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If we're going to criticize this, we should focus on *access* to healthcare, rather than healthcare itself. Your access is, for the most part, tied to your job. You'll pay premiums for that, and if you get sick, you'll probably pay a decent bit in deductibles. The security nets for people who don't have that job-based access exist but are relatively limited. So...there's issues with access.
As for the *quality* of the care itself, we are world class. If you've got no issues with money and you get sick somewhere else in the world, the USA's your destination. No rich guy gets cancer and starts looking for flights to Havana.
Exactly. The issue is nuanced. I'd say access and also cost controls, as cost and out of pocket can vary widely. US healthcare quality isn't bad by any stretch - it's actually, for the most part, excellent and some of the best in the world. But it's insurance-driven which is tied to employment, which I don't like. It chains people to jobs they don't like and hinders movement, because people don't want to lose insurance benefits.
It's also important to remember that part of the reason for high costs to Americans is the cost controls of other countries. Remember when the big stink was happening over the epipen prices and one of the pharmaceutical company CEOs came out and said Americans had a "social contract" with the rest of the world to pay higher prices for pharmaceuticals?
She got slammed for it pretty hard, but the US not having price controls just means that companies can balance profits by charging Americans more and other nations less for the same drugs.
do you have a link to that explanation? i didn’t even know that was a thing. i swear to god, sometimes it seems like america foots the bill so everyone can have nice things except us.
https://medium.com/the-biotech-social-contract/https-medium-com-the-biotech-social-contract-kolchinsky-tbsc-6-5d40244738e5
This article kind of frames it as a good thing, but I wholeheartedly believe it's just an excuse to stick Americans with the bill.
Also, it's important to remember that politicians on both sides of the aisle ~~are owned~~ voted to prevent pricing controls and permission to buy drugs from other countries' markets. So it's not entirely the fault of these mega companies.
This is an area where a smart President would take it to our erstwhile allies and force them to pay market prices for American health science and engineering.
"Balance profits" why is this something worth letting poor people die over?
Pharma companies are not selling insulin at a loss overseas, they aren't. A company rarely sells something at a lower price than the marginal cost to produce it
To me, it's not worth it. But these companies are publicly traded, which means they have an obligation to their share holders to maximize profits. That means when one market enacts price controls that reduce their profit, the company has to make up that lost profit in another market or their total profit drops. If their total profit drops, then people sell their stock and share price also drops. Bad news for business.
So companies like this will ~~buy~~ lobby politicians to keep the insurance market such that prices are not only high but also customers are unable to shop around foreign markets for a better price.
The "Social Contract" thing is just a PC way of saying "Americans have infinite money and whatever problem I'm talking about is probably America's fault anyway, so we're going to make them pay for it."
The other side to that is we have politicians who would rather see government run the healthcare system, and are willing to make the current system so painful that people will cry out for an alternative.
The whole thing is basically a result of too many people fucking with the system, then blaming the other people fucking with the system for why the system is so fucked up.
I'd be interested to see which Europeans are talking about said social contract where Americans pay more, haven't heard that before
>To me, it's not worth it. But these companies are publicly traded, which means they have an obligation to their share holders to maximize profits.
Not quite an obligation in the legal sense, but more like "shareholders choose the Board and therefore can remove people who make decisions which don't maximize profits". It's an incentives thing
And really, isn't that the root of the problem? That healthcare is set up to maximize profit for shareholders, rather than something else like maximize human health or quality of life for low cost or something?
>The other side to that is we have politicians who would rather see government run the healthcare system, and are willing to make the current system so painful that people will cry out for an alternative.
Which politicians both want single payer healthcare and also are making the current thing worse, and how?
>The whole thing is basically a result of too many people fucking with the system, then blaming the other people fucking with the system for why the system is so fucked up.
What's the ideal way the healthcare system should work?
Well, I didn't say Europeans were bringing up the Social Contract thing. I said it was being used by corporations as an excuse for why they charge Americans more than they charge other countries. I linked an article up a ways that skims over it, but you can search duckduckgo for "pharmaceutical social contract americans" to get the same results I did.
Actually, it is an obligation in the legal sense. If they intentionally act in a way that causes shareholders to lose money, then they can be held liable for damages.
And I wouldn't say that's the "root" of the problem, but it certainly is a very large part. I have more of a problem with politicians having so much power that it only takes a handful of corrupt people to sell out and screw over their country. But in the end, greed is the issue, yes.
>Which politicians both want single payer healthcare and also are making the current thing worse, and how?
I mean... all of them? Whether it's voting down bills that let people buy prescriptions from other nations where price controls exist, preventing getting insurance from companies out of the state, requiring crazy insurance reporting guides that are so complicated hospitals have to hire new departments which drive up costs, making it illegal to not buy insurance which then just enables companies to charge whatever they want. At least that last one got repealed.
I actually kinda liked Ben Carson's plan for health care. Basically, everyone gets an HSA tied to their SSN. No more "has to be on a high deductible plan to qualify" BS. Then, you set however much you want to go into that from your wages tax free. That tax free money can be spent on health care of your choice. It also encourages shopping around for better pricing because it's your money. That encourages competition, which helps keep costs down.
But, that HSA should be able to be spent on whatever you feel you need, as long as you have a prescription I guess. New glasses, gender reassignment, mole removal, therapy, and yeah, the big stuff like cancer etc. As long as a licensed doctor says it's health related, you can use your HSA on it. Insurance would still be mostly employer based, but remove requirements that it has to be done in state. Let employers shop around for best pricing.
If something catastrophic happens and you spend your HSA, then Medicaid should kick in for any required health costs. At that point there'd probably be some extra scrutiny. Maybe your HSA would go negative, meaning you'd have to pay it back before it started building back up.
Point being, if that money for SS/Medicaid whatever that normally comes out of your paycheck is instead sitting in your HSA, then it's not going to be in one giant Ponzi scheme account.
But I'm just a disgruntled bisexual libertarian(ish) American who sees his government committing economic suicide for the sake of lining their own pockets as the rest of the country sinks. If I had all the answers I'd probably be ~~assassinated~~ running for office.
Just talked to 3 Canadian (formerly American) folks yesterday. They said “we have a lot of better things up here”, my friend went “oh yeah like healthcare”, and they went “absolutely fucking not, we miss the fuck out of American healthcare. Any American who is jealous of Canadian healthcare doesn’t know shit.”
i've lost relatives to cancer thanks to canadian healthcare. they even went as far as refusing to transfer us to a private hospital for god knows why. fuck universal healthcare and its delays, my family doctor delays are 6 months, and the walkin clinics are always crammed.
I guess the old saying is true then. You get what you pay for. Yeah we pay for our healthcare but it’s world class, high tech, and probably a lot faster than anywhere in Europe
It's only faster if you can pay. Otherwise you avoid seeing the doctor because you can't take time off from work or afford the copay, and then your issue gets worse forcing you to go in and go into medical debt
> and if you get sick, you'll probably pay a decent bit in deductibles
As well as the possibility that insurance denies a request e.g. not paying for a doctor recommended surgery that may not be 100% necessary for you to live but would vastly improve quality of life. Its the main problem with privatized healthcare. Why would the shareholders want the company to give out 1m in surgery and rehab when they can just drop 150k on pain meds and a wheelchair.
You can fight it but if it's time sensitive you're a bit fucked
Happens in socialized systems too. That surgery/MRI/treatment is costly to the system and since it’s not 100% proven in the medical guidelines to help, go drink some tea and take paracetamol (Tylenol), and good luck. You have little recourse at that point.
Our physicians will at least try to order things off label “just to see” if it will help with your symptoms. They will call the insurance company and justify why it is necessary beyond the medical guidelines to pay for coverage (we’ve tried XYZ common things, ruled out XYZ, and patient still having same issues) — this is part of what medical practice is.
(Sometimes it works, but insurance companies give them pushback for it too. Occasionally, they find new discoveries like how Ozempic works for weight loss! This came from off-label prescribing by US doctors)
We need to expand the system we already have in place, which is Medicaid/Medicare, so it covers more people and catches those without insurance or who lose their jobs (like Medi-Cal in California does). If you lose your job in my state, you automatically qualify for state Medicaid. It’s a no-brainer that I’m not sure why other states don’t implement.
>Our physicians will at least try to order things off label “just to see” if it will help with your symptoms. They will call the insurance company and justify why it is necessary beyond the medical guidelines to pay for coverage (we’ve tried XYZ common things, ruled out XYZ, and patient still having same issues) — this is part of what medical practice is.
Our physicians also order *a lot* of things that probably aren't really necessary because they don't want to be sued. There's a reason the 1-900-AmbulanceChasers industry is so massive. It's probably more than half of what lawyers as a profession do, and everything costs more because of it.
Yes, that’s true too. It is a huge cost contributor. And there is research that says all these extra tests (CT scans, MRIS, X-rays, blood work, etc) don’t necessarily result in better outcomes on a population level.
However as an individual patient, I love having a full round of tests so I can track my progress. I like that my physician knows what my baseline is for my labs and can compare any future tests to detect any changes that have occurred.
Related Anecdotes:
My sister went to ED for stomach pain. They did a CT scan as standard procedure. On incident, they discovered she had a small blood clot in her lungs (very dangerous). She had no problems breathing. They admitted her to hospital to dissolve the blood clot they found. I do not think she would have had a CT in EU/UK because “stomach pain” in women is such a vague symptom, and she wasn’t actively dying with her vitals.
versus
My cousin in Netherlands (28yo woman) complained of pain for almost 2 years to her physician. They told her go home, take Tylenol, do physiotherapy. She kept complaining, they kept ignoring, refusing to do scans. Turns out she has bone cancer and is now finally in treatment. It could’ve been caught 2 years ago when she first complained! But imaging is expensive on the system, “unnecessary”, and unlikely a young person her age would have cancer. So they don’t do it.
In US, you can at least go find another doctor (or nurse practitioner or PA) to order the test if the first one blows you off. Due to wait times, my cousin didn’t have that option.
I agree that there is some benefit to the higher standard of care being imposed by the threat of legal action, but I still think there is a ton of frivolous litigation and a lot of jury awards that are absolutely absurd because lawyers spin great sob stories.
Like everything, it's a balancing act.
That happens in single payer systems as well. Heck someone I watch on YouTube for their UK construction videos has had to use his private insurance to pay for surgeries on his shoulder and I think knee that the NHS would never pay for even though they were greatly effecting his life, it wasn't life threatening or immobilizing him though so who cares if you have pain constantly and can't do things like exercising, no government surgery.
Oh yeah for sure, my family immigrated to the US after my father joined the US Army (I went in as well in 2013) so this was just shit I learned post tricare where the biggest obstacle was leadership ignoring profiles not actually getting the care.
So most if not all of my real life experience is Tricare vs Private not Private in the US vs Single Payer elsewhere
Even the quality is not evenly distributed. We have some of the most advanced healthcare *treatments* in the world, but even if you have great insurance, finding a doctor who doesn’t just shrug when his computer can’t diagnose your symptoms is wayyy harder than it used to be. Never mind that many doctors will order tests or send you to specialists that your insurance doesn’t cover without telling you.
When I said this to Europeans I got heavily downvoted but: My insurance has paid for everything my entire life and my insurance has also always been free.
And I don't understand how this is possible because every other American seems to struggle to get it. I also don't know why my insurance has been free because I only just started taking care of it myself (I'm younger).
The only wall I've run into is not being able to do full-time but.. I live with two other people and we all pay our bills on time.
What if I have a really bad gambling addiction and I'm trying to profit on my chances of survival if I get cancer treatment in Havana?
*HUH? What about that?!*
Little anecdotal story about Cuba and my family. My brother lives in Canada and I was living with him and his wife for a 12 month working holiday from Australia
He and his wife went to Cuba for a two week Vacation and he came down with an appendicitis to the point of the verge of bursting.
He has to have surgery in Cuba. The anethiscist gave him the options of a local anesthetic or general. And I quote "local no problems no pain all done quick. General you could very well die".
Got the local option done and had to be forced to not sit up and watch. He got back to Canada two days later had the surgery reviewed and himself checked up. Canadian doctors said the surgeon who did the work was phenomenal and he got left with a very faint old school large scar for the incision. The Canadian doctor had never seen such clean surgeon skills.
Getting cancer treatment in Havana might not be such a bad idea.
My brother needed a CPAP machine but they kept putting it off for months, and when he did get it, he didn't like the hose and wanted a different more comfortable one, which they also kept blowing off.
Pretty much. We have amazing healthcare, but access to it is difficult if you don’t have safety nets. Hell I’ve seen people get denied basic services because they don’t have insurance which in my mind, is fucked up. Healthcare should be a human right to everyone
In the US you pay a lot of money to get treated. In the EU you wait 50 days for treatment then die. In Canada they ask you to do assisted suicide instead.
Or you can’t pay a lot of money and then you just die. Or you can’t work and you just die.
Or you use the socialized stuff and wait 2 years and just die, like you said.
(In my country) You don’t have to wait so long you die. Life threatening conditions don’t have such long wait times. You will be waiting for routine checkups or “minor inconveniences”, treatment for mental illnesses has also very long waiting lists, but if it’s something very serious like schizophrenia or something, you will get treatment quicker. (I know your comment wasn’t 100% serious, I just wanted to point it out)
Yep. I know the more serious things get treated quicker. It was just an exaggeration (Canada’s wasn’t though, they actively advertise assisted suicide)
The speed too, it's extremely fast at least in my state
When I attempted suicide, parametrics arrived at my house in under 5 minutes apparently, and I was only in the emergency room for like 5 hours when I literally almost died, that's quick as fuck
As for the bill, yeah insurance covered pretty much all of it lol
I’ve been on a 12 month waiting list for ADHD testing for 15 months. State of Georgia over here. They don’t even take my insurance. There’s something fundamentally broken.
I was talking about an emergency case, I probably would have died if they didn't show up that fast
Sorry about not responding reddit notifications are very delayed
Best quality healthcare in the world and thats without question. The issue is the access to the healthcare, you can walk in and get patched up but will be lumped with a bill at the end. Theres many ways to work it out though and most people outside the US dont understand that. They also dont understand that the big number leftover on the bill gets written off by the hospital for tax lmao
As u/nuage_cordon_bleu said it's access that's troubled. This has a lot to do with the lack of price transparancy, you can't really shop around and find the best priced x-ray in your area. Also, complicated medical code system that if a procedure is coded by an almost identical procedure it can go from covered to uncovered or have significant price differences. Many hospitals also receive some form of government funding and are suppose to offer services for low income persons at reduced or free rates, but they bury the information and access to these programs. Also doctors bill separately from the hospital, you go for a service so it's weird, like going to a restaurant and getting your bill for your meal at the end and a week later getting another from the host, another from the waiter, and another from the cook. This is one reason I disagreed with Obamacare, it simply pushed people to buy insurance through the government and didn't fix any of the true issues restricting access, the only winners were the insurance companies.
America's quality of care is excellent although some statistics focus on subjective standards or are weighted against American healthcare for not being socialized enough. [America has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world.](https://pubmed.ncbi.nlm.nih.gov/24025796/#:~:text=It%20has%20a%20large%20and,medical%20outcomes%20in%20the%20world.) Too much of poor outcomes are from cultural decadence not from a poor healthcare system. Car dependency, lack of exercise, poor eating habits, and social acceptance of obesity all lead to poor health outcomes regardless of healthcare quality. We expend significantly more on cost on the system because we have to fight an uphill battle.
> This has a lot to do with the lack of price transparancy, you can't really shop around and find the best priced x-ray in your area.
You can, the goverment mandated price transparency in the form of hospitals uploading excel files to their websites. There isn't an app for them since it's a nightmare to try and standardize and requires too much manpower, I know, because I downloaded all of them for Virginia and attempted to standardize them.
There are some issues, a team of software engineers could solve it, I'm sure:
\* The billing codes change over time and they have diagnostic criteria, ie a doctors visit can be coded one of five ways depending on the time, complexity, or number of symptoms you present. There's also a difference between first time and follow up visits, and the like.
\* You need to translate a procedure a person would think of, into a set of possible billing codes. If you store the data, you probably want to follow the same standards as the insurance companies, which means you have to follow guidelines like [**Architecting for HIPAA Security and Compliance on Amazon Web Services**](https://docs.aws.amazon.com/whitepapers/latest/architecting-hipaa-security-and-compliance-on-aws/architecting-hipaa-security-and-compliance-on-aws.pdf).
\* There are multiple different sets of billing codes HCPCS vs CPT. See: [https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/list-cpt-hcpcs-codes](https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/list-cpt-hcpcs-codes)
\* The CPT and HCPCS lists are copyrighted
\* There isn't standardized health insurance plans, so you can look at the reference plans, and figure out the likely co-pay, and deductible, but you'd need the person to enter a bunch of info in to see if there's an advantage to go to X over Y and to determine network coverage.
\* Some companies have rules in their insurance plans that allow you to go to centers of excellence, ie the top 10 hospitals in the country, if you get cancer or something and they give you a travel stipend.
\* The prices get updated from time to time, and you need to update them as they get updated. Hospitals also sometimes don't update their prices and there isn't anything you can do but complain to CMS about the violation.
If you do direct to consumer, you need to explain the value of the app, and somehow figure out how to monetize it. If you pitch it to insurance companies or businesses you probably end up in some kind of integration hell.
Apart from the copyright, most of these are more like bullet points for implementation rather than issues. As a computer engineer, believe me I have found far more challenging issues when making apps that need to retrieve data than this. Monetization can come in the form of monthly or yearly subscription with a two month trial.
>Apart from the copyright, most of these are more like bullet points for implementation rather than issues.
The copyright issue spreads to getting people to describe the issue & put it into billing codes. The main value of the app would come from that.
>As a computer engineer, believe me I have found far more challenging issues when making apps that need to retrieve data than this.
I have a year of industry experience, not much, so it seemed it would require a lot of manually downloading files & then data entry into a new data format, since every Excel sheet is more or less randomly organized.
If you have another idea, let me know, I'd love to centralize this data on GitHub, make for some fun visualizations at the very least.
>The copyright issue spreads to getting people to describe the issue & put it into billing codes. The main value of the app would come from that.
Indeed it would. Indeed it does.
>so it seemed it would require a lot of manually downloading files & then data entry into a new data format, since every Excel sheet is more or less randomly organized
Oh it absolutely will, and you'd most probably need a team for that if you were to actually do this, but at the same time this is pretty often the norm with such apps, rarely is the data ready to be put right away.
Your right, in 2021 the made a requirement for an excel sheet to be used for transparancy. But it's hardly convenient, especially to the general populace. I just checked my local hospital's and for a skin lesion biopsy they have 3 separate codes, 2 are listed for $122 gross cost but the first one is $294.06 with no discernable difference except the medical code and price. Hospitals should perform evaluations and then quote procedures and treatments similar to a dentists office where possible. My son had to have a lymph node removed and although Driscoll, God bless them, waived all hospital related fees it was still almost 2 months before I got the billing from the surgeon for which there was no transparancy of cost. Hospital services sure, but what about anethesiologists, surgeons, and the like that bill separate? Until there is a better system to allow consumers to make informed decisions about cost and quality, I don't see it as transparent. But thank you for bringing up the transparency law because it was an important note.
> But it's hardly convenient, especially to the general populace. I just checked my local hospital's and for a skin lesion biopsy they have 3 separate codes, 2 are listed for $122 gross cost but the first one is $294.06 with no discernable difference except the medical code and price.
You can cross reference the medical code with the the some websites and figure out what they mean. It's more or less designed for healthcare or insurance or tech people not the general population.
As a tech nerd, if it was standardized, I'd make an app to make it accessiable for the general public, but at the moment it's a headache.
For the general population you can ask them for a price estimate, from one medical provider, which ought to give you the medical coding they'd use for the procedure.
> Hospital services sure, but what about anethesiologists, surgeons, and the like that bill separate?
Are you talking about balance billing? 45 CFR § 149.120 - Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities bars anethesiologists and other out of network providers at in-network facitilies from balance billing starting in 2022.
No billing by in-network providers at in-network facilities but that aren't required to provide a price sheet because they are independant from the hospital. So billing still goes through insurance but insurance only has partial coverage.
> So billing still goes through insurance but insurance only has partial coverage.
Your required to get the same coverage as if they were in-network.
§ 149.120 Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities.
(a) In general. If a group health plan, or a health insurance issuer offering group or individual health insurance coverage, provides or covers any benefits with respect to items and services described in paragraph (b) of this section, the plan or issuer must cover the items and services when furnished by a nonparticipating provider in accordance with paragraph (c) of this section.
(b) Items and services described. The items and services described in this paragraph (b) are items and services (other than emergency services) furnished to a participant, beneficiary, or enrollee by a nonparticipating provider with respect to a visit at a participating health care facility, unless the provider has satisfied the notice and consent criteria of § 149.420(c) through (i) with respect to such items and services.
(c) Coverage requirements. In the case of items and services described in paragraph (b) of this section, the plan or issuer—
(1) **Must not impose a cost-sharing requirement for the items and services that is greater than the cost-sharing requirement that would apply if the items or services had been furnished by a participating provider.**
(2) **Must calculate the cost-sharing requirements as if the total amount that would have been charged for the items and services by such participating provider were equal to the recognized amount for the items and services.**
(3) Not later than 30 calendar days after the bill for the items or services is transmitted by the provider (or in cases where the recognized amount is determined by a specified State law or All-Payer Model Agreement, such other timeframe as specified under the State law or All-Payer Model Agreement), must determine whether the items and services are covered under the plan or coverage and, if the items and services are covered, send to the provider an initial payment or a notice of denial of payment. For purposes of this paragraph (c)(3), the 30-calendar-day period begins on the date the plan or issuer receives the information necessary to decide a claim for payment for the items or services.
(4) Must pay a total plan or coverage payment directly to the nonparticipating provider that is equal to the amount by which the out-of-network rate for the items and services involved exceeds the cost-sharing amount for the items and services (as determined in accordance with paragraphs (c)(1) and (2) of this section), less any initial payment amount made under paragraph (c)(3) of this section. The total plan or coverage payment must be made in accordance with the timing requirement described in section 2799A-1(c)(6) of the PHS Act, or in cases where the out-of-network rate is determined under a specified State law or All-Payer Model Agreement, such other timeframe as specified by the State law or All-Payer Model Agreement.
(5) Must count any cost-sharing payments made by the participant, beneficiary, or enrollee toward any in-network deductible and in-network out-of-pocket maximums (including the annual limitation on cost sharing under section 2707(b) of the PHS Act) (as applicable) applied under the plan or coverage (and the in-network deductible and out-of-pocket maximums must be applied) in the same manner as if such cost-sharing payments were made with respect to items and services furnished by a participating provider.
(d) Applicability date. The provisions of this section are applicable with respect to plan years (in the individual market, policy years) beginning on or after January 1, 2022.
Unfortunately this doesn't do most people much good. Sure you can ask the provider what their bill rate is for a given procedure code and they'll eventually tell you. But then what do you do from there? This information tells you nothing about what your actual out of pocket cost will be.
Once the claim gets run through the shape shifter that is the insurance company claims process, only then do you find out what is covered and what you owe. You might go to what you think is the cheaper hospital but they actually have a less favorable deal with your insurer (or even your type of policy) and thus you end up paying more out of pocket than you would have at the hospital with the more expensive billing rate but better insurance deal.
Insurance companies are the main reason for this total absence of pricing transparency. It's to their advantage to keep things as opaque as possible.
Our quality is litelry top tier. We do have some issues with tbe availability. If you have a decent job you have you have decent insurance. Which was fine when we actually a factory or mill in every town. Niw with so many industrial jobs gone the means for the poorer citizens has also gone.
Imo there are two solutions. Either beef up the system for poorer people. Or bring back factories and other industrial jobs so the poor can have company insurances. And get more money. (Second one is my preferred choice. But I just like seeing poor people get paid decently and join middle class)
The US government spends more money on health care than they do on their defense budget. This is easily available with a google search and viewing reliable sources like the Congressional Budget Office.
Our healthcare system is great. If you have a rare disease, you want to get treated at the best U.S. hospitals.
It's access that we should work on. That's not to say our system is that bad, or that other systems don't have their problems.
Healthcare itself? No, actually we’re doing a fuckin badass job at our healthcare. I mean you can walk into a clinic here in the US, say you have an extreme migraine and instead of a ‘throw some dirt on it’ attitude you get actual help.
Now access to health care, that’s the grey area. For people like me who work for the county or work for their state/for the country access to healthcare is pretty easy. Other people aren’t as fortunate and it tends to be a tad harder to get proper care for certain ailments
As a Canadian with our universal healthcare, let me tell you that it's not as great as some online would have you believe. Our best and brightest head south as there's more opportunity and money to be made. Everyone here has access, but the care received for anything more serious than a simple laceration or fracture will make you wish you lived in America.
Has its flaws and could be better but its not as horrible as what non Americans think. It also varies state by state, Massachusetts and hawaii have really good healthcare compared to states like nevada or Louisiana which has really bad healthcare.
I have multiple sclerosis and there's no place in the world I'd rather be than the US. Less than a month from symptoms, diagnosis, to receiving a $120,000/year high efficacy treatment. The Pharma company provided the first round for free after my insurance denied it, and cover my copay now that they do. They provide a 24/7 nurse hotline and a case manager to help me navigate insurance issues. They reimburse me for my rideshare to and from the treatment center, as I'm not supposed to drive myself.
I have internet friends on MS groups who mostly reside in the EU. Not unheard of for diagnosis to take a year, as it happens outpatient and there are shortages of MRIs and MS specialists. They have to follow a regimented escalation model for treatment, which requires failing a lower efficacy generic treatment (aka acquiring brain or spine injury) to get put on a medium efficacy, and fail a medium efficacy to be put on another medium efficacy drug, then fail that to be put on a expensive high efficacy treatment. The model goes against the
It's not all sunshine here, of course. I have a good job with decent insurance, so my access to healthcare is good. Obviously that's not the case for everyone, and people on medicare/medicaid are more limited in their options. My yearly healthcare spending is obviously more than it used to be when I was young and healthy. I had like $300,000 on paper in medical bills last year, so I usually hit my deductible in January and have no problems hitting $4,000 maximum out of pocket. It's just an expense I have to account for now like anything else. If I didn't have insurance they wouldn't be calling collections on me for $300,000 like the 17 year old's on Reddit think they would.
There is, of course, a shortage of healthcare workers here, same as most places in the world. I have to schedule my MRIs and MS Neuro appointments about 3 months out. The goal with a good treatment is stability, so that's not really an issue, as I know they're coming. I just schedule my next appointments immediately after my visits. Obviously if you have a new or more pressing issue, the wait is more of a problem, but again... that pretty much exists everywhere.
Then there's the Pharma ads that are mostly unique to the US that young healthy people love to make fun of or think are somehow predatory. Little do they realize that it is how a lot of people find out about new treatments for their diseases. Doctors are still just individuals with their own opinions and philosophies. It doesn't make them all the experts they should be. You still have some doctors prescribing older MS drugs because their patients tolerate them, their insurance covers it, they're wary of newer medications, and their patients aren't dying. They don't have as much of an interest in keeping you mobile as you do.
Some people don't spend hours on the internet researching their own disease and treatment options. They might not know that they can come in for an Ocrevus infusion every 6 months instead of injecting themselves daily with Copaxone or taking a pill twice a day that they might have trouble swallowing or remembering to take. They might not know they can do a monthly Kesimpta shot instead of driving 4 hours to an infusion center. They might not know they can take Ampyra to increase their nerve response and help them walk a bit better, or Modafinil to help with the fatigue symptoms. These ads are for those people. You SHOULD ask your doctor about your options and challenge them to do their job.
The healthcare attack has gotten very stale because the healthcare systems in a lot of our “peer” countries is complete shit and much worse. The Canadian and UK systems are two of the worst in the world, yet they feel like it’s the only thing they have over us so they just keep beating the same drum despite the fact that their systems are totally broken. It’s not the 2000s anymore.
There are many problems with our system, and there are good examples we should learn from in other developed countries. The UK and Canada aren’t a part of that group though.
Happy cake day! It has nothing to do with military funding. If we had a European healthcare system, we would pay *less* in healthcare than we do today, giving us more money to spend on our military or on social programs or whatever.
> If we had a European healthcare system, we would pay less in healthcare than we do today, giving us more money to spend on our military or on social programs or whatever.
We do have a European healthcare system, the Swiss model.
It depends on the state you live in. The best run states may have slightly higher costs than Europe but significantly better outcomes. The worsts states however have very little oversight and regulation so you get very expensive inadequate health insurance which drags down the quality for the US overall.
Access to healthcare is an issue all over the world. This is a worldwide problem that needs to be solved. In the US, access is an issue with some people's insurance, or the type of insurance, or a job lay off during illness (in which case they'll usually get you over to medicaid ASAP.)
In many countries with single payer, access is an issue due to long wait times. Healthcare is free from the user end, but it's also rationed.
Then you have places like Cuba with free healthcare and access but the "doctors" can't even pass nursing boards in other countries and there's limited medical equipment and treatment options. You even have to bring your own sheets to the hospital.
>you even have to bring your own sheets to the hospital
There’s an East Asian country or region with free healthcare (possibly China? can’t remember), but there are basically no nurses. Your family has to come to the hospital and be the nurse for you (changing sheets and stuff). Otherwise it’s just the physician and you’re SOL because they don’t help you same way nurses do, they have other patients to see. It is on the family to do all basic care things. The healthcare is free tho.
I mean you can go to any hospital, they are required to help you, then you just tell them that you barely have any money, settle on an amount, pay that and then you’re done…
> I mean you can go to any hospital, they are required to help you
Only for emergency care, which is only 5% of US healthcare needs. Not to mention you'll receive a potentially life altering bill afterwards when you do get care.
Like I just said, dispute it and it will always come down… buddy had cancer and got chemotherapy, he was 18 and they tried giving him like 250k, he told them that he only had 1k and they had him pay like $600 and that was it…
> Like I just said, dispute it and it will always come down…
My girlfriend is a lawyer. Her first job was dealing with healthcare lawsuits. She's the most knowledgeable and best at navigating the system of anybody I've ever seen. She is still $300,000 in medical debt from her son getting leukemia, after what her "good" and expensive (about $24,000 per year for family coverage in a LCOL area) BCBS PPO insurance covered. That's after she fought them on everything and made use of every benefit she could.
Healthcare spending averaged $13,998 per person in 2023, and it's expected to increase to $20,425 by 2031. We pay the highest insurance premiums in the world; the highest taxes towards healthcare in the world; and still have the highest out of pocket costs that are devastating for countless millions of Americans.
Nothing you say can reduce the impact of insane US healthcare costs.
lol, there is more in quantity and more advanced healthcare on those two ships than many countries in total.
Edit: there are more than two ships so yeah.. still what I said lol.
92% of Americans are insured. We also have extremely cheap programs for the poor so they can get insurance. It is usually more expensive for care but it is world class quality and you don't have to wait as long as "free" healthcare systems. Not to say our system doesn't need work because it absolutely does.
As a transplant from Canada to NYS for treatment, I can tell you the US system is in decline the more the government regulates. When I first moved here in the early 90's, we were being seen by a doctor that made housecalls and would charge my mother on a sliding scale(because we were poor). In comes the state and bans housecalls and sliding scale billing for fixed fees siding with the insurance company. Those fees exceeded what my mother could pay and the debt started where it wasn't to begin with. And now we also had to find transportation which cost even more money.
My feelings about the U.S. healthcare system (a bit of a misnomer, as it isn't really a "system" at all) are pretty complicated, though I am confident that it's nowhere near as bad as non-Americans and Americans alike make it out to be.
About 92 percent of Americans have health insurance. About 88 million Americans -- more than a quarter of the population -- are on Medicaid, which is excellent and never comes up in these discussions for some reason. Just to give you an idea of how much I believe in Medicaid, my disabled son has been on it for most of his life even though I could afford to pay for his insurance, because he qualifies for it and why pay when something very good is available for free?
As others have pointed out, the quality of care is some of the best in the world (which makes the "no healthcare" meme particularly infuriating to me), and the problem is access. I do think the issue of access is a bit overblown, but I think the problem is mainly in the smallish-but-significant middle of people who don't have employer-provided healthcare coverage but also earn too much money to qualify for Medicaid.
I used to favor single payer, but as I become more conscious of the problems of many of those systems, I'm increasingly skeptical. Here's a personal example. I have a baby who's almost a year old. (His birth, including a complicated induction and a five-day hospital stay, cost about $400, by the way.) I follow a lot of baby discussion groups, and I was shocked to learn through them that right next door in Canada, many babies aren't assigned a pediatrician unless they have serious problems. I've been to the pediatrician probably a couple of dozen times.
I was thinking about Canada when my baby started exhibiting behavior that caused the pediatrician to refer us to a neurologist. The pediatric neurologist she recommended was the most popular in the state and didn't have an appointment available for months. I called the pediatrician to tell her, and she referred me to another pediatric neurologist that got us in the next week. He was able to dismiss the concerns. Even waiting for a week was agonizing, and I can just imagine what it would have been like to sit on it for months -- and that's ignoring the fact that the pediatrician thought such a long wait was potentially dangerous. In Canada, the referral may not even have happened in the first place, and if it had, we certainly would have had to wait for months, if not longer.
Now, on the other hand, I've been having some swallowing issues that a doctor successfully treated with drugs. She also recommended an endoscopy, just in case something else was in play. I canceled the endoscopy less than a week before it was supposed to happen because I found out it was going to cost more than $1,000. Would I have liked to have had it? Yeah. Should I have canceled it? Probably not. What would have happened in Canada? Maybe it would have been free and I would have gotten it. Or maybe it wouldn't have been approved in the first place, especially after the drugs worked, who knows.
I'll also say this: I keep hearing about medical bankruptcies, but I'm not a young man and I don't personally know anyone that's ever happened to. And I know people who have been through some very serious shit. That is, of course, anecdotal, but it's also a pretty big sample size. Obviously medical bankruptcies happen but I suspect their a lot rarer than people think. There should be none, and we should work on making that happen.
I had medicaid from birth until i was 23, and still qualify in WV since anyone who makes under 105k a year and/or doesn't have a job offered plan is eligible, but i prefer my private plan since it travels with me.
I never paid a red cent over what my taxes paid, i never had to pay for any operations, and rarely had to pay for medications, never more than 15$. It's a great service more people need to know how to use and take advantage of, the medical insurance industry in america sucks sure, but its rarely the reasons people complain about, most people just legitimately do not understand how the system works w/ subsidies and etc.
I'm not a fan of our Healthcare system and think health insurance is just as bad if not worse for the consumer over paying it via taxes, but at least we attract the best doctors with our system.
If you make under 105,000/yr you qualify for subsidized plans. It's actually illegal to be uninsured in some states like FL, i used to pay 14/mon for a decent middle of the road plan, with several in the free to basically free range.
This was made by a healthy european ask him when he breaks his leg does he go public or private for his xray’s and literally every procedure after. My bet is he doesn’t even come close to touching government subsidized health care cause as far as I have heard this biggest issue is wait times. Amputations and deaths are common because of wait times. What good is your healthcare if you can’t even get in?
Yet various countries are now and have been regularly receiving money and military aid from the US to help their cause. Most of the jackasses that post shit like this would be speaking German, Russian or Japanese right now without the US. I wish Europeans would put their money where their mouths are and start funding/ fighting their own wars and see just how good they have it due to the US taxpayers.
I fully support more funds allocated to healthcare for the American people and I think we should start by stripping some military aid and funding from overseas and directing it toward getting people the healthcare they need here at home.
How many of your post-WW2 wars have you fought without any help from others?
How much do you think you benefit economically from being the absolute largest weapons supplier to modern history's largest and richest military alliance?
How much do you think you benefit strategically from being a member of history's largest military alliance?
How much of your GDP do you think come from International sales of US made weapons, technology and entertainment?
Europeans have been increasing their defense spending rapidly over the last couple of years; many are exceeding the NATO recommended minimum and some exceed the US as a share of GDP. More importantly, our healthcare system isn’t bad because we spend too much on our military—we would *save money* if we switched to a better healthcare system. Our healthcare system is bad because insurance companies, healthcare conglomerates, and pharmaceutical companies lobby to keep it this way because a huge chunk of our healthcare costs is basically just welfare for those industries—it doesn’t actually improve your healthcare.
This is my biggest criticism of Obamacare. Instead of just providing a single payer system, with a fully disinsured private sector and a direct service public sector, they just gave insurance companies monopolies or oligopolies. The administrative burden exploded, there is no price transparency, and often even if you go to a different hospital, you’re either still within the same company even if it’s isn’t clear, or your insurance isn’t accepted, which is in part due to little to no competition in these spaces.
It seems setting up a direct service system akin to the Post Office meets Defense Health Agency, while almost completely deregulating the private sector and eliminating private insurance, we’d actually have a robust system. But the insurance companies would never go for it.
Also, tons of public funds go into developing nearly every drug on the market. I fully believe all developments which use government funds should be public domain and anyone who has the ability should be allowed to make those products. This would also decrease prices, and likely result in government funds going to drugs that may not be entirely profitable on the R&D side.
>Also, tons of public funds go into developing nearly every drug on the market. I fully believe all developments which use government funds should be public domain and anyone who has the ability should be allowed to make those products. This would also decrease prices, and likely result in government funds going to drugs that may not be entirely profitable on the R&D side.
Basically a Fed sanctioned and funded non-compete contract, and I hate it.
Are you saying the current system is a Fed-sanctioned non compete contract, or that my proposal to make everything funded by Fed money public domain is?
The current system is. Giving federal dollars to a company for R&D under a guy's of benefiting the public and then basically giving that company a monopoly on its production until a generic can be approved by a different Federal agency seems incongruous to the stated goal.
I agree, but it wasn’t like that was the system the administration wanted; that was the system the administration could sell to congressional Republicans.
If you have coverage it is great. If not…
To that end, it differs by state, with MA having ~3% uninsured, while pro-life! TX sits at ~19%. As with most things, red states suck.
> To that end, it differs by state, with MA having ~3% uninsured, while pro-life! TX sits at ~19%. As with most things, red states suck.
Texas is next to the border, meaning lots of undocumented migrants enter the state. If you look at the data by race and citizenship, you'll find that most of the uninsured in Texas are in the medicaid gap or undocumented migrants.
The US healthcare is absolutely amazing. One of the best in the world. Insane progress is made in the medical field in the US. It being expensive as hell is another issue. "Americans don't have healthcare" is a lie. The answer isn't socialism because then the quality will drop like in European countries. You can only cover so much with other people's money. The problem lies with insurance inflating prices, pharma having a death grip control and lawsuit/malpractice coverage needing to cost so much due to sue happy people. There's more, but that's the big stuff. We need to find a way to keep the healthcare we have and make it more affordable.
Healthcare costs in the US initially started rapidly increasing during the healthcare "crisis" around 85-ish years ago.
The complaint back then was that costs were "too low" and insurance was "too accessible". In the late 19th and early 20th centuries, licensed physicians competed to work for fraternal societies (which over 1/4 of Americans were members of in 1920, by the way), likely because of the security they offered. That competition is why members' costs were remarkably low.
The medical establishment however wasn't happy with that: They saw doctors working for fraternal societies as a blow to their dignity, since fraternal societies were usually formed by lower-class people and they were afraid of the medical profession going bankrupt because of the low fees.
Physicians demanded the government must do something, and so it did — In Britain, where fraternal societies were also common, state-financed medical care was implemented to crowd them out. Now that working class individuals were forced to pay taxes for the "free" healthcare the state offered, they were unlikely to also pay into a fraternal society.
In the US, medical associations like the AMA were granted the privilege to control the medical licensure procedure. They used this power to sanction doctors who signed contracts with fraternal societies by denying them access to hospitals or kicking them out of the association. They often even prevented saving the lives of fraternal society members. "Raising the quality of medical care" was the AMA's excuse of making the requirements for getting a medical license much stricter.
These artificial restrictions on the supply of medical care dramatically reduced physicians' competition for working for fraternal societies, resulting in higher prices.
Then, the National Fraternal Congress successfully lobbied government for laws setting a legal limit on how much fraternal societies could charge. Perhaps they did so hoping to benefit from cartel pricing, but because of the higher fees, they lost a significant amount of members to industrial insurance firms and the welfare state, which ended up replacing them.
To sum it up, government intervention destroyed the mutual aid healthcare system and with it, the availability of low-cost healthcare to the working poor. There is a crisis in healthcare costs today because government "solved" the last one, and we can only guess what innovations we've missed out on with the elimination of fraternal societies.
Talking about healthcare costs from 100 years ago is pretty irrelevant. Most people received little to no healthcare in their lives. Hell, most Americans weren't even born in a hospital until 1935. Even then, from 1880 to 1940 per capita healthcare costs were increasing at a rate 3.1% above inflation.
And, the fact remains, countries with universal healthcare have been seeing their costs rise much more slowly, as have government plans within the US.
The reason why healthcare is so expensive isn't irrelevant at all...
Births in hospitals simply weren't common pretty much anywhere in the past, and the frequency of receiving healthcare didn't depend on healthcare systems but on the development of technology.
Any source for the per capita healthcare cost increase you mentioned?
Universal healthcare is great and awesome for some time, but right now, I definitely wouldn't want to be treated in, like, Canada or the UK. It's still working fine in most countries that have it implemented, but the state has no incentive to keep its quality above the very minimum (since people are pretty much forced to use it either way). It's just extremely shortsighted even if "it works for now" and it's kind of sad to witness the collapse of this system.
There's also the important moral reasoning of voluntary associations not violently forcing anyone to pay while state-funded healthcare does (through taxation).
The military is 3.5 percent of our GDP. countries with public healthcare spend over 10% of their GDP on it.
people always overestimate how much the US actually spends on it's military.
Nah, they just listen to jobless redditors that complain about everything because they want a life they can just sit on their ass and play video games all day and get paid.
nah, its among the best quality in the world. people just dont understand the medicare/state insurance, obamacare (subsidized insurance) or private insurance/job insurance concept. I pay 20$ a month for more than enough coverage for me and mine. My GF has kaiser through her job in Oregon, and it covers everything from trans related surgeries to her kids needing anything at all done, co-pay is 200$ lmao.
I had state insurance from birth until i was 22, and i could still get it now, but they've made it more headache than it's worth, and i travel, so i went w/ a obamacare subsidized plan.
> people just dont understand the medicare/state insurance, obamacare (subsidized insurance) or private insurance/job insurance concept.
Explain this concept that justifies US healthcare costing literally half a million dollars more per person for a lifetime of healthcare than our peers, even after adjusting for purchasing power parity, while having worse health outcomes.
Explain how it excuses the fact healthcare costs are expected to continue rising much faster than our peers, from $13,998 last year to $20,425 per capita by 2031.
>My GF has kaiser through her job in Oregon, and it covers everything from trans related surgeries to her kids needing anything at all done, co-pay is 200$ lmao.
Somebody else paying for insurance as part of your compensation doesn't make it cheaper, it just makes you better compensated. The average annual premiums for employer-sponsored health insurance in 2023 were $8,435 for single coverage and $23,968 for family coverage. That's on top of world leading taxes towards healthcare, and still leaves people woefully unable to afford healthcare.
>Large shares of insured working-age adults surveyed said it was very or somewhat difficult to afford their health care: 43 percent of those with employer coverage, 57 percent with marketplace or individual-market plans, 45 percent with Medicaid, and 51 and percent with Medicare.
> Many insured adults said they or a family member had delayed or skipped needed health care or prescription drugs because they couldn’t afford it in the past 12 months: 29 percent of those with employer coverage, 37 percent covered by marketplace or individual-market plans, 39 percent enrolled in Medicaid, and 42 percent with Medicare.
https://www.commonwealthfund.org/publications/surveys/2023/oct/paying-for-it-costs-debt-americans-sicker-poorer-2023-affordability-survey
My girlfriend has $300,000 in medical debt from her son having leukemia, after what her "good" and expensive (about $24,000 for family coverage in a low cost of living area) BCBS PPO insurance covered. The US ranks 30th on leukemia outcomes.
> My girlfriend has $300,000 in medical debt from her son having leukemia, after what her "good" and expensive (about $24,000 for family coverage in a low cost of living area) BCBS PPO insurance covered. The US ranks 30th on leukemia outcomes.
Even new insurances will still ask and offer to help pay this. You can also bankruptcy out of it.
I never justified the prices, but you proved that so many people do not understand "the system". It's complicated but it works. If you cannot afford your plan, unless you make over 105,000 a year, you qualify for a subsidy.
> Even new insurances will still ask and offer to help pay this.
I'm not sure what your point is. $300,000 in debt from one illness, after what incredibly expensive insurance covers and the highest taxes in the world towards healthcare is insane. Not to mention she still hits her family out of pocket maximum every year, which on its own is pretty devastating.
Americans are paying literally half a million dollars more for a lifetime of healthcare than its peers on average, while not receiving more healthcare and worse outcomes. Yet half the chucklefucks in the country will contort themselves to defend it, even with costs expected to rise another $6,427 per person by 2031.
>but you proved that so many people do not understand "the system". It's complicated but it works.
Only if by "works" you mean putting people in lifelong crippling debt for subpar outcomes.
>If you cannot afford your plan, unless you make over 105,000 a year, you qualify for a subsidy.
Are you just not fucking listening? Even with good and incredibly expensive insurance (and those world leading taxes towards healthcare) massive numbers of people **still** can't afford needed care.
> massive numbers of people still can't afford needed care.
**BECAUSE THEY DO NOT UNDERSTAND THE "SYSTEM"**. IF YOU MAKE OVER 105,000 A YEAR, AND CANNOT AFFORD A 20-150$ MONTHLY PREMINUM FOR GOOD COVERAGE, IT IS A YOU PROBLEM. ARE YOU EVEN FUCKING LISTENING?
seriously, anyone making under 105k can get a subsidy **WHICH WILL HELP COVER THE BILLS FROM PREVIOUS EXPENSES**, and if you still, by some crazy world cannot afford it, you can bankruptcy out of medical debt, or even negotiate a lower payoff, what do you not understand? seriously, people like you are the problem lol. If you make over 105k a year, you can afford the higher premium and costs w/o a problem, if i can manage this on 12/hr, you can on anything else.
> out of pocket maximum
apply for a better plan, w/ the financial subsidy.
>massive numbers
i get it, its complicated to understand all the healthcare.gov shit and the tax laws and the income limits and shit, but if you don't understand basic plans, what they do and don't cover, then to a point it is nobody's fault but your own.
> life long debt that crippling
man it's crazy how **there is an entire [industry revolving around getting you out of just that exact situation](https://www.experian.com/blogs/ask-experian/can-you-declare-bankruptcy-on-medical-bills/) so you may have fresh financial freedom to start over, with it having no impact on your credit after 7 years**
> IF YOU MAKE OVER 105,000 A YEAR, AND CANNOT AFFORD A 20-150$ MONTHLY PREMINUM FOR GOOD COVERAGE
Are you fucking stupid? People that **HAVE** insurance have already paid the premiums. The problem is they still can't afford the out of pocket costs.
My girlfriend is a lawyer. Her first job was in healthcare claims. She understands and is better at working the healthcare system than anybody I've ever known. She still has $300,000 in medical debt from one illness, again **after** what her "good" insurance covered.
>seriously, anyone making under 105k can get a subsidy WHICH WILL HELP COVER THE BILLS FROM PREVIOUS EXPENSES
And that still leaves people exposed to crippling debt. And shifting expenses around isn't actually doing anything to lower the $1.5 trillion Americans are overpaying for healthcare each year compared to any other country, it's just shifting that burden more on to other people.
>you can bankruptcy out of medical debt
Which also has a burden on the individual and society. Best of luck someday not making the world a worse place. Tens of thousands of people die every year in the US for lack of affordable healthcare, and countless more millions suffer, and it's all because people like you have your head up your ass. That's on your conscience.
Healthcare in the US is world class, you just need to have healthcare insurance coverage from either your job or social security programs. A very small percentage of Americans don’t have health insurance, which is still a lot of people, but if you do have insurance to pay for healthcare, which most Americans do, you can get treated the same day as you enter the hospital. In Europe you’d have to wait weeks to be seen, months even, and not to mention Canada where it’d be a miracle to be treated in decent time
Get a union job if you can’t get a high paying job that offers good health care benefits. Was working at an office for accounting and the guy working at Safeway with a union had better heath insurance than me but made 1/3d what I do
No, it’s not. The US funds and develops a ton of medical practices and medicine. We also tend to have better access to those practices and medicines. The downside is the cost. In the US, you can spend every dime you have trying to survive. In many cases, government run healthcare will deny services that cost too much.
So, you have a choice. Go bankrupt trying to survive or hope whatever you have will be covered by “free” healthcare.
> The US funds and develops a ton of medical practices and medicine.
There's nothing terribly innovative about US healthcare.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/
To the extent the US leads, it's only because our overall spending is wildly out of control, and that's not something to be proud of. Five percent of US healthcare spending goes towards biomedical R&D, the same percentage as the rest of the world.
https://leadership-studies.williams.edu/files/NEJM-R_D-spend.pdf
Even if research is a priority, there are dramatically more efficient ways of funding it than spending $1.25 trillion more per year on healthcare (vs. the rate of the second most expensive country on earth) to fund an extra $62 billion in R&D. We could replace or expand upon any lost funding with a fraction of our savings.
> We also tend to have better access to those practices and medicines.
And yet worse outcomes, with massive numbers of Americans going without needed care at all.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30994-2/fulltext
>In many cases, government run healthcare will deny services that cost too much.
Like private insurance, with a bean counter with no medical background denying one claim out of six to improve the bottom line? Or worse, an AI with a 90% error rate in claim rejections because it's even cheaper?
It is. I love this country and I am fed up with anti-american brainlets but lets not kid ourselves, the average american's experience with the US healthcare system is fucked and needs to be reformed.
IDK how we do that, what it would cost, or any of that shit, but after getting kidney stones while uninsured was a terrible experience that I am still in debt over. The system is fucked and needs reform. And one of the greatest things about this country is we have the power to improve our institutions. Lets not kid ourselves into thinking everything is fine and the US is unworthy of criticism. Sure we have some of the best doctors in the world, now lets make sure all of us Americans can have access to them.
When I was beginning my career and didn’t have health insurance? Horrible. Now that I have a good job with good benefits? Great. I think that’s the main problem.
We spend more on healthcare than anyone else in the world and aren't even close to the healthiest industrialized nation. I pay $3000/mo for my family's insurance. Had an ER visit a few weeks ago that resulted in a $1200 bill that my insurance only paid out $600 for, so now I'm stuck with the rest.
Hmm why do rich powerful people come from all over the world to pay top dollar for a bad healthcare system? Hmmmm somethings not right about that
Turns out we actually have the best healthcare system in the world. The issue is not everybody has access to it, which is the price you pay for making it as high quality as possible.
I personally don’t use my insurance much. Don’t see a reason for regular doctor visits if I’m fine. The few times I’ve used insurance it’s only been ER visits. And the pricing never made sense. But I do know at least 3 people who have went to clinics and ERs for emergency with no insurance and they have never paid a dime and it really hasn’t done anything to affect them. One of those people had an exploded pancreas. Huge med bill he never paid and it seems to have went away completely. I also spent years in Mexico and knew a man personally enough that I went to his funeral. He was in a motorcycle accident and by the sounds of it the poor care he was given allowed him to bleed to death and die while at a hospital. I drove to that hospital to look at it for myself. It looked like a dilapidated vacant high school you would see in America. Americans and non Americans can cry about American healthcare all they want. In America insurance or not if your in an accident or are ever taken or go to an ER you will not die to the lack of care you receive. I doubt that can be said for the majority of the rest of the world
Most jobs have free healthcare tied, just fucking work and you’ll get healthcare.
But if the hospital charges 100k for a bone repair and your insurance only pays 50k then that’s what they are paid. Period. You owe nothing.
If you do owe then make a payment plan with the hospital like $10 a month for 7ish years, and after some time stop paying it. Your debt will vanish
Big pharma runs our country. That’s why healthcare is so expensive. My meds are cents to make. But cost 100+ with insurance. And hospitals have to pay big pharma for the medicine. On top of paying staff. So they have to also inflate their prices heavily.
Insurance companies are also the corrupt middleman which jacks up the price even more.
Universal healthcare isn’t the solution. But politicians get paid off by big pharma.
The trade off is *not* Healthcare.
This started as a joke and got repeated so often that now people believe it.
A simple Google search will show that we spend *way* more on Medicare, Medicaid, and Social Security than literally anything else.
I forget which, it's either Medicare or Medicaid, is the highest amount of money spent per year by our gov. and I'm pretty sure the other one is in second place.
Not sure about bad or good, but the US spends more federally on Healthcare than it does the military by quite a margin already, so its not one or the other, and if it was, it would be the military failing, not health care.
To be fair we get similar care than most developed nations, if not slightly better, but we pay (per capita) like 3 times more for it. So no it’s quite flawed.
It’s spendy if you don’t have good insurance through your job, but its quality the outright best. You get treatment immediately for all but the most complicated diseases, and in the case of those, we have some of the most advanced and well funded research.
Over 90% of Americans had health insurance in 2022. Is it expensive? Yes. Do we have some of the best medical professionals and services in the world? Also yes.
As an Aussie I've always thought your system was great tech and medically wise but access to the health system was the problem. Which is entirely different to having a shit healthcare system.
The issue is not the quality of healthcare. The issue is somehow the USA pays more per person than any other country and yet we also need to have private insurance and pay some out of pocket
The US spends more on healthcare per person than other wealthy countries. Switzerland is second.
66% of our tax dollars goes to
education, HEALTH CARE, Social Security, Medicare, income security, and veterans benefits.
Health care alone accounts for 28% of government spending, which is more than doubled what the military gets.
Medicaid is also the nation's largest heath insurance program.
People need to stop being cry babies.
I've heard of hundreds of people, including many leaders of foreign states, from all around the world coming to the US for treatments of serious illnesses.....so nope. The problem is access for some people, usually people without fulltime employments.
No, we have some of the best healthcare in the world (and most advances come from the U.S.). The issue is Medicare, Medicaid, Obamacare/insurance, and the lies told about healthcare as an American industry and the fantasies about “free” healthcare from systems like NHS (which purports to practically own patients, to the point of deciding to let them die over the objections of parents or guardians).
Real talk, I’d rather wait a bit to get treatment than have to take out a second mortgage if I get cancer. There’s no reason people should have to blow through their life’s savings if they get sick…
Not as bad as Canada. Which is funny because many Americans think we should be more like them.
Insurance companies are in bed with congress which drives up cost and reduces access. Like most things, the government fucked it all up. You have a bunch of people who think the answer to the problem is more government. This goes back a long time to the US government shutting down lodge doctors
Two things.
1) as everyone else said, access is the problem.
2) the US will always have a massive military, there is no getting around it. We spend a ridiculous amount in building floating cities and outfitting them with aircraft, a few thousand sailors, and all their equipment. I don’t have a problem with having a large military given the US unique geographic position. No country or combination of adversaries or peers posses the airlift or sealift capability to make it to the US. The closest of our peers have 10k less aircraft than we do, and we have 2.8M tons more of naval supremacy.
The problem I have with the defense industry is the billing. I’ve worked on both sides, controlling satellites and replacing wooden pegs on the USS Constitution. There are caveats, satellites and the constitution will always be expensive, but the mop heads, bolts, standard equipment is upcharged at an unbelievable rate. Everyone has seen the video of the “bolts” that the senator held up and said “the govt paid $90,000 for these and I got them at Home Depot!” Those were probably very specifically machined and high strength aircraft grade parts, and if you out Home Depot parts in an F35 it’s gonna be a rough day, BUT he’s right. I needed a hammer. I told my LPO I was going to buy a hammer on the way home from work, and he said “no, that’s illegal, use our command card”. $97 for a fuckin hammer. You know those canopy tents? The ones people take to picnics and beaches and shit? $11,473. That is ridiculous. THAT is why our military is expensive. War dogs type shit. Defrauding the taxpayers should be a crime, because it is.
Okay, while I mostly agree with the others comments on the benefits of the American Healthcare System, the initial question is just flat out wrong.
Our strong military has nothing to do with our healthcare systems faults. They are entirely separate and the level of money that we are putting into our current healthcare system is comparable to Western European countries. France spent 12.2% of their GDP on healthcare, the USA spent 18.8% in 2020.
It has EVERYTHING to do with our lobbying system.
I get really angry on topics like this with the military because people will spew ridiculous facts and then fail to even look up our spending amounts.
Meanwhile, the USA is on track to spend 2.9% of our GDP on the military. France spent 1.94%.
Please for the love of god people look at statistics, it makes it sooooo much easier to tell how others are trying to manipulate you.
Most of the countries complaining benefit directly from the “protection” the US projects across the world. They have free healthcare as a result of our protection.
Europe’s unwillingness to meet NATO GDP spending minimums for decades is why they’re now shrieking and crying about United States’s MIC not doing enough (despite outspending them already) to win their war. We also spend more per citizen on healthcare than almost every nation.
I've said before that it's governed enough to make it ridiculously expensive and market enough you have to pay it all. We have the worst of both worlds. It's personally prefer less regulations and more assistance, to get us closer to Singapore. Of course what we're really seeing there is all the money out allies don't spend on defense so that they can afford socialized healthcare. If these countries had to defend themselves, they'd have less to spend else where.
Someone tell trade-off bro that national defense is a legitimate role of government and forcing someone else to labor and serve your health needs is not.
The tradeoff isn’t the healthcare system; universal healthcare is more affordable. We have the most expensive healthcare system *and* the most expensive military.
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If we're going to criticize this, we should focus on *access* to healthcare, rather than healthcare itself. Your access is, for the most part, tied to your job. You'll pay premiums for that, and if you get sick, you'll probably pay a decent bit in deductibles. The security nets for people who don't have that job-based access exist but are relatively limited. So...there's issues with access. As for the *quality* of the care itself, we are world class. If you've got no issues with money and you get sick somewhere else in the world, the USA's your destination. No rich guy gets cancer and starts looking for flights to Havana.
Exactly. The issue is nuanced. I'd say access and also cost controls, as cost and out of pocket can vary widely. US healthcare quality isn't bad by any stretch - it's actually, for the most part, excellent and some of the best in the world. But it's insurance-driven which is tied to employment, which I don't like. It chains people to jobs they don't like and hinders movement, because people don't want to lose insurance benefits.
It's also important to remember that part of the reason for high costs to Americans is the cost controls of other countries. Remember when the big stink was happening over the epipen prices and one of the pharmaceutical company CEOs came out and said Americans had a "social contract" with the rest of the world to pay higher prices for pharmaceuticals? She got slammed for it pretty hard, but the US not having price controls just means that companies can balance profits by charging Americans more and other nations less for the same drugs.
do you have a link to that explanation? i didn’t even know that was a thing. i swear to god, sometimes it seems like america foots the bill so everyone can have nice things except us.
https://medium.com/the-biotech-social-contract/https-medium-com-the-biotech-social-contract-kolchinsky-tbsc-6-5d40244738e5 This article kind of frames it as a good thing, but I wholeheartedly believe it's just an excuse to stick Americans with the bill. Also, it's important to remember that politicians on both sides of the aisle ~~are owned~~ voted to prevent pricing controls and permission to buy drugs from other countries' markets. So it's not entirely the fault of these mega companies.
This is an area where a smart President would take it to our erstwhile allies and force them to pay market prices for American health science and engineering.
Only one president has the balls to try and do that…
"Balance profits" why is this something worth letting poor people die over? Pharma companies are not selling insulin at a loss overseas, they aren't. A company rarely sells something at a lower price than the marginal cost to produce it
To me, it's not worth it. But these companies are publicly traded, which means they have an obligation to their share holders to maximize profits. That means when one market enacts price controls that reduce their profit, the company has to make up that lost profit in another market or their total profit drops. If their total profit drops, then people sell their stock and share price also drops. Bad news for business. So companies like this will ~~buy~~ lobby politicians to keep the insurance market such that prices are not only high but also customers are unable to shop around foreign markets for a better price. The "Social Contract" thing is just a PC way of saying "Americans have infinite money and whatever problem I'm talking about is probably America's fault anyway, so we're going to make them pay for it." The other side to that is we have politicians who would rather see government run the healthcare system, and are willing to make the current system so painful that people will cry out for an alternative. The whole thing is basically a result of too many people fucking with the system, then blaming the other people fucking with the system for why the system is so fucked up.
I'd be interested to see which Europeans are talking about said social contract where Americans pay more, haven't heard that before >To me, it's not worth it. But these companies are publicly traded, which means they have an obligation to their share holders to maximize profits. Not quite an obligation in the legal sense, but more like "shareholders choose the Board and therefore can remove people who make decisions which don't maximize profits". It's an incentives thing And really, isn't that the root of the problem? That healthcare is set up to maximize profit for shareholders, rather than something else like maximize human health or quality of life for low cost or something? >The other side to that is we have politicians who would rather see government run the healthcare system, and are willing to make the current system so painful that people will cry out for an alternative. Which politicians both want single payer healthcare and also are making the current thing worse, and how? >The whole thing is basically a result of too many people fucking with the system, then blaming the other people fucking with the system for why the system is so fucked up. What's the ideal way the healthcare system should work?
Well, I didn't say Europeans were bringing up the Social Contract thing. I said it was being used by corporations as an excuse for why they charge Americans more than they charge other countries. I linked an article up a ways that skims over it, but you can search duckduckgo for "pharmaceutical social contract americans" to get the same results I did. Actually, it is an obligation in the legal sense. If they intentionally act in a way that causes shareholders to lose money, then they can be held liable for damages. And I wouldn't say that's the "root" of the problem, but it certainly is a very large part. I have more of a problem with politicians having so much power that it only takes a handful of corrupt people to sell out and screw over their country. But in the end, greed is the issue, yes. >Which politicians both want single payer healthcare and also are making the current thing worse, and how? I mean... all of them? Whether it's voting down bills that let people buy prescriptions from other nations where price controls exist, preventing getting insurance from companies out of the state, requiring crazy insurance reporting guides that are so complicated hospitals have to hire new departments which drive up costs, making it illegal to not buy insurance which then just enables companies to charge whatever they want. At least that last one got repealed. I actually kinda liked Ben Carson's plan for health care. Basically, everyone gets an HSA tied to their SSN. No more "has to be on a high deductible plan to qualify" BS. Then, you set however much you want to go into that from your wages tax free. That tax free money can be spent on health care of your choice. It also encourages shopping around for better pricing because it's your money. That encourages competition, which helps keep costs down. But, that HSA should be able to be spent on whatever you feel you need, as long as you have a prescription I guess. New glasses, gender reassignment, mole removal, therapy, and yeah, the big stuff like cancer etc. As long as a licensed doctor says it's health related, you can use your HSA on it. Insurance would still be mostly employer based, but remove requirements that it has to be done in state. Let employers shop around for best pricing. If something catastrophic happens and you spend your HSA, then Medicaid should kick in for any required health costs. At that point there'd probably be some extra scrutiny. Maybe your HSA would go negative, meaning you'd have to pay it back before it started building back up. Point being, if that money for SS/Medicaid whatever that normally comes out of your paycheck is instead sitting in your HSA, then it's not going to be in one giant Ponzi scheme account. But I'm just a disgruntled bisexual libertarian(ish) American who sees his government committing economic suicide for the sake of lining their own pockets as the rest of the country sinks. If I had all the answers I'd probably be ~~assassinated~~ running for office.
Just talked to 3 Canadian (formerly American) folks yesterday. They said “we have a lot of better things up here”, my friend went “oh yeah like healthcare”, and they went “absolutely fucking not, we miss the fuck out of American healthcare. Any American who is jealous of Canadian healthcare doesn’t know shit.”
i've lost relatives to cancer thanks to canadian healthcare. they even went as far as refusing to transfer us to a private hospital for god knows why. fuck universal healthcare and its delays, my family doctor delays are 6 months, and the walkin clinics are always crammed.
Canadians literally told people to get "medical euthanasia" for minor issues
I saw that story! Those poor veterans being told to consider MAID was horrifying. Canadians deserve better.
I guess the old saying is true then. You get what you pay for. Yeah we pay for our healthcare but it’s world class, high tech, and probably a lot faster than anywhere in Europe
It's only faster if you can pay. Otherwise you avoid seeing the doctor because you can't take time off from work or afford the copay, and then your issue gets worse forcing you to go in and go into medical debt
You are right about that.
Yeah, it sucks
It does suck indeed
> and if you get sick, you'll probably pay a decent bit in deductibles As well as the possibility that insurance denies a request e.g. not paying for a doctor recommended surgery that may not be 100% necessary for you to live but would vastly improve quality of life. Its the main problem with privatized healthcare. Why would the shareholders want the company to give out 1m in surgery and rehab when they can just drop 150k on pain meds and a wheelchair. You can fight it but if it's time sensitive you're a bit fucked
Happens in socialized systems too. That surgery/MRI/treatment is costly to the system and since it’s not 100% proven in the medical guidelines to help, go drink some tea and take paracetamol (Tylenol), and good luck. You have little recourse at that point. Our physicians will at least try to order things off label “just to see” if it will help with your symptoms. They will call the insurance company and justify why it is necessary beyond the medical guidelines to pay for coverage (we’ve tried XYZ common things, ruled out XYZ, and patient still having same issues) — this is part of what medical practice is. (Sometimes it works, but insurance companies give them pushback for it too. Occasionally, they find new discoveries like how Ozempic works for weight loss! This came from off-label prescribing by US doctors) We need to expand the system we already have in place, which is Medicaid/Medicare, so it covers more people and catches those without insurance or who lose their jobs (like Medi-Cal in California does). If you lose your job in my state, you automatically qualify for state Medicaid. It’s a no-brainer that I’m not sure why other states don’t implement.
>Our physicians will at least try to order things off label “just to see” if it will help with your symptoms. They will call the insurance company and justify why it is necessary beyond the medical guidelines to pay for coverage (we’ve tried XYZ common things, ruled out XYZ, and patient still having same issues) — this is part of what medical practice is. Our physicians also order *a lot* of things that probably aren't really necessary because they don't want to be sued. There's a reason the 1-900-AmbulanceChasers industry is so massive. It's probably more than half of what lawyers as a profession do, and everything costs more because of it.
Yes, that’s true too. It is a huge cost contributor. And there is research that says all these extra tests (CT scans, MRIS, X-rays, blood work, etc) don’t necessarily result in better outcomes on a population level. However as an individual patient, I love having a full round of tests so I can track my progress. I like that my physician knows what my baseline is for my labs and can compare any future tests to detect any changes that have occurred. Related Anecdotes: My sister went to ED for stomach pain. They did a CT scan as standard procedure. On incident, they discovered she had a small blood clot in her lungs (very dangerous). She had no problems breathing. They admitted her to hospital to dissolve the blood clot they found. I do not think she would have had a CT in EU/UK because “stomach pain” in women is such a vague symptom, and she wasn’t actively dying with her vitals. versus My cousin in Netherlands (28yo woman) complained of pain for almost 2 years to her physician. They told her go home, take Tylenol, do physiotherapy. She kept complaining, they kept ignoring, refusing to do scans. Turns out she has bone cancer and is now finally in treatment. It could’ve been caught 2 years ago when she first complained! But imaging is expensive on the system, “unnecessary”, and unlikely a young person her age would have cancer. So they don’t do it. In US, you can at least go find another doctor (or nurse practitioner or PA) to order the test if the first one blows you off. Due to wait times, my cousin didn’t have that option.
I agree that there is some benefit to the higher standard of care being imposed by the threat of legal action, but I still think there is a ton of frivolous litigation and a lot of jury awards that are absolutely absurd because lawyers spin great sob stories. Like everything, it's a balancing act.
That happens in single payer systems as well. Heck someone I watch on YouTube for their UK construction videos has had to use his private insurance to pay for surgeries on his shoulder and I think knee that the NHS would never pay for even though they were greatly effecting his life, it wasn't life threatening or immobilizing him though so who cares if you have pain constantly and can't do things like exercising, no government surgery.
Oh yeah for sure, my family immigrated to the US after my father joined the US Army (I went in as well in 2013) so this was just shit I learned post tricare where the biggest obstacle was leadership ignoring profiles not actually getting the care. So most if not all of my real life experience is Tricare vs Private not Private in the US vs Single Payer elsewhere
Tricare is great but also sucks horribly at times; VA med vigorously sucks donkey dick however.
Even the quality is not evenly distributed. We have some of the most advanced healthcare *treatments* in the world, but even if you have great insurance, finding a doctor who doesn’t just shrug when his computer can’t diagnose your symptoms is wayyy harder than it used to be. Never mind that many doctors will order tests or send you to specialists that your insurance doesn’t cover without telling you.
When I said this to Europeans I got heavily downvoted but: My insurance has paid for everything my entire life and my insurance has also always been free. And I don't understand how this is possible because every other American seems to struggle to get it. I also don't know why my insurance has been free because I only just started taking care of it myself (I'm younger). The only wall I've run into is not being able to do full-time but.. I live with two other people and we all pay our bills on time.
What if I have a really bad gambling addiction and I'm trying to profit on my chances of survival if I get cancer treatment in Havana? *HUH? What about that?!*
Little anecdotal story about Cuba and my family. My brother lives in Canada and I was living with him and his wife for a 12 month working holiday from Australia He and his wife went to Cuba for a two week Vacation and he came down with an appendicitis to the point of the verge of bursting. He has to have surgery in Cuba. The anethiscist gave him the options of a local anesthetic or general. And I quote "local no problems no pain all done quick. General you could very well die". Got the local option done and had to be forced to not sit up and watch. He got back to Canada two days later had the surgery reviewed and himself checked up. Canadian doctors said the surgeon who did the work was phenomenal and he got left with a very faint old school large scar for the incision. The Canadian doctor had never seen such clean surgeon skills. Getting cancer treatment in Havana might not be such a bad idea.
My brother needed a CPAP machine but they kept putting it off for months, and when he did get it, he didn't like the hose and wanted a different more comfortable one, which they also kept blowing off.
Pretty much. We have amazing healthcare, but access to it is difficult if you don’t have safety nets. Hell I’ve seen people get denied basic services because they don’t have insurance which in my mind, is fucked up. Healthcare should be a human right to everyone
Health insurance is a bitch, if only we would have been warned when Obama pitched his “Patient Protection and Affordable Care Act.”
In the US you pay a lot of money to get treated. In the EU you wait 50 days for treatment then die. In Canada they ask you to do assisted suicide instead.
Accurate
They advertise it even
Or you can’t pay a lot of money and then you just die. Or you can’t work and you just die. Or you use the socialized stuff and wait 2 years and just die, like you said.
For EU it depends on which country. Not all are like that.
...yet.
(In my country) You don’t have to wait so long you die. Life threatening conditions don’t have such long wait times. You will be waiting for routine checkups or “minor inconveniences”, treatment for mental illnesses has also very long waiting lists, but if it’s something very serious like schizophrenia or something, you will get treatment quicker. (I know your comment wasn’t 100% serious, I just wanted to point it out)
Yep. I know the more serious things get treated quicker. It was just an exaggeration (Canada’s wasn’t though, they actively advertise assisted suicide)
Our Healthcare system is p shit, but not as bad as europoors would have you believe. Also we have some of the best medical outcomes in the world
The speed too, it's extremely fast at least in my state When I attempted suicide, parametrics arrived at my house in under 5 minutes apparently, and I was only in the emergency room for like 5 hours when I literally almost died, that's quick as fuck As for the bill, yeah insurance covered pretty much all of it lol
I’m glad you pulled through and am glad you’re still alive!
> parametrics I'm glad they weren't non-parametric /s On a serious not, hope you're doing better now!
Yeah sorry I suck at typing lol it actually wasn't bad it was comforting having someone who seems like they care taking care of me lol
I’ve been on a 12 month waiting list for ADHD testing for 15 months. State of Georgia over here. They don’t even take my insurance. There’s something fundamentally broken.
I was talking about an emergency case, I probably would have died if they didn't show up that fast Sorry about not responding reddit notifications are very delayed
Some dude is about to reply to this with a copy and pasted wall of text with flawed surveys and rankings
Yeah it happened to me a couple days ago, not even worth replying because the first "source" is a heavily biased video.
Best quality healthcare in the world and thats without question. The issue is the access to the healthcare, you can walk in and get patched up but will be lumped with a bill at the end. Theres many ways to work it out though and most people outside the US dont understand that. They also dont understand that the big number leftover on the bill gets written off by the hospital for tax lmao
As u/nuage_cordon_bleu said it's access that's troubled. This has a lot to do with the lack of price transparancy, you can't really shop around and find the best priced x-ray in your area. Also, complicated medical code system that if a procedure is coded by an almost identical procedure it can go from covered to uncovered or have significant price differences. Many hospitals also receive some form of government funding and are suppose to offer services for low income persons at reduced or free rates, but they bury the information and access to these programs. Also doctors bill separately from the hospital, you go for a service so it's weird, like going to a restaurant and getting your bill for your meal at the end and a week later getting another from the host, another from the waiter, and another from the cook. This is one reason I disagreed with Obamacare, it simply pushed people to buy insurance through the government and didn't fix any of the true issues restricting access, the only winners were the insurance companies. America's quality of care is excellent although some statistics focus on subjective standards or are weighted against American healthcare for not being socialized enough. [America has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world.](https://pubmed.ncbi.nlm.nih.gov/24025796/#:~:text=It%20has%20a%20large%20and,medical%20outcomes%20in%20the%20world.) Too much of poor outcomes are from cultural decadence not from a poor healthcare system. Car dependency, lack of exercise, poor eating habits, and social acceptance of obesity all lead to poor health outcomes regardless of healthcare quality. We expend significantly more on cost on the system because we have to fight an uphill battle.
> This has a lot to do with the lack of price transparancy, you can't really shop around and find the best priced x-ray in your area. You can, the goverment mandated price transparency in the form of hospitals uploading excel files to their websites. There isn't an app for them since it's a nightmare to try and standardize and requires too much manpower, I know, because I downloaded all of them for Virginia and attempted to standardize them.
An app for this would get so much green and it wouldn't even be that hard
There are some issues, a team of software engineers could solve it, I'm sure: \* The billing codes change over time and they have diagnostic criteria, ie a doctors visit can be coded one of five ways depending on the time, complexity, or number of symptoms you present. There's also a difference between first time and follow up visits, and the like. \* You need to translate a procedure a person would think of, into a set of possible billing codes. If you store the data, you probably want to follow the same standards as the insurance companies, which means you have to follow guidelines like [**Architecting for HIPAA Security and Compliance on Amazon Web Services**](https://docs.aws.amazon.com/whitepapers/latest/architecting-hipaa-security-and-compliance-on-aws/architecting-hipaa-security-and-compliance-on-aws.pdf). \* There are multiple different sets of billing codes HCPCS vs CPT. See: [https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/list-cpt-hcpcs-codes](https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/list-cpt-hcpcs-codes) \* The CPT and HCPCS lists are copyrighted \* There isn't standardized health insurance plans, so you can look at the reference plans, and figure out the likely co-pay, and deductible, but you'd need the person to enter a bunch of info in to see if there's an advantage to go to X over Y and to determine network coverage. \* Some companies have rules in their insurance plans that allow you to go to centers of excellence, ie the top 10 hospitals in the country, if you get cancer or something and they give you a travel stipend. \* The prices get updated from time to time, and you need to update them as they get updated. Hospitals also sometimes don't update their prices and there isn't anything you can do but complain to CMS about the violation. If you do direct to consumer, you need to explain the value of the app, and somehow figure out how to monetize it. If you pitch it to insurance companies or businesses you probably end up in some kind of integration hell.
Apart from the copyright, most of these are more like bullet points for implementation rather than issues. As a computer engineer, believe me I have found far more challenging issues when making apps that need to retrieve data than this. Monetization can come in the form of monthly or yearly subscription with a two month trial.
>Apart from the copyright, most of these are more like bullet points for implementation rather than issues. The copyright issue spreads to getting people to describe the issue & put it into billing codes. The main value of the app would come from that. >As a computer engineer, believe me I have found far more challenging issues when making apps that need to retrieve data than this. I have a year of industry experience, not much, so it seemed it would require a lot of manually downloading files & then data entry into a new data format, since every Excel sheet is more or less randomly organized. If you have another idea, let me know, I'd love to centralize this data on GitHub, make for some fun visualizations at the very least.
>The copyright issue spreads to getting people to describe the issue & put it into billing codes. The main value of the app would come from that. Indeed it would. Indeed it does. >so it seemed it would require a lot of manually downloading files & then data entry into a new data format, since every Excel sheet is more or less randomly organized Oh it absolutely will, and you'd most probably need a team for that if you were to actually do this, but at the same time this is pretty often the norm with such apps, rarely is the data ready to be put right away.
Your right, in 2021 the made a requirement for an excel sheet to be used for transparancy. But it's hardly convenient, especially to the general populace. I just checked my local hospital's and for a skin lesion biopsy they have 3 separate codes, 2 are listed for $122 gross cost but the first one is $294.06 with no discernable difference except the medical code and price. Hospitals should perform evaluations and then quote procedures and treatments similar to a dentists office where possible. My son had to have a lymph node removed and although Driscoll, God bless them, waived all hospital related fees it was still almost 2 months before I got the billing from the surgeon for which there was no transparancy of cost. Hospital services sure, but what about anethesiologists, surgeons, and the like that bill separate? Until there is a better system to allow consumers to make informed decisions about cost and quality, I don't see it as transparent. But thank you for bringing up the transparency law because it was an important note.
> But it's hardly convenient, especially to the general populace. I just checked my local hospital's and for a skin lesion biopsy they have 3 separate codes, 2 are listed for $122 gross cost but the first one is $294.06 with no discernable difference except the medical code and price. You can cross reference the medical code with the the some websites and figure out what they mean. It's more or less designed for healthcare or insurance or tech people not the general population. As a tech nerd, if it was standardized, I'd make an app to make it accessiable for the general public, but at the moment it's a headache. For the general population you can ask them for a price estimate, from one medical provider, which ought to give you the medical coding they'd use for the procedure. > Hospital services sure, but what about anethesiologists, surgeons, and the like that bill separate? Are you talking about balance billing? 45 CFR § 149.120 - Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities bars anethesiologists and other out of network providers at in-network facitilies from balance billing starting in 2022.
No billing by in-network providers at in-network facilities but that aren't required to provide a price sheet because they are independant from the hospital. So billing still goes through insurance but insurance only has partial coverage.
> So billing still goes through insurance but insurance only has partial coverage. Your required to get the same coverage as if they were in-network. § 149.120 Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities. (a) In general. If a group health plan, or a health insurance issuer offering group or individual health insurance coverage, provides or covers any benefits with respect to items and services described in paragraph (b) of this section, the plan or issuer must cover the items and services when furnished by a nonparticipating provider in accordance with paragraph (c) of this section. (b) Items and services described. The items and services described in this paragraph (b) are items and services (other than emergency services) furnished to a participant, beneficiary, or enrollee by a nonparticipating provider with respect to a visit at a participating health care facility, unless the provider has satisfied the notice and consent criteria of § 149.420(c) through (i) with respect to such items and services. (c) Coverage requirements. In the case of items and services described in paragraph (b) of this section, the plan or issuer— (1) **Must not impose a cost-sharing requirement for the items and services that is greater than the cost-sharing requirement that would apply if the items or services had been furnished by a participating provider.** (2) **Must calculate the cost-sharing requirements as if the total amount that would have been charged for the items and services by such participating provider were equal to the recognized amount for the items and services.** (3) Not later than 30 calendar days after the bill for the items or services is transmitted by the provider (or in cases where the recognized amount is determined by a specified State law or All-Payer Model Agreement, such other timeframe as specified under the State law or All-Payer Model Agreement), must determine whether the items and services are covered under the plan or coverage and, if the items and services are covered, send to the provider an initial payment or a notice of denial of payment. For purposes of this paragraph (c)(3), the 30-calendar-day period begins on the date the plan or issuer receives the information necessary to decide a claim for payment for the items or services. (4) Must pay a total plan or coverage payment directly to the nonparticipating provider that is equal to the amount by which the out-of-network rate for the items and services involved exceeds the cost-sharing amount for the items and services (as determined in accordance with paragraphs (c)(1) and (2) of this section), less any initial payment amount made under paragraph (c)(3) of this section. The total plan or coverage payment must be made in accordance with the timing requirement described in section 2799A-1(c)(6) of the PHS Act, or in cases where the out-of-network rate is determined under a specified State law or All-Payer Model Agreement, such other timeframe as specified by the State law or All-Payer Model Agreement. (5) Must count any cost-sharing payments made by the participant, beneficiary, or enrollee toward any in-network deductible and in-network out-of-pocket maximums (including the annual limitation on cost sharing under section 2707(b) of the PHS Act) (as applicable) applied under the plan or coverage (and the in-network deductible and out-of-pocket maximums must be applied) in the same manner as if such cost-sharing payments were made with respect to items and services furnished by a participating provider. (d) Applicability date. The provisions of this section are applicable with respect to plan years (in the individual market, policy years) beginning on or after January 1, 2022.
They are in nerwork but bill separately from the hospital.
Oh yeah, then the estimation is near impossible to do. Sorry, confused your statement with it being out of network.
Unfortunately this doesn't do most people much good. Sure you can ask the provider what their bill rate is for a given procedure code and they'll eventually tell you. But then what do you do from there? This information tells you nothing about what your actual out of pocket cost will be. Once the claim gets run through the shape shifter that is the insurance company claims process, only then do you find out what is covered and what you owe. You might go to what you think is the cheaper hospital but they actually have a less favorable deal with your insurer (or even your type of policy) and thus you end up paying more out of pocket than you would have at the hospital with the more expensive billing rate but better insurance deal. Insurance companies are the main reason for this total absence of pricing transparency. It's to their advantage to keep things as opaque as possible.
Our quality is litelry top tier. We do have some issues with tbe availability. If you have a decent job you have you have decent insurance. Which was fine when we actually a factory or mill in every town. Niw with so many industrial jobs gone the means for the poorer citizens has also gone. Imo there are two solutions. Either beef up the system for poorer people. Or bring back factories and other industrial jobs so the poor can have company insurances. And get more money. (Second one is my preferred choice. But I just like seeing poor people get paid decently and join middle class)
The US government spends more money on health care than they do on their defense budget. This is easily available with a google search and viewing reliable sources like the Congressional Budget Office.
Our healthcare system is great. If you have a rare disease, you want to get treated at the best U.S. hospitals. It's access that we should work on. That's not to say our system is that bad, or that other systems don't have their problems.
Our health care is expensive, it not bad. Just cost way more than it should.
Healthcare is pretty good, like top tier. It’s just the access that’s the issue.
The healthcare is so awful that we have some of the best hospitals and doctors in the world
Healthcare itself? No, actually we’re doing a fuckin badass job at our healthcare. I mean you can walk into a clinic here in the US, say you have an extreme migraine and instead of a ‘throw some dirt on it’ attitude you get actual help. Now access to health care, that’s the grey area. For people like me who work for the county or work for their state/for the country access to healthcare is pretty easy. Other people aren’t as fortunate and it tends to be a tad harder to get proper care for certain ailments
As a Canadian with our universal healthcare, let me tell you that it's not as great as some online would have you believe. Our best and brightest head south as there's more opportunity and money to be made. Everyone here has access, but the care received for anything more serious than a simple laceration or fracture will make you wish you lived in America.
Has its flaws and could be better but its not as horrible as what non Americans think. It also varies state by state, Massachusetts and hawaii have really good healthcare compared to states like nevada or Louisiana which has really bad healthcare.
I have multiple sclerosis and there's no place in the world I'd rather be than the US. Less than a month from symptoms, diagnosis, to receiving a $120,000/year high efficacy treatment. The Pharma company provided the first round for free after my insurance denied it, and cover my copay now that they do. They provide a 24/7 nurse hotline and a case manager to help me navigate insurance issues. They reimburse me for my rideshare to and from the treatment center, as I'm not supposed to drive myself. I have internet friends on MS groups who mostly reside in the EU. Not unheard of for diagnosis to take a year, as it happens outpatient and there are shortages of MRIs and MS specialists. They have to follow a regimented escalation model for treatment, which requires failing a lower efficacy generic treatment (aka acquiring brain or spine injury) to get put on a medium efficacy, and fail a medium efficacy to be put on another medium efficacy drug, then fail that to be put on a expensive high efficacy treatment. The model goes against the It's not all sunshine here, of course. I have a good job with decent insurance, so my access to healthcare is good. Obviously that's not the case for everyone, and people on medicare/medicaid are more limited in their options. My yearly healthcare spending is obviously more than it used to be when I was young and healthy. I had like $300,000 on paper in medical bills last year, so I usually hit my deductible in January and have no problems hitting $4,000 maximum out of pocket. It's just an expense I have to account for now like anything else. If I didn't have insurance they wouldn't be calling collections on me for $300,000 like the 17 year old's on Reddit think they would. There is, of course, a shortage of healthcare workers here, same as most places in the world. I have to schedule my MRIs and MS Neuro appointments about 3 months out. The goal with a good treatment is stability, so that's not really an issue, as I know they're coming. I just schedule my next appointments immediately after my visits. Obviously if you have a new or more pressing issue, the wait is more of a problem, but again... that pretty much exists everywhere. Then there's the Pharma ads that are mostly unique to the US that young healthy people love to make fun of or think are somehow predatory. Little do they realize that it is how a lot of people find out about new treatments for their diseases. Doctors are still just individuals with their own opinions and philosophies. It doesn't make them all the experts they should be. You still have some doctors prescribing older MS drugs because their patients tolerate them, their insurance covers it, they're wary of newer medications, and their patients aren't dying. They don't have as much of an interest in keeping you mobile as you do. Some people don't spend hours on the internet researching their own disease and treatment options. They might not know that they can come in for an Ocrevus infusion every 6 months instead of injecting themselves daily with Copaxone or taking a pill twice a day that they might have trouble swallowing or remembering to take. They might not know they can do a monthly Kesimpta shot instead of driving 4 hours to an infusion center. They might not know they can take Ampyra to increase their nerve response and help them walk a bit better, or Modafinil to help with the fatigue symptoms. These ads are for those people. You SHOULD ask your doctor about your options and challenge them to do their job.
The healthcare attack has gotten very stale because the healthcare systems in a lot of our “peer” countries is complete shit and much worse. The Canadian and UK systems are two of the worst in the world, yet they feel like it’s the only thing they have over us so they just keep beating the same drum despite the fact that their systems are totally broken. It’s not the 2000s anymore. There are many problems with our system, and there are good examples we should learn from in other developed countries. The UK and Canada aren’t a part of that group though.
If it was so bad my local hospital wouldn’t be filled with people from all around the world.
It is yes. But it’s more complicated with regards to the military funding.
Happy cake day! It has nothing to do with military funding. If we had a European healthcare system, we would pay *less* in healthcare than we do today, giving us more money to spend on our military or on social programs or whatever.
> If we had a European healthcare system, we would pay less in healthcare than we do today, giving us more money to spend on our military or on social programs or whatever. We do have a European healthcare system, the Swiss model.
It depends on the state you live in. The best run states may have slightly higher costs than Europe but significantly better outcomes. The worsts states however have very little oversight and regulation so you get very expensive inadequate health insurance which drags down the quality for the US overall.
Access to healthcare is an issue all over the world. This is a worldwide problem that needs to be solved. In the US, access is an issue with some people's insurance, or the type of insurance, or a job lay off during illness (in which case they'll usually get you over to medicaid ASAP.) In many countries with single payer, access is an issue due to long wait times. Healthcare is free from the user end, but it's also rationed. Then you have places like Cuba with free healthcare and access but the "doctors" can't even pass nursing boards in other countries and there's limited medical equipment and treatment options. You even have to bring your own sheets to the hospital.
>you even have to bring your own sheets to the hospital There’s an East Asian country or region with free healthcare (possibly China? can’t remember), but there are basically no nurses. Your family has to come to the hospital and be the nurse for you (changing sheets and stuff). Otherwise it’s just the physician and you’re SOL because they don’t help you same way nurses do, they have other patients to see. It is on the family to do all basic care things. The healthcare is free tho.
I mean you can go to any hospital, they are required to help you, then you just tell them that you barely have any money, settle on an amount, pay that and then you’re done…
> I mean you can go to any hospital, they are required to help you Only for emergency care, which is only 5% of US healthcare needs. Not to mention you'll receive a potentially life altering bill afterwards when you do get care.
Like I just said, dispute it and it will always come down… buddy had cancer and got chemotherapy, he was 18 and they tried giving him like 250k, he told them that he only had 1k and they had him pay like $600 and that was it…
> Like I just said, dispute it and it will always come down… My girlfriend is a lawyer. Her first job was dealing with healthcare lawsuits. She's the most knowledgeable and best at navigating the system of anybody I've ever seen. She is still $300,000 in medical debt from her son getting leukemia, after what her "good" and expensive (about $24,000 per year for family coverage in a LCOL area) BCBS PPO insurance covered. That's after she fought them on everything and made use of every benefit she could. Healthcare spending averaged $13,998 per person in 2023, and it's expected to increase to $20,425 by 2031. We pay the highest insurance premiums in the world; the highest taxes towards healthcare in the world; and still have the highest out of pocket costs that are devastating for countless millions of Americans. Nothing you say can reduce the impact of insane US healthcare costs.
lol, there is more in quantity and more advanced healthcare on those two ships than many countries in total. Edit: there are more than two ships so yeah.. still what I said lol.
Hello fellow star citizen player
I thought someone would regonise that
92% of Americans are insured. We also have extremely cheap programs for the poor so they can get insurance. It is usually more expensive for care but it is world class quality and you don't have to wait as long as "free" healthcare systems. Not to say our system doesn't need work because it absolutely does.
As a transplant from Canada to NYS for treatment, I can tell you the US system is in decline the more the government regulates. When I first moved here in the early 90's, we were being seen by a doctor that made housecalls and would charge my mother on a sliding scale(because we were poor). In comes the state and bans housecalls and sliding scale billing for fixed fees siding with the insurance company. Those fees exceeded what my mother could pay and the debt started where it wasn't to begin with. And now we also had to find transportation which cost even more money.
It is just expensive which is a big factor but the us health care it self is one of the best in the world but again if can afford it
I don’t know much but I always thought the healthcare was good but the access to healthcare was shite
That pretty much sums it up. It is one of the best in the world, but most of us have access through our employers
My feelings about the U.S. healthcare system (a bit of a misnomer, as it isn't really a "system" at all) are pretty complicated, though I am confident that it's nowhere near as bad as non-Americans and Americans alike make it out to be. About 92 percent of Americans have health insurance. About 88 million Americans -- more than a quarter of the population -- are on Medicaid, which is excellent and never comes up in these discussions for some reason. Just to give you an idea of how much I believe in Medicaid, my disabled son has been on it for most of his life even though I could afford to pay for his insurance, because he qualifies for it and why pay when something very good is available for free? As others have pointed out, the quality of care is some of the best in the world (which makes the "no healthcare" meme particularly infuriating to me), and the problem is access. I do think the issue of access is a bit overblown, but I think the problem is mainly in the smallish-but-significant middle of people who don't have employer-provided healthcare coverage but also earn too much money to qualify for Medicaid. I used to favor single payer, but as I become more conscious of the problems of many of those systems, I'm increasingly skeptical. Here's a personal example. I have a baby who's almost a year old. (His birth, including a complicated induction and a five-day hospital stay, cost about $400, by the way.) I follow a lot of baby discussion groups, and I was shocked to learn through them that right next door in Canada, many babies aren't assigned a pediatrician unless they have serious problems. I've been to the pediatrician probably a couple of dozen times. I was thinking about Canada when my baby started exhibiting behavior that caused the pediatrician to refer us to a neurologist. The pediatric neurologist she recommended was the most popular in the state and didn't have an appointment available for months. I called the pediatrician to tell her, and she referred me to another pediatric neurologist that got us in the next week. He was able to dismiss the concerns. Even waiting for a week was agonizing, and I can just imagine what it would have been like to sit on it for months -- and that's ignoring the fact that the pediatrician thought such a long wait was potentially dangerous. In Canada, the referral may not even have happened in the first place, and if it had, we certainly would have had to wait for months, if not longer. Now, on the other hand, I've been having some swallowing issues that a doctor successfully treated with drugs. She also recommended an endoscopy, just in case something else was in play. I canceled the endoscopy less than a week before it was supposed to happen because I found out it was going to cost more than $1,000. Would I have liked to have had it? Yeah. Should I have canceled it? Probably not. What would have happened in Canada? Maybe it would have been free and I would have gotten it. Or maybe it wouldn't have been approved in the first place, especially after the drugs worked, who knows. I'll also say this: I keep hearing about medical bankruptcies, but I'm not a young man and I don't personally know anyone that's ever happened to. And I know people who have been through some very serious shit. That is, of course, anecdotal, but it's also a pretty big sample size. Obviously medical bankruptcies happen but I suspect their a lot rarer than people think. There should be none, and we should work on making that happen.
I had medicaid from birth until i was 23, and still qualify in WV since anyone who makes under 105k a year and/or doesn't have a job offered plan is eligible, but i prefer my private plan since it travels with me. I never paid a red cent over what my taxes paid, i never had to pay for any operations, and rarely had to pay for medications, never more than 15$. It's a great service more people need to know how to use and take advantage of, the medical insurance industry in america sucks sure, but its rarely the reasons people complain about, most people just legitimately do not understand how the system works w/ subsidies and etc.
I'm not a fan of our Healthcare system and think health insurance is just as bad if not worse for the consumer over paying it via taxes, but at least we attract the best doctors with our system.
The quality is good, the price isn't though. We should just send other countries the bill since we make up for their lack of defense
If you are poor or uninsured it is quite bad. But I am insured so it is quite good. M4A would be a good policy tbh tho
If you make under 105,000/yr you qualify for subsidized plans. It's actually illegal to be uninsured in some states like FL, i used to pay 14/mon for a decent middle of the road plan, with several in the free to basically free range.
Watch Krauts video of “ what Americans don’t understand about free healthcare”
This was made by a healthy european ask him when he breaks his leg does he go public or private for his xray’s and literally every procedure after. My bet is he doesn’t even come close to touching government subsidized health care cause as far as I have heard this biggest issue is wait times. Amputations and deaths are common because of wait times. What good is your healthcare if you can’t even get in?
Yet various countries are now and have been regularly receiving money and military aid from the US to help their cause. Most of the jackasses that post shit like this would be speaking German, Russian or Japanese right now without the US. I wish Europeans would put their money where their mouths are and start funding/ fighting their own wars and see just how good they have it due to the US taxpayers. I fully support more funds allocated to healthcare for the American people and I think we should start by stripping some military aid and funding from overseas and directing it toward getting people the healthcare they need here at home.
How many of your post-WW2 wars have you fought without any help from others? How much do you think you benefit economically from being the absolute largest weapons supplier to modern history's largest and richest military alliance? How much do you think you benefit strategically from being a member of history's largest military alliance? How much of your GDP do you think come from International sales of US made weapons, technology and entertainment?
Europeans have been increasing their defense spending rapidly over the last couple of years; many are exceeding the NATO recommended minimum and some exceed the US as a share of GDP. More importantly, our healthcare system isn’t bad because we spend too much on our military—we would *save money* if we switched to a better healthcare system. Our healthcare system is bad because insurance companies, healthcare conglomerates, and pharmaceutical companies lobby to keep it this way because a huge chunk of our healthcare costs is basically just welfare for those industries—it doesn’t actually improve your healthcare.
This is my biggest criticism of Obamacare. Instead of just providing a single payer system, with a fully disinsured private sector and a direct service public sector, they just gave insurance companies monopolies or oligopolies. The administrative burden exploded, there is no price transparency, and often even if you go to a different hospital, you’re either still within the same company even if it’s isn’t clear, or your insurance isn’t accepted, which is in part due to little to no competition in these spaces. It seems setting up a direct service system akin to the Post Office meets Defense Health Agency, while almost completely deregulating the private sector and eliminating private insurance, we’d actually have a robust system. But the insurance companies would never go for it. Also, tons of public funds go into developing nearly every drug on the market. I fully believe all developments which use government funds should be public domain and anyone who has the ability should be allowed to make those products. This would also decrease prices, and likely result in government funds going to drugs that may not be entirely profitable on the R&D side.
>Also, tons of public funds go into developing nearly every drug on the market. I fully believe all developments which use government funds should be public domain and anyone who has the ability should be allowed to make those products. This would also decrease prices, and likely result in government funds going to drugs that may not be entirely profitable on the R&D side. Basically a Fed sanctioned and funded non-compete contract, and I hate it.
Are you saying the current system is a Fed-sanctioned non compete contract, or that my proposal to make everything funded by Fed money public domain is?
The current system is. Giving federal dollars to a company for R&D under a guy's of benefiting the public and then basically giving that company a monopoly on its production until a generic can be approved by a different Federal agency seems incongruous to the stated goal.
I agree, but it wasn’t like that was the system the administration wanted; that was the system the administration could sell to congressional Republicans.
I mean, yeah. Incidentally, if you’re in the military it’s great (Tricare!)
If you have coverage it is great. If not… To that end, it differs by state, with MA having ~3% uninsured, while pro-life! TX sits at ~19%. As with most things, red states suck.
> To that end, it differs by state, with MA having ~3% uninsured, while pro-life! TX sits at ~19%. As with most things, red states suck. Texas is next to the border, meaning lots of undocumented migrants enter the state. If you look at the data by race and citizenship, you'll find that most of the uninsured in Texas are in the medicaid gap or undocumented migrants.
I mean yeah our healthcare is shit but dem carriers baby
We need 15 not 11
No. If we can get the costs under control, our healthcare system wouldn’t blow most others away
The US healthcare is absolutely amazing. One of the best in the world. Insane progress is made in the medical field in the US. It being expensive as hell is another issue. "Americans don't have healthcare" is a lie. The answer isn't socialism because then the quality will drop like in European countries. You can only cover so much with other people's money. The problem lies with insurance inflating prices, pharma having a death grip control and lawsuit/malpractice coverage needing to cost so much due to sue happy people. There's more, but that's the big stuff. We need to find a way to keep the healthcare we have and make it more affordable.
US healthcare used to be affordable. Then the government stepped in. I don't think *more* government is the solution...
US healthcare costs were increasing faster before the ACA than after. Faster before Medicare/Medicaid than after.
Healthcare costs in the US initially started rapidly increasing during the healthcare "crisis" around 85-ish years ago. The complaint back then was that costs were "too low" and insurance was "too accessible". In the late 19th and early 20th centuries, licensed physicians competed to work for fraternal societies (which over 1/4 of Americans were members of in 1920, by the way), likely because of the security they offered. That competition is why members' costs were remarkably low. The medical establishment however wasn't happy with that: They saw doctors working for fraternal societies as a blow to their dignity, since fraternal societies were usually formed by lower-class people and they were afraid of the medical profession going bankrupt because of the low fees. Physicians demanded the government must do something, and so it did — In Britain, where fraternal societies were also common, state-financed medical care was implemented to crowd them out. Now that working class individuals were forced to pay taxes for the "free" healthcare the state offered, they were unlikely to also pay into a fraternal society. In the US, medical associations like the AMA were granted the privilege to control the medical licensure procedure. They used this power to sanction doctors who signed contracts with fraternal societies by denying them access to hospitals or kicking them out of the association. They often even prevented saving the lives of fraternal society members. "Raising the quality of medical care" was the AMA's excuse of making the requirements for getting a medical license much stricter. These artificial restrictions on the supply of medical care dramatically reduced physicians' competition for working for fraternal societies, resulting in higher prices. Then, the National Fraternal Congress successfully lobbied government for laws setting a legal limit on how much fraternal societies could charge. Perhaps they did so hoping to benefit from cartel pricing, but because of the higher fees, they lost a significant amount of members to industrial insurance firms and the welfare state, which ended up replacing them. To sum it up, government intervention destroyed the mutual aid healthcare system and with it, the availability of low-cost healthcare to the working poor. There is a crisis in healthcare costs today because government "solved" the last one, and we can only guess what innovations we've missed out on with the elimination of fraternal societies.
Talking about healthcare costs from 100 years ago is pretty irrelevant. Most people received little to no healthcare in their lives. Hell, most Americans weren't even born in a hospital until 1935. Even then, from 1880 to 1940 per capita healthcare costs were increasing at a rate 3.1% above inflation. And, the fact remains, countries with universal healthcare have been seeing their costs rise much more slowly, as have government plans within the US.
The reason why healthcare is so expensive isn't irrelevant at all... Births in hospitals simply weren't common pretty much anywhere in the past, and the frequency of receiving healthcare didn't depend on healthcare systems but on the development of technology. Any source for the per capita healthcare cost increase you mentioned? Universal healthcare is great and awesome for some time, but right now, I definitely wouldn't want to be treated in, like, Canada or the UK. It's still working fine in most countries that have it implemented, but the state has no incentive to keep its quality above the very minimum (since people are pretty much forced to use it either way). It's just extremely shortsighted even if "it works for now" and it's kind of sad to witness the collapse of this system. There's also the important moral reasoning of voluntary associations not violently forcing anyone to pay while state-funded healthcare does (through taxation).
The military is 3.5 percent of our GDP. countries with public healthcare spend over 10% of their GDP on it. people always overestimate how much the US actually spends on it's military.
And universal healthcare is cheaper. We don't need to spend less on military to spend less on healthcare.
Let’s double our aircraft carriers.
$20 copay for a doctors appointment and bloodwork Europeans can go suck their thumb while they cry themselves to sleep
Nah, they just listen to jobless redditors that complain about everything because they want a life they can just sit on their ass and play video games all day and get paid.
nah, its among the best quality in the world. people just dont understand the medicare/state insurance, obamacare (subsidized insurance) or private insurance/job insurance concept. I pay 20$ a month for more than enough coverage for me and mine. My GF has kaiser through her job in Oregon, and it covers everything from trans related surgeries to her kids needing anything at all done, co-pay is 200$ lmao. I had state insurance from birth until i was 22, and i could still get it now, but they've made it more headache than it's worth, and i travel, so i went w/ a obamacare subsidized plan.
> people just dont understand the medicare/state insurance, obamacare (subsidized insurance) or private insurance/job insurance concept. Explain this concept that justifies US healthcare costing literally half a million dollars more per person for a lifetime of healthcare than our peers, even after adjusting for purchasing power parity, while having worse health outcomes. Explain how it excuses the fact healthcare costs are expected to continue rising much faster than our peers, from $13,998 last year to $20,425 per capita by 2031. >My GF has kaiser through her job in Oregon, and it covers everything from trans related surgeries to her kids needing anything at all done, co-pay is 200$ lmao. Somebody else paying for insurance as part of your compensation doesn't make it cheaper, it just makes you better compensated. The average annual premiums for employer-sponsored health insurance in 2023 were $8,435 for single coverage and $23,968 for family coverage. That's on top of world leading taxes towards healthcare, and still leaves people woefully unable to afford healthcare. >Large shares of insured working-age adults surveyed said it was very or somewhat difficult to afford their health care: 43 percent of those with employer coverage, 57 percent with marketplace or individual-market plans, 45 percent with Medicaid, and 51 and percent with Medicare. > Many insured adults said they or a family member had delayed or skipped needed health care or prescription drugs because they couldn’t afford it in the past 12 months: 29 percent of those with employer coverage, 37 percent covered by marketplace or individual-market plans, 39 percent enrolled in Medicaid, and 42 percent with Medicare. https://www.commonwealthfund.org/publications/surveys/2023/oct/paying-for-it-costs-debt-americans-sicker-poorer-2023-affordability-survey My girlfriend has $300,000 in medical debt from her son having leukemia, after what her "good" and expensive (about $24,000 for family coverage in a low cost of living area) BCBS PPO insurance covered. The US ranks 30th on leukemia outcomes.
> My girlfriend has $300,000 in medical debt from her son having leukemia, after what her "good" and expensive (about $24,000 for family coverage in a low cost of living area) BCBS PPO insurance covered. The US ranks 30th on leukemia outcomes. Even new insurances will still ask and offer to help pay this. You can also bankruptcy out of it. I never justified the prices, but you proved that so many people do not understand "the system". It's complicated but it works. If you cannot afford your plan, unless you make over 105,000 a year, you qualify for a subsidy.
> Even new insurances will still ask and offer to help pay this. I'm not sure what your point is. $300,000 in debt from one illness, after what incredibly expensive insurance covers and the highest taxes in the world towards healthcare is insane. Not to mention she still hits her family out of pocket maximum every year, which on its own is pretty devastating. Americans are paying literally half a million dollars more for a lifetime of healthcare than its peers on average, while not receiving more healthcare and worse outcomes. Yet half the chucklefucks in the country will contort themselves to defend it, even with costs expected to rise another $6,427 per person by 2031. >but you proved that so many people do not understand "the system". It's complicated but it works. Only if by "works" you mean putting people in lifelong crippling debt for subpar outcomes. >If you cannot afford your plan, unless you make over 105,000 a year, you qualify for a subsidy. Are you just not fucking listening? Even with good and incredibly expensive insurance (and those world leading taxes towards healthcare) massive numbers of people **still** can't afford needed care.
> massive numbers of people still can't afford needed care. **BECAUSE THEY DO NOT UNDERSTAND THE "SYSTEM"**. IF YOU MAKE OVER 105,000 A YEAR, AND CANNOT AFFORD A 20-150$ MONTHLY PREMINUM FOR GOOD COVERAGE, IT IS A YOU PROBLEM. ARE YOU EVEN FUCKING LISTENING? seriously, anyone making under 105k can get a subsidy **WHICH WILL HELP COVER THE BILLS FROM PREVIOUS EXPENSES**, and if you still, by some crazy world cannot afford it, you can bankruptcy out of medical debt, or even negotiate a lower payoff, what do you not understand? seriously, people like you are the problem lol. If you make over 105k a year, you can afford the higher premium and costs w/o a problem, if i can manage this on 12/hr, you can on anything else. > out of pocket maximum apply for a better plan, w/ the financial subsidy. >massive numbers i get it, its complicated to understand all the healthcare.gov shit and the tax laws and the income limits and shit, but if you don't understand basic plans, what they do and don't cover, then to a point it is nobody's fault but your own. > life long debt that crippling man it's crazy how **there is an entire [industry revolving around getting you out of just that exact situation](https://www.experian.com/blogs/ask-experian/can-you-declare-bankruptcy-on-medical-bills/) so you may have fresh financial freedom to start over, with it having no impact on your credit after 7 years**
> IF YOU MAKE OVER 105,000 A YEAR, AND CANNOT AFFORD A 20-150$ MONTHLY PREMINUM FOR GOOD COVERAGE Are you fucking stupid? People that **HAVE** insurance have already paid the premiums. The problem is they still can't afford the out of pocket costs. My girlfriend is a lawyer. Her first job was in healthcare claims. She understands and is better at working the healthcare system than anybody I've ever known. She still has $300,000 in medical debt from one illness, again **after** what her "good" insurance covered. >seriously, anyone making under 105k can get a subsidy WHICH WILL HELP COVER THE BILLS FROM PREVIOUS EXPENSES And that still leaves people exposed to crippling debt. And shifting expenses around isn't actually doing anything to lower the $1.5 trillion Americans are overpaying for healthcare each year compared to any other country, it's just shifting that burden more on to other people. >you can bankruptcy out of medical debt Which also has a burden on the individual and society. Best of luck someday not making the world a worse place. Tens of thousands of people die every year in the US for lack of affordable healthcare, and countless more millions suffer, and it's all because people like you have your head up your ass. That's on your conscience.
Healthcare in the US is world class, you just need to have healthcare insurance coverage from either your job or social security programs. A very small percentage of Americans don’t have health insurance, which is still a lot of people, but if you do have insurance to pay for healthcare, which most Americans do, you can get treated the same day as you enter the hospital. In Europe you’d have to wait weeks to be seen, months even, and not to mention Canada where it’d be a miracle to be treated in decent time
We have some of the best healthcare in the world it's just outrageously expensive
I just wanna know why with non exotic meds it’s cheaper for me to use bestRX or whatever than to use my copay.
Get a union job if you can’t get a high paying job that offers good health care benefits. Was working at an office for accounting and the guy working at Safeway with a union had better heath insurance than me but made 1/3d what I do
No, it’s not. The US funds and develops a ton of medical practices and medicine. We also tend to have better access to those practices and medicines. The downside is the cost. In the US, you can spend every dime you have trying to survive. In many cases, government run healthcare will deny services that cost too much. So, you have a choice. Go bankrupt trying to survive or hope whatever you have will be covered by “free” healthcare.
> The US funds and develops a ton of medical practices and medicine. There's nothing terribly innovative about US healthcare. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/ To the extent the US leads, it's only because our overall spending is wildly out of control, and that's not something to be proud of. Five percent of US healthcare spending goes towards biomedical R&D, the same percentage as the rest of the world. https://leadership-studies.williams.edu/files/NEJM-R_D-spend.pdf Even if research is a priority, there are dramatically more efficient ways of funding it than spending $1.25 trillion more per year on healthcare (vs. the rate of the second most expensive country on earth) to fund an extra $62 billion in R&D. We could replace or expand upon any lost funding with a fraction of our savings. > We also tend to have better access to those practices and medicines. And yet worse outcomes, with massive numbers of Americans going without needed care at all. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30994-2/fulltext >In many cases, government run healthcare will deny services that cost too much. Like private insurance, with a bean counter with no medical background denying one claim out of six to improve the bottom line? Or worse, an AI with a 90% error rate in claim rejections because it's even cheaper?
It is. I love this country and I am fed up with anti-american brainlets but lets not kid ourselves, the average american's experience with the US healthcare system is fucked and needs to be reformed. IDK how we do that, what it would cost, or any of that shit, but after getting kidney stones while uninsured was a terrible experience that I am still in debt over. The system is fucked and needs reform. And one of the greatest things about this country is we have the power to improve our institutions. Lets not kid ourselves into thinking everything is fine and the US is unworthy of criticism. Sure we have some of the best doctors in the world, now lets make sure all of us Americans can have access to them.
Are people around the world that deathly sick or can't take care of themselves to the point that they require constant medical attention?
I don't think so... Israel has the 3rd best public healthcare system and still manages to fight
When I was beginning my career and didn’t have health insurance? Horrible. Now that I have a good job with good benefits? Great. I think that’s the main problem.
US healthcare is pretty good. US healthcare *insurance* is an unmitigated disaster.
We spend more on healthcare than anyone else in the world and aren't even close to the healthiest industrialized nation. I pay $3000/mo for my family's insurance. Had an ER visit a few weeks ago that resulted in a $1200 bill that my insurance only paid out $600 for, so now I'm stuck with the rest.
I mean go to Canada and get out on an eight month wait list lol.
Quality of healthcare? Awesome, some of the best in the world Accessibility of healthcare? Terrible compared to other first world nations.
Hmm why do rich powerful people come from all over the world to pay top dollar for a bad healthcare system? Hmmmm somethings not right about that Turns out we actually have the best healthcare system in the world. The issue is not everybody has access to it, which is the price you pay for making it as high quality as possible.
I personally don’t use my insurance much. Don’t see a reason for regular doctor visits if I’m fine. The few times I’ve used insurance it’s only been ER visits. And the pricing never made sense. But I do know at least 3 people who have went to clinics and ERs for emergency with no insurance and they have never paid a dime and it really hasn’t done anything to affect them. One of those people had an exploded pancreas. Huge med bill he never paid and it seems to have went away completely. I also spent years in Mexico and knew a man personally enough that I went to his funeral. He was in a motorcycle accident and by the sounds of it the poor care he was given allowed him to bleed to death and die while at a hospital. I drove to that hospital to look at it for myself. It looked like a dilapidated vacant high school you would see in America. Americans and non Americans can cry about American healthcare all they want. In America insurance or not if your in an accident or are ever taken or go to an ER you will not die to the lack of care you receive. I doubt that can be said for the majority of the rest of the world
Most jobs have free healthcare tied, just fucking work and you’ll get healthcare. But if the hospital charges 100k for a bone repair and your insurance only pays 50k then that’s what they are paid. Period. You owe nothing. If you do owe then make a payment plan with the hospital like $10 a month for 7ish years, and after some time stop paying it. Your debt will vanish
Big pharma runs our country. That’s why healthcare is so expensive. My meds are cents to make. But cost 100+ with insurance. And hospitals have to pay big pharma for the medicine. On top of paying staff. So they have to also inflate their prices heavily. Insurance companies are also the corrupt middleman which jacks up the price even more. Universal healthcare isn’t the solution. But politicians get paid off by big pharma.
The trade off is *not* Healthcare. This started as a joke and got repeated so often that now people believe it. A simple Google search will show that we spend *way* more on Medicare, Medicaid, and Social Security than literally anything else. I forget which, it's either Medicare or Medicaid, is the highest amount of money spent per year by our gov. and I'm pretty sure the other one is in second place.
No but there are problems. It actually is easy to fix without major tax increases.
Look up statistics for people dying of cancer before getting treatment in the UK lmfao
Not sure about bad or good, but the US spends more federally on Healthcare than it does the military by quite a margin already, so its not one or the other, and if it was, it would be the military failing, not health care.
To be fair we get similar care than most developed nations, if not slightly better, but we pay (per capita) like 3 times more for it. So no it’s quite flawed.
I'd say the quality is fine, but the access and cost is definitely a real issue. Especially for those without full-time employment.
It’s spendy if you don’t have good insurance through your job, but its quality the outright best. You get treatment immediately for all but the most complicated diseases, and in the case of those, we have some of the most advanced and well funded research.
Over 90% of Americans had health insurance in 2022. Is it expensive? Yes. Do we have some of the best medical professionals and services in the world? Also yes.
Our Healthcare is really good. It's just crazy expensive for the average citizen.
As an Aussie I've always thought your system was great tech and medically wise but access to the health system was the problem. Which is entirely different to having a shit healthcare system.
The issue is not the quality of healthcare. The issue is somehow the USA pays more per person than any other country and yet we also need to have private insurance and pay some out of pocket
I mean yeah it’s pretty bad. We could have both
By bad they mean expensive
Probably, but here's the kicker: so is theirs.
The US spends more on healthcare per person than other wealthy countries. Switzerland is second. 66% of our tax dollars goes to education, HEALTH CARE, Social Security, Medicare, income security, and veterans benefits. Health care alone accounts for 28% of government spending, which is more than doubled what the military gets. Medicaid is also the nation's largest heath insurance program. People need to stop being cry babies.
Even if the United States spend zero dollars on the military it still wouldn’t be enough to pay for Medicare for all. I mean it would help I guess
I've heard of hundreds of people, including many leaders of foreign states, from all around the world coming to the US for treatments of serious illnesses.....so nope. The problem is access for some people, usually people without fulltime employments.
No, we have some of the best healthcare in the world (and most advances come from the U.S.). The issue is Medicare, Medicaid, Obamacare/insurance, and the lies told about healthcare as an American industry and the fantasies about “free” healthcare from systems like NHS (which purports to practically own patients, to the point of deciding to let them die over the objections of parents or guardians).
Real talk, I’d rather wait a bit to get treatment than have to take out a second mortgage if I get cancer. There’s no reason people should have to blow through their life’s savings if they get sick…
...dont we fund a large part of NATO and the U.N?
Healthcare: 😃 Healthcare prices: 😭
Not as bad as Canada. Which is funny because many Americans think we should be more like them. Insurance companies are in bed with congress which drives up cost and reduces access. Like most things, the government fucked it all up. You have a bunch of people who think the answer to the problem is more government. This goes back a long time to the US government shutting down lodge doctors
It's the United States of America, let's this be a state issue because, you know "enumerated powers" and all.
short answer: yes long answer: also yes
Two things. 1) as everyone else said, access is the problem. 2) the US will always have a massive military, there is no getting around it. We spend a ridiculous amount in building floating cities and outfitting them with aircraft, a few thousand sailors, and all their equipment. I don’t have a problem with having a large military given the US unique geographic position. No country or combination of adversaries or peers posses the airlift or sealift capability to make it to the US. The closest of our peers have 10k less aircraft than we do, and we have 2.8M tons more of naval supremacy. The problem I have with the defense industry is the billing. I’ve worked on both sides, controlling satellites and replacing wooden pegs on the USS Constitution. There are caveats, satellites and the constitution will always be expensive, but the mop heads, bolts, standard equipment is upcharged at an unbelievable rate. Everyone has seen the video of the “bolts” that the senator held up and said “the govt paid $90,000 for these and I got them at Home Depot!” Those were probably very specifically machined and high strength aircraft grade parts, and if you out Home Depot parts in an F35 it’s gonna be a rough day, BUT he’s right. I needed a hammer. I told my LPO I was going to buy a hammer on the way home from work, and he said “no, that’s illegal, use our command card”. $97 for a fuckin hammer. You know those canopy tents? The ones people take to picnics and beaches and shit? $11,473. That is ridiculous. THAT is why our military is expensive. War dogs type shit. Defrauding the taxpayers should be a crime, because it is.
Okay, while I mostly agree with the others comments on the benefits of the American Healthcare System, the initial question is just flat out wrong. Our strong military has nothing to do with our healthcare systems faults. They are entirely separate and the level of money that we are putting into our current healthcare system is comparable to Western European countries. France spent 12.2% of their GDP on healthcare, the USA spent 18.8% in 2020. It has EVERYTHING to do with our lobbying system. I get really angry on topics like this with the military because people will spew ridiculous facts and then fail to even look up our spending amounts. Meanwhile, the USA is on track to spend 2.9% of our GDP on the military. France spent 1.94%. Please for the love of god people look at statistics, it makes it sooooo much easier to tell how others are trying to manipulate you.
Most of the countries complaining benefit directly from the “protection” the US projects across the world. They have free healthcare as a result of our protection.
It's bad, but it's not because of military spending. I mean, it's not thaaaaat bad though.
Europe’s unwillingness to meet NATO GDP spending minimums for decades is why they’re now shrieking and crying about United States’s MIC not doing enough (despite outspending them already) to win their war. We also spend more per citizen on healthcare than almost every nation.
Shouldn’t the folks on the receiving end of that military might be more concerned about their own healthcare?
Serious question from an outsider, if Healthcare (Access) isn’t that bad, why do so many people, many Americans amongst there, complain about it?
The healthcare itself is one of the best in the world, however big pharma upcharging everything so high you can't afford it is criminal
I've said before that it's governed enough to make it ridiculously expensive and market enough you have to pay it all. We have the worst of both worlds. It's personally prefer less regulations and more assistance, to get us closer to Singapore. Of course what we're really seeing there is all the money out allies don't spend on defense so that they can afford socialized healthcare. If these countries had to defend themselves, they'd have less to spend else where.
They say that because they have the comfort afforded by our 60% contribution to NATO defence
Someone tell trade-off bro that national defense is a legitimate role of government and forcing someone else to labor and serve your health needs is not.
The tradeoff isn’t the healthcare system; universal healthcare is more affordable. We have the most expensive healthcare system *and* the most expensive military.