One thing I'd like to understand is why there is such a difference between medical costs here and those in Haiti. At the time the book Mountains Beyond Mountains was written, in 2003, it often cost $15,000 to $20,000 annually to treat a patient with tuberculosis, while it cost one one-hundredth of that-- $150 to $200-- to treat a patient for the disease in Haiti. Even if the figures aren't completely accurate, the sheer difference would still be there.
Indeed, the United States pays more per capita for medical care than any other country on Earth. My first guess for why the disparity exists is that there is a market willing and able to pay more for medical treatment, so suppliers see the demand and respond with higher prices. According to at least one doctor (go to http://scienceblogs.com/denialism/2009/05/what_is_the_cause_of_excess_co.php), part of the reason is administrative prices here. People here have a higher standard of living, and so the cost of care is shifted to the consumer to pay for that standard. This is oversimplified, but it is good to know that institutions in Haiti like the Zanmi Lasante are able to pay such a comparatively small amount for treatment. This medical facility is an example of the good being done in a country known so long for the bad.
Indeed, the United States pays more per capita for medical care than any other country on Earth. My first guess for why the disparity exists is that there is a market willing and able to pay more for medical treatment, so suppliers see the demand and respond with higher prices. According to at least one doctor (go to http://scienceblogs.com/denialism/2009/05/what_is_the_cause_of_excess_co.php), part of the reason is administrative prices here. People here have a higher standard of living, and so the cost of care is shifted to the consumer to pay for that standard. This is oversimplified, but it is good to know that institutions in Haiti like the Zanmi Lasante are able to pay such a comparatively small amount for treatment. This medical facility is an example of the good being done in a country known so long for the bad.
This is a good question. Here are some thoughts.
ReplyDeleteOne, supply and demand. The demand for medical care in the US is high. It's high because its cost is not born directly by the user, but by an intermediary known as an insurer, be it public (government, medicare) or private, (a private insurance company). When demand for a product or service remains high because increases in cost reflected by that high demand are not passed directly to the consumer, the demand and thus cost will not fall. For example, I should have to think twice for running to the doctor for a sniffle. It should cost me enough that I weigh my need for medical attention vs. the cost I will pay for that medical attention. However, in our current environment,that is not the case. I pay my $25 or $50 co-pay and someone else picks up the balance. Where is the inducement for me not to run to the doctor in that picture? Answer? There is no inducement. Result? Demand remains high and thus the cost. In Haiti? Going to the doctor I would imagine is for real need, not a sniffle. Demand for un-needed/unwaranted healthcare is no doubt less.
Two: litigation; Providers of healthcare products and services continue to experience litigation with huge settlements. Until we see legal reform that brings sanity to amounts of settlement regarding providers of and to the healthcare industry, including malpractice, reduced costs in healthcare will be difficult to achieve. Regarding Haiti? Probably not allot of attorneys trolling the waters for malpractice settlements, etc.
Three: government regulation; when you have government beauacracy dictating how an industry will conduct its business, users costs will dramatically rise. Time and administrative costs to simply comply with government regulation is huge and must be passed on to users. As long as government regulation rules business, costs will continue to rise. Haiti? Not sure what role government plays in Haitian healthcare, but I would imagine nothing when compared to the US.
Again, very interesting and pertinent question you have asked.
Lee Robinson
Thanks for the clarification, Lee! All three of your points make sense. Your first point, regarding supply and demand, seems like it would account for more of the higher costs than even litigation. When a large population has ease of access to medical care, and someone else has to pay for most of it, prices will remain high (like you said). Thanks for your input.
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