Healthcare in the US is broken and they won’t let you fix it because the money is too good. Think about the fact that PBMs, which is there to save and manage on pharma is incentivized to promote drug price inflation. That’s just one “small” piece of this clusterf*k. It’s layers and layers of these convoluted system of incentives.
As to OP, the simplest solution is to move out of the US early enough or become “poor” enough and be in a wealthy blue state by the time you get to this predicament.
Healthcare is little more than a jobs program at this point.
I believe it is the largest industry by employment in every single state now.
That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.
> Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.
I'd love to hear what you think "really fixing it" is, please share.
I can report that all (almost all?) of the hospitals and their networks both big and small in the area I am in have had layoffs this year of admin staff and healthcare professionals (nurses, doctors, etc). They have reduced bed counts, and cut programs and treatment options available. All of this was done in the name of the "affordability crisis" and is kind of like the 3rd wave of this kind of consolidation, belt-tightening behavior. And..prices haven't gone down, and they keep cutting.
> I believe it is the largest industry by employment in every single state now.
This made be curious, so I looked around. FWIW, healthcare constitutes ~11% of the workforce in the US. It's ~16% in Germany, ~10% in the UK, and ~5% in France.
As a percentage of GDP healthcare is far higher in the US, of course.
That is not exclusively an American thing. In my country currently 17% of the workforce is in healthcare. Probably need to start exporting more old folks to 3rd world countries where they can live out their days in resorts.
Is it a coincidence that the industries with the most heavy government involvement - health care, education, and housing - are the most messed up with perverse incentives?
Whereas the software industry, with near zero government involvement, has had enormous improvements in function and has pushed the cost to literally zero.
> Whereas the software industry, with near zero government involvement, has had enormous improvements in function and has pushed the cost to literally zero.
What's most frustrating about this-- just take the poultry industry. To bring the cost to zero, all it would take is a single hacker to steal one government-regulated chicken and click "Copy" in its elusive little context menu[1].
Try telling that to a young person today. If you're like me you'll get the so-called "Gen Z Stare" in response.
When it comes to healthcare, we didn't used to have so much regulation.
And, well, it sucked. People died, black people got injected with radiation, and we experimented on humans.
Ultimately, I don't want poor people to just... die. Because that's bad. So we need some sort of guarantees.
Or, we don't: in which case, I hope you're content scraping bodies off the freeway for free. Someone has to do it if we're not paying for their healthcare and disposal costs. Hope you're not busy next weekend!
Most other advanced nations have nationalized health care which works much better.
The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.
I think the broader extrapolation is that the social contract has emerged around giving private enterprise wide latitude to promote the public welfare. However that does mean that the quality of said welfare entirely revolves how profitable you are to said enterprise. While great for airline tickets, its a tragedy for healthcare.
Where did you get that number from? It doesn't even pass the sniff test.
17% of GDP is spent on healthcare. Claiming 60% of that is just "middleman overhead" makes no sense when the highest European countries spend 70% of what the US spends on healthcare.
If you want an actual analysis of why US healthcare costs are higher, I'd recommend the McKinsey study that compared category spending vs OECD countries. Exhibit 2 on page 4.
Eh. Most of the US' "worse outcomes" are upstream of the healthcare system and would be upstream of it under any other country's healthcare model too. (Diet/exercise, and vehicle-related injury.) Feel free to criticize the spending, but the worse outcomes angle is kind of disingenuous.
The fun part is that government intervention has driven a lot of the messed up things about US healthcare.
Super inflated prices nobody pays? - law on “U&C prices”
Consolidation of small oncology clinics into huge hospital systems? - law on 340B prices
All of these laws were put into place in an attempt at regulating prices, and as a result, entities exploited the law to give themselves even more profit than if the laws never existed.
Now that’s not to argue the government is solely at fault, but it’s remarkable how much government intervention had made the US system worse, not better.
My youngest and I were discussing how removing zoning barriers to ADU (in-law suites) can be a big win for families and small win for housing in general.
In short, build an efficiency apartment on family property for an alone-living relative. Family can better provide support; the relative's residence goes back into the housing supply.
The municipality provides usual construction inspections but doesn't prevent the construction for non-pragmatic reasons.
There's another interesting twist to this. The insurance company is willing to pay a certain hourly rate to home health care providers. There is a limited number of health care providers willing to work for this rate. Supplementing the rate is not permitted. Lo and behold, it is sometimes not possible to find a health care provider which the insurance will pay for.
I was living with MS for years before being officially diagnosed in 2021. I got annual MRIs, and I did not take any meds due to side effects. I had one flare up in 2021. My legs decided to a break and I was numb from the waist down. I decided to try MS-4. The numbness and Muscle spasms went away after a couple of weeks, but it took almost 3 months to walk properly without a cane. In June, it will be four years without incident, and I am extremely happy that I made the decision to not take any meds and went for the MS-4 formula even though my neurologist got upset and one told me to quit my job because I will be disabled. Well, I am not disabled, I still refuse to take those meds, and I am doing just fine. Believe in yourself and go with your instincts. Doctors don't know it all. I’m surprised a lot of people with MS haven’t heard of the MS-4 protocol, Visit uinehealthcentre. net I hope you find it helpful
The best way to do long-term care for a loved one is to hire the nurses they like at a facility they stay at for a short while to treat the sick person at home. This is vastly cheaper than doing so in a facility, and the nurses earn more and are incentivized to keep the person as healthy as possible because the job pays very well since there is no facility extracting enormous overhead and executive salary costs from their salary.
I wonder if moving his father to an assisted living facility at some point will be a better option. I have little experience with this topic so I am genuinely curious.
In my experience, these facilities are all in crisis. They can't find people to staff the facilities and provide care and when they do, they can't afford to pay them.
My father has a neurodegenerative disorder and we've struggled to find a place that will provide consistent care. My mother, a retired nurse, is the one who tends to do a significant amount of the work to feed, clean, and otherwise care for him despite paying over $10k/month. It's infuriating.
Oh wow, that's frustrating! I hope you find someone to provide consistent care at a reasonable price. Btw do your parents live in a state with high cost of living or this is a general situation across the country?
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As to OP, the simplest solution is to move out of the US early enough or become “poor” enough and be in a wealthy blue state by the time you get to this predicament.
I believe it is the largest industry by employment in every single state now.
That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.
I'd love to hear what you think "really fixing it" is, please share.
I can report that all (almost all?) of the hospitals and their networks both big and small in the area I am in have had layoffs this year of admin staff and healthcare professionals (nurses, doctors, etc). They have reduced bed counts, and cut programs and treatment options available. All of this was done in the name of the "affordability crisis" and is kind of like the 3rd wave of this kind of consolidation, belt-tightening behavior. And..prices haven't gone down, and they keep cutting.
This made be curious, so I looked around. FWIW, healthcare constitutes ~11% of the workforce in the US. It's ~16% in Germany, ~10% in the UK, and ~5% in France.
As a percentage of GDP healthcare is far higher in the US, of course.
If we fix healthcare costs we can spend more on hospitals. With more hospitals means more jobs and more competitive care costs.
In addition, a lot of those insurance jobs are facing pressure from "AI".
For a simple outpatient procedure, the fee from the hospital dwarfs that of the anesthesiologist and surgeon.
For an inpatient stay, the hospital charges thousands of dollars per night for a room! Makes the Ritz Carlton look cheap!
https://en.wikipedia.org/wiki/List_of_largest_United_Kingdom...
Keeping people healthy is labour intensive.
Eh, I kind of disagree. It would put a lot of insurance people and hospital admins out of a job, but the boots-on-the-ground providers would be fine.
Whereas the software industry, with near zero government involvement, has had enormous improvements in function and has pushed the cost to literally zero.
What's most frustrating about this-- just take the poultry industry. To bring the cost to zero, all it would take is a single hacker to steal one government-regulated chicken and click "Copy" in its elusive little context menu[1].
Try telling that to a young person today. If you're like me you'll get the so-called "Gen Z Stare" in response.
1: Assume a 2d chicken.
And, well, it sucked. People died, black people got injected with radiation, and we experimented on humans.
Ultimately, I don't want poor people to just... die. Because that's bad. So we need some sort of guarantees.
Or, we don't: in which case, I hope you're content scraping bodies off the freeway for free. Someone has to do it if we're not paying for their healthcare and disposal costs. Hope you're not busy next weekend!
The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.
17% of GDP is spent on healthcare. Claiming 60% of that is just "middleman overhead" makes no sense when the highest European countries spend 70% of what the US spends on healthcare.
If you want an actual analysis of why US healthcare costs are higher, I'd recommend the McKinsey study that compared category spending vs OECD countries. Exhibit 2 on page 4.
https://www.mckinsey.com/~/media/mckinsey/dotcom/client_serv...
Administrative costs are way higher in the US, but it only accounts for 15% of the higher cost.
The biggest driver is outpatient care - Americans get way more healthcare and it costs more (quantity * price).
Super inflated prices nobody pays? - law on “U&C prices”
Consolidation of small oncology clinics into huge hospital systems? - law on 340B prices
All of these laws were put into place in an attempt at regulating prices, and as a result, entities exploited the law to give themselves even more profit than if the laws never existed.
Now that’s not to argue the government is solely at fault, but it’s remarkable how much government intervention had made the US system worse, not better.
In short, build an efficiency apartment on family property for an alone-living relative. Family can better provide support; the relative's residence goes back into the housing supply.
The municipality provides usual construction inspections but doesn't prevent the construction for non-pragmatic reasons.
ref: https://duckduckgo.com/?t=h_&q=zoning+to+allow+ADU%2C+in-law...
Deleted Comment
My father has a neurodegenerative disorder and we've struggled to find a place that will provide consistent care. My mother, a retired nurse, is the one who tends to do a significant amount of the work to feed, clean, and otherwise care for him despite paying over $10k/month. It's infuriating.