American healthcare is the epitome of capitalism run amok.
It’s terrible and the only thing worse than the exorbitant fees is the complete and utter lack of consideration to the patient’s time.
It’s terrible and the only thing worse than the exorbitant fees is the complete and utter lack of consideration to the patient’s time.
The lack of regard for patient schedules is a direct result of how insanely packed the schedules of providers are. Fifteen minutes per patient is luxurious and my partner spends a lot of time after work entering notes for patients she saw that day (she "works" 32 hours / 4 days a week, which is really closer to 40-45 all told). My understanding is that the clinic does not have a high profit margin (serving medical / medicare patients + high overall costs), so every patient counts, and the admin staff will add people w/o permission. It's common for her to find patients scheduled over her breaks or for her to be scheduled after she should have left the building. Burnout has always been bad but it's reaching epidemic levels now in the wake of covid, which further restricts the supply of healthcare and makes people wait longer to be seen.
For a recent event, I got a whole nurse calling me from the "insurance" company, out of the blue, seemingly just to chat about the medical situation and how things are going. I haven't figured out what her KPIs are, but I doubt she remains so friendly when you bump up against them! And she obviously represents a severe misallocation of labor - the industry would be better off if someone with her education (and likely experience) was actually providing healthcare.
Worse the odds are good she was hired to help the insurance company prevent people from getting healthcare.
It's the same story every time. Something works relatively OK (US health care before 20 century big-gov), huge changes to incentive structure and overheads are introduced by statists ignoring higher order effects, everything goes downhill, statists blame capitalism.
Let me legally not have insurance, pay anyone in cash for my health care (no licensens and government enforced monopolies), and buy any medicine I'd like and opt out of this madness completely and let's compare with real capitalism.
If you try doing health care this way for long enough, you might even discover which incentives are poorly aligned without collective policy of some kind, but who knows, maybe not.