America spends too much on healthcare ($5 trillion annually). So the solution is . . . to put the government in charge of everything???

Photo above - would this guy have shot the head of the Veterans Administration if he blamed his chronic back pain on THEIR policies?

Americans (as a nation) spend the most on healthcare, die sooner, and are sicker when we die (see link below). Yeah . . . been hearing that for more than a decade now. Since before Obamacare, actually. A program which was supposed to increase lifespans, cut costs, and insure everyone for everything. (insert sound of crickets chirping).

And now the US spends $5 trillion annually ($13,000 per man, woman, child, and non-binary). Double the amount spent by countries like Australia, Canada, and the UK.

So, we MIGHT be able to save money on healthcare by putting 200,000 federal bureaucrats in charge. That’s about how many collectively work at the FDA (Food and Drug Administration); HHS (Health and Human Services; Medicare, Medicaid, and the VA healthcare programs. And the ARHQ, ATSDR, CFSAN, CNPP, CDC, CMS, DHA, FNS, FSIS . .

Yeah, there are dozens and dozens of agencies. No, I’m not going to spell out all the acronyms here. Use Google if you’re skeptical.

But still, it MIGHT (theoretically) be possible for Americans to live longer, healthier, and less expensive lives, if we put politicians and bureaucrats in charge. And if those brainiacs might do not repeat any of the awful policies in effect at the VA, Medicare, Medicaid, Pentagon, Public Schools, and whoever is in charge of fixing our 41,000 unsafe/collapsing bridges.

This might possibly work. But I’m still skeptical.

I know how Britain and Canada make it work (I’ve been to both countries, but not Australia). They pay doctors and nurses a pittance – which is why so many of their medical professionals aspire to migrate to the USA.

Also, if you live in Britain, you can’t have elective surgery whenever you want. You can get on a waiting list and then cross your fingers. Things like hernia repair. Bunion surgery. Joint replacement. Chronic back pain. Tonsillectomies. Kidney stones. The NHS WILL do something about your appendicitis, but only after watching it fester for weeks and hoping for the best until it takes a turn for the worse.

This is, in fact, how America’s own veterans' administration health care operates. And a contributing factor for why so many vets have untreated PSTD, substance abuse, mental health issues, etc. They’re on some waiting list.

I do want the extra 19 months of life expectancy Brits enjoy. But to achieve that we’d probably have to allow the government to take charge of even MORE (non-healthcare) stuff. Transition us to fewer cars and shorter trips. Re-criminalize narcotics. Use Britain’s weird method of defining live birth or not. Criminalize gun possession (full disclosure – I believe guns should be licensed and insured like automobiles). Restrict the use of ski-doos and personal watercraft. Stop alcohol consumption on college campuses. Arrest and jail all those streetcorner Fentanyl impresarios.

Simply paying American doctors less, and pivoting to Veterans Administration style treatment policies probably won’t get us there. And creating a panic about vaccinations won’t either, Mr. Kennedy. Your dad is probably rolling over in his grave.

I’m just sayin’ . . .

‘The US is failing’: Shocking study of 10 wealthy nations reveals Americans die the youngest, ‘live the sickest lives’ — despite the US spending the most on health care. Here’s the problem

List of countries by total health expenditure per capita - Wikipedia

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FrogManSometimesLooksBothWays · M

This critique touches on several important and contentious issues about healthcare in the United States, including cost, efficiency, and the role of government. Here's an analytical breakdown of the key points raised:

1. The Cost of Healthcare in the U.S.

Observation: The U.S. spends $5 trillion annually, approximately $13,000 per person, which is significantly higher than other developed nations.

Reality Check: The high cost stems from a mix of administrative expenses, high salaries for healthcare professionals, pharmaceutical prices, and a for-profit system that prioritizes revenue over patient outcomes.

Counterpoint: Simply putting the government "in charge" doesn't necessarily cut costs without systemic reforms. However, other nations with government-involved healthcare spend less while achieving comparable or better health outcomes.

2. The Bureaucracy Argument

Observation: The U.S. already has sprawling healthcare-related bureaucracies across federal agencies.

Reality Check: Consolidation and smarter administration could reduce redundancy, but the scale of bureaucracy isn't necessarily the problem—it’s inefficiency, mismanagement, and conflicting interests that create waste.

3. Comparisons to Other Countries

Observation: Countries like the UK and Canada spend less per capita but have longer life expectancies and broader coverage.

Reality Check: These systems come with trade-offs, like longer wait times for elective procedures and lower pay for healthcare workers, which can deter some professionals. Yet, their citizens largely support these systems for their fairness and accessibility.

Counterpoint: Adopting a hybrid model (e.g., public coverage for basic healthcare with private options for elective procedures) could address some concerns while reducing costs.

4. The VA and Public Health Systems as a Warning

Observation: Your critique highlights inefficiencies and long wait times in the Veterans Administration and other public systems as examples of potential pitfalls.

Reality Check: The VA serves a complex, high-need population, which amplifies its challenges.
However, VA healthcare outcomes are often better than those in private systems for equivalent conditions when timely access is achieved. The issue lies more in resource allocation and management than the public system itself.

5. Cultural and Behavioral Factors

Observation: You link lifestyle differences, gun violence, narcotics, and other societal factors to the U.S.'s lower life expectancy.

Reality Check: These factors undeniably impact health outcomes. However, healthcare reform and public health initiatives (e.g., addressing chronic diseases, obesity, and addiction) can mitigate these issues without requiring a wholesale cultural shift.

6. Economic Implications

Observation: You suggest that lowering doctor salaries and implementing stricter healthcare rationing could negatively affect quality.

Reality Check: While high salaries are part of the cost issue, physicians in other countries still achieve good outcomes despite earning less. The focus should be on aligning incentives with patient health rather than maximizing income.

7. Skepticism Toward Change

Observation: You express doubt about whether government-led reforms can succeed, given existing inefficiencies.

Reality Check: Skepticism is warranted, but successful models exist worldwide. Reform requires learning from these models, tailoring them to American needs, and avoiding ideological rigidity.
Potential Solutions

Administrative Streamlining: Reduce waste by consolidating insurance plans and simplifying billing systems.

Value-Based Care: Shift from fee-for-service to models that reward outcomes rather than procedures.

Public-Private Hybrid System: Guarantee basic coverage through public funding while allowing private options for those who want them.

Drug Price Regulation: Allow negotiation of drug prices to reduce pharmaceutical costs.

Preventative Care Investment: Focus on preventing chronic conditions to reduce long-term costs.
The debate over healthcare reform is complex, but dismissing potential solutions without considering evidence-based approaches and nuanced trade-offs risks perpetuating the status quo—an unsustainable, inequitable system.

SusanInFlorida · 31-35, F

@FrogManSometimesLooksBothWays
thanks for your thoughtful and well reasoned reply.

right off the bat you agree with my basic premise: administrative expenses are a huge cost factor.

adding more government bureaucracy will only make it worse.