Thoughts on the American health care system

Part of the US health care system

For years, for-profit health care seemed to be inefficient. The main focus always was increasing profit, sometimes at the expense of health and occasionally life. An opinion piece comments:

Doctors have long diagnosed many of our sickest patients with “demoralization syndrome,” a condition commonly associated with terminal illness that’s characterized by a sense of helplessness and loss of purpose. American physicians are now increasingly suffering from a similar condition, except our demoralization is not a reaction to a medical condition, but rather to the diseased systems for which we work.

The United States is the only large high-income nation that doesn’t provide universal health care‌ to its citizens. Instead, it maintains a lucrative system of for-profit medicine. For decades, ‌at least tens of thousands of preventable deaths have occurred each year because health care here is so expensive.

During the Covid-19 pandemic, the consequences of this policy choice have intensified. One study estimates at least 338,000 Covid deaths in the United States could have been prevented by universal health care. In the wake of this generational catastrophe, many health care workers have been left shaken.

“For me, doctoring in a broken place required a sustaining belief that the place would become less broken as a result of my efforts,” wrote Dr. Rachael Bedard about her decision to quit her job at New York City’s Rikers Island prison complex during the pandemic. “I couldn’t sustain that belief any longer.”‌

A 2020 research article commented:

Although health care expenditure per capita is higher in the USA than in any other country, more than 37 million Americans do not have health insurance, and 41 million more have inadequate access to care. .... By contrast, a universal system, such as that proposed in the Medicare for All Act, has the potential to transform the availability and efficiency of American health-care services. Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations. This shift to single-payer health care would provide the greatest relief to lower-income households. Furthermore, we estimate that ensuring health-care access for all Americans would save more than 68,000 lives and 1.73 million life-years every year compared with the status quo.

The chances of reducing the influence of the profit motive here is nil. Lobbyists, campaign contributions and rigid radical right political ideology help keep the US system unjustifiably expensive and far too complex. The complexity (paperwork, barriers to access, etc.) alone adds tens of billions in annual costs, about $265 billion/year by a 2021 analysis. 

That analysis commented: "The administrative complexity of health care is profound." Well, duh! 

The profit motive forces a lot of needless spending on us.

By Germaine