I’ve never understood why America doesn’t have a decent health care system. And then America voted for Trump, and everyone appears shocked at what he has done…
There is something very wrong with American attitudes.
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Encourage not sleeping, advertise and manufacture processed garbage, encourage drinking poison, and most of all encourage working long hours over getting any physical activity.
Yeah, good luck with that. It’s an every man for themselves environment, the government and American society is fine with throwing your body into the meat grinder for more profit.
Ironically we’d be much more productive if we incentivized a healthier lifestyle for the population.
My mother is an elementary school teacher in a conservative Michigan town. She generally doesn't talk politics at work, but a coworker mentioned that the school's "no questions asked" free breakfast and lunch policy was ending next year due to federal education cuts. My mom's co-teacher, who voted for Trump, expressed surprise, saying she didn't realize that was something likely to be cut, or that the states would make up the shortfall.
Anyone remotely following US politics wouldn't be surprised, and would know that most states are fairly strapped for cash. (Whether that's societally optimal is besides the point.) This is a pattern I see over and over again, on both sides of the line: you see Trump voters surprised that cuts to the FDA result in higher food recalls, and you see Democratic voters saying that nothing got done over the last four years.
It baffles me. I have more awareness of the local politics in our small Canadian town than I did when I lived in Chicago, and it all just comes from listening to my friends talk about current events. It's a wild feeling.
That's a large reason why there is no major change in this area, even though one is sorely needed.
Personally, I'd just open Medicare up to anyone who wants it by paying some additional fee each month and see how that goes, but that's too simple for most politicians I think.
Then, once it fails, they will just lie and again blame Democrats for it instead of circling back to their talking points about how they wanted to kill Obamacare.
This is just some people. I have met a fair number of people who just think it is too bad, so sad if you are too poor or do not have a good enough job for good healthcare. I was visiting Canada once, and the folks at the company I was visiting recounted the last American who rolled through who espoused the "well, I guess they die" talking points - to their horror.
But so so so much is wrong financially for hospitals, clinics and pharmacies.
This administration is poking the house of cards with a really large stick.
Pharmacies are so fucked by PBMs( that politicians only pay lip service to dealing with) that they _owe_ money to the PBM everytime they fill many prescriptions. Negative reimbursements. Many small time pharmacies now play games to refuse prescriptions because of how bad it is. PBMs have tried to counter by having distributors write contracts that bar refusals. Chain pharmacies aren't doing much better and are where the negative reimbursement customers end up.
"Mom & pop" doctor offices simply are going extinct. Due to both polticians lumping on requirements for digital records, infinite insurance games and cost of real estate going to the moon, every new doctor just joins a mega-hospital-network because they are already 2 million in debt after schooling. Old doctors just sell out their clinics to those hospital networks. Suddenly doctors that work there get put under strict quotas. This is something I've seen happen in real time in my suburban part of NY. My doctor's office that also fell under the growing blob of a mega-network, now has numerous signs saying "new concerns brought up during the appointment must be done under a new appointment for billing purposes".
It's a weird scenario. American politics is so loud and omnipresent that I, as a Brit on the Internet, end up following it involuntarily because it ends up in every discussion everywhere. But so much of it is just weird things made up by right wing talking heads.
The quality of care, technology, and expertise are top-tier for those with excellent insurance or deep pockets. But the system is neither free nor particularly efficient. For many, access is limited by cost, bureaucracy, and inequities. So yes, it is best care available, but not best care accessible.
It's targeted across all US demographics. Sometimes covertly.
And increasingly it's fine-tuned towards individual interests and psychological triggers.
It's also worth noting that the percentages are substantially higher than the averages for the portion of the population who generally votes.
https://www.census.gov/library/publications/2024/demo/p60-28...
More:
https://www.unionhealthcareinsight.com/post/why-employer-hea...
We're talking about folks who non-ironically walk around with signs saying "keep government out of my medicare". https://archive.nytimes.com/krugman.blogs.nytimes.com/2011/0...
> 44 percent of Social Security recipients, and 40 percent of Medicare recipients, believe that they don’t benefit from any government social program.
I'm not exactly holding my breath that they'll suddenly grow a brain to connect cause and effect against the word of Dear Supreme God King.
These people aren't stupid - far from it! I work with electricians all day and they're sharp as tacks. But most of 'em have been lied to so long they buy it all, hook, line, and sinker. Quite a few of them get drawn in by the social conservative outlook and then just go along with the rest of it.
Most Americans can get pretty good care. It also tends to be painful to get. You don't just go to the doctor. You visit some horrible web site clearly built by someone who doesn't have to use it, go through the list of in-network providers, pick one, call, find out that the list is out of date and they don't accept your insurance.... And then come the surprise bills. The office coded your lab work wrong so it doesn't count as preventive, pay up, or spend an hour on the phone correcting it. You offhandedly told the doctor you're feeling tired lately during your annual physical, and they give you some tips on getting better sleep. Then you get a bill because that counts as a consultation for a specific medical problem, so your free annual physical now requires you to pay a copay.
God forbid you have a major incident. Nobody can ever tell you how much things will cost. You'll be dealing with bills for months, and you won't be able to trust that any of them are legitimate.
The actual health providers are usually OK. The health insurance is godawful.
Maybe they're differentiating their care providers and insurer, but that's a level of critical thinking I wouldn't expect.
The big question is how big the fee is. Even with Medicare you have plenty of costs, and that's after paying 5.6% of pay into the system for 30+ years. My guess would be that the cost will be similar to what we're seeing on the ACA market with $500-3000 premiums depending on your deductible.
The problem is it costs what it costs. To reduce individual cost you have to reduce the cost of service or pay for it from some other source.