Medical costs are vastly inflated at every level in almost every way, from the buildings to devices to employees. Much of this is due to the government setting being the largest purchaser and setting up regulations paid for by special interests to drive up costs at every single level and point of contact. Notice for Lasik surgery where the government is not the largest purchaser and most people pay out the their pocket the cost has gone down dramatically. When special interests get control of the pricing, costs go up dramatically. It's interesting that the US pays 3 times what other advanced countries pay for medical and the US ranks 35th in quality. That means US medical has figured out how to charge us an additional two trillion dollars for bottom end quality for a modern country. This indicates massive corruption across the industry. If Silicon Valley worked like this a smart phone would cost about 2000 dollars. It's time to apply the Silicon Valley culture of ever improving technology at ever lower costs to medical instead of the Washington D. C. culture.
In certain area, I do agree that government regulation actually caused higher cost. For example, in Illinois (probably many other states too), each hospital has its own territory sanctioned and guaranteed by the State of Illinois. There are basically no competition in the same area. While making a lot of money, all hospitals here are non-profit organizations and pay zero tax.
On the other hand, our senators and congressmen intentionally to handicap government in managing cost. For example, the Federal government is prohibited by Congress to negotiate Medicare Part D price with makers of drug. Medicare Part D alone is an $80 billion Federal spending a year!
Can you image Intel, TSMC, or Apple are legally prohibited to negotiate price with their vendors?
Let Medicare negotiate drug prices: Our view
Why our Republican controlled Congress wants to do this way when Republican claims they are pro market competition? Other than corruption, can we find a better reason?
I have several opportunities visited Taiwan and used hospital, exam facility, and doctor services there. There are several things impressed me:
1. Doctors and nurses there don't use pens too often. The type info into computers, print from computers, and electronically transfer orders and prescriptions. I can't understand why America invented the computer but for many healthcare providers here in USA, using computers are not a standard practice. Many doctors will ask their secretaries or assistants to use computers but not themselves.
2. Each hospital or doctor office in Taiwan might charge a service or procedure differently. But to all people visit the same doctor or the same hospital, the price is the same. The only difference between John and Bob got a CAT scan at the same hospital is who are going to pay the expense and what percentage that is. Here in USA, doctors and hospitals are doing price gouging depending on if the patient has insurance or not and what kind of insurance he/she has.
3. In Taiwan, there is no so-called "gatekeeper" step before seeing another doctor or a specialist. If a patient feel the hospital or doctor did not give him/her the best service, the patient can just go to see another hospital or doctor immediately. It seems increasing cost, but strangely it encourages competition. A bad hospital or a sloppy doctor will notice the consequence very quick.
In short, Taiwan government implemented a National Health Insurance system to cover everyone. In the process, the system they implemented actually encourages market competition and best practice. Because everything is computerized, the doctors and hospitals get pay very quick. If there is any significant abuse or mistakes, their data warehousing and analytic system will spot that and initiate a corrective action very quick.
IMHO, to improve the efficiency and outcome for our healthcare system, government's involvement is a must. But I have little confidence on our congressmen and senators who can guide our country to achieve a best result. This is because in healthcare discussion, they will get into ideological passion too quick.
Back to our semiconductor industry. Can we imagine TSMC, Intel, Samsung, Qualcomm, TI, Toshiba, NXP, and Xilinx will "Not" pay attention to how other companies doing and learn the best practice from each other?
In healthcare policy debate, it's unthinkable that a congressman will dare to say, for example, for situation A we can learn what Canada did, for policy B we can learn the experience from France, for regulation C we can learn it from Taiwan. Are you kidding, learn from Canada or France? No way! Learn from Taiwan? Are you insulting America?
I clearly remember several years ago during the Obama healthcare reform debate, a TV news station announced the result of an opinion survey they did. According to their survey result, there are more than 90% of American believe they have the best healthcare system in the world!
I was stunned. It's not because I don't trust the integrity of that survey. I was stunned because if we exclude Canada, Mexico and those central America tourist spots, most American seldom set foot in foreign countries or use foreign countries' healthcare services. How can they make a meaningful comparison of healthcare system between US and other countries when they never went to another country?
