow of medical tourists in North America is predominantly from Canada to the US, despite Canada’s vaunted health care system.
It is well understood that the UK’s once-proud National Health System these days controls costs by putting patients on long waiting lists for operations – and many patients do not survive long enough to get the life-saving operation.
Again, it is anecdotal, but my only direct knowledge of the frequently-admired French health system relates to an elderly in-law who was left to suffer painfully from eminently treatable gall stones.
More anecdotes from Filipino co-workers – medical costs there are a small fraction of costs in the US … but they are still far above what most Filipinos can afford.
A major contribution to restoring the US medical system would be to conscript every single lawyer who is getting rich off medical malpractice suits and send them to Zelensky for priority service at the front.
Sure, stats can be faked. That applies to the US as well as other countries. Maybe US stats are faked to make US healthcare look better than it actually is. In my analysis from 2017, I compared many developed countries with the US on the following criteria:
- life expectancy
- breast cancer death rate
- prostate cancer death rate
- maternal mortality
By all these metrics, the US fared worse. Four other countries were highlighted (Switzerland, Japan, Australia, and UK) but there were many others that had comparable outcomes at about half the cost. I also refer you to the two graphics linked above, which include other countries. The interesting thing about the cost curve is that the US costs began to diverge from those of other developed countries beginning in the late 1970s. One can make some conjectures about why that might be; a good candidate is Medicare. While it was enacted in the 1960s, it’s reasonable to expect a lag until many people became eligible and it came into its own.
Anecdotally, there is also a brisk trade in medical tourism from the US to India. So not all the medical tourism is in the same direction. It may be that for certain rare diseases, it’s worth traveling to the US for care.
Nevertheless, if the outcomes are comparable to US cases (viz. list of various criteria, above), one has to wonder if these anecdotes are meaningful.
Coincidentally, I have my own anecdote about the French system. An American friend has a daughter living in France who is married to a French national. One of their children has had severe medical problems and they have had superb care, according to my friend. That’s the trouble with anecdotes, eh?
Exactly! That is the impact of those evil lawyers. Medical malpractice suits put up the cost of medical care for everyone through the consequent very high cost of insurance which medical professionals & institutions are required to carry. The resulting “defensive medicine” of unnecessary scans etc further adds to the cost of medical care for everyone.
Criticisms of the high cost of US medical care are accurate – but the problem lies in the legal system (i.e. the human greed of lawyers), not in the medical system. Just as with medical care itself, proper treatment of a defective system first requires accurate diagnosis.
It’s both. The tort system is certainly part of the problem but the medical system is also broken. From the lack of price transparency to the effect of third-party payers, there are other factors besides lawyers to blame. Imagine going to the grocery store and only finding out the price of items when it’s time to pay. Next, imagine a food system in which all food purchases are subsidized for everyone in a complex, multi-party payment system. How might those elements influence the cost of food?
Furthermore, one can aim higher than merely reducing the costs by a factor of two. It’s not as if these other countries have optimized their systems; they are just less broken than the US system. But don’t worry, our betters assure us that the US has he best system in the world and that medical costs haven’t really increased at all in the last half century because we have all this cool new technology.
Healthcare and education (especially post-secondary) are unsustainably expensive. In both cases, the cost has outstripped general inflation by a large factor. They’re bubbles and, as is the nature of bubbles, they will pop.
To echo Billy Clinton, it depends on what the meaning of “medical system” is. Is the medical system the convoluted mess of government regulations and government subsidies, or is the medical system the process by which treatment is delivered to patients?
My view is that the delivery of actual medical treatment to patients in the US is mostly quite good. The administrative mess is absolutely terrible. And that administrative mess was largely created by politicians (who are mostly … lawyers) and their bureaucratic staffs (mostly led by … lawyers). You are completely correct that the administrative side of the medical system in the US is a disaster, but that is not actually health care.
We do have to wonder – within living memories, genuine health care involved doctors visiting patients in their sick beds at home; what happened?
While it’s mostly the first, it’s both. Doctors in the system are constrained by the administrative side of the system. Primary care physicians are told what they can and cannot do, which tests they can order and when — at least the ones who belong to large corporate practices, which is most of them. There is no sharp distinction between the administrative side and the practice side.
Anyhow, this leaves unaddressed the question of why the US is such an outlier in cost. Other countries also have massive bureaucracies, regulations, and subsidies. Admittedly, they don’t have as many lawyers.
To your point about the “…process by which treatment is delivered to patients,” that has also declined since the 1950s.
Milton Friedman received at least two heart surgeries. He said every subsequent surgery was more expensive which had nothing to do with medical technology and progress
Also ChatGPT outperformed doctors:
https://archive.is/xO4Sn