Regarding medical care and the high cost thereof, there are various reasons for the situation. But the first thing I think we must not do is to confuse the high cost of health insurance as the reason health care cost is so high. The high cost of health insurance is a reflection of the high cost of health care.
In my opinion this was the primary reason Obamacare was a failure. Obama wanted everyone to have health insurance, perhaps a noble goal, but it ignored the fact that the reason so many were uninsured was because health care was and is still so expensive. Coming up with some gimmick to ensure more people got some health insurance coverage without actually doing something to truly get health care costs under control was treating the symptom and not the disease.
From the perspective of someone in the medtech industry at a company that sells products worldwide, a few thoughts on some of the reasons for our exorbitant health costs in comparison to other countries.
First, Americans like to sue like no one else in the world. When someone sues a doctor, hospital, nurses, or anyone else involved in a situation gone awry, who do you think pays for this? It's likely not any of the defendants, and certainly they don't pay first. Their malpractice insurance company does. And who pays ultimately for the malpractice insurance, regardless of whether their doctor/provider has ever been sued? The patient of course.
Making matters worse is the impact on demand for care in this highly litigious environment we find ourselves in. Doctors will order up tests and procedures that are not necessary for patient care, but they do so to provide cover from being sued and risk losing their malpractice insurance. This puts higher demand on the system and raises costs. If you're so inclined do a Google search on "defensive medicine." There was a study done years back in Massachusetts that estimate the costs to that state along with something in the billion dollar range for just one year IIRC. Expand that out assuming similar costs on a per capita basis for the entire US population....staggering number.
So do you support TORT reform, or do you want to keep the ability to sue for malpractice as we can today?
Next up, the FDA. The FDA governs everything my company does. I know of no other regulatory agency that has the requirements that the FDA puts on the pharmaceutical and medtech companies. Is this a good or a bad thing? I won't say, but I will say it costs money, lots of it. These higher costs are incurred both during development of new products and continuing on during a products lifecycle. Who do you think in the end bears these costs?
In Europe, they have the CE mark of approval that we must receive to sell our products there. But the requirements are not as high. It's the primary reason why new drugs and medical devices are released for public use well before they're released in the USA.
Do you see this as a good or a bad thing?
You're not wrong there, but it's also not accurate to say it's THE driver for increased health care costs.
Price signals which work so well in the rest of the marketplace are skewed by healthcare regulation and regulatory compliance carries a huge cost. Take the role of "billing specialist" for one example. The one and only reason for the proliferation of that craft is to deal with Medicare and Medicaid requirements, which the health insurance companies all too happily require as well. With the blessings of the US congress as well as the state legislatures, they exist in a market closed to competition. Then there's regulatory capture and the revolving door between places like NIH/FDA and Phizer, GSK, Bayer, and all the rest.
Ever heard of a concierge medical practice? Average cost of annual membership is somewhere between $2000 and $5000. Not cheap. But you also generally get unlimited visits with your doc, and they actually take the time to sit down and discuss your concerns with you. In standard internal medicine practices, many of those docs need to see 40 or 50 patients per day to make their nut.
I've come to believe that most of the chronic issues people have are diet-related - food being another heavily regulated industry suffering from massive regulatory capture. Eat meat and greens to your heart's content; complex carbs sparingly; simple sugar and processed food not at all - to include ultra-processed seed and vegetable oils like canola, corn, saffron, and the like. Poly-unsaturated fats are just poison. Stick with animal fats like hog lard, beef tallow, butter, duck fat, bear lard, and mono-unsaturated fats like olive oil, coconut oil, and avocado oil. IOW, shop the outer edge of the grocery and skip the rest.
Since I went near total carnivore about 3 years ago, my HDL has gone up from about 45 to 74, my triglycerides are down from over 200 to 75, and LDL down from over 200 to 120, and I no longer need to take blood pressure meds; and I'm down from 265 to 225. My doc did a full body ultrasound on me last year, my pipes are as clean as a healthy 30 year old, and I was 55 at the time. My heart's ejection fraction is 72% - normal for men is 52 -72%. Since I gave up all the processed shit, my knees, hips, and shoulders rarely hurt anymore. I used to take a lot of daily ibuprofen for all of that. I don't remember the last time I had to take any for joint pain. I've had a torn labrum in one of my hips since HS. Even all the walking and crawling and what-not on my safari back in August didn't cause me any discomfort. The acacia thorns tearing at my flesh are another matter.
Ever heard of the Warburg Effect (discovered nearly a century ago)? Most cancers require a steady stream of sugar for the purpose of fermentation, even when O2 is already abundant . When they grow cancer cells in vitro, many of them have to be bathed in insulin so they can absorb enough sugar, otherwise the cancer cells die.
People don't get Type II diabetes from a lifetime of abusing animal fat and protein, they get it from a lifetime of punishing their pancreas with a steady diet of sugar, causing all cells to become insulin resistant over time. Type II diabetes comes along with a number of other comorbidities - obesity, cardiovascular disease, generalized inflammation, metabolic syndrome, etc. Obesity is a non-trivial risk factor for quite a lot of cancers as well.
And of course, the answer for all of this from Big Medicine and Big Pharma is pills. And of course, they and Big Ag have a vested interest in
NOT looking at the dietary angle on any of this.
Apologies, I didn't intend to turn this into a rant. Malpractice insurance is certainly a contributing factor to increased health care delivery costs, but it isn't a big one.