As a self-employed guy for most of my life who had to secure health insurance in the private market-place and as a Vietnam veteran who now is covered by the VA, I think I'm in the almost perfect position to pass judgment on this video. And that is that this is the most honest, unbiased and factual report on this subject I have ever seen! VERY HIGHLY RECOMMENDED FOR ALL.
I think something that gets left out of these debates is stress. Even if the costs were the same I'd want the system where I never have to think about money while I'm going through cancer to the system where I have to deal with bills and bankruptcy while going through cancer.
That is what I have here in Denmark. Peace of mind is such a relief. I learned that when I studied in Beijing and my ball sack began to hurt like hell. (It was an air bubble in a blood vessel) the Beijing doctor told me it was cancer and it would spread to my heart unless I had a 50,000RMV surgery soon. I did not believe him. My doctor in Denmark told me, either that doctor tried to scam me, or he was unable to read a simple Ultrasound picture, that means he was incompetent. So yeah peace of mind is such a relief it is amazing. That is why I want dental to be free here as well. I am the sole provider, no job, I am during my master's thesis right now. And I have big holes in my teeth that really need to be fixed.... but I don't feel like I have the funds. But if I wait till I have a job and it gets worse then it might be even more expensive -_-
My mother was lucky enough to be treated for her (now eradicated) cancer with no financial worries. Unfortunately, it took the sacrifice of my now deceased father as a military service member and Vietnam War's Agent Orange exposure survivor to make that happen.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.-,.-,-.,-,.
As a senior Australian, one of my biggest fears is Australia sliding into an American style of healthcare. I've always relied on the Australian public healthcare system and have never had any problems with it. I see my doctor twice a year for a check up and pay only about six bucks for prescriptions. Once a year I have a raft of blood tests which the system covers.
@@pinetworkminer8377 ,, for a start, the US system is a profit driven system . Medications are very expensive over the counter, there is a network system where health professionals, pharmacists etc work within networks. Any treatment outside the network won't be covered by insurance. Also, insurance companies can deny or offer a 'lesser' treatment/medication than your doctor has prescribed. My greatest fear is not being able to afford healthcare when I need it.
The idea of bankruptcy due to medical debts. That sort of overhead is an anchor on just about every business decision one makes, once you get past the invulnerability of youth.
Another great video, thank you for continuing your work! I'm a pharmacist for a large "not for profit" health system in the US and the inefficiency of just the my section of healthcare is astounding. One problem I see in the US is that most citizens cannot fathom the idea that another country is doing something better than us. They refuse to look outside of the box of US exceptionalism for anything that could make their lives healthier, safety, less expensive... it's kind of depressing to know that we waste so much money on everything from healthcare to education to military spending...and the majority of the population won't open their eyes.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
Well said. You didn't say it, but I will: American's are ignorant, lazy, selfish, uneducated, juvenile. I am not saying that everyone is, but as a whole, that is where we are. We allow stupid people like Trump, Mitch McConnell, MTG, Lauren Boebert, Jim Jordan, Matt Gaetz, Ted Cruz along with many others like them to run our country. Truly, we are doomed for catastrophic failure. We have already crossed the line over that milestone! Sorry, but it's true.
The ironic part of that statement is you actually get pretty good self and family health coverage if you go work on those bombs, drones, etc. You know actually earn that cover instead of demanding it for free.
@@swampcastle8142 The bombs aren't free either and spending megabucks on bombs that are gone when used is a waste of money. Universal single-payer healthcare builds a healthy population. Why do you think Bismarck provided healthcare to the German people back in the 1883? To build a strong, healthy population.
@@swampcastle8142Americans spend 18% of our GDP on healthcare. Most wealthy nations spend about 9-10% and have better outcomes and universal coverage.
@brianfleury1084 Every country that I was stationed in that had single source or universal health care had the worst care for the local population. So no thanks. Rather have the bombs. (Unhealthcare)
@@swampcastle8142yeah sure, "EARN IT" its not like the millions of people workin around the USA, serving your food, building your houses, raising your children, educating said children have actually done ANYTHING to earn healthcare... bunch of lazy MFs... amirite?😊
@@arnodobler1096 nuking hurricanes, stop testing to reduce cases...there's just so. damn. many. My absolute favourite is from 2016 where he told his followers at a rally that he thought his MAGA-slogan was corny and stupid but it tested well in focus groups so he's using it...and the crowd erupted in furious applause. It's just insane.
It bugs me that people don’t realize that we’re all in this together. If I have a medical emergency and can’t pay for the treatment they already performed, that loss gets passed on to the community. It’s a big game and the loser is everyone who is struggling to keep up.
The most ridiculous of all is that USA is already spending similar % of tax payer money on healthcare compared to European countries with mostly tax funded healthcare, yet it's still expensive AF and we haven't even started to count the money patients have to pay on top of that tax money. Everyone would benefit from cutting out private middlemen from the equation, healthcare would be affordable or even almost free for pretty much the same price as everywhere else... you just don't have to pay yourself sick dealing with private companies. But alas, that cannot happen because it's "evil socialism". The idea of paying for healthcare of somebody else and yourself is just too much for some people to handle, even if it ends up being cheaper for themselves too.
@@spugelo359 all that shows is that americans are selfish and dont care about their citizens. A healthy society is so much cheaper than a sick society!
🎯. Truer words have never been spoken! If US had both a better fully funded public education system as we did in the 40s-80s & unions, I believe the idea of unity, fellow Americans working together for the common good would be possible. The uber greedy rich oligarchs have changed all that by being able to buy politicians to change our laws, our workplace, and educational system. It's mostly privatized and under their control. Too few Americans understand what "common good," even means. If they don't see that you're filing medical bankruptcy doesn't effect them directly, they stay apathetic and ignorant...until it happens to them. Which it can because no one is guaranteed any right to healthcare in our country like other countries are. Greedy oligarchs. They have been our problem Day 1.
I’m in Texas. It’s amazing how much I pay for my own health insurance through my employer and costs on my own. I feel I’m being ripped off monthly, but too busy working to slow down. I’m too busy working to slow down for sick days. I look at how many people are uninsured or can’t go to a doctor or buy medicine & actually feel lucky. This just grinds the working class down. Then we have elite anti-abortion groups pushing for more babies to be born by the poor (rich will have abortion access), and I wonder how anyone pays for prenatal care, birth in a hospital, postnatal care. Give me a break. Literally.
Love your delivery, and how you really make some complex issues easier to understand and to explain to others when debating a subject. I must say I never really considered the tie in with education and tort reform in trying to reform Americas health care system.
Ashton, you have actually managed to make me understand for the first time in my life, why the US is not in a position to change the health care system so easily. The way all these things are interwoven there is not much hope to see change in the forseeable future I fear. Let me repeat what I stated earlier this year: You are an excellent teacher!
10:09 Ronald Reagan Advisor "We are in danger of producing an educated proletariat. That’s dynamite! We have to be selective on who we allow [to go through higher education].” So they literally created Student Loan programs "Before Reagan became governor of California, tuition was free for California residents... Reagan began cutting state funding of public universities by 20%... His justification was that colleges have become too liberal" "When Reagan became president, he continued his efforts to dismantle the public education system, targeting federal aid to students. In his campaign for the presidency, he advocated for the total removal of the U.S. Department of Education." Project 2025... Trump is planning on dismantling the Dept of Ed Uneducated people do what they are told and don't question authority
The US is not in a position to change it, simply because about half the country doesn't want to change it, and any time progress is made towards changing it, the other half undoes the progress.
Her video isn’t really that great, a lot of mistake and overlooking big issues that would get in the way of medicine here. We have a unique population those European models wouldn’t work here
MIXED healtcare system where GOV decides what can & can't be. 60% of all dollars in the system is from TAXPAYERS. OBAMACARE the UNaffordable Health Care Act is a preponderance of GOV regulations FORCING the private sector into offering what it doesn't want to. Alex Epstein 's "FOSSIL FUTURE" on sale now.The Moral Case for Fossil Fuels. HUMAN FLOURISHING
Good friend of mine is from UK. He got moved around as an exec for his company, from UK to France to Italy and finally to the USA. He has a wife and three sons so his family fully experienced all four systems. I asked him how does the US system of healthcare compare? His succinct reply - "Healthcare in America is arbitrary cruel and frightening"
one interesting aspect of healthcare in the US is that your insurance in your home state, does not automatically cover you in another state. in reality this just means that going to a doctor in a different state, say while you are traveling for work, will result in a potentially astronomic 'out of network' bill. Imagine having a heartattack in a different state, and then getting a bill afterwards that will give you a stroke.....
This topic is so huge and all-inclusive that it resembles the car-dependency situation in the US of A. “Fixing it” would entail so many changes that it next to impossible to imagine where to start. To me the basic line is the people themselves, the voters. Only when they no longer accept the current situation and demand a different, a better system things can start to improve. Your nurse example was revealing. She is not willing to give up her humongous salary in favour of a better system. Understandable, since it is the foundation of her life choices. These things can never be made individual but need to be universal. Hence the term universal healthcare. If it is your personal responsibility not to get killed in traffic, you buy a giant SUV and make sure YOU are safe, high and dry in your vehicle. The fact that other road users may get killed in the process is their problem, not yours. The same applies to healthcare.
It’s not as hard as you think. It takes one step. Get rid of capitalist intrestgroups from politics. Aka ban fucking lobbing and corporate donations. US has a massive real economy and a fiat currency. Which means money and goverment spending never could be an issue. The more the goverment spends on projects the better. It would eat into capitalist’s profits tho, that’s why it’s not happening. Same goes to US car dependancy, scarsity of housing, poverty and inequality and so god damn many other problems. Just fucking take back politics from the corporations...
@@azpont7275 the biggest problem of universal healthcare isnt that its not affordable but rather that the moment you implement it so many people that are currently not able to get real care would use the system that for the first dozens of years or maybe a bit more it would be incredible pricey. the US basically fucked itself with such a bad system that it cant change it without massive spendings now.
The three highest paid jobs in Australia are surgeons followed by anaesthesiologists followed by specialist physicians. We have universal healthcare but with the option of buying private health insurance if we want some of the non-critical extras like private room, choice of doctors, shorter waiting time for elective surgery. You'd probably find that preventative health care gets a higher priority as well, which will keep costs down.
@@rey6708The US pays already far too much for Medicare, Medicaid and VA Medic. They (poor, elderly and veterans) represent about 20% of the population and it costs the same (percentage of GDP) as other countries pay for all citizens. Your healthcare system pushes up prices up to five times as high (for medication, operations, treatments, medical aids) as in other western countries. The US is doing something wrong here and employers and healthcare insurance companies are profiting from this mistake.
Very cool and interesting explanation! Basically it says: All the huge amount of money in the US healtcare system lands in somebodys pocket ..... and nobody wants to lose that. Very cool the connection to the education and law system - I didn't connect the dots until now.
I think you did a great job of summarizing they key issues in a mere 26 minutes. I’m a health economist and everything you say is spot on. The only thing I’d like to add is that Europeans often have a difficult time understanding the nature of our federation. You cannot really talk about a national healthcare system in the context of a constitution that fundamentally assigns health policy to the states. I live in Maryland. For decades, my state has regulated the price hospitals can charge. We have gone from being one of the most expensive states in the country for inpatient services to very middle of the pack. Our system pays hospitals more only when they deliver higher quality care; for this reason, there are generally no for-profit hospitals in the state. It may look like we have a “broken” insurance market, because our nonprofit health insurer dominates the market. However, this is largely because for-profit insurance companies cannot dramatically change their costs by manipulating their network of covered hospitals. Massachusetts has achieved near universal health coverage. Other states are also working on demonstration projects to move away from a fee-for-service model. Reform is possible in the US, but the magical will happen at the state level.
Many of us know know from deathplenity to abortion. You less state and too much local state i too many things. By that You lack of needed reforms. And a kind of funny You fear the state. Its the privates which are the problems in these matters as well.
A very interesting video, thank you very much for that. It is one of my favorite topics. I worked for a German employer here in the US for many years. Just recently I became a US citizen as a retiree and this way enjoyed the benefits of the German healthcare system all my working life as well as now Medicare. My impression is, that mainly the political will is not there. And as long as so many people believe it is against their freedom to be 'forced' into a health insurance contract without seeing the benefits of worry free healthcare, there does not seem to be a path forward. However, in respect to your question: some of the cost could be cut by changing the insurance system; create a non-profit insurance system like in Germany the public health funds/Betriebskrankenkassen. By law they are not allowed to make a profit; if they do, they have to return the money to the insured. The ACA, has something similar if I understand that correctly. If the US insurance company pays out less than 80% of what they took in in premiums, they have to give that back. Then in respect to education, my daughter is a PhD candidate in medical research. She received her science bachelor from a modestly priced state school and enjoyed from her first day on in graduate school a salary that provides her with a modest living in Manhattan. Students in Science, Technology, Engineering and Math (STEM) are being paid for their research and training they give to younger students. If that is possible for STEM why not for for medical school? But walking with those ideas into nowadays Congress would probably cause you great bodily harm - and cost for deductibles to have the bodily harm fixed again :-))
Politicians use the word "socialist" to scare people away from universal healthcare. Medical and pharmacist lobbies give those politicians campaign contributions to prevent their cash cow from being popped. The politicians spread hysteria that healthcare will go away and your taxes will go up and it will create a totalitarian state if we move to universal healthcare.
One of the travesties of the American health insurance industry in the past several decades involves turning very large not-for-profit insurance companies to for-profit companies. Such a huge step backwards. The biggest example is Anthem (now called Elevance) which acquired Blue Cross affiliates in about a dozen different states and turned them into for-profit companies. Luckily, Blue Cross and affiliated companies in most states still operate as not-for-profit organizations.
"That doesn't mean that we as American's don't have a lot to learn from other countries and how they operate." Sadly that is one of the impossible thoughts ever for American's to swallow. I honestly think the world map for most Americans is a map of the Continental United States and beyond that is just says, Here be Monsters. So we almost never learn from other nations.
As someone living in the UK it is my opinion that the USA won't get universal health care because too many individuals and corporations make so much money off poorer people they won't allow it to change, that's what I think.
The average rate of increase for health insurance premiums almost halved for individuals after the passing of Obamacare. It went from 7.9% to 4%. Yes, more money was spent in healthcare but we are covering more people
Europe regulates cost of each medical procedure to prevent price gauging by the hospitals. Medical degree is free and students are expect to service the society in public hospitals who paid for their degree. Medical staff are given a comfortable income, not a crazy high income Yes it's not perfect , but the society sounds much more fair than USA
The problem is that a lot of hospitals are now run by private companies, basically equity funds. They have to maximize profits so they try to keep salaries and number of staff low. That's why al lot of nurses are fed up and actually quit their job during or after covid.
There is also the issue of administrative waste, specifically in the insurance side of things. The itemization, collation, billing, price 'negotiation' with insurance companies and so on are a ridiculous affair compared to European style healthcare systems. The hospitals are incentivized to micro-itemize and vastly overcharge because that's how they make their money, they then have a few rounds of negotiations with the insurance companies and they decide between themselves what the real price is and what is covered or not, if the doctor or specialist was out of network or not etc, etc at the end they decide on a figure that the customer will have to pay.
@@birgitlucci9419there is an issue solution to that problem. Buy them out. Either make private hospital care illegal, or make sure that they can not be run for profit at all. This mean they can not use the money they earn to invest in anything else but the hospital where the money comes from. No you can't use that money to make a new hospital, that is the same as for profit. Here in Denmark private hospitals can be forced to take on normal people whenever we see it fits. This is almost only used for long waiting times. But we could just send them to the private places if we wanted to, in principle. And they are still here. They need to provide better care than what non-private provides, or specialty care, dental, beauty surgery and so on. The high standards should never be lower. It should not be profit driven, but driven to provide above normal service or specialty service. That is what I want to see for the school system as well in the USA. Here it is supposed to be like that, if it is like that? Eh it depends. Some are money hungry, who don't care about the education of the kids..
@@Sindrijo You're exactly right - And the right try to claim nationalisation leads to administrative waste and "big government". In reality it's always the opposite! It's increasingly going that way here in the UK too, with every little hospital department having to consider itself as a small business. It's shockingly bad, un-cost-effective management, but due to right wing interference trying to gradually privatise the NHS over several decades. Everything has to be cost controlled and within certain budgets etc. when it's supposed to be a service that's already paid for. I can see first hand how the whole system is getting ready to be able to provide itemised bills when they finally start charging patients here.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,..-,.-,.-,.-,.,
I am from Austria which has nationalized health care with a private option. In essence that means the government decides what you get (in terms of health care) otherwise you need to pay the difference out of pocket or via private insurance. A friend of mine (a orthopedic surgeon) did a study several years back. The gist is people with puplic option only, often don't get hip replacement surgery usually opting for less invasive treatment. While people with private insurance can opt for the surgery whenever they want and have them much more often. Turned out the live expectation of people with private insurance is significantly lower then people who don't have it, because of the risk factor of surgeries. Unsurprisingly technocrats, doctors and statisticians have a better grasp on health care than grandma.
This is really interesting! I wonder if there is a similar research made here where I live (Finland). The system is very similar, and the private sector definitely pushes people to have more invasive treatments than the public sector, including things like x-rays when they are not really needed.
In America, I was sold on a couple of joint replacement surgeries, mostly because it made the practitioners a lot of money. None of them worked out as promised and I sincerely regret agreeing to these surgeries, they have ruined my life.
@@Llortnerof That's a problem here to, it's in my experience more a problem with pharmacies. They tend to push herbal treatments, homeopathy, etc. really hard because prices and profit margins for real medicine is fixed. So if you opt for the herbal treatment they earn more. Doctor tend to give homeopathy to people when nothing would be the best option but grandma wants something so she feels better, hence the sugar pills.
That's actually one of the realizations that led to the plan for the Affordable Care Act (before it was watered down 100 times): by providing evidence based treatments only, the cost can be significantly reduced because with private insurance there is little incentive to avoid unnecessary treatments.
Bravo!!!! My comment is apolitical. I just want to applaud you for a very reasonable, comprehensive explanation. You gave a beautifully unbiased presentation. I love the way you laid everything out and posed your thought-provoking questions at the end.
I lived in Saudi Arabia most of my life. Though a third world world country, healthcare has been fairly accessible even to the poor. My father once told us that story about an African guy (that had used to work for him) after he had died in his home-country in Africa. My father said, "the guy went to the hospital. Well, if you go to the hospital in Africa, you know you're already dying, because you won't go there unless it is THAT urgent". Years later after I was in the US, I remembered what my father said, and I was like, "Thank God I'm not in Africa but in the US. Oh wait."
The US hasn't been able to give healthcare to its own citizens for over a century. RWANDA now has universal healthcare. Thats a country where they were butchering each other with machete's just twenty years ago, and THEY now have universal healthcare. I have to say one thing about social media now, is that its no longer like when social media first started and it was full of americans talking about how its the greatest country in the world. Now I don't see those kinds of comments very often.
I like apples and I like oranges,but America and Sweden or Finland or Germany America under Obama almost got it right but insurance companies won and now are eating away at your social security system 😅
I don't know much about healthcare in America tbh. But once I had a conversation with some Americans and their view was "I pay for my healthcare and you pay for yours. I won't pay for you". I want to believe that this was an exception and not many people there, think like that. But it literally shocked me. I think it's common ethics that when someone needs help for his life to be saved , that he will be taken care of , without getting a bill afterwards that will bankrupt him. Because after all what's above human life? And ofc , we don't live in a utopia and costs need to be paid but that's why we pay taxes here. If an unemployed person needs to be taken care of , essentially the rest will pay for him. But if I become unemployed tomorrow and that unemployed person is then employed, his taxes will save my life. Probably my view is pretty simplistic cause I don't get all the economics. But I think that the whole mindset of this country is money driven. If a human being is considered an economic unit , how do we expect for the healthcare system to be an exception? I think their whole society needs such a restructure, that a substantial change in this issue, is probably not feasible.
There needs to be an incremental plan drawn in advance. As there can't be one overhaul to fix it all, there need to be time-set milestones for the next 15-20 years so the system can adapt. The most essential coverage must be given as soon as possible (maternity care, antibiotics and life threatening emergencies [including ambulances], and regular blood/urine tests should all be completely free without conditions). The rest can follow in 5,10,... years when the financial burden of the transition relaxes. Most likely, lawsuits would reduce if healthcare was less expensive to the individual, as people sue for minor things in desperation to get some money back on their expenses. Salaries can be just frozen (so the rest catch up with inflation), instead of reduced. Regulations can cap the administrative cost per patient of a hospital in order to be eligible to participate in the program. And most importantly, pharmaceuticals must be made for a fraction of the current cost (with conditions that the cheaper produced, but equivalent quality medications *must* be chosen by the doctor). Long timeframe is also required so the mentality of the people can change.
You are generally right. The entire health infrastructure in the US is fundmentally broken except for the wealthy and needs to be overhauled to move to a universal health care system. Ashton touched on it when referring to the ridiculous education costs racked up by students which then drives a bunch of other behaviour such as favouring specialisation over general and public health. The US has the highest health outcomes costs for the lowest outcomes in the developed world. For example, pharmaceuticals are insanely expensive as there is no PBS or equivalent scheme and medical systems are not working together to bulk-buy and price negotiate pharmaceuticals for lower prices. Another example is the high cost of medical insurance driven from the high payouts of medical claims. If peoples' medical outcomes from bad decisions were still covered by the medical system, and people didn't need to sue to get enough money to cover their future medical costs, then insurance costs would drop. If there is ever a strong will in the US to improve health outcomes, it will require long-term planning as many existing structures need to be torn down and rebuilt. The current US failure of understanding universal health care is that they just see it as someone else paying for their insurance, and not actually getting insurance companies out of the picture altogether and dramatically lowering the cost of delivering high-value healthcare.
What an excellent video, thankyou. I trained as a nurse in Britain and I've worked for 20 years in France. I earn about 30,000 euros a year, but I have the satisfaction of being proud of providing a public service, while knowing that my family will have their health needs covered.
Like I was saying, people engage in medical field in Europe with commitment and devotion to heal, not to get rich. At least, for the most part. The ambitious ones go to private path and the greedy one go to the US. In Europe, and pretty much in most part of the world, doctors heal people, they're not accountants before being a medecine man.
I have never seen anyone go so much in depth on this issue. You made me realise that there is no quick fix. I believe that the government negotiating prices on medication is a good start, but so far they only negotiate a limited amount of medications. I know there are caveats to that mandate, as having to take into account the cost of research and development, something that limits the bargaining power. Here in Norway, we have no such caveats, and the government negotiate prices of every medication in the country. I know, the pharmaceutical lobby and all of that, but to me that would be the place to start. And again, astonishing and in depth video, I don't know how you are able to do it.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..,-,-,,-,.-,.-,.-
Though I highly enjoyed and mostly agreed with this video, I believe some of the obstacles stated in this video of implementing a certain type of universal healthcare in the USA feels like she's "drowning in a glass of water". Specifically talking revenue and expenses, the administrative costs in the US due to unnecessary practices from the for-profit insurers to ration your care (like prior authorizations, denials, delays or fighting for reimbursement from providers, etc) as you pay high premiums, deductibles, copays and coinsurances would save an astronomical amounts of money. As we know, private insurers never lose, so any provider (ex: radiology clinic) has to fight with admin bs for reimbursement, in order to make sure they don't lose, they up charge an X-ray that the insurance would end up paying because they pass the cost on to the consumer, HOWEVER, if you get that same x ray ordered from your referrer and don't use insurance, you'll pay about half the price as the radiology clinic would get reimburse with no hassle and doesn't need to up charge you (this example is practiced basically in every part of healthcare). You CAN maintain a high reimbursement for the medical staff, you just have to be witty to understand what works and what doesn't: Medical staff works and should deserve a worthy salary, these for-private insurers don't, they jack up the prices to line their pockets, they are parasites and unnecessary middleman. I mean, this is lengthy already and it would take more than a comment to write it all but I wasn't too convinced on how difficult a solution would be on some things that she raised. However, she did mention how lobbyists from all these companies have congress in their back pockets and THAT is the real problem to getting anything done and Obamacare is a great example, lobbyist hands were all over that bill.
That sounds pretty scary. I am wondering, with the density of medical practitioners already low, what happens if you have an accident or some other medical emergency somewhere in the boonies in the US? But we do have our own set of problems here in Germany. Similar problem, everybody wants everything anywhere anytime. Recources are limited. So they do have to be managed in some way or other. And that management is also strictly politically motivated and dominated. Examples: - Being a general practitioner or a pediatrician is on the lower end of the reimbursement scale. Hence there are much fewer GPs and pediatricians than needed. - Being a general practitioner in the countryside is even worse. So lots of practices with the current GPs hitting the retirement age are now closing down for lack of successors. - OTOH larger cities swarm with lots of the same specialty doctors next to each other. And they all want to make a living. - Certain types of treatment are being paid better than others. Leading to treatments with may pay better, but are not necessarily better for the individual patient. The notorious example are spinal disc surgeries. Less aggressive treatments would often be more in the interest of the patients, but they pay worse - and might be more expensive upfront. - Everybody wants to have the full service hospitals and pharmacies nearby, nobody wants to pay for it, and nobody wants have to make do with “only” basic services locally and having to go somewhere else for the specialty services. Even the argument that is much better for you to have your new hip done at a hospital that is making 300 of them every year 80 kilometres away rather than being one of eight such patients locally does not really wash. Typical response: “I want that hospital to be in my town! Period!”. Currently the discussion is about concentrating extreme perinatal care at hospitals which do at least 25 cases every year below 1,250 grams birth weight. According to the studies this would improve the outcome for the newborns - but, well, I think you will guess the general response to that. - Local politicians revel in "saving the local hospital". Never mind that it is neither medically nor financially viable. - The medical role model is still the self-employed registered MD with his or her own mom-and-pop practice. Group practices or syndicates are not quite a thing yet. - And so on. It is kind of a Gordian knot. Too much government meddling makes things excessively expensive for suboptimum overall performance. Too little oversight does the same, just with a slightly different flavour.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
When I lost insurance and my doctor was begging me to go back for the treatment I needed. I told them "Unless y'all are offering to donate y'all's services, then I can't afford anything. Just visiting you before the other charges is already $200." And the receptionist was worried and said what am I going to do then, and all I could say was just roll the dice and see what happens
It seems to be an attitude problem. US is somewhat unique in terms of the whole "manifest destiny" mentality. If you truly believe that everything is under your control and you can be extremely successful based on the merit of your work and abilities only, it doesn't make sense to build systems aimed at social support. And changing perception of your identity is a very tough thing to do. Unfortunately, realistically, I don't see how this changes, without things getting so bad in US that society would be forced to re-examine basic assumptions about itself. You need to admit that your labour and talents are not enough, and that there are things outside of your control, and that investing into the common pot makes sense, becase there might be a day where you'll need that help. Europe went through that process by virtue of having a lot more time and being a lot more compact than US. I honestly wish there was an easier way.
I was about to comment: "The problem with the US is the US", which is more or less what you said. Indeed, the famous quote: "America is the only nation which has gone from barbarism to decadence without the usual interval of civilization"
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.
Just because you asked: 1. Free education. My US dentist wanted $ 800 for a tiny front tooth filling, because she 'owes 265K in education cost'. 2. Forget about malpractice suits. I hate folks who get rich on other folk's misery. Should have sued Kaiser 7 years ago, when they misdiagnosed the staph infection in my knee as 'gout', and the nurse I met the next day, with a red swollen knee the size of a newborn's head told me: 'you were lucky you came here in time, you would have died a painful and horrible death within 24hours'.
A few things to address some of the obstacles mentioned here, which can be avoided with good policy: 1) Medical professional wages don't have to decrease. Europeans might be used to the lower wages, but American Healthcare professionals aren't. To avoid a mass exodus, guaranteeing the standard current of living for medical professionals is a worthwhile investment. The majority of costs in American health, as with most things, is not the labor force, but the profiteering and administrative costs of maintaining the system we have. Remove all that, and we might not be paying half what we do now, but we'll still be paying something close to it. 2) By shoring up wages for medical professionals, the gov't can avoid (but should still be working on solving) the issue of resolving the expense of for-profit college. 3) Malpractice insurance is subject to the same deep flaws of health insurance in a world that refuses to eliminate the profit motive from an industry that in no way benefits from it, in terms of innovation or productivity. By nationalizing Malpractice insurance in the same way we would health, we can lower costs, saving us money, and work on the cultural practice of suing doctors. At the same time, shunting the for-profit model means fewer medical decisions being made based on what is profitable vs what is medically necessary. With fewer mistakes and unnecessary prescriptions and procedures, malpractice costs will likely also see a significant decrease. While their lawyer friends might not want to see fewer cases brought to them, this gap can be offset by the fact that absolutely nobody cares if rich lawyers are less rich (😂).
Thank you for your explanation of American healthcare system. We have our own problem with healthcare in Canada, like long wait times. At least I did not go broke due an emergency gallbladder surgery.
No one here in Canada likes long wait times! It is because a shortage of doctors and nurses which exists in the US. Here in Canada, there are steps being taken in many provinces to improve situations. I’ve not waited long for good care. Some places are better than others.
I’m no expert but I have a strong opinion that the source of this inflated pricing is coming from the increasing costs to get a higher education in the medical field. You can justify healthcare wages comfortably sitting way above six figures because the cost of their education is multitudes higher than that. As a result, every patient has to carry that burden. If we want to address why wages are so inflated in the healthcare industry, we have to first correct the outrageous cost of attendance for medical school and the like
It's all part of a system of issues and the cost of education is a part of it - but I wouldn't lay the blame solely on the cost of medical school. Even positions that don't require the same amount of training are also significantly (if not double) the salary in the USA versus most of Europe (administrators, technicians, nurses, etc.). A large part of the issue IMO is that we have no oversight or regulation in how pricing is structured in the first place. Hospitals and treatment centers can make up any price they want for procedures, scans, and visits and bill them to the insurance companies with little to no checks/balances. There is no reason why an head/neck MRI cost my mom $13,000 (before insurance) in the USA, but the same procedure in Germany without insurance costs less than 1,000 out of pocket.
I am Australian. A couple of years ago I had heart valve replacement surgery.All of the tests, appointments etc. leading up to the operatation, my time in hospital and the on going care have not cost me anything.
Also, a lot of times those people come out of school from whatever medical field with huge educational that unlike in Europe. And yes, nurses should get paid way more than any tenured college professor that’s foolish to think that the professor should earn more than the nurse
Nations whose national defense is effectively funded by another nation can well afford to spend that money somewhere else, and need to recognize that their benefactor doesn't have this luxury.
In US the nurse example NEEDS $ 120k per year to survive. $ 60k per year in Germany is worth a lot more than $ 120k in the US. When I take myself as example: I would need to earn about three times as much to have somewhat the same quality of living - actually more.
@@Bookhermit Simple groceries is about three times as expensive. And if you look for fresh herbs, which are common here, you won't find them. The dried herbs are 4x or 5x as expensive. If the $ were not a world currency the exchange rate would reflect ist. Hence the reason for more dedollarization pressure than ever before. BRICS might have a real outcome.
Hell, yes, it would work... if only Americans weren't so indoctrinated to misunderstand that 'social' programm does not mean 'socialist' programm. There are many different ways to make a universal healthcare system work; Germany's being one of them. Yes, it's not perfect, by no means. But it certainly is better than what the USA currently exhibit. That's my honest opinion BEFORE I watched the video. Let's see how this plays out.
It's super interesting.... the quote "sicko socialism" comes into play in the final chapter, as its a quote from the Fox News Anchor I used in the video. Interestingly it is in reference the expansion of Medicare - which has been in place for almost 60 years.
The problem exists, because the State interferes automatically with the US principle of individual liberty. In Germany you have the same principle, but as it is one country, your individuality is embedded in being a people, what makes one person to an extend more social. In the US, you are not or far less and communitarian only in the traditional States in the middle of the country. Especially at the coastal areas, individual greed thrives in a more and more anomic area, which is a pull factor created by the State's interference. Germany also had it's Obamacare after 1998 (Red-Green) by Ulla Schmidt, what was a horror and got refinanced with a lot of closures of doctor offices in the countryside, so that basically migrants can get free stuff in the city and it's not crashing instantly.
@@urlauburlaub2222 I think there is a big difference in mindset between the USA and Germany. Americans (as a group) usually are talking about their 'rights' and 'choices'. Germans have 'obligations', restricting their 'freedom' like in not defaming your opponents (Artikel 2, Grundgesetz: "Jeder hat das Recht auf die freie Entfaltung seiner Persönlichkeit, soweit er nicht die Rechte anderer verletzt und nicht gegen die verfassungsmäßige Ordnung oder das Sittengesetz verstößt."), not shooting at people, yielding your right of way on the street (§1, STVO: "Wer am Verkehr teilnimmt hat sich so zu verhalten, dass kein Anderer geschädigt, gefährdet oder mehr, als nach den Umständen unvermeidbar, behindert oder belästigt wird.")
@@wora1111 Hmm, no. The US Constitution doesn't say anything else than the German one, but the US is far more multicultural and Socialistic than Germany. So, the average German is more social. Younger generations are different, because they are not homogenous anymore and so they are more like the US Americans and want less community.
@@urlauburlaub2222 "the US is far more multicultural", hmm, willing to take a ride with the Straßenbahn with me in Karlsruhe? Those that can be called 'Germans in second generation' are the absolute minority - even though all will talk German among themselves, usually fluently, many without any accent. Even more so with the younger people (30 and below). I know fewer 'young' people but those I know are not less social, they usally hvae thought about the subject less that the older ones. But when watching their behavior they are just like us 'old ones': Getting up to make room for older people, moving to the side of the road to let others pass more easily, and so on. And yes, that includes immigrants and refugees (after they acquired some German).
I’m an American expat retired to France. Health care here is magnificent. I pay €600 per year for health insurance. This covers 70% of the cost of treatment. Here, a primary care office visit costs €27 (about $30) I’ve had extensive cancer surgery years ago and with long term illness, like cancer, the medical expenses are covered at 100%. (Their goal is to keep people health and to treat them, rather than to make money.) I again have cancer and am being treated at a hospital that’s 1 1/2 hours away. I have free medical taxi/ambulance coverage. They pick me up at my house and take me to the hospital and either wait or come back later to take me back home. When I need blood tests, a nurse comes to my house. Here, doctors go into medicine to helps people, not to get rich. It makes a huge difference,
When I was growing up, kids got vaccinated at school. If we really wanted to, we could offer health screenings for everyone and address issues before they become chronic. Prevention being a focus, more than expensive hospital stays and drugs.
America is like a job with crappy benefits. Most Americans have never traveled and lived outside the country and are none the wiser about what life in other countries is like. Like a job, you can always leave it for a better one if you are brave enough, and wise enough to know there is something else better out there for you.
Why couldn't an individual State create a social medicare system? I understand that would have it's own hurdles, but if all private insurance in the state of Hawaii (for example) was funneled through the state (along with Medicaid) it should allow the oversight necessary for universal access for state residents. If insurers are paying more per citizen than in Canadian or European systems, there should be incentive to explore a more efficient option.
Its funny that as a Surgeon with nearly 20 years of practice and the highest qualification in my field of work, I earn as much as a nurse in the US. ( in the case of a Dollar like now nearly equals a Euro and both numbers are brutto)
As a US citizen, this video was very educational and explained in layman's terms quite well the failure of the healthcare system that does not break you financially. I have lived in Hungary for 3 years now and am thankful that I can see a doctor or dentist when I need to and not have anxiety about going into financial ruin.
Not sure that the first cab of the rank for addressing cost should be worker costs.. e.g. nurses. They at least work for their living. Insurances, pharma profiteering, hospital overcharging are all lower hanging fruit.
As a medicaid recipient: I see value in allowing a basic level of coverage, such as in basic doctor visits and such, and my sister is in the Healthcare field and she supports UHC, but America has many specialized categories in the health field, and how would that play? We definitely need to bring the cost of our education down as a factor for any major healthcare reform. The costs of college tuition is outrageous.
The reason medical school has gotten so expensive is because American college funding is operated with near-total disregard for the law of supply and demand. If your response to rising prices is to enable the buyer to increase demand (and that is exactly what student loans do), you're going to get higher prices.
When the UK introduced the NHS (universal health care system) just after WW2 there was considerable opposition from the doctors and less so from other staff. This was overcome by a capitalist country with difficulty as Bevan, the government official driving the introduction of the NHS, drove it very hard in a country and it's people that had just gone through a war and believed all people deserve proper health care. The system also allow private health care if an individual should want it but gives no reduction in contributions to state health care.
A few thoughts come up around the idea of health insurance: 1. Health insurance companies are not charities and add zero value to the system (as long as you agree lottery tickets aren't a valid investment opportunity). So doing without them would be an obvious improvement in the financial efficiency of our medical system 2. If you're uninsured, pretty much every health care provider will automatically cut your bill in half. Kinda makes the while thing look like a scam 3. When someone says they're against universal healthcare because they "don't want to pay for other people's unhealthy decisions", what do they think the hospital does when someone else can't afford to pay? 4. Insurance companies have entire departments devoted to finding new and interesting ways to deny claims. As a anecdote, my ex once had her routine obgyn checkup declined due to an unspecified "pre-existing condition". On appeal, we were declined yet again and gave up and paid. What was the condition? Being female? The world may never know
I'm in the building trades and have been in a LOT of homes in 4 decades I've been doing finish carpentry. I can tell you hands down, besides lawyers, Doctors have the nicest, most expensive homes and furnishings inside. Sure they may not early in their career, but they eventually get there and when they do money seems to be no object for them.
It is a big problem, that the US healthcare system is business rather than a utility. To change that could be done over time without breaking the bank. A slow transfer from private incentives to non-profit or even state funded healthcare, could save the common man, and keep the doctors and nurses not happy, but maybe understanding. No nation gains anything from making healthcare to expensive from large parts of the population. It might sound cynical, but it could be something like if you are born the 1st of jan. 2024 or later, you will have free non-profit health care for your entire life in the US. That could make the transition less painful and more realistic. Slowly but steady the US citizens would have their universal healthcare, and the business element would slowly fade away at least for the majority. Rich people could still have their insurance based health care, if they want, but the difference might come down to the art hanging on the walls. Just my five cents
One thing is never acknowledged. The Canadian system of healthcare insurance costs the Canadian govt. less than what current health insurances + owned suppliers cost US taxpayers. Got that? Here, numbers. In Canada, your proof of citizenship or landed immigrant status provides you healthcare for ANYTHING, no charge beyong parking fees while your car is in their parking lot. All paid from 9.5% of gdp which government collects as general tax revenue. In USA, the governments pay insurance companies huge amounts for employee benefit health insurance (federal, state, regional + municipal), PLUS huge amounts for military healthcare, PLUS huge amounts for veteran's healthcare (VA hospital nets etc). When you add together all these costs, they are 2% of gdp HIGHER than the single payer system in Canada costs in total to cover ALL citizens. Yet the US system THEN ADDS an additional 8% of gdp in cost, to cover all the people uncovered! Gross! And quality is not an issue. I've had many debates. Eg per capita, Canada has twice as many top medical universities as the US. Research is higher in Canada than US, aside from patent extension patents. To say it differently, if the US implemented the Canadian system of healthcare INSURANCE, then people's taxes would be REDUCED, they would make zero personal payments, and they could tell their priest that they supported a system where no-one got left out on the street.
A little more than decade ago the amount of money that the US government put into the US healthcare system with public expenditure was actually MORE as a percentage of GDP than the UK's National Health Service (which was very good at that time). This very clearly indicates that it was enough to pay for an entirely publicly-funded America healthcare system without the need to resort to private medical insurance. At that time I should also note the UK's NHS was well ahead of the United States in terms of the standard of healthcare in *most* areas. Americans were paying two and a half times the price for a slightly inferior standard of healthcare. Though the UK NHS has slipped relative to its European neighbours, it would probably still be broadly comparable. What's certainly true, though, is that Europeans don't worry about healthcare in the way that Americans do. When we watch a film or documentary with Americans talking about deductibles and whether their HMO plan covers them, for many Europeans this is so bewildering that's it's like watching a soap opera set on Mars. It's so beyond parody that it's scarcely believable that people actually do that sort of thing when they could easily afford not to do it all (and pay far less in the process).
In the USA, as in most countries including those with universal healthcare or socialized medicine, there is a combination of private and public healthcare. We have community hospitals run by the counties or cities, and we have private hospitals. If the USA adopted a plan to give everyone a minimum of coverage in public hospitals with employees paid by the public, it could also include provisions to pay for the medical education for those employees who sign up for say a ten year stint with the public system. In addition, all medical malpractice insurance would be covered. This would require the public hospitals to come under a federal system. Costs would come down. Drug prices would be negotiated by the government to a reasonable level. Meanwhile, private practice and hospitals and private insurance would continue to exist for those who prefer it and can afford it. And due to the existence of the federal system where prices are fixed and lower, private practice prices and drugs should also come down. Also, most people will opt to buy private insurance thereby maintaining the high quality of care and R&D.
What if doctors and healthcare providers got most of their education subsidized by the government if they would agree to a salary scale that would be more in line with a universal Healthcare system that works. If the Healthcare provider decided they wanted to leave the universal Healthcare system they would have to pay the government back the loan for thier education.
I didn't see your previous video, but in the intro you mentioned better wait times in Europe. I lived in Germany about 15 years and my wait times were significantly longer there every single time. I wait like 10 minutes here in the usa abs sometimes it was like 4 hours in Germany. Maybe my state and Healthcare provider is particularly good in the usa adhd maybe in Germany the town I lived in was also an exception to the rule, but that was my experience.
This lady makes exceptionally well researched and high quality videos. She's obviously very smart and hard working. Some of the best videos on RUclips.
I work for my county's welfare programs and also believe in universal healthcare. The ACA was definitely not perfected but was a step in the right direction. It opened up free healthcare to a lot of low income families, some of whom I talk to on a regular basis. But I agree with the majority of comments, until we are seen as patients and not customers, it's going to take a lot of work to get out of last place.
Hello. I am a truck driver from Ohio. Before the Affordable Healthcare Act, just about every job I had, offered free single health insurance and family insurance for a small fee. Including the job I have now. In fact, the I have now had really good insurance. Most cases, I only had to pay a $20 copay for just about anything. After they passed the Affordable Act. The company did away with my insurance all together. And the paper they showed me, the insurance didn't just double. It went up 4X. They just couldn't afford to keep the employees insured. And it was cheaper for them to pay the penalty instead of even keep us insured with crappy insurance. So that's what they did. I tried to look for places I knew had good insurance. But pretty much every place locally did pretty much the same thing. I haven't had insurance since. I am in a gray area. I make to much for free or discounted insurance. I just can't afford it. Thanks for the good video!!
The NHS in the UK was developed in the late 1940's, when the country was still recovering from World War 2, London and our other cities were bomb damaged ruins. It was done without 'bankrupting the country'. So I'm sure the US, the richest country in the world, can do it too, if they want to. If only the US could start thinking of healthcare as a service and not a business. Would Americans want their police and fire depts run the same way as they run their healthcare
The USA needs public health care. Health is paramount, nothing else matters. Everybody wants to live a good, nice life, so in order to do that you need to be healthy.
I've been enduring pain for three years in a row and the doctors haven't solved my problem yet. I've been paying medical debts for three long years and no one takes away my pain.
Physican salary has stayed almost the same in the past 50 years when considering inflation and total % of healthcare spending, while other sectors such as pharma, medical devices, logistical services, and admin have increased by 100s%. I feel focusing on the salary of workers doesn't paint a fare picture on the reasons of healthcare costs. Healthcare was much more affordable decades ago while at the same time individual physician pay was higher when adjusted for inflation.
I lived in Japan for ten years. Their universal system(shakaihoken)was fair and affordable. I only paid 22900¥ ($229.00)a month, and it covered 70% of treatment, drugs, and dental. It worked! I never had a high medical bill. Since returning to the US last year, I have already accumulated $1900 medical debt. When I talk to people about it, they immediately shut me down and scream socialism and try to tell me how it's unfair to have to pay for someone else’s medical bills and that it would take months to see the doctor. 🙄
The problem is far more fundamental. The Manchester capitalism prevalent in the US has always favoured the wealthy. The leaders of industry have egregiously indecent salary levels that are completely detached from their input. There is nothing wrong with a market economy so long as it is regulated to the point where free enterprise is creating wealth for the well being of all but excessive concentration of wealth is shunned. The de-regulation of financial markets, leading to excessive profit maximisation for the sole benefit of shareholders has impoverished a very large number of salary earners and destroyed whole industries. The Boeing company after the “reverse” take over by McDonnell Douglas is a good example. A well run corporation requires to be a good social player, not only a money making vehicle for shareholders. As a former owner of a small industrial group of companies I know what I am talking about. Our companies were very profitable but immediately after sale to another industrial group, benefits such as a double December salary for all and four weeks fully paid holidays for our entire work force were rescinded by the new owner.
Ive heard of so many times from Canadians how their system still requires loads of things to be paid for, the governing bidy rejects procedures, and wait times are insane. The US has a broken healthcare system for sure, but its not the only one. That might make me sound like I'm opposed to universal healthcare, but I'm not. In the end i just want a system that works, regardless of how it works.
I remember I was afraid to get penalty for not having insurance for half a year because I couldn’t afford it, Obamacare was still expensive with my income at the time.
You asked for input in how a universal healthcare option could be implemented in the US, so here is one option I have thought of. The road to become a licensed physician is very costly, and as you pointed out in the video, often leave the newly minted doctor with a substantial student debt. If the government could build community hospitals with emergency rooms, or somehow use or create positions in existing private hospitals (nonprofit?) for newly minted doctors fresh out of medical school. These doctors could have attended medical school for no cost, or at least very low cost, courtesy of the US government, who will foot the bill for their education. In return said new doctors would contractually work for a period of years, perhaps a dozen, for much lower wage, similar to the pay level for doctors in other western countries. This model could also be applied to other professionals in the medical field. There would be a lot of details to work out, but it could be a start. Thanks for yet another great video.
As far as I can tell (using a very simplified model) healthcare works like this; People pay money into a big pot, when they need healthcare, the money is paid out of this pot. There should be enough money in this pot to pay for all the healthcare requirements for the people enrolled. There should also be extra left over. The difference between for-profit and non-profit, is what is done with that money. One uses that money to pay for people who cannot afford to enrol (or don't earn enough to pay taxes for it, as in the UK) and the other is used to line the pockets of investors. I know this is very simplified but it does point out the absurdity of those who think that socialised medicine (or the ridiculous notion that this is some sort of communism) is in some way different from the way the private healthcare is funded. If you take out a policy tomorrow and get cancer 6 months down the line, who is paying for that treatment? Not you, any money you paid in will be burned through in a couple of treatments or less. It'll be the 'community' of insurance policy holders, whose money is in the big pot that pays for you ( what about the poor idiot, who pays hundreds of thousands into the pot never to get anything out of it?).
In Australia... A problem with UHC is the hospitals make patients wait for attention anywhere between 4 to 8 hours, making sure patients don't want to attend again. Private Doctor visits are fine but you might still have to pay a high % of the Bill.
Implement a similar colleges fees system as the UK for medical degree, you only pay back a percentage off your earnings over 30k. You're gonna have to take control of the hospitals as well. Tbh the argument against it is basically that too many love and benefit from the grift. Would take someone like Bernie with the backing of his party to come close to it.
The fact that this is such an open discussion in the US these days is cause for optimism! I remember when Bernie Sanders was running on universal healthcare in 2016, it was still viewed as such a radical idea that would never happen. These days, it's discussed across the political spectrum in good faith (among the general public). If I recall, I wanna say South Dakota voted to expand "ObamaCare" funding in 2020; a place that was staunchly opposed to it for years. I've even have heavy Republican acquaintances that are open to the idea. With the constant news of mass shootings, they like to point at poor mental health being the main reason behind them, and believe expanding access to reaources to mental help will curb most of the threat of gun violence. I personally think there's more to it than that, but still glad we're heading the right direction. Change is slow, but it's coming.
In the UK that nurse would have to cut her income by far more than a half. Average NHS Nurses pay in the UK doesn't even break $40k. Of course if she is a senior nurse with years of experience and a specialism she could make up to $60k, but only about 10% of NHS nurses are at that level, the vast majority earn under $50k (even after more than 15 years in the profession).
I was unaware of all implications of an eventual switch towards a universal and free health care system, going to salaries, education fees, professional liability, insurances and the justice system. Thanks for the explanation but also disappointed to conclude it will forever be impossible in the US.
You're absolutely right that trying to convert the United States into a "universal" health care system would basically destroy health care in the United States. But there are a LOT of aspects of US health care that you did not touch on, but you would've had to triple the length of this video to even get a cursory glance at much of that. Even your take on the ACA was woefully simplistic as well. It decimated the health insurance market by severely restricting choice. One thing about insurance as well many aren't aware of is the loss ratio. That's the minimum percentage of premiums that must be paid out to claims. For large health insurance plans in the US, that's 85%, 80% for all others. States can set that number higher, and States also tend to require insurance companies maintain a "reserve". And the idea an insurance company could just... run short on money seems foreign to so many people. Anyway... There's also the cost of government regulation. The FDA takes one hell of a cut of that with all their licensing and regulatory fees. Drugs cost billions to bring to market from concept to final licensing. Along with medical malpractice insurance is also business insurance on the drug companies to cover litigation after a drug comes to market. Drug companies also have programs in place to give prescription drugs FOR FREE or at drastically reduced cost to qualifying patients. And part of the cost of bringing a drug to market are the drug studies and clinical trials, in which the drug company not only absorbs the entire cost of all materials, but also covers any health care costs for patients who are in the study, along with paying participants - we've all probably heard the radio ads. Then there's the single largest mistake the United States ever made with regard to health care: the artificial limits on the number of practitioner licenses and seats in medical schools. And all that came courtesy of the American Medical Association. Add on top of this "certificate of need" laws for building hospitals and clinics or setting up ambulance or medical transportation companies. All of that artificially restricts supply in health care. And "certificate of need" laws are very pernicious on that front since... the other market participants have the ability to veto someone new entering their markets.
You could do a stupid simple move and copy what we do with electricity grid providers in germany. Regulate their profit and cap it at 3%. And regulate what insurances have to cover, make it a standard catalog to make sure they are actually competing on cost and they dont cut the coverage. And fix your drug prices, negotiate prices and scrap the law prohibiting that. That would help you a lot without changing the system too much.
Your premise on doctor retention is flawed. Almost all doctors are forced to work under physician groups or hospital dominated practices. Many doctor positions are replaced by nurse practitioners or physician assistants that are paid nearly the same as an MD and sometimes offer superior care, depending on the individual. The provider is not the problem, it’s the profit making entity that oversees the practice. Individual doctor are almost always forced into group practices by the hospital through patient admission policies and cost to maintain a practice, malpractice insurance and insurance reimbursement rules. Hospital administrators have been on a constant assault on non-profit hospitals that had existed and even when denied find ways around the laws preventing the conversion by making every activity within the non-profit building, profit making. The only way to fix this is to eliminate the profit model of medical care. Imagine what would happen if all of our municipal services like roads, sewage treatment and water became privatized. That municipality would either become unaffordable to all but the richest Americans or bankrupt. This is where the “scary” European socialism model model works. If all basic essentials in life were non profit; medical care, water, sewer, electricity, internet, education, transportation then the playing field is leveled. The advantages of inherited wealth still exist but are not insurmountable for the individual. Unfortunately due to lobbying by powerful special interests/profit making entities in our current political climate will never achieve this without a “New Deal” type of intervention by our government with buy in from the politicians and population. The unmitigated greed of certain parts of our corporate world will never allow such altruism and empathy in our infrastructure. In their world empathy is weakness and needs to be routed from the system.
Thank you for pointing out that health care costs are tied to things like lawyers fees (and believe me, those costs go waaaay beyond malpractice premiums). Also in America, everyone is expecting the best care possible. Which includes the latest & greatest in chemotherapy, blood pressure control, “blood thinners”, diabetes and weight control. Also look at how many CT scanners and MRI units PET/CT scanners and expensive angiography suites we have compared to other countries. Also note that your wait-time statistics were for initial evaluation, and not for things like follow-up imaging or elective surgeries. Also, it’s hard to put a dollar value on the cost of the American obesity epidemic, but it is enormous (pun intended). Finally, comparing with large countries like France and Germany may be reasonable, but comparing with smaller countries with very homogeneous populations, like the Scandinavian countries, which are like medium-sized US states at best, is problematic. My best suggestion for the US is to cut all Federal involvement, and let the individual states try to figure it out for themselves. Hopefully, you’ll get 50 different solutions, and the best can be a model for the others to follow.
There's one issue that nodoby has touched: The medical profession hs become a cartel in the US. Cracking the cartel will be immensly difficult - they have dug in.
Excellent description of the Healthcare system in the USA and why universal healthcare for the country has its challenges. People need to take responsibility for there own individual health and not rely on the sick care system. With more people healthy and well, less patients for the clinics/hospitals = less profits for the medical/pharma corporations. Lower demand for sick care = less cost for it. Those interested in working in the healthcare field would have less financial barriers to face. I'm all for each of us being being health/medically savvy. Perhaps we all can be our own person physician (doctor).
American culture is to help yourself, be independent, why pay for someone else’s care? In the U.K. and EU, we ALL pay to help each other. You can do everything in your own power to stay healthy, but you never know what’s coming, accidents, cancer, genetic dispositions? Can’t see it ever changing in the USA, too many people making too much money in getting people sick, and treating them.
Health Care is also corporate support. Less workers showing up to work sick and making others sick. Less workers unafraid of switching jobs and taking risks.
In terms of high cost of health care and how to help reduce it? One way is to increase the windfall profit tax on the oil companies by 30%. Another is to stop subsidizing the sugar industry and other industry with free money that they don’t even need. Another way is to force the drug companies from charging so much by putting a cap on what they charge. We can always take harsh measures and gradually reduce salaries in the medical field
I currently have a health insurance plan through Obamacare, because I don’t qualify for my job’s health insurance (our parent company requires 38 hours/week to qualify, but our location isn’t open that many hours). I pay $322/mo for it, and while my PCP visits have been free, the insurance has yet to pay for ANYTHING else. Every specialist visit I’ve had (even in network) has been $150-300. I’m hoping I can whittle down the deductible before the end of the year, because I was supposed to have a colonoscopy back in may but couldn’t afford it until I hit my deductible.
As an American citizen without insurance, I could not get a biopsy of what started as a quarter size tumor in the bottom of my right lung for nearly two years while I waited for Medicare to take effect. By the time I had surgery I had less than a third of my right lung because the tumor grew so large from December 29, 2009 to Valentine's Day, 2012, followed by chemotherapy. I have advanced COPD and tackycardia because my heart has to work so hard to get oxygen to all of my body. I am still constantly amazed that the cancer didn't metastasize like it did with immediate family members. I am living the remainder of my life as fully as I can, having previously survived Ovarian and Uterine cancer surgery and chemo in January, 2004. Almost 20 years! I am beyond appreciative of still being alive and fortunate all my cancers were in stage One or Two. I almost "fell through the cracks" as they say. I don't have a solution, I just know it shouldn't be that way. Talk about a helpless feeling. Attorneys are required to donate a certain amount of time to defendants without attorneys, why not doctors? Hospitals? Heavy sigh...
Well, you obviously can't cut reimbursements to healthcare providers... Which leaves you with medication costs and administrative expenses. Education cost and student loans are also a good consideration. A lot of this could be accomplished without increasing government expenditure. It would likely not allow to cut the cost in half, but hey, 20-30% is still a great result.
One solution would be to have the US government lawmakers pay their own healthcare, just as they expect the rest of society to do. than we would be getting somewhere.
As a self-employed guy for most of my life who had to secure health insurance in the private market-place and as a Vietnam veteran who now is covered by the VA, I think I'm in the almost perfect position to pass judgment on this video. And that is that this is the most honest, unbiased and factual report on this subject I have ever seen! VERY HIGHLY RECOMMENDED FOR ALL.
I think something that gets left out of these debates is stress. Even if the costs were the same I'd want the system where I never have to think about money while I'm going through cancer to the system where I have to deal with bills and bankruptcy while going through cancer.
The patients health should always come first.
That is what I have here in Denmark. Peace of mind is such a relief. I learned that when I studied in Beijing and my ball sack began to hurt like hell. (It was an air bubble in a blood vessel) the Beijing doctor told me it was cancer and it would spread to my heart unless I had a 50,000RMV surgery soon. I did not believe him. My doctor in Denmark told me, either that doctor tried to scam me, or he was unable to read a simple Ultrasound picture, that means he was incompetent.
So yeah peace of mind is such a relief it is amazing. That is why I want dental to be free here as well. I am the sole provider, no job, I am during my master's thesis right now. And I have big holes in my teeth that really need to be fixed.... but I don't feel like I have the funds. But if I wait till I have a job and it gets worse then it might be even more expensive -_-
My mother was lucky enough to be treated for her (now eradicated) cancer with no financial worries. Unfortunately, it took the sacrifice of my now deceased father as a military service member and Vietnam War's Agent Orange exposure survivor to make that happen.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.-,.-,-.,-,.
You can always set up a crystal meth lab in an old RV in the desert with Jessie.
As a senior Australian, one of my biggest fears is Australia sliding into an American style of healthcare. I've always relied on the Australian public healthcare system and have never had any problems with it. I see my doctor twice a year for a check up and pay only about six bucks for prescriptions. Once a year I have a raft of blood tests which the system covers.
What are the reasons for your fears?
@@pinetworkminer8377 ,, for a start, the US system is a profit driven system . Medications are very expensive over the counter, there is a network system where health professionals, pharmacists etc work within networks. Any treatment outside the network won't be covered by insurance. Also, insurance companies can deny or offer a 'lesser' treatment/medication than your doctor has prescribed.
My greatest fear is not being able to afford healthcare when I need it.
The idea of bankruptcy due to medical debts. That sort of overhead is an anchor on just about every business decision one makes, once you get past the invulnerability of youth.
60% of the money used in American healthcare is taxpayer funded. OBAMACARE aka the UNaffordable Healthcare Act.
@@pinetworkminer8377 The obvious. A sick care system based on private "insurance", driven by greed.
Another great video, thank you for continuing your work! I'm a pharmacist for a large "not for profit" health system in the US and the inefficiency of just the my section of healthcare is astounding. One problem I see in the US is that most citizens cannot fathom the idea that another country is doing something better than us. They refuse to look outside of the box of US exceptionalism for anything that could make their lives healthier, safety, less expensive... it's kind of depressing to know that we waste so much money on everything from healthcare to education to military spending...and the majority of the population won't open their eyes.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
Well said. You didn't say it, but I will: American's are ignorant, lazy, selfish, uneducated, juvenile. I am not saying that everyone is, but as a whole, that is where we are. We allow stupid people like Trump, Mitch McConnell, MTG, Lauren Boebert, Jim Jordan, Matt Gaetz, Ted Cruz along with many others like them to run our country. Truly, we are doomed for catastrophic failure. We have already crossed the line over that milestone! Sorry, but it's true.
@@JohnnyLynnLee As an American I agree. Socialism is not Communism.
@@JohnnyLynnLeeWhy do you think that Brazil is the only country that has that?
Capitalism:The UNKNOWN Ideal by Ayn Rand. Alex Epstein 's "FOSSIL FUTURE" on sale now. The Moral Case for Fossil Fuels. HUMAN FLOURISHING
I really don't like my free bombs, drones, missiles, and nuclear weapons. I would much prefer free healthcare.
The ironic part of that statement is you actually get pretty good self and family health coverage if you go work on those bombs, drones, etc. You know actually earn that cover instead of demanding it for free.
@@swampcastle8142 The bombs aren't free either and spending megabucks on bombs that are gone when used is a waste of money. Universal single-payer healthcare builds a healthy population. Why do you think Bismarck provided healthcare to the German people back in the 1883? To build a strong, healthy population.
@@swampcastle8142Americans spend 18% of our GDP on healthcare. Most wealthy nations spend about 9-10% and have better outcomes and universal coverage.
@brianfleury1084 Every country that I was stationed in that had single source or universal health care had the worst care for the local population. So no thanks. Rather have the bombs. (Unhealthcare)
@@swampcastle8142yeah sure, "EARN IT" its not like the millions of people workin around the USA, serving your food, building your houses, raising your children, educating said children have actually done ANYTHING to earn healthcare... bunch of lazy MFs... amirite?😊
In the UK they are privatising our NHS by the back door. So in the last 12 years the Tories have destroyed the service.
"Nobody knew that healthcare could be so complicated..."
The guy had so many...let's say _interesting..._ quotes, but this one always stood out to me.
Same.
3. August 2020: 'Trump promised a health-care plan in two weeks.' That aged well.
I mean: "bleach" "Biden is leading us into WW2".......🐵
@@arnodobler1096 nuking hurricanes, stop testing to reduce cases...there's just so. damn. many.
My absolute favourite is from 2016 where he told his followers at a rally that he thought his MAGA-slogan was corny and stupid but it tested well in focus groups so he's using it...and the crowd erupted in furious applause. It's just insane.
@@knietiefimdispo2458 probably under audit for bonespur infection. He could release it at any point just by thinking about it, though.
It bugs me that people don’t realize that we’re all in this together. If I have a medical emergency and can’t pay for the treatment they already performed, that loss gets passed on to the community. It’s a big game and the loser is everyone who is struggling to keep up.
The most ridiculous of all is that USA is already spending similar % of tax payer money on healthcare compared to European countries with mostly tax funded healthcare, yet it's still expensive AF and we haven't even started to count the money patients have to pay on top of that tax money. Everyone would benefit from cutting out private middlemen from the equation, healthcare would be affordable or even almost free for pretty much the same price as everywhere else... you just don't have to pay yourself sick dealing with private companies. But alas, that cannot happen because it's "evil socialism". The idea of paying for healthcare of somebody else and yourself is just too much for some people to handle, even if it ends up being cheaper for themselves too.
@@spugelo359 all that shows is that americans are selfish and dont care about their citizens. A healthy society is so much cheaper than a sick society!
🎯. Truer words have never been spoken!
If US had both a better fully funded public education system as we did in the 40s-80s & unions, I believe the idea of unity, fellow Americans working together for the common good would be possible.
The uber greedy rich oligarchs have changed all that by being able to buy politicians to change our laws, our workplace, and educational system. It's mostly privatized and under their control.
Too few Americans understand what "common good," even means. If they don't see that you're filing medical bankruptcy doesn't effect them directly, they stay apathetic and ignorant...until it happens to them. Which it can because no one is guaranteed any right to healthcare in our country like other countries are.
Greedy oligarchs. They have been our problem Day 1.
It's more expensive for society in general for private healthcare...Somebody pays..
I’m in Texas. It’s amazing how much I pay for my own health insurance through my employer and costs on my own. I feel I’m being ripped off monthly, but too busy working to slow down. I’m too busy working to slow down for sick days. I look at how many people are uninsured or can’t go to a doctor or buy medicine & actually feel lucky. This just grinds the working class down. Then we have elite anti-abortion groups pushing for more babies to be born by the poor (rich will have abortion access), and I wonder how anyone pays for prenatal care, birth in a hospital, postnatal care. Give me a break. Literally.
Love your delivery, and how you really make some complex issues easier to understand and to explain to others when debating a subject. I must say I never really considered the tie in with education and tort reform in trying to reform Americas health care system.
Ashton, you have actually managed to make me understand for the first time in my life, why the US is not in a position to change the health care system so easily. The way all these things are interwoven there is not much hope to see change in the forseeable future I fear.
Let me repeat what I stated earlier this year: You are an excellent teacher!
10:09
Ronald Reagan Advisor "We are in danger of producing an educated proletariat. That’s dynamite! We have to be selective on who we allow [to go through higher education].”
So they literally created Student Loan programs
"Before Reagan became governor of California, tuition was free for California residents... Reagan began cutting state funding of public universities by 20%... His justification was that colleges have become too liberal"
"When Reagan became president, he continued his efforts to dismantle the public education system, targeting federal aid to students. In his campaign for the presidency, he advocated for the total removal of the U.S. Department of Education."
Project 2025... Trump is planning on dismantling the Dept of Ed
Uneducated people do what they are told and don't question authority
The US is not in a position to change it, simply because about half the country doesn't want to change it, and any time progress is made towards changing it, the other half undoes the progress.
Her video isn’t really that great, a lot of mistake and overlooking big issues that would get in the way of medicine here. We have a unique population those European models wouldn’t work here
MIXED healtcare system where GOV decides what can & can't be. 60% of all dollars in the system is from TAXPAYERS. OBAMACARE the UNaffordable Health Care Act is a preponderance of GOV regulations FORCING the private sector into offering what it doesn't want to. Alex Epstein 's "FOSSIL FUTURE" on sale now.The Moral Case for Fossil Fuels. HUMAN FLOURISHING
The US isn't changing the system because it makes excuses not to do so, not because of its size or the number of people.
Good friend of mine is from UK. He got moved around as an exec for his company, from UK to France to Italy and finally
to the USA. He has a wife and three sons so his family fully experienced all four systems.
I asked him how does the US system of healthcare compare?
His succinct reply - "Healthcare in America is arbitrary cruel and frightening"
one interesting aspect of healthcare in the US is that your insurance in your home state, does not automatically cover you in another state. in reality this just means that going to a doctor in a different state, say while you are traveling for work, will result in a potentially astronomic 'out of network' bill. Imagine having a heartattack in a different state, and then getting a bill afterwards that will give you a stroke.....
That sounds crazy. I guess the insurance companies will use every trick to pay less and make more $$$s.
This topic is so huge and all-inclusive that it resembles the car-dependency situation in the US of A. “Fixing it” would entail so many changes that it next to impossible to imagine where to start. To me the basic line is the people themselves, the voters. Only when they no longer accept the current situation and demand a different, a better system things can start to improve. Your nurse example was revealing. She is not willing to give up her humongous salary in favour of a better system. Understandable, since it is the foundation of her life choices. These things can never be made individual but need to be universal. Hence the term universal healthcare. If it is your personal responsibility not to get killed in traffic, you buy a giant SUV and make sure YOU are safe, high and dry in your vehicle. The fact that other road users may get killed in the process is their problem, not yours. The same applies to healthcare.
It’s not as hard as you think.
It takes one step. Get rid of capitalist intrestgroups from politics. Aka ban fucking lobbing and corporate donations.
US has a massive real economy and a fiat currency. Which means money and goverment spending never could be an issue. The more the goverment spends on projects the better. It would eat into capitalist’s profits tho, that’s why it’s not happening.
Same goes to US car dependancy, scarsity of housing, poverty and inequality and so god damn many other problems.
Just fucking take back politics from the corporations...
@@azpont7275exactly.
@@azpont7275 the biggest problem of universal healthcare isnt that its not affordable but rather that the moment you implement it so many people that are currently not able to get real care would use the system that for the first dozens of years or maybe a bit more it would be incredible pricey. the US basically fucked itself with such a bad system that it cant change it without massive spendings now.
The three highest paid jobs in Australia are surgeons followed by anaesthesiologists followed by specialist physicians. We have universal healthcare but with the option of buying private health insurance if we want some of the non-critical extras like private room, choice of doctors, shorter waiting time for elective surgery.
You'd probably find that preventative health care gets a higher priority as well, which will keep costs down.
@@rey6708The US pays already far too much for Medicare, Medicaid and VA Medic. They (poor, elderly and veterans) represent about 20% of the population and it costs the same (percentage of GDP) as other countries pay for all citizens. Your healthcare system pushes up prices up to five times as high (for medication, operations, treatments, medical aids) as in other western countries. The US is doing something wrong here and employers and healthcare insurance companies are profiting from this mistake.
Very cool and interesting explanation!
Basically it says: All the huge amount of money in the US healtcare system lands in somebodys pocket ..... and nobody wants to lose that.
Very cool the connection to the education and law system - I didn't connect the dots until now.
I think you did a great job of summarizing they key issues in a mere 26 minutes. I’m a health economist and everything you say is spot on. The only thing I’d like to add is that Europeans often have a difficult time understanding the nature of our federation. You cannot really talk about a national healthcare system in the context of a constitution that fundamentally assigns health policy to the states. I live in Maryland. For decades, my state has regulated the price hospitals can charge. We have gone from being one of the most expensive states in the country for inpatient services to very middle of the pack. Our system pays hospitals more only when they deliver higher quality care; for this reason, there are generally no for-profit hospitals in the state. It may look like we have a “broken” insurance market, because our nonprofit health insurer dominates the market. However, this is largely because for-profit insurance companies cannot dramatically change their costs by manipulating their network of covered hospitals. Massachusetts has achieved near universal health coverage. Other states are also working on demonstration projects to move away from a fee-for-service model. Reform is possible in the US, but the magical will happen at the state level.
Many of us know know from deathplenity to abortion.
You less state and too much local state i too many things. By that You lack of needed reforms.
And a kind of funny You fear the state. Its the privates which are the problems in these matters as well.
Good to know, the info is appreciated!
"Only when the deliver higher quality care."
That sounds extremely subjective. It sounds like a scam.
@@jensholm5759 good grief. Can you type whole sentences? I'll likely still disagree with you, hut damn.
Sorry I has a bad spelling day not born the spoon.
A very interesting video, thank you very much for that. It is one of my favorite topics.
I worked for a German employer here in the US for many years. Just recently I became a US citizen as a retiree and this way enjoyed the benefits of the German healthcare system all my working life as well as now Medicare. My impression is, that mainly the political will is not there. And as long as so many people believe it is against their freedom to be 'forced' into a health insurance contract without seeing the benefits of worry free healthcare, there does not seem to be a path forward.
However, in respect to your question: some of the cost could be cut by changing the insurance system; create a non-profit insurance system like in Germany the public health funds/Betriebskrankenkassen. By law they are not allowed to make a profit; if they do, they have to return the money to the insured. The ACA, has something similar if I understand that correctly. If the US insurance company pays out less than 80% of what they took in in premiums, they have to give that back.
Then in respect to education, my daughter is a PhD candidate in medical research. She received her science bachelor from a modestly priced state school and enjoyed from her first day on in graduate school a salary that provides her with a modest living in Manhattan. Students in Science, Technology, Engineering and Math (STEM) are being paid for their research and training they give to younger students. If that is possible for STEM why not for for medical school?
But walking with those ideas into nowadays Congress would probably cause you great bodily harm - and cost for deductibles to have the bodily harm fixed again :-))
Politicians use the word "socialist" to scare people away from universal healthcare. Medical and pharmacist lobbies give those politicians campaign contributions to prevent their cash cow from being popped. The politicians spread hysteria that healthcare will go away and your taxes will go up and it will create a totalitarian state if we move to universal healthcare.
3.9642857142857142857142857142
One of the travesties of the American health insurance industry in the past several decades involves turning very large not-for-profit insurance companies to for-profit companies. Such a huge step backwards. The biggest example is Anthem (now called Elevance) which acquired Blue Cross affiliates in about a dozen different states and turned them into for-profit companies. Luckily, Blue Cross and affiliated companies in most states still operate as not-for-profit organizations.
"That doesn't mean that we as American's don't have a lot to learn from other countries and how they operate." Sadly that is one of the impossible thoughts ever for American's to swallow. I honestly think the world map for most Americans is a map of the Continental United States and beyond that is just says, Here be Monsters. So we almost never learn from other nations.
As someone living in the UK it is my opinion that the USA won't get universal health care because too many individuals and corporations make so much money off poorer people they won't allow it to change, that's what I think.
You are correct
That's about the size of it....
Exactly...and the voter's are stupid.
The average rate of increase for health insurance premiums almost halved for individuals after the passing of Obamacare. It went from 7.9% to 4%. Yes, more money was spent in healthcare but we are covering more people
Europe regulates cost of each medical procedure to prevent price gauging by the hospitals.
Medical degree is free and students are expect to service the society in public hospitals who paid for their degree. Medical staff are given a comfortable income, not a crazy high income
Yes it's not perfect , but the society sounds much more fair than USA
The problem is that a lot of hospitals are now run by private companies, basically equity funds. They have to maximize profits so they try to keep salaries and number of staff low. That's why al lot of nurses are fed up and actually quit their job during or after covid.
There is also the issue of administrative waste, specifically in the insurance side of things. The itemization, collation, billing, price 'negotiation' with insurance companies and so on are a ridiculous affair compared to European style healthcare systems.
The hospitals are incentivized to micro-itemize and vastly overcharge because that's how they make their money, they then have a few rounds of negotiations with the insurance companies and they decide between themselves what the real price is and what is covered or not, if the doctor or specialist was out of network or not etc, etc at the end they decide on a figure that the customer will have to pay.
@@birgitlucci9419there is an issue solution to that problem. Buy them out. Either make private hospital care illegal, or make sure that they can not be run for profit at all. This mean they can not use the money they earn to invest in anything else but the hospital where the money comes from. No you can't use that money to make a new hospital, that is the same as for profit.
Here in Denmark private hospitals can be forced to take on normal people whenever we see it fits. This is almost only used for long waiting times. But we could just send them to the private places if we wanted to, in principle. And they are still here. They need to provide better care than what non-private provides, or specialty care, dental, beauty surgery and so on.
The high standards should never be lower. It should not be profit driven, but driven to provide above normal service or specialty service. That is what I want to see for the school system as well in the USA. Here it is supposed to be like that, if it is like that? Eh it depends. Some are money hungry, who don't care about the education of the kids..
@@Sindrijo You're exactly right - And the right try to claim nationalisation leads to administrative waste and "big government". In reality it's always the opposite!
It's increasingly going that way here in the UK too, with every little hospital department having to consider itself as a small business. It's shockingly bad, un-cost-effective management, but due to right wing interference trying to gradually privatise the NHS over several decades. Everything has to be cost controlled and within certain budgets etc. when it's supposed to be a service that's already paid for. I can see first hand how the whole system is getting ready to be able to provide itemised bills when they finally start charging patients here.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,..-,.-,.-,.-,.,
I am from Austria which has nationalized health care with a private option. In essence that means the government decides what you get (in terms of health care) otherwise you need to pay the difference out of pocket or via private insurance. A friend of mine (a orthopedic surgeon) did a study several years back. The gist is people with puplic option only, often don't get hip replacement surgery usually opting for less invasive treatment. While people with private insurance can opt for the surgery whenever they want and have them much more often. Turned out the live expectation of people with private insurance is significantly lower then people who don't have it, because of the risk factor of surgeries. Unsurprisingly technocrats, doctors and statisticians have a better grasp on health care than grandma.
This is really interesting! I wonder if there is a similar research made here where I live (Finland). The system is very similar, and the private sector definitely pushes people to have more invasive treatments than the public sector, including things like x-rays when they are not really needed.
In America, I was sold on a couple of joint replacement surgeries, mostly because it made the practitioners a lot of money. None of them worked out as promised and I sincerely regret agreeing to these surgeries, they have ruined my life.
What annoys me about the German system is that they still allow Homeopathic woo "medicine". At least it generally doesn't make things actively worse.
@@Llortnerof That's a problem here to, it's in my experience more a problem with pharmacies. They tend to push herbal treatments, homeopathy, etc. really hard because prices and profit margins for real medicine is fixed. So if you opt for the herbal treatment they earn more. Doctor tend to give homeopathy to people when nothing would be the best option but grandma wants something so she feels better, hence the sugar pills.
That's actually one of the realizations that led to the plan for the Affordable Care Act (before it was watered down 100 times): by providing evidence based treatments only, the cost can be significantly reduced because with private insurance there is little incentive to avoid unnecessary treatments.
Bravo!!!! My comment is apolitical. I just want to applaud you for a very reasonable, comprehensive explanation. You gave a beautifully unbiased presentation. I love the way you laid everything out and posed your thought-provoking questions at the end.
I lived in Saudi Arabia most of my life. Though a third world world country, healthcare has been fairly accessible even to the poor.
My father once told us that story about an African guy (that had used to work for him) after he had died in his home-country in Africa. My father said, "the guy went to the hospital. Well, if you go to the hospital in Africa, you know you're already dying, because you won't go there unless it is THAT urgent".
Years later after I was in the US, I remembered what my father said, and I was like,
"Thank God I'm not in Africa but in the US.
Oh wait."
How is saudi a third world country
Saudi Arabia is a 1st world country & very wealthy
The US hasn't been able to give healthcare to its own citizens for over a century. RWANDA now has universal healthcare. Thats a country where they were butchering each other with machete's just twenty years ago, and THEY now have universal healthcare.
I have to say one thing about social media now, is that its no longer like when social media first started and it was full of americans talking about how its the greatest country in the world. Now I don't see those kinds of comments very often.
I like apples and I like oranges,but America and Sweden or Finland or Germany America under Obama almost got it right but insurance companies won and now are eating away at your social security system 😅
Can you please expand on that? I don't understand what this story about an African guy has to do with Saudi-Arabia, a rich developed country.
That was a really interesting analysis, showing the systemic problems of US healthcare reform. Thank you for that
I don't know much about healthcare in America tbh. But once I had a conversation with some Americans and their view was "I pay for my healthcare and you pay for yours. I won't pay for you".
I want to believe that this was an exception and not many people there, think like that. But it literally shocked me. I think it's common ethics that when someone needs help for his life to be saved , that he will be taken care of , without getting a bill afterwards that will bankrupt him. Because after all what's above human life? And ofc , we don't live in a utopia and costs need to be paid but that's why we pay taxes here. If an unemployed person needs to be taken care of , essentially the rest will pay for him. But if I become unemployed tomorrow and that unemployed person is then employed, his taxes will save my life. Probably my view is pretty simplistic cause I don't get all the economics.
But I think that the whole mindset of this country is money driven. If a human being is considered an economic unit , how do we expect for the healthcare system to be an exception? I think their whole society needs such a restructure, that a substantial change in this issue, is probably not feasible.
There needs to be an incremental plan drawn in advance. As there can't be one overhaul to fix it all, there need to be time-set milestones for the next 15-20 years so the system can adapt. The most essential coverage must be given as soon as possible (maternity care, antibiotics and life threatening emergencies [including ambulances], and regular blood/urine tests should all be completely free without conditions). The rest can follow in 5,10,... years when the financial burden of the transition relaxes. Most likely, lawsuits would reduce if healthcare was less expensive to the individual, as people sue for minor things in desperation to get some money back on their expenses. Salaries can be just frozen (so the rest catch up with inflation), instead of reduced. Regulations can cap the administrative cost per patient of a hospital in order to be eligible to participate in the program. And most importantly, pharmaceuticals must be made for a fraction of the current cost (with conditions that the cheaper produced, but equivalent quality medications *must* be chosen by the doctor).
Long timeframe is also required so the mentality of the people can change.
You are generally right. The entire health infrastructure in the US is fundmentally broken except for the wealthy and needs to be overhauled to move to a universal health care system. Ashton touched on it when referring to the ridiculous education costs racked up by students which then drives a bunch of other behaviour such as favouring specialisation over general and public health.
The US has the highest health outcomes costs for the lowest outcomes in the developed world. For example, pharmaceuticals are insanely expensive as there is no PBS or equivalent scheme and medical systems are not working together to bulk-buy and price negotiate pharmaceuticals for lower prices.
Another example is the high cost of medical insurance driven from the high payouts of medical claims. If peoples' medical outcomes from bad decisions were still covered by the medical system, and people didn't need to sue to get enough money to cover their future medical costs, then insurance costs would drop.
If there is ever a strong will in the US to improve health outcomes, it will require long-term planning as many existing structures need to be torn down and rebuilt. The current US failure of understanding universal health care is that they just see it as someone else paying for their insurance, and not actually getting insurance companies out of the picture altogether and dramatically lowering the cost of delivering high-value healthcare.
What an excellent video, thankyou. I trained as a nurse in Britain and I've worked for 20 years in France. I earn about 30,000 euros a year, but I have the satisfaction of being proud of providing a public service, while knowing that my family will have their health needs covered.
Like I was saying, people engage in medical field in Europe with commitment and devotion to heal, not to get rich. At least, for the most part. The ambitious ones go to private path and the greedy one go to the US. In Europe, and pretty much in most part of the world, doctors heal people, they're not accountants before being a medecine man.
I have never seen anyone go so much in depth on this issue. You made me realise that there is no quick fix. I believe that the government negotiating prices on medication is a good start, but so far they only negotiate a limited amount of medications. I know there are caveats to that mandate, as having to take into account the cost of research and development, something that limits the bargaining power. Here in Norway, we have no such caveats, and the government negotiate prices of every medication in the country. I know, the pharmaceutical lobby and all of that, but to me that would be the place to start. And again, astonishing and in depth video, I don't know how you are able to do it.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..,-,-,,-,.-,.-,.-
Though I highly enjoyed and mostly agreed with this video, I believe some of the obstacles stated in this video of implementing a certain type of universal healthcare in the USA feels like she's "drowning in a glass of water". Specifically talking revenue and expenses, the administrative costs in the US due to unnecessary practices from the for-profit insurers to ration your care (like prior authorizations, denials, delays or fighting for reimbursement from providers, etc) as you pay high premiums, deductibles, copays and coinsurances would save an astronomical amounts of money. As we know, private insurers never lose, so any provider (ex: radiology clinic) has to fight with admin bs for reimbursement, in order to make sure they don't lose, they up charge an X-ray that the insurance would end up paying because they pass the cost on to the consumer, HOWEVER, if you get that same x ray ordered from your referrer and don't use insurance, you'll pay about half the price as the radiology clinic would get reimburse with no hassle and doesn't need to up charge you (this example is practiced basically in every part of healthcare). You CAN maintain a high reimbursement for the medical staff, you just have to be witty to understand what works and what doesn't: Medical staff works and should deserve a worthy salary, these for-private insurers don't, they jack up the prices to line their pockets, they are parasites and unnecessary middleman. I mean, this is lengthy already and it would take more than a comment to write it all but I wasn't too convinced on how difficult a solution would be on some things that she raised. However, she did mention how lobbyists from all these companies have congress in their back pockets and THAT is the real problem to getting anything done and Obamacare is a great example, lobbyist hands were all over that bill.
That sounds pretty scary. I am wondering, with the density of medical practitioners already low, what happens if you have an accident or some other medical emergency somewhere in the boonies in the US?
But we do have our own set of problems here in Germany. Similar problem, everybody wants everything anywhere anytime. Recources are limited. So they do have to be managed in some way or other. And that management is also strictly politically motivated and dominated. Examples:
- Being a general practitioner or a pediatrician is on the lower end of the reimbursement scale. Hence there are much fewer GPs and pediatricians than needed.
- Being a general practitioner in the countryside is even worse. So lots of practices with the current GPs hitting the retirement age are now closing down for lack of successors.
- OTOH larger cities swarm with lots of the same specialty doctors next to each other. And they all want to make a living.
- Certain types of treatment are being paid better than others. Leading to treatments with may pay better, but are not necessarily better for the individual patient. The notorious example are spinal disc surgeries. Less aggressive treatments would often be more in the interest of the patients, but they pay worse - and might be more expensive upfront.
- Everybody wants to have the full service hospitals and pharmacies nearby, nobody wants to pay for it, and nobody wants have to make do with “only” basic services locally and having to go somewhere else for the specialty services. Even the argument that is much better for you to have your new hip done at a hospital that is making 300 of them every year 80 kilometres away rather than being one of eight such patients locally does not really wash. Typical response: “I want that hospital to be in my town! Period!”. Currently the discussion is about concentrating extreme perinatal care at hospitals which do at least 25 cases every year below 1,250 grams birth weight. According to the studies this would improve the outcome for the newborns - but, well, I think you will guess the general response to that.
- Local politicians revel in "saving the local hospital". Never mind that it is neither medically nor financially viable.
- The medical role model is still the self-employed registered MD with his or her own mom-and-pop practice. Group practices or syndicates are not quite a thing yet.
- And so on.
It is kind of a Gordian knot. Too much government meddling makes things excessively expensive for suboptimum overall performance. Too little oversight does the same, just with a slightly different flavour.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
When I lost insurance and my doctor was begging me to go back for the treatment I needed. I told them "Unless y'all are offering to donate y'all's services, then I can't afford anything. Just visiting you before the other charges is already $200." And the receptionist was worried and said what am I going to do then, and all I could say was just roll the dice and see what happens
It seems to be an attitude problem. US is somewhat unique in terms of the whole "manifest destiny" mentality. If you truly believe that everything is under your control and you can be extremely successful based on the merit of your work and abilities only, it doesn't make sense to build systems aimed at social support. And changing perception of your identity is a very tough thing to do.
Unfortunately, realistically, I don't see how this changes, without things getting so bad in US that society would be forced to re-examine basic assumptions about itself.
You need to admit that your labour and talents are not enough, and that there are things outside of your control, and that investing into the common pot makes sense, becase there might be a day where you'll need that help.
Europe went through that process by virtue of having a lot more time and being a lot more compact than US.
I honestly wish there was an easier way.
I was about to comment: "The problem with the US is the US", which is more or less what you said.
Indeed, the famous quote: "America is the only nation which has gone from barbarism to decadence without the usual interval of civilization"
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.
Just because you asked: 1. Free education. My US dentist wanted $ 800 for a tiny front tooth filling, because she 'owes 265K in education cost'. 2. Forget about malpractice suits. I hate folks who get rich on other folk's misery. Should have sued Kaiser 7 years ago, when they misdiagnosed the staph infection in my knee as 'gout', and the nurse I met the next day, with a red swollen knee the size of a newborn's head told me: 'you were lucky you came here in time, you would have died a painful and horrible death within 24hours'.
I would start with education as well. It would have so many benefits to the society overall. But of course, that is not simple either.
As long as politicians are receiving money from healthcare Lobbyng. or have stock in Health care....., nothing will change.
A few things to address some of the obstacles mentioned here, which can be avoided with good policy:
1) Medical professional wages don't have to decrease. Europeans might be used to the lower wages, but American Healthcare professionals aren't.
To avoid a mass exodus, guaranteeing the standard current of living for medical professionals is a worthwhile investment. The majority of costs in American health, as with most things, is not the labor force, but the profiteering and administrative costs of maintaining the system we have. Remove all that, and we might not be paying half what we do now, but we'll still be paying something close to it.
2) By shoring up wages for medical professionals, the gov't can avoid (but should still be working on solving) the issue of resolving the expense of for-profit college.
3) Malpractice insurance is subject to the same deep flaws of health insurance in a world that refuses to eliminate the profit motive from an industry that in no way benefits from it, in terms of innovation or productivity.
By nationalizing Malpractice insurance in the same way we would health, we can lower costs, saving us money, and work on the cultural practice of suing doctors. At the same time, shunting the for-profit model means fewer medical decisions being made based on what is profitable vs what is medically necessary.
With fewer mistakes and unnecessary prescriptions and procedures, malpractice costs will likely also see a significant decrease. While their lawyer friends might not want to see fewer cases brought to them, this gap can be offset by the fact that absolutely nobody cares if rich lawyers are less rich (😂).
Thank you for your explanation of American healthcare system. We have our own problem with healthcare in Canada, like long wait times. At least I did not go broke due an emergency gallbladder surgery.
Wait times in Canada & in Finland are Longer than I have heard of in the USA. That is also my experience
No one here in Canada likes long wait times! It is because a shortage of doctors and nurses which exists in the US. Here in Canada, there are steps being taken in many provinces to improve situations. I’ve not waited long for good care. Some places are better than others.
I am 70 a Canadian and never suffered from any wait time!
I’m no expert but I have a strong opinion that the source of this inflated pricing is coming from the increasing costs to get a higher education in the medical field. You can justify healthcare wages comfortably sitting way above six figures because the cost of their education is multitudes higher than that. As a result, every patient has to carry that burden. If we want to address why wages are so inflated in the healthcare industry, we have to first correct the outrageous cost of attendance for medical school and the like
It's all part of a system of issues and the cost of education is a part of it - but I wouldn't lay the blame solely on the cost of medical school. Even positions that don't require the same amount of training are also significantly (if not double) the salary in the USA versus most of Europe (administrators, technicians, nurses, etc.). A large part of the issue IMO is that we have no oversight or regulation in how pricing is structured in the first place. Hospitals and treatment centers can make up any price they want for procedures, scans, and visits and bill them to the insurance companies with little to no checks/balances. There is no reason why an head/neck MRI cost my mom $13,000 (before insurance) in the USA, but the same procedure in Germany without insurance costs less than 1,000 out of pocket.
I am Australian. A couple of years ago I had heart valve replacement surgery.All of the tests, appointments etc. leading up to the operatation, my time in hospital and the on going care have not cost me anything.
The nurse salary might be lower in Europe, but so is cost of living. The difference in quality of life might not be very noticeable at all.
Also, a lot of times those people come out of school from whatever medical field with huge educational that unlike in Europe.
And yes, nurses should get paid way more than any tenured college professor that’s foolish to think that the professor should earn more than the nurse
Excellent, fact-based, non-biased coverage of the U.S. Healthcare system. More people in the U.S. need to know the facts underlined in this video.
Nations whose national defense is effectively funded by another nation can well afford to spend that money somewhere else, and need to recognize that their benefactor doesn't have this luxury.
the majority of our hospitals are non-profit. but non profit does not equal non expensive...
In US the nurse example NEEDS $ 120k per year to survive. $ 60k per year in Germany is worth a lot more than $ 120k in the US. When I take myself as example: I would need to earn about three times as much to have somewhat the same quality of living - actually more.
But medical insurance is much of WHY we need so much more to survive
@@Bookhermit Simple groceries is about three times as expensive. And if you look for fresh herbs, which are common here, you won't find them. The dried herbs are 4x or 5x as expensive. If the $ were not a world currency the exchange rate would reflect ist. Hence the reason for more dedollarization pressure than ever before. BRICS might have a real outcome.
Hell, yes, it would work... if only Americans weren't so indoctrinated to misunderstand that 'social' programm does not mean 'socialist' programm.
There are many different ways to make a universal healthcare system work; Germany's being one of them. Yes, it's not perfect, by no means. But it certainly is better than what the USA currently exhibit.
That's my honest opinion BEFORE I watched the video. Let's see how this plays out.
It's super interesting.... the quote "sicko socialism" comes into play in the final chapter, as its a quote from the Fox News Anchor I used in the video. Interestingly it is in reference the expansion of Medicare - which has been in place for almost 60 years.
The problem exists, because the State interferes automatically with the US principle of individual liberty. In Germany you have the same principle, but as it is one country, your individuality is embedded in being a people, what makes one person to an extend more social. In the US, you are not or far less and communitarian only in the traditional States in the middle of the country. Especially at the coastal areas, individual greed thrives in a more and more anomic area, which is a pull factor created by the State's interference. Germany also had it's Obamacare after 1998 (Red-Green) by Ulla Schmidt, what was a horror and got refinanced with a lot of closures of doctor offices in the countryside, so that basically migrants can get free stuff in the city and it's not crashing instantly.
@@urlauburlaub2222 I think there is a big difference in mindset between the USA and Germany. Americans (as a group) usually are talking about their 'rights' and 'choices'. Germans have 'obligations', restricting their 'freedom' like in not defaming your opponents (Artikel 2, Grundgesetz: "Jeder hat das Recht auf die freie Entfaltung seiner Persönlichkeit, soweit er nicht die Rechte anderer verletzt und nicht gegen die verfassungsmäßige Ordnung oder das Sittengesetz verstößt."), not shooting at people, yielding your right of way on the street (§1, STVO: "Wer am Verkehr teilnimmt hat sich so zu verhalten, dass kein Anderer geschädigt, gefährdet oder mehr, als nach den Umständen unvermeidbar, behindert oder belästigt wird.")
@@wora1111 Hmm, no. The US Constitution doesn't say anything else than the German one, but the US is far more multicultural and Socialistic than Germany. So, the average German is more social. Younger generations are different, because they are not homogenous anymore and so they are more like the US Americans and want less community.
@@urlauburlaub2222 "the US is far more multicultural", hmm, willing to take a ride with the Straßenbahn with me in Karlsruhe? Those that can be called 'Germans in second generation' are the absolute minority - even though all will talk German among themselves, usually fluently, many without any accent. Even more so with the younger people (30 and below).
I know fewer 'young' people but those I know are not less social, they usally hvae thought about the subject less that the older ones. But when watching their behavior they are just like us 'old ones': Getting up to make room for older people, moving to the side of the road to let others pass more easily, and so on. And yes, that includes immigrants and refugees (after they acquired some German).
I’m an American expat retired to France. Health care here is magnificent. I pay €600 per year for health insurance. This covers 70% of the cost of treatment. Here, a primary care office visit costs €27 (about $30) I’ve had extensive cancer surgery years ago and with long term illness, like cancer, the medical expenses are covered at 100%. (Their goal is to keep people health and to treat them, rather than to make money.) I again have cancer and am being treated at a hospital that’s 1 1/2 hours away. I have free medical taxi/ambulance coverage. They pick me up at my house and take me to the hospital and either wait or come back later to take me back home. When I need blood tests, a nurse comes to my house. Here, doctors go into medicine to helps people, not to get rich. It makes a huge difference,
When I was growing up, kids got vaccinated at school. If we really wanted to, we could offer health screenings for everyone and address issues before they become chronic. Prevention being a focus, more than expensive hospital stays and drugs.
America is like a job with crappy benefits. Most Americans have never traveled and lived outside the country and are none the wiser about what life in other countries is like. Like a job, you can always leave it for a better one if you are brave enough, and wise enough to know there is something else better out there for you.
Why couldn't an individual State create a social medicare system?
I understand that would have it's own hurdles, but if all private insurance in the state of Hawaii (for example) was funneled through the state (along with Medicaid) it should allow the oversight necessary for universal access for state residents. If insurers are paying more per citizen than in Canadian or European systems, there should be incentive to explore a more efficient option.
Its funny that as a Surgeon with nearly 20 years of practice and the highest qualification in my field of work, I earn as much as a nurse in the US. ( in the case of a Dollar like now nearly equals a Euro and both numbers are brutto)
As a US citizen, this video was very educational and explained in layman's terms quite well the failure of the healthcare system that does not break you financially. I have lived in Hungary for 3 years now and am thankful that I can see a doctor or dentist when I need to and not have anxiety about going into financial ruin.
Endless story. It will never change. Work, work, work, buy, buy, buy, earn, earn, earn, have, have, have.
Not sure that the first cab of the rank for addressing cost should be worker costs.. e.g. nurses. They at least work for their living. Insurances, pharma profiteering, hospital overcharging are all lower hanging fruit.
As a medicaid recipient: I see value in allowing a basic level of coverage, such as in basic doctor visits and such, and my sister is in the Healthcare field and she supports UHC, but America has many specialized categories in the health field, and how would that play? We definitely need to bring the cost of our education down as a factor for any major healthcare reform. The costs of college tuition is outrageous.
The reason medical school has gotten so expensive is because American college funding is operated with near-total disregard for the law of supply and demand. If your response to rising prices is to enable the buyer to increase demand (and that is exactly what student loans do), you're going to get higher prices.
When the UK introduced the NHS (universal health care system) just after WW2 there was considerable opposition from the doctors and less so from other staff. This was overcome by a capitalist country with difficulty as Bevan, the government official driving the introduction of the NHS, drove it very hard in a country and it's people that had just gone through a war and believed all people deserve proper health care.
The system also allow private health care if an individual should want it but gives no reduction in contributions to state health care.
A few thoughts come up around the idea of health insurance:
1. Health insurance companies are not charities and add zero value to the system (as long as you agree lottery tickets aren't a valid investment opportunity). So doing without them would be an obvious improvement in the financial efficiency of our medical system
2. If you're uninsured, pretty much every health care provider will automatically cut your bill in half. Kinda makes the while thing look like a scam
3. When someone says they're against universal healthcare because they "don't want to pay for other people's unhealthy decisions", what do they think the hospital does when someone else can't afford to pay?
4. Insurance companies have entire departments devoted to finding new and interesting ways to deny claims. As a anecdote, my ex once had her routine obgyn checkup declined due to an unspecified "pre-existing condition". On appeal, we were declined yet again and gave up and paid. What was the condition? Being female? The world may never know
I'm in the building trades and have been in a LOT of homes in 4 decades I've been doing finish carpentry. I can tell you hands down, besides lawyers, Doctors have the nicest, most expensive homes and furnishings inside. Sure they may not early in their career, but they eventually get there and when they do money seems to be no object for them.
It is a big problem, that the US healthcare system is business rather than a utility.
To change that could be done over time without breaking the bank.
A slow transfer from private incentives to non-profit or even state funded healthcare, could save the common man, and keep the doctors and nurses not happy, but maybe understanding.
No nation gains anything from making healthcare to expensive from large parts of the population.
It might sound cynical, but it could be something like if you are born the 1st of jan. 2024 or later, you will have free non-profit health care for your entire life in the US. That could make the transition less painful and more realistic. Slowly but steady the US citizens would have their universal healthcare, and the business element would slowly fade away at least for the majority.
Rich people could still have their insurance based health care, if they want, but the difference might come down to the art hanging on the walls.
Just my five cents
One thing is never acknowledged. The Canadian system of healthcare insurance costs the Canadian govt. less than what current health insurances + owned suppliers cost US taxpayers. Got that? Here, numbers.
In Canada, your proof of citizenship or landed immigrant status provides you healthcare for ANYTHING, no charge beyong parking fees while your car is in their parking lot. All paid from 9.5% of gdp which government collects as general tax revenue.
In USA, the governments pay insurance companies huge amounts for employee benefit health insurance (federal, state, regional + municipal), PLUS huge amounts for military healthcare, PLUS huge amounts for veteran's healthcare (VA hospital nets etc). When you add together all these costs, they are 2% of gdp HIGHER than the single payer system in Canada costs in total to cover ALL citizens. Yet the US system THEN ADDS an additional 8% of gdp in cost, to cover all the people uncovered! Gross!
And quality is not an issue. I've had many debates. Eg per capita, Canada has twice as many top medical universities as the US. Research is higher in Canada than US, aside from patent extension patents.
To say it differently, if the US implemented the Canadian system of healthcare INSURANCE, then people's taxes would be REDUCED, they would make zero personal payments, and they could tell their priest that they supported a system where no-one got left out on the street.
A little more than decade ago the amount of money that the US government put into the US healthcare system with public expenditure was actually MORE as a percentage of GDP than the UK's National Health Service (which was very good at that time). This very clearly indicates that it was enough to pay for an entirely publicly-funded America healthcare system without the need to resort to private medical insurance.
At that time I should also note the UK's NHS was well ahead of the United States in terms of the standard of healthcare in *most* areas. Americans were paying two and a half times the price for a slightly inferior standard of healthcare. Though the UK NHS has slipped relative to its European neighbours, it would probably still be broadly comparable.
What's certainly true, though, is that Europeans don't worry about healthcare in the way that Americans do. When we watch a film or documentary with Americans talking about deductibles and whether their HMO plan covers them, for many Europeans this is so bewildering that's it's like watching a soap opera set on Mars. It's so beyond parody that it's scarcely believable that people actually do that sort of thing when they could easily afford not to do it all (and pay far less in the process).
In the USA, as in most countries including those with universal healthcare or socialized medicine, there is a combination of private and public healthcare. We have community hospitals run by the counties or cities, and we have private hospitals. If the USA adopted a plan to give everyone a minimum of coverage in public hospitals with employees paid by the public, it could also include provisions to pay for the medical education for those employees who sign up for say a ten year stint with the public system. In addition, all medical malpractice insurance would be covered. This would require the public hospitals to come under a federal system. Costs would come down. Drug prices would be negotiated by the government to a reasonable level.
Meanwhile, private practice and hospitals and private insurance would continue to exist for those who prefer it and can afford it. And due to the existence of the federal system where prices are fixed and lower, private practice prices and drugs should also come down. Also, most people will opt to buy private insurance thereby maintaining the high quality of care and R&D.
What if doctors and healthcare providers got most of their education subsidized by the government if they would agree to a salary scale that would be more in line with a universal Healthcare system that works. If the Healthcare provider decided they wanted to leave the universal Healthcare system they would have to pay the government back the loan for thier education.
I didn't see your previous video, but in the intro you mentioned better wait times in Europe. I lived in Germany about 15 years and my wait times were significantly longer there every single time.
I wait like 10 minutes here in the usa abs sometimes it was like 4 hours in Germany.
Maybe my state and Healthcare provider is particularly good in the usa adhd maybe in Germany the town I lived in was also an exception to the rule, but that was my experience.
Yes, sometimes one has an appointment, and will send away.
This lady makes exceptionally well researched and high quality videos. She's obviously very smart and hard working. Some of the best videos on RUclips.
Thank you!
I work for my county's welfare programs and also believe in universal healthcare. The ACA was definitely not perfected but was a step in the right direction. It opened up free healthcare to a lot of low income families, some of whom I talk to on a regular basis. But I agree with the majority of comments, until we are seen as patients and not customers, it's going to take a lot of work to get out of last place.
Hello. I am a truck driver from Ohio. Before the Affordable Healthcare Act, just about every job I had, offered free single health insurance and family insurance for a small fee. Including the job I have now. In fact, the I have now had really good insurance. Most cases, I only had to pay a $20 copay for just about anything. After they passed the Affordable Act. The company did away with my insurance all together. And the paper they showed me, the insurance didn't just double. It went up 4X. They just couldn't afford to keep the employees insured. And it was cheaper for them to pay the penalty instead of even keep us insured with crappy insurance. So that's what they did. I tried to look for places I knew had good insurance. But pretty much every place locally did pretty much the same thing. I haven't had insurance since. I am in a gray area. I make to much for free or discounted insurance. I just can't afford it. Thanks for the good video!!
The NHS in the UK was developed in the late 1940's, when the country was still recovering from World War 2, London and our other cities were bomb damaged ruins. It was done without 'bankrupting the country'.
So I'm sure the US, the richest country in the world, can do it too, if they want to. If only the US could start thinking of healthcare as a service and not a business.
Would Americans want their police and fire depts run the same way as they run their healthcare
The USA needs public health care. Health is paramount, nothing else matters.
Everybody wants to live a good, nice life, so in order to do that you need to be healthy.
I've been enduring pain for three years in a row and the doctors haven't solved my problem yet.
I've been paying medical debts for three long years and no one takes away my pain.
Physican salary has stayed almost the same in the past 50 years when considering inflation and total % of healthcare spending, while other sectors such as pharma, medical devices, logistical services, and admin have increased by 100s%. I feel focusing on the salary of workers doesn't paint a fare picture on the reasons of healthcare costs. Healthcare was much more affordable decades ago while at the same time individual physician pay was higher when adjusted for inflation.
I lived in Japan for ten years. Their universal system(shakaihoken)was fair and affordable. I only paid 22900¥ ($229.00)a month, and it covered 70% of treatment, drugs, and dental. It worked! I never had a high medical bill. Since returning to the US last year, I have already accumulated $1900 medical debt. When I talk to people about it, they immediately shut me down and scream socialism and try to tell me how it's unfair to have to pay for someone else’s medical bills and that it would take months to see the doctor. 🙄
The problem is far more fundamental. The Manchester capitalism prevalent in the US has always favoured the wealthy. The leaders of industry have egregiously indecent salary levels that are completely detached from their input. There is nothing wrong with a market economy so long as it is regulated to the point where free enterprise is creating wealth for the well being of all but excessive concentration of wealth is shunned. The de-regulation of financial markets, leading to excessive profit maximisation for the sole benefit of shareholders has impoverished a very large number of salary earners and destroyed whole industries. The Boeing company after the “reverse” take over by McDonnell Douglas is a good example. A well run corporation requires to be a good social player, not only a money making vehicle for shareholders. As a former owner of a small industrial group of companies I know what I am talking about. Our companies were very profitable but immediately after sale to another industrial group, benefits such as a double December salary for all and four weeks fully paid holidays for our entire work force were rescinded by the new owner.
in Australia we both have government Medicare and private medical insurance,
Ive heard of so many times from Canadians how their system still requires loads of things to be paid for, the governing bidy rejects procedures, and wait times are insane.
The US has a broken healthcare system for sure, but its not the only one.
That might make me sound like I'm opposed to universal healthcare, but I'm not. In the end i just want a system that works, regardless of how it works.
I remember I was afraid to get penalty for not having insurance for half a year because I couldn’t afford it, Obamacare was still expensive with my income at the time.
No federal penalty .
You asked for input in how a universal healthcare option could be implemented in the US, so here is one option I have thought of.
The road to become a licensed physician is very costly, and as you pointed out in the video, often leave the newly minted doctor with a substantial student debt.
If the government could build community hospitals with emergency rooms, or somehow use or create positions in existing private hospitals (nonprofit?) for newly minted doctors fresh out of medical school.
These doctors could have attended medical school for no cost, or at least very low cost, courtesy of the US government, who will foot the bill for their education.
In return said new doctors would contractually work for a period of years, perhaps a dozen, for much lower wage, similar to the pay level for doctors in other western countries.
This model could also be applied to other professionals in the medical field.
There would be a lot of details to work out, but it could be a start.
Thanks for yet another great video.
As far as I can tell (using a very simplified model) healthcare works like this; People pay money into a big pot, when they need healthcare, the money is paid out of this pot. There should be enough money in this pot to pay for all the healthcare requirements for the people enrolled. There should also be extra left over. The difference between for-profit and non-profit, is what is done with that money. One uses that money to pay for people who cannot afford to enrol (or don't earn enough to pay taxes for it, as in the UK) and the other is used to line the pockets of investors. I know this is very simplified but it does point out the absurdity of those who think that socialised medicine (or the ridiculous notion that this is some sort of communism) is in some way different from the way the private healthcare is funded. If you take out a policy tomorrow and get cancer 6 months down the line, who is paying for that treatment? Not you, any money you paid in will be burned through in a couple of treatments or less. It'll be the 'community' of insurance policy holders, whose money is in the big pot that pays for you ( what about the poor idiot, who pays hundreds of thousands into the pot never to get anything out of it?).
In Australia...
A problem with UHC is the hospitals make patients wait for attention anywhere between 4 to 8 hours, making sure patients don't want to attend again.
Private Doctor visits are fine but you might still have to pay a high % of the Bill.
Implement a similar colleges fees system as the UK for medical degree, you only pay back a percentage off your earnings over 30k.
You're gonna have to take control of the hospitals as well.
Tbh the argument against it is basically that too many love and benefit from the grift.
Would take someone like Bernie with the backing of his party to come close to it.
The fact that this is such an open discussion in the US these days is cause for optimism! I remember when Bernie Sanders was running on universal healthcare in 2016, it was still viewed as such a radical idea that would never happen.
These days, it's discussed across the political spectrum in good faith (among the general public). If I recall, I wanna say South Dakota voted to expand "ObamaCare" funding in 2020; a place that was staunchly opposed to it for years. I've even have heavy Republican acquaintances that are open to the idea. With the constant news of mass shootings, they like to point at poor mental health being the main reason behind them, and believe expanding access to reaources to mental help will curb most of the threat of gun violence. I personally think there's more to it than that, but still glad we're heading the right direction. Change is slow, but it's coming.
In the UK that nurse would have to cut her income by far more than a half. Average NHS Nurses pay in the UK doesn't even break $40k. Of course if she is a senior nurse with years of experience and a specialism she could make up to $60k, but only about 10% of NHS nurses are at that level, the vast majority earn under $50k (even after more than 15 years in the profession).
I was unaware of all implications of an eventual switch towards a universal and free health care system, going to salaries, education fees, professional liability, insurances and the justice system. Thanks for the explanation but also disappointed to conclude it will forever be impossible in the US.
You're absolutely right that trying to convert the United States into a "universal" health care system would basically destroy health care in the United States.
But there are a LOT of aspects of US health care that you did not touch on, but you would've had to triple the length of this video to even get a cursory glance at much of that. Even your take on the ACA was woefully simplistic as well. It decimated the health insurance market by severely restricting choice.
One thing about insurance as well many aren't aware of is the loss ratio. That's the minimum percentage of premiums that must be paid out to claims. For large health insurance plans in the US, that's 85%, 80% for all others. States can set that number higher, and States also tend to require insurance companies maintain a "reserve". And the idea an insurance company could just... run short on money seems foreign to so many people. Anyway...
There's also the cost of government regulation. The FDA takes one hell of a cut of that with all their licensing and regulatory fees. Drugs cost billions to bring to market from concept to final licensing. Along with medical malpractice insurance is also business insurance on the drug companies to cover litigation after a drug comes to market. Drug companies also have programs in place to give prescription drugs FOR FREE or at drastically reduced cost to qualifying patients. And part of the cost of bringing a drug to market are the drug studies and clinical trials, in which the drug company not only absorbs the entire cost of all materials, but also covers any health care costs for patients who are in the study, along with paying participants - we've all probably heard the radio ads.
Then there's the single largest mistake the United States ever made with regard to health care: the artificial limits on the number of practitioner licenses and seats in medical schools. And all that came courtesy of the American Medical Association. Add on top of this "certificate of need" laws for building hospitals and clinics or setting up ambulance or medical transportation companies. All of that artificially restricts supply in health care. And "certificate of need" laws are very pernicious on that front since... the other market participants have the ability to veto someone new entering their markets.
You could do a stupid simple move and copy what we do with electricity grid providers in germany. Regulate their profit and cap it at 3%. And regulate what insurances have to cover, make it a standard catalog to make sure they are actually competing on cost and they dont cut the coverage.
And fix your drug prices, negotiate prices and scrap the law prohibiting that.
That would help you a lot without changing the system too much.
Your premise on doctor retention is flawed. Almost all doctors are forced to work under physician groups or hospital dominated practices. Many doctor positions are replaced by nurse practitioners or physician assistants that are paid nearly the same as an MD and sometimes offer superior care, depending on the individual. The provider is not the problem, it’s the profit making entity that oversees the practice. Individual doctor are almost always forced into group practices by the hospital through patient admission policies and cost to maintain a practice, malpractice insurance and insurance reimbursement rules. Hospital administrators have been on a constant assault on non-profit hospitals that had existed and even when denied find ways around the laws preventing the conversion by making every activity within the non-profit building, profit making. The only way to fix this is to eliminate the profit model of medical care. Imagine what would happen if all of our municipal services like roads, sewage treatment and water became privatized. That municipality would either become unaffordable to all but the richest Americans or bankrupt. This is where the “scary” European socialism model model works. If all basic essentials in life were non profit; medical care, water, sewer, electricity, internet, education, transportation then the playing field is leveled. The advantages of inherited wealth still exist but are not insurmountable for the individual. Unfortunately due to lobbying by powerful special interests/profit making entities in our current political climate will never achieve this without a “New Deal” type of intervention by our government with buy in from the politicians and population. The unmitigated greed of certain parts of our corporate world will never allow such altruism and empathy in our infrastructure. In their world empathy is weakness and needs to be routed from the system.
Your missing the number 1 cost of health care is corporate profit CEO bonuses. Stop using nurses and doctors salaries as the main issues
Thank you for pointing out that health care costs are tied to things like lawyers fees (and believe me, those costs go waaaay beyond malpractice premiums). Also in America, everyone is expecting the best care possible. Which includes the latest & greatest in chemotherapy, blood pressure control, “blood thinners”, diabetes and weight control. Also look at how many CT scanners and MRI units PET/CT scanners and expensive angiography suites we have compared to other countries. Also note that your wait-time statistics were for initial evaluation, and not for things like follow-up imaging or elective surgeries. Also, it’s hard to put a dollar value on the cost of the American obesity epidemic, but it is enormous (pun intended).
Finally, comparing with large countries like France and Germany may be reasonable, but comparing with smaller countries with very homogeneous populations, like the Scandinavian countries, which are like medium-sized US states at best, is problematic.
My best suggestion for the US is to cut all Federal involvement, and let the individual states try to figure it out for themselves. Hopefully, you’ll get 50 different solutions, and the best can be a model for the others to follow.
States will never do it. Nice way to forget about it.
There's one issue that nodoby has touched:
The medical profession hs become a cartel in the US. Cracking the cartel will be immensly difficult - they have dug in.
The US Military healthcare run by US government works very well
Excellent description of the Healthcare system in the USA and why universal healthcare for the country has its challenges.
People need to take responsibility for there own individual health and not rely on the sick care system. With more people healthy and well, less patients for the clinics/hospitals = less profits for the medical/pharma corporations. Lower demand for sick care = less cost for it. Those interested in working in the healthcare field would have less financial barriers to face. I'm all for each of us being being health/medically savvy. Perhaps we all can be our own person physician (doctor).
Universal Healthcare EDUCATION.
Personal care is only a small part of health. You are dodging the main issues.
American culture is to help yourself, be independent, why pay for someone else’s care? In the U.K. and EU, we ALL pay to help each other. You can do everything in your own power to stay healthy, but you never know what’s coming, accidents, cancer, genetic dispositions? Can’t see it ever changing in the USA, too many people making too much money in getting people sick, and treating them.
Health Care is also corporate support. Less workers showing up to work sick and making others sick. Less workers unafraid of switching jobs and taking risks.
In terms of high cost of health care and how to help reduce it? One way is to increase the windfall profit tax on the oil companies by 30%. Another is to stop subsidizing the sugar industry and other industry with free money that they don’t even need. Another way is to force the drug companies from charging so much by putting a cap on what they charge. We can always take harsh measures and gradually reduce salaries in the medical field
I currently have a health insurance plan through Obamacare, because I don’t qualify for my job’s health insurance (our parent company requires 38 hours/week to qualify, but our location isn’t open that many hours). I pay $322/mo for it, and while my PCP visits have been free, the insurance has yet to pay for ANYTHING else. Every specialist visit I’ve had (even in network) has been $150-300. I’m hoping I can whittle down the deductible before the end of the year, because I was supposed to have a colonoscopy back in may but couldn’t afford it until I hit my deductible.
As an American citizen without insurance, I could not get a biopsy of what started as a quarter size tumor in the bottom of my right lung for nearly two years while I waited for Medicare to take effect. By the time I had surgery I had less than a third of my right lung because the tumor grew so large from December 29, 2009 to Valentine's Day, 2012, followed by chemotherapy. I have advanced COPD and tackycardia because my heart has to work so hard to get oxygen to all of my body. I am still constantly amazed that the cancer didn't metastasize like it did with immediate family members. I am living the remainder of my life as fully as I can, having previously survived Ovarian and Uterine cancer surgery and chemo in January, 2004. Almost 20 years! I am beyond appreciative of still being alive and fortunate all my cancers were in stage One or Two. I almost "fell through the cracks" as they say. I don't have a solution, I just know it shouldn't be that way. Talk about a helpless feeling. Attorneys are required to donate a certain amount of time to defendants without attorneys, why not doctors? Hospitals? Heavy sigh...
Well, you obviously can't cut reimbursements to healthcare providers... Which leaves you with medication costs and administrative expenses. Education cost and student loans are also a good consideration. A lot of this could be accomplished without increasing government expenditure. It would likely not allow to cut the cost in half, but hey, 20-30% is still a great result.
One solution would be to have the US government lawmakers pay their own healthcare, just as they expect the rest of society to do. than we would be getting somewhere.
They are on Obamacare