U.S. health spending on pace to hit $6T
statnews.com
statnews.com
[1] https://www.kff.org/medicaid/medicaid-financing-the-basics/#...
[2] https://usafacts.org/answers/how-much-does-medicare-cost-the...
https://www.beckershospitalreview.com/finance/top-100-us-hos...
The only problem? No one has the political will to do it.
> Someone is charging way too much for goods and services
It's more money chasing meager supply. They're charging market rates. However when the market is distorted through the described arrangement, it's clear what has to change - the structure of international finance.
Americans are getting actual products and services in return for depreciating IOUs.
It’s like a loan where the lender pays interest.
Why would anyone be against that?
Note: This is different from the strategic interest in maintaining domestic industries. That’s very defensible. But I don’t understand the fear of a trade deficit denominated in your own currency (other countries have bigger genuine concerns with a dollar denominated trade deficit, because if their currency falls against the dollar suddenly, they’re kind of screwed, at least in the short term).
Sure, the US benefits by having cheap goods. This means precisely that there's more money chasing services. It's why we have cheap televisions(yay!) but expensive healthcare, education, housing. Those things cannot be made elsewhere and imported into the US to benefit from the power of trade imbalance.
1. Page 14 of 56. https://www.bea.gov/sites/default/files/2026-06/trad0426.pdf
For example, Medicare is launching a new program in July that pays a fixed rate for achieving defined outcomes, like lowering blood pressure or cholesterol. Medicare's explicit goal here is to create incentives to automate the repetitive parts of care delivery with software. (Much of preventive cardiology is surprisingly algorithmic and guideline-driven, so this is more plausible than it seems.)
This reverses the incentives of the current system, where CPT codes incentivize doing more "stuff" (but not necesarily delivering the most effective care efficiently).
If you're a software engineer who cares about health, and have been sitting on the sidelines till now, I think the next few years are a really interesting time to make a contribution.
do you have thoughts on what that looks like? what does the hiring landscape look like?
What are good things to read, etc?
There is so much to be done and it is not going to be solved by any one thing. That in mind, something like an independent third party patient advocates / advisors would be great. It is hard to be an informed patient these days, Navigating insurance and paperwork is tough and getting second opinions is sometimes had.
Or put another way - how does a smart lay person evaluate the independent advocates? Do incentives align?
How many times have I heard this, about how many techs. But this time for real?
Health spending in the us is too tied up with the country’s economy for it to ever be reduced. Same goes for housing. The cost of both of these will continue to increase. As long as the investor class is satisfied, this is all that matters.
These are massively incomparable. Most householders live in homes they own. Those homes, moreover, are usually a substantial if not dominating fraction of their net worth. And they're leveraged. This produces a broad level of interest in maintaning or raising home prices.
Healthcare is more narrowly owned. It's not as leveraged. And very few housholds have a commanding fraction of their net worth in healthcare assets.
Most healthcare in America isn't paid for by the patient.
The only thing that will fix American healthcare is absolute abolishment of private insurance. That's it. No amount of gentle incentive tweaking or whizbang technology is going to solve the fundamental problem of human greed and immorality.
Allowing private health insurance to exist is inhumane and can only result in profit extraction and exploitation of the most vulnerable members of society whose only options are literally to pay up or die.
That's the break. We've allowed profit-seeking individuals to stand in between citizens and literal life saving medicine. And you think the solution to that is to add more middlemen and profiteering exploitative corporations. Utter insanity.
The solution is to make it illegal for anyone to say "no, you may not have this life saving medication or proceedure". The solution is to remove profit from medicine. To allow profiteering and gatekeeping of people's very lives is immoral in the extreme. Giving more private corporations more influence is insanity. The solution is less private influence of medicine, not more.
Like the other commenter suggested, medical tourism is a viable answer. Most Americans have probably heard of Turkey for hair transplants, but the truth is that certain countries specialize in specific procedures, and are the BEST in the world at performing them, and with the best outcomes.
I've done several procedures abroad and saved 70-80% vs the US cost, and that's including the travel and vacation portion. Yes, medicine costs a lot, but most people are ignorant to where most of that money is going to pay for, and how expensive the "system" makes things in the US.
Would that make it better, or worse? And why?
The obvious points are medicines and equipment. To some degree, these are actually the most justifiable parts of the industry that should be for profit.
The parts that are far less justified: - The insurance industry surrounding healthcare. Obamacare brought in some regulation that drastically slowed the growth of healthcare costs. - The education industry surrounding healthcare. Becoming a doctor in the U.S. is incredibly expensive. You rack up massive loans, you’re racking up interest on those loans for years, well into your late 20s (including the loans you racked up for your undergrad), and then you’re spending the first decade of your career all the way to the late 30s, just paying those loans back. You’re one of the most sought after professional in the world and yet it takes you until your late 30s to basically break even. The upshot of that is you charge a ton not just to pay back your loans but to justify spending so much time and energy on a career that means you start being money positive for the first time in your late 30s. - Insurance. The American legal system that does not place any penalty on frivolous lawsuits essentially inserts a significant cost due to bad actors on everyone. Personally, I’m not clear on what this cost actually is and how significant it is, but if you talk to doctors and hospital administrators, they seem to believe it’s incredibly high. - Hospitals being for profit. I actually think for profit hospitals are more efficient than non profit ones, but the problem here is what they prioritize. A non profit hospital system may prioritize family care and regular checkups to keep people healthy and prevent them from falling sick in the first place. A for profit hospital probably prioritizes surgeries and elaborate procedures that make a lot of money. And that’s before we get to spending on customer acquisition, either due to fancy buildings etc or just straight up advertisement and marketing.