Is the Healthcare System Broken?
One thing I hadn't realized when learning about the American healthcare industry is just how ridiculous the amount of spending is. Dr. Sean Masaki Flynn speaks to how this is the case. He points out how the US is using about 18% of GDP on healthcare costs every year, while other areas of GDP are comparatively tiny. The military and social security are both around 4%-5% of US GDP spending. Since other countries are spending much less for much better healthcare outcomes, why is the US still allowed to have such a terrible system?
Overall System
One reason why the Healthcare System is so broken is due to the overall attitudes about insurance. As almost all expenses are paid by the government or private insurance groups, the medical providers don't have a strong connection to the actual patients. To me this is an awful result of the system, due to the fact that it removes the Humanity from the decision making processes. I believe that one essential part of a high quality society is charitable giving, and choosing to give or donate of your time or money to the betterment of the people around you simply because of your moral and ethical beliefs.
As we choose to give to others around us, we forge connections as we learn of others. The third party payer system of insurance takes a lot of that away from our societies because insurance becomes the focus. It isn't a question of what is ailing this certain person, but instead a question of "which insurance codes will I be able to bill for?" While there are absolutely still great doctors out there, it is this overall shift away from the individual person and more towards the entity of an insurance provider that is costing us in this regard.
Inefficiencies in Bureaucracy
One other negative aspect of the insurance system is that it is too expensive. Healthcare costs have grown tremendously, and most people can't keep up. One reason for this is the inefficiencies of the insurance bureaucracy. Instead of one person directly paying another person for a good or service provided, as would happen in a cash and carry healthcare system, we instead have to pay someone, who has hundreds of employees. These employees will collect your information, handle your claims, and talk to the doctor for you. All of which you could do for yourself. Then there has to be someone to manage that employee, someone to train that employee, someone to manage the manager, and the list goes on. All of these things cost money, and the only ways to obtain that money is to charge the customer a high enough price in order to have sufficient margin in order to afford all of those things, and/or to take on so many customers that each employee is dealing with such a volume of customers that the numbers become feasible.
Either option is bad. In the first example, customers are charged more than is fair for the services provided, leading to bloat and increased cost. In the second example, the employees have so much going on that they become less efficient, start forgetting things, confuse one customer for another, or just become generally overworked.
Overall, a more direct cash approach saves money for the average person. Your dollars will go further.
The Worst Case Scenario
I believe that another aspect of why the insurance industry is so prevalent in the US is the fear of the worst. In the event of a disaster, you or your family will likely incur large costs. As the average individual has very little savings, this is a financial nightmare. There isn't a reasonable way to pay for a $100,000 heart surgery, so we turn to payments.
It works similar to any other large purchase. If you are not financially prepared to buy a car or a house in cash you will end up trading a large upfront cost for a much smaller monthly payment. Over the life of this debt, you will end up paying significantly more than the original cost, simply because if your inability to pay the original cost.
This worst case scenario works exactly the same. If someone can not pay for an expensive cost upfront, you will pay hundreds to thousands of dollars a month for your entire life just to negate the possible outcomes of a disaster.
The Middle Ground
Ultimately, our healthcare system needs help. However, there is not an easy solution. We need to find a way to simultaneously reduce costs, increase personal responsibility, and retain a system where people who can not afford payment in the worst cases can still receive high quality treatment.
I tend to agree loosely believe that some sort of required savings program, similar to social security, is a decent middle ground. If people were required to save when they were healthy, most people would have a large chunk of money available for when they are ill. Add contingencies for those people who have the worse happen, and you have at least a better system than what we have currently.
It will, however, not be easy. I worry about how we could adopt a widespread system like this. I think that companies will be slow to move because it may be unknown or difficult. Congress will also likely no help, as they tend not to be able to do much productive these days. Without a country wide acknowledgement of the current broken system, as well as a large effort of reform, I do believe it will be possible. Insurance companies will fight hard to keep the system, because they are the only ones who truly benefit from it.
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