Is the US health system collapsing?

[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.

How do you get an mri that quickly. I have to wait 2-3 months for an mri or ct or ultra sound. I waited 9 months for one specialist, normal is 2-4 months and after years I finally have a diagnosis but no one is qualified to treat it. They gave me a referral but did not code it right so the outside specialist will not see me and it’s been a nightmare. I rarely see the same doctor twice except my primary care who I keep changing and they put me back to them. They are terrible.

[Anonymous]

Anonymous wrote:

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.

How do you get an mri that quickly. I have to wait 2-3 months for an mri or ct or ultra sound. I waited 9 months for one specialist, normal is 2-4 months and after years I finally have a diagnosis but no one is qualified to treat it. They gave me a referral but did not code it right so the outside specialist will not see me and it’s been a nightmare. I rarely see the same doctor twice except my primary care who I keep changing and they put me back to them. They are terrible.

In this instance I was referred to a civilian provider for the MRI. If you have to wait longer than 90 days within the military system, they are supposed to provide a referral to a civilian.
Are you in the DMV? It’s so hard to navigate healthcare here.

[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).

News Flash:
We never had a health care system, only sick care. Poisoned food will eventually make almost anyone sick.

[Anonymous]

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

that is BS- many other countries manufacture drugs, people would still be able to buy medicine, the CEO and shareholders would just make less money. the French, Swiss & Danes all manufacture pharmaceuticals and would mandate price controls regardless and the third world countries I know about manufacture their own pharmaceuticals as well- some for export so no- we pad the bottom line but we don't just pay for everyone else's meds. We make it more profitable for pharmaceutical companies to invest in R&D but it's not like they will just stop developing new meds.

[Anonymous]

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

You know that companies are often paid NOT to bring new pharmaceutical products to market, so that there’s no competition that would bring costs down? Learn about pay-not-to-play and patent abuses. It’s appalling.

It is, to be clear, perfectly logical in a system where the entire purpose of medicine is to maximize shareholder growth. But it is appalling.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

How do you get an mri that quickly. I have to wait 2-3 months for an mri or ct or ultra sound. I waited 9 months for one specialist, normal is 2-4 months and after years I finally have a diagnosis but no one is qualified to treat it. They gave me a referral but did not code it right so the outside specialist will not see me and it’s been a nightmare. I rarely see the same doctor twice except my primary care who I keep changing and they put me back to them. They are terrible.

In this instance I was referred to a civilian provider for the MRI. If you have to wait longer than 90 days within the military system, they are supposed to provide a referral to a civilian.
Are you in the DMV? It’s so hard to navigate healthcare here.

Is this just in the military an issue? I just had a health issue and was able to get an MRI the very next day after my doctor ordered it. I’m in the DMV. Medicare.

[Anonymous]

The false notion that healthcare is a right. Meaning hospital level healthcare with the best technology, pharmaceuticals, surgeons, doctors, specialists and personalized coordination of it all for illegals or anybody else who just walks into a hospital with no ability to pay anything. While this is a noble (but lazy and childish) notion ... It degrades the whole system for everybody. Much like public schools have become sloppy, slovenly and somewhat stinky due to the same deeply flawed conflict between fantasy and reality.

[Anonymous]

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

You know that companies are often paid NOT to bring new pharmaceutical products to market, so that there’s no competition that would bring costs down? Learn about pay-not-to-play and patent abuses. It’s appalling.

It is, to be clear, perfectly logical in a system where the entire purpose of medicine is to maximize shareholder growth. But it is appalling.

Provide links and sources and not just a headline you saw.

[Anonymous]

Anonymous wrote:The false notion that healthcare is a right. Meaning hospital level healthcare with the best technology, pharmaceuticals, surgeons, doctors, specialists and personalized coordination of it all for illegals or anybody else who just walks into a hospital with no ability to pay anything. While this is a noble (but lazy and childish) notion ... It degrades the whole system for everybody. Much like public schools have become sloppy, slovenly and somewhat stinky due to the same deeply flawed conflict between fantasy and reality.

It is a proper notion that first world countries assume.

I know MAGA is rushing to make the U.S. 3rd world, but I'm not jumping in that bandwagon

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

How do you get an mri that quickly. I have to wait 2-3 months for an mri or ct or ultra sound. I waited 9 months for one specialist, normal is 2-4 months and after years I finally have a diagnosis but no one is qualified to treat it. They gave me a referral but did not code it right so the outside specialist will not see me and it’s been a nightmare. I rarely see the same doctor twice except my primary care who I keep changing and they put me back to them. They are terrible.

In this instance I was referred to a civilian provider for the MRI. If you have to wait longer than 90 days within the military system, they are supposed to provide a referral to a civilian.
Are you in the DMV? It’s so hard to navigate healthcare here.

Yes, live here. With mri, doctors wanted me to do it at military hospital so the results will be in the system.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

How do you get an mri that quickly. I have to wait 2-3 months for an mri or ct or ultra sound. I waited 9 months for one specialist, normal is 2-4 months and after years I finally have a diagnosis but no one is qualified to treat it. They gave me a referral but did not code it right so the outside specialist will not see me and it’s been a nightmare. I rarely see the same doctor twice except my primary care who I keep changing and they put me back to them. They are terrible.

In this instance I was referred to a civilian provider for the MRI. If you have to wait longer than 90 days within the military system, they are supposed to provide a referral to a civilian.
Are you in the DMV? It’s so hard to navigate healthcare here.

Is this just in the military an issue? I just had a health issue and was able to get an MRI the very next day after my doctor ordered it. I’m in the DMV. Medicare.

Yes, probably. They don’t have enough techs to run the machines. It’s the worst it’s ever been and they are having hiring freezes. Tricare is the worse it’s ever been and we’ve had it many years.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The false notion that healthcare is a right. Meaning hospital level healthcare with the best technology, pharmaceuticals, surgeons, doctors, specialists and personalized coordination of it all for illegals or anybody else who just walks into a hospital with no ability to pay anything. While this is a noble (but lazy and childish) notion ... It degrades the whole system for everybody. Much like public schools have become sloppy, slovenly and somewhat stinky due to the same deeply flawed conflict between fantasy and reality.

It is a proper notion that first world countries assume.

I know MAGA is rushing to make the U.S. 3rd world, but I'm not jumping in that bandwagon

Nope..it just ends up like public school. Two systems.. private for the rich and crap for the losers. We are in that transition now since Obamacare. Illegals and the general public can just walk in to a mess and the rich buy concierge

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The false notion that healthcare is a right. Meaning hospital level healthcare with the best technology, pharmaceuticals, surgeons, doctors, specialists and personalized coordination of it all for illegals or anybody else who just walks into a hospital with no ability to pay anything. While this is a noble (but lazy and childish) notion ... It degrades the whole system for everybody. Much like public schools have become sloppy, slovenly and somewhat stinky due to the same deeply flawed conflict between fantasy and reality.

It is a proper notion that first world countries assume.

I know MAGA is rushing to make the U.S. 3rd world, but I'm not jumping in that bandwagon

Nope..it just ends up like public school. Two systems.. private for the rich and crap for the losers. We are in that transition now since Obamacare. Illegals and the general public can just walk in to a mess and the rich buy concierge

I noticed that too. A tremendous decline in quality since Obamacare.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The false notion that healthcare is a right. Meaning hospital level healthcare with the best technology, pharmaceuticals, surgeons, doctors, specialists and personalized coordination of it all for illegals or anybody else who just walks into a hospital with no ability to pay anything. While this is a noble (but lazy and childish) notion ... It degrades the whole system for everybody. Much like public schools have become sloppy, slovenly and somewhat stinky due to the same deeply flawed conflict between fantasy and reality.

It is a proper notion that first world countries assume.

I know MAGA is rushing to make the U.S. 3rd world, but I'm not jumping in that bandwagon

Nope..it just ends up like public school. Two systems.. private for the rich and crap for the losers. We are in that transition now since Obamacare. Illegals and the general public can just walk in to a mess and the rich buy concierge

So your approach is private for the rich and nothing for the poor?

BTW ACA props up private medical insurance— in your education analogy it would be vouchers for private school not public schools.

The enshittification of medical care is caused by companies trying to extract more profit out of the system, not by the government encouraging more people to enroll in thr system.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The false notion that healthcare is a right. Meaning hospital level healthcare with the best technology, pharmaceuticals, surgeons, doctors, specialists and personalized coordination of it all for illegals or anybody else who just walks into a hospital with no ability to pay anything. While this is a noble (but lazy and childish) notion ... It degrades the whole system for everybody. Much like public schools have become sloppy, slovenly and somewhat stinky due to the same deeply flawed conflict between fantasy and reality.

It is a proper notion that first world countries assume.

I know MAGA is rushing to make the U.S. 3rd world, but I'm not jumping in that bandwagon

Nope..it just ends up like public school. Two systems.. private for the rich and crap for the losers. We are in that transition now since Obamacare. Illegals and the general public can just walk in to a mess and the rich buy concierge

So your approach is private for the rich and nothing for the poor?

BTW ACA props up private medical insurance— in your education analogy it would be vouchers for private school not public schools.

The enshittification of medical care is caused by companies trying to extract more profit out of the system, not by the government encouraging more people to enroll in thr system.

Not really. Tricare is government and a hot mess.