Why America's Healthcare (Sickcare) System Is Broken and Unfixable
(July 16, 2014)
Here's a two-word summary of why the American healthcare system is fundamentally broken and cannot be fixed with policy tweaks: perverse incentives.
If you type sickcare in the custom search box on this site, you get 10+ pages of articles. I have covered healthcare/sickcare in depth for many years. I have many correspondents within the sector (doctors and nurses), and have paid the unsubsidized costs of insurance as an employer or as a self-employed worker for 30+ years.
Here are two charts and three stories of many I've published over the years:
ObamaCare: The Neutron Bomb That Will Decimate the U.S. Economy (November 21, 2013)
Greed + Cartels = U.S. Sickcare/ObamaCare (February 13, 2014)
Obamacare is a Catastrophe That Cannot Be Fixed (December 6, 2013)
The unsubsidized cost of Obamacare for two 60-year old healthy adults ($23,244 annually) for an inferior plan to what we had before exceeds the cost of rent or a mortgage for the majority of Americans. Please ponder this for a moment: buying healthcare insurance under Obamacare costs as much or more as buying a house.
Here's a two-word summary of why the American healthcare system is fundamentally broken and cannot be fixed with policy tweaks: perverse incentives. Physician Ishabaka provides a telling example of how perverse incentives operate beneath the surface of what patients (and clueless politicos) see:
Today I saw a 16 year old boy who weighed 310 pounds - the wave of the future - will have type II diabetes by his 20's, probably have at least one leg amputated by his 40's.
Meanwhile, elsewhere in the world, equivalent care is affordable. Since the advanced, developed nations of Taiwan and Japan both provide care for one-third of what the U.S. spends per person, we already know that fully 65% of what we spend on sickcare is waste, fraud, defensive medicine (i.e. medically worthless tests given to stave off future lawsuits), profiteering, racketeering and paper-shuffling.
Consider this report from correspondent Barry P.:
I've been visiting the Philippines and came down with an ear infection. I tried to allow my immune system do the work, but after 3 days of no improvement my wife dragged me to the hospital, Makati Medical Center (MMC). MMC is one of two-or-three hospitals that the well-to-do go to when the need arises. Just as modern as the average US city-hospital. I have no health insurance in The Philippines.
I have direct experience of similar costs in Thailand and China for care that was as good or better than in the U.S. (i.e. minimal waiting and paperwork, caregivers were polite, care was efficient, test machines of the exact same type and brand as in the U.S., etc.).
Correspondent M. submitted this report on the change in U.S. healthcare from a non-profit community-based hospital system to a centralized profit machine:
I reviewed this same topic with 3 different MD practitioners in recent months and ALL said the same thing!... namely, that medical care transitioned from local community MD non-profit run, into psychopath MBA profit run (at the hospital level) starting in the 1970s. They emphasized or gave examples of how the effective local non-profit MD run community hospital was taken over by for profit MBAism, typically with huge buyouts of the previous MD non-profit operators. Medical care became just another avenue for system wide racketeering via transition from local to larger system (i.e. racketeering).
Large-scale rackets like sickcare cannot survive without a Central State that
collects taxes and funnels the proceeds to the racketeers, who of course have
bought political influence with their plundered profits. This is a self-reinforcing
system that cannot be reformed in any meaningful way. It will bankrupt the nation and
then we'll have a chance to start over with an affordable, efficient, fair
system that is focused on prevention and health rather than profiting from disease, fraud and lawsuits.
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