US healthcare still stupidly expensive, with pathetic outcomes, study finds

Administrative bloat and cost drivers

• Many comments blame US healthcare costs on excessive non-clinical staff: layers of front-desk, phone, billing, and insurance workers for simple visits.
• Some argue this stems from dealing with thousands of insurers and multi-layer coverage, leading to “10 administrators per doctor.”
• Others cite studies (from major medical journals) suggesting billing/insurance-related (BIR) costs, while real, are not the primary cost driver; overall service delivery and end-of-life care dominate.
• There is debate over how large administrative overhead really is (claims around ~25% vs “tens of dollars per encounter”).

For‑profit system, regulation, and market failure

• Many see a profit-maximizing, heavily lobbied system with regulatory capture as core: high executive pay, investor returns, and opaque pricing.
• Others note that other countries also have for‑profit components; they argue the US problem is weak/warped governance, vertical consolidation, and non-transparent markets rather than profit per se.
• Several point out healthcare demand is inelastic and often urgent, so “free market” discipline doesn’t work well.

Health behaviors, food, and built environment

• A strong subthread argues obesity, poor diet, sedentary lifestyles, and car dependence are major drivers of bad outcomes and strain on the system.
• Counterarguments: prevention and management of “lifestyle” diseases are still part of healthcare; international data on avoidable/treatable mortality still show the US underperforming even after accounting for such factors.
• Disagreement over how much US food quality (sugar in everything, additives) vs simple overconsumption and lack of exercise explains obesity.

Access, capacity, and wait times

• Some claim US wait times (especially ER) are shorter than in public systems; others provide anecdotes of months-long waits for specialists, especially pediatrics and mental health.
• A key rejoinder: for many Americans, wait time is effectively “infinite” because they cannot afford care or lack providers nearby.
• Commenters highlight structural doctor shortages: limited medical school slots and residencies, high tuition and debt, alleged deliberate scarcity.

Inequality, politics, and public response

• Repeated themes: the system works well for well-insured professionals but fails millions who are uninsured or underinsured.
• Several see healthcare as a jobs program for the non-college workforce, making reform politically harder.
• Strong pessimism about meaningful reform timelines; some recommend emigrating. Others suggest mass strikes or political mobilization but doubt Americans’ will.
• The ACA is cited as a meaningful improvement, but recent policy moves are said to be eroding its coverage.

Public vs. socialized models

• Many argue markets cannot solve healthcare and call for some form of national or Medicare-like system; others propose limiting insurance to catastrophic care and using cash markets for routine services.
• Comparisons to Canada, the UK, continental Europe, Switzerland, Cuba, and prison healthcare are used both to praise and to criticize alternatives, with conflicting anecdotes on quality and wait times.