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The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician
199 points by CynicalMD on Jan 12, 2023 | hide | past | favorite | 214 comments
I am a Millennial primary care physician. I began training before COVID hit, so I have perspective as someone who practiced medicine before, during, and after the pandemic. There are multiple, long-standing issues in medicine, many that have been unmasked by COVID but have been festering for a long time:

Doctors don’t run hospitals. Due to EMTALA, every single patient that shows up to your emergency department has to be treated. When insurance companies and private equity realized that you can’t say no to doing the work, then why should they pay you? Ultra lean staffing prior to covid led to the sh*tshow during the pandemic and, now that everyone is quitting, things are now in total collapse.

Go to any hospital in the country and, even if you have a serious problem like a heart attack, sepsis, a kidney stone blocking off your ureter while your kidney fills up with pus and you’re turning grey and shivering because you’re dying, well, chances are you’re going to be lying in a bed in the hallway.

Up in the ICU hopeless 95 year olds will sit on ventilators and other life support machines for weeks because doctors don’t have any discretion in stopping futile care. You can be a 30 year old pregnant woman, and you will die waiting for your ICU bed in the emergency room. There are 30 rooms in the ER, but 3 nurses overnight…what do you think happens if you have an accident and urinate or have a bowel movement in the bed? That’s exactly what happens. Good luck getting pain medicine for your kidney stone, there’s 10 other patients and they’re all sicker than you.




Veteran doc and health services executive here. Three recommendations to improve your overall healthcare experience as a patient.

Number one recommendation: spend $$$ on a concierge primary care doc. Depending on your market can be anywhere from $1,500 to $15,000 per year. Why? Concierge doc will help you triage your problems, give you great access, keep you out of the hospital/ER, and help you cut through red tape if you need to engage the system.

Number two recommendation: seek care in facilities in high-income communities with relatively small general hospitals (i.e. Greenwich Hospital in CT) UNLESS you need tertiary/quarternary care. Why? Much better staffing. Much less riff-raff common people stuff (i.e. like homelessness) and much higher patient expectations about quality of care.

Number three recommendation: pay up for/seek out a cadillac insurance plan from a high quality insurer like Aetna or United with a low deductible (not high) and low copays. Why? Makes the patient experience much better on the back end with much less paperwork if you do engage the system.

Yes, I understand that I'm saying "be rich", but if you can afford any of the three recommendations above your healthcare experience will be MUCH better.


Undoubtedly all of this is true and an effective set of strategies for people of means to navigate the system. But this is precisely why healthcare reform will never take root in the U.S. There is no vision for public health. As an academic discipline, public health is robust in the U.S.; but there is no traction in the practical realm because the ghosts of Puritanism still inhabit the the sociopolitical structures. The poor apparently deserve their poor health access.


For leaders, this is the beauty of health insurance companies (better called managed care organizations, MCOs).

For places like UK and Canada, leaders have to answer to everyone for why access and quality of healthcare is declining. In the US, using the MCOs, leaders can more easily direct sufficient healthcare to who they want it to go to without being able to be identified as the cause.

For example, leaders can tell MCOs to reimburse healthcare providers less for Medicaid (poor people), and more for Tricare (military) and Medicare (old people who vote), and even more for federal government employee health plans (for themselves). Or they can tell MCOs to require more “prior authorization” (PA) for Medicaid so people give up more quickly at getting medicine, whereas federal government employee plans can require fewer PAs.

Add employer specific risk pools/deductibles/copays/out of pocket maximum limits into the mix, and there are multitude of levers that can be pulled to ensure people are getting the quantity and quality of healthcare corresponding to their socioeconomic level.

Rich people always had concierge medical care. But with the use of MCOs, you can drill it down to income/wealth/political quintiles or even deciles.


"The poor apparently deserve their poor health access." Exactly what a large percentage of Americans believe. I disagree with them, but hard to make an argument for a better system when many believe that the poor shouldn't have quality healthcare.


Healthcare in this country is so broken. This industry should be made as simple efficient and affordable as visiting Walgreens. The regulations, the cartel-like barriers to competition, the behemoth corporate powers. The only way to get adequate care is to become so rich you can escape the whole thing.


I've received COVID vaccinations at Walgreens, but nothing else you'd call health care. I would imagine that if the industry limited itself to filling prescriptions (though prescribed by whom?) and selling aspirin etc., it could be very simple, efficient, and affordable.


> keep you out of the hospital/ER

You're a veteran doctor. You are presumably fully aware of the health statistics in this country. And yet, you did not list the number one correct recommendation:

If you are overweight, lose the weight.

~80% of healthcare costs in this country are attributable to chronic conditions, and ~80% of chronic conditions are caused by obesity or lifestyle directly connected to obesity.

You improve your own health outcomes, and reduce the burden on the healthcare system as a whole, by ~64% if you're not fat.

And your response, as a doctor, mirrors the most infuriating thing about your profession:

  Hi, you're 260lbs and pre-diabetic. I'm going to put you on Metformin. 
  Hi, you're 280lbs and your LDL/HDL is WAY too high. Here's a prescription for statins.
  Hi, you're 190lbs at 5'1 and your infertility is caused by LH/FSH imbalances. Take this Clomid.
When the hell are the "professionals" in your line of work going to stop medicating away the consequences of this absolutely absurd epidemic and actually address it? The only time I've ever heard of a physician actually advising an obese person to lose weight is for conditions where pharmaceutical interventions don't exist, such as non-alcoholic fatty liver disease. The rest of the time? Take these drugs so you have a couple more years to enjoy your triple bacon cheeseburgers and large fries.

It's absolutely maddening.


You're not wrong about the root cause of chronic medical conditions. Depending on how you count, something like 1/7 of all healthcare spending now goes to type-2 diabetes and related conditions, and nearly 100% of those cases are caused by lifestyle issues.

But it's unfair to blame doctors. In a typical office visit they only have a few minutes with the patient which isn't enough time for useful lifestyle counseling. And it isn't even really their job anyway; diet counseling should be provided by Registered Dieticians who are specifically trained in that field. Any real improvements will require major national political policy changes to better align incentives and shift resources away from treatment and towards prevention.


Thank you for your sane reply.


serious question - you think overweight people do not know they are overweight? And they don’t know it’s bad for them? They are probably overweight because they physically have trouble losing the weight (disability, hormonal issues, etc), or they have no self-control, or they are poor and don’t have the means or time to focus on their health.

if you are already fat and prediabetic, you have a lifestyle problem, not a medical problem a doctor can fix.


I used to work with a brilliant software engineer who weighed at least 400lbs when we worked together. Incredibly smart, kind, and thoughtful, and funny. But there was this one puzzling thing about her.

She was vocally critical of the mere concept of "fat" and would find any excuse to pick fights about it. During a company-wide meeting of about 1200 people it was announced that we'd be inviting employees and their families to a theme park for the day, all to ourselves. She stood up during the Q&A portion and asked if the company would be, in her words "giving people who didn't fit on the rides a sum of money equal to the cost of admission, travel expenses, and meals." The HR rep asked for clarification, to which she said "those of us who were born too big to go on rides shouldn't be denied benefits other people get because they fit. That's discriminatory."

She would also frequently and passionately argue about how the idea of "overweight" or "underweight" is an invention of capitalism - a tool to get people to spend money on books, gyms, diet programs. No amount of rational debate would alter her stance. She'd cite supposed medical journals from memory disputing the concept of obesity if anyone asked "aren't there health risks?"

Denial is a crazy, sometimes heart breaking, thing. There are people who don't believe that being fat is unhealthy.

She was one of them. I say "was" because she died of cardiac arrest at the age of 27 while at work, 20 feet away from where I was sitting. Even now, I still have a hard to reconciling who she was (smart, rational, kind) with what she believed and how she died. Utterly tragic.


My point is that the medical industry prioritizes treatment of expedient consequences over treatment of root causes, and then they bitch that they're so overworked and overwhelmed.

If they were truly interested in un-clogging their hospitals and clearing their dockets, they'd be actively engaged in treating root causes. Sure, maybe alongside the pharmaceutical interventions, but the focus ought to be on the cause.

To your points:

- Most moderately overweight people do not, in fact, know they are. Humans operate on the basis of visual comparison, not medically significant measurements like BMI or visceral fat measurements. If you look approximately like your other overweight coworkers, friends, etc, then you'll assume you're fine (in the genpop case, HN denizens and other data-driven folks likely excluded).

- Many of those who are morbidly obese to the point it's obvious they're much larger than their peers, are likely blind to the actual health consequences of their behavior. The general population is vaguely aware that being fat is not super healthy, but they have no idea of HOW devastatingly unhealthy the actual medical literature indicates. On top of this, you have HAES/fat-acceptance nutcases convincing huge swathes of the obese population that they are perfectly healthy.


The medical industry prioritizes treatment of current problems instead of prevention because that's how incentives are set up in the system. Most treatments are delivered under under a fee-for-service model. Insurers and government generally won't pay to prevent a patient who isn't obese yet from becoming obese.

Any major changes will have to come at the state and federal government level. The medical industry can't do much to change that on it's own.


Your solution to the healthcare crisis is just make everybody lose weight and all the problems of our system go away. You ever try to lose 10 pounds? 100? Spend some time in a general medicine clinic and come back to me.


No, all the problems wouldn't go away. But a healthy-weight population would cost roughly 64% less to treat, which implies a 64% reduced hospital congestion and workload. This could get offset somewhat as people die later in life of "old age" rather than chronic conditions or CVD events, but those costs would be much lower. So let's say a 50% reduction over the long run.

Yes, I am a former fatty who has kept it off for well over a decade now. It's really quite trivial to do.


I have to say, at least if you're tied to employer healthcare plans, there are bad Aetna and United contracts out there. I've had better runs (on the west coast at least) with Anthem Blue Cross, in terms of engaging with the system. I've been lucky enough in my life to have high quality plans that the employer subsidies (100% paid for me, 80% for my partner) with very low deductibles, and they're PPO to boot (no HMO hoops), which helps when you want to completely by pass getting a recommendation to see a specific doctor (useful when you know what you're doing)


Have had both employer provided Kaiser and Aetna. Aetna was awful while Kaiser was great. Aetna made us jump through all kinds of hoops to get a simple prescription (not pain meds) while it was only a quick phone call with Kaiser. In fact, while in great pain we had to wait for over 8 hours with Aetna to even talk with someone before we gave up and went to GoodRx and got the help we needed nearly instantly. I don't really know where I'm going with this, but I have to say there's a wide discrepancy between employer provided health insurance. I had ACA and it was actually really good! No or low copay (less than $10) and was always able to get ahold of someone when I needed it.


Kaiser is legendarily great healthcare, so I hear you.

Not familiar with Kaiser being in NYC, but I can say that Aetna is probably the best insurer here (again, depending on your plan).


Having had Kaiser, it really, really really depends on what care you seek.

Broken arm? great. Straightforward / well known ailment? Check check check. Psychiatric care? Hit or miss, but was not good in our experience (I can attest to some close friends and family who did receive quality care). Need an uncommon specialist or research doctor? Horrible.

My partner has a relatively rare thoracic spinal herniation issues, and Kaiser just wanted to put her on drugs and tell her "too bad, its all we can do". No physical therapist specializations, only 1 standard MRI and was looked at by a doctor who was not a specialist in thoracic spinal issues. When we balked at that, they then tried to turn around say it was "all in her head". We had to go out of pocket to see a physical therapist who specialized in this sort of thing to get any real help, and we have as of yet to meet a doctor who's willing to take on her case and advocate for specialized care, who then recommended us a chronic pain psychiatric specialist who's job is, to tl;dr, to help train the mind to lessen the daily chronic pain. That combined with a pretty strict diet & regiment of physical activities are the only thing giving her quality of life. Kaiser blew it. I can only imagine how much worse off we'd be had I not have a good job to cover the costs out of pocket.


Aetna seems to be hit or miss here in California. My brother had it and it was great for him. For me, it doesn't compare to Kaiser


Aetna is known to be low quality, especially after CVS bought them. CVS has a ton of debt and I do not see CVS management to have a culture of investing in employees. They are known for their retail business, where it is typical to ride employees to the limit until they burnout.

I like sticking to BCBS insurers, such as Elevance, Regence, Independence, Horizon, etc.


Except BCBS Premera here in Texas. They're having a bitch fight with Ascension/Seton healthcare, which includes Dell Children's Center and the majority of the good hospitals and ERs in the area, as well as many doctors practices. But Open Season ended in November, so now people can't switch insurance companies so that they can actually go to their healthcare provider of choice.

And BCBS desperately wants to force you to use only their approved pharmacies, but as of late last year there is a new law here in Texas that makes that illegal. So, what BCBS does is make their preferred pharmacy "optional", but what is not optional is that you can't get any drugs from any other pharmacy until you call up their preferred pharmacy on the phone and speak to a human being to get them to opt you out of the "optional" preferred pharmacy. And imagine how hard that process is these days.

Fuck BCBS.


Aetna used to be good here in Texas. That was a few years back. I had them when I worked at Whole Foods, and that was probably what you'd call a "Cadillac Plan".

Now, as bad as BCBS Premera is, it's still better than Aetna. Maybe it's because CVS bought Aetna, or some other reason, but they've definitely taken a major nosedive here in the last few years.


Agreed. If your employer is trying to skimp on cost you can end up with some really poor options. Lesson there is to find an employer that offers generous benefits. Easier said than done, I know.


I’ve been on paperwork side of health a small bit.

1) cash pay / direct / concierge

Agreed - especially if employer plan not great. Some of these folks do house calls. I did this for a while

2) high income area

Sadly agreed. Even in a city if a hospital is more accessible etc that can be tough. I did a walk in to sf general once a long while back - took me 20 minutes to walk out. Great hospital, but waiting room was nuts. Had a finger burned being an idiot and got seen very quickly at a different sf hospital - night and day difference in waiting room

3) mixed view on this. Kaiser brings some peace of mind - grandfathered hsa plans w 2k deductible and some free base car not a bad experience - key for me is not coordinating/ dealing w multiple bills. Their issue resolution team is terrible though on billing


#3 - Kaiser is great, no question. Just not familiar with them since they don't have a presence in NYC. Honestly, if we had to emulate one model in the country it would definitely be the Kaiser model.


>Number one recommendation: spend $$$ on a concierge primary care doc.

Fuck the country I was born in if this is the solution I need to keep myself healthy in a place I pay more than my fair share of taxes and rent to scumbag landlords just to live. Fuck this world.


Exactly this - life in the USA has felt like an unfamiliar board game, run by a rules lawyer who has a grudge against you (personally), my entire life. No wonder we have a shorter life expectancy than _Cuba_!


Cuba is definitely an outlier specifically for that among developing countries and therefore not a great comparison.

I hate the US healthcare experience and try to avoid it, but somehow after all the craziness you hear about half the country uninsured and $500k medical bills, the life expectancy numbers are actually not that terrible. I'm not sure why.


Anyone who has medical insurance regulated under the Affordable Care Act (Obamacare) will not receive a $500k bill. The individual out-of-pocket maximum is only $9k.

https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...


what about the dodge where when you to an emergency room, there are multiple providers who bill separately (doc x was not on the emergency room bill, he's some other provider).


I suspect Cuba is an outlier because they have a reasonably functional healthcare system, but at the same time most people are too poor to overeat or indulge in substance abuse. They literally can't afford to sit around and get fat.


That’s not what you need to keep yourself healthy. Statistically, you need to not overeat, exercise, walk a lot, and not do too much risky shit (i.e., ride a motorcycle). Obviously there are exceptions, but in a system where people are actually taking care of themselves the resources are there for it. The sooner people realize they alone are responsible for most of their health, the better off we’ll be.


If you're in the category of paying more than your fair share of taxes you probably can afford to buy instead of rent. But if you want to keep renting, find a non-scumbag landlord. They exist, I've rented from them.


Don't blame the rest of the world for your own country's fuck-ups.


Health insurers (payers) don't deliver different levels of service based on a plan’s deductible or copay. That's literally just a field in the database. All of your claims and prior authorization requests still flow through the same systems.

In general high deductible health plans can be good option for consumers who are in good health and have the financial means to absorb an occasional large medical bill. There are also tax incentives for such plans.

https://www.healthcare.gov/glossary/high-deductible-health-p...


>Number three recommendation: pay up for/seek out a cadillac insurance plan from a high quality insurer like Aetna or United with a low deductible (not high) and low copays. Why? Makes the patient experience much better on the back end with much less paperwork if you do engage the system.

Why would the size of the deductible/copay affect the amount of paperwork? My naive assumption would be that the amount of paperwork would be O(1) with respect to the amount of money changing hands -- same way you will always be asked if you want a receipt in a store, regardless of how much stuff you bought.

Also, how do I know if an insurer is "high quality"? Neither Aetna nor United is available in my state.

(Thanks in advance for any replies -- I still have about 3 days during which I can switch my insurance for 2023; was thinking of switching to a high-deductible plan since I don't anticipate using my plan much in 2023)


>I still have about 3 days during which I can switch my insurance for 2023; was thinking of switching to a high-deductible plan since I don't anticipate using my plan much in 2023)

If you have sufficient cash flow and savings to afford out of pocket maximum (usually $10k or so for a family), and you can max out contributions to an HSA, it is always advantageous to opt for an HSA eligible plan (which are legally defined as High Deductible Health Plans, but they will say “HSA” in the name of the plan).

This is due to the triple tax advantages of an HSA, which surpass any other type of investment vehicle.

You can put pre tax money in an HSA, all investment earnings are tax free, and withdraw all of that free of tax to reimburse yourself for healthcare expenses you incur at any time during your life.

So you keep a spreadsheet of all your healthcare expenses, pdfs of receipts, and do not touch it until you absolutely need to. Use a free Fidelity HSA to have access to all investment options (you can continuously transfer from any HSA your employer uses to fidelity HSA).

In the absolute worst (best?) case that you simply do not have healthcare expenses, the HSA functions as an IRA, and you pay regular income tax when you withdraw after age 65.


A high deductible plan can save you money on the front end, but if you start using that plan you should prepare for rain - a deluge of bills from providers who have no idea what the insurance owes and what you owe.

And God-forbid you use a narrow network plan like an EPO because it's hard to figure out ahead of time what services are covered by the network and what's not. I went to see a doc who was in-network and only paid a $25 copay, which was great, but the lab where my routine blood work was sent was NOT in network and now I'm looking at $1,000 in lab bills for a test I didn't ask for.


>a deluge of bills from providers who have no idea what the insurance owes and what you owe.

But if the provider can't communicate with the insurance in order to figure that out, why would a different deductible/coinsurance change that?

I was actually told that I met my deductible in 2022, and then I got another big bill in the mail. So that made me think deductibles are a scam and I should just pick the plan with the lowest premium.

(Thanks a lot for answering my questions by the way!)


The deductible is one of two thresholds that are typical on insurance plans. The second, higher threshold is the out of pocket maximum.

So some aspect of the coverage might be a 20% coinsurance, where you pay the full cost up to the deductible and then pay 20% of the cost after that until you have reached the out of pocket maximum.

Most of the fees you pay count against both of them, so like if you pay $35 to visit your primary care doctor, you are $35 closer to meeting your deductible, and then also $35 closer to reaching your out of pocket maximum. Lots of frequently used services are covered as a fee based co-pay rather than as coinsurance.

If you have a major expense for something that is covered as 20% coinsurance, the amount up to the deductible would be 100% out of your pocket, and then the coverage would kick in and pay for 80% of the rest (until your 20% exceeds the out of pocket maximum).

I kind of wonder if disallowing insurance companies to negotiate deals with providers would actually end up improving things a lot (because it would create pressure to normalize prices vs fucking around to save a little bit).


@ShredKazoo

Most providers do communicate with the payor and have a decent idea of what you owe, so I was being a bit snarky there. If they know you have a zero copay, you make no payment on site with no follow up bill afterwards.


If you have a zero copay plan and your provider is in-network, for example, you're not going to be getting a bill in the mail later saying you owe XYZ dollars.

If, however, if you have a situation where you are using co-insurance (you pay x% and the insurance pays 1-x%) the backend bills and related paperwork can be a nightmare.

In terms of quality I'm really talking about the plan design moreso than the insurer and I'm really talking about a benefit rich plan, which is always going to cost more (and a lot more upfront).


Hi, I apologize if my comment is not relevant to the conversation, but this specific comment seems very useful to my personal situation and I desperately need some further insight on the matter.

I am an US expat living in a country with free universal healthcare. It is also affected by a war that started a year ago. I could not leave then because I had a life threatening health emergency and had to spend 2 month in a hospital. Luckily, it was finally resolved, but i need to stay on heavy meds to remain in remission.

And they just discovered that I have a tumor in my kidney that requires major surgery. To have surgery here is almost certain death from complications/infections/neglect (i've seen it happen)

So I have to go back to US.

My plan is to move back, buy a "cadillac" health plan on ACA market place. I understand that one can enroll after enrollment period if moving from overseas. Then try to get a treatment.

What is the best approach to get the treatment as fast as possible? Is concierge thing only way to go? I checked major cancer centers in an area where I plan to settle, they are all accepting new patients. Does it mean I can go directly to them and expect them to treat me right away?

Most important question. What if I denied insurance or it is delayed and I end up uninsured? Is there a way to get a treatment first and pay later/negotiate price, payment plan, etc

Any advice is appreciated

Thank you


Go to Slovakia. Relative cheap and relative good health care. At least some years ago. Language may be a problem.


May be some years ago. Now Slovakia is also affected by a nearby war and packed with refugees from Ukraine.


>concierge doc

Can you please elaborate? I need something like this and I'm willing and able to pay for it.

How would I get started finding one?


Another term for this is direct primary care.

https://www.forbes.com/health/healthy-aging/concierge-medici...


Basically, like a doctor with a membership club. Generally doesn't take your insurance, although some services might covered by your insurance.

Good example is MDVIP - https://www.mdvip.com/. I have no relation to the company other than being a customer. I pay $1,600 a year for my Mom to be a member and it's the best money I've ever spent.


Would it still be good to have insurance in addition to this, in case of disaster?


Yes, you definitely should have a health insurance plan of some type. Your concierge doc fee will not pay for a visit to the ER, which can bankrupt the average person who doesn't have coverage.


Thank you. My local practioners are terrible and border on being unethical.


Or do what I did and get on an A320 with a one-way ticket.

I haven't set foot anywhere in North America in almost ten years, and frankly I don't miss it.

The food is better, the transport is far better, the weather is better, and my health care costs are literally a rounding error.

Where do I live, you ask?

Not in the US.


Why do you define United as a cadillac plan? I've only had awful experiences with them thus far.


"Up in the ICU hopeless 95 year olds will sit on ventilators and other life support machines for weeks because doctors don’t have any discretion in stopping futile care. You can be a 30 year old pregnant woman, and you will die waiting for your ICU bed in the emergency room."

I recently went through a situation where my family member was the 95 year old. The immediate family had no basis to judge whether the care being given was futile or not. The doctors, the "palliative care" specialists, completely s** the bed there. We would have been open to good, quantitative, rational medical arguments -- the type of data-driven conclusions that guide the rest of the medical world -- but instead the palliative team (external consultants actually) seemed capable only of the basest emotional and social manipulations. We concluded from the lack of rational arguments that there was in fact no well-reasoned basis to discontinue care, and that the palliative team was really just a crew of hired guns brought in to lower hospital costs.

If you do in fact see this inefficient rationing of precious care as a major source of burnout, it seems to me that there is an enormous, wide-open opportunity to conduct studies on predicting outcomes for ICU patients & other patients with advanced conditions. It really made my spine tingle when every single doctor I asked about this simply had no reply.


This is an open debate in the medical community. I’m told there have been pilot programs for “end of life counseling” where folks at a certain age are given advice about quality of life expectations once this situation is reached. They often responded by talking to their families and creating plans for ending care before things are bad, solving the weird pressures that families feel in that situation. I’ve not yet gotten an answer as to why this hasn’t become a policy yet, but it seems like it could help.


End of life counseling became a political third rail when it was rebranded as "death panels" by Sarah Palin in order to delegitimate the ACA. Since then, it has been avoided as a topic of public discourse by the media.

Discourse around death in general makes people queasy. We tend to avoid the cognitive dissonance between the idea that supplying less end of life care would dramatically reduce medical expenses and the idea that all people deserve the best chance at life[1]. We are similar avoidance when MAID is discussed specifically because we know incentives and values clash.

1. this could probably be phrased better. sanctity of human life and dignity if human life don't quite fit because those are meager at EoL and value of human life sounds a but off.


> supplying less end of life care would dramatically reduce medical expenses

This is a myth.

  [Those] with a high chance of dying accounted for only 5 percent of total Medicare spending, and among them about half survived in any case

  total spending on end-of-life care is only 9 percent of the total cost of health care.


9% of $4.3 trillion is $387 billion. That’s a pretty dramatic reduction.


Unfortunately that figure contains selection bias - it is measured for those who die, but the figure for those who survive is missing.

That reduction is simply not achievable unless you can accurately predict who is going to die, which turns out to be very difficult to do.

The most significant health costs are for chronic conditions, and their ongoing consequent costs.

Your point is as non-sensical as saying we could save millions of dollars by killing 10% of the population at random.


I mean, hospice knows roughly when someone is near death because when you remove care, the patient basically starves, and that generally follows a pretty clear progression.

It seems like the hard part is making sure people have had the conversation. If I'm over 80 years old and can't communicate or feed myself, I'm not expecting much of a recovery. I think a lot of people would acknowledge that if they were asked to think about it.

(of course there are lots of situations where a good recovery is pretty likely, but hopefully the doctors aren't waffling about what to do in those situations)


Talking about impending death and especially anything even close to "euthanasia" is absolutely verboten in many places, contexts, cultures and countries.


Just so it's clear, you decided not to discontinue care, and to continue their care, correct?


I’ve been working in the health tech space for awhile now and it’s sad how you’re not alone in noticing this. It’s the dirty secret of the entire industry, and there’s too many things disincentivizing any fixes.

The more I witness this the more I realize that having a single payer is necessary to actually break up enough of the monopoly to get some traction on this problem. Until then there are too many middle men and bureaucrats blocking this change.

Thanks for fighting the good fight so far.


> The more I witness this the more I realize that having a single payer is necessary to actually break up enough of the monopoly to get some traction on this problem. Until then there are too many middle men and bureaucrats blocking this change.

By "single payer" do you mean the European model of "socialized" healthcare? That may be necessary (I don't know) but it's clearly not enough.

I'm in France, and I hear the exact same complaints from physicians here [0], and the hospitals seem to be in terrible shape. People quitting or being on leave, hence understaffing, so more people quitting because of burnout, etc.

[0] Basically, the gist is that for some time, hospitals have been run "like an enterprise", seeking (cash) efficiency above all. There was absolutely no slack in the system, so when COVID hit, medical professionals ended up in a terrible situation. This situation has not subsided even after the epidemic became less of an issue.


I'd like to see a different take on single payer. First, allow anyone to buy into medicare for their insurance provider (at a market reasonable price for younger people, subsidized like it is now for seniors). This could act as a nation-wide insurer without any "funny business" such as getting charged thousands because an assistant that wasn't in-network showed up the day of your surgery.

Second, if an employee isn't covered by employer healthcare, the employer side of FICA should be increased to provide for employee coverage. That way if someone is working 40 hours a week, but for multiple part-time employers, they still get the same medical coverage as a full-time employee.

Third, when I go in for a procedure, I want all bills to go to the insurance provider, they pay everything. Then the insurance sends me a bill for my co-pay. Make that a law. That way I'm not stuck with getting dozens of separate bills up to years after a procedure, with no way of really knowing what should have been covered by insurance or not.


This is essentially what the “public option” in the original Obamacare proposal was — an opt-in publicly owned insurance company, which would compete with all the other insurers, but not have the overhead of their business models. Unfortunately, it was axed alone with much of the other important aspects of that bill.

The great irony is that the initial Obamacare proposal was a Republican policy — originally proposed in the mid-‘90s as an alternative to the proposal from the Clinton White House, and implemented in Massachusetts by Mitt Romney when he was the governor. The Republican congress and conservative media machine were so invested in seeing Obama fail that they instead branded it socialism and fought it tooth and nail. It would’ve been a fantastic opportunity for a resurgence in bipartisanship in government, and could potentially have averted the subsequent 14 years of animosity and bitter obstructionism. Ah well, so it goes.


> By "single payer" do you mean the European model of "socialized" healthcare?

Its socialized healthcare. You dont have to put in quotes. It was first advocated by socialists in the First Socialist International at the end of 19th century. It constitutes part of the social democratic program.


The reason I put it in quotes is that at least in France, healthcare is not completely free, and somewhat resembles the US model. Sure, everyone has to pay and gets "free" healthcare, but that's the basic level, barely above "none".

If you need dental work, glasses, etc, you better have either cash or a "mutuelle", which is usually tied to your employer (though you can purchase your own above that if you like). Lower-level jobs don't always have one (or it doesn't cover much).

However, procedure prices might be lower than in the US, though (I don't actually know) which is a big part of the issue with access to healthcare.


> in France, healthcare is not completely free, and somewhat resembles the US model

That's the result of the privatization that has been pushed by the Anglosaxon business lobbies to Europe and everywhere else since Reagan/Thatcher period. They forced privatization of whatever they could get away with. Its still a socialized system with some forced privatization being pushed through. France is not the only country - all US satellites have been pushed to do some degree of privatization.


Procedure cost is a huge factor: AFAICT, it's generally cheaper everywhere than the US, frequently dramatically cheaper, for the same procedure, for out-of-pocket (non-insurance) cost.

Here in Japan, everyone has insurance, either private through their company, or public through the government, and the insurance pays a flat 70% of the cost, and the patient pays the other 30%. But the procedure costs are generally not that high to begin with, so the 30% copay ends up being pretty cheap usually.


Single payer is certainly socialized public healthcare, but not all socialized public healthcare is single payer. I think Americans are predisposed to treat it as an either-or because Canada, which is used most often for comparisons by virtue of being the country with which relatively more Americans are familiar, is single payer. However, many European countries aren't, and there's no discernible pattern for countries with single payer being better than other forms of public healthcare.

I think pushing for single payer specifically is one of the biggest mistakes of the American left, because it's that much harder to sell in US due to more restrictions - and that's inherent in the model. If we took something like the German model instead, I think we'd be way ahead by now.


I could see a single payer system having the same problems. All it would take is a system with some incentive to save money, and a bureaucracy. I could easily see Congress designing a single payer system that had both of those.

Would it be as bad? Hard to say. In one way it would be worse: There would be no alternative. You couldn't switch insurance providers to get something better.

And, in fact, just today I saw stuff about a lady in Canada who had to wait 7 hours (+/- a small amount, don't have it in front of me) for the ER, and wound up dying. People were saying "The system is broken." Well, isn't Canada single payer?

So maybe single payer isn't a magic solution. Maybe we should look at what's going wrong in Canada before we design such a system ourselves. (Single payer may still be the answer, but it's going to have to be a well-designed single payer system.)


>I could see a single payer system having the same problems.

You can look at the UK right now. The root problem has nothing to do with health insurance companies or who is paying. The problem is drastic increases in net benefit recipients relative to net payers/labor providers into the system.

I.e. declining proportions of healthy, working people willing to provide labor at a sufficiently low price, such that in order to keep providing the same level of service, more and more of the country’s resources have to go towards healthcare.

The other problem is also advancements in medicine that keep people alive longer and longer while utilizing ever more healthcare services.


To be fair, the current govt is preciding over a (self inflicted) economic collapse in all areas, not just the NHS.

And ultimately voters have no-one to blame but themselves. (or half of them anyway.) leaving the EU is epically dumb on a truly impressive scale.

So now looking at the NHS, complaining about under-funding and under-staffing, when those were completely predictable outcomes of Brexit isn't going to inform good health system forces.

Japan might be a better place to look if you want examples.

In truth the US has plenty of money in the pot to implement effecient health care. But for-profit companies will not go quietly into the night.


> So now looking at the NHS, complaining about under-funding and under-staffing, when those were completely predictable outcomes of Brexit isn't going to inform good health system forces.

I don't agree with this. I don't live in Britain, so I'm not fully aware of how Brexit has affected things over there.

I live in France. Didn't leave the EU, as a matter of fact it's one of the countries pushing the most for it. Same issues with the health system. A few months ago we were rationing paracetamol. Now we're back to not allowing sales of it online because of shortages.

I'm not saying Brexit helped, but I doubt it was the main cause, seeing how the same exact effect happened elsewhere, at the same time, while staying in the EU.

It would seem to me that, for whatever reason, many countries chose efficiency of the healthcare system above all else. Meaning closure of hospital beds, reduction of medical staff, etc.

This may be great for producing cheap Toyotas. No one cares if theirs is one week late because something unforeseen came up. It doesn't work as well for medical emergencies.


Its pretty easy to find shortages and flaws in any system.

And yes, national health is always tempting for budget cuts because its a huge number, and trimming it 5% gives real returns.

Shortages of drugs and equipment are often tied to supply-chain issues more than budget, and again that's a barrel of worms best left for another thread.

Clearly single-payer can work, but it does need the single-payer to, well, pay.

Brexit is a large factor because the UK was a net-importer of aid from Europe. And Europe was the biggest trading partner. Predictably leaving has decreased the economy such that tax revenues are down, which in turn means less to spend on social services.

Then we can talk about freedom of movement, and the number of Europeans who staffed the NHS and who no longer do so, and cannot be replaced by other Europeans.

So sure, the global economy is taking strain at the moment. Brexit is not the only cause. But its a pretty big sucking chest wound.


Sure, every situation has its shortcomings, possibly even big sucking chest wounds which don't help.

But my point was that if multiple systems, some of which seem different (US vs EU), all with different apparent wounds, appear to fail in the same way at the same time, maybe there's something that's common among them which is the actual cause. Perhaps it's just a coincidence. But which is more likely?


I would argue they're not failing in the same way though.

The US system is "failing" in the sense that health services are not available/affordable to all.

The NHS has issues with funding and staffing.

France has issues with supply chains.

Any system will have flaws, but just because no system is perfect it does not mean that all are imperfect in the same way.


France absolutely has staff and funding shortages, on top of the supply chain issues for medicine [0].

For the US, there sure is the affordability issue, but I don't think that's anything new. However, OP's point is that there had already been staff shortages for a while before COVID, but now the proverbial camel's back has been broken:

> Ultra lean staffing prior to covid led to the sh*tshow during the pandemic and, now that everyone is quitting, things are now in total collapse. [...] There are 30 rooms in the ER, but 3 nurses overnight…

This is the exact situation in France. The hospitals are physically still there, but there's not enough staff.

---

[0] French only, but the title reads "Health ministry admits to emergency services being closed" https://www.lefigaro.fr/conjoncture/urgences-le-ministre-de-...


I don't get why the underlying problem is not even being discussed here at all. Any attempt to fix the system will have to increase investment in both training and drug research.

This will be a large investment (if doubling the training budget produced double the graduates that would not be enough), and will NOT bear fruit until those people actually graduate, which is 6 years minimum, and mostly 10 years away. So for 10 years, it means paying through taxes while getting minimum to no improvements in return. Furthermore, such a large increase is not possible at short notice, even if the money is available, so it will take more than 10 years time.

For research one might take profit margins of large pharma as an indicator: a fully nationalized, but equally capable, pharma research system would cost some 15% less, assuming nationalizing introduces zero inefficiencies. BUT that money would have to come from taxpayers directly through the government budget.

And nobody is looking for 15% reduction in drugs costs. That just won't move the needle enough. So in reality the government would have to increase the drug research budget to make drugs cheap.

Failing to do this will mean medicine becomes less accessible to people, regardless of whether we switch to a single payer system or not.

So let's get real here: we will fail to do this, and it will get worse.


The problem in the UK is that conservatives and neo-liberals have been actively dismantling the service over the last 20 years.

At a time when there were already staffing difficulties conservatives dis-incentivised people from becoming nurses by removing training bursaries.

Parts of the system have already been stealthily privatised with the associated drop in quality and additional costs. In many cases employees of the NHS are simultaneously being paid private rates using public money through schemes like "right to choose".

At a time when staff nurses are being told they don't deserve higher pay, private agencies are being paid >3 times the staff rate in order to fill gaps in staffing caused by lack of pay and overwork. The result is artificially inflated staffing costs and an incentive for the remaining staff to move over to the agency for what is often double what they'd be earning.

The correct course of action is to bring costs back into line by expunging the parasitic private healthcare system. Every agency position eliminated pays for 2 staff nurses with a healthy pay rise. The improvement to staffing ratios would further improve the nature of the job.


This seems like a problem that would right itself if the conservatives allowed for more immigration


It would not be a new idea:

https://time.com/6051754/history-filipino-nurses-us/

The difference this time is “extra” young Filipinos may not be as numerous:

https://www.macrotrends.net/countries/PHL/philippines/fertil...

And they might have more preferable work options such as work in IT fields.


It's an unfair way to fix the problem.

Let poorer countries pay to train nurses and doctors, and then wealthier countries take the best because they can pay more for them due to economic dominance.

We do it in New Zealand by importing a lot of doctors (Chinese and Indian seem common), and nurses . The reason we need to import doctors is because we export a lot of doctors and nurses to wealthier countries such as the USA.

In New Zealand, we get people from poorer countries because we can pay more, and we also get people from first world countries because people want to move here for the lifestyle or for their children.


I've read that a single-payer system is very unlikely in the USA, due to political forces. The tremendous inefficiency of the American medical system increases costs, but also provides more jobs, and those job-holders vote.


In the USA its all about the money. Those "political forces" are not a grassroots movement, people in the street demanding insurance-based healthcare.

No, it's well organizes, very well paid, lobbying on behalf of a profit-based health system. A system that generates lots of profits for nice big companies.

And make no mistake, they're not going to roll over.

And sure, doctors are depressed because they're finally coming to realise that medical care (in the US) is not about "helping sick people" (despite their good intentions.)

Doctors and nurses set out with the noblest goals, then find themselves inside a system where the one true goal is to separate people from their money. They rile against "adminustrators" while at the same time failing to note that those administrators are the _reason_ for yhd business, and actual doctoring is just medical janitoring.

Yay free markets!


> are not a grassroots movement, people in the street demanding insurance-based healthcare.

> No, it's well organizes, very well paid, lobbying on behalf of a profit-based health system. A system that generates lots of profits for nice big companies.

I am not a lobbyist or an owner of an insurance company. I am a "person on the street". I do not want single payer.


The US could have medicare for all and additional private insurance simultaneously.


Lobbyists have been successful convincing you of something in their paymasters interest and not at all in yours.


I despise the current system, but arguments like this do a lot of damage to the reform cause.

Aside from the incredible arrogance of assuming that GP is just so much stupider and more manipulable than you, it's also factually wrong in enough cases that it instantly discredits you. For example, many people who are upper-middle-class and above are better off in the current system.


Can I ask why? Even right wing think tanks agree that medicare for all would save 2 billion a year in healthcare costs at least

https://thehill.com/blogs/congress-blog/healthcare/484301-22...


It is simple, calculating, and heartless.

When there is a fixed amount of X available, a fair division of X across Y people gives everyone X / Y.

When you need more than X / Y, you are screwed (ask anyone in england who's needed cataract surgery on their second eye and was told that QoL improvement was not there, like it was for the first, so GTFO)

Since I can afford to buy a lot more than X / Y of healthcare for me and my family, should it be needed, the outcome for that limited and, to be honest, complete set of people whose well-being i care about is better in the current system.


I appreciate your honesty.

I completely agree that the current system is excellent for those who can afford it, and queuing-based-on-worth certainly appeals to those with worth.

In the US this worth translates into money, which translates into lobbying. You are not marching in the streets because you don't need to. Your money speaks for you.

I say this not to patronise you, since you clearly understand this is the case. I say it merely to point out that this system works for the few, not the many. And yes it works well for the few.

Regarding your cateract example, if the queue is need based, and you have two patients, then one with 2 cateracts is ahead of someone with 1. That's another system, a system I agree which would be most distressing to someone with 1 careact and lots of spare cash.

I get that any system other than the current one will make you worse off. Equally I hope you see that any system at all will be a massive step forward for huge numbers of people.

Sure, I get it. I prefer systems that favor me. The seething masses aren't "real" to me. I don't know them like I know me and the people I care about. I care about my medical needs now, not some hypothetical "other person". Like you, I can pay for my medical, and I appreciate that I can.

But I also wonder if this is the best way. It works for me, but maybe there's something better for us all.


I will also add that many problems in the US and other countries stem from the perversion of incentives and benefits of the few over the many. What I mean is that keeping this broken system in place as it greatly benefits the insurance companies, of which there are a few. It’s so valuable that they have the money and resources to buy the politicians, pay for the media campaigns and lobby the propaganda outlets to mitigate any power the populace has to address the issue. This allows industries to control pretty much all policy in the US. It’s a sad state of affairs.


> a system I agree which would be most distressing to someone with 1 careact and lots of spare cash.

It wouldn’t be distressing to someone with lots of spare cash in the UK because they would just get the surgery done privately. There seems to be a common misconception that private healthcare is not available in the UK.


> ask anyone in england who's needed cataract surgery on their second eye and was told that QoL improvement was not there, like it was for the first, so GTFO

A bad example, given that private cataract surgery is quite affordable in the UK. You could quite easily pay that much in the US even if you had insurance.

https://lp.opticalexpress.co.uk/cataract-v1-0/?cam_id=20230&...


X isn't fixed though.

New technology, new knowledge and training all increase X. It's relatively fixed at a given moment in time (where your point is very true), but society shouldn't be making a major structural decision one moment at a time.


private care exists in the UK.


The article says $2 trillion over 10 years, that's $200 billion a year.


That is far too simple, as if citizens voting made a difference. Today, single-payer systems are overwhelmingly popular in the US, but one has yet to be implemented. The political corruption (known as "campaign contributions" which is "free speech" in the US after the citizens united decision) ensures that it won't happen, despite it being overwhelmingly positive in polling year after year on both sides of the aisle.


Pull up a list of the Fortune 500. Look how many US healthcare companies are in the top 100. Many in the top 20.

That, plus the loosening of donation rules aka "corporations are people", is all you need to know about the state of American healthcare.


Not sure I agree with this. Lower cost of care via single-payer would seem to create more jobs not less. Would be nice to find out though.


It will also massively hurt global drug and medical research.

We are the leader in it partly because we pay these exhortation prices when the rest of the developed world simply won't play that kind of game.

I'm okay with biting that bullet, and taking a global reduction of health research by some double digit percent for awhile, but that's a serious unintended consequence of single payer.

I'm a Bernie voter who supports single payer, but it's not sunshine and roses everywhere, and crooked capitalism really does do some "not bad" things for us.


> It will also massively hurt global drug and medical research.

This may not be the case, since much research is subsidized by the government and educational funding providing labs that train the scientists the pharmaceutical companies utilize. Single-payer may result in lower costs and therefore more money for support of research and laboratories. Also, pharmaceutical companies would not need to spend vast amounts for marketing their drugs direct to consumers.


The government subsidizes much of the basic research needed to identify candidate drugs. However, private companies usually pay for the human trials necessary to bring new drugs to market. A stage-3 clinical trial can cost >$1B with no guarantee of success. It's a huge financial risk.

In theory we could nationalize the whole industry, and let government bureaucrats decide which clinical trials to fund. I'm skeptical whether that would produce better results. Government employees with no skin in the game have a poor record of picking winners.


> It will also massively hurt global drug and medical research.

I doubt it would. Private drug companies would still exist and charge the same money regardless of whether the insurance is paying for it or "the single payer system".


I don't know, many of the major drugs, like penicillin, insulin, thorazine, birth control etc were developed without those hurdles, and not in the USA. But US gave us Viagra)


We already have a ridiculously regulated, stifling environment. More stifling is not the answer, just look at the wait times and patients being denied basic care in Canada and the UK. We need to end the ridiculous grip the AMA has on the # of doctors; get rid of the hospital certificates of need, and encourage a new industry of medical professionals who specialize in certain areas without unneeded training in other areas.


Canada and the UK illustrate the downside of single provider, but the US has embraced all of the bad about single provider, but with multiple providers. Anyone can get into the game, but no one tries to make the product better. The patient is not the customer in either the US or Canada or the UK. They are the same in that respect and that is what matters.



The American Medical Association does not control the number of doctors. The primary bottleneck in producing new doctors is limited federal (Medicare) funding for residency programs. The AMA has been actively lobbying Congress to increase the number of doctors.

https://savegme.org/


“… encourage a new industry of medical professionals who specialize in certain areas without unneeded training in other areas.”

Sounds stifling. What’s the problem with holistic training? Except some admin does not want to pay for it?

Extreme division of labor will just create backups for some specialists and time to twiddle thumbs for others.

The opposite across society seems necessary; people need to become more self reliant across contexts. Remove industrial manufacture pipelines so more raw materials are available to the general public and make more holistic and well rounded people.


I don't know. In my opinion there's nothing wrong with holistic training but I think there's also nothing wrong with different training paths. Better to let them all flourish and find their way in the system.

It all needs to happen in my opinion though: let the current provider models stay, but let in lots of other educational models, and empower people to take more care of themselves by giving them access to what they need. Everything is far too overregulated in medicine, or at least is regulated in the wrong way.

Even within the physician model it's broken and overregulated. Board certification is ridiculous and insane in some specialties.

I think medicine is just an amplified version of a lot of problems in the US, but it also has significant consequences for life and wellbeing.


Single payer is good but it doesn’t solve the problem of really sick old people running up the bill for everyone. I don’t even see what the way out is. Really old people that are subjectively classified as irrecoverable have to get private insurance on top of single payer maybe otherwise you get cut off. That subjective decision maker will get called a “death panel” though. Someone’s got to make some hard decisions somewhere.


This seems like a good spot to repost a few passages from Limits to Medicine, Medical Nemesis: The Expropriation of Health by Ivan Illich, 1974:

"A world of optimal and widespread health is obviously a world of minimal and only occasional medical intervention. Healthy people are those who live in healthy homes, on a healthy diet, in an environment equally fit for birth, growth, work, healing, and dying; they are sustained by a culture that enhances the conscious acceptance of limits to population, of aging, of incomplete recovery and ever-imminent death."

“Man's consciously lived fragility, individuality and relatedness make the experience of pain, of sickness and of death an integral part of his life. The ability to cope with this trio autonomously is fundamental to his health. As he becomes dependent on the management of his intimacy, he renounces his autonomy and his health must decline.”

“The more time, toil, and sacrifice spent by a population in producing medicine as a commodity, the larger will be the by-product, namely, the fallacy that society has a supply of health locked away which can be mined and marketed.”

"Health designates a process of adaptation. It is not the result of instinct, but of an autonomous yet culturally shaped reaction to socially created reality. It designates the ability to adapt to changing environments, to growing up and to aging, to healing when damaged, to suffering and to peaceful expectation of death. Health embraces the future as well, and therefore includes anguish and the inner resources to live with it".

""Health," after all, is simply an everyday word that is used to designate the intensity with which individuals cope with their internal states and their environmental conditions. The society which can reduce professional intervention to the minimum will provide the best conditions for health."


The alternative you ask for then, is for people to merely die and suffer in pain while doing so. In the past, that's what we did, because there just was no option for such people.

I looked up Ivan Illich, and this essay critiques modern medicine as creating "lifelong patients." That indeed is what has happened, but the alternative is for people to just die. The reality really is I don't really believe anyone ever took death "peacefully" as he puts it here, they too raged and cried and felt all the painful emotions people feel today, they just would actually die and so those emotions would eventually cease. The argument then should be about values: do we actually value human beings as sacred, important things, and their lives are worth preserving just because they are human? The only way you can accept his argument is your answer to this is no.


I disagree.

Look at your body. It's multicellular, not one living thing. Your very cells both compete and cooperate with one another for resources to survive (just as we humans do amongst ourselves). For the greater good of the organism (you), individual cells are programmed to die when they are in poor health or old age or in too much stress, to allow younger healthier cells to take their place for the greater good of the organism as a whole. When this process is averted, or goes awry, old/unhealthy cells remain and the organism suffers, as it has to support these old/unhealthy cells which don't contribute their fair share to the organism. It has to divert resources which could otherwise go to new younger healthier productive cells. Worse, is cancer, which is literally when cells rebel their original programming, and become selfishly greedy. Obviously, as we all know, these things can lead to the organism becoming dysfunctional and even dying.

This reality applies to cells, and to organizations like companies, governments, and even species.

So to answer: are lives worth preserving? Yes. But reality is, there can come times when the preserving the lives of the old, is directly at odds with the lives of the young, and choosing to preserve old lives over young lives, is harmful to lives as a whole.


Holy shit, GTFO of here with that shit. You first!


The alternative could be to tax the fk out of sugar and other parts of our food chain known to cause people to go into the obesity-diabaetes pipeline. Obesity related health problems are BY FAR the most common killer in America today.

But we won't do that because it'll make some very rich people upset and it'll reduce individual liberty. We value individual liberty over a healthy population.


haha the other thread said the real culprit is the vegetable oil, not sugar. Twenty years ago it probably would have been fat. Too many things to ban!


Unfortunately we seem to be stuck in a local maxima, where we do not yet know how to do permanent regeneration to keep someone well in the healthy zone, but also know how to keep people into what can best be describe as "Not yet dead" (but certainly not "healthy" either).

Groups focused on longevity and removing age related diseases, in theory, should eventually get us to a point where the best parts of youth (including learning and plasticity) should make it unnecessary to have children any more, save for replacement of those who die from other causes (and maybe populating other planets etc).


Great quote, thanks for sharing.


Wrote Hacking Healthcare for O'Reilly, created ClearHealth/HealthCould open source EMR, built and operated ~90 acute care management services organizations (MSO) (the "things" that operate the non-medical aspects of many acute care systems).

Healthcare is highly dysfuctional but I want to dampen the notion a little bit that it is in some unique and new kind of collapse today. Everything you are stating is nearly verbatim what was being said in the 1980s at the dawn of HMO legislation which was somehow supposed to fix things.

There has been a lot of pushing the food around the plate since then. My view is that there are three legs to the tripod of the healthcare system, providers, patients and insurers. For fourty years those three legs have been fighting each other on many fronts and no leg is willing to give substantial ground. If I had a magic wand I would bring into existence a being of profound integrity and leadership that could negotiate meaningful compromises between those three groups but I think practically speaking, that is a pipe dream. The current status quo will continue, more or less, how it is for several decades yet.

I will agree with the other comentator that if you are sick a direct access primary care doctor or concierge doctor can really help. In many cases they can end up saving money versus deductibles and by helping you find specialists and facilities in your budget and timeframe. They vary but can be found in most markets for $1500 - $3000 per year. That's not cheap by any means but something that can pay for itself quickly.

I would also say to OP, seriously consider becoming a direct access provider. Feel free to reach out to me and I can put you in touch with some folks who you can talk to. You are not alone in your sentiment and in large part those sentiments are what led to the creation of direct primary care.

du@50km.com


It is unique from my perspective. I have 17 years with major metro fire/ems department. We have crested into the hundreds of thousands 911 call volumes. People have literally stopped thinking and just call 911 for every minor inconvenience.

A massive number of calls are simply untreated low-grade fevers where the patient was unaware of the fever. I am OBLIGATED and MANDATED to send them to the ED if they request transport. Furthermore, I am LEGALLY bound to offer transport to the ED. I have ZERO authority to tell them to take a fever reducer and call back if that doesn't fix their medical concern.

We are taught to use differential diagnosis in paramedicine. However, we are not allowed to diagnose per medical guidelines from the medical director. Working with this dichotomy has made the entire pre-hospital care system complete bullshit. Based on what I see in the ER, the entire system is on the precipice of complete failure. This collapse is unique and new due to the absurd volume of patients and bullshit policy that has not changed.


Is direct primary care something to do instead of insurance, or in addition to insurance? I know someone who gets direct primary care and has no insurance, but I was telling him he should get insurance anyway in case of disaster -- was my advice incorrect?


Typically it is something you do in addition to insurance, though there is not a one size fits all model to it. Different providers and systems offer different levels and types of it. Atlas MD in kansas is an interesting one which is aimed at average income people and offers some pharmacy and labs at heavily discounted prices. From a cost savings standpoint things like x-rays, ultrasounds, ECG/EKG, stitches, cast removal, minor in office procedures, etc, are often done at no additional cost beyond the annual price. An ECG/EKG might be as much as $400 or more against your deductible, which instead could go toward direct primary care where it would be included.

In particular if you have say a chronic condition which remains unresolved after several interactions with the general purpose health system a direct primary care doctor has the time to put towards your case on an individual basis to potentially get to the bottom of it. My experience has been that they also do a much better job at management of chronic conditions but I would really like to see some more studies done in that area.


Thanks for the info everyone!


My fiance works as therapist in USA. I was born and raised in Argentina.

Sometimes when I see the healthcare system in USA I cannot believe how the country could be like that, how people cannot think for a moment about other people in needing, I really cannot believe why there is people that cannot want universal healthcare. It is beyond my worst imagination.

It is an human right, it is someone suffering. I know that is expensive, I know that there is a lot of things to do, but people is dying, because they are poor, because they cannot pay an insurance, because the insurance is for profit and is not hiring more doctors, etc.

Healthcare system and education system is something that I cannot believe how bad it is in usa. And is sad af.


It's not the people in general - many people, including every family member and friend of anyone who has ever been seriously ill while not being seriously wealthy, understands just how bad things are. However, when things are this bad, (and this is actually _the best things have ever been_ [1]), it's so easy to spread fear and anxiety that the situation could get worse, when you represent the people who profit from this situation. This effectively paralyzes public opinion. At this point, over half a million Americans work for health insurance companies _alone_, and health care spending overall is now over 17% of GDP [2]! Unfortunately, this rot is now structural.

[1] Before the Obama administration, your health insurance could be denied or cut off based on arbitrary reasons ("pre-existing conditions"), and if you did not have a job that provided health insurance, you had to pay this cost entirely yourself - unless you qualified for Medicaid through absolute destitution. The Affordable Care Act ("Obamacare"), despite being a massive compromise from universal health care, allowed the sick and poor to get subsidized insurance, shielding tens of millions of people from the worst outcomes of the system.

[2] https://www.healthaffairs.org/do/10.1377/hpb20220506.381195/


Wasn’t this bound to happen? The US population is aging rapidly, their need for healthcare services continues to grow, yet there are limited resources. I’ve had an elderly parent go thru COVID, fall and get badly bruised (but nothing broken), develop a gastroenteritis - and my goal was to manage them at home and avoid a hospitalization. Fortunately it worked out, but I know it won’t always. The only way to manage this onslaught to the system is to be able to better monitor and manage patients as outpatients - so that the heart attack, stroke etc can be avoided. The system is not quite there yet, but it is heading in that direction.


No it was not bound to happen. Greed and deregulation made it happen.

Don't give people inflation adjusted raises for a decade, remove all nurse to patient ratios, run them through hell, and then you're right it's inevitable


America used to be a country that understood production. Today, America has become a has-been country mired in divisive politics and systematic enrichment of vested interests.

The solution is simple guys.

1. Produce unlimited number of doctors, nurses, insurance companies, drugs. Flood the market with healthcare practitioners.

2. Remove all unnecessary paperwork and regulations. Let doctors start private practices like a startup. Let them charge a fee without insurance. Let insurance compete with prices on the street.

Another way to think about this is, use the dentist model for doctors.

I know 50% of the population will comment about "fraud" and "eligibility". But guess where we are with all the "fraud protection" today.


Or we can copy just implement universal healthcare like everyone else.

Seriously literally every other developed country has single-payer. The only reason the US doesn't is we got unlucky with how Healthcare originated in the US. For us it started as workers comp, as opposed to other countries where it started as Healthcare.


I like point 1, but point 2 sounds like a nightmare.


Point 2 is very important. All the prior authorization paperwork, forms, sequence of tests are not necessary. Those are imposed by regulations and insurance on the providers. Outcomes are not any better due to that.

You don't need to go much further than Asian countries to see how less paperwork makes things move fast.


Removing unnecessary paperwork and the private insurance model altogether is great. Removing regulations and reasonable standards of care for doctors is the nightmare.


Yes, there are two types of bureaucracy. It is not too hard to figure out which of them is unnecessary garbage.

Reasonable standards need to exist. But asking patients to drive an hour to sign a document for a treatment 4 months later is not acceptable.


Seems like we need to lift the residency limits and allow for more doctors to be added to the work force.


There is no limit by rule -- just by funding. We've had really nice increases in medical school graduates since the ACA, but predictably, one of the two major parties is staunchly against spending more dollars on residency slots so they torpedo the legislation every time when it's proposed (the vast majority of residency funding is provided via Medicare). The most recent bill:

https://www.congress.gov/bill/117th-congress/house-bill/2256... https://www.congress.gov/bill/117th-congress/senate-bill/834...


The issue isn't a shortage of residency slots, it's that we don't allow doctors with foreign residencies to practice in the United States.

The physicians in Spain and South Korea and Costa Rica are really good. Arguably better than American doctors based on health outcomes. Many would jump at the chance to earn high American wages. There's no reason a South Korean doctor with ten years of experience in the world leading hospitals of Seoul shouldn't be allowed to practice medicine in the US just because he didn't do a residency in rural Alabama


Ah. The good ol’ “steal the good workers from the poor countries to serve my wealthy country that doesn’t want to invest in training its own workers” argument. What happens when those workers are tapped and/or the cost/benefit for them is not attractive? Back to square one.


There are numerous physicians who have immigrated to the US already and are stuck working menial jobs instead of providing people with care when they are fully qualified to do so. There’s absolutely no good reason for this.


There's 1.1 million physicians in the US, and about 12.8 million worldwide. Almost all of whom are making substantially lower salaries than their American counterparts. Many more than 50% lower. Even if 10% were willing to immigrate for a huge wage boost we could replace every doctor in America multiple times over.


Huge wage boost erased by increased supply and much higher living costs. Also, I am not convinced quality is the same and language barrier results in poor communication with patients. Let other countries have their doctors and train doctors in your own country is the proper and moral solution.


I mean, that's one solution to a similar problem - but we also have a fixed number of residency slots and an increasing number of med school graduates, including overseas ones who could come to the US and complete their training in US Residency programs.

https://www.aamc.org/news-insights/medical-school-enrollment...


Do hospitals lose money on medical residents without federal funding? I'd figure residents provide a lot of labor for the hospitals.


Yeah, residency programs are extremely expensive to run -- most of the work they do is duplicative, especially for 1st & 2nd year students. You're essentially paying multiple doctors a little money to follow doctors who make a lot of money around. They do cover overnight shifts, but they still need to be supervised by 'real' physicians so there aren't really any savings. Vox did a good summary of the whole situation last year;

https://www.vox.com/22989930/residency-match-physician-docto...


I would say it's not so clear, and it's open for debate until hospitals open up their books.

Yes residents need to be supervised, but one doctor can supervise many residents seeing many more patients than they could alone. If hospitals didn't have residents they would have to hire more doctors.

Also consider that a resident costs less to employ than a nurse and that the hospital bills for all the work residents do.

Finally, doctors in teaching hospitals tend to be payed less than doctors in non-teaching hospitals.


Right, exactly - I'd skeptical of the claim that residents cause hospitals to lose money.


It took the ER 4 hours to give me pain meds for my kidney stone. They sent me to imaging where the tech asked “did they give you any pain meds?” and I said no, and she sighed. The PA knew within two minutes I had a stone but it took them hours to give me anything for it while I lay in a gurney in on the open floor while Covid patients coughed all around me during the height of the pandemic.


The New York times recently had an excellent piece on how exorbitant greed, even in the non-profit side of healthcare, has decimated its quality over the last decades.

https://www.nytimes.com/2022/12/15/business/hospital-staffin...


Wondering why this for profit organization isn't on the hook for tax fraud


They are well connected, I'd guess.


Sounds like you're not working in a Kaiser hospital.

My dad has serious kidney stone problems and does not have to deal with the dystopian shit you're talking about.

KP was famously overcrowded during COVID, but the dysfunction you describe is simply not on that level throughout the whole country.

Really, we could bandaid a lot of these harms by making it easier to get access pain killers. I think the opioid crisis was worth allowing legitimate people to get access to strong pain killers quickly on negative utilitarian grounds.


Continued:

Why did you end up in the ER in the first place? If you’re lucky enough to have a primary care doctor, they probably couldn’t see you for at least a week or two because they’re too busy. By busy, I mean filling out prior authorization forms - the bureaucratic stranglehold of the health insurance companies is immense. If you had abdominal pain the primary care doctor could easily order labwork and a CT scan and treat you outside the hospital - but now every CT scan is denied as a matter of fact - the only way to get it approved is an x-ray first, or an ultrasound, or getting the labs done, then a series of byzantine forms and “peer to peer” conversations with someone who is probably a retired psychiatrist and has no medical knowledge whatsoever and will lose their job if they let too many CT scans get approved. Easier just to say “go to the ER” and wash ones hands.

When I say lucky enough to have a primary care doctor, that’s because they’re all quitting. Due to the politics of covid, trust in the healthcare system and physicians is at an all time low. Patients yell, they are demanding, they are untrustworthy. 50% of the workload of a primary care physician is filling out spurious sick notes for work, for school, accommodation letters for the clinically lazy, emotional support animal letter requests, FMLA, short term disability, long term disability, etc. the bureaucratic nonsense is never ending. The “my finger hurts why is that I want an MRI” messages in the inbox are never-ending. The mental health crisis always makes its way into the primary care doctors office or the ER.

There are many failing institutions in the U.S. that are failing or have failed: the family structure, the system of employment for anyone with a low I.Q., the war on drugs, the criminal justice system. All of these failures lead to broken human beings who eventually end up at their PCP’s office or in the emergency room. One lonely night in the ICU as a trainee I realized the majority of our beds were taken up by hardcore alcoholics withdrawing to the point they needed to be put on a ventilator and sedated into a coma.

Doctors are also considered prey by the legal system. Patients are looking to sue and win the lottery. Our education system produces too many hungry lawyers. They are looking to get lucky, your medical malpractice insurer is looking to settle - it’s cheaper. The big scam now is that your malpractice insurer has the authority to settle with someone suing you without your permission. When you settle you get put in a national database of doctors who settled, your reputation is tarnished.

Why be a primary care physician? You are a tool of the health insurance companies. You get 15 minute visits (5 minutes in reality), unreasonable “metrics” with the only goal being decreasing compensation. Patients feel shortchanged, the medicine you practice is hurried, unsafe. Your inbox fills up with endless requests, the paperwork piles up, you get ever more burdened, and tired, and underpaid. In this endless grind if you make a mistake you will get sued. We are taught in medical school not to prescribe antibiotics needlessly as it harms people, but in reality that’s what patients want and now you get a customer feedback metric, which incentivizes hurting people.

It’s simply impossible to practice medicine in an ethical manner. It’s the same for allied health professions like nurses, lab techs, pretty much everyone except for the health insurance company execs who profit. Don’t get me started on the revolving door between the FDA and pharmaceutical companies. We get to pay for drugs like aducanumab that don’t do anything but bankrupt the system, but the officials who approve this corruption will get nice private industry gigs in a few years on the down low.

There is so much wrong and so much corruption at this point, the examples are endless. I could literally write a book on all that is wrong. But I don’t have to. The system is collapsing in real time. The next time you get sick, or a parent needs to be hospitalized, or someone you love gets cancer, you’re going to learn what the collapse of civil society means. Things are getting worse and worse and one day you will look around and wonder what the hell happened? Where did all the responsible adults go? The doctors pretend to care, the insurance companies pretend to pay, the hospitals pretend to be open, the drug makers pretend their drugs work. It’s all rotten from top to bottom.

Can we fix the U.S. Healthcare system? My opinion is no. There are too many interested parties and too much bureaucracy, and their goal is not the only goal that matters - taking care of patients. It will collapse and be replaced out of necessity by something that can do what it claims to do.


> Patients yell, they are demanding, they are untrustworthy.

This gets a lot of comment, but it's half the story. I get most of my medical care abroad, but have escorted family through through local medical visits. I've noticed a marked decline in empathy among medical staff the past few years, even in the secretaries at the front desk. This seems to be a general social trend, not just a problem of bad patients.


Reminds me of a friend who passed away from what was essentially doctor apathy.

While recovering from a major surgery started getting terrible abdomen pains. Doctors could hardly even be bothered to tell her to deal with it, completely dismissed her.

about a week later a new resident comes in, pokes and prods her a bit (no doctor prior could even be bothered to do that), looks horrified and orders some scans.

Her stomach had burst and was leaking into abdominal cavity the whole time, she later passed from the complications.

I gained a ton of sympathy for folks for fight and push back against doctors after that.


You hear both sides, likely the "doctors could hardly be bothered" might be in fact due to some doctors being overworked.

I was in the A&E (what is the ER in singapore and the UK I think) and I had severe chest pain due to chest infection. There were like 40 of us in there and like 5 nurses that one nurse just blew me off when I asked for pain killers because she didn't read my record properly and thought I took acetaminophen that morning. It took the pain getting worse to the point I was rocking and screaming for them to give me tramadol. that said, I sympathize with the situation, given they were running around and hardly able to fill out the paper work and do their normal tasks AND be attentive to the sick.

That said, hey I hear you. That doctor fucked up and it was on them yes, it does not absolve them. That said, things sure are getting worse in total across the system in the US, and bad attitudes doesn't explain nationwide scales. For that, you must look at systemic solutions, especially if you don't want more people to die in such situations again.


In case anybody is wondering whether there’s a game of telephone happening from mad family members, I was literally there watching this happen. I regret not speaking up.


It’s probably a runaway positive feedback loop. Someone is an asshole to you, you’re less likely to treat the next patient as well, leading to them treating the next nurse a bit worse.


Many, many people are still rushing to enter med schools, despite numerous comments like yours and essays like mine: https://jakeseliger.com/2012/10/20/why-you-should-become-a-n...


It still pays well, and the system is setup to be very generous to physicians. Student loan forgiveness is available to physicians[0] and its not super hard to meet at least one of the qualifications, as physician demand has been intense for decades, so the debt load can be decreased significantly (and often outright forgiven after a set number of years) by just working the job.

The pay is also still super good. Even a primary care physician will most likely make 200K or more. Specialty physicians typically make even more than that, I've seen quoted anywhere between 300-700K, sometimes more.

And don't discount prestige. While jury is out if lawyers still garner prestige with the average person, being a board certified medical doctor certainly does, and I don't think this privilege in society should be discounted (and arguably, might even be deserved at times). This inevitably will drive at least some of it.

While physician assistants, nurse practitioners and other forms of care are eating at the very low end of a physicians duty, we're a long, long way from anything really upending them.

Taken all together, I'm not surprised. Though residency is grueling and the work is hard, it does seem to pay off in the long run, unlike alot of other things in society.

That said, nurses and PA's are also in super high demand, and I've seen some nursing salaries even edge out doctors in some cases when they do travel stuff, and of course you aren't married to your student debt the same way (all that fancy forgiveness is tied to actually being a doctor, after all) so if you get stressed, hate it, or otherwise give up the ghost on that career, its easier to move on

EDIT: I'm not saying these are good reasons, per se, but they certainly are, from all available evidence, reasons people become an M.D.

[0]: https://www.nerdwallet.com/article/loans/student-loans/medic...


> The next time you get sick, or a parent needs to be hospitalized, or someone you love gets cancer,

Years ago my father had a stroke. Luckily there's a stroke ICU that was close. He got good care/attention there and for the week or so after (out of the ICU) before going home.

After that, to your point, pretty much a shit show. He was just a number. Care, consideration and compassion was effectively rationed. It not about health, wellness and outcomes. It's about money. Money. Money.

To me, the only short term solution is to stay healthy. Eat right. Exercise. Etc. That said, that's not where the masses are headed. Into the iceberg we go...


The last sentence is chilling. What can or will replace it? And how?

tbf, it sounds like you're just saying the US will collapse because while the health care system is a big part of it, the whole US is facing issues as you pointed out.


> Can we fix the U.S. Healthcare system? My opinion is no.

I am going to say that every large 'super' institution will end up in this problem ... Unfixable.

Whether it is military, judiciary or educational system -- they have the same issues as the healthcare system -- when they grow 'super-large' and become managed centrally (either directly or via near-centralized money flows).

It is the nature of end-days of human-driven society super-structures (gradual corruption, then selective-outrage decision making, then more corruption, then a form of centralized control that removes innovation/investment incentives, then the down-fall in quality of function/service, then the destruction).

So the only solution to that, and I am 'stealing' this idea from the US founding fathers -- is to avoid having these near-centralized super structures.

Many think that we need this superstructures (including near-monopolies in business) to build complex things: planes, vaccines, CPU chips.

But we do not, and we should find a political and economical systems that are effectively based on many localized 'guilds' and decision centers linked into ad-hoc-chains to create increasingly better outcomes (with the cost of some repetition, some anarchy, and some missteps).

Military and supreme court are the only institutions that I think should be centralized, but they have to be ran with checks and balances that are distributed across the many 'local' decision and power centers.

So that's the only way I can think of to avoid this constant periodic death of the human-led super-structures.


I'd like to add one more thing to this you probably experienced as well. My family has several people in medicine. All of them have done a stint in a hospital before quitting for greener pastures.

The homeless problem (now renamed "experiencing homelessness" as if this is a cure-all) has reached such critical mass that hospital beds fill up with patients that have no ailments. How do they do this? I'm sure you know. A homeless person who is either withdrawing, or cold, or hungry, or just a nuisance will come into the ER and tell the attending that they are suicidal. At this point a bunch of alarms go off. At least here where I live this means they are issued a bed immediately ahead of nearly all other patients and subject to 24 hour monitoring. They can, depending on hospital load, be given free room and board for up to 72 hours before a psychiatrist is mandated to give them a cursory once-over before sending them back to the street. They'll be back next week, once again suicidal, and once again consuming more resources than they will ever in their life time put back in.

The hospital can do nothing because turning down one of them who is actually suicidal would damage the hospital. So, people with actual real problems are pushed even further to back or left to line the hallways on gurneys because a homeless person was mildly inconvenienced by their, in all likelihood, self-imposed suffering.

Your notes on primary care are spot on. That has been my experienced as a layman with medical family. I know what they are going through yet I still feel shortchanged and often ignored by my PCP. Private clinics are no better.


The real problem in our health care system is private equity trying to profit off of it, not improve healthcare. It is well-documented that whenever the government is billed, the business model is to overcode and pocket 40% of the money. Physicians For a National Plan (PNHP) think the answer is a single payer healthcare system.


There was an interesting article published recently about ICUs, the medical wonders that happen there and the problems with them. It goes much deeper on this very topic and is very interesting:

https://thebaffler.com/salvos/the-power-and-peril-of-the-icu...

It tracks the problem to the emergence of ICU wards being profit centers for hospitals, a development that began decades ago. Every hospital suddenly built an ICU ward and off to the races they all went.

Also predictably, as jeanlucneptune touched on above, this lead to affluent neighborhoods having better care than non-affluent ones.


You cannot simultaneously support a welfare state and open borders.

Every non-payer added to the system lowers the quality for the existing members.


Well, you have closed borders and a non welfare state.


I have a question, which you may not know the answer to, but I'm just asking it to everybody these days.

Let's say hypothetically that all the medical providers suddenly all decide to stop being evil. They increase staffing to safe ratios. They even have extra staff so people can take vacations and have days off without it being a problem. They give everyone very good compensation and the big time administrators stop being unfairly overcompensated. They only make people work a maximum of 40 hours per week like normal humans.

If they decided to do this, the question is, are there enough staff available? Are there enough humans who have sufficient training in medicine, who are willing and able to fill all of those positions in every part of the country? In every part of the world?

Surely capitalism and greed are the immediate problem. But is it masking a deeper problem that there just are not enough medical resources to go around? I don't know. It might be, it might not be. If there is enough, then ok. The only problem we have is greed, and we're already fighting to solve that. But if the deeper problem is there, is there any short term solution? Sure we can start training people and make lots of incentives for people to enter the field, but that will take years.


> But if the deeper problem is there, is there any short term solution?

No.

> Sure we can start training people and make lots of incentives for people to enter the field, but that will take years.

Yes. But it should be done.

Also, there shouldn't be shortages of saline IV solution and bacteriostatic water -- but no one's rebuilding the factories destroyed by hurricanes in Puerto Rico because there's not "enough" of a shortage to make ROI on new factories.

Most medical supplies need to be moderately overproduced every year via subsidies just like our crops and basic foods are. Otherwise the rationality of the commodities markets will ensure there's constantly a light/partial shortage of basic healthcare goods like..."water".


Some things should not be ruthlessly efficient; what appears to be waste is tail risk premium. Alas, that “efficiency savings” becomes someone’s bonus or profit, and a loss for the rest of us.


Allow CEOs to keep their performance-based bonuses. However, add a stick to balance out that carrot, like capital punishment if your hospital falls below a certain level of patient outcome on the year.

Seriously though, if the people responsible for hospital cutbacks had to rely on the same level of care the average American gets, we would never have gotten to this state.


We have to compensate the supply chain for accepting the burden of being prepared for these risks. Today we pass “anti-gouging” laws declaring that we refuse to value it at all.


I personally think the way your question is framed is kind of an example of how insidious the influence of the current system is.

It's not a matter of "are there enough humans who have sufficient training in medicine who are willing and able to fill all those positions?" It's are there enough humans with sufficient training in whatever positions there could be to meet the health needs that exist?

Just for example: it's pretty clear many things done by physicians could be done by other providers, like pharmacists, psychologists, dentists, optometrists, if we broadened our idea of what those specialties (and their subspecialties) could look like. There are also probably types of providers that could exist that don't exist at all now, that we're not imagining because the healthcare system makes so many assumptions about what it looks like. Maybe all these things will involve additional training opportunities or whatever, but if you let people do what they are capable of, they'll find a way.

Sure, train more physicians. They'd be there. But you'll find even more people willing to do all sorts of things in ways we aren't currently imagining. We're constrained by convention.


Except that's the status quo. These days, all but the most intense of medical procedures is being done by increasingly less qualified people.

Nurse too expensive? Get a CPA!

Most of the time I go for checkups I see a CPA for the majority of the time, a nurse for less, and almost no time with a doctor. Excepts are usually for surgery or other intense operations.

This idea of "just let less holistically trained people do the work" honestly sucks. Dentists are better on average at teeth cleaning than dental cleaning specialists. MDs are better on average at putting IV needles in, etc


Given how many news stories there have been about people leaving the field due to the working conditions, low pay, and insurance red tape, it seems like getting rid of that enormous layer of inefficiency would do double duty both in terms of freeing up money for productive uses and not pushing experienced workers out.


You use the words "red-tape" and "inefficiency" there in a very patient-centric way.

Whereas from a profit point of view fewer doctors is good, more insurance red tape is good, effeciently increasing bills and billing customers is good.

The health system is set up to maximise profits. And it is doing so most effeciently. If you want a different outcome then you need a different system.


Medical resources will always be limited. There is no way to get around the fact that people are willing to spend nigh infinite amounts of money staying alive a little longer. There is no way around rationing. You either ration through the free market like in the 3rd world, ration via time like in Canada and England or do both like in the US.

Even with zero greed in the system we would still have to ration things.

I'd argue that we are not currently 'fighting greed' at all. The US healthcare system is not capable of prioritizing anything. It's a mishmash of corporate and government entities hobbled by regulation with no clear entity in charge.


> Sure we can start training people and make lots of incentives for people to enter the field, but that will take years.

Ok then. Get started on it now! This has been a known issue for decades, so I’m not expecting much action until it gets so bad that a revolt occurs.

The private insurance model is still a horribly broken concept that needs to be addressed as well. Single payer seems to be the only reasonable alternative to prevent the broken feedback loop (insurance companies are driven by higher premiums which are driven by higher costs so there is no accountability) of the current system.


> Surely capitalism [...] problem

Spoken like someone who's never lived NOT under capitalism. It amazes me how young people today say things like this, as if they are self evident. I used to think that I'd not wish that life on anyone, but really y'all could use some, to see the contrast.


> lived NOT under capitalism

What, for example, is "NOT capitalism?" You mean like communist countries? You seem to be making the old mistake of thinking communism and capitalism are opposites of one another.

What is more, the problems with the communist countries was massive cryptic bureaucratic systems preventing practical problems being solved. If you hadn't noticed (or just ignore OP entirely) we have this exact problem right now with the health care/insurance system under the capitalist US system.

This is what I mean by capitalism and communism aren't opposites. Capitalism is turning our society into something like what was seen under more oppressive communist governments. And simply voting as if "things are better here, now, than it was under communism" won't solve the very real, pressing problems that OP was talking about.


I lived "not under capitalism", and while I have many problems with that system, one of the few things that it actually could legitimately boast of was healthcare that was available to everyone, no matter how poor. I don't see any reason why the much richer capitalist societies can't afford the same thing, if they wanted to.


The deeper problem is the demographic pyramid. We have lots of old people and the younger generation is smaller. Of course there's not enough caretakers, which is why the US systematically imports them from other countries, leaving those countries with the same problems.

Ultimately, there is no escaping the market. No amount of public-funding, socialism, or outright communism can escape the simple facts of supply and demand. Right now, medicine is expensive because demand exceeds supply. Do insurance companies and bad administrations exacerbate that? Yes, of course they do. But they are only exacerbating an existing problem.


I don't disagree that the population pyramid shape is a root factor. And that shape is likely to get worse, not better as time goes on.

Given that it's not "solvable" (at least not without a nice pandemic targeting old people, who can be convinced not to protect themselves) it's worth then looking at "best", not necessarily "perfect", systems that may deal with it.

The approach of "best healthcare for those who can afford it" is one way to go. All resources ploughed into some sub-section of humanity, those who can pay the most.

Or we might go with "good healthcare for everyone", so alas limited heart transplants.

And I get it. There will be winners and losers. At an individual level you can have all the money in the world, and yet die when some poor person is ahead of you in a queue. "Surely the queue should be in order of net-wealth?".

No system is going to make every medical intervention on all patients all the time. We won't in fact live forever.

That doesn't necessarily mean that the current system is the best alternative. (unless you're a share-holder, then it clearly is.)


What you're saying maybe true in the long run but it's not true right now. There are more nurses holding nursing degrees that are not in bedside care than nurses performing bedside care right now in the United States.

These people could easily be brought back into bedside care but the pay and conditions are absolutely abysmal.


IIRC, that swapped a few years ago...Millenials are now the largest cohort followed by Gen-Z, Boomers and then Gen-X.

Given Gen-X is both the smallest and next cohort to start retiring, I'm guessing medicare, SSI, etc. will have a few years to 'catch-up' before the Millenials start retiring.


Anecdote alert. Recent visits to hospitals for myself and others did not exhibit these terrible conditions. There are so many new hospitals in my area that some are practically empty. Staff were amazing and no chance someone is pooping in their bed … you can barely get any sleep with all the staff checking in on you.


Um don't know where you're working but that isn't how any of the hospitals or ERs here are running. I was into an ER room being treated within 20 minutes only a week ago... and they said they were pretty busy that day.

This all reads like complete and utter FUD

EDIT: Never mind engagement, I see this is nothing but a SP propaganda thread.


SP?


Single payer


Your post and comment in this thread were a truly depressing read.


Not to discredit what you're saying, but everyone seems to forget all the other employees at hospitals.

I've been in Canadian healthcare IT for 20 years, and for the past 5-10 we've been overworked, understaffed, denied vacations and sick days...

The past year alone half our department walked out because we just couldn't deal with it anymore.

The users (doctors, nurses, janitors, shipping/receivers, maintenance staff, etc) aren't happy, we're not happy, yet upper management gets a round of promotions.

I feel for you, but the whole system is broken and won't change until someone steps in and overhauls everything. (Or they'll just outsource everything and everyone loses.)


The food system is sh*t. All these problems in healthcare are downstream of the real problems with the environment and food production pipeline. Preventative care is basically ignored and the problem will just get worse.


Do you have recommendations on what the average citizen should do if they get sick and need serious medical attention? I assume the options vary depending on amount of money available, but preferable for non-billionaires.


Are the problems the same for all branches of healthcare? The conditions of hospital emergency rooms have been a topic of concern for many years. But there is also the matter of worsening conditions at small clinics, especially since the implementation of the ACA. Would it be more informative to distinguish between hospitals and small clinics when discussing problems and causes?


The fact that OP feels powerless to practice without the enormous infrastructure of a hospital is clearly an issue. We need medical care regulatory reform which allows doctors to clean up this market.

Until then I just seek treatment outside the US, yay remote work!


Was in the ER recently for an undiagnosed clam allergy. I'll echo everything the OP is saying. Healthcare in my area is going to be luck to survive all the kids going back to school this week and passing around all the germs from Xmas visits.


Thanks for sharing your thoughts. I hear similar things here in Canada and from friends in Europe. Seems like the system is globally collapsing regardless of the flavour. No system was ready for what covid put it through


In what way are we working to lower the barrier of entry into medical practice? How do we create safe ways for diagnosis and treatment to be accomplished without need for a human medical practitioner?

Who is trying to make level 5 AI doctors?


If I were king:

1) Free time-saver perks for all hospital staff. I'm talking cleaners to the houses, pre-cooked take-home family meals, the whole nine yards.

2) Temporarily lower the threshold for trained medical professionals. There are many students and immigrants with plenty of education and skills. Get them in hospitals until we reach the point where it becomes a space issue rather than a staffing one. Give more experienced staff priority pick on working hours. Stem the bleeding and stop the work exhaustion/burnout.

3) Start longer term efforts to ramp up training of medical professionals. It's only gonna get worse with the baby boomers retiring and needing their own care.

4) Tell "big insurance" and "big healthcare" to put up or shut up. Slap on metrics and quotas focused on efficiency and net outcomes. Tweak the metrics until they get the picture. Set the bars high enough that the majority of issues are solved if the bar is met. If they can't meet the bar, hit their pocket books until they go bankrupt, nationalize them, then convert to single payer.


Are there any country where medical service is overall good or improving year by year? Maybe there are some ratings already compiled?



Don't forget all the nurses and doctors fired for not getting the COVID vaccine as well. Probably wasn't the wisest decision.


Everyone knew Obamacare would cause this (or make it worse), but no one could do anything about it because there was no alternative plan acceptable to a large enough majority.

Obamacare dramatically increased deductibles, in the name of providing "coverage" to everyone. What ends up happening is people don't pay the deductive.

What should have happened is politicians should have worked on costs, not on payments. They should have worked on dramatically increasing healthcare supply not availability. Trump tried, a bit, by forcing hospitals to release price lists, but I have not seen lower costs as a result.

And I don't just criticize, I have two ideas to help:

1: Encourage capitation[1] - people should pay a fixed amount that covers everything* no exclusions, no co-pays, or anything else. Care is gated by lower cost professionals who escalate to higher cost general practitioners, and then specialists, as needed. The Doctors are paid a fixed salary that does not depend on how many people they see or how many procedures they do.

2: Gut employer healthcare. Just give everyone cash (in a tax controlled way) that can only pay for healthcare. In a two person household they can pool the cash and it should be enough to pay for coverage, with complete competition. People with lower income would automatically receive subsidies that would help.

3: No more special Medicare coverage - it would be routed via the identical path that others use, except the subsidy is higher. I've helped people on Medicare - the government coverage is terrible, the only good coverage is Medicare Advantage which is private care paid for by the government, which works well.

[1]: https://en.wikipedia.org/wiki/Capitation_(healthcare)


> Obamacare dramatically increased deductibles, in the name of providing "coverage" to everyone. What ends up happening is people don't pay the deductive.

What does this mean? The Affordable Care Act did not directly increase deductibles. It even provided huge subsidies from the young and healthy to the poor and old via age rating factors, restricting of pricing criteria (removal of pre existing conditions exclusions), and implementation of out of pocket maximums.

> 2: Gut employer healthcare. Just give everyone cash (in a tax controlled way) that can only pay for healthcare. In a two person household they can pool the cash and it should be enough to pay for coverage, with complete competition. People with lower income would automatically receive subsidies that would help.

This was a non starter during Affordable Care Act negotiations due to upper middle class people being up in arms about their premiums going up due to being in the same risk pool as poorer and sicker people.


> The Affordable Care Act did not directly increase deductibles.

My deductible before the ACA was around $500 before, and around $4000 after. In one year it changed that much. Other people I've spoken with had the same experience.

> It even provided huge subsidies from the young and healthy to the poor

Only to people not in employee health care plans, which always have high deductibles.

> about their premiums going up due to being in the same risk pool as poorer and sicker people.

I'm not seeing the connection. People can buy whatever plan they want, receiving the money in cash doesn't force people into any particular risk pool. Not to mention the ACA majorly combined pools, and in fact did cause premiums to go up for this exact reason.


> My deductible before the ACA was around $500 before, and around $4000 after. In one year it changed that much. Other people I've spoken with had the same experience.

I meant the deductible increase was not a statutory part of ACA, but an inevitable part due to the drastic increase in benefits (all preventative care, all medicines assuming there was efficacy data, out of pocket maximum instead of benefit maximum).

Before ACA, insurance could deny you healthcare easily. After ACA, they had to provide the benefit, even if the medicine cost $1M per month, and the insurance company could not choose to drop you as an insured.

> Only to people not in employee health care plans, which always have high deductibles.

As far as I know, this applies to all ACA compliant health plans, even ones that employers subsidize:

https://www.healthcare.gov/how-plans-set-your-premiums

> I'm not seeing the connection. People can buy whatever plan they want, receiving the money in cash doesn't force people into any particular risk pool. Not to mention the ACA majorly combined pools, and in fact did cause premiums to go up for this exact reason.

Being part of an employer subsidized insurance plan’s risk pool can result in you being in a better risk pool than the public ones on healthcare.gov. For example, white collar businesses with lots of young, healthy employees like law firms and tech companies.


> Obamacare dramatically increased deductibles, in the name of providing "coverage" to everyone. What ends up happening is people don't pay the deductive.

I don't understand this. Are you saying everyone just lets the bills for the deductible go to debt collections?


I've heard it often remarked in my circles (wryly and bitterly) that "bankruptcy and gofundme are the American health care plans of choice". So yes, it would seem that for a lot of stuff the plan is just to let it go to collections and then default for as long as you can get away with it.

(n.b. I have some relatively significant physical health issues, so if I can't afford medical tourism and/or get on an absurdly good plan before I'm 26, I may end up being forced into a strategy like this)


> just lets the bills for the deductible go to debt collections?

Yes. Nothing happens as a result. They mail letters, and try to call, and that's about it. It doesn't even hurt credit scores, since they exclude medical debt.


> been unmasked by COVID

Too soon friend.

Honestly I didn't lay in a bed in the hallway when the shot's mycarditis got triaged as "might be a heart attack". And as for who pays, well that dose cost me $3000[2] and my insurance another $20000, good thing I didnt take an ambulance there. But I guess I should be honored to pay it in the name of social contract and social good. The government gave free vaccines, but didn't own up to the expensive part. I'm all for saving the lives of the elderly at the cost of the young... in vampire movies. But, in real life the boomers should at least have had the decency to at least cover the cost -- something they easily can afford to do[1]

[1]: https://youtu.be/lQQPicCoaG4?t=129

[2]: https://webcache.googleusercontent.com/search?q=cache:FA4cPr...




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