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https://www.healthsystemtracker.org/chart-collection/health-...
Instead, our system is the worst* of both worlds. The government limits the supply to prevent competition, but allows those they've licensed to charge as much as they want.
*(That is, worst for patients; it's the best for profits)
Even if there were no insurance, I don't believe there exists a possible free market for expensive emergency medical procedures either.
The UK's death panel is called NICE: https://en.wikipedia.org/wiki/National_Institute_for_Health_...
We should have something similar in the US. 80% of all healthcare spending is consumed by people in the last 3 years of their life.
Your experience with insurance in the US is very different from mine.
My experience is insurance denying my 34 year old sister's MS meditation until she ended up in the ER.
The democrats wanted to get subsidized healthcare for low income people and people with existing health issues that would guarantee they would be uneconomical to insure. The healthcare providers, insurance companies and pharma companies wanted to remain viable, profitable businesses.
The compromise was to essentially guarantee profits to healthcare companies by crafting legislation that overcharges young people, healthy people, male people, middle class and affluent people to subsidize costs for other groups, while giving a consistent profit margin regardless of costs to insurance companies.
There is nothing about American healthcare that resembles functioning markets or capitalism. It's a very heavily regulated industry where the government exerts extreme control, while choosing to legislate in a way that maintains a consistent flow of money to influential lobbying groups and political donors.
Frankly the difference I noticed post Obamacare was a friend of mine was able to get insurance in time to not go bankrupt treating her colon cancer.
I can't get behind the idea that Obamacare is somehow what broke our medical system.
Insurance companies had teams of people who, if you made a substantial claim, would look over your application for anything that was amiss. And if they found it, they'd drop you so they wouldn't have to pay.
Your health record became a criminal record. You just hoped there was nothing on it that would prevent you from getting coverage in the future.
Obamacare has some very serious problems, but at least you can't be denied insurance just because you have back pain.
Before Obamacare, some policies had lifetime limits, which could affect expensive treatments like cancer.
We celebrated the fact that now medicare can negotiate 10 drug prices. It should negotiate all drugs. The organization that gets the lowest prices is the VA. Congress could easily pass a law saying medicare will only pay that much and it would not cost much to implement.
System is very broken.
[0] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
This is cope, just like "(socialist catastrophe) wasn't caused by TRUE socialism" is cope.
The mechanism by which capitalism causes concentration of wealth and power, and by which said concentration then creates means, motive, and opportunity for self-dealing is crystal clear.
Speaking of DI, DI is a money-printing machine, with CT and MRI machines that range from a few hundred thousand to over a million have breakeven points well under two years. And the DI companies work to find and gather physicians who want to start a DI practice. Offer financing, consulting, and then, shockingly, we find that physicians who own a DI practice or a share in one tend to over-refer their patients to imaging.
The emergency care angle is what drives the socialism / capitalism bickering and that's what I see a the biggest impediment to actually making effective change.
SF Bay Area peninsula -> Stanford
Austin -> St David's
Since the American system doesn't allow people who can't pay for emergency care to die the system ends having a socialist component. Socialism is such a hot-button issue that we can't have mature conversation about funding it. Almost any conversation about it gets caught-up in partisan and "personal responsibility" bickering.
It would be easier if we just let people who can't pay die.
That's repugnant and wrong, but it would certainly make the conversation easier.
[0] hint: receiving bills for charges you never assented to is not a foundation of a working market, and should obviously be illegal.
I moved to Canada recently and caught a flu that I didn't take care of and, in turn, developed into pneumonia. It took me FIVE days to be able sit down with a doctor and get an antibiotic prescribed even thought it was more than evident I needed immediate care. I could have died if I waited another day. But was it free? ... ehrm ... yeah.
In Mexico, doctors are as free market as it can get, downsides and upsides of that considered; with cash in hand you can get any kind of attention you need in the exact moment you need it. And it's not even that expensive, after converting MXN <-> USD. I could've dropped by with any of the 1,000s doctors that are available, many of which don't even require appointments. I would've got the attention I needed and the antibiotic prescription in 2-3 hours. That would had cost me ~60 USD.
> About one-third of Mexico’s registered workers report earning the minimum wage, which will amount to about $1.75 per hour starting Jan. 1.
$60 is 4 days wages for 1/3 of workers in Mexico. It's the equivalent of $820 for someone making 75k per year in the US. So it's the same as any other free-market healthcare system: easy access for the wealthy at the exclusion of the poor.
https://apnews.com/article/mexico-minimum-wage-increase-peso...
I'm not saying it's fair, I'm saying it's cheap, compared to the US as that is implied by the context of this conversation.
When you buy a $1 dollar shirt from Malaysia, is it cheap? Yes. Is it fair? Who knows.
It's the same thing.
Also, doctors in Mexico make way more than minimum wage, it's not unusual for some of them to have incomes around 200k-300k USD/year, plus read about RESICO and your jaw will drop to the floor. The average person in the US would kill to have the income and purchasing power doctors have in Mexico.
[1]: https://www.washingtonpost.com/outlook/2020/08/06/health-ins...
I went through that ordeal ~4 months ago, me, personally, I didn't read it on a magazine or whatever.
Ask anyone who has a dog, preferably a big dog, what it costs for a vet visit.
Better yet, talk to someone who has had a sick dog. Something terminal, or possibly terminal. Costs are wayyy lower. Same x-ray, same imaging, many similar medicines. I've talked with vets, human doctors, and doctors who own dogs. They all come to the same conclusion:
Only ONE key difference - there is no insurance or government regulation involved (obvously stuff like taxes, basic health codes, licensing, but I think you know what I mean).
I'm more than happy to agree with you if you could show me a plausible explanation for this enormous disparity in costs.