1. This is a 28 page document.
2. It is over 2 MB, so can take a little while to download on a slow connection.
Given those two facts, it may be a while before I have time to read the entire thing. The first couple of pages look pretty interesting, though, putting into more formal language some of the factors that anyone who pays attention to the state of the healthcare industry in this country should already know.
It is very well written and quite direct on some points, the main thesis being that even when normalized by national wealth per individual US healthcare is still more expensive than other developed nations.
Among the points made is that, economically, healthcare is not as tightly coupled, or not coupled in the same way, as other products. For instance given the arcane nature of clinical therapy and for other reasons, competitive pricing transparent to the consumer is less accessible. A very salient point. And furthermore an orientation to newer innovative technologies which are more expensive invokes the dichotomy of access to the the wealthy rather than the less so.
But in the entire report, in its entire analysis of excessive US healthcare costs, not one thing is said about practice insurance and US litigious burden. Not one thing. And this from an internationally recognized institution. That in itself is reason to consider the entire report less than comprehensive and weak-minded.
The USA has three times more lawyers per capita than any other nation on the planet. And this impinges on healthcare, big time. As in ambulance chasing. As in every physician's judgement being brought before a court of non-technical judges. Thus the McKinsey rationalization of the arcane or obscure technical nature of the healthcare product, and decisions, is clearly incorrect when routinely challenged by non-expert lawyers, judges, or juries. This is not a rant but a blatant logical flaw, both in this report, and in the national discussion overall. Obamacare as I understand it (who does?) says nothing about tort reform or litigious burden.
Thanks again for the post, the report has some salient points and statistics; but does circumvent major problems in the US healthcare situation. The Suntrade Institute has, and can, issue a somewhat more pointed critique with solutions. But, like Sara Palin or the Tea Party, a whole population of phonies (the Left) will not want to hear it.
Johnny Suntrade
Off the top, it looks dishonest. There are 1 m physicians in US. If average physician income is $250k (which is high estimate)with 100% overhead ( high but probably close), that amounts to $500 b of the $ 1,700 b health care spending , yet the first assertion in the PDF is that the the comparative over-spending is $650 b and “physicians and hospitals” account for $436 b of that. It then lists provider response to high margins and the fact that care is based largely on physician judgment as the first two responsible factors. Two things come to mind. Even in a more extended discussion later on in the paper ( I haven’t read the whole thing), and especially relative to the other countries, there is no interpolated discussion of the rapacious US trial lawyer bar and how this influences “physician judgment.” Nor is there discussion of an everyday observation, namely that there are few hospitals in the country that in any five year period are not renovating or building a new wing. I heard the head of the buildings trades council in Philadelphia on the Dom Giordano program one time, and he told me all I ever needed to know about that. He sat on the board of the hospital system, it may have been Tennant, it could have been others as well. The hospital expansion projects use union workers, and a prime goal of negotiations for the building trades contracts is , try to guess, premium health benefits ( the Cadillac plans). The fact that this PDF ignores ( or fails to highlight, if you have seen discussion in the parts I haven’t read)leads me to believe it is an argument constructed on a Democrat/ socialist template.