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So of course, following the money, where does all that extra spending go?

Bigger profits for hospitals, which used to be mostly nonprofits. Bigger profit for drug companies. Lots and lots of bullshit admin/billing/clerical/medical IT jobs. Stuff like that. Nothing actually important.

Like you said, the worst of all worlds.
 

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People's natural inclination is to want to be taken care of, not to be free. It's not surprising most people and most countries would prefer to trade liberty for being taken care of.
There are some things that bring greater benefit to society when they're done on an equitable basis by a government that can be held accountable. Law enforcement, the judiciary, basic education, highways, environmental protection, etc., etc. Omitting health from the list seems terribly myopic to me.
 

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It’s amazing how calm the ocean is just above the rear truck bed, as if the hand of a God came down and calmed the waters!
Here's the un-calmed un-cropped version. Chevy made the El Camino for many years. I always liked the car although I never owned one. My wife was watching 47 Meters Down last night and I didn't want to watch it. I played with this design instead.

28628
 

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So of course, following the money, where does all that extra spending go?

Bigger profits for hospitals, which used to be mostly nonprofits. Bigger profit for drug companies. Lots and lots of bullshit admin/billing/clerical/medical IT jobs. Stuff like that. Nothing actually important.

Like you said, the worst of all worlds.
Have to disagree on your view on Medical IT. IT is actually the most important part of healthcare,
 

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So of course, following the money, where does all that extra spending go?

Bigger profits for hospitals, which used to be mostly nonprofits. Bigger profit for drug companies. Lots and lots of bullshit admin/billing/clerical/medical IT jobs. Stuff like that. Nothing actually important.
Note that some of what many consider to be essential health care providers (physicians, nurses, physical therapists, etc.) need substantial education that is very expensive in the US, so they need high pay just to pay off their educational debt. Even then, many physicians have difficulty managing that debt, starting with $400,000 in debt when they enter post-residency work at around age 30. Nursing education is less expensive, but there is an increasing preference for bachelor's degree nurses over associates degree nurses. The entry level degree for physical therapy recently changed from a master's to a doctorate, increasing cost and debt borne by new entrants to the profession.

Given the debt pressure, it should not be too surprising that stories about excessive expensive treatment (that often causes harm in addition to being useless or of dubious help) show up regularly.
 

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Funny I thought health care was the most important part of healthcare ;)
Back in the 1800's. Without the speed and accuracy of information (allergy, med interaction, etc), you're just hoping to get lucky. ;)
 

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Back in the 1800's. Without the speed and accuracy of information (allergy, med interaction, etc), you're just hoping to get lucky. ;)
Some IT is essential for effective modern medicine. But how much of IT used in health care is used for things like billing and dealing with a multitude of different government and private insurance companies that are part of the inefficiency in US health care?
 

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Some IT is essential for effective modern medicine. But how much of IT used in health care is used for things like billing and dealing with a multitude of different government and private insurance companies that are part of the inefficiency in US health care?
Taiwan's Medicare for All using IT cut admin cost to 1% (vs 15% in the US private sector and about 5% for Medicare). More impact than you realize.
 

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Note that some of what many consider to be essential health care providers (physicians, nurses, physical therapists, etc.) need substantial education that is very expensive in the US, so they need high pay just to pay off their educational debt. Even then, many physicians have difficulty managing that debt, starting with $400,000 in debt when they enter post-residency work at around age 30. Nursing education is less expensive, but there is an increasing preference for bachelor's degree nurses over associates degree nurses. The entry level degree for physical therapy recently changed from a master's to a doctorate, increasing cost and debt borne by new entrants to the profession.

Given the debt pressure, it should not be too surprising that stories about excessive expensive treatment (that often causes harm in addition to being useless or of dubious help) show up regularly.
Right, so maybe a medical education shouldn't cost $400,000. It doesn't cost that much in a lot of other countries.

You know this reminds me of a funny story. About a year and a half ago I was at an international conference, having a conversation with a slightly tipsy Finn. He grouses, "you know what I pay in taxes in Finland? 30%! Imagine that! And what do I get for my 30%? All I get is free healthcare, free university, and free childcare. Feh!"

So I go, "Well, in America I also pay about 30% in taxes, but I don't get free healthcare, free university, or free childcare. Instead I get 11-billion-dollar Gerald Ford class aircraft carriers and 120 million F-35 fighter jets."

Then a Korean foreign exchange student living in Germany started complaining about going to the hospital for some very serious-sounding emergency medical treatment (I can't remember what it was) and receiving a 150 Euro bill for it. He was incensed! How outrageous! At this point I didn't have the heart to tell him that this is just what happens every time you interact with any aspect of the health care system in the USA, and $150 would be getting off lightly.
 

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Taiwan's Medicare for All using IT cut admin cost to 1% (vs 15% in the US private sector and about 5% for Medicare). More impact than you realize.
Sure, if you do it right, it can really help.

Here in the USA some law was passed a long time ago, sometime in the 90s I think, mandating the adoption of electronic medical records, in an earnest effort to bring about the kind of improvement you're currently benefiting from.

So what happened? Well, each hospital, doctor's office, urgent care facility, and insurance company followed the law and adopted an electronic medical record system--a different one. So when you change providers or

And of course now there is a huge industry of software houses selling these EMR systems. Dozens of them. Tons and tons. Some may be good. Some may be terrible. But none of them seem to be compatible with any other one. When you move to a different provider or insurance agency, the records don't get transferred over automatically. It's up to you to request them and send them over to the new one, and from my experience doing this several times in the past few years, the lowest common denominator seems to be printouts. Some very tech-savvy places will let you fax them. But it's as if each facility is speaking a mutually unintelligible language, unable to communicate with any other one.

All of the potential benefits of a centralized or at least interoperable record-keeping system have been obliterated, yet we all bear the cost and overhead associated with an extra complicated and highly technical layer of administration.
 

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Now that's funny.
You know you can order a Bolt with no rear seats for delivery use, right?
Yes, that's what the link to GM fleet was all about. It looks like they offer some custom choice install materials to replace the empty spot where seats would have normally been.
 
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