[ryani]

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.

[hellotheretoday]

Its kind of that way

How do you reduce inefficiencies and cut costs without compromising care?

You cut jobs that are redundant. America spends an insane amount of money on administrative overhead. 4x the average of other wealthy nations [1]. This is largely in part because our fragmented insurance system leads to excessive redundancy in administrative roles

So meaningful reform means cutting jobs. Or you do the shitty political move and preserve these useless jobs for the sake of keeping people employed because our social safety net is a joke and the cost cutting you do make is at the expense of compromising care and vulnerable populations (eg cutting Medicare and Medicaid benefits). Then you get more clinician burn out and struggle to fill key clinical roles/staffing issues, scheduling issues and longer appointment waiting periods, more deaths and complications from a lack of preventative care, more mental health issues and drug abuse in communities, etc. all of which is happening in the USA.

[1]https://www.pgpf.org/blog/2023/07/how-does-the-us-healthcare...