Why is the US health care system so terrible?

[msc545]

The US has the world’s most expensive health care system, and that system delivers the worst health outcomes of any country in the rich world. Also, the US is unique in relying on market forces as the primary regulator of its health care system. Are these things related?

[Goahead76]

Because it's designed to make money, not to make you well. Anyone familiar with the large pharmaceutical companies can tell stories of a very promising medicine having its funding cut because it wasn't profitable.

[normalice]

In general, any time you ask "why does _____ suck in the US?" the answer is republicans.

[msc545]

Republicans, and Capitalism.

[Goahead76]

And then if you ask the other side they'll answer Democrats. Two political cults stuck in their ruts and unable to think outside it.

[normalice]

Right, republicans put a lot of weight on the Goebbellian "accuse the other side of that which you are guilty" strategy to produce exactly the false conclusion you just illustrated.

[normalice]

Oops, hit post instead of return. Meant to go on to say:
And yet, every single inch of progress towards more accessible Healthcare was pushed exclusively by democrats and opposed exclusively by republicans. Ignore the accusations and look at the voting records. Knowing how each party voted, then look at what they say. It becomes instantly obvious Republicans are full of soggy shit.

[Goahead76]

I think the misconception is you think they're in charge, the elected officials, they're not. The are owned by the pharmaceutical companies among others. They do as they're told. They're happy to have Republicans and Democrats fighting each other though because it keeps people off target, allows them to maintain enormous influence.

[Goahead76]

The three branches of government:
1. Big Pharma
2. Military industrial complex
3. Big Tech

Those three run everything no matter who you vote in.

[normalice]

The reason they run everything is both cause and effect of our apathy, though. If democrats were rewarded with a surge in polls and voter enthusiasm every time they push back a little bit they would keep pushing. But instead they are pounded with nonstop far right misinformation pushing the idea that democrats are communists, democrats are socialists and, as you have illustrated, that in fact democrats are the same as republicans.

It's weird you know who is behind it all but you don't know how. The onky way these companies can maintain their control is by controlling voters. Making people feel clever for concluding both sides are the same is a marketing strategy they came up with several decades ago, and it still works.

[normalice]

*only way...

Also, another correction: it is only Democrat leaning voters they try to target with bothsidesism by trying to make them feel clever for concluding it. You will not find bothsidesim in right wing media because bothsidesism was only ever intended as a way to discourage Democratic voters.

[ProbablyClueless]

Here are the reasons I think it sucks:

• Treating symptoms and not problems.
• we differentiate (from a legal standpoint) between doctors who can and those who cannot heal your body by physically manipulating it, which defeats holistic care.
• The rest of our society is hell bent on doing everything in the laziest way possible with the fastest results.
• For-profit, shareholder-owned companies are allowed to make decisions about patient care on the basis of capitalizing on their bottom line consumer.
• Medical professionals are insanely overworked and constantly have private "incentives" dangled in front of them to promote certain products.
• Legal liability (understandably) scares the absolute shit out everyone, so the doctors are terrified of taking innovative chances on their patients, and the lawyers make a killing (dark pun only half intended) off of exploiting patient suffering.
• All the various lawyers involved in every aspect of healthcare development, implementation, compliance, funding, etc.; makes getting anything done a miracle.

[msc545]

Agreed except for your comment about "doctors who can and those who cannot heal your body by physically manipulating it" which is sort of weird, no offense intended. What did you mean by this?

[ProbablyClueless]

No offense taken. In America, we have separate disciplines for Allopathic, Naturopathic, Osteopathic, and Chiropractic physicians. Those doctors are only supposed to treat/respond to your conditions in the way they are certified to do so. If you have a muscle spasm in your back, a doctor of internal medicine (allopathic) isn't generally going to refer you to a chiropractor, they'll prescribe you a muscle relaxant because that's what they are trained to do.

Well, what if the only thing stopping you from suffering years of backpain is to get your ribs popped back in place? Too bad. Because even though it's way cheaper and more effective to have your doctor physically push those ribs back into place, your allopathic doctor isn't certified to do that; all he can do is prescribe the muscle relaxant. You have to visit an osteopath or a chiropractor to push your ribs back into place. Fluid build up in your legs could be the same way, or even an obstructed bowel.

[msc545]

Actually, an allopathic doctor can do what you describe - why just don't?

[msc545]

meant to say "They just don't"

[ProbablyClueless]

Gotcha! That makes more sense. I don't know then, man. Now the situation makes even less sense to me. I guess it's just a training problem.

[msc545]

I don't think it's really the training problem as much as it is a lack of belief on the part of allopathic people in physical manipulation methods.

[msc545]

Besides, if you really believe in this stuff, you can always go to chiropractors or movement therapists or other people like that.

[msc545]

It's not as though there isn't a ton of these people running around.

[ProbablyClueless]

The only pushback I'm going to give you there is that I don't think it's reasonable to expect the average patient to have that level of awareness about their own care needs.

[msc545]

I hear you, but if you have back pain and there is no other serious cause, you might want to see a chiropractor since chiropractic is arguably more effective than physical therapy. Other than muscle strains and pains, physical stuff is not very good.

[Anonymous]

First off, I'm not sure all you claims you made are completely accurate i think some are disputable. Secondly the healthcare system has been estimated to employ about 1/3 of Americans in some way. Be it doctors and nurses pharmaceuticals or insurance. It's a tremendous beast! But that brings me to my 3rd point. Name a country more Capitalistic than the United States? It gives us the largest economy in the world. But with that comes definite drawbacks. We try to monetize EVERYTHING! Look at student loans. It was originally intended to help people get an education. But then some money grabbing d***head came along and decided to turn it into a moneymaking venture. And our politicians we're bought to look the other way at best, or at worst downright support it (probably as "good for the economy"). But back to my original point. The bottom line is there's too many people making too much money off the Healthcare system. We have a line of people all set to take thier cut of the profits when someone gets sick. And we have ourselves to blame as a country. We allowed the Healthcare system to grow into this monster. And with each passing year, decade etc. It is a cancer that grows. No politician wants to commit career suicide by f***ing with it.

Sorry for the long post.

Short answer: "unbridled greed".

[DrPepper12]

Just calling it a "system" gives it WAY TOO MUCH CREDIT. First, "for profit healthcare" is an abomination and a crime. Market forces dictate poor outcomes generally but high technology & innovation for those willing to pay.

Many americans are either too selfish or too dumb to understand why single payer is vastly superior and just like to bellow "SOCIALISM!" to anything productive and progressive. They are filled with false ideas and revel in their ignorance.

[msc545]

Exactly right.

[WindAtMyBack]

It's not terrible. It's arguably one of the best. But that also means expensive. However, a big reason why it's expensive is because the US supplements the rest of the world. If the rest of the world paid it's share, it would be cheaper in the US, and more expensive everywhere else.

Yea, a large portion of the US medical field is big business. And the rest of the world should be thankful for it. Or the US could have simply not spent so much money, and the rest of the world would be years, maybe decades, behind where it is now.

[DrPepper12]

How in the world do you get the idea that it's expensive because we supplement the world? What does that even mean?
Yes us healthcare is innovative and miraculous FOR THOSE THAT CAN AFFORD IT

[WindAtMyBack]

@DrPepper12

Because the US has done more medical research than the rest of the world combined. Where do you think all that money we spend on healthcare goes? WE are paying for it with our high health care costs, and to a lesser degree with our taxes. If we were not paying so much, medicine would NOT be as advanced as it is.

[DrPepper12]

I agree, rx's and innovative procedures are subsidized by us taxes.

But that cutting edge stuff. Why bother if millions are locked out of even annual physicals? Eyeglass? Insulin?

[msc545]

We share research results, and sharing is something people like Windatmy back don't understand. He thinks only Communists share. Sharing costs nothing by definition.

[WindAtMyBack]

@DrPepper12
"Why bother if millions are locked out of even annual physicals? Eyeglass? Insulin? "

So you think we should stop doing medical research and turn back the clock a decade or two? Either we do it or we don't. If we do it, then it costs money, lots of it.

I'm just saying how it works. I'm saying when you compare prices in the US to other countries, you have to consider WHY the costs are so high in the US and lower elsewhere. I would definitely prefer that other countries do more of the research, and there is a trend in that direction.

Not too long ago the US was doing more like double the rest of the world. The last I looked it was about half. I don't know if that's a decrease in what the US spends, or an increase in what other countries spend. For sure the portion paid for by taxes in the US has decreased, but at the same time the portion paid for privately has increased.

@msc545
I didn't say a thing about not sharing. I simply said how it works, and one of the reasons why there is a cost difference. The amount of money the US has spent on research has greatly advanced medicine - and everyone benefits.

You asked why the system is terrible. The medicine itself isn't terrible, it's very very good. It's just very expensive. I stated one reason why. I say it largely because it's something most people don't consider. It's also something people need to think about if they seriously want to decrease costs. It's a tradeoff. If you decrease costs, you will also decrease R&D.

That is not the only reason for high costs, not even close, but it's one that people don't usually consider

[msc545]

No the problem is once again is the thing you aren't mentioning. Capitalism.

[WindAtMyBack]

Capitalism is not a problem. It's a HUGE bonus that's been extremely successful. Anyone who thinks otherwise has no idea how things work and shouldn't even be talking about it.

Without capitalism, it's like I already said, medicine would be set back many years or decades.

[msc545]

Oh sure - you can tell because medicine in countries without Capitalism like China and Cuba and the Nordic countries is set back "many years or decades" right?

LOL!

[WindAtMyBack]

You didn't read a thing I said. Where did China, Cuba and the Nordic countries get their tech from? The majority came from the US.

On top of that, the Nordic countries are capitalist. And the Chinese economy didn't take off until they embraced many aspects of capitalism. If they hadn't done that, they would not be anywhere near where they are today.

Perhaps you think Volvo, Ericsson and Nokia are not aggressively competing in the world market.

[msc545]

Bulllshit.

[DrPepper12]

It's cheaper elsewhere because of volume discounts to single payer. Problem with research is we subsidized it and private companies monetize it. Very easy to fix with patent and licensing changes.

[AviatorTom]

The US Health Care System is actually quite good. Its main difficulty is caused by the US legal process, in which anyone can sue anyone else. That causes health professionals to be very careful in what they do, for fear of being sued for malpractice. It also requires health professionals to carry expensive malpractice insurance, which drives up costs. Hospitals also must carry expensive malpractice insurance. and most hospitals are for-profit, which further makes care more expensive.

In summary US Health Care is good, but expensive.

[msc545]

As a health care provider, I can tell you that malpractice insurance is a bit expensive, but that is NOT the problem.

The problems are pharmacy middlemen and insurance companies.

[DrPepper12]

How can it be good if millions lack it, can't use it, can't access it or have it in inadequate amounts or quality?

It's far beyond legal expenses or liability. For profit healthcare just should not exist.

[msc545]

@DrPepper12 Profit (Capitalism) is the Sacred Cow of the US unfortunately.

[Anonymous]

I used to work for large company that designs and manufactures medical devises. The regulatory burden imposed on companies like that by the FDA is absolutely oppressive and significantly adds to the cost of doing business, and thus the cost of healthcare.

Part of the reason health outcomes are worse in the US is because most Americans have very unhealthy habits and lifestyles.

Also keep in mind that other countries get to benefit from American-produced medical practices, technologies, drugs, etc., without having to incur the cost of developing those things.

I will say that I hate the fact that almost one out of three TV adds is for prescription drugs, which obviously drives up the cost of medications.

[msc545]

The reason that medical devices are heavily regulated is because the companies that make them cannot be trusted to regulate themselves, and without regulation they would be making devices that injure and kill people in order to increase their profits.

[Opinion Owner]

Well no shit, dumbass. But it doesn't change the fact that it's a significant factor in the high cost of healthcare in the US.

[msc545]

Without capitalism you wouldn't have this problem. Also, the cost of liability insurance is of course baked into the cost of medical devices.

[Opinion Owner]

Without capitalism, you'd have a whole set of other problems. If you'd rather have those, go on and move to N Korea or China.

[msc545]

Okay, well you've just proved that you really have no understanding of economics at all.

[SotiCoto]

I was sure the US Healthcare system used to have a reputation for overcompensating by doing excessive tests to justify charging patients more for things they didn't need. I was of the impression that it was horribly greedy but actually got decent results in the end... but if it isn't even managing that then one has to wonder what it is even good for.
I've long since given up on the British healthcare system (the NHS) because, putting it simply, they're completely incompetent and overburdened... probably because they keep hiring foreigners with dubious qualifications from 3rd world countries.

[OfMiceandMen]

I am not overly familiar with it, is there a set of standard costs that doctors have to apply/follow when billing or is it whatever they choose based on the facility?

In Canada we have more or less a standardized cost that OHIP allows Doctors to invoice the health care system.

[exitseven]

I would not go anyplace else for healthcare. I have been to Canada and people always talk about how great healthcare is in Canada. There are hospitals that looked like a strip mall.

It is true that Obamacare has made healthcare more expensive and restrictive to most people but it is still better than anyplace in the world. Rich oil sheiks, celebrities and millionaires all come to the US when they need critical care.

[DrPepper12]

You are addressing care that is cutting edge and innovative. what about simple health care for the masses? We fail miserably!
Obamacare has expanded access to MILLIONS who didn't have it. As far as expense, OF COURSE it would be more expensive! It required coverage of pre existing conditions! Whats the point of healthcare if it only covers new ailments?

[exitseven]

@DrPepper12 If you have good insurance you get good healthcare. This is why you should goto a good college, major in something marketable and get a good job with good benefits.

[msc545]

I agree - the care itself is first-rate. It is the access that is the problem.

[DrPepper12]

@msc545
@exitseven
WHY IN GOD'S NAME WOULD YOU LINK HEALTHCARE TO EMPLOYMENT? It was A WWII mistake that NIXON of all people tried to fix. Do you realize what a drag on the economy is cuz they're linked?

[exitseven]

@DrPepper12 Everything is linked to employment when you come right down to it. What kind of car you drive, the house you live in. where your kids go to school, what you eat for dinner and so forth.
The rich always get the best of everything. That is why everyone wants to be rich/. Unless you have rich parents or will the lottery you need a good job with good benefits.

[DrPepper12]

Yeah and healthcare is linked to oxygen. WTF dies that even mean? You just can't get it. You don't want to.

[exitseven]

@DrPepper12 The only reason that Oxygen is not only for the rich is that they haven't figured out how to do it yet.

[msc545]

Up here in Canada is of very good quality but equally important to it is accessible unlike that in the US.

[msc545]

I hate not being able to edit. That should read healthcare in Canada is accessible unlike that of the US

[exitseven]

@msc545. I needed a hip replacement. I got in to see the doctor in two weeks and he scheduled the surgery in 3 weeks. In Canada it would have taken over a year

[slatyb]

The outcomes are fine for people with good health insurance. Terrible for those without.

[handsomelad70]

So many Yanks can't access it because of its outrageous expense and many doctors and hospitals are far from poor rural and urban folk.

[DrPepper12]

Because too many yanks are selfish ignorant manipulated fools.

[handsomelad70]

@DrPepper12 AMEN, DrPepper12 !!!

[RedInnocent69]

Like education, it’s actually the best. But you’d never know it, unless you’re rich.

[Anonymous]

Because here when you pay for Healthcare, you get it. Everywhere else, you pay for Healthcare, and don't get it. Healthcare is expensive, try to escape that reality, and you'll get nowhere

[DrPepper12]

Are you actually saying every other civilized nation DOESN'T provide health care? Yes, it is expensive, not having it is even MORE EXPENSIVE.

[noohair]

The health care system is what the politicians created. We voted for it.

[Pterodon]

Don’t care. My healthcare is free since I was smart and became a vet

[msc545]

How long does it take you to get an appointment, and how is the quality at the VA?

[Pterodon]

If I’m sick I walk in. I’ve had very good care

[msc545]

ok good. Not every vet gets good or prompt care.

[DrPepper12]

Translation: "I sold my liberty and potentially my life for benefits. Now I've got mine and fuck ya all. Lifes cold, pack your own heat"

[Pterodon]

@DrPepper12 yeah you too could’ve joined

[DrPepper12]

Dont you understand and accept that it shouldn't be that way? Healthcare is a human right.

[Pterodon]

@DrPepper12 says who? It isn’t in the rest of the animal kingdom

[DrPepper12]

I knew you would say that and it precludes further dialogue. I hope you come to change your mind about the grotesqueness of for profit healthcare and that simple humanity requires we provide healthcare for each other without qualifications.

[Pterodon]

@DrPepper12 I’m not gonna pay for it

[msc545]

@DrPepper12 He does not believe in human rights. Thinks they are a Communist plot.

[DrPepper12]

Even if you're an unempathetic bag of shit, you are into less taxes and greater economic productivity, right?

[dustybiker2]

Money.

[DrPepper12]

*** In the wrong hands for the wrong reasons for the wrong outcomes.

[AngryCarl]

Profiteering, corruption and price gouging.

[NathanDavis]

capitalism

[lightbulb27]

Good question…

[Anonymous]

Big pharma