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Yeah. The hardest number I've seen is that if we reduced the spend on health care in the US just to the OECD average, it would reduce overall revenue in the se

• whizzter 3y ago
  Depends on how much of that trillion goes to actual salaries or how much goes to dividends? Worst part of the privatization of the Swedish school system is that we know that the tax-money we pay to educate our kids is being diverted to Neo-Nazi funders and Saudi oil funds.
  • secabeen 3y ago
    Outside of Pharmaceuticals, most of the US health-care system is non-profit, so no dividends are allowed. High salaries are allowed, but there aren't business owners that get the surplus the business generates.
    • activescott 3y ago
      The OP article provides clear evidence that for-profit companies is not limited to Pharma: > ...insurers, chemists, drug distributors and pharmacy-benefit managers (PBMs)—sitting between patients and their treatments. In 2022 the combined revenue of the nine biggest middlemen—call them big health—equated to nearly 45% of America’s health-care bill, up from 25% in 2013. Big health accounts for eight of the top 25 companies by revenue in the S&P 500 index of America’s leading stocks, compared with four for big tech and none for big pharma. It goes on to detail their profit relative to the S&P as well.
      • secabeen 3y ago
        Thank you, I stand corrected on this point.
    • GeekyBear 3y ago
      > there aren't business owners that get the surplus the business generates You don't have to be a sole proprietor for those at the top to take a ridiculous level of compensation. > Nonprofit hospitals are under increasing scrutiny for skimping on charity care, relentlessly pursuing payments from low-income patients, and paying executives massive multi-million-dollar salaries—all while earning tax breaks totaling billions. https://arstechnica.com/health/2023/10/nonprofit-hospitals-skimp-on-charity-while-ceos-reap-millions-report-finds/ https://arstechnica.com/health/2023/10/nonprofit-hospitals-s...
    • gumby 3y ago
      This was true until the Nixon administration, which not coincidentally is when the cost structure began to skyrocket.
    • jjeaff 3y ago
      "Most" might be technically correct on some grounds. But more than 1/3 of American hospitals are for profit several of the largest health insurance providers are for profit. and basically every specialist, independent doctor practice out there is private.
      • 0xParlay 3y ago
        Do people ask themselves why Obamacare was politically viable? None of the entrenched interests really seemed to mind.. Wonder if Obama does that wink to his PE friends when they meet
        • losteric 3y ago
          It's called political compromise, you might remember there are two parties in the system.
• dmurray 3y ago
  > we should not accept any health care reform proposal that any of the American Medical Association, the Pharmaceutical Research and Manufacturers of America, or the American Hospital Association are generally supportive of. That seems like a lot of people to piss off to get any reform done. Wouldn't an actual smart negotiator play off one against the other, and make the doctors support the initiative at the expense of the pharma industry, or vice versa?
  • dclowd9901 3y ago
    Hm. That’s a good point. Provide government care and it pays more than private insurance (which it should if economies of scale are employed). That would basically gut the private industry entirely.
  • ericmay 3y ago
    You’re right it’s a lot of “people” to piss off, but in this context it’s like being a sheep trying to negotiate what’s for dinner with a wolf. Speaking of negotiators. These groups have very skilled so they wouldn’t just let themselves be played off against each other to their own detriment.
  • vidanay 3y ago
    I feel like "piss off a lot of people" is a general prerequisite to any substantial reform on any topic. Almost anything that requires reform is going to be at the point where it is being abused and (inordinately) capitalized on.
    • cloche 3y ago
      There's always winners and losers with any type of change. Look at COVID. Some companies thrived and had their best years ever and others went bankrupt and closed down. A lot of negotiators talk about win-win agreements which may be true with just two parties. I think once you get beyond that, no true win-win agreement is possible and some people are going to lose out. Trying to appease every single interest group is what leads to a lack of progress.
  • 3y ago
• maximinus_thrax 3y ago
  > That's a lot of peoples salaries and livelihoods wiped out and they will fight tooth and nail to protect it. Why? We're currently undergoing a major shift in labor wrt to automation, AI which will absolutely destroy entire sectors. Not a lot of people give a shit, it's considered good for the bottom line and for profitability. But when it comes to healthcare, the narrative is that we suddenly care about labor? People applauded the tech layoffs but the parasitic private insurance overhead is just too important? Disgusting
  • gumby 3y ago
    I interpreted that comment as an observation “about the weather”: not defending it, just pointing it out. There’s a parallel to that observation: these parasites are a major part of the S&P (not as much as the article claims, per another comment) which means if they decline it will look like a secular decline in the market (=> peoples’ retirement savings) which will cause vocal anguish. That latter phenomenon is why bills like the IRA splash out so much money on the fossil fuel companies.
  • SoftTalker 3y ago
    AI will hit medicine pretty hard, it seems to me. Everything about medicine that isn't research is mostly identifying symptoms and applying the correct "standard of care" which an AI should be very very good at.
    • deleted 3y ago
      [deleted]
    • Retric 3y ago
      We haven’t gotten rid of pharmacies and that’s the easiest part of medicine to We haven’t gotten rid of pharmacies and that’s the easiest part of medicine to automate. I don’t think AI diagnosis is going to change costs noticeably because tests and treatment is so much more expensive and you need people to provide that.
  • godelski 3y ago
    > AI which will absolutely destroy entire sectors. Not a lot of people give a shit, A lot of people __do__ give a shit and this is a very common conversation among blue collar workers. I've heard about it every Christmas for the past 5 years from people who don't know how to google. Mass shifting in jobs has always been a big conversation but there's just a big divide between the working class where people aren't talking together as much. We have coal miners complaining about "big solar" taking their jobs. We have the whole "just teach to code" fiasco. We have a lot of discussions about Amazon. And I can keep going. If you think this is a "suddenly care" type of thing then you're likely in a bubble or not paying attention (a different bubble).
• deleted 3y ago
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• teaearlgraycold 3y ago
  Same for politicians. If they aren't getting shut down by the established powers they probably aren't the person you want. That doesn't necessarily work the other way, though. Trump getting opposed by many doesn't make him the right guy for the job. But Biden making his way through politics with financial and political support means he's just another one of them.
• vxNsr 3y ago
  Just to put it more succinctly: you’re in favor of angering all healthcare providers (doctors, nurses, etc) to make healthcare better. I don’t know if the outcome you want is the outcome you’re gonna get with that strategy. Might want to consider the humans actually affected and how they might react instead of treating everyone as some faceless cabal of evildoers bent on pulling money out of your pocket.
  • thfuran 3y ago
    And also consider that most doctors and nurses probably don't like the way the healthcare system currently works. Certainly none of the dozen or so that I know personally do. Using "makes doctors angry" a proxy for whether a proposed reform is a good idea probably isn't one.
    • QuarterReptile 3y ago
      On the other hand, "makes doctors happy" would lead you to some bizarre local maxima, and we seem to have quite a lot of those already.
      • vxNsr 3y ago
        I just think angering the people who are supposed to be caring for me is a great way to receive subpar care, I don't care how moral and "above it all" healthcare workers are supposed to be, at the end of the day they're human and if you tell them you don't value their hard work, they may just put in a little less effort than you'd like. (just like you might do the same for a boss who belittles you and refuses to give the raise you feel deserve). As an example, in many countries where they have socialized healthcare, nurses and doctors do often go on strike, which has always resulted in worse care during those times...
  • FireBeyond 3y ago
    > bent on pulling money out of your pocket Speaking of which, I am not sure why doctors are allowed to limit the number of doctors who can become licensed each year.
• tiahura 3y ago
  In the course of my work as an ambulance chaser, I spend a considerable amount of time reviewing medical records and bills - including all sorts of unrelated treatment. I agree with your concerns with the AMA et al. It’s clear that we are way overpaying SOME doctors and hospitals. It’s also clear that our demand for medical treatment is almost insatiable and about as inelastic as it gets. Ie we need to tell some drs and hospitals, fu the gravy train is over; but we also need to tell Joe Public, no you don’t have an existential right to wegovy.
• scotty79 3y ago
  > peoples salaries and livelihoods wiped out and they will fight tooth and nail to protect it And small and big fortunes. Don't forget that those that protect fortunes are way more effective than all other.
• tehjoker 3y ago
  National Health Service, let the government run healthcare.