71% of the monetary budget of the guidelines gets paid by the pharmaceutical industry in 2018-2019.
Category: Economics
Interesting article regarding health economics
Abstract
Background:Little is known about the long-term effects of high-deductible insurance on care for chronic medical conditions.
Objective:To determine whether a transition from low-deductible to high-deductible insurance is associated with delayed medical care for macrovascular complications of diabetes.
Design:Observational longitudinal comparison of matched groups.
Setting:A large national health insurer during 2003 to 2012.
Participants:The intervention group comprised 33 957 persons with diabetes who were continuously enrolled in low-deductible (≤$500) insurance plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans. The control group included 294 942 persons with diabetes who were enrolled in low-deductible plans contemporaneously with matched intervention group members. Intervention:Employer-mandated transition to a high-deductible plan.
Measurements:The number of months it took for persons in each study group to seek care for their first major macrovascular symptom, have their first major diagnostic test for macrovascular disease, and have their first major procedure-based treatment was determined. Between-group differences in time to reach a midpoint event rate were then calculated.
Results:No baseline differences were found between groups. During follow-up, the delay for the high-deductible group was 1.5 months (95% CI, 0.8 to 2.3 months) for seeking care for the first major symptom, 1.9 months (CI, 1.4 to 2.3 months) for the first diagnostic test, and 3.1 months (CI, 0.5 to 5.8 months) for the first procedure-based treatment.
Limitation:Health outcomes were not examined.
Conclusion:Among persons with diabetes, mandated enrollment in a high-deductible insurance plan was associated with delays in seeking care for the first major symptoms of macrovascular disease, the first diagnostic test, and the first procedure-based treatment.
The reason why American Healthcare is so expensive
American Healthcare is the most expensive healthcare of the world. This could be could of two reasons:
- The healthcare is poorly organised
- USA has a higher disease load
I think the main reason is reason number 1, which coincidentally also creates 2 creating even higher healthcare expenses.
The reason
A large group is uninsured. This drives up the costs for everyone.
Imagine 1,000 Uninsured People. Of those 1,000 people 30 develop chest pain. Because they are uninsured, they do not seek medical care. Of those 30, 10 people develop an myocardial infarct and present at the ER. The hospital has to treat them and for costs are made for 10 Myocardial infarcts and the longterm results.
Contrast this to the next example:
A large group is insured. This will dampen the costs for everyone.
Imagine 1,000 insured people. Of those 1,000 people 30 develop chest pain. Because they are insured, they seek medical care. They are properly treated by cardiologists. This proper treatment prevents myocardial infarction, only 1 person in the 30 develops a myocardial infarct. This not only increases proper healthcare, it also decreases total costs made in the
Comparison with cleaning your room:
If you clean your room everyday, it is an easy task and costs only 5 minuts
However if you wait really long, it becomes a way harder task. Every week, it will take you an hour. Compare this to 7 times 5 = 35 minutes. Ignoring early problems will result in way bigger problems down the road.
Multiple factors:
People of low socioeconomic class have a way higher disease burden. Coincidentally, this group is more often uninsured. This exponentiaties the cost.
Question:
Is this a dichotomous effect (insured vs uninsured) or can there be a comparable continuous effect found in healthcare with universal insureance? This can be intersting for ways to reduce costs in universal healthcare, which in my eyes is the gold standard for a good health economy.
Bonus video with extra effect:
A writing place. 