Is the US health system collapsing?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The other thing that's stunning is the cost of medication in the USA. I know people who go on trips abroad just to stock up on their regular medicines that are 1/20 of the price in other countries.

If the cost of medication was the same globally only the us could afford it

Snort. Pfizer's CEO gets paid $35 million/year, 2nd among all corporate CEOs. Yes, it is expensive to develop new drugs, but that doesn't explain why low cost generics aren't more widely available in the USA

Watch the “farm bill.” It is a massive piece of legislation that flies under the radar. Look at that bill, and you will see how big pharma funds R&D. Tax credits. Huge amounts of corporate welfare.

"pharm bill"

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was on a girls trip and all of them were doctors from the UK and Canada, except for my friend who is an American in the UK and a clinical psychologist. They could not wrap their heads around our healthcare system. They did not know how any America could sleep at night when one illness could send you into bankruptcy.

+1 for all that's wrong with the NHS and Canadian healthcare, most of their citizens don't worry about medical bankruptcy.

Great medical care in the US is for the rich.
Good or decent medical care in the US is for the UMC who have good insurance.
Everyone else is just screwed.

See I think this is the answer. Healthcare is great for the rich and good to great for umc. If you have great insurance then it is decent. Nightmare for mc and broken for poor. Not the treatment but the delivery.

It is unclear what the answer is.

There’s no way to provide healthcare for everybody. It’s either rationing with people dying or waiting forever or spending all your money for life saving treatment .

It’s called reality

There is also something called research, and outcomes studies, and patient satisfaction. A lot of this international work has been done by The Commonwealth Fund and the Harvard School of Public Health. Turns out that when universal healthcare is actually well-funded and not financially gutted by the powers that be, people like it, and it works.

But you don't want to know about that, and I don't want to listen to you piss on things, so here we are.

We are broke. Universal healthcare is a fantasy that would be a miserable failure with rationing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The other thing that's stunning is the cost of medication in the USA. I know people who go on trips abroad just to stock up on their regular medicines that are 1/20 of the price in other countries.

If the cost of medication was the same globally only the us could afford it

Snort. Pfizer's CEO gets paid $35 million/year, 2nd among all corporate CEOs. Yes, it is expensive to develop new drugs, but that doesn't explain why low cost generics aren't more widely available in the USA

Watch the “farm bill.” It is a massive piece of legislation that flies under the radar. Look at that bill, and you will see how big pharma funds R&D. Tax credits. Huge amounts of corporate welfare.

"pharm bill"

NP
I googled this but nothing came up.
Any link so that I can read up on this topic?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was on a girls trip and all of them were doctors from the UK and Canada, except for my friend who is an American in the UK and a clinical psychologist. They could not wrap their heads around our healthcare system. They did not know how any America could sleep at night when one illness could send you into bankruptcy.

+1 for all that's wrong with the NHS and Canadian healthcare, most of their citizens don't worry about medical bankruptcy.

Great medical care in the US is for the rich.
Good or decent medical care in the US is for the UMC who have good insurance.
Everyone else is just screwed.

See I think this is the answer. Healthcare is great for the rich and good to great for umc. If you have great insurance then it is decent. Nightmare for mc and broken for poor. Not the treatment but the delivery.

It is unclear what the answer is.

There’s no way to provide healthcare for everybody. It’s either rationing with people dying or waiting forever or spending all your money for life saving treatment .

It’s called reality

There is also something called research, and outcomes studies, and patient satisfaction. A lot of this international work has been done by The Commonwealth Fund and the Harvard School of Public Health. Turns out that when universal healthcare is actually well-funded and not financially gutted by the powers that be, people like it, and it works.

But you don't want to know about that, and I don't want to listen to you piss on things, so here we are.

We are broke. Universal healthcare is a fantasy that would be a miserable failure with rationing.

When something works with adequate funding, and it's well-documented, then it's not a miserable failure. You can MAKE anything a miserable failure without adequate funding, though. So congratulations -- you got that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The other thing that's stunning is the cost of medication in the USA. I know people who go on trips abroad just to stock up on their regular medicines that are 1/20 of the price in other countries.

If the cost of medication was the same globally only the us could afford it

Snort. Pfizer's CEO gets paid $35 million/year, 2nd among all corporate CEOs. Yes, it is expensive to develop new drugs, but that doesn't explain why low cost generics aren't more widely available in the USA

Watch the “farm bill.” It is a massive piece of legislation that flies under the radar. Look at that bill, and you will see how big pharma funds R&D. Tax credits. Huge amounts of corporate welfare.

"pharm bill"

NP
I googled this but nothing came up.
Any link so that I can read up on this topic?

https://www.congress.gov/bill/118th-congress/house-bill/3160

https://www.doctorswithoutborders.org/latest/msf-supports-reintroduction-pharmaceutical-research-transparency-act

[Anonymous]

Maybe health care collapse will be blessing in disguise.
Restart from scratch with a new drawing board.

[Anonymous]

Anonymous wrote:Funny, I just returned from GW where I was scheduled to get an MRI to follow up on a mammogram and ultrasound. GW told me that I needed an MRI for further diagnosis. I ended up having to reschedule because they needed an order from my doctor, and the doctor's assistant sent in the wrong order. Nevermind that no one told me that I needed to get an order or that GW never provided the report to my doctor. Paid the co-pay. So I have a few more weeks to wonder if I have cancer. Great!

It was like being at the Mad Hatter's table. And I have excellent insurance.

I am going through the same ridiculous hoop jumping. Most recent is that I saw my PCP to get her to write the order for the MRI but she told me I have to get blood work done first to check kidney function. So I have to do the labs and then she’ll write the order, after which I finally can schedule the MRI. Meanwhile who knows what is happening with my actual health. Now tell me one good reason why the doctor who found the lump on my mammo and ultrasound couldn’t have sent me down to the lab the very same day and written the order for the MRI a few days later when the results came back!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

Typically, medical tourists recover and stay in that country a bit longer until they are fully recovered.

Harder to do in the more expensive countries like Canada and UK.

I think if you go to cheaper countries, there are medical care packages you can buy. It covers the cost of the medical treatment, stay at a place where you can recover and you get care.

*If* something happens months later, I guess you have to go back or try to find a US doctor who will deal with it (most probably won't due to malpractice).

But, when you don't have the money for medical care, you are going to take that small risk of something happening to get that care that you can afford.

When complications arise when patients return to the US, they appear in ERs and doctors are not happy about being faced with someone else's mess. Probably more with people who go to Mexico since part of the idea is likely not have to spend money on boht travel and extended stay in another country.

This is the typical scare tactic to dissuade people from traveling abroad for much cheaper medical care, how is that any different than in the U.S.? If I get a hip replacement done by a crappy surgeon in California, move to Virginia, and then need to go to the EE because of the crappy surgery, the ER doc in VA is still going to be dealing with crappy work left behind by a doctor far away.


American doctors think they’re the best in the world and that the rest of the world is incapable of training just as good physicians. What a farce. Typical dumb scare tactics used to convince Americans they should keep paying 10-1000x more for the same procedures that are done elsewhere in the world at just as good if not better standards than what you get here.

This. The difference in cost isn't because our doctors or equipment are better, it's due to many factors.

1) Doctors have to make enough to compensate for huge student debt and many years of not earning enough to pay it off. Otherwise nobody will be going into medical profession
2) Insurance companies are not non-profits and will be looking out to maximize returns.
3) Big Pharma and medical equipment industry will lobby hard to get their products pushed to general public and incentivize medical professionals to give them to patients. This may not often be in patient's interests due to high prices or drugs/equipment later proven to be unsafe.
4) Malpractice insurance is very costly here and doesn't exist overseas. If someone screws up your surgery overseas, can you sue?
5) Not every hospital can turn away uninsured, some have to take in patients who are expensive to treat and will never pay. This cost is prorated to the paying customers in the form of exorbitant and irrational fees for the same procedures/meds provided in other clinics and urgent care centers for a fraction of the cost.
6) Big hospital systems have huge admin overheads and dont' care to compete on prices with smaller clinics or radiology centers.
7) hospital rooms cost more than 5 star hotels and this doesn't include care

These are standard insurance industry talking points. PP, are you affiliated with an insurance company of payer.

Nope. Not at all. I would never advocate for insurance industry and our entire healthcare clusterf**k. I Had stated this in point (2) .
This doesn't negate issues with Hospital systems and Big Pharma I observe directly as a consumer.

I've had private health insurance and high deductible corporate plans. I've had to fight multiple claims and a couple of these lasted for years to avoid paying many thousands hospitals/insurance said I owed when they change things around with their network contracts. I am not a fan.

Can we talk about the bolded? I also have good insurance, but the last couple of years I have defn seen an increase in me being told I was responsible for things that are clearly covered in my plan. The biggest reason I get is "well we did cover that, but the medical office coded this other thing and that thing isn't covered." Like I'm supposed to discuss coding on check out. Last was I went in for an annual well woman aka gyn check. The visit was covered, but the Dr's office "coded" an extra charge for the pelvic exam. I was absolutely incredulous.....like how can you do an annual gyn exam without a pelvic? Back and forth, back and forth until I finally figured that right appeal mechanism and got it removed. It was also "only" for $50 so I'm sure a lot folks wouldn't even fight it. But this type of thing is happening more and more in my experience. And I'm sure it all has to do with players in the system trying to maximize profits. Not healthcare.

They are literally scamming us. Right out in the open.

Exactly! I hate that our politicians are all (except trump-lol) owned by these massive corporations. Start with Blackrock and Vanguard. They’re robbing us into oblivion, and we have next to zero legal protection.

[Anonymous]

US healthcare collapsed about 40 years ago. The entire world is laughing at the US and Americans for their stupidity when it comes to healthcare. I mean people across the world cannot even comprehend the prices we pay for virtually anything healthcare related because it makes zero sense. The entire thing needs to be nuked from orbit and start all over again. Watch this video for the Japanese perspective on US healthcare costs. Many of them don't even know the prices for ambulances or hospital stays because the price is low it is negligible. They go to the doctor 12 times a year. We are so done with the US in retirement. The entire healthcare system collapsed. Millions of Americans can't even get regular care anymore because PCPs are concierge.

It thank God we spend trillions blowing up gost herders in the middle east and spent another trillion in the F35. Whatever would we do without killing and our toys for killing?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Funny, I just returned from GW where I was scheduled to get an MRI to follow up on a mammogram and ultrasound. GW told me that I needed an MRI for further diagnosis. I ended up having to reschedule because they needed an order from my doctor, and the doctor's assistant sent in the wrong order. Nevermind that no one told me that I needed to get an order or that GW never provided the report to my doctor. Paid the co-pay. So I have a few more weeks to wonder if I have cancer. Great!

It was like being at the Mad Hatter's table. And I have excellent insurance.

I am going through the same ridiculous hoop jumping. Most recent is that I saw my PCP to get her to write the order for the MRI but she told me I have to get blood work done first to check kidney function. So I have to do the labs and then she’ll write the order, after which I finally can schedule the MRI. Meanwhile who knows what is happening with my actual health. Now tell me one good reason why the doctor who found the lump on my mammo and ultrasound couldn’t have sent me down to the lab the very same day and written the order for the MRI a few days later when the results came back!

Hoop jumping here too, and I have military healthcare, which is as close to the UK and Canadian system as you get. It's amazing to not really pay for it (we are prime so no co-pays), and I've been very happy with the quality of military doctors once I can actually get in to see them, but it's such a long wait for every appointment. And as you shift around to different specialties you have to wait 2 days for the referral to schedule, then at least a month for an initial appointment, then who knows how long for the actual fix.
Example:
Pain in knee - see primary care physician who prescribes rest for two weeks
Still pain - primary care physician refers to sports medicine and PT
PT takes 6 weeks to get an initial appointment
Sports medicine is a 4 month wait so kicked out to civilian care
Civilian referral takes 3.5 weeks for an appointment
MRI ordered after 6 weeks of pain
MRI takes 3 weeks to get an appointment
4 days for the MRI report
another week for a follow up appointment with sports med
Cyst found that needs surgical removal
Referral back to military orthopedist
4 week wait for initial appointment
Additional 3 weeks to schedule the out patient surgery

So about 4-5 months to diagnose and schedule a fairly simple out patient procedure. I'm active duty, so this took me away from a large portion of my work for that entire time. There's just so much run around and jumping from doctor to doctor and every one starts from scratch. It's really not working.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Funny, I just returned from GW where I was scheduled to get an MRI to follow up on a mammogram and ultrasound. GW told me that I needed an MRI for further diagnosis. I ended up having to reschedule because they needed an order from my doctor, and the doctor's assistant sent in the wrong order. Nevermind that no one told me that I needed to get an order or that GW never provided the report to my doctor. Paid the co-pay. So I have a few more weeks to wonder if I have cancer. Great!

It was like being at the Mad Hatter's table. And I have excellent insurance.

I am going through the same ridiculous hoop jumping. Most recent is that I saw my PCP to get her to write the order for the MRI but she told me I have to get blood work done first to check kidney function. So I have to do the labs and then she’ll write the order, after which I finally can schedule the MRI. Meanwhile who knows what is happening with my actual health. Now tell me one good reason why the doctor who found the lump on my mammo and ultrasound couldn’t have sent me down to the lab the very same day and written the order for the MRI a few days later when the results came back!

Hoop jumping here too, and I have military healthcare, which is as close to the UK and Canadian system as you get. It's amazing to not really pay for it (we are prime so no co-pays), and I've been very happy with the quality of military doctors once I can actually get in to see them, but it's such a long wait for every appointment. And as you shift around to different specialties you have to wait 2 days for the referral to schedule, then at least a month for an initial appointment, then who knows how long for the actual fix.
Example:
Pain in knee - see primary care physician who prescribes rest for two weeks
Still pain - primary care physician refers to sports medicine and PT
PT takes 6 weeks to get an initial appointment
Sports medicine is a 4 month wait so kicked out to civilian care
Civilian referral takes 3.5 weeks for an appointment
MRI ordered after 6 weeks of pain
MRI takes 3 weeks to get an appointment
4 days for the MRI report
another week for a follow up appointment with sports med
Cyst found that needs surgical removal
Referral back to military orthopedist
4 week wait for initial appointment
Additional 3 weeks to schedule the out patient surgery

So about 4-5 months to diagnose and schedule a fairly simple out patient procedure. I'm active duty, so this took me away from a large portion of my work for that entire time. There's just so much run around and jumping from doctor to doctor and every one starts from scratch. It's really not working.

The healthcare systems is maximizing the money that your insurance will pay. That hoop jumping keeps dozens of people employed. And no, single payer won't fix this because one part of the government will want to maximize what it gets from another part. The focus of government is to grow in size, not provide service.

[Anonymous]

Anonymous wrote:After some very complicated issues involving a family member I started following a subreddit for doctors and other healthcare professionals. They are highly critical of the situation with healthcare--mostly US but foreign docs chime in as well, sometimes to report what's bad where they are, other times to express their sympathy to docs working in the US.

Issues include corporatization of medicine such as huge mergers and vertical integration (United Health Group being an example), private equity (buying hospitals only to loot them--like the woman in Boston who died postpartum because the medical device to remove a blood clot in her liver had been repossessed), administration demands, treating healthcare like customer service, and also problems with patient populations (sometimes fed up with them, sometimes pointing to social determinants and other factors that affect patients). Also the politics relating to pregnancy and abortion and transgender care.

They fairly consistently say that the system is crashing or has crashed but not acknowledged. I wonder what the lay public (especially the well-informed public) thinks of all this--is it falling apart? If you think so, is it because of stuff you have personally dealt with or stuff on a larger scale you have read about (e.g. investigations of large insurers for Medicare advantage fraud, antitrust investigations starting with regard to private equity, other news related to healthcare).

In one word: Yes.

[Anonymous]

We also have a really different approach to medicine than we did 2 generations ago. My grandparents only went to their GP for everything and probably got about a quarter of the test/scans/lab work that we all get regularly. Now, at age 47, I feel like I get tests run all the time and inevitably something comes back to follow up on that requires a specialist. People also spend a lot more time with regular appointments at dermatology, optometry, allergists, PT, behavioral health, etc. for pretty run of the mill things that I think 50 years ago were just ignored or dealt with. I'm not saying it's wrong, but it creates this huge backlog. And I wonder if we're just making people money and causing ourselves stress? Or are we actually caring for our health? Can see either side of that argument.

[Anonymous]

I haven’t read this entire thread but my dog died after we went to some private equity owned vet and then I found out my kids pediatrician office was too. I had noticed that they had been pushing crazy tests within the past year (my son had a mild sore throat, no other symptoms but k wanted a strep test since he’s prone to strep. They insisted on a flu test too even tho he had 0 fever or respiratory symptoms) or charging a well visit as a regular appointment. It’s so hard to not feel nickeled and dimed!

[Anonymous]

People blame pharma when prescription drugs make up 600B of 5 trillion in healthcare expenditures. But that money is actually being spent to relieve symptoms and cure disease and a ton of the remaining 4.4T is going toward padding profits for insurers, hospitals, pharmacies, and doctors.