The American Healthcare Conundrum

Post by fhsm » Tue, Mar 17, 2026, 12:21 AM UTC

tacticalturtle wrote: post #67

hardtke wrote: post #53

Earlier quoted context omitted.

We rarely discuss the primary source of health care cost differences in the United States -- US doctors get paid a lot more than elsewhere. I haven't seen a credible proposal to address that. Most of the salary difference can be blamed on deliberately created shortages of doctors in many specialities. Not enough medical school slots (horror stories among my kid's friends of not getting accepted) and then also shortag…

I really don’t think doctor salaries are the primary difference when they make up less than 10 % of health care costs: > However, new research by Stanford health economist Maria Polyakova and colleagues — using unique data on physician income — shows that physicians’ personal earnings account for only 8.6 percent of national health-care spending https://siepr.stanford.edu/news/just-how-much-do-physicians-...

Post by Rury » Tue, Mar 17, 2026, 12:21 AM UTC

jandrewrogers wrote: post #86

timtim51251 wrote: post #7

Lots of people are saying nonsense here. The actual reason commercial insurers pay more is that's the only way to can make more profits. Because of Obamacare requiring 80% of the money they collect to be spent, the insurance companies just get to keep 20%. So insurance companies spend more so they can collect higher premiums. That's how they make more money. Several doctor friends have told me this as well.

There are other structural issues at work that you see across US government procurement generally, Medicare just being one example. The unit costs of doing business with the US government are higher than with private companies even after accounting for economies of scale. The US government also requires that they pay the lowest price. Consequently, unit economics are usually worse when dealing with the government tha…

Post by da_chicken » Tue, Mar 17, 2026, 12:22 AM UTC

nradov wrote: post #49

Retric wrote: post #37

Earlier quoted context omitted.

> part of the healthcare system that is moderately competitive. That’s only half the story though insurance companies also try and reject way more claims, cover fewer people, and are just harder to get money from than Medicare. This means hospitals can’t afford to give them cheaper rates as they just require vastly more work from staff for the same procedure. The industry isn’t blind to this effect, but has little re…

That's true to an extent, and those minimal controls are why Medicare also wastes billions on paying fraudulent claims. https://relentlesshealthvalue.com/episode/ep502-how-some-pre...

Post by [deleted] » Tue, Mar 17, 2026, 12:22 AM UTC

ipsento606 wrote: post #85

nostrebored wrote: post #28

Earlier quoted context omitted.

ACA enshrined the worst parts of the American healthcare system for years to come. It is a politicized victory that is the best solution for no American citizens. Places I’ve been with fully privatized healthcare or single payer are both significantly better for consumers. Insurance companies have raised prices to restore profit, were briefly a mandatory expense, and will exist for years to come.

> ACA enshrined the worst parts of the American healthcare system for years to come before the ACA, insurers could deny coverage for pre-existing conditions people have forgotten how bad things used to be

Post by nradov » Tue, Mar 17, 2026, 12:27 AM UTC

mothballed wrote: post #48

nradov wrote: post #31

Earlier quoted context omitted.

Price caps always and everywhere cause shortages, including long queues for certain types of care. This may be acceptable but we need to understand the trade-offs when making any changes.

Price caps create shortages when they are the rate limiting factor, which is always the case when imposed on a free market whenever the cap is below the market price, so this is an extremely accurate statement when dealing with things like lightly regulated commodities. Whether they would be the rate limiting factor in health care remain to be seen, since health care is highly regulated with regulatory capture, licen…