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US spends most on health care but has worst health outcomes

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Re: US spends most on health care but has worst health outcomes

#11

Post by stuaxo »

silisili wrote: post #8

This isn't at all surprising, for multiple reasons. The entire insurance industry existing is a big one. That we are all overweight is another. I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I've not met a single person completely against it, mostly just people against people abusing emergency rooms. Certain big media and politicians are agains…

The Insurance industry is a bug vampire squid sucking money out of the system, and ironicly stopping many from getting the health outcomes they need.

Re: US spends most on health care but has worst health outcomes

#12

Post by stuaxo »

emodendroket wrote: post #7
personjerry wrote: post #6

Earlier quoted context omitted.

The issue is the medical-industrial complex in the US, intimately tied with a huge medical insurance industry, that spends a lot of money lobbying to fight against reform. And healthcare is already a heavily regulated industry so any political barriers become even harder to overcome. I believe Obamacare was an attempt to wiggle around to a (somewhat shitty) solution. I suspect change will only come once the existing…

Well, some won’t and I think that exposes another issue: the poor outcomes have a lot to do with a lot of people not getting care or waiting too long due to cost. If money is no object the US healthcare system is as good as any (I bet you would see this if you broke down by socioeconomic status).

Of course, though that is only the case for a very small minority of people.

There is a big overlap with those people and the people that ultimately make decisions affecting whether that system exists though.

Re: US spends most on health care but has worst health outcomes

#13

Post by altacc »

hunglee2 wrote: post #2

I think everyone is aware of this by now - the question is, do we understand what is preventing reform? It seems that we need to move beyond the revelation that 'the system is bad' and starting doing something about it. If so, what?

Seems to me it's ideology and profit.

The US isn't the only country with a partisan, ideological driven political landscape but it is probably the loudest. Ideologues on the right are able to pander to their base by equating any healthcare reform as socialist, substandard, death panel creating and an affront to freedom. People will accept a bad deal if they think it is the right deal.

Healthcare companies benefit so much that they are one of the biggest lobbying industries in the US, spending $690 million a year on lobbying (quick Google result, so pinch of salt). The changes they want are those that will profit them more, so it benefit them to feed the ideologues.

Re: US spends most on health care but has worst health outcomes

#14

Post by nosianu »

emodendroket wrote: post #7
personjerry wrote: post #6

Earlier quoted context omitted.

The issue is the medical-industrial complex in the US, intimately tied with a huge medical insurance industry, that spends a lot of money lobbying to fight against reform. And healthcare is already a heavily regulated industry so any political barriers become even harder to overcome. I believe Obamacare was an attempt to wiggle around to a (somewhat shitty) solution. I suspect change will only come once the existing…

Well, some won’t and I think that exposes another issue: the poor outcomes have a lot to do with a lot of people not getting care or waiting too long due to cost. If money is no object the US healthcare system is as good as any (I bet you would see this if you broke down by socioeconomic status).

> If money is no object the US healthcare system is as good as any

I don't think so. The medical personnel are way too stressed. You having money does not change that the people that will see you suffer in an inhuman system.

Even apart from money, how on earth is it possible that the people who should know more better than anyone else the effects of stress and lack of sleep let doctors work in far too long shifts? How does the existence of 24 hour shifts make any sense?

The system has a lot more problems than just money.

Just one example link: https://bcmj.org/articles/sleep-deprivation-among-physicians

It's not just the US: https://www.theguardian.com/society/2022/jan/17/nhs-doctors-...

Also always interesting to read: https://old.reddit.com/r/medicine/

Re: US spends most on health care but has worst health outcomes

#15

Post by roenxi »

hunglee2 wrote: post #2

I think everyone is aware of this by now - the question is, do we understand what is preventing reform? It seems that we need to move beyond the revelation that 'the system is bad' and starting doing something about it. If so, what?

As far as I can tell nobody agrees on the details of why the system is bad. I'll pick on the split between the medically assisted dying vs. preserve life at all costs camp as a simple example. Both sides could probably agree that the current situation is bad, but neither side is about to give ground on why or which direction to go next.

In my view, there are a lot of trivial and important changes that could make US healthcare cheaper, better and more available. As long as I don't specify any further details, everyone can agree with me.

Re: US spends most on health care but has worst health outcomes

#16

Post by altacc »

panny wrote: post #5

>the system is bad Doctors aren't paid when you are healthy. How would you suggest fixing such a system? Because if you figure it out, there's a whole system of auto mechanics that could probably benefit from the solution.

It is not necessary to have to propose a solution before highlighting flaws or having an opinion about some thing. This is arguing in bad faith. Besides, you only have to read any article like this to find examples of other healthcare systems that have better outcomes for less spending

Second, you've not only massively oversimplified, you have also made a false equivalence. Doctor's aren't the only ones getting paid, the CEOs take home billions, as do shareholders. If you think going to the hospital in the US is the same as taking a car to a garage in the US, then you are greatly mistaken. To equate the 2 is either unthinkingly glib or willfully disingenuous.

Re: US spends most on health care but has worst health outcomes

#17

Post by Arnt »

emodendroket wrote: post #10
Arnt wrote: post #9

Earlier quoted context omitted.

So what? Both of the countries I've lived in have carried out health-related reforms (one a really big reform — almost half of hospital beds were closed, the other a much smaller reform). The people who lost income didn't matter for the success or failure of either reform.

So they can spend a lot of money to convince people that reforms are bad, they can buy influence among powerful politicians, and all the rest of the moves that make it so elite preferences do a lot to dictate policy the world over. Are we being naive here?

I think so, yes.

You're basically saying that there are lobbyists and that's an insurmountable obstacle, and throwing your hands up in the air. You're not, for example, trying to learn how the countries that executed reforms successfully did so.

EDIT: You could easily find a list online of the top ten health systems. Learning about the reforms carried out by each of those in the past 30 years requires effort, but it's really not impossible.

Re: US spends most on health care but has worst health outcomes

#18

Post by pigsty »

stuaxo wrote: post #11
silisili wrote: post #8

This isn't at all surprising, for multiple reasons. The entire insurance industry existing is a big one. That we are all overweight is another. I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I've not met a single person completely against it, mostly just people against people abusing emergency rooms. Certain big media and politicians are agains…

The Insurance industry is a bug vampire squid sucking money out of the system, and ironicly stopping many from getting the health outcomes they need.

A small group chat I’m a part of has one person who works for an insurance company. Reading his messages about his work day is just depressing.

“Oh, yeah, if someone has that cancer and they’re under 45 it’s an auto-reject from me. Just too unlikely for them to have it” was one message that’s stuck with me. You (or your company) pays thousands of dollars a year (or more) to an insurance company to cover you for when the worst things happen—and despite you or your doctors trying to get your shit together, somebody chilling 1500 miles away skims your report and auto-declines any form of coverage just because it seems unlikely. Then it’s an uphill battle of trying to not only battle your illness and your daily life, but a company that has employees with worse judgement than an AI thrown together by some dude on Twitter in a weekend.

It’s disgusting to think about.

Re: US spends most on health care but has worst health outcomes

#20

Post by peoplefromibiza »

panny wrote: post #5

>the system is bad Doctors aren't paid when you are healthy. How would you suggest fixing such a system? Because if you figure it out, there's a whole system of auto mechanics that could probably benefit from the solution.

> Doctors aren't paid when you are healthy

They are, here in my country.

I am healthy (AFAIK) my taxes are paying for doctors too.

Also, I am healthy (AFAIK) because I go to the doctor even when I am not sick to check on my health.

I already paid for it.

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