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this post was submitted on 06 Aug 2023
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We really need to start redistributing how we spend money on health care. Public option, lower executive pay. More non-emergency long term facilities for patients with psych issues or rehabilitation, and chronic illness care. Better pay and shorter shifts for doctors and nurses. Subsidies for medical tech companies to offset end-user price. More government-funded research into medical tech.
Health care should realistically be our biggest industry akin to a military with the social status of being a soldier and the compensation of being a software developer. We have the wealth and technology to help most people live healthy lives. We need the government to incentivize allocating it correctly.
Healthcare is a bigger industry than military. Medicare alone is almost spending the same as defense and that's not counting Medicaid or Tricare (military Healthcare) and private spending.
Executive pay is high and could go down, but it's hardly an issue overall. A big problem is lack of doctors at all, especially rural areas, but general practice is becoming scarce everywhere. There's also a massive incentive problem that encourages companies to have ERs full of non emergencies.
Spending more or adding another public option isn't going to fix the problem, ther needs to be a massive realignment of incentives. Specialists are over paid and over utilized. For example an endocrinologist can charge about twice as much as a GP to manage a diabetic patient and the patient still has to see different doctors for anything else. A GP can manage 95%+ of diabetic patients with no need to consult an endocrinologist and manage the vast majority of other medical issues that person may have. Very few doctors choose to become GPs though because it's significantly lower pay, and not significantly shorter training periods.
The incentive program is screwed up because to a Healthcare company it's more revenue to have people go to the ER for everything than set up a GP office. That also assumes they can find doctors to staff both, which again is getting more difficult. That ER doctor (another specialist) telling someone to drink fluids and rest for a cold brings more revenue than a GP that said the same thing.