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Comment by shingen | Hacker News Reader

Want to get our costs down to competitive levels?

85% of all healthcare costs in America are for those over the age of 65. America has the leading health care system for the elderly. We pay for 80 year olds to have surgeries that they can't get in Canada or France.

Nobody wants to talk about it though, because it's not a nice thing to say, that grandma is buying six extra months at a price of a million in treatment.

Socialized medicine will slice the most money out of treatment for people in that demographic. It's by far the largest savings spot. Good or bad, you can debate that endlessly; but that's exactly what will happen.

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Although I disagree with your flippant tone, it's a fact that over 30% of medical costs come from care delivered in the last 6 months of life. Obviously you'd expect some top-heaviness here, but it makes one wonder about the cost of futile care (both in $$ and human suffering).

It wasn't meant to be flippant (or insensitive), just matter of fact.

My grandmother extended her life by about eight months by having breast cancer surgery at 87 or so. Was that ok? Personally I loved my grandmother. However, it was paid for by taxpayers. Her quality of life was terrible in those last eight months, but she did want to keep fighting to live. It's an extremely sensitive issue to debate on either side. The obvious bottom line is that we can't keep having our cake and eating it too.

This PDF shows the 65+ demographic as accounting for 35.6% of health expenditures in 2004:

https://www.cms.gov/NationalHealthExpendData/downloads/2004-...

It seems highly unlikely that it would change so drastically in just 8 years. Where does your 85% figure come from?

Was probably found from the same source that I used when researching the worrying fact that, as it turns out, 78.2% of statistics are made up on the spot.

My grand-parents, at 86 and 87, recently had multiples surgeries: eyes, hips, pacemakers... They are quietly approaching the bionic state.

Those are costly procedures, taking place in public hospitals without any extra. Yay for socialized medecine !

Which brings me to my question : what kind of surgeries can't you get at 80+ years old in France ?

There aren't any. The parent to this thread doesn't know what they're talking about. :)

It's just a way that the media/government gets people to accept their poor health care situation: it's better! and you couldn't get it anywhere else! The high costs? That's just the way things are, never mind these examples in every other developed country in the world.

All of this is bullshit.

Not true. The largest savings would be in not having to deal with the administrative overhead of our current system.

A full 1/3 of the cost of healthcare in America goes into maintaining our system and not into actual patient care.

Um, no. Patient care is the biggest culprit in US overspending on medicine. Administrative overhead is minor.

http://theincidentaleconomist.com/wordpress/what-makes-the-u...

The article you linked to doesn't show this. The pie graph at the end has a big green chunk which refers to, "Remaining health care spending". It doesn't say this only pertains to patient care. Also the chart is about spending higher than expected given our wealth.

I didn't find a place in the article that talked about administrative costs (i.e. salaries, bonuses, profits) that go to insurers.

Insured middle classes competing directly with the super-rich over a limited pool of medical professionals is probably the biggest culprit.

I don't believe that is the case. Otherwise, we would see a shortage of care provided. Since everyone gets care, the competition with the super rich- if any- is vote driving prices

And you don't think you see a shortage of care provided?

[edit] And hang on a second. You say if any? Really? You think there is no competition for resources?

If the US has the leading healthcare for the elderly in the world, how come it comes 36th in terms of life expectancy?

Because healthcare is but one of a zillion factors that influence life expectancy?

Fair point.

I still doubt that it is the extra cost of caring for elderly people really well that is the major factor that is keeping the other costs high though. Especially since there are less very elderly people, as a percentage of population, than in other developed countries.

Because people have to reach old age before they get "leading healthcare for the elderly"; the ones that don't reach old age cause low ranking in life expectancy charts.

Because we're also the fattest and least healthy (diet & exercise) of the nations with high per capita income and moderately high life expectancy.

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