Is the US health system collapsing?

[Anonymous]

Anonymous wrote:

Anonymous wrote:It isn’t collapsing. It has collapsed.

100%

When someone goes to the ER with chest pains & is waiting in the waiting room for 9 hrs instead of immediately being taken to triage, it's a broken system.

When an elderly person is diagnosed with having had a stroke in the ER & discharged with orders to follow up with a neurologist within 7 days, but the earliest appointment you can get them is 8 months out, the system is broken. My sibling and I sat calling with our mom to try to get my dad an appointment & this was the result. We have him on a dozen different waitlists but we're still 4 months away from his appt. Terrifying.

A friend went through something similar in finding a Derm. Her Derm couldn't get her in until FEBRUARY 2025 and she had a worrisome spot appear that was rapidly changing. After finding none that could get her in, she went the concierge Derm route. Luckily she had the funds to do so, but what about those who can't go that route? We're going to get to the point where those without the funds to seek alternate treatments get sicker or die while waiting.

The medical schools and accreditation boards keep doctors in low supply to keep wages up.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Yep and you know Trump has an amazing bigly plan to replace the ACA right??
LOL

Anything is better than Obummer's Unaffordable Care Act.
But hey, "free" health care for all these illegal migrants tight?

But Trump never came up with this "anything" , and even some Rs voted to keep ACA.

[Anonymous]

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.

You are aware that the majority of people who declare medical bankruptcy have insurance, right? Healthcare is only for the rich for serious medical problems. My sibling declared medical bankruptcy and makes over $150k a year. If one gets cancer, MS, or some rare disease, you better be rich!

yes which is why I stated: "who have good insurance.". Clearly your sibling did not have "good insurance".

[Anonymous]

Yes, how is this even a question.

We are now approving therapies that cost $5M per dose with HIGHLY questionable efficacy all because highly desperate patients can complaon that there are no other options. Pharmaceutical companies know this and sell people hope in a vial while raking in billions. Who do you think gets stuck with the tab for these insanely expensive therapies that might not even do anything? Taxpayers do. We also all do in the form of higher premiums to defray the cost. It's entirely a s show that will bankrupt the entire country and the HC system. But pharma gets to walk away with billions and huge bonuses for their CEOs.

[Anonymous]

Anonymous wrote:To the medical professionals and admins who have responded to this thread -

We can someone do - today - in the DMV to access better care?

Take a deuce on the lawns of some of your neighbors in Chevy Chase, Potomac, and Alexandria who all work for the whole insurance lobby, pharmaceutical lobby, AMA, and hospital lobby. The people right next to you in this area are the bottom of the barrel trash swamp rats ruining this country, destroying loves, and yes, are even killing lots of people by denying access to affordable medical care in this country. They're literally right next to you. Lobbyists should all be made public so we can see who is ruining the country.

[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

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

[Anonymous]

Anonymous wrote:

Anonymous wrote:It's an absolute sh!tshow.

I am a patient. Because of my condition, I have had several organs removed and my altered anatomy is often a consideration in treatment of other issues.

Because of this condition I need regular access to specialists. Primary care doctors typically punt anything even remotely related to my underlying condition to specialists. I have not seen an adult primary care doctor attempt to "coordinate care" among these specialties in decades (our kids' ped is better at this.) We recently attempted to find one who would actually do this work, at concierge rates, and could not.

About a month ago my GI attempted to prescribe a medication. This required a prior authorization, an appeal, and my giving my physician "power of attorney" to appeal for me--via fax. This was the only way they accepted the documents: fax.

The Rx was successful. I had a "discount card" for the copay so I paid $0. The charge to my insurer for the drug, which is available for $100 for a 30-day supply in generic in India, Canada and other nations where generic meds are routinely produced at high quality, was $5600 for a month.

Several other medications I use, which are not obscure, have been in shortage states or unavailable entirely in the last couple of years. (None of these are stimulants, by the way--I know folks are aware of those shortages; these are additional.)

Another family member has post-acute COVID and is seen by a doc in the GW Long COVID clinic. The doc is great but absolutely swamped. This family member has also needed care from across a range of specialties: cardiology, pulmonology, gastroenterology, urology, neurology, physical therapy. There is a protracted wait for each. The integrated institutional supports are nonexistent (I'm actually watching a National Academies webinar on this right now--their report is here: https://nap.nationalacademies.org/read/27756/chapter/1#ii) and I expect this to get worse and not better.

The waits are longer. Many specialists are leaving practice. My insurance (United Healthcare) just experienced a hack that prevented adjustment of claims for almost three months.

I am white, heterosexual, highly educated, and have made handling our health care an additional quarter-time job (sometimes more). The experiences of people who are also experiencing racial and other bias in docs' offices must be tens of times worse--let alone people who do not have platinum-plated health insurance (I have throughout) and/or lots of experience navigating this system.

It's falling apart. Large parts of it are irredeemable already. I don't know of a provider who doesn't also think this.

The grim reality is that if you require long-term medical care and services, it is more financially profitable for you to die.

They picked the wrong gal to bet on laying down for that nonsense.

[Anonymous]

Is it really good anywhere?

Last week there were big complaints in the UK about the NHS computer system that led to unfavorable health outcomes and deaths.

My friend couldn't find a PCP in Toronto for months.

Other countries are losing doctors to higher paying countries and don't produce enough specialists. People wait years for joint surgery, or months for oncology appointments.

How much of this is because medical science can do more so demand is higher for an increased number of treatments.

[Anonymous]

Anonymous wrote:Is it really good anywhere?

Last week there were big complaints in the UK about the NHS computer system that led to unfavorable health outcomes and deaths.

My friend couldn't find a PCP in Toronto for months.

Other countries are losing doctors to higher paying countries and don't produce enough specialists. People wait years for joint surgery, or months for oncology appointments.

How much of this is because medical science can do more so demand is higher for an increased number of treatments.

It's not "great" anywhere unless you have a lot of money, but at the least, if you get seriously ill, you will get free treatment in Canada and the UK, not so here. Medical bankruptcies is only a thing in the US.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It isn’t collapsing. It has collapsed.

100%

When someone goes to the ER with chest pains & is waiting in the waiting room for 9 hrs instead of immediately being taken to triage, it's a broken system.

When an elderly person is diagnosed with having had a stroke in the ER & discharged with orders to follow up with a neurologist within 7 days, but the earliest appointment you can get them is 8 months out, the system is broken. My sibling and I sat calling with our mom to try to get my dad an appointment & this was the result. We have him on a dozen different waitlists but we're still 4 months away from his appt. Terrifying.

A friend went through something similar in finding a Derm. Her Derm couldn't get her in until FEBRUARY 2025 and she had a worrisome spot appear that was rapidly changing. After finding none that could get her in, she went the concierge Derm route. Luckily she had the funds to do so, but what about those who can't go that route? We're going to get to the point where those without the funds to seek alternate treatments get sicker or die while waiting.

So much truth. I'm also helping my elderly parents navigate health issues and it's insane. You can't reach actual humans have have to wait for return calls. When you do get to speak with someone, there are no appointments for necessary specialty care in the time you need it. Patients are told to go to the ER if things get too bad. When you do that, the patient has to deal with long waits and is not able to get a room for days. It's terrible. I never want to hear people complaining about patients using the ER again - there isn't care available anywhere else.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It isn’t collapsing. It has collapsed.

100%

When someone goes to the ER with chest pains & is waiting in the waiting room for 9 hrs instead of immediately being taken to triage, it's a broken system.

When an elderly person is diagnosed with having had a stroke in the ER & discharged with orders to follow up with a neurologist within 7 days, but the earliest appointment you can get them is 8 months out, the system is broken. My sibling and I sat calling with our mom to try to get my dad an appointment & this was the result. We have him on a dozen different waitlists but we're still 4 months away from his appt. Terrifying.

A friend went through something similar in finding a Derm. Her Derm couldn't get her in until FEBRUARY 2025 and she had a worrisome spot appear that was rapidly changing. After finding none that could get her in, she went the concierge Derm route. Luckily she had the funds to do so, but what about those who can't go that route? We're going to get to the point where those without the funds to seek alternate treatments get sicker or die while waiting.

So much truth. I'm also helping my elderly parents navigate health issues and it's insane. You can't reach actual humans have have to wait for return calls. When you do get to speak with someone, there are no appointments for necessary specialty care in the time you need it. Patients are told to go to the ER if things get too bad. When you do that, the patient has to deal with long waits and is not able to get a room for days. It's terrible. I never want to hear people complaining about patients using the ER again - there isn't care available anywhere else.

My mother abroad had to wait for the health system to send her letters for appointments. They sent her one for a CAT scan for a very bad headache. It arrived a week after a brain hemorrhage - the headache was an indication of the looming hemorrhage. She should have been sent straight to the ER by the doctor, which is where she ended up anyway in the middle of the night.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It isn’t collapsing. It has collapsed.

100%

When someone goes to the ER with chest pains & is waiting in the waiting room for 9 hrs instead of immediately being taken to triage, it's a broken system.

When an elderly person is diagnosed with having had a stroke in the ER & discharged with orders to follow up with a neurologist within 7 days, but the earliest appointment you can get them is 8 months out, the system is broken. My sibling and I sat calling with our mom to try to get my dad an appointment & this was the result. We have him on a dozen different waitlists but we're still 4 months away from his appt. Terrifying.

A friend went through something similar in finding a Derm. Her Derm couldn't get her in until FEBRUARY 2025 and she had a worrisome spot appear that was rapidly changing. After finding none that could get her in, she went the concierge Derm route. Luckily she had the funds to do so, but what about those who can't go that route? We're going to get to the point where those without the funds to seek alternate treatments get sicker or die while waiting.

Is this small town USA?

[Anonymous]

For ER and neurologist?

[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).

Short answer - yes.

Longer answer: First, I refuse to call what we have for healthcare in the US a "system" because a system is something with a a lot of disparate parts working together. That's not what we have. We have something more like a scheme.

Many things in the US are breaking down based on whether you are upper class or lower class. If you are upper class with money or good health insurance you will be fine. If not, then you won't. Our life expectancy is declining. Our maternal and infant mortality rates are shameful (but we have one political party obsessed with forcing women to carry all pregnancies to term instead). And worst of all, we have been gaslit into thinking this is all normal and not an absolute travesty.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It isn’t collapsing. It has collapsed.

100%

When someone goes to the ER with chest pains & is waiting in the waiting room for 9 hrs instead of immediately being taken to triage, it's a broken system.

When an elderly person is diagnosed with having had a stroke in the ER & discharged with orders to follow up with a neurologist within 7 days, but the earliest appointment you can get them is 8 months out, the system is broken. My sibling and I sat calling with our mom to try to get my dad an appointment & this was the result. We have him on a dozen different waitlists but we're still 4 months away from his appt. Terrifying.

A friend went through something similar in finding a Derm. Her Derm couldn't get her in until FEBRUARY 2025 and she had a worrisome spot appear that was rapidly changing. After finding none that could get her in, she went the concierge Derm route. Luckily she had the funds to do so, but what about those who can't go that route? We're going to get to the point where those without the funds to seek alternate treatments get sicker or die while waiting.

The medical schools and accreditation boards keep doctors in low supply to keep wages up.

And to keep the profession prestigious.