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The real reason American health care is so expensive

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Hint: single-payer won’t fix America’s health care spending. Subscribe to our channel! http://goo.gl/0bsAjO Americans don't drive up the price by consuming more health care. They don't visit the doctor more than other developed countries: http://international.commonwealthfund.org/stats/annual_physician_visits/ But the price we pay for that visit - for a procedure - it costs way more: http://static1.squarespace.com/static/518a3cfee4b0a77d03a62c98/t/57d3ca9529687f1a257e9e26/1473497751062/2015+Comparative+Price+Report+09.09.16.pdf The price you pay for the same procedure, at the same hospital, may vary enormously depending on what kind of health insurance you have in the US. That's because of bargaining power. Government programs, like Medicare and Medicaid, can ask for a lower price from health service providers because they have the numbers: the hospital has to comply or else risk losing the business of millions of Americans. There are dozens of private health insurance providers in the United States and they each need to bargain for prices with hospitals and doctors. The numbers of people private insurances represent are much less than the government programs. That means a higher price when you go to the doctor or fill a prescription. Uninsured individuals have the least bargaining power. Without any insurance, you will pay the highest price. For more health care policy content, check out The Impact, a podcast about the human consequences of policy-making. https://itunes.apple.com/us/podcast/the-impact/id1294325824?mt=2 Vox.com is a news website that helps you cut through the noise and understand what's really driving the events in the headlines. Check out http://www.vox.com to get up to speed on everything from Kurdistan to the Kim Kardashian app. Check out our full video catalog: http://goo.gl/IZONyE Follow Vox on Twitter: http://goo.gl/XFrZ5H Or on Facebook: http://goo.gl/U2g06o
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Text Comments (13182)
Rita Caetano (1 hour ago)
It's spelled "Portugal". Thank you
P R (3 hours ago)
You can't shop for something that has a hidden price list. A person has no clue to how much it costs before seeing a doctor or buy a medication. Also calling for a price does not work when they refuse to tell you the price over the phone.
luis lee (11 hours ago)
You put only biased chart, why don't figure out facts in details on usa in healthcare regulations? You democrats legislated socializing healthcare with obama care and make it's worst and you come to tell me that the private health insurance is the problem?
David Wassenaar (14 hours ago)
Greed is Good has been the big lie for over half a century.  One other clip you might want to check on medical care cost is the Adam ruins everything clip goes over a lot of the same thing makes a claim that hospitals and insurance companies are in on it charging us 300-1000% over the actual cost which the Insurance company makes a big deal of cutting that in half which means the hospital is only charging you 150-500% over the actual cost.  Here is fun experiment for you try calling you insurance company and get them to tell you how much they negotiated for you medical procedure. That is a no go for most of them. Pretty much we have set up a market, based on price gouging that is protected by lobbyist money and the fact that everyone is doing it. If we want to fix healthcare two laws have to be passed one we can change health whether it is employer paid or when ever we want not just once a year or when "life events happen" and 2 hospitals and insurance companies have to provide a true break done of the cost going all the way back to how much it actually cost the hospital to buy an IV bag or pay their doctors. We put those two laws into effect the US "consumer" Patients get to have a modicum of control over their own healthcare cost.
William Straughan (14 hours ago)
ask them how much government tax they pay these countries pay a lot more gov taxes than the u s
Paul Bouchard (16 hours ago)
Sorry, health care is a criminal enterprise in America,
Clime Life (17 hours ago)
This is why I don't believe in health care. Eat right, drink GOOD water, work out regularly, & just take care of yourself THROUGHOUT your life not just after you get sick. I refuse to get health care & make up for the majority of the populations ignorant choices that result in these ridiculous prices. This year they are removing the tax penalty for not having healthcare. I've never had health care in my 20 years of living along with my 38 yr old mother & my 52 yr old father. My dad used to suffer really bad from hemorrhoids & high cholesterol but after he purchased a kangen machine, a Japanese preventative health care medical-grade water device that is prescribed to patients with colon cancer in Japan (research Dr. Hiromi Shinya), he no longer suffers from it. After my family disintegrated my mom started eating very badly with her new family & got diagnosed as pre-diabetic during a check up (the doctor recommended she begin the keto diet which I discouraged her from because it revolves around meat, poultry, eggs, and dairy which are detrimental to not only our health but also the planet) & instead told her to start eating more whole plant-based foods like fruits, veggies, legumes, & seeds, while also drink at least 97oz of kangen water daily. There is so much corruption in healthcare & medicine, y'all need to stop believing everything that you are told by doctors. I don't even blame doctors at this point because it's not their fault that they're not taught these things. They're only taught what the industry wants them to know; without sick people there is no profit. They don't know much about preventing diseases, only how to prescribe drugs & perform surgeries. I suggest to whoever is reading this and wants to know more, or is probably ridiculing me, to do their own research & find books on doctors that confess these things themselves like, "The Alkaline Cure: Lose Weight, Gain Energy and Feel Young" & so many more. My husbands parents have health care & make almost 5x as much income as mine but they're currently drowning in debt for surgeries that they can't even afford to buy a kangen machine for prevention...or at least don't want to because they'd rather believe American doctors rather than foreign ones.
Source Code Deleted (1 day ago)
The problem is that Americans don't see or choose the prices from the hospital's chargemaster. Socialized healthcare wont resolve this problem this is why it will cost 40 trillion to implement.
Piopincilo (1 day ago)
USA is just profit simple as that!!
Shivam Prasad (1 day ago)
A kidney transplant in USA will cost you around $400,000. While the same thing in India (in private hospitals) will cost you only about $9,000.
chris Favorite (1 day ago)
Usa is greed beyond profits. moving to ecuador.
Grello Grey (1 day ago)
Good thing you ran this trwough a checker before posting or else youd miss the Protugal -.-
jesbsnrn (1 day ago)
thank you
Paul Thompson (1 day ago)
Those against single payer love to say...if the govt dictates what they pay doctors then less people will want to be doctors and ultimately there will be less really smart doctors because they cant make enough money.
Chandler Mcmahan (1 day ago)
If the master charge lists of each hospital were available to the public. Not the gov and not strictly insurance companies. But the customers. Itd force the prices lower without single payer.
Geoffrey McCorbin (1 day ago)
The cost of healthcare couldnt possibly have to do with people being forced to pay for services they dont need/want.. nope... definitely not that. Cause ya know, "mUh SoCiAlIsM"
Arené Lomax (1 day ago)
(By your data) If America eliminated government subsidies, then health care would be less expensive than all those other countries.
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Raymond Strunk (2 days ago)
Don't pretend ours is a free market system. We pay so much because our government mandates large employers provide insurance, AND regulates limited numbers of insurance companies in each state FOR that state, without possibility of new startups or competition across state lines. Your premise is flawed. While you rightly identify insurance expense as the majority cost in our system, you fail to identify the obvious response: stop government interference in the medical insurance industry. Instead, you draw the inaccurate conclusion that healthcare is an exceptional industry that will perform MORE efficiently under government control. Recind legislation mandating healthcare insurance and limiting competition between insurers to bring down insurance rates (the problem rightly identified at the beginning of the video).
Charles Bickel (2 days ago)
Insurance is the problem.
Christian Henrriquez (2 days ago)
I just want to say something. My aunt lived in the USA (she died a few months ago), and she would always come back here (El Salvador) to take care of her teeth, her knees, her eyes, etc. etc. even if that meant having to wait 1 year or more which is when she came to visit, instead of going through her savings for a knee pain treatment. We may not have the best health system, but at least it's free. :)
Grinning Guise (2 days ago)
We need MOAR BOMBZ!! Who can afford healthcare??
Allen Smith (2 days ago)
Simply greed.
__TidePods__ (2 days ago)
taijiangah (2 days ago)
You forgot to mention another reason Healthcare is so expensive in the States is due to the fact that malpractice insurance is equally expensive. We live in a country where people order hot coffee and then sue when the coffee is too hot.
Reid Brinkley (2 days ago)
Carl Swanson (2 days ago)
Because it's not a Free Market moron, the government has their fingers in everything. Notice you didn't mention the cost of Medicare/Medicaid compliance... because you can't defend it. You're either an idiot or deliberately dishonest.
Grinning Guise (2 days ago)
Can you point to a FREE MARKET system in the world with better outcomes?
Jordan Wood (2 days ago)
Cause Murica that’s why.
homeofthegooddeal (2 days ago)
Years ago South Carolina implemented the lottery Program to help pay for college. Next semester the school doubled their price. So Basically the school was getting money from both the government and the people. I feel this is what the health care system Does in general. I feel as if the government's role should not be of a provider but of a protector. I feel as if the government should be more on regulating health care cost than supplying endless amounts of money.
Neffariousnyc (2 days ago)
If medicare is so great, why do so many old people also have to buy gap insurance from private companies to cover long term care or surgeries that medicare won't cover? Healthcare isn't expensive because of a lack of bargaining power by insurance companies against government programs, its expensive because the consumer has next to no bargaining power at the point of service. Doctors and Hospitals control the services and can set the prices they charge for healthcare. Thats why some doctors perform surgeries at no cost to the patient. It is misleading to suggest that "the open market" is to blame for the cost of healthcare simply because insurance companies can't compete with government insurance programs.
Cookie mon (2 days ago)
Wow so much stupidity in this video. Government is better than private sector at providing health care? Such stupidity. Government is full of waste and corruption they would make things worse. You covered only the surface of the problem just to show your biased opinion. The problem with health care in the USA is that there's too much government. Do your research well and educate yourself. Also you dumbass if you think government is best for putting prices use your brain and think what that would do to quality of services. Imagine what would happen to the iPhone if 10 years ago the government stepped in to say phone too expensive you have to charge half....the lack of economic literacy is the real problem. Also people need to take better care of of their health
BIGDAVE5352 (2 days ago)
From my experience I have paid a whole lot less than if I had insurance. The patients with insurance pay more because of the extra red tap associated with billing the insurance company. In fact my doctor quit accepting insurance and let go 6 staff members so he can be more efficient. He told me that he had to pay those 6 people to transcribe the billing to the insurance company and then wait 90 days to get paid. Then if one thing was coded wrong the insurance company would reject the claim. Now he bills the patient directly and the rates are much lower and the quality of care is much better.
WAKANDA FOREVER (3 days ago)
I grew up in America and I currently live in West Africa. Just had a tumor removed and it cost me around $500. The same procedure would have cost me at least $15,000 or more in America. Being poor in America is a death sentence.
Kyle Fraga (3 days ago)
You do not know what you are talking about
KLJF (3 days ago)
the moment money was invented our desent into hell was inevitable .
Jesse Alexander (3 days ago)
How much do people who work in healthcare get paid in other countries where it is free
franzb69 (3 days ago)
conventional medicine is even more corrupt that the government. that's why.
Theo G (3 days ago)
How about the fact that without the us medical economy, the rest of the world would suffer. I'm Canadian, the only reason we have new resources and cheaper medication is because we leverage the us as a single consumer to get cheaper equipment and prescriptions since they've already been made for the American consumer. Wake up people, if the Americans go single payer it will have a long-term detrimental effective to global healthcare.
T. M. N. (3 days ago)
How the hell does this video just have 65k likes and nearly 8k dislikes?! Do people who dislikes this even watched it (or exists)?
Alexander Wang (4 days ago)
Look where privatization got us.
MiniatureMasterClass (4 days ago)
Ryan Toomey (4 days ago)
America has one of the best healthcare systems. I hear about so many Canadians coming into the U.S. to receive healthcare because they can't get it in Canada.
MrBati122 (4 days ago)
The US sucks
AndyDog67 (4 days ago)
Greed, plain and simple.
1angrykoala (4 days ago)
This video is so incorrect it baffles the mind. Never in the history of the US has government EVER ran, managed, or created anything as effectively and efficiently as the private sector. Ever.
1angrykoala (2 days ago)
+Grinning Guise No faith is required. Facts don't lie.
Grinning Guise (2 days ago)
your faith is commendable, but misguided
Anna Barata (4 days ago)
Am I the only one seeing "Portugal" spelled like "Protugal"...
imtyaz ahammad (4 days ago)
compare it with india 🇮🇳
Joe B (4 days ago)
The real reason is greed. Period.
David Urry (5 days ago)
Why do the uninsured get screwed on price? It's because the doctors negotiate with insurance companies for the "average price". So your bill at 4X helps the doctor get more out of the insurance company. The insurance company also encourages this behavior by doctors because it incentivizes the uninsured to get insurance.
Benson Fang (5 days ago)
isn't that effectively price controls 2:34
The Red Look Podcast (5 days ago)
You failed to mention the reason the public resources is so cheap is because other people foot the bill. The more money you make - the more you have to pay into it. You also failed to mention that people don't have to rely on the governmetn to say yes or no about a procedure and the wait time is the lowest. Last, innovation is overall and degree of specialists are highest here.
Jon Greenbaum (5 days ago)
Why have that sub headline "Single Payer Won't fix America's Health Care Spending"? The conclusion about a Medicare opt in isn't something that single payer advocates oppose. And free college education usually accompanies Medicare for All platforms espoused by progressive candidates. That mediates the problem of comparatively overpriced American doctors with huge debt (actually its the specialists that are outlyers in our system). This headline and subhead just feels really disingenuous. What was going on there?
Brajesh Singh (5 days ago)
The US system is not that bad as it is made out to be...you just have be "smart" or responsible enough to buy insurance or if you are poor enroll in medicaid ....I think instead of making a big fuss or a debate as it is termed in politically correct terms and eventually do nothing the policymakers can easily make health insurance provisions more consumer friendly, educate people about the various insurance options they have and improve things substantially....complicated and expensive procedures will always be a contentious issue and maybe out of the reach of poor or low income individuals...that is where more deliberations maybe required ...
Tom Bosma (5 days ago)
Your introductory argument would only be true if we chose to not give health care to those currently on private programs. If a minority of citizens (~35%) are insured on public programs and the cost is approximately the same as private spending (which covers ~72% of citizens) and that of other countries per GDP, then logically extension of the public systems to the general public would result in an increase in cost per GDP.
colten tackett (5 days ago)
The problem isn't how the private sector spends the problem is that the government is involved at all, if there was no mandatory insurance the health care cost would plummet. This also goes for car insurance but in a slightly different way if the government didn't mandate it the it would be cheaper for everyone to get that wanted it.
MandoMonge (5 days ago)
#1 reason I love my third world country and wouldn't want to go to the US
Yo Now (5 days ago)
Jack Lan (6 days ago)
Everytime I hear someone say "free" healthcare and "free" college, I cringe.
Kevin Tideson (6 days ago)
Nope! It’s not totally right.. In U.K. example, if your hospital signs up with NHS or Medicare as in USA, only then government can dictate price to your services to ALL of your costumes.. But if you do run your own private health care centre and chose to do not make a business with NHS or Medicare as in USA, you do have a right to market your services at any price you wish
Iu Iulitza (6 days ago)
From my personal experience with universal healthcare , when i was 17 , i waited one month in hospital because we didn't knew we have to bribe the surgeon to rush the procedure . Second day after we paid him , i was on the table. So you understand why people are kind of skeptics. It sounds good on paper but in reality the demand for free healthcare it;s so high that medics become corrupt and prioritize the rich clients while the poor ones have to wait in line.
jasonlajoie (6 days ago)
I lived the first 30 years of my life in America being told how it is the greatest country on Earth. It didn't take long traveling abroad to see through this lie. I've spent the past 15 years living in Switzerland and have not even gone back to the U.S. for a visit. Best decision of my life, as I've been watching things only get worse over there.
jasonlajoie (6 days ago)
But the average American is just too ignorant to know how the system is flawed and will never try to do anything to change it. Some will shout "We want Universal Healthcare" but this can never work until the prices are regulated down to a reasonable level.
dmonarre dmonarre (6 days ago)
This rebuttal is general, but still directly applies: https://www.youtube.com/watch?v=gPJWwiKnYGs&t=1s
dmonarre dmonarre (6 days ago)
dmonarre dmonarre (6 days ago)
Uhh, https://www.amazon.com/Basic-Economics-Thomas-Sowell/dp/0465060730
dmonarre dmonarre (6 days ago)
dmonarre dmonarre (6 days ago)
Daniel Kariuki (6 days ago)
Unless you want to pay more taxes leave health care in private hands
MrPiercegarnettallen (6 days ago)
Vox is a complete embarrassment of a company. I dare anyone to explain to me how this guy doesn’t recognize that private insurance companies don’t negotiate on our behalf because THEY ARE HEAVILY REGULATED AND SUBSIDIZED BY THE GOVERNMENT ALREADY. Private spending is so high because doctors don’t have an incentive to lower prices and “private” insurance companies don’t have an incentive to negotiate because of government involvement. The free market built our healthcare system through innovation, competition, and supply side economics. Industries have never grown because the government dictated prices to the supplier.
dan hemmerling (6 days ago)
In the next 2 years I will have a Stoma Reversal and get a new Kidney. I don't have private health but it will cost me $0, nothing, zero apart from medicines when I get home butthe price of medications are subsidised so I will only pay $36 even if the real cost is $1,000 or more. I pay 2% ofmy gross income for this. This could work in America if they got over the Socialist/Communist propaganda bullshit.
Eoin Melby (6 days ago)
In terms of cost, there are good simple policies to use (if you have politicians who support it of course, lol) one would be frontline investment in prevention of diabetes/heart disease, an acceptance that childhood obesity must be tackled aggressively. The other is a law banning all "within patent" non-generic medications, then individually negotiating certain drugs to be exempt from this. A recent big pharma study showed that giving Aspirin 90mg reduces the risk of cardiovascular disease over 75mg aspirin. Even without looking at the study, hazard a guess why it was done? Yup, that drug company is the only one that sells it at 90mg. In the UK we laugh at that blatant attempt to rip off the taxpayers, in the US I would have no doubt that that dose of aspirin becomes the norm, at quadruple the cost, and a handy donation from big pharma goes to the prescribers and managers who implement it.
Xuan Cong Nguyen (7 days ago)
I thought Obama did something about that ? Did he do anything ?
Mark English (7 days ago)
Health Insurance is The Reason Many Americans CAN'T Afford Healthcare.
JackManic1984 (7 days ago)
And those regulations on public healthcare making it cheaper jacks up the cost for everyone paying for their healthcare out of pocket. Government is what is making the cost go up, not private businesses.
robertson Patrickson (7 days ago)
I think you guys should do a video on the Singapore healthcare system. It's mostly private and utilizes the free market better than the United States. The problem is individuals are not involved in the decision making process, it's bigger companies.
Right Wing Nutjob (7 days ago)
The Netherlands healthcare is 100% privatized with the governmejt subsidizing the people that cannot afford to buy it. So you got that chart wrong
Nathan (7 days ago)
This video flat out misses the facts, there's no real investigative journalism going on. Gov't regulation with O-care, Hippa, 1983 prospective payment, is why this is so expensive. The added work involved, just to bill people is insane. way to many employees have to touch a bill just to get paid. the answer is allow health insurance to be like car insurance. Get insurance out of the payment process, make them pay the patient, and the patient pays the bills. Remember to get checked for cancer after any vox video.
Rayna Bailey (7 days ago)
I was having acute pain in my lower right abdomen for a week. Thought it could possibly be a cramp until i woke up one morning and blacked out from the pain. I told my bf to drive me to urgent care because i didnt have insurance and didnt want to risk driving up the medical bill that i already knew was expensive. I had a physical, blood test, ultrasound and cat scan. The bill ended up being 3,000 :( good thing i didnt take an ambulance
James Bond (7 days ago)
Stop blaming the US government. I am here in Vietnam where doctors let you die if you don’t pay up front.
Hard_ Living (7 days ago)
$600 MRI Scan for them to only tell me there is nothing they can do and gave me basic pain medication that I could’ve gotten in my local grocery store, That was after waiting in the lobby for 5 hours. I never go to the doctor now unless I can barely walk and even then I dread the visit.
sbcavo4332 (8 days ago)
I agree that American health care is dogshit and can easily be done better but id love to see you guys start putting citations in your video essays.
Dinesh Vah (8 days ago)
This is a bad analyses since you try to filter out the profit the insurance companies make. The government is not the best option. They need to create transparency. Force insurance and hospitals to re invest certain profits they make to lower health and medicine costs.
Altrunchen (8 days ago)
Why does it always seem like lobbying is the problem?
VYCanis Majoris (8 days ago)
Nice oversimplification dumbass
Andy K (8 days ago)
The reason US healthcare is so expensive is because we USE IT! If Americans took as good of care of themselves has they do of their homes, yards, cars, etc. The amount of preventable chronic health conditions requiring treatment would fall dramatically. Therefore not requiring so many trips to the doctor, ER, surgeon, etc. And health providers would have to lower costs.
Piotr Wawreniuk (8 days ago)
If american public health spending is as big as in other countries, then why do they still spend so much money in private sector?
Ee Dd (8 days ago)
The real reason American health care is so expensive - we have the best doctors in the world.
John Dunn (8 days ago)
and don't forget 90% of all the "work" done in the hospital is done by people qualifying for food-stamps and public assistance. all the money goes to investors, administration, drug peddlers and vendors. oh, and "doctors" that will give you (on average) 11 seconds of their time. it's faster than a debt-card swipe.
John Nycto (9 days ago)
American health care is a cash cow for: 1) Doctors 2) Hospitals 3) insurance companies 4) drug companies (not necessarily in that order).
Jarret Averett (9 days ago)
The Free Market isn't the problem, because it isn't a true free market - state laws, government regulations, etc prevent the free market from taking care of the issue. When an insurance company in one state can't sell across state lines then its not a truly a free market. Insurance companies have special provisions in the law that allow them to do things other industries wouldn't even dream of like denying to pay what is owed or how much they will pay. This has had a domino effect of having Doctors and Hospitals inflate their costs to ridiculous amounts knowing that the insurance will only pay a fraction of the cost, but that way they get paid closer to what they should have in the first place. Then the insurance turns around and bills the consumer for part of the inflated costs they've already decided they won't pay.
Lauchboy (9 days ago)
Putting VA in the Amercian governmental healthcare spending makes the first chart look better than it actually is
Josh Bull (10 days ago)
So it’s the governments fault for high prices... they can threaten and lower prices for them which raises private prices
Fishy 6734 (10 days ago)
I’m sorry but I’d rather not have to pay an increased amount in taxes to use a service I will barely use. Also if I need to go to the doctors I’d rather get help immediately and not be put on a months waiting list. cough cough Canada. The US is the greatest country in the world and no one can change my mind!!
Kareem West (10 days ago)
@vox - Name one thing the government does that is cheaper than the private sector.
Derek Vuong (10 days ago)
I live in the US I'm a healthy 26 years old and paid 235 per month and my company paid the other half. I have to pay out of pocket for any doctor visit until I hit 3k then they will pay the rest. There're times where I got sick but didn't want to visit the doctor because I would have to pay out of pocket for a visit until I hit 3k. It sucks.
v_espertine (10 days ago)
Because America is a non-society. Sorry, but it's true. There's absolutely no sense of community in the U.S. None. Zip. Zero. It's all about ME ME ME and at the most your "nuclear family." Which explains why someone who develops cancer and needs chemotherapy, who falls down in the street of an aneurysm, or has acid thrown in their face or gets embedded with nails from a terrorist blowing themselves up has to pay for the treatment they receive. It is utterly embarrassing that America doesn't think the healthcare of its citizens should be a human right and free at the point of access (not that the taxes paying for it are free of course) rather than a business.
Balanced Wellness (10 days ago)
What a biased video
Willem DaFuckedUp (10 days ago)
3:52 This is actually 100% nonsense
Tony Johnson (10 days ago)
Here's a tip: Want the Rich in America to not have so much Political Power? Ban Lobbying.
Posi P (10 days ago)
just another employee talking.

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