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The reason US heathcare is so expensive....

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The VA actually does a good job with containing healthcare costs and are essentially forced to be efficient. They are the only federal system that can negotiate drug prices directly with the drug companies (it's against the law for medicare to do so) and if they don't get the deal they want, they use a comparable drug. The HMOs learned this practice from the VA. The electronic medical record that they use was way ahead (like a decade) of the rest of the civilian hospital systems, although now the other systems have caught up somewhat. Having a good universal electronic medical record throughout their system makes them much more efficient as well.

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Both Artful Dodger and Buz denegrated the VA. You haven't said they are off topic. Pres. Trump is slowly privatizing the VA and vets are being given vouchers for private care. The VA was given as bad example of what universal health care would be like. It is a good example. I attempted, in my ignorant way, to point that out. Sorry my text and spelling offended you.
Quote by Buz


I see it first hand, as the other way around. Islands of mediocrity located in the poorest areas, which are far less than than most anywhere else in the world. Healthcare here is generally too expensive, but it is not often mediocre, and predominently excellent.

Yes, Americans pay more than anyone else, but they do pay it, and still have one of the best average standard of livings on the planet.

All that aside, we shouldn't have to pay what we do. The system needs to be changed. The ultimate reason it is more expensive is that there are too many hands taking a piece of the money pie.


I haven't spent enough time in the US to know exactly how large the islands are. But I have seen a number of reports suggesting that the US performs poorly on a large number of measures of health outcomes. Some of that is probably due to lifestyle factors such as consuming enormous amounts of high fructose corn syrup, but this report puts the US last of 11 countries in 'healthcare outcomes' and 'mortality amenable to healthcare' (ie people dying from things that could have been prevented if they'd received adequate healthcare). And, of course, the US is miles above all the rest in terms of percentage of GDP spent on healthcare...

But, ultimately, I agree with you - the system needs to be changed. And you might be right on the ultimate reason... although a related issue is that the most important things to do well (preventative and first-line healthcare) don't earn enough money. Much more financially rewarding to treat late-stage cancer in a big hospital than to prevent it occurring or catch it early...
Quote by icurOK2
Pres. Trump is slowly privatizing the VA and vets are being given vouchers for private care.


Trump does not deserve to be credited with this. The privatization and vets being given vouchers is and was an old concept that was in the works starting back under George W. Bush. It gained traction under Obama but the Republicans were not going to allow it to happen under his presidency.
Quote by PhilU


I haven't spent enough time in the US to know exactly how large the islands are. But I have seen a number of reports suggesting that the US performs poorly on a large number of measures of health outcomes. Some of that is probably due to lifestyle factors such as consuming enormous amounts of high fructose corn syrup, but this report puts the US last of 11 countries in 'healthcare outcomes' and 'mortality amenable to healthcare' (ie people dying from things that could have been prevented if they'd received adequate healthcare). And, of course, the US is miles above all the rest in terms of percentage of GDP spent on healthcare...

But, ultimately, I agree with you - the system needs to be changed. And you might be right on the ultimate reason... although a related issue is that the most important things to do well (preventative and first-line healthcare) don't earn enough money. Much more financially rewarding to treat late-stage cancer in a big hospital than to prevent it occurring or catch it early...


You have to dig deeper, as the health issues vary greatly by subculture. Changes need to be made in the lifestyle of certain subcultures. The types of food they cook and eat, the higher rate of sedentary lifestyle, violence, use of hard drugs and such. That all varies drastically by subculture here, of which we have a multitude. The healthcare is actually available for everyone, especially the poor. It's the lower and middle of the middle class that gets shafted because they are carrying the financial load in our health insurance system. Poor often don't pay anything at all. Public hospitals and clinics are required by law to treat them. Private institutions can turn them away. But in many areas or metros, the public hospitals are often better than the private ones.

One thing that definitely needs to be changed is government control over where hospitals can build and serve. For any new hospital to be built, the government must approve a 'certificate of need'. Unfortunately, this is usually awarded on a political basis rather than actual need and certainly not to stimulate competition. I want to see that abolished and let hospitals compete on best price and best service.

People, who otherwise have an excellent standard of living are the ones having a hard time paying outrageous prices for healthcare because of inadequate health insurance coverage or the affording the greatly inflated price of health insurance for self-employed people.
Our healthcare system is the most expensive for westernized countries because of all the companies making money from it. We pay more for insulin than anywhere else in the northern hemisphere. Insulin that's made in America is cheaper in Mexico than America. Big pharma pushed drugs that don't work or hide the side effects. The drug hydroxychloroquine was pushed by trump because his son-in-law owned stock in the company that makes it. Florida now has over ONE MILLION DOSES and hospitals won't use it because patients with COVID-19 have a higher death rate than those who don't take it. Money talks loud. We're talking about hundreds of Billions of money that comes from american workers and makes the rich richer.
The only remedy is everybody pays a fixed percentage of their income and nobody gets turned away from a hospital. Sure, the rich can have their private rooms and gourmet meals but everybody is cared for.

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One reason not spoken of frequently is that the USA effectively subsidizes single-payer systems. R&D in the field of medicine is incredibly expensive, time consuming and prone to failure, plus it requires some really intelligent people to do the R&D, people who are worth the fortune they're being paid.

To give a concrete example, let's say someone needs a pacemaker, new ones are being developed and improved constantly. The cost most single payer systems pay for that is lower than the R&D cost of the pacemaker. Americans pay a higher price so that the companies making/improving the pacemaker can continue to improve them.

This is one reason, it's not the only reason, nor is it a major reason, but R&D costs are a relevant factor.

The R&D cost should be spread out globally by all users not just inflicted on USA users. Done this way the amortization of the product development cost would be faster. The trouble is politicians are continuously corrupted by Big Pharmaceutical companies and healthcare networks making it impossible to reduce healthcare costs.