Why does the U.S. have a poor healthcare system?

[mynjms]

OP could have been worded better

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[yehhhboiii]

Well your initial premise is begging the question. It's not so much a poor healthcare system as it is the poor health of the people that it's supposed to care for. Doctors in other countries aren't dealing with hordes of unhealthy, obese individuals who believe that freedom means they can do whatever they want despite the consequences and have the gall to demand that other people take responsibility for their actions.

 

[Gut Shot]

I have had a difficult time getting a straight answer on this. By what evidence do we say that the U.S. has a poor healthcare system?

I'm sure some part of this belief came from the WHO ranking system more than a decade ago that put the U.S. pretty far down the list of countries in terms of quality of care. However the WHO came under intense scrutiny for their methodology from this report and subsequently ceased publishing their rankings. They were essentially taking self-reported statistics from each country and comparing them directly without actually making sure the statistics were consistent (i.e. what age is a fetus considered "viable").

The WHO model was incredibly complicated. I don't blame them for not wanting to do it again.

I've also heard the argument that we spend more on healthcare than every other country without any improvement in quality. What puzzles me about this is that we spend more on EVERYTHING than every other country: education, recreation, energy, construction, and everything in between.

It's virtually impossible to start a thread like this without an ensuing argument, but I would just like to know: what is your most compelling evidence for why the U.S. has poor healthcare?

We don't just spend more than any other country, we are a severe outlier.

And what do we get for all that spending? Coverage of the entire population? No. Portable electronic health records? No. Shortest wait time to see a PCP? No. Universal prenatal care? No. World-leading access to preventive care? No. World-leading management of chronic diseases? No.

Highest proportion spent on administrative overhead? Yes.

 

[chemsmith]

Well your initial premise is begging the question. It's not so much a poor healthcare system as it is the poor health of the people that it's supposed to care for. Doctors in other countries aren't dealing with hordes of unhealthy, obese individuals who believe that freedom means they can do whatever they want despite the consequences and have the gall to demand that other people take responsibility for their actions.

 

[MiracleforMD]

Make insurance companies non-profit like many European nations. Regain 30-40% of spending. Boom. Problem solved.

 

[Gut Shot]

Well your initial premise is begging the question. It's not so much a poor healthcare system as it is the poor health of the people that it's supposed to care for. Doctors in other countries aren't dealing with hordes of unhealthy, obese individuals who believe that freedom means they can do whatever they want despite the consequences and have the gall to demand that other people take responsibility for their actions.

America has higher rates of obesity than other industrialized nations, but we have the lowest prevalence of smoking, and our rate of alcoholism is on the low side. In terms of cardiovascular disease we are pretty middle-of-the-pack.

So unfortunately you cannot just wave a little magic wand and pawn the whole thing off on fat, entitled patients. Our "system" really is deeply screwed up.

 

[Drrrrrr. Celty]

The Healthcare systems of nations are almost impossible to compare. A nation that is heterogeneous, large and spread out, and multiple environmental and urban factors that affect vastly different populations cannot be compared to a nation that effectively stretches between two longitudinal plains and is in majority populated by one or two ethnic groups.
The American health care system has to deal with a lot more issues than many other nations do. Thus this raises the cost of healthcare through means of transportation, having to buy equipment to stock hospitals across the country, etc.
I mean lets be honest, a small country like Singapore pays less per capita because it only buys enough specific machines per capita, as opposed to the US that needs ever hospital stocked for everything including most situations save for level 1 trauma events ( Which probably ever 3rd hospital is prepared for).

This not to say that we don't have issues, because we do have them. But generally if the healthcare system wasn't as good as it was, then most Americans would be dead by 60.

Edit: Defensive Medicine is the key word in healthcare costs. For every dollar spent on medicine, another is spend on defensive medicine to protect doctors for lawyers.

 

[yehhhboiii]

Okay I will allow for a significant portion of blame to be ascribed to insurance companies and malpractice lawyers who get in the way of the doctor-patient relationship and don't allow for medicine to be practiced as it had been in the past.

 

[Gut Shot]

The Healthcare systems of nations are almost impossible to compare.

Odd, considering people have been doing it for decades.

A nation that is heterogeneous, large and spread out, and multiple environmental and urban factors that affect vastly different populations cannot be compared to a nation that effectively stretches between two longitudinal plains and is in majority populated by one or two ethnic groups.

Why not?

The American health care system has to deal with a lot more issues than many other nations do.

Does it?

Thus this raises the cost of healthcare through means of transportation, having to buy equipment to stock hospitals across the country, etc.
I mean lets be honest, a small country like Singapore pays less per capita because it only buys enough specific machines per capita, as opposed to the US that needs ever hospital stocked for everything including most situations save for level 1 trauma events ( Which probably ever 3rd hospital is prepared for).

Singapore spends less because it price controls the bejeezus out of everything. The rest of the above paragraph simply makes my brain run out through my eye sockets.

 

[Gut Shot]

and malpractice lawyers who get in the way of the doctor-patient relationship and don't allow for medicine to be practiced as it had been in the past.

You mean when doctors could commit malpractice without fear of repercussions? Would those be the good old days?

 

[Aerus]

Me:

 

[Gut Shot]

Me:

I know. Single malt, coming right up.

 

[911 Turbo]

I know. Single malt, coming right up.

Aren't you a surgical resident? Or attending?

 

[Gut Shot]

Aren't you a surgical resident? Or attending?

Either way, I'm off this week.

 

[Drrrrrr. Celty]

Odd, considering people have been doing it for decades.

Does that make it right?

Why not?

You've never been outside the country have you?

Does it?

yes.


Singapore spends less because it price controls the bejeezus out of everything. The rest of the above paragraph simply makes my brain run out through my eye sockets.

Singapore is a city state where the health can be centrally monitored as opposed to peripherally as we do in this country. Sorry, but there's no way getting around it. We waste a lot of money on the necessity of spreading things out to accommodate suburbia. This not to mention over 70% of Singapore is a single ethnic group with almost identical life styles.

 

[487806]

Either way, I'm off this week.

 

[yellowfish]

America has higher rates of obesity than other industrialized nations, but we have the lowest prevalence of smoking, and our rate of alcoholism is on the low side. In terms of cardiovascular disease we are pretty middle-of-the-pack.

So unfortunately you cannot just wave a little magic wand and pawn the whole thing off on fat, entitled patients. Our "system" really is deeply screwed up.

An excerpt from a Kaiser study on U.S. healthcare costs:

"Rise in chronic diseases – Longer life spans and greater prevalence of chronic illnesses has placed tremendous demands on the health care system. It is estimated that health care costs for chronic disease treatment account for over 75% of national health expenditures. [7] In particular, there has been tremendous focus on the rise in rates of overweight and obesity and their contribution to chronic illnesses and health care spending. The changing nature of illness has sparked a renewed interest in the possible role for prevention to help control costs."

Not saying that our system doesn't need [significant] tweaking, but we certainly have some of the highest costs in the world in terms of managing chronic diseases as well as end-of-life healthcare.

 

[Gut Shot]

Singapore is a city state where the health can be centrally monitored as opposed to peripherally as we do in this country. Sorry, but there's no way getting around it.

How about every other industrialized nation, then?

We waste a lot of money on the necessity of spreading things out to accommodate suburbia.

Do you have any evidence that our healthcare infrastructure is poorly distributed relative to population? Or are you just making it up as you go?

This not to mention over 70% of Singapore is a single ethnic group with almost identical life styles.

How do you know their lifestyles are "almost identical"?

 

[yellowfish]

The Healthcare systems of nations are almost impossible to compare. A nation that is heterogeneous, large and spread out, and multiple environmental and urban factors that affect vastly different populations cannot be compared to a nation that effectively stretches between two longitudinal plains and is in majority populated by one or two ethnic groups.
The American health care system has to deal with a lot more issues than many other nations do. Thus this raises the cost of healthcare through means of transportation, having to buy equipment to stock hospitals across the country, etc.
I mean lets be honest, a small country like Singapore pays less per capita because it only buys enough specific machines per capita, as opposed to the US that needs ever hospital stocked for everything including most situations save for level 1 trauma events ( Which probably ever 3rd hospital is prepared for).

This not to say that we don't have issues, because we do have them. But generally if the healthcare system wasn't as good as it was, then most Americans would be dead by 60.

Edit: Defensive Medicine is the key word in healthcare costs. For every dollar spent on medicine, another is spend on defensive medicine to protect doctors for lawyers.

Singapore is a city state where the health can be centrally monitored as opposed to peripherally as we do in this country. Sorry, but there's no way getting around it. We waste a lot of money on the necessity of spreading things out to accommodate suburbia. This not to mention over 70% of Singapore is a single ethnic group with almost identical life styles.

Serenade your arguments are pretty subjective and vague, riddled with assertions without evidence. I'm not convinced.

 

[Gut Shot]

Not saying that our system doesn't need [significant] tweaking, but we certainly have some of the highest costs in the world in terms of managing chronic diseases as well as end-of-life healthcare.

Agreed, but the issue here is really about disease prevalence. The common refrain is that we spend more because we have a higher prevalence of chronic disease than other nations. I do not think that is the whole story.

 

[Planes2Doc]

It's poor for some people, but not others. It depends on who you are.

 

[ZoakRoak]

The answer to this comes with a plethora of non-PC reasons but if people are happy telling themselves otherwise, so be it.

 

[yellowfish]

It's poor for some people, but not others. It depends on who you are.

That seems to be the case across the world. Isn't the issue in the U.S. that, on average, especially when analyzed per capita, our outcomes are worse than other developing countries?

i.e. "in 2006, the United States was number 1 in terms of health care spending per capita but ranked 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy.[3] These facts have fueled a question now being discussed in academic circles, as well as by government and the public: Why do we spend so much to get so little?"

-from the NEJM

 

[Arbor Vitae]

Ain't nobody got time for healthcare.

 

[IslandStyle808]

I have had a difficult time getting a straight answer on this. By what evidence do we say that the U.S. has a poor healthcare system?

I'm sure some part of this belief came from the WHO ranking system more than a decade ago that put the U.S. pretty far down the list of countries in terms of quality of care. However the WHO came under intense scrutiny for their methodology from this report and subsequently ceased publishing their rankings. They were essentially taking self-reported statistics from each country and comparing them directly without actually making sure the statistics were consistent (i.e. what age is a fetus considered "viable").

I've also heard the argument that we spend more on healthcare than every other country without any improvement in quality. What puzzles me about this is that we spend more on EVERYTHING than every other country: education, recreation, energy, construction, and everything in between.

It's virtually impossible to start a thread like this without an ensuing argument, but I would just like to know: what is your most compelling evidence for why the U.S. has poor healthcare?

1) The U.S. focuses on more pay-per-volume health care and not a pay-per-value.
2) The country also focuses on the curative aspect of medicine and not the preventive aspect.

 

[notbobtrustme]

An excerpt from a Kaiser study on U.S. healthcare costs:

"Rise in chronic diseases – Longer life spans and greater prevalence of chronic illnesses has placed tremendous demands on the health care system. It is estimated that health care costs for chronic disease treatment account for over 75% of national health expenditures. [7] In particular, there has been tremendous focus on the rise in rates of overweight and obesity and their contribution to chronic illnesses and health care spending. The changing nature of illness has sparked a renewed interest in the possible role for prevention to help control costs."

Not saying that our system doesn't need [significant] tweaking, but we certainly have some of the highest costs in the world in terms of managing chronic diseases as well as end-of-life healthcare.

Cause or effect? The person who can't afford to visit the doctor lets his issues compound until he/she cannot stand his quality of life. Is that a cause of high healthcare spending or an effect of our policies that marginalizes access to healthcare for a huge swath of the population?

 

[wjs010]

The WHO model was incredibly complicated. I don't blame them for not wanting to do it again.



We don't just spend more than any other country, we are a severe outlier.

And what do we get for all that spending? Coverage of the entire population? No. Portable electronic health records? No. Shortest wait time to see a PCP? No. Universal prenatal care? No. World-leading access to preventive care? No. World-leading management of chronic diseases? No.

Highest proportion spent on administrative overhead? Yes.

and why do you think that is? I think it is because of paper pushers, ie the big fat bureaucratic hand that sticks its fingers in between the doctor and patient.

 

[Gut Shot]

and why do you think that is? I think it is because of paper pushers, ie the big fat bureaucratic hand that sticks its fingers in between the doctor and patient.

Why does it only have to be one thing?

 

[Arbor Vitae]

We also have one of the lowest federal income taxes compared to other nations, which decreases federal revenue.

 

[MedPR]

Because Americans:

1. are fat
2. are lazy
3. expect the government to take care of them, but don't want the government to control them
4. are poorly educated
5. are fat

 

[darklabel]

I believe we are the one of the few industrialized countries in the world that you can declare bankruptcy due to a unforeseen hospital visit as an uninsured patient.

 

[cwrig14]

Because Americans:

1. are fat
2. are lazy
3. expect the government to take care of them, but don't want the government to control them
4. are poorly educated
5. are fat

Relevant avatar?

 

[MedPR]

Relevant avatar?

Pure muscle, my friend.

 

[CrimsonKing]

I believe we are the one of the few industrialized countries in the world that you can declare bankruptcy due to a unforeseen hospital visit as an uninsured patient.

Because in the other industrialized countries you are insured by your national healthcare system.

Not sure what argument you are trying to make, but the waste of that uninsured person simply can't happen in the first place elsewhere in the developed world.

 

[MedPR]

I believe we are the one of the few industrialized countries in the world that you can be uninsured

Yup.

 

[yellowfish]

Cause or effect? The person who can't afford to visit the doctor lets his issues compound until he/she cannot stand his quality of life. Is that a cause of high healthcare spending or an effect of our policies that marginalizes access to healthcare for a huge swath of the population?

That's an example of a particular type of patient, and in this case the answer is both. Marginal access to healthcare is inextricably related with healthcare spending inefficiencies.

 

[GSPhamily]

I have had a difficult time getting a straight answer on this. By what evidence do we say that the U.S. has a poor healthcare system?

I'm sure some part of this belief came from the WHO ranking system more than a decade ago that put the U.S. pretty far down the list of countries in terms of quality of care. However the WHO came under intense scrutiny for their methodology from this report and subsequently ceased publishing their rankings. They were essentially taking self-reported statistics from each country and comparing them directly without actually making sure the statistics were consistent (i.e. what age is a fetus considered "viable").

I've also heard the argument that we spend more on healthcare than every other country without any improvement in quality. What puzzles me about this is that we spend more on EVERYTHING than every other country: education, recreation, energy, construction, and everything in between.

It's virtually impossible to start a thread like this without an ensuing argument, but I would just like to know: what is your most compelling evidence for why the U.S. has poor healthcare?

First, as it has been previously stated by other members, the wording of your question is poor because it already assumes that the US health care system is flawed and is asking for reasons why that is so (you won't really see me argue against this point though). A better phrasing would be why does the US rank so poorly in standard metrics used to measure the health of the overall population while spending more money per capita and more money as a percentage of GDP than any other nation? The US ranks low in both infant mortality and life expectancy and the discrepancies in those figures cannot be adequately explained by differences in demographics between the US and other industrialized nations (such as population homogeneity). The principle question is what about the health care system in the US leads to such gross costs while not providing tangible benefits.

There are multiple reasons for this, but I am going to focus on 4. First, the health care system in the US is extremely complex and complicated, which leads to uncertainty in the health care market. This ultimately drives up costs. If you are over the age of 65 or have end stage renal failure, you probably use medicare to cover up to 80% of your medical costs. If you are unable to cover the remaining 20% or are extremely poor (below poverty in most states), then you probably use medicaid. If you are a military veteran, then you most likely go to a VA hospital and see a VA doctor. If you are employed, then hopefully you are covered by your employer through a private insurance plan, otherwise you have to pay for your own insurance. Except for the VA, which has its own physicians and facilities, all of these different organizations will reimburse hospitals and physicians at different rates. Moreover, up until Obamacare, the procedures covered by these different insurance plans varied, meaning that a procedure that is covered by one insurance plan may not be covered by another insurance plan. (Obamacare has set requirements on procedures covered on the basic plans that insurance companies offer).

Second, another factor that drives up costs are the number of people who are not insured (this will change due to Obamacare). Emergency rooms are federally mandated to admit individuals who are in acute distress, and often times these individuals do not have the means to pay for ER services. As a result, hospitals shift the costs to those with insurance by billing insurance companies for amounts greater than the out-of-pocket costs for a procedure. But the number of uninsured also represent a more unique strain on our health care system. Emergency rooms are federally mandated to admit individuals suffering from acute disorders, but are allowed to turn away people with chronic disorders that are not in acute distress. People that need to be on long term drug regimens, chemotherapy, immunosuppressants, etc, such as people with diabetes, autoimmune disorders, cancer, TB, or HIV who are not insured are unable to secure adequate health care. As a result, their chronic illness is exacerbated until it becomes an acute disorder, which leads them to seek care at ERs. At this point, the cost to care for this patient, and potentially resuscitate them, is much, much greater than the cost to maintain their chronic illness. Part of the reason why these uninsured exist is because A) they were too poor to afford insurance, B) they chose not to purchase insurance because they were young and healthy, or C) insurance companies were not required to cover those with preexisting conditions and were allowed to drop such individuals (Obamacare attempts to address this)

Third, due to the complexity of the US health care system, an enormous amount of health care dollars are spent on administrative and clerical work. The US is unique in that 20% of total health care expenditures are spent on clerical staff and administrative staff. Other industrialized nations comparable to the US only spend about 10%. It is unfair to expect the health care staff (physicians, nurses, OT, PT, etc.) to determine who to bill, how much to bill for, and how to manage the revenue and losses of an organization when their is uncertainty in reimbursement. As such, the US pays enormous amounts of money to money managers, accountants, and businessmen to make financial decisions. As stated previously, part of this is due to the complexity but another part of this is due to a more devious reason. (Obamacare mandates that insurance companies must spend 90% of their revenue on patient care. If this is not possible, then the remaining will be re-issued to the insurance consumer as a bonus.)

Fourth, and most important (at least in my opinion), insurance companies in the US are allowed to operate for profit. This means that insurance companies are more beholden to their investors than their customers, and in some circumstances, the interests of the investor and patient do not coincide. This has led to an enormous bureaucracy within insurance companies to determine what procedures are covered, how much is charged in premiums, the cost of deductibles, who gets covered and who doesn't, etc. etc. Insurance companies must balance themselves between providing enough coverage that they are still appealing to customers, while not so much in order to maximize profits. In some European nations, health care is owned and operated solely by the government. In other nations, only 1 insurance company exists, which is a public insurance company operated by the government. In still other nations, private companies exist, but their operations are heavily regulated by the government. However, in ALL of these cases, health care is strictly a non-profit operation for basic coverage. (Some European countries allow private insurers to profit on "Cadillac" insurance plans)

Now, I'd like to note that though I portray Obamacare in a very positive light in this post, Obamacare does have its flaws. I feel that addressing these flaws go beyond the scope of the original question and this post. Also, sorry for the wall of text.

TL;DR - There are 4 primary reasons why the US health care system has such poor results. 1) The complexity of the health care system. 2) The number of uninsured. 3) The administrative costs of a complex system. 4) US insurance companies are allowed to operate for profit

If you're interested to learn more, I highly recommend The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care by TR Reid.

 

[Izzyi]

I have had a difficult time getting a straight answer on this. By what evidence do we say that the U.S. has a poor healthcare system?

I'm sure some part of this belief came from the WHO ranking system more than a decade ago that put the U.S. pretty far down the list of countries in terms of quality of care. However the WHO came under intense scrutiny for their methodology from this report and subsequently ceased publishing their rankings. They were essentially taking self-reported statistics from each country and comparing them directly without actually making sure the statistics were consistent (i.e. what age is a fetus considered "viable").

I've also heard the argument that we spend more on healthcare than every other country without any improvement in quality. What puzzles me about this is that we spend more on EVERYTHING than every other country: education, recreation, energy, construction, and everything in between.

It's virtually impossible to start a thread like this without an ensuing argument, but I would just like to know: what is your most compelling evidence for why the U.S. has poor healthcare?

The evidence, I believe, is based mainly on the rising cost of healthcare. The quality of healthcare in the US is one of the best, if not the best.

We point fingers at every direction yet we still haven't come to any conclusion on how to fix the US healthcare system.

Firstly, let's count our blessings. In America, people very rarely die of childbirth or cholera. The lifespan of American's are comparatively longer than other countries (#40/198, not bad at all), children get vaccines and mother's get prenatal care. Yay to America.

Now onto the reasons why I think the cost of healthcare is rising.

Defensive medicine plays a part. And I don't believe that it is entirely the fault of physicians. Patients expect perfection and doctors aim to provide perfection, but that is not always the case. A thin red line separates undertreatment and overtreatment, just tethering in between are lawyers who are out to get doctors who have spent most of their lives in hard, altruistic labor (ok, well most of the doctors at least). There should be a cap or some regulation to malpractice issues and there should be a way to tell patients that medicine is not a magic wand to correct the err in their ways (i.e. just because we can do bypass surgeries successfully doesn't mean that it can erase the years of abuse that an obese patient has done to his body)

The obesity problem also plays a big part especially since it targets so many organs which require more specialists which in turn causes more tests to be ordered. It's like an interdepartmental tea party every time an obese, non-compliant patient gets wheeled into the hospital. I don't think that we are quite adapted yet to the changing world; food availability, accessibility, and excesses everywhere (I'm looking at you, buffet enthusiast) are still new to our primordial behavior towards food. We haven't quite 'figured' out yet that these surpluses are actually bad for us. Add to that the external factors that a modern and affluent country can bring to its people; stress, anxiety, depression, etc. all of which can lead to grave health concerns including obesity.

I have read some indignant posts on this thread. I think that we need to remember first that America's healthcare is much better than others, and far better than having no healthcare at all. I admit that it is faulty, and I strongly believe that we can do better.

 

[GSPhamily]

I'd like to address a few things I take issue in the previous post.

The evidence, I believe, is based mainly on the rising cost of healthcare. The quality of healthcare in the US is one of the best, if not the best.

The quality of health care in the US is the best, but access to health care in the US is extremely limited.

We point fingers at every direction yet we still haven't come to any conclusion on how to fix the US healthcare system.

There are many proposed solutions to US health care, but there isn't a lot of political will to address the problems that the US health care system faces.

Firstly, let's count our blessings. In America, people very rarely die of childbirth or cholera. The lifespan of American's are comparatively longer than other countries (#40/198, not bad at all), children get vaccines and mother's get prenatal care. Yay to America.

The US ranks 40th in life expectancy behind Cuba, Chile, Slovenia, and Costa Rica. Moreover, I argue with the contention that mother's get prenatal care. Mother's in the US are not entitled to prenatal or early infant care, this type of care is only available to those who are able to afford it or who are covered by their employer.

Moreover, the US ranks 34th in infant mortality behind South Korea, Croatia, Cyprus and Cuba, just to name a few.

Now if this were all happening because the US spends little on health care, it wouldn't be a big deal. But that's not the case, and the reasons why is what this post seeks to address. The US spends more money on health care than any other nation, and it isn't even a close race. Yet, despite being the only country in the world that spends 17% of its GDP on health care, we still rank 40th in life expectancy and 34th in infant mortality.

Now the reasons you listed for the discrepancy in costs are valid. However, there are other valid reasons for discrepancies in cost and results, such as the cost of pharmaceuticals, greater heterogeneity in the US population, a larger gap between the rich and the poor, etc. etc.

 

[Spinach Dip]

I will make this as simple as possible:

Because America is a capitalist country, and everything is done for profit.

Does your company need more profits? Increase prices or decrease services. Those are the two simplest ways. Repeat across the whole healthcare system for several decades.



I could throw in a dozen more (lesser) reasons, but that one covers most of it.

 

[Yorick]

I will make this as simple as possible:

Because America is a capitalist country, and everything is done for profit.

Does your company need more profits? Increase prices or decrease services. Those are the two simplest ways. Repeat across the whole healthcare system for several decades.



I could throw in a dozen more (lesser) reasons, but that one covers most of it.

This.

 

[GSPhamily]

I will make this as simple as possible:

Because America is a capitalist country, and everything is done for profit.

Does your company need more profits? Increase prices or decrease services. Those are the two simplest ways. Repeat across the whole healthcare system for several decades.



I could throw in a dozen more (lesser) reasons, but that one covers most of it.

But this isn't exactly true, at least for the health care industry. Would you classify Medicare as a capitalistic program? What about Medicaid? Certainly not the Veterans' Association. The lines become blurred further when you consider companies that receive government subsidies and grants. Agricultural companies that offer insurance policies to their employees? Defense contractors? For better or for worse, health care is an industry that encompasses both the private and public sector. When the federal government mandates certain guidelines and policies, its difficult to to definitively say that this is a problem of capitalism. I don't think the US health care system suffers from an ideological problem, at least not completely. I believe that it's a systemic and structural problem that needs to be addressed. The guarantee issue and the individual mandate go hand in hand.

 

[Gut Shot]

Because in the other industrialized countries you are insured by your national healthcare system.

If you take the time to learn about other health care systems you find they are actually extremely diverse in how they are structured and how they deliver care. Britain's NHS is completely socialized. Canada has socialized insurance but most care is delivered privately. Germany has mainly employer-based coverage. Switzerland has an individual mandate to purchase private insurance. To name just a few.

 

[Gut Shot]

Because Americans:

1. are fat
2. are lazy
3. expect the government to take care of them, but don't want the government to control them
4. are poorly educated
5. are fat

This reasoning is

1. intellectually lazy

 

[Gut Shot]

I will make this as simple as possible:

Because America is a capitalist country, and everything is done for profit.

Less than 20% of hospitals in America are for-profit.

 

[Gut Shot]

Now onto the reasons why I think the cost of healthcare is rising.

Fascinating. Do yourself a favor. Google "thomas bodenheimer high and rising healthcare costs" and read Parts 1-4. They are all free access.

 

[IslandStyle808]

The US ranks 40th in life expectancy behind Cuba, Chile, Slovenia, and Costa Rica. Moreover, I argue with the contention that mother's get prenatal care. Mother's in the US are not entitled to prenatal or early infant care, this type of care is only available to those who are able to afford it or who are covered by their employer.

I had a few question about this. I though countries such as Cuba had care that is given by the government itself? Considering that Cuba is not wealth, why would they have the ability to give prenatal care for its citizens while the U.S. does not?

 

[Gut Shot]

I had a few question about this. I though countries such as Cuba had care that is given by the government itself? Considering that Cuba is not wealth, why would they have the ability to give prenatal care for its citizens while the U.S. does not?

Cuba is not wealthy, but it spends almost all the money it has on its health care system, and it is a system that is both highly organized and centered around preventive medicine.

 

[GSPhamily]

I had a few question about this. I though countries such as Cuba had care that is given by the government itself? Considering that Cuba is not wealth, why would they have the ability to give prenatal care for its citizens while the U.S. does not?

It's not that the US doesn't have the ability to give prenatal care, it's that the US doesn't have the incentive or will to give prenatal care nor is it mandated at the federal level (it varies at the state level). This is primarily a function of the US having a predominantly unregulated, private health care system. Insurance companies can choose what procedures their plans cover in the US while in other countries, insurance companies are mandated to cover certain procedures.

Secondarily though, it's because the US really doesn't care about children as much as it should, at least in my opinion. Public education, especially for poor districts, is terrible and underfunded. New mothers are not entitled to maternity leave to care for their newborns. Preschool and early childhood programs are paid largely out-of-pocket by families, so poor families are often unable to afford such care. All of these lead indirectly to greater infant mortality.

A good read is Urban Injustice: How Ghettos Happen by David Hilfiker if you're interested.

 

[IslandStyle808]

Cuba is not wealthy, but it spends almost all the money it has on its health care system, and it is a system that is both highly organized and centered around preventive medicine.

I wonder why the Cuban government puts so much effort into preventive care while the U.S. insurance companies don't? In the long run, wouldn't the U.S. insurance benefit more from a preventive care model vs. curative care model (less people in the hospital=more long term profit)?