General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe best health care system in the world
If you set out to design the most complicated, inefficient, ineffective, frustrating, back-*ssed health care system possible, you could not do better than the current US system.
It is effectively designed by, for, and to serve insurance companies, Big Pharma, and middlemen, to funnel a river of taxpayer dollars to insurance and drug cos. while ensuring that the smallest possible amount gets spent on actual care and the ins. cos. et al. charge all they can get away with (which is a lot, since most people prefer health to sickness and death) and otherwise do all they can to deny and delay benefits while imposing admin requirements that either afford additional fee-extraction opportunities or impose massive, externalized man-hour costs on patients, their families, and employers and on doctors and other actual providers of care (not to mention worry, stress, and poorer health).
Our system ensures that there is little or no rhyme or reason as to who gets insurance and what kind; if you live in one state, you may be able to afford insurance; if you live in another state, you may not, or may have to sell or give away your home in order to qualify for Medicaid; and the variations in the kinds of costs of insurance depending on where you live and who you are or aren’t employed by are equally random from the point of view of everyone except the insurers who get to define them.
The goal of those who get to define them is, of course, to extract as much value from the system as possible without actually getting convicted of a crime; and even if a company gets convicted, of course, the executives responsible usually walk away unscathed and on to their next job.
Meanwhile, millions of patients, employers, and providers spend countless hours per year re-evaluating the ever-changing landscape of available plans to decide which ones they’ll purchase or participate in and then applying for them, filing claims and appealing, if they don’t simply give up on it all. (Moreover, in order to apply for Obamacare, you must give up a fair amount of private info; and in order to receive care at all, you must give up a fair amount of private info to gawd knows how many providers and intermediaries – my own info has been on the dark web for years, not because I clicked on something I shouldn't but because those who required the info failed to keep it safe – here again, more uncompensated time, effort, and costs imposted on patients.)
Even after you’ve done your research and selected a plan that you think will cover your needs for the year, committing to it for the next year, the insurer can unilaterally change what it will cover at the drop of a hat. Drugs they said were covered are no longer covered (and in the US, without insurance, you can expect sky-high prices for them); doctors they said were in-network drop out as soon as they can afford to do so; and I’m not sure what other coverages they’re entitled to change at will, while you have no power to switch plans until the year is up.
This system in which concern for profits preempts all others is also destroying the quality of what care we do manage to receive. Doctors, having seen their patients’ claims denied by insurers under an ever-expanding list of pretexts, learn to record in their notes an ever-expanding list of whatever criteria ins. cos. devise. I appreciate the value of records and checklists and don’t mean to suggest they should be discarded altogether, but between these pressures and the challenges of making a living while bearing all the admin costs imposed by our system, it’s to the point that doctors often rush through appointments, barely glancing at their patients, their eyes glued instead to their computers as they check long lists of boxes and cut-and-paste the required language into forms – then exiting as quickly as possible, leaving patients with questions for which they must make additional appointments in order to obtain answers – creating additional burdens and/or costs.
A continual escalation in box-checking and magic-language-repeating requirements imposed by insurers ensures continuing denials and delays in benefit payments and does little to deter fraud, since fraudsters learn at least as quickly as anyone else what boxes to check and what magic language to use.
The system is so onerous that some of the best or most talented doctors or potential doctors either decide to choose other careers, retire early, or charge extra “concierge” fees for their services in order to be able to provide decent, non-rushed care.
There are a great many other aspects of the US health care system that are serious f*cked, and I won’t go into them all; but I think it’s important to at least note in passing that leaving pharmaceutical development and testing in the hands of Big Pharma, together with the endemic revolving-door and other kinds of regulatory capture that we currently allow of the FDA and the CDC as well as other governmental regulatory agencies, have on many occasions resulted in serious harm to patients. One result, of course, is that new drugs or treatments are not always properly tested before they’re allowed into the market, effectively making patients Big Pharma’s unwitting guinea pigs; another is that new drugs or treatments that are unlikely to be profitable aren’t developed at all.
And meanwhile, of course, we have the most expensive system and worst life expectencies of any developed nation in the world.
It doesn't have to be this way.
Canada's health care system, e.g., like those of many other developed nations, is universal, free, and was recently designated by the World Health Organization as the best in the world. We could just copy it, but for our lack of political will.

Turbineguy
(38,943 posts)There are a number of successful models we could emulate. I hear the French have a good system.
erronis
(18,718 posts)Last edited Sun Dec 22, 2024, 05:19 PM - Edit history (1)
I do remember growing up in a small rural town with family doctors who made house-calls, a small local hospital, larger hospitals a couple of hours away. Medical bills were paid directly as possible (some bartering still went on.) There were no "pre-approvals" or "claim denials". I'm sure there were financial hardships but they weren't because of insurance behemoths demanding their 10 pounds of flesh.
Our current system grew more like a parasitic tumor.
BadgerMom
(3,176 posts)Why would wealthy white jerks want that? /s
TBF
(35,069 posts)pandr32
(12,805 posts)
Each of the Canadian provinces funds the healthcare system rather than the Canadian government. Still, it's better than the U.S. healthcare system where people aren't viewed as patients but as profit centers. If the U.S. were to adopt the Canadian model the major needed would be not to rely upon the individual states for funding but by the federal government. Each state then can supplement federal funding if they want to.
I'd like to see a healthcare system in the U.S. like they have in Europe or even Canada.
WOLFMAN87
(33 posts)for giving us for profit healthcare
Blue Full Moon
(1,969 posts)WmChris
(280 posts)I belive Ronny Raygun was also a perpetrator of accountants doing medicine.
elleng
(139,056 posts)Utterly random.
AlexSFCA
(6,297 posts)CA and WA are pretty good for healthcare markets. States that opted out of medicaid are much worse.
TheRickles
(2,663 posts)Their model will spread to the other 50. (probably not, but it's an interesting thought.....)
mamacita75
(156 posts)Your signature line is great. I have never seen that one before.
Appreciate your input.
TheRickles
(2,663 posts)Check out the book to learn about the wise man who says that quote.
AlexSFCA
(6,297 posts)just the fact that you cannot be denied coverage for pre-existing conditions and that parents can keep their kids covered as dependents through 26 y.o. is huge. The health coverage and insurance market in 2007 was much much worse. Like everything, it’s location dependent, same with schools, zip code determines a fundamental difference in public schools.
appalachiablue
(43,510 posts)Here’s a sad statistic for you: In the United States, we have a whopping 1.4 million people employed with the job of DENYING HEALTH CARE, vs only 1 million doctors in the entire country!
That’s all you need to know about America. We pay more people to deny care than to give it...
https://www.democraticunderground.com/
Grumpy Old Guy
(3,733 posts)... for killing the public option.
MMBeilis
(455 posts)Farmer-Rick
(11,715 posts)That's what I remember Sarah Palin for.
Oh those imaginary death panels that never got explained or understood. But they were in someone's imaginary single payer plan.
It was because of the need for triage that she made up that BS.
Funny how we now have a large group of filthy- rich people making life and death decisions right now and people are dying from a lack of medical attention. But those aren't considered death panels.
The right wing went all out on the propaganda to keep us from having a functional medical system.
Evolve Dammit
(20,440 posts)! And every provider seems to have their own dam' system.
J_William_Ryan
(2,604 posts)But for rightwing ideologues with their lies and demagoguery about ‘socialism,’ ‘communism,’ and ‘I have to wait six months for routine surgery.'
It wasn’t always like this.
In the 50s, 60s and early 70s, 95 percent of medical treatment was done in hospitals – no surgery centers or outpatient clinics.
You saw your doctor for simple things – shots, prescriptions, a few stiches; and most Americans could afford to see a doctor, no health insurance needed.
If you needed more advanced medical treatment you were admitted to the hospital where you used health insurance – private or Medicare.
And in those days health insurance was like homeowner’s insurance or car insurance, you rarely used it – if at all.
Then came the explosion of medical treatment and technology – and an explosion of medical costs; now you needed medical insurance to see your doctor, you couldn’t afford to see a doctor otherwise.
Insurance companies responded to the cost explosion by prioritizing profit over patient care.
too many – nearly all! – Dems have also been so captured by the health care capitalists that they don't even bother to ask for what we want. (Remember how Obama took the public option off the table before negotiations even began?)
Republicans have successfully pushed us to where we are now by consistently making demands that initially seemed outrageous but eventually became normalized. We need Dems to start demanding free, universal health care, stronger protections for unionization, much stronger Wall St. regulation, etc. etc.
"A map of the world that does not include Utopia is not worth even glancing at, for it leaves out the one country at which Humanity is always landing. And when Humanity lands there, it looks out, and, seeing a better country, sets sail. Progress is the realisation of Utopias."
– Oscar Wilde (1897), Collected Works of Oscar Wilde: The Plays, the Poems, the Stories and the Essays Including De Profundis”, p.1051, Wordsworth Editions.
Beck23
(368 posts)Ron Green
(9,858 posts)We have enough investment schemes in this country; we need a health care system.
GiqueCee
(2,072 posts)... "promote the general Welfare". It says nothing about predatory financial exploitation of those in need of care.
Incidentally, when you Google "The Common Good in the Constitution", the first thing that pops up is from the Heritage Foundation. How fucked up is THAT? Those sociopaths do NOT do "Common Good", or "General Welfare". They do greed, malice, and deceit.
walkingman
(9,026 posts)we can change this if we simply elect people in both parties that are not paid employees of the billionaire class.
But whining is not the same as informed voting.
Wake Up, Wake Up, Wake Up!
snot
(11,018 posts)that's also its URL. They recognize how Citizens United, the regulatory revolving doors, etc. have enabled Big $ to capture Congress, and they've formulated what's just about the only plan I know of that might have a chance to actually reverse that tide.
The plan involves getting honest people into the political pipeline at the local level so that there will eventually be better candidates available up the food chain, as well as measures to improve accountability to voters and systematically close the loopholes that currently allow "legalized corruption."
IbogaProject
(4,195 posts)They blocked going for a national health system in the 1940s as the Dixiecrats refused to cover minorities. Then the AMA decided to keep the number of medical students too low to provide enough Doctors for a growing population. Everywhere else went universal between the 40s & 70s.
duhneece
(4,342 posts)If everything falls apart in the coming few years, I’m going to fight for truly good, affordable, accessible healthcare. The easiest transition I’ve read about is Medicare for All.
Hermit-The-Prog
(36,631 posts)Northern_Light
(41 posts)We hear all the time about people coming to the US for medical care. I'm pretty sure those people are wealthy enough to afford it. Why else would Americans go overseas for medical care that they can afford.
Bettie
(18,105 posts)whenever someone says we have the best health care system in the world, he corrects them.
He says we have the best health care INFRASTRUCTURE in the world, combined with a system that is designed to move cash from the people who can't afford it to the people who don't need it and it is VERY efficient at the task it has been designed for.
The sad thing is that our system could deliver care to our population, but being designed for each step of care costing more than the one before and insurance able to deny at any step of the process, that doesn't happen far too often.
And miss me with "but health insurance companies are the BEST".
Festivito
(13,677 posts)We stole land from indigenous Indians.
We stole work from slaves.
We stole raw materials from poor countries who owe us for the munitions we sold them.
We stole potential Social Security money by giving it to the rich in the form of tax breaks.
We stole even more to pay interest on the money we borrowed in order to give those tax breaks.
We have little left but to steal from each other. Got health care? Here we come!