Social Question

ETpro's avatar

How can the US fix its dysfunctional healthcare system?

Asked by ETpro (34536points) September 21st, 2013

The US is at the bottom of the developed world in healthcare outcomes. Yet we spend a whopping 18% of on Gross National Product on healthcare where the world’s best system, France, spends just half that much per person. Watch this video and then suggest how we might catch up with the best in the world and at the same time contain costs that are on track to bankrupt our economy.

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29 Answers

YARNLADY's avatar

The people in the U. S. are too split right down the middle between wanting it and not wanting it. Unfortunately, with such a disparity, it will not happen any time soon.

ragingloli's avatar

What do you mean by “can”?
Does it mean all theoretically and practically available solutions?
If yes, the answer is universal healthcare.
Or does “can” mean only things that the mccarthyists would not immediately kill?
In that case, you are doomed.

gailcalled's avatar

(its and not it’s)

ragingloli's avatar

you should close the brackets with )

marinelife's avatar

We have a plan in place to make a good start on it, but the Republicans are threatening to block it.

RealEyesRealizeRealLies's avatar

Shoot everybody in the foot.

Everything will change quick fast and in a hurry.

JLeslie's avatar

Some group or organization or President needs to work tirelessly for years to really gather the information about how the system rips everyone off and that there is no transparency. Then they need to convince the population to actually pay attention to health costs and support some real truth to be told. There needs to be a better task force checking on how much fraud is committed, and I am not talking about medicaid and medicare, but I do include those, I mean fraud committed by doctors. i just had another unnecessary test, and when I asked for the doctor to do one additional that I really do need for health reasons, she said I had to make another appointment because of insurance. Fuck that shit! I’m so tired of it, I could cry from it really. The lack of integrity in the system is overwhelming to me.

Forget giving everyone health care (although that is very imprtant to me). What? Give everyone the same shitty, dishonest, overpriced system? The American public is too devided on real socialized medicine, let’s do the American thing of truth and transparency, please let that still exist in my country to some extent, and make this right. This is not buying a dress or a sportscar, this is about our health as individuals and a nation.

jaytkay's avatar

Medicare for everybody.

Even the most right-wing seniors will tell you they like Medicare.

Pachy's avatar

With the plan President Obama worked so hard to turn into the law of the land, he’s taken the first real step toward doing something to fix the system. It’s only a start, but thumbs up to him for his efforts and thumbs down to narrow-minded, narrow-sighted Tea Party folks and others who don’t want to give the new legislation a chance.

Linda_Owl's avatar

Unfortunately we need to make Health Insurance illegal (& I am saying unfortunately because of the job losses). If the United States continues to have huge health insurance corporations, we will never see a better out-come than we have now.

SavoirFaire's avatar

Haven’t you learned anything from the right-wing rhetoric, @ETpro? Fixing problems is socialism. We don’t do that here in America! ~

bolwerk's avatar

ObamaCare offers some improvements. Supposedly healthcare costs here in NY state are expected to drop by more than half thanks to ObamaCare. That’s pretty damn good. Admittedly, we started off unusually high, but both libruls and slopebrows konservatives who claim ObamaCare isn’t doing any good are full of shit, for entirely different reasons.

josie's avatar

By calling it what it is.

A Sick Care System.

When you call it a health care system, morons imagine that health can be bought.

If you call it a sick care system, people may at least begin to think about it.

bolwerk's avatar

I’m guessing @josie is being at least partly facetious, but he has a point. It shouldn’t be a sickcare system though. Part of controlling costs is encouraging people to use the care system to find problems before they become expensive, which means having healthy people get checked out periodically.

drhat77's avatar

We need to decide if healthcare is a business or not. We have this schizophrenic attitude about healthcare where the right hand tell doctors and administrators “cost-containment” while the left says “if you mess up, you can be sued”. The two do not work well together, because cost containment almost always means some tolerance of error. In manufacturing, that means a certain small amount of product is going to be defective. To make every product perfect would too expensive. In medicine, that means a small amount of missed diagnoses or suboptimal outcomes needs to be tolerated.
If it is truly a business, it needs to be treated like one. That means people need to pay for the services provided.
But we can’t do that, because we are compassionate people who cannot tolerate just leaving people to die because they cannot afford healthcare. So if these are our mores, we need to fund it accordingly. Sweden has decided that instead of wringing their hands they allow themselves to be taxed more in order to keep a comprehensive social care program, including healthcare, funded. I don’t know if the swedish system can be applied to us though.

ETpro's avatar

Thanks to all who have replied, It’s nice to see so much interest in how the US can fix its dysfunctional healthcare system.

More later. For now I am flagging myself first for “it’s” when “its” was meant in the OP.

hearkat's avatar

Non-profit health insurance companies would be a good start.

JLeslie's avatar

@drhat77 Then the errors should not be charged for by the doctor. Do you agree with that? Give me a refund when you diagnosed me wrong? Or, when you prescribe me something thay can kill me, when you should have known better? Those have happened to my family more than once and I still had to smile and pay the doctor. I am not talking about difficult to diagnose, or unknown allergies to medicine. I mean things like a doctor prescribing lotrimin to a family member who had a bad case of plantars warts. Or, a doctor prescribing two meds together that have a black box warning specifically not to prescribe those specific drugs together.

drhat77's avatar

@JLeslie I’m not saying errors should be tolerated. I’m saying business-style cost containment applied on medicine can’t work because it would mean acceptance of some kind of error rate, which I think doctors and patients do not want.

JLeslie's avatar

@drhat77 When my hairdresser gives me a bad color she re-does it for free. Part of the cost of doing business is sometimes a person is unhappy with the service, or a garment doesn’t hold up well and the business has to eat the cost. I once had a ultrasund tech in my GyN office completely forget to count my antral follicles when I was thinking about another invitro cycle. This is unforgivable! A fuck up is another month of waiting. Month month month. Not a day. A month when each month it doesn’t work is another month and fertility cycles can actually easily be two months with cessation of menstrual cycles and then the drugs to grow multiple ovums.

So, when I found out she screwed it up, I called the office to come in ASAP to have it redone, and I told them to make sure they wouldn’t charge me, and the fucking bitch argued with me that I have to pay. Sorry to swear so much, but incompetence and having zero empathy or brain power to see the logic in repeating the 5 minute diagnostic is so outrageous and upsetting to me I can hardly think straight. Honestly, it has shortened my life and left me childless dealing woth people like this in the medical profession. I do believe if I had been talking directly to my doctor she would have done it for me no question for no fee, I hope that would also mean not filing to my insurance as well. But, all those GD gatekeepers in the doctors office preventing us from speaking to doctors make it stressful to even insist on speaking to the doctor. It is absolutely horrible. I do have a couple doctors who will speak to me, they would happily say I don’t bother them all the time. Sometimes I don’t ask to speak to them for years on the phone. I really hate being treated like I am the pain in the ass and not willing to pay when they have fucked up. They should be apologetic and accomodating if they had any sense or integrity. I know a little more about medicine than the average person, and I know a lot about things I have done routinely, because I have them done routinely.

Oh, and my credit is over 700 and my husband’s is over 800. I pay my bills. I once sent my credit report to the doctor who was being awful to me, well the billing people, and to the better business bureau. First time I have ever contacted the BBB, that office had one other complaint on record and it was also regarding billing. I asked to speak to the doctor multiple times and they would not let me, this was before it got so blown out of proportion that I wrote BBB.

drhat77's avatar

@JLeslie you are proving my point. Medicine is not just another business. It is not a widget factory. When we make it operate as such is when shit like this goes on.
One of the reasons I like being an Emergency Physician is because there is no gatekeeper while you are my patient. You can walk up to the desk any time and talk to me. But I also run one of the most expensive outfits, and the “business” value of the ER is always up for debate.

JLeslie's avatar

@drhat77 I see your point now. It is the very reason I am for socialized medicine. I grew up in socialized medicing, military, and it was great for the most part. When a friend of mine was starting to obsess about endometria and other female cancers, her doctor scheduled her for an ultrasound even though she had no symptoms. Costs basically nothing, because the machine is already purchased, the tech is salaried, and she just scheduled when there was off hours and they are not routinely busy. So, she was not pushing or delaying any patients who might need it for more cirtical reasons. Her mother died from caner and the worry was getting to her. I know we don’t want people to just have a bunch of senseless testing done, but the dwelling on the costs, that are higher because of the system, is a waste also.

I always say if the government ran things I am sure they would screw some things up, but I also believe the intent would be to provide healthcare to the citizenry. The insurance companies, corporations, and doctors running it has meant the main intent is to make money. Many doctor today chose medicine partly because of the money. Not all, of course some have a genuine interest in medical science and helping people, but they also dwell a lot on the money. I want doctors to make good money for all the work they do becoming doctors and practicing, but I don’t want what procedure they do to affect their income. I mean, I just submitted to an unnecessary internal exam and breast feel me up (barely pushed on my breast, she never would have found a small tumor or cyst, especially if it was against my chest wall or near my underarm) so she could charge me more. I realized once I was already naked and having it done.

drhat77's avatar

Being a soviet emigre always makes me worried about socialized anything. But the problem with our multi payor system in this country is that private insurances can make money by pushing off the higher risk / higher utilizing patients off on the government through medicare and medicaid, thus skiming off the employed / low risk / low utilizers. Whatever buearecrati issues and potential for graft that exists with a one payor system, at least it will solve that problem. It is too much a of a political no-no to touch, though, for most.

bolwerk's avatar

The U.S. has decades of perfectly well-administered Medicare and okay-ish Medicaid. The sky didn’t fall.

ETpro's avatar

@bolwerk Not only did the sky not fall. It is by far our most cost effective healthcare. And it yields great healthcare results because preventative care is available. It would be even more cost effective if Republicans on Congress didn’t prevent Medicare form negotiating for volume discounts on prescription drugs the same way all for-profit insurers do. That alone pretty well tells you who the really care about.

bolwerk's avatar

There isn’t much the Republikans are right about. I really can’t think of a more sociopathic political force in the western world, except maybe (MAYBE!) a few euro-fascist parties that poll in the single digits.

ETpro's avatar

@bolwerk The Republicans are right about what will make the handful of multi-billionaires and huge multinational corporations that fund them fantastically more wealthy at the expense of the rest of us. The most comedic part is most of the Tea Party doesn’t even realize they are stooges being used to do that.

bolwerk's avatar

Are they? It’s a short-term game at best. Eventually, when you keep selling out the future, there isn’t a future left.

Maybe they except The Rapture sooner than I do.

ETpro's avatar

@bolwerk There was a reason that Aesop’s wrote the story of The Goose that Laid the Golden Eggs. But people whose greed drives them to sociopathy don’t care what their actions do to their children. Their only interest is short term gain. Witness the fact that 95% of the increase in wealth since the great recession of 2007 has gone to the top 1%, and that’s not enough for them. The Republican Party is now insisting that unless they can delay of kill the Affordable Care Act, defund food stamps, cut social security and medicare, increase offshore drilling even in environmentally sensitive areas, build the Keystone Pipeline, and enact the Ryan budget with huge tax cuts for the wealthy; they will shut down the government and potentially default on debt Congress voted to incur.

That doesn’t sound to me like someone with a serious concern for the future of this country.

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