US healthcare still stupidly expensive, with pathetic outcomes, study finds
US health care is criticized as uniquely expensive yet delivering worse outcomes and shorter life expectancy than other wealthy countries, despite consuming a far larger share of GDP. Commenters point to a tangle of causes: administrative bloat from fragmented private insurance, regulatory capture and profit incentives, artificial scarcity of doctors, poor population health driven by food and built environments, and large gaps in access for the uninsured. Many contrast U.S. care with public or mixed systems abroad, arguing that meaningful reform would require structural changes—potentially including some form of universal or more socialized coverage—rather than marginal tweaks.
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.