[rcafdm]

No, but this is addressed in my post. Australia's obesity rate is substantially lower, plus they suffer from lower homicide, drug abuse, and the like. More generally, the diminishing returns to health spending imply there's very little to believe the higher expenditure the US makes is likely to purchase appreciably better outcomes (even with different healthcare regimes).

[hdlothia]

Are you the original author? Have you done an evaluation on the financial consequences of both healthcare systems as well? Do people suffer medical bankruptcies at similar levels in our peer nations?

[rcafdm]

Yes, I'm the author of the blog (RCA). No, I haven't studied this narrow question, though it's somewhat tangential to the arguments I've advanced (outcomes; prices; aggregate costs; etc). I have, however, seen several studies that suggest "medical bankruptcies" have very little to do with medical debt and much to do with the effects of their health on their employment/earned income (also similar patterns in Canada and some other comps in the available data...)

https://www.nejm.org/doi/pdf/10.1056/NEJMp1716604

[smcl]

Going back to comparison between US and its "peer nations" though - I would imagine in this group of countries the concept of medical bankruptcy is largely unknown given that many have socialised healthcare.

For example I'm sure there are people in the UK who have turned to the private sector for treatment and in doing so incurred debts which resulted in bankruptcy. But that's such an exceptional unusual concept I'd be surprised if it occurred more than a handful of times in any given year.

[rcafdm]

The point is that almost all of what people have termed "medical bankruptcy" has approximately nothing to do with healthcare costs. It has to do with income/career disruption associated with their health, so these issues play out to a similar degree in other countries for similar reasons.

While I can believe there is somewhat higher variance in the US system in terms of bills/prices/etc, which sometimes affects people meaningfully, it's also worth pointing out that out of pocket costs aren't unusually high in the United States. I mean, we might have a slightly larger problem with these, but that's much more of an implementation detail in terms of who pays and how much than the sort of top-down policy proposals some people seem to believe are necessary (because they've badly misdiagnosed the situation or are ideologically blinkered)

[hdlothia]

Why do you feel that aggregate cost is more relevant than cost to patient? If other systems are able to have the same outcome at more affordable rates for the average patient, isn't that better.

[rcafdm]

My analysis strongly suggests costs strongly track with income levels. Relative Prices rise with income, but purchasing power also rises, so it's not necessarily less affordable relative to incomes actually earned domestically.

https://randomcriticalanalysis.com/2019/12/03/no-means-no-th...

Some people may prefer a regime that offers more insulation (socialization) from the true costs (generally overstated IMO), but that's something of a different problem with different potential solutions than the popular notion that US prices are inexplicably high or outcomes inexplicably bad where we're (presumably) likely to win-win-win if only we copy the regimes found elsewhere.

[hdlothia]

34% to 28% is substantially lower?

[rcafdm]

The exact numbers depend on the source/methodology, but all credible estimates show large differences and these differences imply large effects for mortality rates [in the broader population](https://randomcriticalanalysis.com/2019/11/07/a-tale-of-two-...).