We'll never be rid of it. It's politically impossible to get rid of. And I don't mean "political" as in D vs R.
The amount of money we spend on healthcare in excess of the OECD average is more than we spend on the military. 10% ish of that is the entire yearly profit of the healthcare industry. The other 90% is raw inefficiency. And where does that 90% go? Mostly to salaries. Eliminate our inefficient system, and you eliminate millions of middle class jobs.
No politician will do it. They may talk about it and campaign on it knowing it won't happen. But they will never pull the trigger because it would be political suicide.
This is such a crazy take. "Because the waste is so huge, it's impossible to do anything".
It's not like any individual reform is going to suddenly end all that waste and put everyone involved out of a job. Iterative small improvements make a real difference in people's lives, and won't provoke an immediate giant supply-side shock.
I don't pretend to have the answers to the question of "what reforms should we do?" but throwing our hands up and saying "nothing!" is not the answer.
While I agree with you on this bleak outcome, it's more that it's a progressive vs conservative issue. Progressives make up a minority of the democrat party and 0 of the republican party.
The only way to really change this is voting for progressives when possible, though it's hard to convince others that this is what you need to do.
If you are in a blue state, vote in the primaries for the progressive candidates. If you are in red states, that's voting for democrats in general and the most centrist republicans in the primary.
The absolute worst thing to do is to not vote and let the most conservative candidates run wild.
Solid take. It'd be much more fine if that 90% could convert over to something useful in times of crisis. But recent public health events have suggested otherwise.
I think the government could make progress by focusing on just cutting costs or just reducing inefficiencies. When the two are conflated and attempted at the same time, the incentives don't actually line up so nothing happens.
I've lived with Swedish, German and now Czech healthcare in addition to American (with very good health insurance). I'd choose any of them over the American system. I find other Americans' fear of change to such a terrible and expensive system very confusing.
Imagine any single one of those companies being the single payer insurance you are forced into. They (government included) become far worse. Rationing care, deciding who lives or does, underpaying doctors and nurses till the best ones quit and the remaining have any care burned out of them. That’s what’s happened in other countries and regions and every time there is a surge or a more complicated care you and loved ones are left to die or deprived of care options.
Yet we have examples of nationalized health care across the world that isn't this system you are describing. The US stands alone in it's terrible health care (and the price we pay for it).
We already ration care, it's based on what you can afford. We already underpay doctors and nurses like crazy, just go talk to one. We already drive them to burn out, because the current health care system is prioritizing admin pay over quality care.
The hellscape you imagine is the american system. It literally could not be done worse if we tried.
Exactly why the entire system should be nationalized instead of outsourced. Further, nationalized healthcare promotes political engagement on a basis of material necessities that politicians must be accountable for.
>Rationing care, deciding who lives or dies, underpaying doctors and nurses till the best ones quit and the remaining have any care burned out of them
This is literally happening under the current system now. My cancer treatment plan, should I ever get it while I'm living in America, is to blow all my cash and buy an exit bag on credit.
With USDA captured by agricultural interests, and FDA by pharmaceutical lobby, what’s to prevent the regulatory capture of this new single-payer agency?
So the answer to "rent seeking vampire insurance companies" is a rent seeking vampire government agency?
No thank you.
The answer to government created problems isn't a government created department.
All you have to do is look at all of history to see the results of increased government power. Look at the lies of the unaffordable care act. look at the fact that things the government promises as "free" become unaffordable and worse.
I'm very anti government / anti bureaucracy. But in this case it is hard to argue with results. The European system is simply more efficient at delivering healthcare. Here's a really long and detailed report showing why I'm right: https://www.mckinsey.com/~/media/mckinsey/industries/healthc...
But you don't need to worry, it's politically impossible to get rid of the healthcare industrial complex which is 5x the size of the more frequently cited military industrial complex.
fallingknife|2 years ago
The amount of money we spend on healthcare in excess of the OECD average is more than we spend on the military. 10% ish of that is the entire yearly profit of the healthcare industry. The other 90% is raw inefficiency. And where does that 90% go? Mostly to salaries. Eliminate our inefficient system, and you eliminate millions of middle class jobs.
No politician will do it. They may talk about it and campaign on it knowing it won't happen. But they will never pull the trigger because it would be political suicide.
Also, if you want to know more than you ever needed to about the US healthcare system and why it is so expensive I highly recommend this report: https://www.mckinsey.com/~/media/mckinsey/industries/healthc...
ryani|2 years ago
It's not like any individual reform is going to suddenly end all that waste and put everyone involved out of a job. Iterative small improvements make a real difference in people's lives, and won't provoke an immediate giant supply-side shock.
I don't pretend to have the answers to the question of "what reforms should we do?" but throwing our hands up and saying "nothing!" is not the answer.
cogman10|2 years ago
The only way to really change this is voting for progressives when possible, though it's hard to convince others that this is what you need to do.
If you are in a blue state, vote in the primaries for the progressive candidates. If you are in red states, that's voting for democrats in general and the most centrist republicans in the primary.
The absolute worst thing to do is to not vote and let the most conservative candidates run wild.
kyleyeats|2 years ago
I think the government could make progress by focusing on just cutting costs or just reducing inefficiencies. When the two are conflated and attempted at the same time, the incentives don't actually line up so nothing happens.
peteradio|2 years ago
CogitoCogito|2 years ago
FireBeyond|2 years ago
With "platinum" healthcare, my out of pocket for dealing with an (admittedly complex) kidney stone was $8,000.
For nine days hospital stay for gout (oof) in Australia, I paid $38 out of pocket... because I wanted premium TV channels.
dzink|2 years ago
cogman10|2 years ago
We already ration care, it's based on what you can afford. We already underpay doctors and nurses like crazy, just go talk to one. We already drive them to burn out, because the current health care system is prioritizing admin pay over quality care.
The hellscape you imagine is the american system. It literally could not be done worse if we tried.
xkekjrktllss|2 years ago
Kerb_|2 years ago
This is literally happening under the current system now. My cancer treatment plan, should I ever get it while I'm living in America, is to blow all my cash and buy an exit bag on credit.
lxm|2 years ago
orange-mentor|2 years ago
I've got no love for drug company lobbyists, but drug companies do actually manufacture real things.
Health insurance companies are different.
Once it becomes a government benefit, there are no more lobbyists. There is no market actor to lobby on behalf of, because the market ceases to exist.
wernercd|2 years ago
No thank you.
The answer to government created problems isn't a government created department.
All you have to do is look at all of history to see the results of increased government power. Look at the lies of the unaffordable care act. look at the fact that things the government promises as "free" become unaffordable and worse.
fallingknife|2 years ago
But you don't need to worry, it's politically impossible to get rid of the healthcare industrial complex which is 5x the size of the more frequently cited military industrial complex.
jackblemming|2 years ago