This is the fundamental fact of American health care: We pay much, much more than other countries do for the exact same things. For a detailed explanation of why, see this article. But this post isn’t about the why. It’s about the prices, and the graphs.

One note: Prices in the United States are expressed as a range. There’s a reason for that. In other countries, prices are set centrally and most everyone, no matter their region or insurance arrangement, pays pretty close to the same amount. In the United States, each insurer negotiates its own prices, and different insurers end up paying wildly different amounts. That’s what Steven Brill’s explosive article was about, and it’s why you see U.S. prices expressed as a range rather than a single number.

angiogramoffice visit

angioplasty

bypass surgery

hip replacementknee replacementC sectionnormal deliveryappendectomyhospital dayMRICT scan abdomenhip prosthesiscolonoscopynexiumlipitornasonexcymbaltavytorincelebrex

After all these graphs, this final graph shouldn’t be a surprise.gdp health care duh

Further reading:

– Why an MRI costs $1,080 in America and $280 in France.

Further watching:

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timothybendel
Clearly there is much to be done to reform our healthcare system. However, there is one issue that I seldom see in any article: patent theft.Many countries simply steal the intellectual property used to make drugs. American companies spend billions to develop a new drug and get it through FDA approval, only to have it stolen by other countries. This effectively kills foreign sales and the drug companies respond by raising prices in the USA.Many of these drugs are “cheap” in other countries for this reason.
LMay29
4/4/2013 11:28 PM EDT
A graphic is worth a thousand words.

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Harryball
4/4/2013 11:33 PM EDT
Forgot to include the medicaid recipitant and illegal immigrant who got those procedures done for FREE. Opps not free the taxpayers paid for it!
Bill Wesley
4:42 AM EDT
forgot to mention the trillions in bogus charges the medical establishment awards themselves for free, er, not free, the insurance buyer pays for it.
lonquest
Would you like to talk about the 10,000% markup on Tylenol at the hospitals now?The American hospital system is a fraud machine. That’s where the money’s going.Blaming the poor for the corruption of the hospital business is, … well, … just typical Republican politics.
Ok, now let’s see the graphs and charts on outcomes, morbidity and mortality of these various procedures by country. Being from South Africa, a country on this list, I can tell you that I would rather pay the extra cost and actually live through the surgery and have a decent quality of life afterwards.
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Bill Wesley
4:47 AM EDT
What you are implying is wrong, Canada is the lowest on the list and outcomes there are better, the USA’s medical care outcomes are not that good, even CUBA is better! Paying more only insures that you pay more, you get what you BARGAIN for not what you PAY for

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Joe Cottereuax
What you are not being told are 3 major reasons why healthcare is more expensive in the USA:1. American patients subsidize foreign medicine sales of American medical products because many countries do not allow adding in the cost of R&D, government compliance and marketing, into the cost of the products. American pharmaceutical companies for example, must past onto Americans, those costs in order to recoup investment.2. America has no ceiling on medical lawsuits resulting in high malpractice insurance premiums whose cost is passed onto patients. An anesthesiologist could pay over $300,000 for insurance, and can charge $3,000 an hour (or more) in the operating room. Other countries limit lawsuits and place a ceiling on the how much is awarded thus lowering malpractice premiums.3. America insurances companies cannot sell across state lines reducing competition; this is not a problem in other countries.AND go figure, nothing in Obamacare addresses ANY of these points.
crenvy
4/4/2013
None of those points, however, explain the lion’s share of why costs in the U.S. are so high. Those are just talking points with no substance behind them. For example, because health insurance is privatized in the U.S., you can tack on at least 25% to costs so that the executives of those companies and their shareholders get their slice.
riohato
We are a GREEDY nation, that’s all there is to it.
Joe Cottereuax
4/4/2013
BlueWaterSong
4/3/2013
@killroy71:Your “reasoning”, while quite “truthy”, is completely at odds with the facts:http://www.washingtonpost.com/blogs/wonkblog/wp/20…
Capitalism doesn’t work for health care. If those graphs don’t prove it, nothing would convince you. The problem is, there’s no inelasticity of demand. When you need health care, you’re a sitting duck. Capitalism REQUIRES that sick people be taken advantage of. It HAS to result in the ridiculous prices you see above, because capitalists will raise prices as high as they can, and since you can’t say no to health care, you HAVE to pay.Only socialism works with health care, and it works well. It’s a fact–a proven, established fact.
Joe Cottereuax
4/4/2013
crenvy
4/4/2013
Joe, get over yourself, OK. Take the RW talking points elsewhere instead of point to them ad nauseum. We heard you the first time.
Lacuna Chinaski
Someone spent a lot of time making those graphs. But what will follow in their aftermath? Higher costs, and higher costs, and higher costs. Stephen Brill’s Time expose WAS explosive, indeed, but will anything ever change for the better? Ha! Of course not. This is America.
ccalvert
4/2/2013 12:43 PM EDT
There is a simple answer to your question: The Republicans would not let Obama and the Democrats address pricing issues. They insisted that we continue to let the private sector and the “free hand of the market” address the pricing issue.Let me see. On the open market, just how much is this life saving procedure worth to you? “Well let’s see, it costs $12 for the $1 drug and the two minutes it takes for you to give me the pill, so I would think $24 is a reasonable price.” The reply: “Oh no, you misunderstand. I didn’t ask how much it would cost to make a profit or meet expenses. I asked how much is it worth to you. This is the free market, and I think the market sets the price not at $24 but at $2400. Now remember, there is no way for you to do comparative pricing, we have prohibited that. So you can either walk out the door and hope you can find a better deal by traveling city to city, state to state spending weeks or months looking for a reasonable solution, or let the ‘free market’ solve the problem for you. And since you are sick, and immobile, you can’t really start a lengthy blind search for a good price, especially since you will have to pay the price of a doctor’s visit and diagnosis just to be allowed to ask about pricing. So why don’t we just let the ‘free market’ solve this one, okay?”And people wonder why single payer systems cost about half of the US private market solution….
OpenMinded
4/2/2013
The reason why insurance and private pay prices are so high is to make up for the low Medicare reimbursement and the indigent care provided for free. These graphs show what the individual pays. I would like to see a comparison showing the total cost to the government, insurance, and the individual. Despite what many believe, if the government pays for it, it is not “free”. Government has to pay for it somehow, and that is through taxes. Either way, the individual pays along with any government overhead costs (not to mention crony deals, etc.)
If health care can be provided for less, why aren’t doctor offices and hospitals opening that offer discounted services to get more business? They could be the “Wal-Mart” of healthcare and dominate the industry. I think that there are many inefficiencies in the “free market” approach. However, letting someone else decide what is “fair” is a very scary scenario to me. If those providers do not agree with the set price, they will stop providing the service or product. This is what is happening with many doctors here in the US. As Medicare reimbursements are decreased, many doctors are leaving their individual practices, where they can earn more by working more, to join hospitals under guaranteed salaries with no motivation to help more people. Flawed as it is, I have not seen a better system than the free market.
anderson2
4/2/2013
Pure GOP Conservative “Trickle Down” voodoo designed to continue the problem…AND THE PROFITS…IGNORE!
OpenMinded
4/2/2013
No. I think both parties are buffoons. They each lie to serve their own interests and pad the pockets of their friends.You can’t deny that healthcare has a cost. Government is funded by taxes. In the end, taxpayers pay for healthcare if the government provides it.
@IsaccVanBrunt thanks for sharing. You are so right about Congress, they voted themselves healthcare for life, while attempting to repeal Obamacare for the millions of those without access to healthcare or preexisting conditions. We could have had the public option to compete with the private market or Medicare for all, allowing people to buy in to the program. Do bulk purchases of pharmaceuticals and negociate prices, just like the VA does instead of the way that it is done now. For all that the US spends we don’t have the best healthcare outcomes and infant mortality rates. We must insist that as consumers there be as end to 77.00 guaze. We’re driving our country into the ground with these outrageous mark-ups on essential services. Speaking of “trial lawyers”…I see no reason why someone injured, given the wrong treatment or as it happens every year, has surgery and the wrong limb or organ is operated on. A piece of guage or surgical equipment is left in the body, should not have the right to sue the responsible parties. If it happens to you or your family, you want a good attorney.
sega61
You need to add a graph for how much the trial lawyers make in these countries as well, especially those who specialize in plaintiff medical malpractice.
Kismet47
Make that 45 years I’ve paid premiums of $50 a month
jkhamlin
4/2/2013
You’re welcome. Our higher costs subsidize your artificially low costs.
jkhamlin
4/2/2013
First, our military is what keeps your country safe, not your little pretend military. Second, the companies that make and sell healthcare products in your country are the same ones who make and sell them in our country. They sell them at a loss in your country because of the artificial controls on prices. They have to make up the losses somewhere. That somewhere is my country. WE subsidize YOUR little utopian fantasies. These are called FACTS. I notice you have none. You only have name calling. Sure sign of someone on the losing side of an argument. Go get an education! Preferably not in Canada. They’re apparently not to bright there.
SuperG
4/2/2013
Ex-heathcare exec here. Trust me – prices in the US are EXTREMELY inflated. One of the most popular pieces of equipment cost the company in time, labor and materials around $60. We charged insurance between $400 and $600. Your idea of ‘facts’ is simply wrong.
Miro
4/4/2013
Thank you for speaking up SuperG! This is what we citizens need to grasp and stop putting up with it…everyday we are overcharged.
As a user of our system with both Crohn’s Disease and COPD…I am soooo grateful I am a Canadian. I have spent 4 years paying premiums to our Medicare but I have taken so much more out of it.Our citizens feel it is up to all us to take care of some of us who have greater needs. I’m waiting for a lung transplant which in the U.S. costs $500,000 and I will have to pay nothing.
jkhamlin
4/2/2013
Of course, in the US, you wouldn’t have to wait NEARLY as long for the lung transplant, or any of the tests leading up to getting on the transplant list.
jkhamlin
4/2/2013
Actually, I’m a doctor and I used to be a financial planner. I’ve forgotten more about how it all works than the sum total of what you have ever learned. If I’m an idiot, then you are an ameba.BTW, I know EXACTLY how your system works. Not only from the above, but a lot of the medical students who rotate through the facility I work at are from Canada. We have a lot of discussions at work. They are all amazed at how much more efficient we are here and how patients actually get care here.Nice try though, moron.

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4Angels
4/2/2013
Unless, of course, you have no medical. Yeah, I’ll take Canada’s long wait over US’s never happening system.
Kismet47
4/2/2013
I doubt jkhamlin is a doctor….just another ignorant Republican.

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wolfemi1
4/3/2013
“Actually, I’m a doctor and I used to be a financial planner. I’ve forgotten more about how it all works than the sum total of what you have ever learned. If I’m an idiot, then you are an ameba. “Doctors 1) tend to not be petty and childish, and 2) can generally spell “amoeba”.
wolfemi1
4/3/2013
“We have a lot of discussions at work. They are all amazed at how much more efficient we are here and how patients actually get care here. “Sure, this totally happens. Oh, and they all said to tell me to tell you that Obama DROOLS lol!!!
Looking for 2 more charts: 1. Total compensation for Hospital CEOs; 2. Total Compensation for CEOs of Health Insurance companies. Should look like the others above.
sparkplug1
4/1/2013
Beckers Hospital Review puts non profit hospital ceo compensation at between 700k to 2.4m, for profit hospital CEO compensation at 1.2-3.4 m/y, and health insurance CEO Hemsley of United Health Care made 7.4 million in cash compensation and 98 million in stock options for 2010 according to the St. Louis Post. Google is fun and depressing.
OpenMinded
4/2/2013
Why do you think it is that other, well qualified executives are not hired for less? You would think the shareholders would want to get the best candidate for the least amount of money.
jkhamlin
4/2/2013 2:24 PM EDT
You have a good point with the hospital CEOs. You DON’T have a good point with insurance CEOs. Hospital CEO compensation directly affects cost of healthcare, as do the salaries of armies of people working in healthcare who have nothing to do with healthcare. On the other hand, insurance company CEO compensation is not related to the cost of healthcare. Insurance companies don’t profit from their premiums, so their premiums vs claims actually breaks even. CEO salaries don’t come from premiums/claims money.
OpenMinded
4/2/2013
That is the problem with not allowing health insurance to be offered across state lines; you create insurance oligopolies within each state. Without free market competition, they can charge whatever they like and pass it on to customers via their premiums.
jkhamlin
4/2/2013 2:38 PM EDT
OpenMinded: That’s how insurance works. The premiums pay for the claims. Pretty much the most fair system you can think of. The way you stated it makes it seem like you’re saying the opposite. I think what you mean is: It could work better with a larger risk pool than a single state.Insurance companies don’t just “charge whatever they like and pass it on to customers via their premiums.” They charge what it takes to cover claims, cost of paying claims, maintaining adequate cash reserves to cover catastrophic losses, etc. They don’t make any money from premiums
James Minze
4/2/2013
“They don’t make any money from premiums.”After that statement you are a proven liar.
You can’t be trusted. How is that for plain English?
OpenMinded
4/2/2013
jkhamlin: I meant to say that the CEO’s salary is part of the overhead included in the premium. Increasing the risk pool would only be helpful in the event of a very large scale catastrophe. Since they all have cash reserves, and re-insurance as a backup, increasing the risk pool should not significantly impact the premium.The real problem is the lack of competition. For the not-for-profits, if they can pass on overhead, there is no incentive to be efficient and cost conscious. If there was a free market for insurance companies, those with more efficient operations would win the business away from those who are less efficient.
wolfemi1
4/3/2013
“Insurance companies don’t just “charge whatever they like and pass it on to customers via their premiums.” They charge what it takes to cover claims, cost of paying claims, maintaining adequate cash reserves to cover catastrophic losses, etc. They don’t make any money from premiums.”This is absolute, flat-out BS. Of COURSE THEY DO! How else would they make a profit? Bake sales?And yes, they DO MAKE A PROFIT. Unless they’re specifically nonprofit, in which case they still pay for all the overhead and salaries and bonuses out of the collected premiums, including that of the CEO.
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