How long will we Americans submit to these rent-seeking vampire insurance companies? Single-payer now, please.
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...
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.
That 6.9% of GP is supporting millions of jobs, and to remove an inefficiency like that would put them all out of work. It is not possible to do that in a democracy.
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.
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.
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...
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.
And even then, I've experienced NHS care and it's 1000% better than the experience I've had with american care. It's not perfect by any means, but it's insane how much better it is than what we have here.
Calling it a dumpster fire when the US system exists is laughable at best.
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.
Maybe it's not the best of both worlds, but it's at least a far better safety net than the US provides, and that's the most critical piece. Both for the most affected individuals, and society as a whole (even in terms of cost! An ounce of prevention is worth a pound of cure, and all that.)
In Bulgaria where I have many friends and family, the system has always been nationalized, barely funded by the government. I don’t know a single Cancer survivor there.
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.
Average nurse salary in California (where ~10% of US population lives): $124,000
Average nurse salary in Spain: €29,277
My sources are probably junk, but even with insurance companies out of the picture what is the math that would make the US healthcare cheaper?
This is without tackling the earning rates for specialty MDs, like vascular surgeons, who are not that numerous to begin with.
Yet https://www.wfla.com/community/health/coronavirus/florida-ha...
2. Medicare was not allowed to negotiate drug prices until this year. Drug comonies basically got to wr8te themselves checks. In some ways the Us taxpayer subsidizes drug development for the whole world.
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.
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.
What we had when this country had great healthcare options.
You know... the stuff that was replaced with "Keep your Doctor", "keep your plan", "save $2500 a year" and other lies used to pass the unaffordable care act (and similar).
There's a reason "Free Healthcare" can only pass with lies - and it's because government options/UHC/etc are lies for those who don't look at... well... history.
Funnily enough, speaking of lies and kool-aid, when you talk of ObamaCare to supporters of that political party, they are vehemently opposed.
"What if, instead of ObamaCare, there was, say, an Affordable Care Act that did X, Y and Z?" (where X, Y and Z were actual features of the ACA)
"Oh, that would be much better! I'd love that!"
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.