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> much more expensive and for no good reason There is a good reason: profits and management pay. And greed is good, right? > the problems are fixable Fixable

> much more expensive and for no good reason There is a good reason: profits and management pay. And greed is good, right? > the problems are fixable Fixable in theory. The US would first have to fix the underlying issue, which i.m.o. is government, media and even judicial capture by financial interests. Billionaires are now openly buying "shares" in those. I don't see any sign of it changing anytime soon. It only seems to get worse.

sgerenser 2y ago
It's not just profits and management. Administrators, nurses, and yes, definitely doctors, get paid far higher in the U.S. than in other countries. Who wants to be the one to say we need to cut staff, and cut wages for nurses and doctors, in order to bring down costs? Just cutting fat from insurance companies, or having the government step in as insurer with no other changes, wouldn't move the needle much.
- Maarten88 2y ago
  I'm pretty sure healthcare costs in the US are also higher as a percentage of GDP compared to EU, so higher wages would not explain the difference. Also productivity should be higher? I think pharmaceutical, hospital, insurance and legal companies take all the money.
- paulsutter 2y ago
  Doctor and nurse pay is like 13% of costs. Massive savings are elsewhere
  - sgerenser 2y ago
    Yes there’s tons of overhead and extra costs, but it isn’t mostly at the insurance company level. It’s spread all around the system, that was my point. There’s no one “quick fix” that leaves everyone with the same job and fat salary as they had before.
    - paulsutter 2y ago
      That’s right you’d need to eliminate most administrative jobs, all the jobs at PBMs, etc Then these folks can contribute to the economy constructively, somewhere else instead of being a giant helksink of cost. A win-win for everyone
GolfPopper 2y ago
>There is a good reason: profits and management pay. And greed is good, right? I tried to find a health care CEO to comment, but they're all busy hiding from assassins.

sgerenser 2y ago

It's not just profits and management. Administrators, nurses, and yes, definitely doctors, get paid far higher in the U.S. than in other countries. Who wants to be the one to say we need to cut staff, and cut wages for nurses and doctors, in order to bring down costs? Just cutting fat from insurance companies, or having the government step in as insurer with no other changes, wouldn't move the needle much.

Maarten88 2y ago
I'm pretty sure healthcare costs in the US are also higher as a percentage of GDP compared to EU, so higher wages would not explain the difference. Also productivity should be higher? I think pharmaceutical, hospital, insurance and legal companies take all the money.
paulsutter 2y ago
Doctor and nurse pay is like 13% of costs. Massive savings are elsewhere
- sgerenser 2y ago
  Yes there’s tons of overhead and extra costs, but it isn’t mostly at the insurance company level. It’s spread all around the system, that was my point. There’s no one “quick fix” that leaves everyone with the same job and fat salary as they had before.
  - paulsutter 2y ago
    That’s right you’d need to eliminate most administrative jobs, all the jobs at PBMs, etc Then these folks can contribute to the economy constructively, somewhere else instead of being a giant helksink of cost. A win-win for everyone

GolfPopper 2y ago

>There is a good reason: profits and management pay. And greed is good, right? I tried to find a health care CEO to comment, but they're all busy hiding from assassins.