This will be a little different. I need to rant about health care.
As y’all well know, the United States is the only industrialized nation on the planet still trying to provide health care through a private for-profit system, only using government programs as patches for what the private system won’t touch because there’s no profit in it, like taking care of the elderly.
In 2024, the United States spent an estimated $15,474 per person on health care, according to the Centers for Medicare & Medicaid Services. This isn’t just government spending but all spending, including what we pay out of pocket.
Now let’s look at what other industrialized nations spend. Germany has one of the most expensive health care systems in Europe. They’re spending $9,365 USD per capita per year. Again, that’s all spending. Germany’s health care system is ranked a lot higher than ours, by the way, as measured by outcomes and accessibility. The average spending in European Union countries is $5,005.50 annually per capita. Quality varies, but several of those countries rank higher than the U.S. in quality.
Why are we spending so much more? One reason is that we have no cost controls. I understand providers of pharmaceuticals and medical technology have been free to charge whatever they want in most circumstances. And where else do pharmaceutical companies spend millions on television advertising? Often the same products are far more expensive in the U.S. than anywhere else. Another reason is that keeping track of the many separate insurance plans requires an army of clerical workers to keep track of them. And when uninsured patients can’t pay, or he insurance companies won’t pay, for care already provided, medical facilities often add hidden surcharges to everybody’s bills to make up for the loss.
Other industrialized nations don’t have identical systems, but generally they offer healthcare to everybody through a taxpayer supported system in one way or another. Everybody is covered. These systems get economies of scale and negotiate uniform prices with providers. There is no clerical or advertising overhead. Often there are legal limits on how much profit anyone can charge. Health care dollars aren’t going toward providing profits for insurance companies.
Switzerland is a bit of an aberration. It has a system that’s something like Obamacare on steroids that requires people to purchase insurance policies, but the insurance companies are nonprofit.
Our system is a hot mess that is overrun with price gouging and built-in overheads all over the place. And I am really tired of people telling me that we “can’t afford” a national health care system. I say we can’t afford what we’ve got now. We’re spending all that money and still a lot of Americans don’t have coverage and are basically cut off from the health care system. And it’s going to get worse next year, when more of the cuts in the Big Ugly Bill go into effect.
So keep these numbers handy and show them to anybody you hear saying we can’t afford “Medicare for All” or a national health care system. Please spread the word.
Here's something to think about when considering this broken system. In 2024, seven big insurers posted $71.3 billion in profits and paid their CEOs more than $146 million. This is not overhead, overpriced services or pharmaceuticals, but essentially money taken off the top of what's spent in total on healthcare. This is money that is not going towards care. So when hear about people not able to afford health insurance (and that's key; we're saying health insurance and not "care", which is a big tell in terms of what the system we have is really for). Its this, plus the overhead, plus the overcharging for services that accounts for much of the money that is spent on health care, that does not go to care. This is why healthcare outcomes here are as bad as they are because the system is designed so as to NOT give us what we are paying for. We spend all this money and STILL millions are not covered. By any measure this is a broken system.
As for me, my employer takes a total of $745 per month from my pay in premiums. We have a $5K deductible. Which means in addition to my portion of the insurance, as my employer is paying, that or more, we are still charged for our portion, co-pays, blood tests, x-rays that my health care provider keeps on account, on which we pay another $100+ per month. But if either of us have to stay in the hospital, as one of us did last year, we're looking at additional thousands of dollars. I have a relatively good job so I can afford it. But many people can't afford this level of spending on a service that still may deny you care when you need it, another way they make profit. This is an obscene, inhumane system is not designed to provide care, but to make money off of illness and preventative care.
I would WELCOME paying more in taxes for a single payer system that would save me literally thousands of dollars a year. Abdul El Syed made this point in an MTP interview, where the host tried to intimidate him over raising taxes to pay for Medicare for all. That a single payer system is making headway with the public scares people unfortunately in both parties so much that they are doing all they can to discredit legislators and candidates who would champion common sense change at this level. They would rather maintain the status quo and tell people what's possible in other countries is not possible because of cost in the wealthiest country in the world, so that their big time donors who profit off of this evil system can continue to give them "campaign contributions."
This is why leftist policies are advancing not because of enchantment with socialist ideology but because they see the possible and its really not asking a lot when we can spend hundreds of billions on wars, have our leaders shrug off inflation because it doesn't affect them, while engaging in corrupt deals that have become business as usual.
Canada:Ontario Hospital Insurance Plan (OHIP)
Single payer system for most basics funded out of general revenue. Drugs outside of inpatient status usually self–paid but some employers offer supplementary insurance for prescription drugs. dental, and probably other things I forget at the moment.
Most Canadians, except those reading US–based blogs such as “The Mahablog” will never have heard of “deductibles” or “co–pays”.
I was recently hospitalized for four days with a badly infected leg. I thought it was healing until I woke up one Saturday with a ballooning leg. My stupidity, I should have gone to my doctor.
Services received included CAT scan and an X–ray, various medicines, and inspections (consults?) from a couple of doctors. Upon discharge arrangements were made to have home visits from a wound care nurse and a physiotherapist plus the loan for a month of a bath chair and walker, neither of which I actually needed as it turned out. Total cost to date CDN$0.00.
This is not to say that our Ontario health system or any other Canadian health system is anywhere near “great”, they all have serious problems, but it provides universal coverage for all Canadian citizens and Permanent Residents (equivalent of a US Green Card) .
As far as I know few if any people in Canada face bankruptcy when they need health care. My failure to see my doctor was not for financial worries, I just was a bit stupid and overly optimistic.
Something like that would have ended up costing me literally thousands in copay and deductible payments, even with the insurance I have. Had a similar situation a few years ago. Same insurance which, BTW, is considered "good." I had a swollen leg, they thought it might be a blood clot. I had CT scans and x-rays. Afterwards a "specialist" looked at it. Turns out it was a reaction to medication I had been prescribed and the solution was simply to stop taking the medication. My "insurance" paid for only part of the treatment. I got bills for the CT scan, x-rays, and the specialist. All total cost me upwards of $1200. And I'm already payi9ng $750/month in premiums!
Another time I had to have a colonoscopy. I had one before, and insurance covered it, all but the $50 specialist copay. My employer changed from BC to United Healthcare. I had the procedure and this time they billed me over $2K. Turns out United coded the procedure incorrectly but in such a way that it was not covered. I fought them for months but ended up paying the full amount as I didn't have time and didn't want my credit to suffer (another scam on workers). This is another typical way health insurance companies pad their profits by finding ways to deny care. It should be illegal but so much money is being made and politicians and legislators in both parties are receiving millions in “campaign contributions” that they’d rather have their own people continue to suffer while they piss on us all and call it rain.
This is typical for anyone with health insurance in the US. And yet many people in the same situation as me have been thoroughly propagandized against taxes in general that they insist its better to stick with this crappy system than to pay more in taxes. "I don't want to lose my employer based insurance and pay for others care." Joe Biden had made it such that medical debt was no longer reported on your credit, which would help in terms of bankruptcy. Trump and the GOP reversed it and many thought that was a good thing because, Joe Biden. So its not just the political leaders in both parties, its the f*cking people!
The best health care in America would be having tRump.permanently inserted and attached to your colon. Then you could push out a pooper everytime tRump lies, but only if you eat immense quantities of runny adult-sized roughage and wash it all down with pee.
I can't disagree with a word you said. It looks like the US could cover 100% of our citizens with quality health care at about two-thirds of the current cost (which leaves millions of citizens partially or completely excluded from anything but emergency care when they are at death's doorstep.
Obama walked back the statement that single-payer was the best option. He walked from the Medicare-for-All option. I think because he made a deal with the devil to try to cover everybody by feeding the medical insurance industry. And now even that is getting strangled to death. (So maybe you should have fought the war we have to fight sooner or later…. sooner.)
The American public needs to be reminded frequently of this issue, preferable shortly before elections. Only one party is even pretending to want to provide health care for all. If you want it for you, the safest way to guarantee it is to demand it for all. If you try to game is so it's there for your kind but not their kind, you are risking being redefined as an "out" group sometime in the future.
On the one hand I agree with you on Obama. I understand why he didn't fight harder for single payer at the time in order to get something in place that would provide coverage for more people. What we ended up with was designed in such a way that it was inevitable we would arrive at this moment where funding has been degraded and the program undercut by the GOP, and access diminished. He should have fought for it then.
Its ironic that they are saying, in a not so roundabout way, that Medicare for all is socialism or even "communism" as a way to tamp down the heightened level of interest by the voters in why we are saddled with this system, supposedly for lack of money, when we are spending hundreds of billions on wars and foreign countries who, ironically, take care of their citizens when it comes to health care. We sacrifice on health care, so they don't have to.
I am actually looking forward to the trial of Luigi Mangione, not because I am cheering for him; killing is wrong and if he is found guilty he should pay the price. But because I believe this trial will become a forum to expose some of the more insidious practices of health insurance companies. None of that will justify what Mangione did, but it will hopefully shine a light on the deceptive practices of the health insurance industry.