The figure in Germany is only 11.3 percent, up from 9.4 percent during the same period. Japan’s is 10.2 percent, up from 6.6 percent. Britain’s health care costs are 9.1 percent of G.D.P., up from 6.7 percent in 1995. And China’s is only at 5.5 percent, up from 3.5 percent.
That puts the United States at a material disadvantage far beyond the tax differential. And it harms American companies in particular, since they bear such a big share of those costs. Corporations spend $12,591 on average for coverage of a family of four, up 54 percent since 2005, according to a study by the Kaiser Family Foundation.
“Medical costs are the tapeworm of American economic competitiveness,” Mr. Buffett said, using a metaphor he has employed in the past to describe the insidious and parasitic costs of our health care system.
Mr. Buffett is a Democrat, but his business partner, Charles T. Munger, is a Republican — and a rare one who has advocated a single-payer health care system. Under his plan, which Mr. Buffett agrees with, the United States would enact a sort of universal type of coverage for all citizens — perhaps along the lines of the Medicaid system — with an opt-out provision that would allow the wealthy to still get concierge medicine.
Our bloated health care system, Mr. Buffett asserted, is the true barrier to America’s world competitiveness as well as “the single biggest variable where we keep getting more and more out of whack with the rest of the world.”
But people don’t talk about it enough. “It’s very tough for political parties to attack it, but it’s basically a political subject,” Mr. Buffett said in reply to a question I had posed. (I was one of three journalists and three analysts who, along with shareholders, peppered Mr. Buffett and Mr. Munger with questions during the meeting.)
That’s not to say corporate tax reform won’t help, but it is tiny relative to fixing health care.
Indeed, Mr. Buffett said, even if Washington put in place a tax credit for capital investment, he did not think that BNSF — the railroad company he owns, which spends billions on fixing rail tracks — would do its job faster or better because of the potential tax credit.
greenerdoc on December 7th, 2019 at 05:23 UTC »
I'm a doctor who has recently gotten involved in administration for the past 2 yrs.. let me tell you the shit I see.
I am primarily clinical but have been sitting in more and more meetings (I traded 10 clinical hours a month for some admin responsibilities.. which has been coming to at least 40-50 hours of admin time a month beyond my ~120 hours of clinical time a month)
I am usually the only doctor in these meetings. Everyone else is strictly administrative and nonclinical.. whether they are nursing directors, assistant directors, nursing educators, PI experts, QA specialists, floor nurse managers, infection control nurses or a multitude of RNs who have moved to positions where their only jobs are to make sure one particular aspect of a particular mandate from one or more regulatory/quasiregulatory organization is followed to a T.
I would estimate some of the people in the room get paid as much as I do and others are in the 150-175k range. I also estimate these adminstrative folks outnumber all the hospital based and hospital employed docs at my small community hospital.
At the smaller committee meetings, I would estimate it is costing the hospital about 1500-2k / hour just in hourly salaries of people in the room, at the larger meetings regular weekly meetings, we are easily exceeding 20k or more per hour. There are atleast 3-5 of the meetings daily.. most of these meetings accomplish either nothing, or what could have been accomplished through a simple email exchange.
At one of these, we talk about how to make changes to our practice that will meet conflicting benchmarks from different organizations (ie DOH or CMS) that are out dated and no longer evidence based. These metrics are being published and used to determine our quality and have a substantial impact on our reimbursement.. that's why we are paying an administrator to manually abstract data from charts for the DOH or CMS to review.
There is another standing meeting where we discuss how to meet requirements for a 50k grant where we got to follow 100 frequent asthma patientd (defined as having been to our ED atleast 1once before in the past year.. because we really had to reach to define our 'asthma problem' ) to ensure they get a consult with our respiratory therapists and get an extra med when they are discharged and to get some allergen free pillows. We spent 50 IT hours to modify our EMR and spent countless hours for our RN educator to train all the nurses to change their work flow, and myself to train the docs for a extremely small fraction of patients for which asthma isnt even problem in our community, had perhaps 40 hours of meetings with atleast 10 administrators each at the cost of 200$/hr each only to find that no one was complying with this mandate. We then have another special committee to figure out why our compliance rate is so low only to have more training sessions for the RNs and doctors. All of this was to chase the 50k grant that we got that was submitted from the grant specialist whose sole job was to chase grants for the hospital. A grant to address a problem that isnt even an issue in our community.
This is just 2 of them.. there are SSOOOoooo many more instances that make me question whether our hospital actually knows what it's doing...it makes me think that we are a hospital that is trying to "fake it till we make it".
After two years of this, I am trying to figure how to tell my boss politely this is a waste of my time and would like to go back to strictly clinical time, make as much $$$ as I can, pay off my debts before it all implodes. Hopefully single payer healthcare or whatever replaces it will reduce the administrative burden and costs and doctors can focus on treating patients again. I also hope that when I retire, my out of pocket healthcare costs will be cheap enough that I wont have to worry about chewing through my whole nest egg and retiring in poverty if god forbid me or my wife have a bout with cancer.
Edit: all of this being said, I do feel that my team has contributed significantly to a better hospital, identifying issues, fixing it etc since we starting taking a larger role in hospital operations, but its fucked up knowing that all the admin are happy collecting their fat salaries doing the status quo while my team that is largely clinical from one department.. and carries the burden of driving all this change on the admin side and usually also carry the burden of executing them without any additional resources (we also carry the burden of NOT changing anything since our dept (ED) is where hospital inefficiencies are most pronounced to the community).
mr444guy on December 7th, 2019 at 02:33 UTC »
He ain't lying. I pay 10% of my paycheck towards health care premiums. Fucking bullshit.
Captain_Arrrg on December 7th, 2019 at 01:57 UTC »
Americans on average continue to spend much more for health care—while getting less care—than people in other developed countries