The problem with that theory is it might be right. The American system doesn't easily enable a revolution, so we'll wind up with people looking for more and more extreme candidates to change the system. Not looking forward to Trump Jr. or the Infowars guy getting elected in 2024. barfo
Why do we spend more than twice as much per person on healthcare than Canada and our healthcare is ranked #27 in the world vs. #12 for Canada? (WHO, 2018) There will always be anecdotal instances - but successful management of large systems that ignores overall performance for anecdotal evidence is a losing proposition, and healthcare, quite frankly, is a large system to manage. I am certain that there are things that the US healthcare is better at than the Canadian one, one of them is time for operation for specialist procedures, on the other hand, the wait time for initial visit on average in the US is 3 times longer (24 days vs. 8) than Canada. So, is it important that in the US you wait 2 days for specialist procedure vs. 10 days in Canada, if the average wait time from initial visit to procedure is likely longer in the US (24 + 2 > 8 + 10)? The numbers for the US healthcare system when you look at cost/value are not good, if you look at them objectively, and a large portion of the extra costs is the huge amount of overhead in the US system. Many hospitals in the US, for example, have more than 1 administrative clerk per hospital bed - because dealing with insurance claims for the patients is a nightmare. In Canada they average about 0.15 administrative clerks per hospital bed.
We spend more because too many people want their hands in making money off of it. There are too many middle-men in the US version of Health care. Government is one of those hands though. But what it has created is an artificial price gauging from the hospitals and Doctors offices to try to make money. In a system where there is actually a free market, no Insurance companies, no middlemen there would actually be posted prices, and fewer "mouths" to feed off of you and I going to the doctor. Right now our "spending per capita" is out of control because prices are out of control, and the reason for that IMO boils down everyone is trying to gain from it. Pharma, the Government, Insurance, Doctors, Nurses, Hospitals, etc. If the medical industry was more direct and had less write-offs and doctors not getting paid for their actual services the bills would be a lot less.
Government will always have a hand in anything you want regulated - and without regulation you will get scammers selling you miracle drugs, unaccredited people posing as health professionals etc... The very idea that the government is trying to gain from the system is absurd - the US government health services are not run as a profit center. The issue we have, quite frankly, is that there is not enough regulation - and that's why there are so many private insurance companies with very complicated schemes that make it so complicated and require the administrative overhead, the runaways pharma costs etc... The very fact that the system in countries like Canada, UK, Japan and the Nordic countries with more regulation are so much more efficient go directly against your claim that the issue is government inefficiency. The fact is, you need regulation because of the obvious risks that non-regulated large scale systems poses for critical services. What you want is to find some kind of a trade-off between regulation and innovation that brings to maximum efficiency. The problem in the US (and the numbers prove that it is an inefficient mess) is not because of over-regulation - we have more healthcare providers, insurers and schemes than any other modern country - yet we are the most inefficient of the lot. This shows that we err on the side of 'innovation' to a detriment of the system. Frankly, if we look at healthcare as a closed system and think of it as a very big company - we would all decry it as an inefficient mess where management (the government) does an awful job of regulating how all it's departments operate - and because of that it provides awful service at an exorbitant price. Better management would certainly improve this system - and suggesting that removing regulation from a failing system with less regulation than elsewhere would make it better is not likely to be effective.
You said "Government is one of those hands though. But what it has created is an artificial price gauging..." - so, it seems to me that you do equate it is with inefficiency. If you did not, it was certainly not clear from that sentence. Basically, if you are saying "cut the middlemen" - they options are: 1. Single payer insurance (Government) or 2. Wild wild west, no regulation, everyone can charge whatever they want for whatever service they want with no oversight. It seems that you are either a Bernie supporter despite your objection or believe in complete anarchy and pine for the middle ages when the barber surgeon would prescribe you a pinch of St. John's wort for anything from cramps to fever or a loss of a limb. I assumed that your "government is one of those hands" sentence put you in the #2 category - which is why I went on about regulation etc...
Your assertion on number two is mostly just you trying to phrase things a way that it's like ohh look how dumb you are if you don't think they way I do, I'm not falling for it. Everyone can charge what they want, but prices would be driven down by competition that is how competition works. A "really good" doctor can maybe charge more than an average one, but competition drives prices down. So no they can't charge whatever they want. I am saying that right now the Government plays a huge role in how high our prices are because so many government ran health systems don't pay a large chunk of their bills. So the price gets driven up to account for the people who are essentially not bringing in any money for the Doctor / Hospital / Etc. Ask literally just about anyone who does medical billing or works in finances in the health industry. You also seem to be saying there is no middle ground whatsoever which is almost never the case. You can have regulated industries that aren't beholden to making large profits for the few. Just because America is Crony capitalist doesn't mean it has to be. https://www.healthcaredive.com/news...-physicians-hospitals-far-more-than-m/445949/
My entire premise was about the middle ground - I will quote myself: "What you want is to find some kind of a trade-off between regulation and innovation that brings to maximum efficiency." I am not sure where you are reading it otherwise, but I stated it clearly. I am also saying that the problem of the US health care is not because of over-regulation, it is because of under-regulation and the free-for-all cumbersome system that is out there. The everyone can charge whatever they want is exactly what we have now for pharma prices - and it is a mess - so your idea that free for all is always better is just plain wrong. History has shown again and again that large systems with no regulation fail or become inefficient once they become large enough. It happened in the financial industry, in happened in all kinds of industries and our low regulation, everyone can charge whatever they want for healthcare system is proven to be very inefficient.
There is no free for all now because all the prices are hidden behind a substantial amount of red tape (both government and business). You have no idea what your services cost until they bill you. Your forced to go to certain doctors based on health insurances. Not even close to a free market in healthcare.
It is free for all - because there is no limits on what the pharma companies can bill you, same goes for Doctors, Insurance companies etc... This is the point I am making. More regulation - where you slash the power of private insurance, doctors, pharma companies etc... will simplify the system. Simple as that. Because there is so little regulation - it becomes so complicated to figure out what is what - and that's why administrative costs in the US are so high. Basically, you are calling for more regulation in transparency (so you know what everything costs) - but I think that's not enough, because healthcare is so complicated - I have had the pleasure of a colonoscopy recently (sucks to be old enough to have to do that stuff) - and there are 3 different providers before you even get to the insurance copays etc... (facility, doctors, lab) - and that's a routine precautionary procedure - just imagine a more complicated procedure... That issue is not lack of cost disclosure. Frankly, even tho I had these costs very clear to me, it's not like I can pick and choose, I can not choose a specific doctor, specific lab, specific facility - so getting this and doing comparison shopping is a time suck of epic proportions - that's not going to make it more efficient.
