[tekla]

One of the things I've observed from lots of interaction with Doctors is that that US health care is FUCKING AMAZING, and that drives up cost.

Everyone wants top quality health care, everyone wants tests, everyone wants scans, everyone wants to cover their fucking ass. Take multiple X-Rays when there is no good reason to, to prevent lawsuits. the guy who lied about taking Heroin gets a full lab workup for no good reason.

USA has top tier health care. It's simply not economical to give it to everyone who demands it, and Insurance companies are not dumb and believe everything that gets submitted.

[bruce511]

I'm not downvoting you, but your take is perhaps a tad cynical.

I get your point - yes doctors have a lot of tools at their disposal, and yes using those tools comes at a cost, but wouldn't you want to use those tools if you were in that position?

X-rays are not exactly cutting edge- if a fracture is suspected they are fundamental. Bloodwork etc are key diagnostic indicators. Sure people lie ("Everybody Lies" - House [1]) tests are helpful to understand those lies.

It absolutely can be economical to give everyone the best possible health care - especially at the primary diagnostic stage. That being true, yes, every part of the system is independently determined to maximise their profit. From the X-ray operator to the blood-test-maker.

It's worth remembering that these common tools, that have been around for decades, are still more expensive (by a lot) in the US than elsewhere. Yes, health insurance makes massive profit. But so does precisely everyone else involved at any level.

So if it is "not economic" perhaps its more any issue of "greed" than math.

[1] House is an old TV show about computer support, using medicine as a metaphor.

[mikem170]

> USA has top tier health care. It's simply not economical to give it to everyone who demands it

I've always thought that this is something basic that we need to address as part of any health care reform.

We can't afford to give everyone unlimited health care, so how do we determine the limits?

I assume that a lot of socialized health care systems end up using waiting lists, perhaps based on the patient's age, treatment cost, and probability of a positive outcome, with the option of going outside the system and paying for more/quicker care, for those who can afford it.

One person I discussed this with assumed that there was plenty of money to give everyone care as good as billionaires get. I don't assume that's true. Has it worked out that way anywhere else?

[Waterluvian]

I think for-profit healthcare can do a lot of unnecessary tests and treatments that fall far into diminishing returns or worse.

It’s not necessarily a good thing to want unlimited healthcare for all. Proper use of a scarce resource doesn’t necessarily mean it’s about rationing it with waiting lists and selective treatment. You can probably get quite far by first not overtreating a lot of people.

[ufocia]

Why do we assume that healthcare is a scarce resource? Sure, maybe some diagnostic/treatment equipment is not available everywhere, but the labor/cost issue seems to be created by regulatory capture, i.e. self-imposed barriers to entry. I agree that it is not in the best interest of the apex providers to change that. Telemedicine could be hugely disruptive if allowed to be practiced cross border between states. So would open collaboration of doctors between countries, e.g. I heard that some pathology operations are already utilizing labor in other countries, but having a domestic pathologist review the findings and signing off.