The Real Problems with American Healthcare

[squatz1]

Healthcare is one of the most debated issues in the American political system, those on the left are calling for a government takeover of the system. Stating that the best system is in the European socialist systems. Those are in the right are calling for reform as well, though not the same sort of reform --  relaxed government policy, and less government involvement.

Though I think both of these solutions have their flaws, I think there is a much better plan that neither party will agree too. Because the lobbyists on both sides will fight them tooth and nail.


1.American Medical Association Influence / Interest
The problem is the American Medical Association (AMA), for those that don't know who they are -- they are an association of physicians and medical students that have an enormous influence on healthcare-related decisions. This association has a vested interest in the status quo.

The AMA limits the number of doctors in the country and makes every single medical procedure in the country require a doctor to be present (or at least signing off on the procedure occurring) Most procedures don't need doctors, and they're merely being paid to sign off on a procedure for no reason. Remove them from the equation, and you've saved a large amount of money -- though you've angered doctors + the AMA and lowered their salaries as there is less demand.

2.Consumer seperation from cost decisions

Have you ever had a doctor tell you something along the lines of "You don't need this procedure, but the insurance company is going to cover it so why don't we just check anyway, we're just being safe!" This sort of behavior, this wasteful behavior that is filled with greed (on the side of the doctor) and carelessness from the patient is what causes a large amount of waste in the healthcare sector.

People don't care about what things cost, because either the government is paying (Medicare, low income, etc.), their company policy is paying, or something along these lines.

This gives the healthcare sector little (to no) incentive to lower costs because no one is shopping around for prices anyway.

If you want a prime example of people being close to cost decisions in a small sector, look to the LASIK eye / plastic surgery business. Cost has been falling for decades because people have to pay for these procedures out of pocket and are going to shop around for the combination of the best deal (price wise) and the best doctor.

3. Failure to allow for common sense reform

ALLOW FOR COMPETITION ACROSS STATE LINES FOR PRIVATE INSURANCE

This can only be summed up by corruption and greed; politicians don't want to anger the private insurance companies in their state by forcing them to compete with other states. Politicians are raking in large amounts of money from the healthcare sector; why would they make business harder for them by forcing them to compete.

Competition is vital in an industry where cost is EVERYTHING.

INCREASE IMMIGRATION OF DOCTORS / NURSES / MEDICAL PROFESSIONALS

If we have such high costs, and people want to come into our nation to either study to be a medical professional, or they are currently one and want to work, we should allow them to thrive like that. Give them a work visa, and let them come into this country to work. Every single new doctor you bring in lowers the cost for all of those as supply increases.

DON'T ALLOW HOSPITALS TO VETO NEW DEVELOPMENT

I don't know if this is an issue all around America, though I know where I live the Hospital around me is allowed to veto development of a new hospital in the area if they'd like to. I don't understand the rationale behind a decision like this, though all it is doing is allowing a Hospital to avoid competition which is vital to our market.

There are without a doubt other issues with the system, though these are the issues that I feel are hurting people the most. I'd love to hear what people think about other issues, and what should be done to fix these problems.

[KingScorpio]

Healthcare is one of the most debated issues in the American political system, those on the left are calling for a government takeover of the system. Stating that the best system is in the European socialist systems. Those are in the right are calling for reform as well, though not the same sort of reform --  relaxed government policy, and less government involvement.

Though I think both of these solutions have their flaws, I think there is a much better plan that neither party will agree too. Because the lobbyists on both sides will fight them tooth and nail.


1.American Medical Association Influence / Interest
The problem is the American Medical Association (AMA), for those that don't know who they are -- they are an association of physicians and medical students that have an enormous influence on healthcare-related decisions. This association has a vested interest in the status quo.

The AMA limits the number of doctors in the country and makes every single medical procedure in the country require a doctor to be present (or at least signing off on the procedure occurring) Most procedures don't need doctors, and they're merely being paid to sign off on a procedure for no reason. Remove them from the equation, and you've saved a large amount of money -- though you've angered doctors + the AMA and lowered their salaries as there is less demand.

2.Consumer seperation from cost decisions

Have you ever had a doctor tell you something along the lines of "You don't need this procedure, but the insurance company is going to cover it so why don't we just check anyway, we're just being safe!" This sort of behavior, this wasteful behavior that is filled with greed (on the side of the doctor) and carelessness from the patient is what causes a large amount of waste in the healthcare sector.

People don't care about what things cost, because either the government is paying (Medicare, low income, etc.), their company policy is paying, or something along these lines.

This gives the healthcare sector little (to no) incentive to lower costs because no one is shopping around for prices anyway.

If you want a prime example of people being close to cost decisions in a small sector, look to the LASIK eye / plastic surgery business. Cost has been falling for decades because people have to pay for these procedures out of pocket and are going to shop around for the combination of the best deal (price wise) and the best doctor.

3. Failure to allow for common sense reform

ALLOW FOR COMPETITION ACROSS STATE LINES FOR PRIVATE INSURANCE

This can only be summed up by corruption and greed; politicians don't want to anger the private insurance companies in their state by forcing them to compete with other states. Politicians are raking in large amounts of money from the healthcare sector; why would they make business harder for them by forcing them to compete.

Competition is vital in an industry where cost is EVERYTHING.

INCREASE IMMIGRATION OF DOCTORS / NURSES / MEDICAL PROFESSIONALS

If we have such high costs, and people want to come into our nation to either study to be a medical professional, or they are currently one and want to work, we should allow them to thrive like that. Give them a work visa, and let them come into this country to work. Every single new doctor you bring in lowers the cost for all of those as supply increases.

DON'T ALLOW HOSPITALS TO VETO NEW DEVELOPMENT

I don't know if this is an issue all around America, though I know where I live the Hospital around me is allowed to veto development of a new hospital in the area if they'd like to. I don't understand the rationale behind a decision like this, though all it is doing is allowing a Hospital to avoid competition which is vital to our market.

There are without a doubt other issues with the system, though these are the issues that I feel are hurting people the most. I'd love to hear what people think about other issues, and what should be done to fix these problems.

what do you expect american healthcare servers only the central banks in the usa and those that serve them

[r1s2g3]

I guess healthcare is costly because hospitals have to treat everybody even the patient is able to pay or not .so they charges a premium fees so that they can remain profitable at end.

Only option I find to cut the cost is to stay healthy.

[KingScorpio]

I guess healthcare is costly because hospitals have to treat everybody even the patient is able to pay or not .so they charges a premium fees so that they can remain profitable at end.

Only option I find to cut the cost is to stay healthy.

healthcare in usa sucks because you have to appoint millions of well educated people without national socialism or other forms of socialism in the countries ideology

to earn money based on sold work.

healtcare in usa will only reach german standards for the masses in quality and affordability if you basically become nazis or socialist to the bones,

or if you mass automatise it.

but given the decadent and profit oriented culture you have you arent really able, the us economy will continue to enrich the rich and the central bankers and those few that are on their payroll.

[mu_enrico]

I prefer capitalism / free markets because I have tasted poor health services in my country. Health services that are free or subsidized will later become low quality. If people want healthcare, then they need to buy an insurance policy. I think European socialist systems would lead countries to bankruptcy if they wish to maintain health care quality.

[unocash]

The problem is you have open borders. Insurees are paying for the non-insured who keep pouring in by the millions. This is not a sustainable system.

[squatz1]

I guess healthcare is costly because hospitals have to treat everybody even the patient is able to pay or not .so they charges a premium fees so that they can remain profitable at end.

Only option I find to cut the cost is to stay healthy.

I've never read into a stat about this -- I'm going to have to research this and get back to you, as I'd like to see the amount of healthcare serviced used by those that have no ability to pay and won't be paying their bills.

I guess healthcare is costly because hospitals have to treat everybody even the patient is able to pay or not .so they charges a premium fees so that they can remain profitable at end.

Only option I find to cut the cost is to stay healthy.

healthcare in usa sucks because you have to appoint millions of well educated people without national socialism or other forms of socialism in the countries ideology

to earn money based on sold work.

healtcare in usa will only reach german standards for the masses in quality and affordability if you basically become nazis or socialist to the bones,

or if you mass automatise it.

but given the decadent and profit oriented culture you have you arent really able, the us economy will continue to enrich the rich and the central bankers and those few that are on their payroll.

Earning money based on sold work is a VERY good system, though when people are separated from cost decisions, there is an artificially low amount of doctors allowed to become licensed, AND government money is being poured into the system -- then you're going to face an issue where prices remain artifically high.

Our profit-oriented culture wasn't supposed to be like this, it was supposed to be a market-oriented system instead of one riddled with regulations and artificial caps and minimums.

The problem is you have open borders. Insurees are paying for the non-insured who keep pouring in by the millions. This is not a sustainable system.

We don't have open borders by choice, it's just SO EASY for people to come across the border and stay in our country -- or to simply overstay their visa and stay here. Our healthcare system can't turn these people away (at least the emergency rooms)

I'll attempt to find a stat on illegal immigration healthcare use and the cost as well.

[okala]

Am not from America thuo but from my experience in the happening in the past am aware of the Obama health care bill/policy what happen to it, I believe the policy should have taken care of all this issues being raised if it still valid. And from all that you have outline from your post I can point out to just two factors that are responsible for this problem in the America healthcare, which are the problem of individuality and the politicians and this is not different from what we are facing in most part of the world.

[KingScorpio]

Earning money based on sold work is a VERY good system, though when people are separated from cost decisions, there is an artificially low amount of doctors allowed to become licensed, AND government money is being poured into the system -- then you're going to face an issue where prices remain artifically high.

maybe i didnt expressed my self clear enough

eraning money based on sold time is basically what puts you into becoming a "working poor"

while others just print money and spend it, you are the idiot that is forced to sell his time to survive.

without an ideology like national socialism, or socialism (i think nazism works better)

you wont get a sustainable workforce that provides high quality healthcare.

only alternative would be automation but then you get a tech worker problem as they will then develop powerful unions.

regards

[sheenshane]

The problem is that, some oligarchs that chosen medical as their industry are only mattering the business sense of their establishment/foundation. They built medical hospitals because of the reason of earning money and not just to provide the medical stuff to the people need. We will not be able to change this. This is the system already and they also have their point. Establishing a hospital means providing medical services that will give you a good amount of profit. The government couldn't even finance a single hospital to offer free medication the people needed.

[yeosaga]

The problem is that, some oligarchs that chosen medical as their industry are only mattering the business sense of their establishment/foundation. They built medical hospitals because of the reason of earning money and not just to provide the medical stuff to the people need. We will not be able to change this. This is the system already and they also have their point. Establishing a hospital means providing medical services that will give you a good amount of profit. The government couldn't even finance a single hospital to offer free medication the people needed.

Where is this free medication you speak of.

[suchmoon]

Have you ever had a doctor tell you something along the lines of "You don't need this procedure, but the insurance company is going to cover it so why don't we just check anyway, we're just being safe!"

Not really. With the massive deductibles and coinsurance payments these days the conversation is often the opposite. "Doctor, how much is it gonna cost?" (doctor has no clue, she doesn't do billing). "Sounds expensive, what's the risk if we don't do it?" (doctor is wasting her time solving financial problems for the patient instead of health problems).

This sort of behavior, this wasteful behavior that is filled with greed (on the side of the doctor) and carelessness from the patient is what causes a large amount of waste in the healthcare sector.

You need to switch doctors . Most of those I've dealt with were passionate about their job, helpful to the extreme, if somewhat limited by the time they can afford to spend with the patient.

That's not to say there is no fraud, particularly in the prevalent pay-per-procedure model. I just don't think that adding monetary negotiation to the doctor-patient conversation is going to change much. It would probably reduce cost somewhat (you can skip MRI but you'll need to get X-ray done and have that appendicitis cut out no matter what) and would increase health problems (already happening with people skipping unaffordable doctor's visits and medications and ending up in emergency rooms).

I don't know if this is an issue all around America, though I know where I live the Hospital around me is allowed to veto development of a new hospital in the area if they'd like to. I don't understand the rationale behind a decision like this, though all it is doing is allowing a Hospital to avoid competition which is vital to our market.

I don't know your specific situation but adding more hospitals just for the sake of competition can backfire. One hospital that is 80% full replaced by two hospitals at 40% would probably result in fixed costs driving up the total cost of care and eventually one of them ending up bankrupt. Good for capitalism, sucks for health.


Healthcare demand is generally quite inelastic even when paying out of pocket. I think market-driven fixes are doomed to fail. There is a good reason why most of the developed world solved that problem the way they did. The US will probably experiment for a few more decades at the cost of trillions of dollars and millions of preventable health issues, and still end up with a single-payer system. If not at the federal level then at least in some states.

[Flying Hellfish]

The problem with US healthcare:  It's singular focus is profit.

There a MANY examples of very effective and cost efficient universal healthcare, there are literally ZERO examples of successful purely for profit healthcare systems, but hey lets not let actual real world examples affect our thinking!

As Suchmoon mentioned this is really not difficult and literally the entire rest of the develop world moved on from this half a fucking century ago LOL.  Yup a few more more decades, a few more trillion dollars, a lowering level of healthcare and lowering age expectancy and eventually the US will figure out not EVERYTHING needs to be purely profit driven!

Now to start to fucking haggle with a doctor or to shop around for something like surgery FUCK that shit OMG, can my doctor focus on fixing my problems and not selling me his cheap ass services, fuck me sideways, I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

[yeosaga]

The problem with US healthcare:  It's singular focus is profit.

There a MANY examples of very effective and cost efficient universal healthcare, there are literally ZERO examples of successful purely for profit healthcare systems, but hey lets not let actual real world examples affect our thinking!

As Suchmoon mentioned this is really not difficult and literally the entire rest of the develop world moved on from this half a fucking century ago LOL.  Yup a few more more decades, a few more trillion dollars, a lowering level of healthcare and lowering age expectancy and eventually the US will figure out not EVERYTHING needs to be purely profit driven!

Now to start to fucking haggle with a doctor or to shop around for something like surgery FUCK that shit OMG, can my doctor focus on fixing my problems and not selling me his cheap ass services, fuck me sideways, I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

The problem lies with the supply and demand of doctors, after all the medical industry is just that. I have shopped around myself. These types of doctors that deal with surgery in the first place are not very abundant. This leaves us left with less trained doctors that charge less for their services because they are inexperienced. We have to balance the system somehow. What other system, that could function as efficiently or better in the US, can weigh the value that doctors deserve for years of hard study. Besides industrialization of the medical areas, what other option is there?

[suchmoon]

I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

I once had an idea of an app for choosing a cheap medical service, with customer ratings and all (don't anyone try to steal my idea, I'm gonna sue you for billions) and eventually came up with about a dozen or so reasons why it would be bad for health outcomes but probably quite profitable for some unscrupulous entrepreneur, "hack cheap cunt slicing me open" being one of them if perhaps not in so many words.

I wonder when Amazon starts adding doctors to its services. Probably needs to lobby to change some regulations first.

[KingScorpio]

The problem with US healthcare:  It's singular focus is profit.

There a MANY examples of very effective and cost efficient universal healthcare, there are literally ZERO examples of successful purely for profit healthcare systems, but hey lets not let actual real world examples affect our thinking!

As Suchmoon mentioned this is really not difficult and literally the entire rest of the develop world moved on from this half a fucking century ago LOL.  Yup a few more more decades, a few more trillion dollars, a lowering level of healthcare and lowering age expectancy and eventually the US will figure out not EVERYTHING needs to be purely profit driven!

Now to start to fucking haggle with a doctor or to shop around for something like surgery FUCK that shit OMG, can my doctor focus on fixing my problems and not selling me his cheap ass services, fuck me sideways, I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

well you cant have people working in that sector for long with the exceptions:

1. profit seekers

2. national socialists

3. socalists.

4. oppressed people that obey a religious defacto enslavement.

[yeosaga]

I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

I once had an idea of an app for choosing a cheap medical service, with customer ratings and all (don't anyone try to steal my idea, I'm gonna sue you for billions) and eventually came up with about a dozen or so reasons why it would be bad for health outcomes but probably quite profitable for some unscrupulous entrepreneur, "hack cheap cunt slicing me open" being one of them if perhaps not in so many words.

I wonder when Amazon starts adding doctors to its services. Probably needs to lobby to change some regulations first.

They may not have doctors yet, but Amazon definitely has plenty of medical equipment to purchase. The only thing missing from the equation of becoming your own doctor is prescription medicines.

[BitBustah]

The problem with US healthcare:  It's singular focus is profit.

There a MANY examples of very effective and cost efficient universal healthcare, there are literally ZERO examples of successful purely for profit healthcare systems, but hey lets not let actual real world examples affect our thinking!

As Suchmoon mentioned this is really not difficult and literally the entire rest of the develop world moved on from this half a fucking century ago LOL.  Yup a few more more decades, a few more trillion dollars, a lowering level of healthcare and lowering age expectancy and eventually the US will figure out not EVERYTHING needs to be purely profit driven!

Now to start to fucking haggle with a doctor or to shop around for something like surgery FUCK that shit OMG, can my doctor focus on fixing my problems and not selling me his cheap ass services, fuck me sideways, I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

Profit is what ruins healthcare, destroys the environment, keeps people homeless, rewards shareholders and not the workers.


Doctors are basically taught by the pharma companies, they are really just paid to push off their new drugs and they will never tell anyone any type of natural cure.  How often have you heard a doctor recommend fasting?

[Flying Hellfish]

I don't want some hack cheap cunt slicing me open with cut rate shit so he can do it cheaper...

I once had an idea of an app for choosing a cheap medical service, with customer ratings and all (don't anyone try to steal my idea, I'm gonna sue you for billions) and eventually came up with about a dozen or so reasons why it would be bad for health outcomes but probably quite profitable for some unscrupulous entrepreneur, "hack cheap cunt slicing me open" being one of them if perhaps not in so many words.

I wonder when Amazon starts adding doctors to its services. Probably needs to lobby to change some regulations first.

AI doctor on Amazon, I'd like to see someone haggle with that motherfucker!

[BADecker]

You will always find healthcare providers who honestly want to help people. They have different ways of going about it. Some of them who know that Big Pharma is only in it for the money, will still continue because they think that this is the best way to help people. Others will form PMAs so that they can treat people in exotic ways by contract, privately, thereby taking themselves and their patients out from under most of the controls and limits set by Big Pharma.

The further we get into understanding how complex the systems of nature are, the further we get into the idea of simply pushing nature in a direction a little, and then allowing nature to take over and do the health care.