Because good things in American healthcare would piss neoliberals off so bad.
Good Thing #1 That Will Never Happen in American Healthcare: Stop Collecting all That Data and running All those Studies
Let other countries run studies on healthcare. They do a better job of it. American healthcare studies are a gigantic scam. They are often funded by Big Pharma or device manufacturers. And they are run through universities that charge big bucks and bill back overhead to the US government. American healthcare studies are the like the Pentagon of the 21st century. Bloated, wasteful, irrelevant, harmful.
Most of the studies don’t benefit anyone. Except perhaps for the big corporations that buy them and the people who run the studies. They corrupt the researchers who rely on them to fund their careers. They pay consulting fees to doctors and researchers to hopelessly and forever compromise the science. Which means it would be laughable if it wasn’t disgusting. The science/medical/academic/pharmaceutical study complex has gone a long way toward destroying American trust in medicine.
You can just imagine how much of a money trough that would shut off. The yowls of enraged funding withdrawal would echo through the halls of giant faceless buildings across the nation. The threats, the warnings, the bitter diatribes. It would be the worst thing to ever happen to America ever – at least that’s what you would hear.
Nevertheless, let other countries do the science. Sad to say – they do a better job of it these days.
Good Thing #2 That Will Never Happen in America: Set an Actual Budget
Whew boy! The US spends about 18% of GDP on healthcare, which is waaaaay more than other nations spend, nations that do a better job on, you know, healthcare. So we’re going to cut that back to 14% of GDP. Which is still a lot more than many nations spend for better outcomes.
OH MY GOD! That’s a huge reduction in actual healthcare spending in America. Oh my god, oh my god, oh my god, we’re all going to die!
That was the vertically integrated for-profit insurers screaming about death by the way. They didn’t mean you were going to die. They meant their executive bonuses were going to die. The HORROR!
So this is obviously never going to happen, but a good thing would be for the United States to do an actual realistic (ha ha ha) assessment of American healthcare capabilities. And the time and resources spent on them.
This assessment would discover that the US healthcare system is a patchwork of insanity. Expensive insanity. Expensive insanity that should, in an ideal world, go the fuck away. That would entail things like changing hospital spending in the US, because hospitals in the US are OUTRAGEOUSLY expensive.
How expensive? Like charging $1.50 for a Tylenol that costs 1.5 cents. 10 times what the pill costs. But hospitals sometimes mark up goods and services by up to 1000%.
One big fat important way to drive down hospital costs is to get rid of the fragmentation of the American healthcare.
Which means getting rid of all those insurance companies and different government entities that get involved and the never-ending expense of billing and collections and all the shit that goes with that.
In fact, you get rid of for-profit hospitals altogether. That gets private equity out of the picture. We’ve saved a shit-ton of money already! Not 4% of US GDP yet, but a shit-ton. After hospitals become non-profit, they stop charging on a fee-for-service basis. So they don’t charge you by the Tylenol and the big expensive unnecessary robotic surgery they make most of their money on these days.
OH MY FUCKING GOD, YOU CAN’T DO THAT! EVERYONE IS GOING TO DIE! By which private equity and insurers and executives and for-profit hospitals mean their executive bonuses. That’s socialized medicine! How can idiots and assholes become supremely wealthy if you have cost-effective hospitals? Maybe they can’t!
GOOD THING THAT WILL NEVER HAPPEN IN AMERICAN HEALTHCARE #3: GET RID OF WASTEFUL, UNNECESSARY, OVERPRICED, INEFFECTIVE SERVICES
Oh dear. The US spends a trillion dollars a year on “unnecessary, overpriced, wasteful, and ineffective services.” A trillion dollars wasted annually in American healthcare.
A trillion.
20% of US healthcare services fall into this category. You could get US healthcare spending down to closer to the norm for developed countries if you just got rid of the waste.
The waste. The gravy train. The fraud. The unnecessary. The overpriced. And the ineffective.
Getting rid of waste in American healthcare would require a culture shift so profound that it would be like rays of heavenly light bursting through the storm clouds of American greed. It would apocalyptic. It would be like making goodness great again. It would be like destroying neoliberalism.
It would be like a miracle.
GOOD THING THAT WILL NEVER HAPPEN IN AMERICAN HEALTHCARE #4: STOP PUSHING FOR LONGER LIVES AND START PUSHING FOR BETTER ONES
You may have noticed, some influential Americans have a longevity fetish. Maybe they’re afraid to die because they’ve heard rumors of hell and they think “Oh shit, I’m a really good candidate for that!”
Maybe not. But the US, and the rest of the world, is jam-fucking-packed with really old people these days. What does really old mean in this context? Over 85.
Some people over 85 have really good quality of life. But lots don’t.
American healthcare ensures they linger after debilitating strokes. Heart failure. Kidney disease. Diabetes. All three. All four.
Alzheimer’s and other forms of dementia take people in slow motion. Elderly people often grind out their days with most elements of their personalities and lives eroded, disappeared, forgotten, invisible.
The drugs and the surgeries work miracles. Miracles of life extension. Miracles of prolonged suffering. Years. Decades.
With everyone afraid to let go. No matter the cost. And the costs can be very very high. For everyone.
The elderly. The families. Society. Including the facilities that house the slowly dying and the underpaid health aides that struggle to care for them.
The motivations for endlessly delaying death may be noble. The realities are cruel. Cruel, costly, and not inevitable.
Other countries do things differently. That may be a scary idea, but things that reduce the cruel and the horrifying are worth looking at. Most of us alive today are going to see more than enough cruelty and horror.
We don’t need to spend our last days on earth wallowing in either.
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