The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

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".

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.

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!

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.