Yes, the US spends by far the most on healthcare per capita, and still gets the worst outcomes. It's not about throwing money at problems. You have to actually solve them (and want to solve them).
Instead of fixing the leaks in the plumbing we're just increasing flow rate at the top of the system. Right now the medical-industrial complex is a business that happens to provide medical services as a byproduct.
Fee for service encourages more medical intervention. It makes break-fix work more profitable than trying to address root causes. Each layer and sub-sector is for-profit. The supply of physicians is capped. Vertical integration can reduce the double margin problem. Specialists are paid more than general practitioners. Surgeries make more money than non-surgical treatment.
People expect someone else (their employer, the government, the rich) to eat the cost of healthcare. Third party payment makes patients price-insensitive. People unironically expect a cure for death. Drugs and medical devices are expected to be perfectly safe. Americans lead unhealthy lifestyles. Soda is the default drink in cafeterias and at parties. Car culture and car only infrastructure promotes physical inactivity. Kids are not allowed to roam. When there was a push to promote healthier school meals there was immense pushback.
Social Security is a separate tax in a separate fund (invested in T-bonds). If you split that out of the budget, the budget looks even worse. The boomers retiring is just going to be bonds maturing without the holder (social security) reinvesting the money.
And yet that GINI keeps rising and cost of living outpaces inflation over the past 40 years in housing, healthcare, and education. If you are bottom quintile, maybe bottom 2, you are poorer now than 40 years ago on average. Recent policy changes seek to drop the third quintile as well.
Herring|10 days ago
supertrope|10 days ago
Fee for service encourages more medical intervention. It makes break-fix work more profitable than trying to address root causes. Each layer and sub-sector is for-profit. The supply of physicians is capped. Vertical integration can reduce the double margin problem. Specialists are paid more than general practitioners. Surgeries make more money than non-surgical treatment.
People expect someone else (their employer, the government, the rich) to eat the cost of healthcare. Third party payment makes patients price-insensitive. People unironically expect a cure for death. Drugs and medical devices are expected to be perfectly safe. Americans lead unhealthy lifestyles. Soda is the default drink in cafeterias and at parties. Car culture and car only infrastructure promotes physical inactivity. Kids are not allowed to roam. When there was a push to promote healthier school meals there was immense pushback.
yoyohello13|10 days ago
lotsofpulp|10 days ago
supertrope|10 days ago
phkahler|10 days ago
arolihas|10 days ago
danny_codes|10 days ago
America is designed for rich people
arolihas|10 days ago