By contrast, he said, while tax rates have fallen as a share of gross domestic product, health care costs have ballooned. About 50 years ago, he said, “health care was 5 percent of G.D.P., and now it’s about 17 percent.”
There are so many inefficiencies with monopolistic practices such as inability to import drugs from outside US, healthcare networks, and on and on.
If the health industry wasn't, you'd have people making a killing importing 2 dollar generic antibiotics from overseas to compete with the 70 dollar generic antibiotics sold at CVS.
There's obviously middle ground somewhere, it's just we as a country lately have a REALLY hard time accepting the fact that compromise isn't a four letter word. At least some of us...
Other countries are getting better health results for way less money which all other things equal makes Americans comparatively less well off.
When I pay $1500 and dozens of hours of time for something that costs $2 and 15 minutes in another country, I am less well off.
I like being healthy, but I'd rather be more healthy for less money than less healthy for more money.
You are right, the money isn't transferred off into a void, it is a wealth transfer from consumers to the healthcare industry.
Total Money spent on heath care has very poor correlation with outcomes. Largely because it includes things like medical billing and advertising which increases costs without providing any benefit. You also often do more dangerous and unnecessary procedures and give more drugs risking poorly understood interactions.
Something like 80% of the benefit of modern heathcare comes from the first 10% of spending. EX: Sanitation and quarantine are cheap and amazing tools to stop the spread of disease where hospitals are extremely expencive and gather sick people together to spread disease. A vaccine is vastly cheaper and more effective than dealing with outbreaks.
― Laurie Garrett, Betrayal of Trust: The Collapse of Global Public Health
* Inefficiencies in delivery mean that those for whom low-cost interventions are most beneficial, most especially pregnant women, and infants and children, don't receive preventive and supportive care which offsets future problems.
* High healthcare costs translate directly to high labour costs, exacerbating the competitve disadvantages American labour faces relative to the rest of the world, and obviating much or all of the advantage of the greater efficiencies of such labour.
* What health care services as are offered are, counter to my first point, late and heroic measures which do little to extend life or its quality, but keep sick patients alive longer. They are delivered largely based on capacity to pay, rather than social need.
* Programmes to increase overall community well-being, ranging from vaccinations, education, and other public-health measures, to treatment of drugs and drink addiction as medical rather than criminal problems, aren't provided. Entire towns and states fall victim to epidemics of entirely preventible conditions: measles, mumps, cervical cancer, HIV/AIDS, alcoholism, drink driving, heroin and opoids additions, cocaine and meth addiction.
* I won't even talk about mental health services. They are a national embarassment and shame to all Americans.
Instead, a handful of insurers, hospitals, drugs manufacturers, equipment manufacturers, and service providers (look up medical transport for an eye-opener) are skimming off fat profits whilst delivering little of actual value, and actively eroding the competitive and health viability of the country as a whole.
The same argument applies to bloated costs of equipment. If a surgical sponge is $500 vs. $10 elsewhere, i doubt the added benefit justifies the extra $490. That $490 is coming out of someones pocket and its a complete waste.
This graph [1] also shows the same story. The return on investment measured by life expectancy in the US is pathetic. The extra money is just not helping... so its either being misused or stolen, probably both.
https://ourworldindata.org/the-link-between-life-expectancy-...
Of course, this is indeed bad for efficiency, if you consider health outcomes vs. spending. And inequality: wealthy people live longer. But then there are questions of fairness.
Elsewhere, in a so-called welfare state where I live, all children get very good care and child mortality is low, but for instance, when I consider myself - a fairly well-to-do person although not wealthy by US standards - I pay a lot to the system but it gives me very little attention. No regular health checks that are normal in the US for people who have a health insurance through employment, no screenings for cancer (women get several types of specific screenings but men do not).
(We use 9 % of GDP to public health, vs. 17 % in the US.)
I know that the care is quite good if I run into a life-threatening situation, but with smaller trouble such as broken bones or a pneumonia, I'll be prioritized down after drug addicts who have a more serious condition that they have inflicted themselves. And they never contributed to the system which tells me to go to a private clinic.
Fortunately the social problems resulting in non-contribution are still quite small, but an increasing number of people are not giving anything and are consuming more and more of the resources.
"...an increasing number" - citation?
While I guess I have no problem with this statement specifically, it's a bit too close to "the top 1 percent of Americans will pay 45.7 percent of the individual income taxes" : http://www.cnbc.com/2015/04/13/top-1-pay-nearly-half-of-fede...
The problem with the latter statement is of course that it makes it sound like the top 1% is unfairly burdened by taxes, while hiding the fact that the richer they get compared to the rest, the larger a share of taxes they'll pay.
Taking it to the logical extreme, if all income went to the top 1%, they'd pay 100% of income taxes, while the lazy 99% contribute zero! Someone quickly give the rich a tax break!
If not, why should consuming those services cost significantly more money?
It might feel right that rich people should pay more, but that's not how any other market works - why should government services be different?
EDIT: To all of the people saying rich people consume more government services than poor people: you're forgetting about welfare payments. In the UK this is the largest government expenditure, and it is consumed almost entirely by people who are not paying for it.
1) You're proposing a flat dollar amount be paid as tax by every citizen. This will be most painfully felt by the poorest. What sort of society do you think this leads to?
2) The rich do employ a lot of people, whose education and safety were provided for by taxes. Then there's all those road and water networks they use to deliver goods to the markets they own, and the large amount of property and contracts they have that are enforced by the state. So yes, I do believe they use more government services than the average person.
3) Plenty of markets work that way: https://en.wikipedia.org/wiki/Price_discrimination Furthermore, in a market, the seller sets the price, and the buyer is free to take his business elsewhere. And there's plenty of countries to choose from - so why should government services be different?
Whole branches of government are set up to protect property in any forms. Outside of life and limb protection, the rich consume property protection more. Land, IP, bank accounts, shares, options, buildings, boats, freight... the rich have it because their property rights are protected by the government.
Moreover, I detest that we even got involved in the wars in the Middle East, and was a strong supporter of NOT retaliating after 9/11. My taxes still pay for them.
Taxes have absolutely nothing to do with a market.
I guess those taxes aren't so bad.
"If not, why should consuming those services cost significantly more money?" One doesn't even need the "if not". This can be a perfectly valid political choice.
"It might feel right that rich people should pay more, but that's not how any other market works - why should government services be different?" Because government services are not "any other market". To illustrate that, one could also turn this around and ask "It might feel right that everyone should pay the same, but that's not how government services work. Why should private markets be different?".