I’m not disagreeing with you at all. There are multiple causes. I was just pointing out that the healthcare system is a negative feedback loop making it all worse.
During a trip to Berlin a number of years ago my knee swelled up to the size of a cantaloupe. Hurt like hell and after resting for a day and taking as much ibuprofen and tylenol and I could we made the decision to go to a German ER knowing it would be a hassle.
First hospital ER wasn’t open on Sunday so we had to taxi to one that was open. Since I did not have life threatening issues I waited all day and finally got in about 7 PM that night.
Doctor came in ordered an ultrasound, did bloodwork and wanted to admit me with possible surgery the next day. Um…that seemed a little extreme so we said no. They supplied me with blood thinner, better pain meds, crutches, and another med that I’ve forgotten and sent us on our way.
The flight home was no fun but the next day I was able to get into my doctor where they drained 81 ml of fluid out of my knee! Normally, they said, the knee holds about 4. No idea what the visit cost me at the time (maybe $50) and they probably charged the insurance company several hundred dollars.
Anyway, we finally go the bill from the German ER. 150 Euro’s. That’s it. And then we spent weeks trying to figure out how to pay it since they just didn’t deal with Americans at all. Eventually we had to give them an ACH number to pay it. I still say it was the best 150 Euro’s I’ve ever spent. I think the hospital was going just write it off.
We’ve had American friends in England and France get sick and have ER visits and surgery and lengthy stays and have had inexpensive bills. Every one of them shakes their head and how the billing part is the least important thing there where it’s on everyones mind in the US.
I don’t know what the answer is for the US health system but I know it sucks for many, many people. Life outcomes dramatically improve for people that make it to age 65. Why? Because of Medicare which is a nationalized health care system. Under that age and something major will place a huge burden on you financially and it’s the number one cause of bankruptcies in America.
1 Like
Can confirm. It is the right order of magnitude.
Oh certainly the health care system is implicated in the drop
As well there are several other causes that are cited that arent immediately the health care system
In this regard the USA is the ONLY country in the G7 and G20 that has had this occur
Nothing in the USA will get better until the donations aka bribes from lobbyists halt.
Corruption loves complicated processes.
2 Likes
Let me say it so: when I need to go to the Hospital I am not even thinking one second about any billing but I am thinking about stuffs I have to do before that my Company can run and so on. The last time I was in hospital the laboratory was 7900 Bucks. I had nothing to do with it, the insurance paid. And I had only to pay: 10 Euro per day. People which have no incomes or at least less than around 9000,- per year can apply not to pay at all.
Also if I need a surgery: costs nothing. When they decide: we need MRT controls of the entire Body: I have nothing to do with it. That is the nice part on the German system.
Oh no, there will not change anything. I needed to go to the dentist in USA when I was there before around ten years. I had to pay for a small thing (extract one) around 970 Dollars. I would want to say: in Germany I would have to pay: attention not to hit the dentist because it is fucking hurting 
All your observations are correct. I’d argue the base problem is that the US system is for-profit, and any system optimized for any random factor X (profit in this case) will be de-optimized for other factors (patient health / well being in this case).
We have had it drilled into us that the profit motive is uniformly and inherently benign and even virtuous, so we tend no to question it. It is not a straight up either/or question of capitalism being good or bad, but in this case it is VERY bad. Healthcare should be non-profit, highly transparent and properly managed to guard against fraud.
That is too much chewing gum and walking at the same time for our politicians.
Even Medicare has its limits. There’s a lifetime payout limit on hospitalization. It’s high, but it’s there. There are pretty significant co-pays, which can eat you alive unless (and sometimes even if) you have a medigap policy to plug that leak. It doesn’t cover medication, which is ridiculously expensive here, although, I have managed to get a prescription drug policy that has worked fine so far, for a mere $12 a month, to cover 80% of my costs. I bristled at first when that policy refused to pay the cost of an inexpensive drug until I figured out they simply wanted me re-prescribed for two 4mg tabs a day instead of four 2 mg tabs, which is actually a reasonable cost optimization for them to do.
Anyway – someone outside the US reading this will see that there are dozens of moving parts that don’t always work well together if they work at all, and be thankful they don’t have to deal with it.
Yes the common mythos is that “the market will find the best solution”
But thats not true
Its like evolution - it will find A solution
But it may be complex, suboptimal, generate bad outcomes, and all sorts of undesirable effects as “the market” flails about trying to find better solutions (much like evolution)
But the seemingly universal belief is that “for profit” is somehow “best” and there’s no room for other options
And not JUST in medial care - all sorts of places
VERY much so and I fight against our provinces moves towards more for profit care every chance I can
Scotland also.
What is the cause?
It’s either deep fried mars bars and heroin or the SNP.
That is indeed something Europeans struggle to understand:
https://www.motherjones.com/politics/2023/03/medicaid-pandemic-coverage-end/
of course it’s anything else but not Brexit…
However, the deep fried marsbars sure aren’t helpful either. I consider myself to be very tolerant, but these things literally cross every boundary of good taste. I get sick just imagining it
Unless Brexit happened 30 years ago it has nothing to do with it.
Scotland’s drug related death rate is 3.5x that of the rest of the UK.
Of course if something goes wrong in your life feel free to blame it on Brexit 
Life’s pretty good in Brexit central though 
Brexit has nothing to do with the decision of people to take drugs.
Exactly, but drugs might have led people to support a decision like Brexit
2 Likes
Scotland had the strongest remain vote which suggests you’re looking through the wrong end of the telescope.
2 Likes