U.S. medical costs tops in world
Study: Malpractice, defensive medicine play tiny roles
By Kristen Gerencher, MarketWatch
Last Update: 7:18 PM ET July 12, 2005

SAN FRANCISCO (MarketWatch) -- Americans pay more for health care per person than citizens anywhere else in the world, doling out half again as much in medical expenses each year as the second-highest-cost country, according to a new study.

And contrary to popular belief and political rhetoric, malpractice lawsuits have little impact on those high costs in this country. Nor does the fact that people elsewhere end up on waiting lists for care that is in short supply do anything to hold costs down, according to the study published in the July/August edition of Health Affairs.

U.S. citizens paid $5,267 per person for health care in 2002, the study found, 53% more than any other industrialized country and $1,821 more than Switzerland, the nation with the second highest per-capita spending.

"What we said three years ago and still reiterate is, it's prices, stupid," said Dr. Gerard Anderson, lead author of the report and a professor at the Johns Hopkins Bloomberg School of Public Health.

"We pay for drugs, hospital stays and doctor visits 2 to 2 1/2 times as much as other countries pay."

While medical malpractice is a problem, its costs account for less than 1% of spending. And defensive medicine, where doctors run tests or do procedures to lower their chances of being sued, makes up no more than 9% of total spending, the study of spending in 30 nations found.

"The finding that litigation and waiting lists do not explain most of the higher U.S. health spending is perhaps not surprising considering previous research showing that the prices of care, not the amount of care delivered, are the primary difference between the United States and other countries," the authors wrote.

In 2001, the average malpractice award in the U.S. was $265,100. That was lower than Canada's $309,417 and the United Kingdom's $411,171 but higher than Australia's average payment per settlement or judgment of $97,014. All four nations had malpractice payments that represented less than 0.5% of total health spending.

But Canada, Australia and the U.K. are getting more litigious, and at a faster rate, Anderson said. Australia's average annual total malpractice payments from 1997 to 2001 increased by 28%, Canada's grew 20% and the U.K. rose 10% compared with a 5% increase for the U.S, the study said.

The presence of waiting lists for medical services didn't appear to account for much of the difference in spending either.

Spending in 12 countries with waiting lists for elective surgery was $2,366 per person compared with $2,696 per person in seven nations, not including the U.S., that said they didn't have substantial waits -

Medical services that require waiting lists comprise only 3% of U.S. health spending.

Drug costs and hospital stays

Americans also pay twice as much for prescription drugs than other countries that benefit from collective bargaining, Anderson said.

"They have a more uniform approach where all the insurers or all the purchasers of care get together and negotiate with the hospitals, with the pharmaceutical industry or the physicians," he said. "They have one block that's the negotiator whereas in the U.S. every insurance company is negotiating individually. It's not as powerful a negotiation."

Despite a widespread belief that Americans make frequent use of some of the best medical care in the world, they see doctors less often and spend 20% fewer days in the hospital than most other countries, Anderson said.

Americans checked in for 4.8 hospital days on average in 2003, down from 5 days in 1999 and 7.3 days in 1980, according to the Centers for Disease Control and Prevention.

"Our whole policy focus for the past 10, 15 years has been trying to reduce encounters, especially hospitalizations," Anderson said. "Why we're still focused as a country on reducing hospital days makes no sense to me."

Doctors' economic expectations after attending medical school also are vastly different in the U.S. compared with other nations because they begin their careers with a much bigger financial burden.

"In virtually no other country do you leave with an average $100,000 of debt," Anderson said. "In most other countries the debt a medical student has is either zero or very small."

"It's both a real difference and a perceived difference," he said. "A doctor feels like he or she is entitled to a very high salary because of this debt, but the reality is doctors make anywhere from $150,000 to $200,000 on average.... In no other country do they make more than $100,000."

Economic impact

Most industrialized countries saw their health spending increase more quickly than their total economic activity. Health spending rose to 14.6% of gross domestic product in the U.S. in 2002 from 13% in 1992 even as analysts credited managed care and cost sharing with holding it down, according to the study.

The gain of 1.6 percentage points was twice the median increase of other developed nations during that time.

Only two other countries spent more than 10% of their GDP on health care in 2002: Switzerland spent 11.2% and Germany spent 10.9% on medical expenditures.

Do you really want a cheap doctor? Doctors are UNDERPAID IMO.

Bump ^

Come on guys who would go to school for 12 years and work 60-70 hours a week for $100K a year.

Anyone?

People with god complexes?

If they think they are underpaid they should try teaching in our public schools system.

Underpaid?

__________________
Pxland

2001 Honda Accord

1995 Jeep Cherokee

1973 MB 280SEL 4.5

This is an entirely separate discussion, and, one worthy of its own thread.

But, I'll summarize it as follows:

I remember taking an airplane flight and sat next to a teacher from the south (Alabama IIRC). She commented about many different things and the discussion came around to teacher's salaries. She was earning about $30K at the time (again IIRC), when the local teachers here in NY were earning about $65K. She was quite convinced that she was just as good a teacher as any of them.

Now, the teachers here make about $80K (after 15 years) and most of the people with kids still have the same opinion:

"If you want to have better schools, you have to pay the teachers more money"

They equate teacher's salaries with a "better school". By their logic, if we pay the teacher $200K, their kids will be 3X more brilliant when they leave.

Please don't equate the effort required by a teacher to that required by a doctor. The teacher works 3/4 of the number of days per year and typically works 3/4 of the number of hours per day.

I don't wish to minimize the difficulty of being a good teacher. I teach balancing of jet engines on occasion and it's not an easy task. However, a doctor has considerably more responsibility, requires considerably more knowledge, and works significantly more hours.

Lets do a tiered health system, For X you can get a doctor with an associates degree and for Y you can see a real doctor.

I wonder how many docs get 90 days paid vacation?

Dang! I'm in the wrong profession.

Make that much and have summers off?!!

__________________

Current:
2014 VW Tiguan SEL 4Motion 43,000 miles.

2016 Hyundai Santa Fe Sport (wife's).

Past:
2006 Jetta TDI 135,970 miles. Sold Nov. '13.
1995 E-320 Special Edition. 220,200 miles. Sold Sept. '07.
1987 190-E 16 valve. 153,000 miles. Sold Feb. '06.
1980 300-D 225,000 miles. Donated to the National Kidney Foundation.
1980 240-D manual, 297,500 miles. Totaled by inattentive driver.

75% of OB-Gyns will be sued. Now, there are some bad OB-Gyns. Are you saying that 75% of them are bad? I think not. Teachers are protected by the union and unless they do something really stupid have job security. Doctors are under constant threat of being sued if the outcome is undesirable IRESPECTIVE of whether they did their best or not. With that in mind, how much do you want to get paid to take that sort of risk? A general practitioner makes about $150K as an average, give or take. With their malpractice insurance eating maybe half of that, and knowing that it rises quite a bit more depending on the speciality, what do you think?

__________________
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99 E300 Turbodiesel
91 Vette with 383 motor
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Then how do doctors live in multi million dollar homes if thats all they make....

You can't even pay for a modest house around here on $80k or less, and certainly not a nice one. Much less drive an $80k + car like many here do.

__________________
Proud owner of ....
1971 280SE W108
1979 300SD W116
1983 300D W123
1975 Ironhead Sportster chopper
1987 GMC 3/4 ton 4X4 Diesel
1989 Honda Civic (Heavily modified)
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Section 609 MVAC Certified
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"He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you." - Friedrich Nietzsche

This is exactly correct, with the exception of the malpractice insurance statements. A family practicioner can typically earn $150K after the practice has been established for awhile. The malpractice insurance is paid out of expenses (not part of the $150K). It's not more than $10K per year, IIRC, because there is very low risk of a malpractice case against a family practitioner. OB-GYN is a completely different discussion. The premiums are huge.

Around here a $150K salary, if reduced by 50% for insurance costs leaves $75K ..factor in student loans...etc....unless you were lucky enough to have rich parents who paid cash.

The lowest prices on houses in theis area are $425K and up...these are 60+ years old and not very nice.

you will NOT qualify for that loan on $75K a year. Rent is over $1,500 a month on a 2 bedroom condo or appartment...

I know Dr's and they earn a mighty comfortible living AFTER they pay their bills....and every one I have seen drives three times the car I dream of which is far more than 3 times what I can afford....and with my wifes income I am sufficently over that $75K number...and I barely get by.

__________________
Proud owner of ....
1971 280SE W108
1979 300SD W116
1983 300D W123
1975 Ironhead Sportster chopper
1987 GMC 3/4 ton 4X4 Diesel
1989 Honda Civic (Heavily modified)
---------------------
Section 609 MVAC Certified
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"He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you." - Friedrich Nietzsche

Exactly. Some things you just DON'T want to bargain-shop for.

Would you really want to have major surgery performed by the lowest bidder?....

Mike

__________________
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1979 300 SD
350,000 miles
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1982 300D-gone---sold to a buddy
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1985 300TD
270,000 miles
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1994 E320
not my favorite, but the wife wanted it

www.myspace.com/mikemover
www.myspace.com/openskystudio
www.myspace.com/speedxband
www.myspace.com/openskyseparators
www.myspace.com/doubledrivemusic

Like everything......you don't always get what you pay for....Thanks to the AMA who keep the butchers in business.

__________________
Proud owner of ....
1971 280SE W108
1979 300SD W116
1983 300D W123
1975 Ironhead Sportster chopper
1987 GMC 3/4 ton 4X4 Diesel
1989 Honda Civic (Heavily modified)
---------------------
Section 609 MVAC Certified
---------------------
"He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you." - Friedrich Nietzsche

Well, what's your druthers, Bone -- socialized medicine? The only thing keeping medical costs even remotely manageable here is the insurance companies. Something's f###ed up, when insurance companies seem like the good guys...

Well definately NOT socialized medicine....but some sort of controls to stem the greed....

And a central federal liscensing of doctors....so the bad ones can't move state to state.

__________________
Proud owner of ....
1971 280SE W108
1979 300SD W116
1983 300D W123
1975 Ironhead Sportster chopper
1987 GMC 3/4 ton 4X4 Diesel
1989 Honda Civic (Heavily modified)
---------------------
Section 609 MVAC Certified
---------------------
"He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you." - Friedrich Nietzsche