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As long as we allow only choices between republican and democrat politicians this will remain. No system they initiate will end this. !NONE! Nothing being proposed today will end this.

William_Mary 8 Jan 25
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As a healthcare practitioner, if healthcare is a right, who provides it? Do you force people to go into debt for school to provide for others' needs? I think we both can agree that our hybrid system is not working. We do not have a free market for healthcare, we do not have a truly state sponsored system. But the solutions proposed in the recent presidential debates do not pass the common sense test. On the other hand, a truly free market has created cell phones that do more in the past 20 years-memory, cameras, etc. While taking an MBA in healthcare management, a classmate from a European country with universal coverage despaired of her fellow citizens with money going to countries with a free market healthcare system to "skip the line." I believe this will happen in the US as well. Do you expect Jeff Bezos not to have his own medical team? This was also seen in Canada 10 years ago: [medpagetoday.com]

My proposition would be to focus more on primary care and ensure those physicians are appropriately compensated. In 2012 (sorry, best link I could find) physicians in the US were only responsible for about 5% of healthcare spending: [forbes.com]

And another link from Forbes about the economics of healthcare: [forbes.com]

Surchin Level 7 Jan 25, 2020

No one is forced to go into debt for education. That is a choice freely made. And college ought to be made free or at least be heavily subsidized enough to where people need not go into debt to afford it.

Free market heathcare is on the same level of terrible and immoral as free market firefighting or free market policing. Desperate people facing danger should not be subjected to the whims of capitalism.

@RoboGraham you are now changing the argument my friend. Do you pay for insurance? No one is forcing you to do that except the state (car insurance, affordable care act), the bank (homeowner's insurance if you have a mortgage). Do you have a mortgage? No one is forcing you to go into debt to buy a house... I disagree with the thrust of your argument at a fundamental level. Do you want more bankers-which physicians are definitely able to do-but not all bankers can become physicians...
I agree it should be more affordable. What is your solution? More taxes? All physicians become federalized? As an Army veteran and eligible for care at the VA-they have some of the worst charting systems and limited access to care. How about people take responsibility for themselves-stop smoking, eat a better diet, exercise more-rather than expecting a pill to treat their blood pressure, diabetes, and lung disease.

@Surchin I have no other option but to pay for the insanely expensive insurance that doesn't even cover everything or else I will die. If your house is on fire, you are in no position to argue and haggle with the firefighter. You pay up or lose everything. It's the same scenario regarding healthcare for anyone with a serious illness.

More bankers? I'm not sure what you are getting at there.

The way to make healthcare affordable is to remove the middle man, the for profit insurers who enrich themselves with money that ought to be used for providing actual healthcare rather than lining the pockets of some fat cat. A rational single payer universal system will be massively more efficient and cost effective. It will remove a great deal of the bloat and redundancy in the current system. It will significantly reduce the cost of healthcare for the average person because any minor tax increase will be minuscule in comparison to the thousands per year people are paying now. The entire country will be healthier and more productive because of it. As it is now, millions of uncovered and under-covered people avoid or postpone accessing care because it's just too damn expensive. So illnesses which would have been no big problem if caught early, progress into major issues requiring even more expensive interventions.

The VA does not offer excellent care because it is underfunded. The health insurance lobby has our politicians in it's pocket. They can't have a good example of government funded healthcare functioning well because it will become a model for the entire system. Their main goal is to avoid the populace from demanding a rational system so they keep the VA underfunded so it will function as a negative example of government funded healthcare.

I agree that people ought to live better and be healthier. But that sentiment does nothing to fix the problem of our dysfunctional healthcare system. Some people will be sick regardless of the diet they eat and the amount of exercise they do. Some people are going to get injured even if they are in tip top shape. Our current healthcare system discourages people from seeking preventative care. They only go to the doctor when absolutely necessary because it's so expensive. So they don't get properly informed about the dangers of these harmful behaviors and they don't get those regular check ups to keep track of how unhealthy they are becoming over time. A universal system will do much to improve the health of the nation. Both the physical health of the people and the financial health.

@RoboGraham The time to discuss and plan insurance needs is before the fact, not at the time of need. Same thing with the fire department. I am sorry for what you are going through, it must be tough needing the insurance that probably seems to not be doing enough. You are seeing healthcare from that lens, and I can only imagine what it is like. I agree health insurance companies are part of the problem. Around 2017-18 timeframe there was an article how the 20 CEOs of the various Blue Cross Blue Shield companies made over $110 million between them. That was money that did not go to employee salaries, lower premiums, or physician salary.

More bankers refers to everyone doing what they see as being in their own self interest. Doctors are not stupid people. If their pay continues to go down, future, potential ones will make changes in their career becoming bankers, lawyers, etc. rather than being physicians.

We do not have a healthcare system in the US. It is a system of systems that do a bad job of communication with each other, and more importantly, the people they are supposed to serve. There needs to be a focus on preventative care. Removing the middleman, the insurance company, from all but catastrophic care can also help reduce costs to the population as a whole. There is a direct primary care movement where the patient pays a "subscription" fee directly to the physician for unlimited care during the time. Often around $75 a month. No insurance involved. Insurance is for the catastrophic problems like heart attack, stroke, appendicitis. This does a couple of things. It allows a physician to know there is a steady stream of of income. Physicians can have smaller numbers of patients which allows for greater access to care. It can reduce the burden on ERs since there is greater access to care. And $75 is often less than the ER co-pay even with insurance. Labs are at cost or at a much lower premium than commercial labs. Here is a link for one such place [atlas.md]

@Surchin it's a proven fact that healthcare can be vastly cheaper on a socialized scale which can be worked at the end of the year when doing your taxes. In 2016 Sanders proposal was approximately $700 for a single middle class person. At the time that would have been approximately 2 months of what was drawn out of my pay at the time. Saving me 10 months of further payments for the rest of the year. That's approximately a $7000 dollar savings in a year that can go towards a hell of a lot of other things, mainly retirement. Why in the hell would anyone want to continue supporting over bloated CEO incomes, bonuses, failed red tape procedures, etc in continued support of a system where it seems like we are paying for better healthcare systems for people around the globe? Because basically that is what we are doing. The population of the US is basically being used to subsidize the rest of the globes universal healthcare. I personally want the same as they get.

In some places they get free transportation to and from their appointments and hospital stays. Reimburse for bus fares if that is the case. Home visiting childcare (nannies) while they're away to their appointments.

We're plainly being hoodwinked on healthcare in the US for manipulated profit needs. And it's well past time for our representatives to do something about it other than depending on their share of the scam being perpetrated on us.

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