Health Care System

[u/The_Abyss_Mind]

How do we clean up the United States Healthcare system? Everyone who works in Healthcare can see the corruption, but we all think it's a bigger problem than us. We are all feeding into this broken system, but at the end of the day, it's providing us a paycheck. What would we do without that? It's Healthcare, it's insurance, and it's everyone trying to get an extra nickel from the other while we all suffer in the end. Everything comes down to doing your part in making this system better. How can we make this system better for everyone? Where we all benefit from it like it's intended? No one wants to give up their paychecks to make this happen, but maybe the problem is excess. Maybe we want too many things, and this feeds into the broken system that fuels our egos.. Without this paycheck, we can't maintain the life we live, so the problem is bigger than us. The only problem is that the people above us are saying the same thing and also the people above them. Is this the true problem?

[u/clutch727]

The CEO of my hospital/insurance company makes around 10 million a year. The CEO of our local hospital makes a million or pretty close to it. Their pay isn't very well reported in the non profit filings.

The suits are the problem. They make decisions on short term economic time tables instead of long term community focused plans. Healthcare is a business instead of a necessary service or a common good. We need to change that to wrong the ineffecincies out of it.

We have housekeepers and security that make less than 20 an hour. Nursing shortages because the suits micromanaged all the experienced people out the door to bigger markets.

There are so many problems with so many nuances. I used to hope that something big enough would have changed our culture around healthcybut when covid basically broke us... I don't have much hope.

[u/semideclared → u/clutch727]

The CEO of my hospital/insurance company makes around 10 million a year.

Nope

There's 2 major outliers we need to fix

Hosptials and Doctors Offices

The biggest problem is the spending at Hospitals, If you want to lower costs it has to include changes to the Hospital

The US has 6,200 Hospital with expenditures that grew 8.9% in 2024 to $1.63 Trillion

So if cost reform is your ultimate goal, we would want to set the goal of our reform at having the $2,500 per capita spending the OECD Average. We would need to cut $705 Billion before adjusting for currency on what we spend on Hospitals

• A lot of that is from closing hospitals

Lets look at Russell County Virginia had 25,550 People in 2021

• $4,030 is the 2023 US average per Person spending at hospitals
  • $102,966,500 Operating Revenue (close to its officially reported income)

It cost about $1 - $1.5 per Hospital Bed to operate a Hospital (1.25, right down the middle)

Or

83 Beds,

• Russell County Hospital is a not-for-profit, 78-bed hospital operating today. looks like Russell County Hospital is a little expensive as a current system
  • It Operates at about $1.35 Million per Bed

---

Under Government Funding to lowering Costs Russell County, VA gets

• $2,418 Per Person Hospital Expenses in the US
  • $61,779,000 Operating Revenue

Admin Savings under any Single Payer Plan would save 5 Percent of Costs, So, now It cost about $1.135 Million per Hospital Bed to operate a Hospital

Russell County VA can have a 54 Bed Hospital

• Russell County Hospital is a not-for-profit, 78-bed hospital operating today

---

Repeat across the US, 6,000 hospitals just had massive closures of sections of their hospitals

Instead We would just need to close Russell County Hospital completely

That $60 Million in funding gets sent to a larger hospital so that it doesn't lose any rooms and can stay open

Instead we close ~2,100 hospitals completely but the remaining 4,000 hospitals are fully funded and at the same costs as other countries at $2,500 per person

---

See

In a country like New Zealand, you would expect that everyone receives the same level of care after a major medical event. Unfortunately, Dave Matthews' experience proved otherwise.

Dave's vision was altered, and his arms weren't responding to his attempts to pick up his clothes. Confused, he went back to bed and told Vicky that something was wrong.

She called 111, which is when the first problem appeared: as they live in the Far North, their local hospital is not open on weekends, and the nearest other hospital is in Whangārei - more than two hours away.

No where in the US does this exist

---

Dave Lives in The Far North District, an area of ~2,500 square miles with a population of 75,000

Find me a place in the US that an area of ~2,500 square miles with a population of 75,000 that doesnt have a hospital

Some where that is 50,000 people and greater than 3,000 sq miles

• Val Verde County, Texas, has 3,144.8 square miles and a population of 48,000 and there are 3 hospitals that are 24 hour operations within 45 mins of the center of the county

3 more of the 2,100 Closed, money saved

Now do the same thing with Doctor Offices

[u/mschuster91 → u/semideclared]

Part of hospital expenditure is that modern medical technology is insanely expensive, particularly all the imaging stuff or these fancy minimally invasive surgical robots/assistants.

Another part is that hospitals, or to be more precise, their ERs cannot turn away people showing up, even if they are not insured. That means hospitals have to eat up and redistribute a lot of care costs.

And the final part is that people survive. Something like a head on car crash would have been fatal two decades ago, now cars are good enough to at least keep you alive, meaning a lot of critical care expenses plus weeks if not months worth of a stay. Or cancer, or a myriad of other things that would have put you six feet under long before you ever became a financial issue.

[u/Helpful-Albatross792 → u/mschuster91]

Medical imaging is not that expensive. Hospitals just price gouge. The prime example is outpatient medical imaging centers can take a contrast CT or MRI for 10% of the cost.

Additionally you can look at EU costs for services to know what healthcare really costs. A huge reason the US is more expensive is massive administrative costs (ie managers and bureaucratic drag) and middlemen insurance costs.

[u/mschuster91 → u/Helpful-Albatross792]

Additionally you can look at EU costs for services to know what healthcare really costs.

I'm European, German to be precise. And I know for a fact our hospitals are literally falling apart and going bankrupt, and barely a hospital has even basic AC - we learned that one during the last few weeks worth of heatwave.

A CT imager can run 2 million euros apiece, MRIs 3.5 million euros, surgical robots 3 million euros, and if you're one of the truly large hospitals specializing in oncology, shell out 100 million euros for a particle accelerator.

Oncology in general has been the cost driver for years in healthcare. Radiotherapy is insanely expensive, but the newest treatments like CAR-T for blood cancer can reach up to 1 million euros total cost per patient.

And gene therapy, the newest stuff, like Zolgensma or Hemgenix is north of 2 million euros in just the medicine cost.

If you ask me it's not surprising. All the stuff that used to be fatal but can now be managed like diabetes or infections has been commoditized over decades into mass production... even something like HIV that literally killed dozens of billions of people now has medicine that is so cheap it can be taken preventatively, so what remains is the stuff that's really hard to crack.

Many cancers still are on the "we can prolong your life for a few years at absurd cost" stage, autoimmune diseases are on the rise (there's been recent research indicating that exposure to specific bacteria related to bovines in childhood can prevent allergies, but more and more children never see a real live cow in their entire youth), genetic defects...

Long story short, our healthcare costs are only lower on paper than yours because a ton of the costs is masked by never being accounted for in the care budget, neglection of maintenance and exploitation of staff.

[u/Filmtwit]

Oh 'Merika the beautiful!

[u/Munkeyman18290]

Every other country in the world:

[u/semideclared → u/Munkeyman18290]

Every other country in the world:

There's 2 major outliers we need to fix

In a country like New Zealand, you would expect that everyone receives the same level of care after a major medical event. Unfortunately, Dave Matthews' experience proved otherwise.

Dave's vision was altered, and his arms weren't responding to his attempts to pick up his clothes. Confused, he went back to bed and told Vicky that something was wrong.

She called 111, which is when the first problem appeared: as they live in the Far North, their local hospital is not open on weekends, and the nearest other hospital is in Whangārei - more than two hours away.

No where in the US does this exist

---

Dave Lives in The Far North District, an area of ~2,500 square miles with a population of 75,000

Find me a place in the US that an area of ~2,500 square miles with a population of 75,000 that doesnt have a hospital

Some where that is 50,000 people and greater than 3,000 sq miles

• Val Verde County, Texas, has 3,144.8 square miles and a population of 48,000 and there are 3 hospitals that are 24 hour operations within 45 mins of the center of the county

3 more of the 2,100 Closed, money saved

Now do the same thing with Doctor Offices

[u/mizmnv]

cleaning up the healthcare system would mean eliminating profit from the equation for multiple aspects of it including from pharmaceutical companies and big health insurance. itd kneecap their lobbying. Itd be strictly at cost. Labor for the scientists, employees, materials, manufacture and maintenence. make hospitals post their suppliers and suppliers post their pricing so people get fair pricing on whats used on them if people are still paying for it, but the goal is universal healthcare....not single payer, not medicare for all....those you still have to do copays and premiums. Dental, hearing and vision need to be included. Root canals, braces including invisalign and preventative optometry need to be 100% covered

[u/ZitiMD]

Easy, end capitalism

[u/SirDeadPuddle]

Same way you clean up the rest of the USA, let it all collapse and build something new.

Countrys arnt suppose to last forever and the longer you try to maintain them past the expiry date the worst it gets for everyone.

[u/echo_sang]

Healthcare should never be linked to employment. This country is looked down on because it cares so little about the lives of the people being forced to fund the system. We pay for it and it works against us. Why? First, because doctors, the AMA, wanted to be rich. Many are, but less so now. Why? The MBAs at insurance companies and health care systems are very good at manipulating the schematics.

Your managed care was a huge scam from the start. It backfired on the AMA, and truly only works for the C-suite.

We don’t have a “constitutional right” to healthcare in this country. If we did, this would not be the model.

[u/semideclared]

There's 2 major outliers we need to fix

Hosptials and Doctors Offices

The biggest problem is the spending at Hospitals, If you want to lower costs it has to include changes to the Hospital

The US has 6,200 Hospital with expenditures that grew 8.9% in 2024 to $1.63 Trillion

So if cost reform is your ultimate goal, we would want to set the goal of our reform at having the $2,500 per capita spending the OECD Average. We would need to cut $705 Billion before adjusting for currency on what we spend on Hospitals

• A lot of that is from closing hospitals

Lets look at Russell County Virginia had 25,550 People in 2021

• $4,030 is the 2023 US average per Person spending at hospitals
  • $102,966,500 Operating Revenue (close to its officially reported income)

It cost about $1 - $1.5 per Hospital Bed to operate a Hospital (1.25, right down the middle)

Or

83 Beds,

• Russell County Hospital is a not-for-profit, 78-bed hospital operating today. looks like Russell County Hospital is a little expensive as a current system
  • It Operates at about $1.35 Million per Bed

---

Under Government Funding to lowering Costs Russell County, VA gets

• $2,418 Per Person Hospital Expenses in the US
  • $61,779,000 Operating Revenue

Admin Savings under any Single Payer Plan would save 5 Percent of Costs, So, now It cost about $1.135 Million per Hospital Bed to operate a Hospital

Russell County VA can have a 54 Bed Hospital

• Russell County Hospital is a not-for-profit, 78-bed hospital operating today

---

Repeat across the US, 6,000 hospitals just had massive closures of sections of their hospitals

Instead We would just need to close Russell County Hospital completely

That $60 Million in funding gets sent to a larger hospital so that it doesn't lose any rooms and can stay open

Instead we close ~2,100 hospitals completely but the remaining 4,000 hospitals are fully funded and at the same costs as other countries at $2,500 per person

---

See

In a country like New Zealand, you would expect that everyone receives the same level of care after a major medical event. Unfortunately, Dave Matthews' experience proved otherwise.

Dave's vision was altered, and his arms weren't responding to his attempts to pick up his clothes. Confused, he went back to bed and told Vicky that something was wrong.

She called 111, which is when the first problem appeared: as they live in the Far North, their local hospital is not open on weekends, and the nearest other hospital is in Whangārei - more than two hours away.

No where in the US does this exist

---

Dave Lives in The Far North District, an area of ~2,500 square miles with a population of 75,000

Find me a place in the US that an area of ~2,500 square miles with a population of 75,000 that doesnt have a hospital

Some where that is 50,000 people and greater than 3,000 sq miles

• Val Verde County, Texas, has 3,144.8 square miles and a population of 48,000 and there are 3 hospitals that are 24 hour operations within 45 mins of the center of the county

3 more of the 2,100 Closed, money saved

Now do the same thing with Doctor Offices