Why Are American Health Care Costs So High?

[@cbekaroglu]

I am a healthcare economist, and I am not sure what your profession is, but every single thing you said in this video is CORRECT. It sums it up all very nicely and it is actually fun to watch. Thank you for the effort!

[@eggbertjohnson2591]

Ah yes like the part about how the government incentivizes competition and not the free market, and how the reason Medicare has the lowest prices is also because of competition 🥴🥴

[@StellaBella488]

Lol I will watch the video a 2nd time since it has regard. Thank you 😂✌🏽

[@Chunky915]

that’s a job? what do you even do? 💀

[@alexobery9813]

​@@Chunky915 it's very simply in the title of the job, quantify and interpret the movement of money and resources in the healthcare industry.

[@kelseybisset88]

Lol, John is a young adult novel writer. But he is very smart.

[@jwhite984]

Nine years later and this is still a huge issue...coming from someone who just had a small bone spur removed from my foot in an out-patient procedure and they apparently billed my insurance company for $27,000. Thankfully I have insurance but I still have to pay a few thousand of that.

[@TheHorseshoePartyUK]

As a Brit I hate to say it but it is extremely unlikely the USA will ever end up with a true NHS. It's a shame, because with your resources it would be 10 times better than ours is. Even as it has been mismanaged the last 13 years. It was in great shape in 2010. However, there are some real issues with trying to bring it in USA. The sheer struggle of administrating it across such a huge country. Also things happen over there like little old ladies taking it upon themselves to feed wild crocs / gators. Other people who think Liberty = having no self-responsibility whatsoever. I'm a Social Market / Democrat; and even I don't want to pay for such people. We also have these people, but not much in the way of dangerous wild animals except city centre brits on a weekend so less of a liability on the taxpayer. TL:DR I think the best system the USA will ever get will be more along the lines of the interestingly mixed Singapore model, or Japan's system where you only pay 1/3rd of your own healthcare costs. A good balance of logical kindness from your own nation via taxation and redistribution, and also the Free Market so many of you enjoy paying $500 for some salted water in a bag for right now.

[@carstarsarstenstesenn]

I don't think it will get any better. For anyone living in the US: consider medical tourism.

[@veemacks7255]

"Thankfully I have insurance" ... I'd call that "partial insurance". A proper insurance pays for all of it. I live in a European country that doesn't have a national health system like the UK, so I have a private health insurance but the big difference is that it pays 100% of everything, without question. Any treatment, any drug, any doctor/hospital - all paid in full. I also pay less than I did when I worked in America and had one of those partial insurances with huge restrictions on where I could get treatment.

[@celestearnett-justice9121]

tis a mood. Had a 30 minute laprosocopy and ablation done recently at an outpatient center and it was like 40K I think. Still waiting to hear my portion of the bill.

[@ChadRFoltz]

I was sent to the hospital for a cardiac event, something that I have every couple of years or so--sometimes multiple times a year--and the entire visit and a single night in bed cost me at least $16,000. It was $5,000 for the overnight stay and $6,000 just for the emergency room. And all they did was give me adenosine and an EKG. They even got mad at me for bringing and taking my own heart meds. I owe my life to health care providers and have throughout my life, but it's terrifying living in a country where health care is treated like a luxury and can put people in debt simply for being sick, something we often can't control. I was born with my heart condition and now I'm forced to live with the financial repercussions of a country that makes people use things like GoFundMe to pay for treatment.

[@heatherstone4164]

Being in the health insurance industry for 15 years it is uncommon that anyone actually "get's it" super duper impressed with this channel, actually using it as a training tool for my staff. You guys RELLY know your stuff. Refreshing, in your face, honest, factual. and to the point. Great job guys.

[@Dee-jp7ek]

I never understood medicinal commercials. Are they expecting me to watch it and be all 'hey that looks neat, I can't wait for my next heart attack!'

[@tstbad59]

Lol

[@crstph]

i think its more so that the next time ur doctor recommends a medication, you’ll pick the drug name that sounds familiar because it feels more “legitimate”

[@Xandycane]

1st, I'm not a fan of them, but there IU s a reason. The original idea is based on previous bad practices. Before, a doctor might get "benefits" for recommending specific drugs that weren't the best for their patient. By allowing commercials, the patient can go in armed with knowledge about drugs that are aimed at their condition. From there, it becomes a discussion about why or why not those specific drugs and what is best for the patient. Is it perfect? Nope. But if nothing else, we now know how dangerous the drugs can be because they tell you every commercial. And those commercials taught many of us that if you know a teen or young adult suffering from depression, keep an eye on them when they start taking medication for it, just in case they become suicidal.

[@Dee-jp7ek]

@@Xandycane if they have depression we should watch out for suicidal behaviors anyway?

[@Xandycane]

@@Dee-jp7ek Definitely, but every depression medication commercial warning tells you any adolescents, teens, an young adults taking depression medication may have thoughts of suicide as a result. The adverse effect is literally to make them even more depressed. And knowing that is a good thing because it's something to watch exceptionally close fir and realize it's not, "they are better because they are on medication" thus some relief, but "they will either get better or much worse" and you're on high alert.

[@shinemperor8950]

As a Canadian with many member of my family having been through healthcare here in Canada I can say with pride, that our system works. It isn't perfect, but it does work quite well. I've had my grandmother treated for her heart, an aunt with cancer, an uncle with an ruptured ulcer and much more in reasonable and in some cases very little time. My sister had a stroke at 27. A stroke, that would have crippled her financially if she had it in the United States. In fact, the cost of the MRI's, the neurological specialist, the stays at a blood clinic to stabilize her PT/INR would have put her in poverty. To this day, every time I have to wait a few(sometimes up to 8) hours in the hospital for something, I remember that if it wasn't for the single payer system we have here, my sister would have had more than just a stroke to recover from. Today she is fully recovered and works two jobs, one full time and the other part time (she's trying to become a teacher). She NEVER complains about taxes... why? Because they make a difference. Also, she works in healthcare as well. The single payer system isn't perfect, but it protects people and is a step forward in creating a more equitable and compassionate society.

[@12345cornbread]

How long did your family have to wait for treatment? Did they have supplement policies?

[@burnyizland]

I'm from Canada. What I've been asking since 2009 is why is Canadian healthcare so inaccessible? It took me 11+ years to get a GP, during which time I became completely disabled from treatable conditions. We used to have bragging rights over America, but lately it feels like a third world country here. It's bad in every province and territory in the country and that fact has been prominently featured in the news for quite some time. I'm glad your family has been fortunate, but it's gotten pretty scary for a lot of people. People are dying waiting in emergency rooms for treatment, on waiting lists for surgeries, and from lack of cancer screening and treatment, among other things. D'oh, I just realized this is an old vid and you wrote that 8 years ago. My bad. I'll leave it here though, since it is true.

[@SeekingVirtueA]

I think your experience makes total sense and we do have issues with our Canadian system. That said, I am incredibly glad we have the system we do.Just not sure what’s needed for making it better tbh.

[@michelemartin7276]

That’s why the US Healthcare corporations are behind the privatisation of the UK’s NHS - Centene is now the largest provider of General Practice care in England.

[@DimT670]

I mean any healthcare system workd better than the us one, evident by comparing the levels of medical debts and delaying treatments in ths us vs anywhere else

[@Waterbuoyed]

Anecdote: My wife, an American who came to Canada for Med School (and stayed), had a conversation with the administrator of her 1000+ bed teaching hospital. He had hosted a conference of Hospital CEO's and was touring them around. A US administrator at one point asked where his 'billing department' was. He pointed out someone (Madge or something) behind a partition. The US administrator was gobsmacked. His billing department occupied an entire floor of his hospital.

[@zooeyhall]

"American health care is expensive because people go to the doctor too much". That's one that really ticks me off. The overwhelming majority of people will not go to see a doctor unless they truly feel sick. After all, how many people actually look forward to being admitted to a hospital? Not unless they have to go!

[@HOTRAILProductions]

There are plenty of people in Canada that go to hospital because they have the sniffles, and the cost gets racked up with each visit.

[@pennst1179]

And yet, conditional on that being true, the total cost of health care per person is still less than in the U.S.

[@HOTRAILProductions]

A lot of people receiving healthcare in the US are not the ones paying for it, nor are they even legal residents. Yes, that has a ALOT to do with excessive healthcare costs.

[@Zack_Wester]

heck I read a nightmare story about a chef that had nose bleeding, cough, dizziness you name it and was on the verge of dying of sickness, still refusing to go to the doctor/hospital and decided to still work. Health inspection that day restaurant was closed down. or in the industry oh no I stabed/crushed my toe I could go to the hospital but then I risk getting fired from my job becas I just made there days sins last accident tick over to 0.

[@joemarchand8313]

English please.....

[@bigd1223]

When I got into a car wreck a few years ago, my ER visit was $8k, paid for by my insurance. and all they did was a CT scan and gave me some pain meds. I couldn't imagine not having insurance and needing to go to the ER. This made me really feel bad for people who don't have health insurance.

[@shannond7437]

Dean M They don’t pay. Another added cost to our healthcare. And FYI the costs are “marked up” to get a higher price from insurance companies so no one without insurance should pay this amount. Also if it were not an emergency you can call or use a healthcare transparency company to give you the cost of the CT. Often two hospitals (even right across the street from each other) will have a large variance in costs for these scans. People can negotiate healthcare costs, I wish more people knew this!

[@GDKira44]

in the UK we pay upfront more for watching TV than for Healthcare

[@pattybaselines]

Yeah dude that 20% sales tax is sweet.

[@arfski]

@@pattybaselines So are those state and federal taxes, oh, and local personal taxes in the US, sweet.

[@Ampersand-rew]

I’d rather pay more for tv than healthcare any day. I also stopped paying for tv sooo just gimme healthcare

[@Brandon_letsgo]

The quality of healthcare in the UK is garbage. Indian doctors that can barely speaks english prescribes APAP for almost everything.

[@isthisjustfantasy7557]

@@Brandon_letsgo Stop talking bollocks, you don't know what you're talking about. Brainwashed fool.

[@frantic1971]

Some say "we've got the BEST health care in the world!" But what good is that? If people can't afford to use it?

[@prlsB4swne]

I'd say watch the video again, because he just said we don't have better healthcare outcomes for our money.

[@alexbrittain8970]

@@prlsB4swne I mean, we have the best medical technology and publish more research than any other country. And since most of that is from the private sector that stuff costs the government nothing. Although it is wasting a lot of money and the bureaucracy is getting in the way of competition and the free market improving itself.

[@janetplace5536]

@@alexbrittain8970 All medical technology does is drive up costs. We have a sick care system not a health care system.

[@alexbrittain8970]

@Temujin and you're basing this on what?

[@alexbrittain8970]

@@janetplace5536 what do you mean "medical technology drives up costs?" Maybe temporarily under ideal conditions but the government strangling business is hardly ideal.

[@elityre2710]

"The truth, as usual, is complex."

[@mortalkaiban]

And everyone wonders why we fear going to the hospital. BECAUSE OF THE BILL..

[@adelaidemarie]

I need to get some wax removed from my ear. It is impacted. I have no insurance. The cost of removing wax? $150.00 Is The cheapest but can't get in till January. There is a doctor who will do it next week but he charges $285.00 Looks like I'll be crossing the border into mexico where I can have it done for $20.00

[@adelaidemarie]

Done The doctor did an excellent job. Twenty dollars

[@darylgud7601]

+Adelaide Marie I need to move closer to the boarder.

[@adelaidemarie]

Daryl Gud yes I know how you feel.

[@wzzupcrazyyyy]

+Adelaide Marie had to remove wax once, couldn't hear a thing anymore after i woke up, got some ointment (2weeks worth) but only needed to use it for 5 days, then they flushed out my ear, all done in 3-5 minutes and it cost me a whopping 17 euros, live in the Netherlands. You pay about 120 euros a month for insurance and have an own risk of 320 euros a year. Still, feelsgoodman aint a thing better than having a problem and having it fixed without going in debt!

[@RyanStorey1231]

+dcareyHQvideos2 That doesn't work for everybody, sadly. At least it doesn't work for me. The only way to remove wax out of my ear is to either pay $150 dollars for my doctor to do it, or grow my pinky fingernail increasingly long and dig in there myself. Which is not the most practical method.

[@mimiHTcat]

us: pays a lot in taxes, doesn't get health care in return uk: pays less taxes and gets free health care logic???

[@TheShatteredlamp12]

+Ian Magnuson Actually as the video says (at 0:22), the US spends more taxes on health than the UK does.

[@craigspillars6729]

Well I guess you could say we get a higher quality service and treatment in comparison to countries with universal healthcare . Also population plays a role within this as well because America has 316.5 million people in comparison to the uk's 64.1 million .

[@mimiHTcat]

Craig Spillars in terms of healthcare, the united states is ranked 37th in the world and dead last when compared with other "developed" countries so...................

[@craigspillars6729]

+mimiHTcat but looking further into this , the U.K. taxes more . People who make £11,000 - £43,000 get taxed 20 % www.gov.uk/income-tax-rates/current-rates-and-allowances While people in the United States are taxed 15% with the income annually at 9,276 - 37,650 . www.irs.com/articles/projected-us-tax-rates-2016 Though I didn't convert the money you'll still see a 2 to 3 percent gap between the two . Btw I'm no expert , I'm just comparing what I find .

[@Implond]

Our government does more for us, benefits, healthcare, council housing if you're homeless. Our government spends less per person on healthcare than the US does, and we don't have to buy insurance (although insurance is available- extremely cheaply I might add- if you want to be in a nice hospital with really nice food and TVs and stuff) I'd also point out that our slightly higher taxes come with a much larger tax free bracket. You aren't taxed on the first £10,200 ($15,000) you earn at all, which means the poorest amongst us are able to focus on building savings than paying for healthcare and the like. Our system is objectively better than the US in this regard, and there is almost nothing that can prove it different.

[@timmymcdee7]

Do you think our lower life expectancy might be somehow related to how we go to the doctor less than Europeans? And is the reason we go less because it's so expensive?

[@andydavis3075]

Timothy McDonald It's mostly do to the American diet but europe is becoming just like the u.s in terms of food and diet even okinawa isn't safe.

[@jessicak6462]

Part of the reason is because life expectancy includes infant mortality rates. More American infants die than in any other country. Part of that is lack of proper pre natal care and treatment, lack of antenatal care and treatment, and how we define an infant (many countries do not include late term miscarriages/stillbirths as part of infant mortality, but US does). So since we have a super high infant mortality rate, that beings the average down for everyone. However, if you only look at the average age of death in the US vs other countries, it's comparable.

[@jochentram9301]

I'd like a source on that; US government statistics define infant mortality as "deaths (per 1000 live births) in the 1st year of life", in line with the WHO's definition.

[@paulm2467]

It's probably more that European countries spend much more time,money and effort on preventative medicine ( one example being infant mortality which , here in the uk , is very closely monitored by specialist midwives throughout the pregnancy, birth and first years)

[@joabjohnstone5217]

@@andydavis3075 no its not

[@frankontaneda8377]

watching in 2019 and still so relevant

[@farenhite4329]

And to think we got Joe fucking Biden as the democratic nominee. Can’t wait for another season of Mr.Trump..

[@MrAodunlami]

Watching in 2020 during a Pandemic and never been more relevant!

[@shemshem9998]

@@MrAodunlami every single reply in this comment section is during a worse time then before, 2020 is a true masterpiece

[@rooney3102]

This video draws terrible conclusions. Watch econ clips

[@Mustaine1ify]

@@farenhite4329 🤣🤣🤣

[@SoldierYena]

Literally everyone should watch this video. Literally. Everyone.

[@christine1902]

I don't think there are too many Indian people who think this video is useful.

[@BattlescapeExtra]

Probably not at the top of anyone's to-watch-list in Ethiopia either.

[@Cwankhede]

christine1902 Actually, it is quite informative even though I'm there.

[@crustindanglade6036]

Honestly I don’t see why it’s not that great of a video

[@arhamshahid5015]

In America we l itterally have a show where a college professor has to start selling drugs in order to pay his medical bills (breaking bad).this is how bad it is.

[@sigiluvsu]

This was my first ever vlogbrohers video :) I watched it because as a kiwi, I couldn't understand why the USA had such inefficiency and poor outcomes. 7 years and a global pandemic later, the contrast in healthcare is wider and more deleterious than ever before. I am so grateful for how our centralised system and robust free care has allowed us to present a united front to one of the biggest healthcare challenges we have faced.

[@geoffreyharris5931]

The US has the most expensive system and one that is very ineffective, and inefficient so naturally the outcomes are poor.

[@tahiti1901]

You're a kiwi?

[@gregarityNow]

You also have John Key so who’s really winning (actually don’t answer that 🙈)

[@athenadiamantidis944]

Once when I got a corneal abrasion I waited in the ER for three hours. Doctor looked at it for literally five to ten minutes, prescribed something, and I was on my way. Bill to the insurance was a little over $2,000. This was all in California. I recently went to Greece and got an ingrown toenail. Total bill for 5 trips to the ER and two surgeries was 4 Euros if I'm not mistaken. (Without insurance)

[@ΘάνοςΚολωνιας-ψ5ε]

Healthcare in us is legal extortion

[@asherujudo7383]

I have seen several videos, read a crapload of articles and listened to politicians debate this issue for years but this is literally the first time I have ever truly understood it.

[@JonathanLLauer]

Yes, this guy nailed it, though a few key points were downplayed: physician pay is a bigger piece of the overage than he mentioned. A McKinsey study in 2008 showed this-- Specialist docs make about double what their colleagues in other developed nations earn. The AMA lobbies to keep funding of residency programs too low to meet demand for new doctors. Also, docs from other nations can't practice here without massive retraining time and costs, also reducing supply of doctors, keeping their pay inflated vs other nations.

[@nicknack9828]

I just sent my application off for medicine at university (college) here im the UK. Here doctors do get paid more than average but also work a lot more hours. The trouble with doctors being paid so much in the US is 1. People be doctors for the money and 2. The inaccessability to healthcare which. If US doctors really want to help people they should cut their wages to make healthcare more accessable.

[@adstanra]

how far should they cut them? They could work for free. That would cut costs? In Canada it usually takes about 10 years of post high school education just to graduate as a family doctor ( specialists require more training). This is 10 years ( at least) of lost income and most graduates are tens ( if not hundreds) of thousands of dollars in dept. Once they graduate, they usually work far more than 40 hours per week, are heavily burdened with responsibility, and must save for their retirement. They also pay far more taxes than average and societal expectations upon them are huge( people expect their performance to always be exemplary). i suspect medical school and residency might cure your apparent naivite

[@oldslowcoach]

@@adstanra1. no one forced anyone to join the medical profession 2. flip that coin... how much should they be able to charge?

[@adstanra]

@@oldslowcoach The pay of a doctor should reflect the things I mentioned in the post.

[@davesy6969]

Doctors and nurses in the USA are paid very well, but Doctors have massive loans to pay off for their training. I know a junior doctor who has just qualified (UK) and got her first placement and she earns about £22,000 a year. The hospital also found her some subsidised accommodation near the hospital. She qualified just in time for the worst pandemic since the Spanish flu.

[@vlogbrothers]

John Green discusses the complicated reasons why the United States spends so much more on health care than any other country in the world, and along the way reveals some surprising information, including that Americans spend more of their tax dollars on public health care than people in Canada, the UK, or Australia. Who's at fault? Insurance companies? Drug companies? Malpractice lawyers? Hospitals? Or is it more complicated than a simple blame game? (Hint: It's that one.) Why Are American Health Care Costs So High?

[@climbingbunny]

As a dis-like-r of universal healthcare, you just made me like it more.

[@DILFDylF]

phonecallz2559 STOP - there might be a problem with the requested link The link you requested has been identified by bit.ly as being potentially problematic. This could be because a bit.ly user has reported a problem, a black-list service reported a problem, because the link has been shortened more than once, OR BECAUSE WE HAVE DETECTED POTENTIALLY MALICIOUS CONTENT.

[@_mr3_]

I like this, it nails most of the big first order effects. The real reasons why costs are so high aren't mentioned here by the way, and you sort of draw a conclusion not supported by facts near the end. We don't negotiate lower prices with companies not because our government isn't there as a centralized negotiator but because our government is in collusion with health care industry. Our health care here is owned by special interest formed between companies and our government, and it's special interest who ultimately sets those prices you quoted across the board, leaving you with few to no price options. They set the rules, they set the care, and they set the prices. Instead of "centralized negotiation" we have centralized collusion. That's your inelastic demand, and it has nothing to do with the economics involved. You don't need a centralized negotiator here just like you don't need one to drive down the cost of say potato chips. You just need fair competition without special interest. And if you think the government (one half of the collusion) can fix this, I'd say history (including the actually affordable care we had here in the past through private organizations) tends to differ...in fact it suggests the opposite through demonstration--highly affordable care through private means with a much more effective level and form of regulation. Remembered Sky's got a point too, Molyneux touches on some of that.

[@skullz291]

mr3 The only way you could substantiate this post is by ignoring Medicare and every other form of socialized medicine in the developed world. They are all superior, cheaper and provide better outcomes than the private healthcare systems in the United States have ever been able to. And if you think you can *artificially* create inelastic demand, you are insane. Demand for healthcare is inelastic because it's not a *choice*. You can't compete with *not dying*. You will accept whatever price is offered to you because you don't have any leverage with which to negotiate besides just skipping town and risking a civil lawsuit/collection agency.

[@_mr3_]

***** If you look at the costs of Medicare versus the private insurance that existed before the "health care industry" took things over (through organizations like fraternal orders), you'd see that private insurance costed a *fraction* of what even Medicare does. The difference is actually embarrassing. Reasons mostly boil down to the fact that it was direct interaction between large groups of patients and a small core group of health providers. The power of people was maximized, providers were still well compensated, and they were the only players involved--those with direct vested interest. The statement "[Medicare and every other form of socialized medicine in the developed world] are all superior, cheaper and provide better outcomes than the private healthcare systems in the United States have ever been able to" could not be less true when you look at private insurance in the US leading up to the mid-1900s. The facts show exactly the opposite. If a cartel forms in a sector and collectively raises its prices such that demand remains but no price, product/service, timing, or other alternatives exist then inelastic demand is "artificially" created (actually it's just created, there's nothing artificial about it). I'm not insane, that's just economics and an apparent lack of understanding of inelastic demand on your part. Inelastic demand doesn't require just products/services with no substitute as you seem to state, it requires a more general lack of demand *choice*. Demand for health care is only inelastic when that demand has no choice. Our choices have been removed not by the nature of the product/service but by the players involved. They have effectively formed a cartel. That cartel is *your government and industry working together in collusion*. If you think your government can offer a better alternative to individuals working together based on direct vested interest and mutual benefit then you are the one that is acting as though you're insane. You are ignoring history and facts in favor of your personal beliefs. I think your apparent beliefs are great and I likely share them, but there are better demonstrated ways to realize them.

[@IrishEyes1989]

Wow, this is definitely one of the most well-balanced, eye-opening explanations of the American healthcare system I've ever heard. I guess what confuses me is why it's so difficult for Americans to agree on a system of universal healthcare. As John mentioned several times, the US is the richest country on the planet. They can certainly afford to provide all of their citizens with healthcare. I am Canadian and here, as in places like Australia, the UK, Europe, & Scandinavia, healthcare is viewed as a basic human right, which it absolutely is. In the US, healthcare is seen as a privilege. If you have money, you can get the best care in the world. If you're poor, sorry buddy, tough luck! It is impossible for us here to understand how that can happen in the world's most powerful nation. This is 2014, for Christ's sake! Americans deserve better.

[@gcree20]

I am also Canadian and I agree with you. However, you have to realize that Americans are fed this pro-capitalist propaganda every single day and it starts when they are very young. Thus, as adults many of the poor have become thoroughly convinced that what is best for the wealthy somehow benefits them as well and believe this is somehow linked to their own freedom. Sadly, there are too many people making too much money off of private healthcare in the US so I can't see it ending any time soon.

[@SinHurr]

You hit the crux of the issue here: "In the US, healthcare is seen as a privilege." We have a very "screw you I got mine" attitude about many things, unfortunately. We'd be a lot healthier, happier, and wealthier if we just buckled down like everyone else and handled out business the smart way.

[@NathansWargames]

if you scaled up what the NHS spends on 54 million people £95.6billion for 2013-2014($164 billion) to what the us would need for 315 million people then you get some idea what you'd need to fund a Universal healthcare system in the US( lets round it up to 6 times the population) then Universal Healthcare in the us would cost $984 billion but since costs are higher for the drugs and wages for staff then it would be closer to $1.5 trillion for instance. the NHS spends 60% of its budget on staffing costs.

[@IrishEyes1989]

You make good points Nathan. It reiterates the message of this video, the fact that it's more complicated than most of us realise for healthcare systems to run smoothly. At the most basic level though, I think - well, I hope - that most people would agree that healthcare is a human right. With all of the knowledge and technology that we possess in this day and age, it's a tragedy that some people still do not have access to basic care. In terms of the financial costs of universal healthcare systems, we do pay higher taxes of course, but I have absolutely no problem with that. It's for the greater good. In the case of the U.S., they could take some of the trillions of dollars in government funds that go to their defence system and improve their healthcare system tenfold. As with the NHS or with our system here in Canada, it wouldn't be perfect (no system is, of course) but it would be a huge step in the right direction. I'm really happy that Obama fought so hard to get the Affordable Care Act made into law. Of course the right wingers will continue to try and sabotage it at every turn but, as with issues like same-sex marriage and marijuana legalization, they can't stop the tide that's already turning.

[@LiarraSniffles_X3]

Nathan Watts Eh, the american gov has magically managed to give banks those kinds of sums in the past, I'm sure they can do it again if they tried.

[@pearlbluesoul]

Still one of if not *the* most solid explanation and summation of the issues. Well done, good sir.

[@zeromailss]

"poor people , old people and congress people" lmao that made my day

[@chasegallagher9754]

The idea that going to the emergency room costs money still blows my mind!

[@naturegirl2110]

And it ain't cheqp neither insured or not. If insured you get a bill from the Dr stating the are out of network with your insurance company. What the hell am I supposed to do ask each Dr before the enter my or probably even the building "Doctor, Doctor are you in network with my insurance"! Too many hands in the cookie jar

[@Jsfun]

+naturegirl2110 And here in the UK, I can go to any doctor I need to and I will pay nothing.

[@chasegallagher9754]

naturegirl2110 As crazy as that sounds its not TOO different just still odd that an emergency room would cost money to me. Canadian btw and that is one of the only things that is actually FREE about our health care system also seeing a family physician is free is SOME provinces(less than half). But an emergency room, That we view as necessary and it would be inhumane to charge someone for emergency medical service.

[@chasegallagher9754]

XTheGamingBossX Yay super socialism!

[@Jsfun]

Chase Gallagher This works out really well; combined with better laws on termination, people aren't at risk of getting their lives fucked by medicine.

[@bliglum]

Only American capitalism would seek maximum profit on unfortunate people desperately trying to not die. Greed is a hell of a thing.

[@alexanderrr1825]

+bliglum It's not even capitalism.

[@bliglum]

***** It's not? What is it then?

[@alexanderrr1825]

bliglum en.wiktionary.org/wiki/creditism mises.org/library/our-money-based-debt

[@bliglum]

***** So a subsidiary of capitalism then.. Same difference, and no less troubling.

[@bliglum]

***** I gotcha. You're saying the overly inflated costs in the healthcare industry are simply a symptom of a much larger economic problem.

[@johnchessant3012]

7 years later and the only proposed fix to our healthcare system that can plausibly address the problems of inadequate price negotiation and bureaucratic inefficiencies (the two biggest problems mentioned in the video, by cost) is still regularly called 'unrealistic'

[@ForestHag]

In the Netherlands you pay somewhere between 90 to 110 euros a month to you healthcare provider. Throughout the entire year you have you "own risk", which for me is 320. Basically how this works is: you pay for your medicine and doctor appointments as you would normally do, but as soon as you have spended that 320, the rest of you healthcare is free for the rest of the year. Also, if you have an extra dentist insurance for only a couple bucks more, you can declare most of your dental cost as well (checkups are free, filling cavities, xrays and root canals are part of the 320 euros). I feel really bad for Americans for paying a lot and getting nothing in return :(

[@healthcareforallhawaii3336]

Great video. I wonder if you've covered the costs of micromanagement of physicians? 35% of health care spending in the USA is on admin costs, and the 'pay per value' system of physician reimbursement is how most of that occurs. Switching to 'pay per time' in a single payer system helps to wipe out 80% of our current admin costs.

[@jaycal1920]

Hello, I think I have the right ***********. I read an article about your conversation with ***************, was that you? I wanted to share some of my findings with you about racism, discrimination and its origins. In particular the current situation around the globe. People all think these incidents are one off occurrences by individuals but the truth is they have a large foundation and I keep reminding people about some history with Roman Catholics in Africa way back from Caesar in Egypt to Mussolini gassing Africans in the 1920 before ww2 and even the ebola outbreak in West African diamond mines and so many other events. Maltese and Italians moving into Tripoli and Libya pushing Africans out onto boats but Malta and Italy closing their borders to refugees.... You also have to realize and consider that the Roman Catholic empire has deeply established roots throughout history and humanity especially considering they have wiped out opposition through genocide, ethnic cleansing, famine and wars. Not only do they cause famines but they then ask everyone else for money to supposedly save them so people who want to help actually help the instigator not the victim. Dr Faucci ties into all of this with his 1980 aids projects. Medicating Africans making them sick while appealing for funds claiming to help them. Italian. Biggest mobs and industries and that's how they do it, and St Johns medical military Maltese and Jewish establishment. They kill people off to take assets and estates while rounding up people who want to help their victims claiming money and funds telling them they are on it. This is the deception and everyone is locked down and isolated and divided and can't do anything about it. They also own the communications, and media, police, courts etc so they can quickly identify and deal with any opposition. This is what happened on 9/11. It was a diversion, it was a way to clear out any defence who wasn't with them and focus it against other opposition. They evicted the defence force and sent them to die and those that didnt were stopped from coming back by medical with claims of PTSD and suicides. Medical military roman catholic. It's bigger than you think.

[@Backinblackbunny009]

Trillions of dollars that is going to make already incredibly rich and powerful people even richer...... so why would they ever allow that to happen?

[@Marchand848]

It’s 2018, and I’m watching a video that speaks truth to power from 5 years ago. Not a single thing has changed.....

[@jamesfriesen191]

All those reasons boil down to one - greed. Greedy CEOs, greedy shareholders, and greedy insurance and pharmaceutical companies.

[@menacedemort2878]

Still waiting for that new season of Sherlock though.

[@localtrashpatrick.8066]

TRUEE

[@GenBloodLust]

It was just announced and there was much rejoicing

[@falhasnamatrix]

Brazil's healthcare system is far from the quality of the British NHS, for example, but is entirely free, including ambulance rides. I know some Brazilians studying in the US that come back when they need health treatment 'cause the long journey ends up being cheaper...

[@joaov.m.oliveira9903]

Yes, I'd say in the country side, within cities of average to medium size the quality of health care facilities and treatment tends to be better. Many cities with 200.000 to 400.000 inhabitants have what they call "regional hospitals" which are generally administered by non-profit organizations contracted by the State or City government. Some are usually associated with a State or Federal university. Anyway, in these cities this kind of hospitals concentrate all the high cost, demanding treatments such as dialysis, transplants, oncology, many rare, complex diseases are treated there, and that is not only because the population of the city gets to be treated there, rather because the entire region might as well send their patients there for something. So these cities are average density, medium income but have an extremely good, cost-free and large scale hospital facility where you feel more secure to rely on in case you need to. I speak as the son of a cancer patient who was treated in one of these by an excellent team of specialists. My mom went to private clinics to get her diagnosis, and to the regional hospital to have chemo and surgery done.

[@mouglliakki]

In India not a lot of people have insurance, because medicine and operations are dirt cheap. My sister is a doctor in United States, but if I fall sick, I would go back to India to seek treatment. Privatization makes everything more expensive in USA.

[@neilsamuel5268]

I think you have a lot of 'anubhav' on this topic 😂

[@sowmyakaur8188]

+Neil Samuel OH MY GOOOOOD

[@Spazik86]

Hmm, maybe the reason is - everything from oil to toothbrush is cheaper in India (beacuse it is poor country)?

[@mouglliakki]

Spazik86 India is the fastest growing major economy on earth. But yes, you are right there is indeed huge amount of poverty back home. Still, whatever the reason, people have access to good quality stuff at dirt cheap prices. Even Oreos cost 75% less. And 98% of population has access to well educated doctors at 7 cents per person.

[@Spazik86]

In India it is quite a risk for civilized person even to eat (even if vaccinated against major diseases), beause of the poor hygiene standarts and dirt everywhere. So I can not imagine level of healthcare in this country, if they can not even cook, bath and shit in clean environment...

[@paddyj7690]

A recent ER visit in Switzerland cost me $411. That included a consultation with the doctor, an x-ray and full blood count. In and out in 90 minutes. A very similar visit to an ER here in Nevada cost me $2800 after discounts. And the Swiss pay a lot less tax than us.

[@Sofus.]

Perhaps it would be a smart idea for Europe. To offer people in the US treatment in Europe included a flight ticket.

[@asherrayawa2821]

Perhaps if your treatment costs were above a certain price than you could get treatment and a ticket at a lower price than usual.

[@stevencassidy6982]

I've heard of Americans coming to Britain for healthcare

[@waynehutchins2141]

It would likely be cheaper to buy a plsne ticket, than pay American healthcare cost.

[@ideeyes4054]

I have also heard of Americans going to Mexico to buy drugs cheaper. Which is kinda ironic

[@airotkiv]

@@ideeyes4054 Yeah or people going to Canada to get insulin.

[@TurlasThe6]

The answer to this video's title is one word: capitalism.

[@ayoiawe]

scyx The guy just finished talking about not using one word as the reason for the problem. How is it capitalism when the government is so far up on in it. There is competition, prices will fall. Crony capitalism is part of the problem but capitalism?

[@alfonso6558]

+scyx so now Europe is communist, right?

[@TurlasThe6]

alfonso6588 No, its Democratic Socialist with some Capitalism in the mix...which I think is the ideal system. Not sure what the fuck you're talking about...

[@alfonso6558]

scyx I was being sarcastic with my comment, but as you have seen in the video, America spends more in healthcare than most european countries, so that doesn't make America very capitalist (in comparison to Europe), and some countries like Switzerland don't have state-funded healthcare and everyone has a cheap health insurance and a better health system than in America and most of the world.

[@TurlasThe6]

Well, I more meant healthcare costs are high to PEOPLE, not to the nation itself. Sorry for the misunderstanding. So, to people, in other countries, healthcare is, in fact, less expensive, in many cases completely free. As we live in a capitalist system, we do not get much of anything free...not even freedom! Ha ha! So, that was my answer to the question at face value from the perspective of an individual, not a country...maybe that was my mistake?

[@bradjune1980]

What I got from this at the start was that a huge chunk of our taxes are spent on healthcare. Ok, but thats money being taken from another person to give someone else care. Shouldnt the question be WHY IS SO MUCH TAX MONEY GETTING US SO LITTLE RETURN.

[@ericstuewe389]

That certainly is the question. And the answer is because it's America and every big business runs free because they have all the money and our governmental leaders are scared to do what's right and lose their precious campaigns. So, there are never any laws passed limiting the power of bigs. Health care can be as greedy as they want because they can.

[@AMcGrath82]

Could you do an updated version of this?

[@shannond7437]

Alexander Scott This sadly still holds up!

[@mr.p215]

No need... nothings changed.

[@TheSavethetigers1]

Nobody should have to pay too much for health insurance! That's outrageous!

[@alexbrittain8970]

That's like saying "no one should pay for food" then how do the farmers get compensated? It's not evil, it's just basic economics. If we were to increase competition and get government out of healthcare it would be cheaper.

[@okbutatwhatcost9087]

@@alexbrittain8970 That's like comparing apples with oranges. Stupid.

[@alexbrittain8970]

@@okbutatwhatcost9087 No, because both are essentially the same. Requirements for life. Prices are simply indicators of market conditions for an industry. If there is more competition, price will go down. Saying "no one should have to pay" for something makes no sense. Nothing is free because there is no such thing as infinite of something. And because everything is limited, we must distribute it in an efficient manner. We do that through a free market system here. When something interferes with that system (i.e government), prices go up, wages do down, etc. Do you understand my point now?

[@liberalbias4462]

@@alexbrittain8970 ya but you cant shop for health care like you can shop for food. And if yoy haven't noticed we don't let people starve if they don't have food.

[@pionieresvizzero2224]

@@alexbrittain8970 and so...why in USA the Healthxare is so expensive ?

[@TomKilworth]

As a citizen of the UK (with a girlfriend who needs healthcare a lot), here're my 2 pence (see what I did there?): The National Health Service (NHS) here is great. Never have I had an issue with waiting time, quality of care or malpractice. My girlfriend has had some long wait times in London where the population is really dense, but she can avoid that by doing walk-in appointments at any other surgery outside of the city (she got an appointment the same day by going to Wiltshire, c.60min away instead) Socialised healthcare is the cornerstone of developed democracy. The poorer members of our community can get healthcare, while the wealthier citizens can still chose to go private (BUPA is the largest private provider here and it does just fine). It's baffling and, ironically, sickening to here the right wing go nuts over socialised healthcare. Mature a little, join the rest of the developed world and try it out. It's good stuff :) Oh, and the UK budget is likely to be balanced in a few years. Go figure.

[@hannahvocal]

This is why I find it baffling that people here can complain about the NHS. Yes, of course it has its faults (my doctor told me my symptoms were all thyroid related, three months later I gave birth!) but compared to the US, we have it so, so, SO much better. I still love the NHS, because at least my way-off diagnosis was free. In the US, I would have had to pay $$$$$ for their trouble. I do have a thyroid condition, for which I'm eligible for free prescriptions. I wonder how much I would have cost my family had I lived across the pond...

[@TomKilworth]

***** Exactly. Anything run by humans will be flawed, and you're right that you're no less likely to have been given the incorrect diagnosis in the US

[@remero69]

The NHS and other socialized systems benefit from the fact that the US's system is not [yet] socialized. Consider the immense leverage that the NHS has in terms of buying power for pharmaceuticals. Essentially, you can't sell drugs to the NHS for much more than the marginal production cost. This has driven nearly every UK pharma but Glaxo out of business, and forces the US to pay for R&D. It takes on average US$ 2B and 10 years to develop a drug, after which you have 7 years of patent protection left. As John said, yes, New Zealanders pay $7 for Liptor.....because American customers of Pfizer paid to develop it.

[@_mr3_]

Think of a person in London that does not have the ability to go outside of their borough for care. Think of that person having no choice but to live in a less well-off area whose available care mirrors the financial wellness of their area. They are forced to go to their local providers, who have incomparably longer waits, less access, and lower quality. All of that is only because they're not as financially well off as others living in more well to-do boroughs. That hypothetical is based on a true story by the way. Just in London alone you have a caste system for health care. Everything has a price. Without that system people may have had more access to charitable support of higher quality for all you know.

[@teethpaste]

Jonathan Lawry I find that a lot of people only consider what would make healthcare cost less for themselves and don't consider the overall impacts of changes on the rest of the industry. Thanks for your post!

[@pyrointeam]

Sorry but just because you are richer than other countries doesn't mean, that all of you are rich and can afford the costs. And why should surgery or medicine be much more expensive than it's really worth? Education and Healthcare should be free (funded by taxes) for everyone in a modern advanced civilization.

[@stvltiloqvent]

+slim shady i really feel so bad for progressive Americans, because socialism isn't necessarily bad...... why can't people tell socialism and communism apart?

[@juandoza5867]

It’s so sad that it’s still like this 9 years later

[@NotJamesWhelan]

Here's the thing about the United States though: the majority of Americans are actually poorer than the average Western European or Australian. The reason for that is inequality. So on paper America's GDP is higher per person than any large country but that's because America is the centre of production. So the people who own that production are also American. So basically you get part of the population that is so rich that what it produces lifts the average way higher. So, say, the top 20% of Americans are doing very, very well but it's at the expense of the bottom 80% because America doesn't have developed social programmes like Europe or Australia do. I've heard several economists actually refer to America as a second world country because it's more akin to Saudi Arabia or the old Banana Republics because of how much of its economy is built on underpaying the people at the bottom. If you go to Western Europe or Australia what you'll see is a lot less McMansions and big gas guzzling cars but also a lot less poverty and inequality and a lot more government programmes to support healthcare costs, unemployment insurance, free childcare, etc. This was a choice, of course. America pursued the welfare state up until the 1960s and then let it tail off big time. Whereas most European countries are still expanding the welfare state. That costs money and raises taxes. So I'd argue that GDP alone is a very poor measure of wealth. GDP + HDI + INEQUALITY INDEX would be a much more accurate measure.

[@bobrolander4344]

Exactly. Not even in Greece or Portugal can you find a single big city in ruins like Detroit. Not one. In richer countries like France, Germany or GB such poverty isn't even imaginable.

[@darinpiotrowski9056]

I found this very interesting and informative. I am a Canadian, by the way. The part about the cost for getting a colonoscopy perked my ears up as I had one ordered by a former family doctor. $1100 in the U.S and over $655 in Switzerland? I didn't pay one cent for mine. Now, I did have to wait a couple of months to have it done, but it was more preventative medicine than an actual emergency, so the amount of time didn't bother me. While we enjoy "free" health care in Canada, most of us still pay through deductions though our employer. It is not a perfect system and sometimes wait times can be a royal pain in the butt, however, I can't imagine living in a first world country without any affordable health coverage.

[@GerryMcAveety]

I live in Scotland. We get free healthcare and free education. We drink a lot more than Americans. Its better.

[@angelaorozco7108]

Watched this when it was posted way back in the day lol. But now I'm in a leadership in healthcare course on Emeritus through John Hopkins University online and here it is as part of the curriculum on healthcare spending in the US!!!! You guys have come a long way!

[@jenlokken]

Awesome and very good info...I personally loved it, I find it ironic that single biggest drags to economy here in America are two things that claim to keep us safe from harm, healthcare and Miltary spending!

[@LonghornChamp05]

***** Just because it wasn't mentioned here doesn't mean its not true… Military spending is one of the biggest (if not THE biggest) expenses in the US. Just look it up...

[@MrCyrus1677]

***** Social Security is specifically paid into by every working American. It is not an entitlement in the sense of "give me something I didn't earn but want". We pay into that account so therefore we are owed that money. Furthermore, the government owes us some money for SS as well considering all the times they've borrowed from it to pay for other federal expenditures. Blaming social security is not a good point to make when discussing where cuts should be made in our spending. Also, might want to check out how the deficit is getting smaller every year our President is in office. Seems his policies are actually taking us in the right direction financially yet most folks don't understand the difference between the national debt and the national deficit. Most everyone I work with thinks they are the same thing. They are not.

[@Vandicoup]

In what USA do you live in, exactly? Despite the military industrial complex's countless flaws and atrocities (like every other military institution out there), the legions of good and honest men and women in our military have always kept us, and innocent and defenseless foreigners, from harm for centuries and still do to this very day, both internationally and domestically. As WWIII looms ever so closer, with China eyeing a potential takeover of Taiwan and Russia and NK continuing to grow angrier and angrier with us, it is only further imperative and absolutely paramount that we continue our military spending and continue developing the latest and greatest military technologies to continue keeping us, and all our allies, safe and well protected against the evils that plague our world on a daily basis. We can't take any chances, not ever. If the USA falls, the rest of the world will surely fall along with us in short time.

[@louisiananlord17]

What disgusts me the most is that the American people cry out for healthcare reform...yet they do nothing. Money has poisoned the doctor's soul and until the state and the medical abode rise up against this Anglo-Saxon disgust of greed, nothing is going to get changed for our healthcare. John Green, thank you for standing up and thank you for speaking out on the livelihoods of the American people.

[@jesuistahmid]

the average doctor hardly gets much more than an average one in canada. it's the health insurance and health care "industry" (yea because they use people's lives as leverage for their prices) that make all the money... the doctors are loser, and the patients are the biggest losers.

[@louisiananlord17]

Medical bureaucrats will be the death of us all.

[@louisiananlord17]

I agree, the US needs this centralized negotiation too.

[@mitchsmith9833]

can you explain how money has poisoned every doctor's soul? doctors are getting payed less and less every year.

[@louisiananlord17]

Then why don't doctors step up and do somethign about this. In the US, if you don't have private insurance you are either dead or in perpetual debt. They know this is going on yet they do nothing. That's why it is poison.

[@andrewmorisseau2575]

Wow, the best explanation of our health care mess I've ever heard, and I didn't sense a hint of political slant in your video! Well done, God bless!

[@janicewallace3728]

I would like to add that you left out people who live with long-term permanent. Like myself. Public assistance health insurance is the only coverage I can get. Needing in-home daily assistance and regular electric wheelchair repairs is expensive. So-called insurance companies don't pay for long-term, permanent care. So I depend on Medicaid and Medicare. As things become more for profit, in home care agencies and repair companies, the poorer the care becomes. It is a daily struggle.

[@markfudge5642]

I live in the UK, The NHS (national health service) is the pride of the nation. Is it perfect ? no it is not, but what it is is all incusive, you will be treated for every illness and some programs e.g. IVF and some plastic surgery are also free. We all get seen, it may take a little longer for non emergency treatment but if we do get very sick we are treated quickly and expertly. Those well off can use private health care if they want to pay. A healthy nation is good for the economy as our workers get the help they need quickly, so less time off. I could not bare to live with the healthcare insurance in the USA. You may loose your house you future just because you are ill.

[@alexanderrr1825]

+Mark Fudge "IVF and some plastic surgery are also free." Avoid using that word. Nothing is free in this world. Be happy that the multitude chipped in. Such a system works because the majority of people are in good health.

[@coltennabers634]

+Mark Fudge The funny thing is, you will actually pay MORE for your healthcare, which will be of lesser quality than that of a private system. Why? Because you must pay for this service your entire life, whether or not you use the service at all, and at whatever quality and expediency the state deems appropriate. And you will be paying not only through income taxes, but taxes on goods as well - increasing the price and consequentially lowering your standard of living. While I will only pay for private insurance - whose yearly cost is considerably lower, and gives me access to much higher quality and expediency - and more importantly, I get to spend the money I earn at MY DISCRETION. But hey, it's free.

[@markfudge5642]

Poliphodiles UniteI sorry but you may have better health care, but thaqt is just you as a nation the USA pays more gdp on healthcare than any other nation and for that extra spend you have a worse life expectancy, add on to that the illness lottery causing bankrupcy to many american families because they could only afford a cheaper medical insurance. I will take my health service free to all, fair and so much better than the no health insurance for the 45 million in the usa.

[@coltennabers634]

Mark Fudge As an American citizen, I can promise you, all you are doing is regurgitating propaganda from the left meant to scare you away from free markets and I would seriously question stats passed by institutions who have an agenda - like the WHO - just as I would question stats passed along by the Cuban government which states, according to them, that their healthcare is vastly superior to the united states. Meanwhile, people are trying to flee Cuba on makeshift rafts to ENTER the US to have their babies and so on. Do you seriously believe more infants are dying in the US than are in Cuba? Nonsense. But even with all that considered, the US left free markets in healthcare many years ago. The high prices are not a result of competition and free markets, high prices are consequence of a LACK of competition and free unregulated markets.

[@coltennabers634]

Mark Fudge But even with all that considered, you are talking about *on average*. You missed the fact that I have the option to spend *zero* on healthcare if I absolutely wanted to. I am young, there is no need for me to purchase any healthcare coverage, and I should have that option if I so choose. The state is not your master, slave.

[@Bubbles-lp2cv]

John makes a point that we pay so much in health care because everything costs more. I find it sad that a simple visit to the emergency room can cost you an arm and a leg. He points out that we dish out all of this money for care that might not even have a significant impact on our health. Yet, they will take your money in a heartbeat.

[@Bubbles-lp2cv]

+Bubbles 007 It astounding to hear the difference in health care costs between theUnited States and other countries. As the video mentioned, the U.S. is richer; however, we pay significantly more than we should. Personally, I find this unacceptable. John mentioned that other countries have centralized negotiations in which medical companies compete for the opportunity to have their product recognized in the health care system. Therefore, medical companies are willing to offer their quality products for low prices. We need this concept in our own country, in attempt to lower health care costs by some degree. Not only do we need a centralized negotiation in the health care system, we need to look at the degree to which tax payers contribute to health care costs. This is a very expensive ordeal that puts a burden on citizens within our society.

[@salvatoretwilighter]

We've got that Obamacare system for decades in the Netherlands. I really don't get why Americans are so against it, it's only a good thing right?

[@Jiefyang]

that cos of the american has this phobia and sensitivity of anything slightly resembling socialism..

[@vendettaAOF]

The Cold War left marks on American's social outlook... Basically most Americans look at it as socialism= communism which = bad.... It's dumb... and part of the reason why living here sucks! haha

[@Jiefyang]

thought u where the "land of the brave".. not very brave to be paranoid of something like bad old socialism.. which reminds me..your defence budget is the next 9 runner up combined.. most of them allies... brave indeed..

[@monkey314159]

not americans, conservatives. They believe the red scare is still going on.

[@SinHurr]

***** Which is doubly stupid because the ACA isn't socialized healthcare in any meaningful sense.

[@amandasmith1236]

My mom is pretty conservative and doesn't believe in universal healthcare. The thing is, she doesn't disagree with many of the pro-universal healthcare points on costs. She's explained to me how prices rise and rise during negotiation between insurance and providers, between citizens and insurance, etc, etc. I've asked her, "Why not go for universal healthcare?" It makes sense to me. Her answer is that she doesn't trust politicians or the government. She sees them only making the issue worse. I'm sharing this because while some (many? most?) conservatives believe the lies about universal healthcare and taxes, another element is that many low to mid-income conservatives say no simply because they don't trust government. (The high income conservatives are lawyers, and they also don't want big government, but that has more to do with not wanting to be regulated.) I'm not sure what the answer is, but I'm saying this all to point out that there's another issue at play with many conservatives and healthcare, and unless we address that massive distrust, we're not going to see any changes. What's the solution? Honestly IDK. Transparency, probably. If we sell the transparency of single payer healthcare to conservatives, that might work. Either way, we've got to address the distrust.

[@ThaddeusHughes]

Ugh... wrong near the end. In a capitalistic system, you as a consumer would choose between providers of healthcare. Companies would compete to lower costs, and thus negotiate for lower device costs. When one company finds a way to lower costs or improve quality, another company would step into play and do the same or better. Another startup would come in with a better solution to a problem, and bam, it would happen! The cycle continues. Capitalism is better than centralization at 'negotiating lower costs'. However, we have stifled this awesome capitalistic works by barring entry into the market (regulatory agencies, schools, etc) and making middlemen to costs (insurance, medicaid/care).

[@matthewarchbold6143]

Jhonas Dunakin

[@tmahundla]

Perfect competition is better at negotiating lower prices, not capitalism as a whole - not when the buyer has no leverage and the sellers occupy an oligopoly and hold all the leverage. You're simplifying the matter and not applying supply/demand to both sides of the equation. Also, its fairly well established by everyone on the universe that healthcare is one of the realms in which the market fails to be inefficient because daraaa... the incentives don't line up, at least not to benefit the patient they don't. The capitalist market is not God - it's an extremely powerful and useful tool. It's utterly silly to insist that it's the answer to everything, especially when statistics and experience points in the opposite direction (sorry dear but whatever your 1st year undergraduate textbook said, America's healthcare system absolutely fails next to the centralized examples - in efficiency, distribution reach, quality and affordability). Economics is not a religion, you don't need to pick a side and you don't need to choose a theory and then blindly throw your faith into it. It's a complex developing science with great minds on all sides of the equation. Let's move the world forwards and stop being so bloody partisan with knowledge. Knowledge doesn't work that way.

[@steveHoweisno1]

Tembisa Mahundla Some great points well made. Still the question remains, why does the health care market fail? Why is it not free and transparent? Socialist solutions have failed in so many other areas. You would not expect the government to feed you or clothe you or build a computer for you. In fact if we entrusted centralized beuracrats with such tasks we would quickly starve/go naked (as people routinely did in communist russia and china). I disagree with your statement that 'the incentives don't line up'. misaligned incentives can only come from a lack of information on the behalf of the consumer and/or bad regulations. The more info and choice the consumer has, the better he can find a good health provider. The easier it is for competition to enter the market, the better the outcome for the consumer. Free but well regulated markets will do a better job at delivering outcomes than centralized bureaucrats. Don't forget that centralized bureaucrats have their own misaligned incentives. You are right that economics is not a religion or a dogma. It is a science and the health market is an interesting experiment. There must be deep reasons why this market fails to be free. Unfortunately I am an engineer, and economics is only a hobby, I have not the time to explore the issue. It seems to me we would then have two options. 1 centralized bureaucracies like basically every other country in the OECD. If it works for them, would it work for the US? I dunno, maybe, probably. 2. Forcing the health care market to be more free. This second option is much more 'American' and more likely to gain wide spread support. Americans are naturally averse to socialist solutions. Of course we can probably do some mixture of 1. and 2.

[@strawberryseason]

steveHoweisno1 you write, "Americans are naturally averse to socialist solutions." Yeah, to their own detriment. We are not even in the top 15 nations in longevity. You write, "In fact if we entrusted centralized beuracrats with such tasks we would quickly starve/go naked (as people routinely did in communist russia and china). " Uh, people starve and go naked in non-communist nations all the time. As a matter of fact, if you check statistics in Russia, their life expectancies went DOWN after the Soviet Union collapsed. Also, compare literacy rates and longevity in Cuba vs. the Dominican Republic. You seem to think that capitalism is always right and socialism always harmful. History does not bear that out.

[@MrDzala]

+steveHoweisno1 Well since the consumer in this case is a person who cannot really choose between requiring medical attention or dying, he has no leverage. Thus the negotiating should be done by someone who does, in which case it's a government. Simple illustration: You cross the street, someone hits you with a car and runs away. Ambulance comes and takes your unconscious ass away into the nearest hospital - you don't choose which hospital you're going to, nor the care they do... heck you didn't even choose if the ambulance would come. Most importantly you would have no time or ability to negotiate, nor avoid the charges that they can come up with out of thin air. You can't negotiate before, since you have noway of knowing it would happen to you. No leverage.

[@BenRollinsActor]

Actually, our healthcare system is the SECOND biggest drag on our economy. The biggest drag on the economy is the Federal Government.

[@jimpemberton]

And now they are closer to being one and the same.

[@MrFishfiddler]

Jim Pemberton yes, which is what corporatism (fascism, by older definitions) is all about -- government married to corporations. But rather than thinking about this in terms of the rhetoric of ideologies aimed at promoting political division (along lines that really don't make much sense, except as it serves the ruling elites) perhaps we should really start thinking about this problem in non-partition terms, and refrain from gravitating to sloganism, right or left.

[@strawberryseason]

the7thson1962, All developed nations in the world have a large and active public sector. And they all have longer life expectancies and better health than nations with smaller public sectors. If you think the government is the problem, then you don't know history.

[@samuelhicks8223]

That highway system sure ruined everything in America. How can I even get to.... wait.

[@hostilepancakes]

Samuel Hicks Um, hello?! Urban highways rammed through minority neighborhoods?! Rural Interstates did wonders, but even Eisenhower was against urban Interstates.

[@digital-alchemist]

Wow, you nailed it man. I am going to share the heck out of this. Subscribed!

[@holaisaaa]

Anytime there is an ability to tax something that is healthy for you those in power will try to, this just opens up the gateway for it! I’m so happy and impressed you started talking about this topic, not many people like to discuss the complexities of it but it’s important!

[@CherriesJubilee]

Thanks...and I actually like longer videos. Of course I enjoy listening to lectures given by intelligent people. Just sayin'...

[@LetsBuildWordPress]

As someone who lives in Northern Ireland... thank you for including us! haha (we always get forgotten about / no-one seems to know we exist! haha)

[@michaeldavis9357]

It is a simple problem: You cannot trust essential services to operate ethically in the hands of private individuals. That's all it is...

[@lucasthemycologist]

You just oversimplified the problem, congratulations. The healthcare services in countries with universal healthcare are also provided by private companies, the government's job in that system is to mediate and organize those transactions. The problem in the US system is that a handful of mega-corporations control the entire market for healthcare services and the people don't have any power to negotiate fairly. One possible solution is to centralize those decisions in the hands of the government, which does not always result in better outcomes and does not fix the problem of mega-corporations retaining a monopoly over the market. In fact, those mega-corporations often receive subsidies from the government and lobby politicians in favor of their interests. Another solution is to decentralize the market and provide the people with more bargaining power so they can make those decisions on their own, without the need of government interference.

[@lucasthemycologist]

It is a simple problem: the US government is controlled by corporations and common people have no power over the political system, despite being fed the lie that their vote matters. The narrative that handing over all essential services to the government will fix everything is only a fairy tale.

[@arbynChief617]

Michael Davis so you really trust the government to manage everything? The same government that hasn’t managed anything right from the war on poverty to the housing crisis. The same government that has been running the VA. The same government that regulates the high hell out of the number of doctors and drugs entering the market. The same government that rations out treatment and decides whether or not you should be treated or not. You trust... the government?

[@illitaret8780]

I see but the moral mob will...

[@matthewrichardson828]

"Centralized Negotiation" is how Health Care prices are so high, not the latter. It is a simple problem with a simple solution. Deregulate and put the prices on the wall. The US is a world leader in cheap, high quality elective surgeries (procedures which aren't covered by insurance). "Centralized Negotiation" is how hospitals are torn down and centralized, how insurance companies are barred from practicing and how I'm prevented from buying insurance and medicine from across boarders. Great video BTW,

[@Jessexual]

... But if deregulation was the answer wouldn't American healthcare prices be lower when compared to highly regulated nations? I'm sorry but your theory is not supported by the evidence.

[@matthewrichardson828]

Not necessarily. I usually tell people, "Sure, socialized medicine is a good idea, but what makes you think _our_ government could do it?" Regulation isn't always bad, but, in America, regulation in healthcare is a even more of a protectionist scheme. Other governments have marginally more effective regulation, but even Europe's system is barely on the rails. What evidence do you have for why birth control pills aren't over-the-counter? Start to answer that and you've answered everything.

[@Jessexual]

Matthew Richardson The government is already doing quite well with socialized medicine. Medicade/medicare are working great as a result of government regulation of medical costs. The social programs in Europe and Australia are also doing well because of the strict regulations. Companies that are free to charge what they want, such as the companies running private healthcare in America have no motive to provide lower costs... so they don't. I'm not entirely sure about birth control actually having never bought the stuff. But Australian hospitals provide emergency contraceptive immediately if requested and seeing a doctor to get a prescription isn't as much of an issue as it is in the USA. So while it's not "over the counter" getting and filling a script for birth control costs around $6 for the average Australian.

[@matthewrichardson828]

Midicade and Medicare aren't doing well. www.forbes.com/sites/aroy/2012/04/23/trustees-medicare-will-go-broke-in-2016-if-you-exclude-obamacares-double-counting/ Sure, maybe Australia has solvent healthcare system (which is private and public), but that doesn't mean our government could socialize ours. Maybe Australia's government could build a better healthcare website too. We currently have a protectionist regime of laws, licensing and underwriting. In our system of government, Free Markets are the only reason prices go down and quality goes up. 'Medial Tourists' flock to Singapore, Hong Kong and Costa Rica. Maybe have better models for the US. Vote with your boots.

[@Jessexual]

Matthew Richardson But the American system has been reliant on the "free market" for decades now and prices have been increasing while coverage has decreased. It took the introduction of the Affordable care act to lower costs and increase the number of illnesses treated by existing plans. The free market didn't do that, government intervention on behalf of the citizens did that. I'm also not sure what you mean by "Make a better website". The website for the affordable care act doesn't represent the effectiveness of the new laws. I'd also like to point out that Costa Rica has a socialized medicare system similar to Europe and Australia.

[@Jenab7]

Health care is the 2nd biggest drag on the economy. The biggest drag is the usury with which the Federal Reserve creates money, which is the largest cause of the deflation of American currency (which we perceive as the inflation in the prices of everything).

[@RittingsTN]

I think you'll find the US spends more on defense than any other aspect. :)

[@plentyofpaper]

Inflation is a negligible issue. The US prints more money, the value of the dollar goes down, prices go up, people get paid more money to compensate, it all balances out unless taken to an extreme. The biggest issue inflation causes is making people whiny. $100 now may be only as valuable as $50 15 years ago, but incomes are twice as high.

[@gentronseven]

Jeffrey Heinze Fry No, it doesn't balance out, you have to take big risks with your money in order not to lose all of your savings.

[@plentyofpaper]

Daniel Heavlin A savings account is hardly a big risk, and they tend to keep up with inflation. Right now, inflation is 2.1% in the US, and savings accounts are generating negligible interest, so this does not currently hold true. Which is why you should put your money in an account that is expected to surpass the inflation rate. There are plenty of low risk options that will do considerably better than that, and if you want to save for the long term, you should go higher risk higher interest as the long period of time will help the investment balance out. Additionally, inflation represents an increase in business revenue, which is used to pay salaries and wages. If inflation is not occurring, raises don't happen, and pay cuts would be required if businesses do poorly. Additionally, without inflation, people have less incentive to invest their money, and the economy suffers accordingly. You can very much view it as an incentive to invest. Negative inflation is even scarier, as you have fewer and fewer people willing to spend and hoarding money becomes a favorable investment. A healthy economy is one where work gets done and goods get produced. The value of the currency used to achieve this is of only minor relevance.

[@thomowen20]

Jeffrey Heinze Fry "If inflation is not occurring, raises don't happen..." Well they AREN'T happening, anyway!

[@TitaniumDragon]

There is, I think, one OTHER important to thing to note here, which is noted nowhere in the video, and this is the fact that a lot of these countries get such low prices because of the United States effectively subsidizing their health care costs as far as R&D goes. Basically, drug companies can charge the people in the US far more money. Because other countries push down their prices, they overcharge people in the US even more to make up for it. The costs of R&D for drugs and new medical devices and all that jazz is quite large - in fact, it is incredibly large. This money needs to come from somewhere, and it must be remembered that many drugs and medical devices fail to actually be useful, and as such, not only do we have to pay for all the ones that work, but we also basically have to pay for the R&D of all the ones that don't. Once you actually get the stuff researched and developed, though, actually producing more of it isn't that expensive. This means that if the UK is forcing you to sell them stuff on the cheap, that's okay as long as you're still making money per unit - if you're selling enough artificial hips for the entire UK, you're strictly better off than if you're not. But the problem is that the money for R&D on those hips has to come from somewhere. So where does it come from? Well, the answer is it comes from gouging those who will pay for it - namely Americans. Which means that the drug companies screw over people in the US because they more or less have to - that's the only place to make the money necessary to recoup your R&D costs. If the US suddenly started negotiating as aggressively as people in other countries, suddenly you would see the drug companies have to spread out those costs - which would mean that while the US would see lower prices, the UK and Canada and other countries would see HIGHER prices because they'd actually have to pay for those R&D costs. If the US socialized medicine (as they should), the drug companies would have to spread out their costs more and, dimes to dollars, all the other countries with socialized medicine will get very angry about suddenly being "gouged". One other thing: lawsuits over drugs and medical devices far outweigh the whole malpractice issue. Aviandra alone accounts for $6 billion, which causes all sorts of issues. I have no sympathy for the drug companies when they deliberately hide side effects, but it is still another cost of doing business which does have to be taken into account. That being said, trying to prevent such payouts would be bad in most cases - if someone is doing deliberate fraud, they need to be raked over the coals and lose large amounts of money.

[@paulmadryga]

"The costs of R&D for drugs and new medical devices and all that jazz is quite large - in fact, it is incredibly large." Drug companies actually spend lots more on advertising than on R & D. (www.sciencedaily.com/releases/2008/01/080105140107.htm) www.huffingtonpost.com/2012/08/09/pharmaceutical-companies-marketing_n_1760380.html "Lawsuits over drugs and medical devices far outweigh the whole malpractice issue." I'm inclined to believe such reports. Perhaps if the companies in question spent less on advertising and more on R & D, those costs might go down....?

[@ChrisDorgan]

LOL the UK does a hell of a lot of it's own R&D. In fact R&D is the or one of the UK's biggest industries. Choose somewhere else to put the blame :P

[@TitaniumDragon]

Paul Madryga That's not how reality works, I'm afraid. It is a very complicated issue. First off, no one wants to make a defective medical device or medicine. Part of the problem, however, lies in the fact that people don't understand the concept of risk. Basically, nothing is foolproof. We have to be willing to accept the fact that sometimes, things are going to go bad. If someone commits fraud, that's one thing. But getting upset because medications have side effects, and people suffer from them... well, that's a bit silly. But side effects and bad things are inevitable. It is the nature of medicine. As far as advertising goes - yes, they spend a great deal of money on advertising. However, this is also incredibly misleading, as it lumps all advertising together. What are the most heavily advertised medications? Tylenol, Advil, aspirin, cold medications, allergy medications, and various other over the counter medications... enormous sums of money are spent on advertising non-prescription drugs, and you see ads for these all the time. Advertising dollars spent on these things are not at all inappropriate, and indeed, from the data I've seen, OTC drug commercials compose roughly 2/3rds of drug advertisements. Thus, while yes, vast amounts of money are spent on advertisements, you have to reduce that number by 2/3rds to get the amount which is spent advertising prescription drugs, which are the "questionable" advertisements - and even in, in many cases it is reasonable that they advertise their drugs, especially to doctors but also to the general public to raise awareness of your options. And even if you look at prescription drugs, how many of those ads are for birth control pills, which are, again, a product that is actually competed over and no longer patent-protected? They make up a not-insignificant chunk of prescription medication advertisements, and it seems kind of silly to say "well, that's wrong", as they are actively competing over customers. People love to talk about the shocking amount of money spent advertising drugs, but you have to recognize that drugs are a business the same as anything else and people have the right to advertise their products, and wouldn't do it if it didn't make them more money. And in many, even most cases, the advertisement isn't even inappropriate - all the various varieties of standard drugs, the only thing separating them in many cases is the name. You can buy upteen varieties of acetaminophen, aspirin, and numerous other common drugs. That goes into the price of the stuff you buy at the store, not the price of your HIV meds, and it is really hard to say that Bayer shouldn't be able to advertise their aspirin.

[@raneemo3718]

Honestly John is the best person on the planet

[@Fitnurd]

More enlightened , but profoundly sad because I have no idea what to do about it.

[@dogonskis]

Move to another country, thats probably a great idea actually. It seems like you pay much more in US for the everything thing compared to any other developed country.

[@manzilla48]

Why are Americans so against Obamacare. In the uk you can get your health care for free. This means healthcare is very accessible and not too expensive.

[@Meloncov]

Many Americans are opposed, in principle, to any expansion of government beyond what it currently does. Others don't understand Obamacare (understandable; it was a gigantic bill) and thus are vulnerable to fear-mongering.Finally, there are people who aren't opposed to government involvement in healthcare in theory, but see Obamacare as being too expensive for a program that doesn't solve many of the fundamental problems with the U.S. healthcare system.

[@haydnevans95]

Obamacare's nowt like the NHS, its not socialized healthcare because the private healthcare companies still get a good deal out of it. NHS is much much better.

[@flatchested2011]

anything privately owned would work better as there money is on the line unlike government

[@octiiXpies]

Haydn Evans and yet the right wing still calls it socialism -groans-

[@flatchested2011]

octiiXpies socialism is just a less severe version of communism in communism the government controlls everything and under socialism the government controlls the major things...such as obamacare

[@shotoa2088]

However the UK seems to heading into this problem with our government trying to disband the NHS several times, for some reason.

[@longliverocknroll5]

The most important fact in the debate for health care being publicly funded is that the U.S.A. is the sole country listed on the "very highly developed country" that does *not* provide publicly funded health care services in some form. Why is this so important? It means that the argument that "it can't work because blah" is ridiculous. Literally every country makes it work.

[@Noam_.Menashe]

@@leandrebonsaint153 What about r creating an incentive for competition, stopping mandates, and lowering the amount of regulations? it will lower the costs while also not getting some of the downsides of free healthcare, such as higher taxes, very long lines and not too much entrepreneurship. Competition has in history lowered prices and improved the quality of the market, why should healthcare be any different?

[@cwsdoa8727]

@@Noam_.Menashe because all other products can be boycotted, but you can not ignore the need for medicine because you would die. This means that the companies selling the drugs can charge as high as they want. Emergency drugs or services are also given to you at times where you are not in a state to decline them (like ambulances or surgery for heart attacks or allergies), so the companies can charge at any price and you would have to pay.

[@TeaParty1776]

@@cwsdoa8727 You evade competiion and innovation which lowers prices.

[@Photons-tx5ef]

What it would take to work is for America to implement cost-containment policies such as global budgeting or price setting for medical procedures. Without these policies, prices rise at too fast a rate for taxes to cover.

[@longliverocknroll5]

@@Noam_.Menashe The “not too much entrepreneurship” argument is just outright bs. One of the best and most innovative heart surgery procedures was innovated in Canada.

[@Benedocta]

1:42 The US is not richer per capita than Switzerland. Just saying.

[@stevencassidy6982]

Japan?

[@mik1984]

You NEED food to live. You NEED fresh water to live. You NEED shelter You NEED clothing You NEED many things to subsist, yet the inelasticity of demand does not cause prices to skyrocket. Even more, inelastic demand is observed even in some goods that are not subsistence relevant, but still their prices don't jump through the roof. The idea that inelastic demand causes prices to rise is economically illiterate. But the reason why leftists moan about inelastic demand is that they don't want to talk about the real and only reason for price escalation, which is OBSTACLES TO COMPETITION, If there is lack of effective competition, then basic microeconomics suggests an option of erecting a monopson to counter a monopoly, and thus negating the negotiating advantage of the monopolist. But that is thinking inside the box. Nobody wants to ask the question why the companies are not competing effectively enough to drive the prices down? And second, half of the healthcare costs in US are costs of government expenditures on health care. How can you blame private health care for US government running its health care cost-inneffectively? And maybe you need to take account for the factor that European governments are unitary governments in nation states. These are different political systems and unlike the US government they have some incentives to keep government programs somewhat effective, which results in ALL federal government programs in US, from education to veteran care to be less cost effective than their European counterparts. The US federal government when running economic programs is doing something it has never been designed to do by the founding fathers.

[@RittingsTN]

The founding fathers couldn't see the future. Its really THAT simple. As smart as they were back in the day - there's no way they could envisage the advancements of technology and science.

[@mik1984]

Richard Stretton The problems of modern government have nothing to do with advancements of technology and science, but with a shift in the model of society from a classical liberal minarchy to a social democracy. The US government system was designed for checks and balances, as a tool for preserving individual freedom on the territory and not for optimal administrative efficiency. The argument about advancement of technology is furthermore bankrupt, as it has debunked nearly 300 years ago. The same argument of science and technology was used by the opponents of free market in XVIII century. Allegedly the free market would not be able to manage the "advanced industries" of that time.

[@mik1984]

John Lunsford "The free market didn't work and we ended that period with the great depression." Nothing personal, but this sentence disqualifies you from having any debate with me. Your head is so full of leftist BS that it would be an exercise in futility.

[@maria44688]

Those really aren't examples of inelastic demand. You do need food to live but you don't need a certain brand of food. Like, you don't NEED Wendy's to live. Therefore, Wendy's cannot charge $20 for a salad because no one needs to buy it. They'll just go somewhere else. So Wendy's has to adjust their prices because they can effect the quantity demanded (which makes it elastic). The same can be said for your other examples too. There are so many different ways to get them that businesses have to be aware of things like prices because otherwise they won't get business. Companies who supply artificial hips, for example, in America don't have to lower their prices because (going back to the Wendy's example) you do, in fact, need that certain brand of salad, whether it's $2 or $20. And even if there are other brands, they all cost pretty much the same amount because they all can get away with it.

[@redstoneking1535]

It will always be hard to have competition among health care companies. If they something goes wrong people die, so we can't let anyone handle these companies, and then the competition becomes strictly limited. The European solution works fine (no competition, the govt handles the system and uses its power to keep prices down). At least it works fine in europe. Maybe it doesn't work as easily in the US, but you can probably make it work. The whole democratic system, as the founding fathers designed it, is kind of outdated and doesn't work really well any longer, so I think there have to be changes anyways. It really bothers me how you just saw a video that explains how a huge amount of factors make health care expensive, but after seeing it you keep insisting that only the factors you care of are contributing.

[@tibodeclercq2131]

You mentioned *Belgium* ; I am from belgium and I *hate* my health care. We have a lot of money in debt and it increses by 500€ per second, in fact within 25 years Belgium will be a developing country. Our problem here is that many people who are actually capable of working don't work, so they let report themselves on the health insurance fund while they actually shouldn't be on it.

[@logicking3765]

Screw insurance company, and the government. Either the government just takes over the whole system or it should stop meddling the system to a point it’s somewhat privatized but not really.

[@fresharche6227]

You know a reason why your drugs are more expensive? YOU ADVERTISE THEM! and thats nuts.

[@agilemind6241]

Only partially, Canada allows advertising for drugs - though with the weird restriction that you can only say the name brand or the condition it is used for not both - and our drugs are still super cheap compared to the US. Course our national healthcare system pushes for generics so hard one of the leading generic-drug producers has it's HQ here.

[@jouneymanwizard]

Here's something fun to do while you endure OTA/cable advertisements: time them. Ad space on TV is sold by time - longer ads cost more (ignoring the cost of production). Longer ads are spending more money to talk to you. Some of the longest? Ads for drugs. Some of the shortest? Ads for cars. (as far as I have seen). Food for thought.

[@animeguy7192]

plus the ads they have for it Re Crazy.

[@echtvergoldet]

They are advertised in Germany, too. But pretty seriously, not old spice style.

[@notdaveschannel9843]

+Echtvergoldet Not for prescription drugs though, surely? I thought that was just the US and New Zealand.

[@JapaneseAnimeChick16]

These videos are fascinating and informative!

[@KGDRAWROF]

The people who don't have health or life insurance get sick and die in the hospital. So the outstanding bills never get paid and get calculated and redistributed to all of the other policy holders so health insurance providers can make up for the loss of revenue. For example, if an insurance company provides insurance to a hundred people and 1 of them dies with 99 dollars outstanding, the other 99 have to take on 1 extra dollar of premium to make up for it. Instead of raising the rates for everybody, they just charge it to new policyholders without them knowing. I used to work for aetna doing underwriting so yeah.

[@daphnefrieden6176]

Uh... so people who don't have health insurance die and health insurance companies have to make up for loss of revenue why?

[@KGDRAWROF]

Thanks for catching that! Without health insurance, the costs are all on the patient. If they die without paying the bills, the debt is not forgiven. To compensate for what might never be regained, hospitals and such, start raising their prices and charging other fees which in turn raises the cost of health insurance because they have to cover for larger sums of money.

[@phongbach7248]

KGDRAWROF they will always have profit no matter what and they just demand a high price. To cover a large sums of money from people who cant pay is just a part of it

[@KGDRAWROF]

Especially now that it's mandatory!

[@futsuu]

I am taxed 35% between local and national tax in Japan. That pays for roads, schools, public servants salaries, and pre-pays for excellent healthcare. I moved abroad about the moment I got off my family health plan and the idea of going back to living in the US makes no financial sense. I know everyone just white-knuckles it over there because they don't have a practical understanding of a better way but... no thank you.

[@Corristo89]

Things become cheaper when everyone pays the same for it but not everyone uses it. For example: going to university costs me about 240 Euros for one semester. During those six months I get a ticket for public transportation for the ENTIRE Bundesland (there is no translation, it really is Bundesland). If I paid for it regularly I'd be paying hundreds... per month. The way it works is that not everybody needs it but pay regardless. You can't back out and say "I don't need it and I don't want others to travel for free with my money!" Healthcare in European countries functions the same way. Everyone pays for it and is therefor entitled to cheap healthcare. How many actually need it on a regular basis? Not that many, so the funds are sufficient to cover most expenses. And most people are happy with it. I don't know anyone that has gone bankrupt because he/she broke a leg and had to be treated in the hospital and woke up with 200.000 Euros debt. Many Americans on the other hand don't want others to have what they believe earned themselves by working hard all their life, especially old people (who, surprise, almost always vote Republican). It's social greed at its most extreme. Many have no interest in supporting those they perceive as "social parasites", leeching off other people. The fact that you can work hard all your life, pay taxes and so on and still not get any form of affordable healthcare is largely ignored.

[@randolphjohnson3486]

Which is why on average we pay less at the Pump than other nations. I was stationed in Kuwait some time ago, and the price at the pump was 18 dollars a liter...

[@jcorava]

Randolph Johnson Interesting because every report I have ever looked at shows gas in Kuwait costing significantly less than in North America (www.expatistan.com/price/gas/kuwait/USD). For sure, Europeans pay more for gas (www.drive-alive.co.uk/fuel_prices_europe.html) but even the most expensive European country is no where near US$10 per liter.

[@MakeMeThinkAgain]

Well done. I think you're wrong about there not being a simple solution though, just slowly expand Medicare until if covers everyone.

[@an.unarmed.civilian]

lololololololololol.

[@exiledfromUSA]

I disagree with one thing John said. He said, "The United States is one of the richest counties in the world." Well, the US is NOT one of the riches countries in the world. The US is deeply in debt. When a baby is born in the US, he is already $50,000.00 in debt.

[@JoyfulJabber]

***** Because all Americans are in debt simply by being a citizen of the USA. All Americans share the 17 trillion dollar debt that the USA has to foreign countries. With 317 million citizens, that debt is more than 50.000 dollars per citizen.

[@Trickxareforkids]

jhertel20 That's incorrect. We as individuals do not share responsibility of the national debt with our government. The biggest portion of our debt pie is actually money the US government owes us (albeit indirectly). The largest holder of US public debt is the social security trust fund.

[@SenpaiTorpidDOW]

That's very flawed. Let me try and clear this up for you. Ok so every country in the world is in debt that has existed for more than a few centuries, also that debt doesn't belong to the people of the country in any way at all and the individuals have no responsibility to pay that, rather the state does. The only way in which public debt affects individuals is that the governemnt must use a certain amount of money each year to pay of debt interest, but it can borrow more to pay for military/healthcare/whatever other spending it needs so long as it pays off the debt interest. The other way it affects things is that clearly a country which can't control it's spending is not in a good shape so it will cause fewer people to want to invest in the country and as a result the value of the currency of the country will plummet.

[@Yeoitsski]

10 years later and nothing has changed

[@rdskn4eva]

United States, the beacon of Capitalism, cant negotiate for the lowest medical prices with other corporations..."Merica.

[@solortus]

+rdskn4eva Bailing out banks is not capitalism, it's corporatism. In capitalism there is no second chances.

[@AWES0MEDEFENDER]

@Critique Everything if you had more than a couple brain cells to rub together then you would read what he said before trying to *debunk* it

[@asrr62]

capitalism is not real.

[@CaseyReads]

Please run for president. I will vote a million times for you. #johngreen2016

[@andrewxc1335]

The first vlogbrothers video I ever saw. And yes, I did ask myself "who the eff is Hank?" It was only after a year of going back and watching videos that I knew why that was funny.

[@m.prince7701]

Here's the thing. Health care especially emergency care, doesn't have many options for competition. You're forced to pay what they tell you without having the benefit of a competitor. One answer to soaring healthcare prices would be fixing the education affordability and availability problem that has so many ppl, who could be a physician or some other health care professional, stopped in their tracks by a frightening amount of student debt or they simply can't afford to get a full time job just to pay for education as well as vast amount of other hurdles working in the medical field that make it seem no worth it. We need more doctors and nurses as well as many other valuable workers in the healthcare industry. This is one of the biggest ways for consumers and governments of any healthcare system or enormously expensive service to control and maintain costs and affordability of it's services. Yes it would require some government intervention but pretty soon, mark my words, there will be a reckoning of sorts with the overbloated costs of healthcare, health insurance and the overworked, overloaded professionals already in the healthcare industry in the United States. You can't take advantage of ppl too long before they demand a solution from the government or the industry that maybe too hard to swallow for the greedy owners of the hospitals and the CEO's of the health insurance companies. Doctors and nurses and the other real workers of the system deserve good pay for their work and dedication as well as a chance to have somewhat of a life away from their job. Education affordability and availability is one of the big answers to the vexing problems of healthcare in the U.S.

[@mdashfaqulislam6998]

Free Market Healthcare: Auction of - " I don't want to die." Buyers- "I will pay as much as I can." Sellers- "I will ask as high as the buyer can pay." Profit for buyers: " life with Bankruptcy "

[@chubbypekingese]

The problem is that if you are a doctor and you recieve ANY money from Medicare you have to charge the Medicare price for that item. There is no negotiating the price or dropping it for any reason. The government fixes the price. A $12.00 arm brace is billed for the price that Medicare sets (*$180.00) and the doctor isnt allowed to lower that price even if the patient isnt billing Medicare. *the price is an example. Do some research and you'll be shocked at the government mark ups. Without competitive pricing the prices cant drop. Its the government that makes the medical prices so high and then its the government that wants you to want a single payer system and they'll tax you to pay for the high prices that they set.

[@jamesfoy1983]

Slightly related--just goes with all government contracts: Military, solar, etc. Government has no incentive to keep prices low, becasue they can always ask for more money to fund their programs, which gives them more power. Then after they leave their positions, they get hired by the companies they were regulating--See Energy Secretary Wu, getting put on Board of Directors for one of the solar companies this week (January 22 2014).

[@flortho2440]

Unfortunately, the arm brace people are taking the money from the actual physicians. I'd be happy for a third of that 180 dollars as reimbursement for an office visit.

[@Unsensational]

Would you happen to have a source for that?

[@SandfordSmythe]

It's pretty much recognized that Medicare pays less than private companies.

[@chubbypekingese]

@@SandfordSmythe, I don’t think you understand what I’m saying… Medicare sets the prices and doctors or facilities that accept Medicare payments have to charge the Medicare prices. Medicare doesn’t allow for those procedures or medical supplies to be billed less than the prices they set.

[@RuleofFive]

Disagree with you on one point....not everyone can "find a way to pay" for overpriced medicine or treatments. In fact 45,000 people a year die in the US because they can't afford to access this corrupt system. Thanks for your video.

[@endrankluvsda4loko172]

The US medical system is a train wreck! I am a vet and after getting out of the military I got sick. I needed medicine that can be bought for about $40 in Canada. Animals, like dogs, can also get this same disease and be treated in the US is about $40. But for me to get the medicine I needed for that disease in the US, they told me it would be $8,000. That is criminal. I never did get better and just gotta deal with it because I don't have $8,000. I will probably eventually just take the $40 medicine made for dogs and hope that it doesn't kill me.

[@nayaabshah1155]

u still here bro?

[@robpattishot]

i wish we had a president like this...smart

[@lukethegreat101]

You mean the president who is trying to centralize health care...

[@granny83]

CZAR KING Nailed It. BOOM

[@lukethegreat101]

***** He passed Obamacare. Despite all its problems this was step one for the United States to develop a healthcare system similar to those seen in every other modern post-industrialized state.

[@reachforacreech]

where does the money go? into the pockets of the super rich

[@eXileLies]

..and, they don't pay Tax in the first place ;)

[@kato4792]

Thats how capitalism works and why our private healthcare sector percentage wise vs the public sector is much larger than other European countries. This system is a lot more important for us than Socialized policies. The U.S invests way more into research and drugs and is the leading country for drug & research output. More than 75% of drugs approved by the FDA come from the private sector. These are things that have to be paid back which adds to the cost. In fact, these other socialized countries we act like "we should strive" after RIDE off of this research. Another thing is that the U.S wait times are much lower than other countries and our survival rate regarding serious illnesses are much higher (UK's NHS had a goal of 4 hours for ER but failed, its still 8 hours whereas US the average is 2hr & less). What is wrong about videos like these is that they focus on the cost of American healthcare and disregard the quality aspect. Furthermore, our system is not perfect for the benefit of Americans but negotiation and regulation will kill competition. Price fixing is not permanent. Also this "negotiation' (coercion) with the private sector and fixating (lowering) the prices would make it not only worse for companies but make it hard for doctors, who spend years and incur debt becoming a doctor, to make money; moreover, it removes an incentive for people wanting to come into the field of medical care. (In the UK there has been thousands of doctors who have left the country and went to the U.S. There has been protest at the NHS from doctors as well.) Lastly, of course, the U.S healthcare still isn't perfect but to look at it so one-sided and to look at just cost and not quality is ignorant. Despite criticisms, it is a system that improves. taxing certain peoples so that people can get free or cheaper public healthcare isnt progressive but regressive. the point of capitalism and private healthcare working together and without government restraint is so that there is an incentive for doctors, prices can improve (look at LASIK used to be 20,000+ now less than 7,000 from many different offers). socialized policies dont improve healthcare, it only moves the burden onto taxes and hurts the overall people through taxes

[@The-Last-Ariya]

Katotohanann you really are so brainwashed man. They still laugh at you for defending them.

[@kato4792]

+Joe S if you dont like capitalism and free market go to a completely state-run socialized country and find how bad it is. even so, come back to me with a real argument. you are ignorant much like your lack of facts

[@The-Last-Ariya]

Katotohanann I am American living in Canada, it’s just fine here bud. It’s funny how u still think your votes matter. America is run and owned by Israel.

[@legoappleinc]

Never get injured while on vacation in the U.S.

[@docileantelope1559]

Well, your first problem would be vacationing in the U.S.

[@AussieSnag]

***** thats called "Travel Insurance"

[@zzyzx0788]

Docile Antelope Nah, we got mountains and fried twinkies n' shit

[@user-B_8]

Or at least make sure to have your Travel Insurance in order, and one that is guaranteed to cover your hospital bills if you should be so unlucky and get injured whilst visiting the US..

[@Eclipse503]

I always purchase emergency medical insurance when I travel to the US.

[@RobertWF42]

Consolidating insurance companies into a single payer system would reduce admin costs. Though in truth you can say that about many businesses around the country, along with universities and state governments.

[@kadanseward3022]

You could. And so you should say that :)

[@Андрей-й5х9ь]

hello from 2020 Pandemic and how it is managed says everything about the US health care system.

[@SoulmateParis]

For decades in the US health care (and to some degree, higher education) is a business, whose main purpose is to make money, and not a service. This is not the case in europe, where left or right believes in sociale services to all citizens including health, education and a roof over your head. The ACA, that has had such trouble to get going, is a shift in the paradigm but still has a looooong way to go.

[@TerraTunesMusic]

Sadly, because it did not include a Single Payer proposal combined with no regulatory tools and painfully bad press, I believe the ACA has set the cause of Universal Healthcare back 10-20 years in the U.S.

[@riley_oneill]

Why is it that businesses like Walmart function on low prices then? Why is it that Ford and Chevrolet don't sell their cars for $100,000? If they are in it for the money why doesn't every business just charge huge sums of money for everything? If Walmart only wanted money they should charge like 5 times the price of everyone else....

[@ahkeelyu]

Riley O'Neill Are you asking for a crash course in economics? The reason walmart and chevy don't charge a million dollars for a banana or banana car is because of demand and competition. If they did, customers would go somewhere else to satisfy their banana cravings. The reason this doesn't apply to healthcare is because healthcare has inherently inflexible demand, as john pointed out a person will pay whatever they have to for the life-saving medical treatment.

[@Mtaalas]

We believe that an access to a health care is a human right and should be accessible for everyone regardless of their ability to pay for it. And for that end, our governments are heavily involved in the healthcare system. And that's a good thing... mostly... but when they screw up, we can vote them out and get in people who have our best interest in mind. Thus, if you fuck up our healthcare, you're not going to last in the office -> you don't want to fuck it up. And everyone's happy :D

[@riley_oneill]

Food is inflexible. Why isn't food 10x the current prices? Why is it that with Healthcare suddenly the options go from many producers to just a single producer, where you have no options... and you have to pay some super high price. There are certainly drug patents involved which prohibit competition. If you need acetaminophen, there are many options and it is very cheap. Kaiser Permanente has nearly 9 million subscribers.. More people than many of the Northern European countries. They are buying from producers for a group of 9m subscribers. Shouldn't they just be able to do the Walmart effect and negotiate low prices (they absolutely do to some degree). Prices drop when you have options. Life saving drugs are commonly in monopoly status for many years. With a monopoly status people can charge high prices because there is no competition.

[@karaymanzimbrul8366]

i like this guy... greatings from Romania...i subscribed:))

[@cristian-si1gb]

+Karayman Zimbrul Ceao!

[@karaymanzimbrul8366]

+cristi1990an Salve....roman?

[@cristian-si1gb]

Karayman Zimbrul Lol, da sunt român.

[@gilian2587]

The Department of Health and Human Services introduced a rule in November of 2020 requiring hospitals to post clear prices before patients receive treatment -- and it requires that hospitals abide by those prices. Guess which organizations are suing to try and block this rule? The American Hospital Association, the Association of American Medical Colleges, and the Federation of American Hospitals. What this means is that it's actually the hospital administrations that are causing the whole problem. Just like it's the university administrations that are the source of the price gouging problem in our university system. This looks a lot like collusion between all of the big hospitals in the country to allow themselves to continue price gouging the people of our country -- in the United States. We have some examples of 'Trustbusting' supreme court decisions that have occurred in the past, for example: United States v. Socony-Vacuum Oil Co., 310 U.S. 150 (1940). So... the solution is simple; if you want to break the super-monopoly and stop the anti-competitive behaviors in the medical industry; then the Supreme Court needs to perform the same trustbusting measures against hospitals that they used to do back between the 1940s and the 1970s. We give the hospitals a choice... be transparent about your prices, or we, the people, will pursue trustbusting measures against them.

[@isahabdullahi5310]

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[@pigboykool]

Why the medical professional cost so much more in the States? Because it is controlled by those powerful Medical Professional Association that greatly limited number of students going into the medical field and the education cost. It is not just the physician, but nurse and other related professional association are trying their best to limit the number of availability of medial professional in the field so they can keep on increasing their salary due to "high demand". For example, less than 20yrs ago, a licensed Physical Therapy only needs a BS degree. Then the APTA changed the requirement to Master degree, and now even a freaking Doctor degree? Guess what, but what they do have not change much over the years. They are still a freaking therapist and their so call "doctor" program is a joke & not much different than the Master program. However, the cost of education is over the roof & not many people is able to finish/afford the school. They successfully articfically limited the number of available physical therapist, inflated their salary and so called "status" as "doctor" in the society while at the cost of American tax payers.

[@adelaidemarie]

You bring up a good point. Thank you

[@spaceface3122]

+pigboykool Yup institutions and government make everything impossible to do. Yet we beg them for more rules and regulations and people think more control and red tape make things better... You used to be able to walk into clinics in the US for impacted ear wax adelaide..(I read your other posts). You shouldn't have had to go to mexico.. Our government and insurance companies are in a screw job together, you shouldn't need to wait or get approval for impacted ear wax. Socialized medicine is not the answer, it is the reason why the doctor didn't take you back and take care of your problem on day 1.. His hands are tied by a bunch of POLITICIANS and greedy bureaucrats in Washington who have no medical training or understanding of the costs of healthcare.

[@pigboykool]

I am on the fence about this issue. The universal health system in Canada & Great Britain work pretty well & they are able to bring the cost down with group bargaining power. The more I read about the America health system & its problem, the more confused I am. We need to have a good independent study about the root cause of America health system from a creditable third party.

[@adelaidemarie]

spaceface3122 I agree