Based on some specific numbers I have seen, I think US work is about 2x of UK (private) work.
Plenty of UK consultants make $300k, but from a conversation I had about 3 years ago you could probably get a couple of heart transplants done here for $500k 
In the end almost nobody pays 500k in cash. It translates to higher insurance premiums.
There are however people who travel to the US for surgery by the very top people, and they pay cash. Lots of it
How this relates to coronavirus I don’t know. I guess it will wipe out the insurers’ reserves and the US taxpayer will have to bail them out.
Silvaire wrote:
Good things cost money and good people should be well paid, also including those developing the tools, drugs and technology.
Agree with you on that, but a problem of the US healthcare system, which is by some margin the most expensive in the world but delivers only mediocre results for the population at large, is that the loads of money sloshing around don’t seem to mainly go to the pockets of those who deliver excellent care but rather into the pockets of managers and shareholders of health insurance and health tech / pharma companies.
Otherwise no single operation would cost anywhere near 500k$.
Just FYI, this also happens in Germany, where private hospital chains such as Helios or Sana are expecting roughly 10 to 12% annual profit from their hospitals. That is outrageous, because they transform public money from the health insurance fonds into private shareholder gain instead of better medical care for the population (or at least better pay for their doctors and nurses…but no, those recieve the same level of pay as we in “public” hospitals do).
BSNGraham wrote:
A quick Google suggests the average salary for a registered nurse in the US is about $75k. Obviously I don’t know how much your mothers nurses are paid, but that’s not the point – you said that $100k was a conservative number.
BSNs in my area are paid an average salary of $130K annually, some more, some less. RNs (non-degreed nurses) are paid less but skilled nursing in the US is now typically done by degreed staff.
There a few places in the world where I would want to be for my healthcare as much as the US. Germany is actually not bad by my observation, but in terms of availability of advanced healthcare, fast and unrestricted, the US would be my choice.
Peter wrote:
There are however people who travel to the US for surgery by the very top people, and they pay cash. Lots of it
Yep, they are very much in evidence at the place I go for primary care. Thanks to them for the subsidy. It’s the same funding structure as that which has evolved for US graduate level education.
@Graham – you’re missing the point that a nurse in the Bay Area will surely make twice as much as the same nurse in Fargo, ND. She will also live 3h / 150km away from where she works, because the .com pay rates made it impossible for her to live anywhere closer.
The US is very big, and very disproportionate; kind of like comparing the money a nurse in London is paid with the one in Lublin.
Not to defend the US health system, just pointing out that “average” is meaningless in this context.
Yes, I am probably exaggerating. Somewhat.
tmo wrote:
She will also live 3h / 150km away from where she works, because the .com pay rates made it impossible for her to live anywhere closer.
My neighbor is a BSN living on her earned income plus I’d guess some child support from her ex-husband. She commutes 30 minutes to work. Here is her house, where she lives alone with her son in about 300 sq meters of space. Oddly enough the house next door to hers has the exact same situation, a single nurse with a son. Both are doing just fine, and that’s what I want when my body is being maintained or repaired by someone.
I suppose another reason that the US is so critical of the WHO is that it very rarely comes at the top of the world’s best health services list:)
But most of us would defend our own health services, if you are happy with the service and the outcomes you receive when you need them and the price you pay, whether directly or through taxes then what does ot matter how much the doctors and nurses get paid.
Well that’s not strictly true, French nurses are, I believe the lowest paid in Europe, but in my experience they are superb (second to none). I would like them to get better pay and accept the need to pay higher social contributions towards that.
I think the French health service is wonderful but I would not criticise other country’s services as I have no up to date personal experience of them.
gallois wrote:
I think the French health service is wonderful but I would not criticise other country’s services as I have no up to date personal experience of them.
Good idea. My immediate family has had direct personal experience with the UK system, the German system and with US healthcare. Some limited experience too with the Swiss and Italian systems. Not the French system though so you’ll note I don’t comment on it
Peter wrote:
How this relates to coronavirus I don’t know. I guess it will wipe out the insurers’ reserves and the US taxpayer will have to bail them out.
I think US insurers are doing very well in this situation. The hospitals are still relatively empty, healthcare deferred for many in expectation of a crisis that never came in most areas. What’s not being done is not being paid for by anybody. It’s the hospitals that are losing money, fast, due to government overreaction to Coronavirus that had them stop work in other areas.
That said, I’m guessing that many of those deferred procedures will be done in the end.
The main difference is the US is that the facilities and equipment are much better, particularly in terms of quantity and availability
I wish I could find that US. The one I live in has an appalling medical system, massively over-priced and not good at what it does. In fact it’s the biggest single reason why we plan a move back to Europe. Insurance is very expensive, but also it doesn’t cover very much. The insurers are always looking for a way to avoid payment, just like all insurers everywhere. There are plenty of horror stories, both in the media and personal anecdotes.
In the two years I’ve been on Medicare, that hasn’t been a single claim that it has paid. Luckily I haven’t needed much, and I just hope it stays that way while I’m here.
Doctors are painful to deal with and work hard to avoid their patients. Every interaction I’ve had with a “normal” US doctor (e.g. in the top-rank Palo Alto Medical Foundation) has lasted less than one minute – their goal seems to be to avoid patients as much as possible. Luckily I had for a long time (but no longer, sniff) a French doctor here in the US, who did things very differently – 15 minute appointments and a deep interest in everything around the patient.
If you do get involved with the system, they will spend $10K’s of your money doing pointless tests, partly to make money and partly because they are terrified of lawsuits.
The US is the only “advanced” country where people routinely die of curable conditions because they can’t afford treatment, and where people are routinely financially ruined by medical problems. The only place where people avoid medical treatment because they’re afraid of the cost.
The US medical system is awful beyond words.
johnh wrote:
The US is the only “advanced” country where people routinely die of curable conditions because they can’t afford treatment, and where people are routinely financially ruined by medical problems. The only place where people avoid medical treatment because they’re afraid of the cost.
The US medical system is awful beyond words.
All that is true, and I very much agree with you.
On the other hand, I understand why Silvaire is happy with the standard of care he and his family receive: He’s wealthy, smart and resourceful. People like him can indeed afford and receive excellent medical care in the US, which is probably on par or even superior to the best we have in Europe.
The fact that this is not true for a huge part of the US population probably plays less of a role to those not personally affected by this dilemma.
As far as Covid-19 is concerned, to get back on topic sort of, you need a system which provides the best possible care for as many people as possible. This puts the US at a disadvantage.
