The deeper problem is the demographic pyramid. We have lots of old people and the younger generation is smaller. Of course there's not enough caretakers, which is why the US systematically imports them from other countries, leaving those countries with the same problems.
Ultimately, there is no escaping the market. No amount of public-funding, socialism, or outright communism can escape the simple facts of supply and demand. Right now, medicine is expensive because demand exceeds supply. Do insurance companies and bad administrations exacerbate that? Yes, of course they do. But they are only exacerbating an existing problem.
You assume the cost of new therapies is workable simply because it’s more efficient than existing.
In reality many existing therapies are all pushing the system into debt and unworkable (for example it overcharges the healthy in order to subsidize the ill).
The reality is $2 million price tag may be acceptable to a multi-millionaire but unworkable for a 40 year old who makes $50K/yr.
After certain age and cost level, the math just doesn’t work out. It’s tough, but once you realize you don’t have the natural right to free or subsidized healthcare, it’s easier to accept.
You don't have a payment system problem in America. What you have is a cost problem. You need some form of government intervention to prevent healthcare providers and drug companies from charging the most optimal price (the one at which they make the biggest medium-term profit), because the most optimal price is the one at which a lot of poor people die and middle-class people go bankrupt.
That is, you don't have to look for solutions for how to find enough money to pay for health care for those who can't afford it right now, you need solutions for how to bring the price down.
The problem is that we're in debt, and there's no one to pay for it, especially with the costs of healthcare increasing, rather than decreasing, as they should when technology improves.
The biggest problem with healthcare is that doctors are sued if they don't provide state of the art care. So there's an incentive to produce more and more expensive drugs and technologies, and no (or at least insufficient) ability to trade off cost vs. effectiveness.
But who is going to pay for it? There are more and more amazing machines, treatments and medicines available every year and soon it will be impossible for society to pay for it. And the longer our lifetimes extend thanks to one treatment, the more treatments we can use in a lifetime, and the cost increases even more.
It's for sure going to become a dilemma going forward (and already is today). Saying that costs will simply go down with volume will likely not be true. At least that is not what the trajectory for the last 50 years has been.
People would hesitate to pay these large sums themselves, if at all they could, and people don't like higher taxes.
Well said. Can we also work on the supply of medical care? We keep giving more and more people insurance which increases demand without doing anything to increase supply and then wonder why prices go up.
For one, doctors educational costs are astronomical in the U.S compared to other countries. The amount of people able to become doctors is artificially limited. Drug prices are unregulated. The cost of developing drugs is high and has been getting higher.
Hospitals have little price transparency and the cost of same procedures at different hospitals is wildly different. The same bag of saline can cost 10x more at one hospital vs another. In markets where there is price transparency, like Lasik surgery or other elective procedures, the prices are far more sane.
One thing that spending double as a percent of GDP on health care and getting worse outcomes proves is that THE SOLUTION TO THE PROBLEM IS NOT TO SPEND MORE MONEY. Unfortunately, this is the only thing American politics knows how to do as more money means more money for every special interest with their hand out.
That's not what happens in practice - a government has a lot more negotiating power, and less skin in the game, than individuals who need the treatment. Governments can and do sometimes refuse to pay treatments that are too expensive. This may cause citizens who want that treatment to be upset, but for 99.99% of treatments it leads to them being a lot more affordable.
There is no "the" problem of healthcare. There are many, many interlocking issues that combine to drive up prices at every step of the way in every corner of the industry.
This might help a little bit, but there is no silver bullet.
Whatever the US does, it needs to realize that the artificially constricted supply of healthcare needs to be loosened. If we throw more money at consumers for healthcare while keeping the tight supply of doctors and hospitals constant, then you just end up paying more money for the same services. Prices go up, doctors, hospitals and insurers get richer, nobody else is better off.
reply