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.
replies(10):
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.
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 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...
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who doesn't have to use it, go through the list of in-network providers, pick one, call, find out that the list is out of date and they don't accept your insurance....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.