The entire healthcare system seems to be built against the population.
I've come to see healthcare providers like doctors, nurses, technicians, and the like, as a conniving, essential part of the scheme. They're incentivized to make you wait hours unnecessarily, rush every visit, and involve as many different people as possible in your care. And then, in the end, send ridiculous bills to both your insurance provider and to you at home. The person who spends the most time with you is usually the one trying to collect the payment. It's absurd.
There is absolutely no reason for a doctor to make over $1000 for a 15 minute conversation.
There is absolutely no reason for a medical equipment provider to bill more than the retail price of a piece of equipment, especially after insurance has already paid more than the full cost of the equipment on each installment.
There is absolutely no reason for a family to receive a bill of almost one million dollars because their baby was premature and was in the NICU (see @thepasinins on instagram).
There are too many layers in the system making a fortune off the public's back while adding little to no actual value.
The main problem the US has is food. As a Spaniard myself, every time I go to the US it is really hard for me to eat well. Good quality food is extremely expensive and inconvenient (full of friction) compared to Japan or Europe.
The solution are not better Hospitals to deal with your diabetes or cancer after all your food has sugars it should not have like corn syrup because sugar is cheap. You have so much additives in your food for preservation. Meat is full of Hormones.
Antibiotics on your vegetables that destroy your microbiota. Genetically Modified to fill the fields with pesticides.
Now Americans are obese as they process the growth hormones from their meat and their microbiota dies from the antibiotics they eat in their vegetables and their meat.
Waiting until your children has autism or asthma or cancer is not the solution.
Zero mention of wait times in the US compared to other countries. Pretty sure that's the chief complaint in most countries that have free-ish healthcare.
You're exactly right but it runs contrary to the narrative being spun.
A quick search reveals the best ER wait times worldwide are in the US, Germany, and Switzerland, with most the rest of western Europe dead last along with Canada and Australia.
Everyone likes to say how great Canadian healthcare is, but talk to actual Canadians and the cracks start to show, you're waiting months for a CT scan, and most need employer-provided health insurance anyway to fill gaps in coverage.
Wouldn't you expect to see that reflected in outcomes? TFA mentions that the only studied country with more avoidable mortality than the US was Mexico. If you aren't seeing it, maybe its not as big a problem as all the people who cannot afford any access to care at all while the country spends more per-person.
Anecdotally, I spend a lot more time literally in waiting rooms in Germany than I did in the US, but getting a specialist appointment is much faster here (getting a therapist absolutely excluded, but I was able to get a psychiatrist to write prescriptions for ADHD meds within a month).
I mean, in rural America short of a trip to the ER with whatever wait time they have, getting a primary care doctor is barely possible and only affordable if your employer provides medical care, which many many don't.
I think generally Americans are happier dying. They want this differentiator between themselves and other countries. They genuinely enjoy the misery it brings to the poorer elements of their society. This is not accidental it appears to be designed that way. Investigating it is a waste of time and not going to change anything until Americans actually want change. (and not just "want" in terms of making facebook posts about wanting it)
As an American, no. Well aside from - yes a significant part thrives on seeing others than them suffer. Years ago, I spent multiple times a year at a B&B on the Hilo side of the big island. The host was one of the last "Grand Dame's" of Hilo. She was a cattle rancher that knew Roosevelt; her husband had been a friend of Linus Pauling. She did hikes in her 70s and 80s few in those ages can do now.
She was grandfathered under a form of medical insurance - I think older Blue Cross/Blue Shield - none can access now. At one point, the US did have better health care than we do at the moment. The fcking idiot boomers (including my parents) bought into the BS from Nixon, Reagan, etc. Hey - (good or bad) - let's stop allowing one to write off debt, but allow companies to do so, etc.
This country does have it's head up it's ass and a significant number blame everyone but themselves and how they vote.
We pay more (as a country) by a lot* and get significantly less for our medical coverage. Want to go self employed with a family of 3? Want a PPO? $4-6k/mo in California right now. Deductibles will be high.
The US has half the number of medical school graduates compared to the average. Instead of creating a lunar base, maybe create more residencies to graduate doctors?
Quote:
“…has produced one of the lowest ratios of medical school graduates, 8.6 for every 100,000 people. This is far lower than the OECD average of nearly 15 graduates per 100,000 people.”
There are many examples of for-profit systems that don’t have this problem, it’s really the heavily regulated for-profit systems that have this “cost disease” issue. It seems to happen whenever there isn’t a transparent market, like the tuition price of a university, the cost of your surgery, or the cost the government will pay for some infrastructure. The buyer doesn’t know what they’ll pay or what product they’ll get for it, so it’s basically not a free market at its most fundamental level.
Healthcare insurance markets are fundamentally broken due to information asymmetry. The situation is aggravated in the USA by vertical consolidation among providers and regulatory failures. (https://www.nber.org/papers/w34928)
It’s also a pretty inelastic good(most people don’t want to die or be sick ever) and decisions can be made without your consent if you are unconscious, sometimes even when you are conscious but it’s been decided that you aren’t competent at the moment.
1. way too many regulations and lobbies that prevent any relaxation by scaremongering
2. unions that artifically constrain labor supply. doctors lobby to keep number of doctors low and regulatory capture preventing forign doctors from entering workforce. Uk for example imports doctors from india.
both political parties have their own agenda to not disrupt above . democrats love regulation and unions. republicans love corporate profits from regulatory capture.
healthcare is exterme opposite of freemarket despite the veneer
Every country has for-profit elements in their healthcare system. The USA is uniquely dysfunctional in its governance. There is regulatory capture at every level.
> Every country has for-profit elements in their healthcare system
You’re right. The Swiss system is deeply privatized, down to compulsory private insurance [1]. It just isn’t as opaque and corrupt as the American one.
Part of the problem with the American system is everyone is cynical with respect to reform, and has a singular bogeyman they’re convinced explains all of the problem, with zero room for multiple causation.
> and has a singular bogeyman they’re convinced explains all of the problem, with zero room for multiple causation
Not sure about that. But each person tends to have something like a single sentinel flag. E.g.: does medicare negotiate drug prices? And if there's a change for the better, they won't believe it's anything but a short term grift until they read it back as "true" from at least 16 different threads over the course of, say, 9 consecutive years.
Given that their representatives currently use phrases like "medicare advantage" to mean "off traditional medicare and on private insurance," that caution seems warranted.
This is an obtuse comment because it doesn't mean anything. Yes we all know that every country has for-profit elements. We also all know that every country has social elements in their system. And non-profit elements.
I find it remarkable that most comments either criticizing the US healthcare system or expressing bewilderment at how Americans seemingly accept this have already been downvoted into dead territory.
It's hard not to see those downvotes as copium or cognitive dissonance given no arguments have been presented to the contrary.
US healthcare industry needs to drop more non-essential workers, and invest more in workers that produce value. the industry is so bloated no wonder its costs are high. Just to get my ears checked i had to be processed by 6 different people including phone systems doing precheck-ins. one person does the actual work!
That's almost entirely due to how our private insurance industry works.
Any given health provider has to deal with thousands of different insurers, and it's not uncommon for individual patients to have primary, secondary, tertiary, and even quaternary insurers the provider then has to deal with to get paid for a procedure.
To keep health care workers focused on providing health care, providers hire a bunch of administrative workers whose job is to offload the work of haggling with insurance onto cheaper workers, but because there's so many insurers, and patients have so many layers of insurance, you end up with something close to 10 administrators per doctor.
Alas, because there's so much money sloshing around in the system, and because the US government is so thoroughly corrupt with bribes from special interests, there's no movement to correct the problem. The system is unsustainable, though, so it will inevitably collapse in on itself at some point, causing a lot of misery and probably death before anything is fixed.
> US healthcare industry needs to drop more non-essential workers, and invest more in workers that produce value.
Only problem is you can’t destroy the jobs program. Someone pointed out to me that
For someone without and particular skills, credentials, network, medical industry jobs provide one of the last few steps to a stable, middle class life that’s also accessible to working class. In other words, it’s one of the last vessels for any sort of social mobility.
Right, most of those 6 are not medical staff, they are probably there for insurance and billing. And compared to Europe we don't even have a lot of doctors, US has fewer per capita. So the money is going to the billing layer, not to actual care.
Medical assistants and nurses work with you before the doctor to increase billable events for the doctor. You could describe this as saving money, but it's not the goal.
Phone and front desk stuff is just administrative burden, scheduling the appointment and making a paper trail.
It will not change on your time horizon. If you want better healthcare, move to a developed country today. It will take a half decade or more for US healthcare to improve in any meaningful capacity, assuming the necessary events take place to enable improvement in the system.
(to improve US healthcare, laws will need to change; when those laws change is a function of election outcomes and cadence; those election outcomes are a function of the electorate, who they vote for, and the rate of cohort turnover; think in systems)
I want to agree with this, but these studies usually make a big mistake - they don't control out for the non healthcare reasons for low life expectancy.
Americans drive cars and most live in unwalkable places. These impart significant risks that the healthcare system, no matter how good, wouldn't impact.
Has anyone dug into this to identify whether they tried to account for built environment? Or food system?
If you research "amenable", "avoidable", "preventable", and "treatable" mortality, you will find similar conclusions from studies that focus on specific aspects of the effects of healthcare on mortality.
> The US had the second-highest avoidable mortality rate—deaths caused by conditions that can be prevented with primary care or treated with timely medical intervention. Only Mexico had higher avoidable mortality. Similarly, the US also had the second-highest rating on years of potential life lost, a measure used to estimate premature death. Again, only Mexico had a higher rating.
About 41k people die on the road in the US per year. While this is very high, and worse than pretty much any other developed country, it’s not going to move the needle _that_ much.
Driving everywhere has the collateral effect of ensuring that people get less exercise. Mexico has an astonishingly high obesity rate (a bit higher than the USA last time I checked), and this increases the risks of many non-car-related causes of death (and illness).
Yeah, I’d buy that car-dependence is a problem there, especially for older people.
Though, in Ireland, for instance, the worst parts of the country for car dependency would be close to as bad as the US. Their life expectancy is a little lower than the national one, but it’s not dramatic, and certainly not as low as the US one. There’s something else going on.
40% of Americans are obese and 75% are overweight. This is largely outside of the control of the medical system, but has a significant impact on mortality and life expectancy.
As a sibling comment pointed out, the medical community consider prevention part of the medical system. It took me a while to understand what I thought was some weird (and potentially intrusive[1]) behavior of some doctors/clinics that they indeed do feel it is within their purview.
Not just discussions with a patient, but advising the government, pushing for regulation on things related to obesity, etc.
Arguably, the problem in the US isn't that these are outside the control of the medical system, but that most Americans believe they should be outside the control of the medical system.
[1] Throwing in questions like "Is there a firearm in your house?" and "Is there a swimming pool in your house" intermixed with "normal" medical questions.
> This is largely outside of the control of the medical system
I assure you that preventative medicine does exist, even in the USA. Moreover, healthcare interventions for people with "lifestyle" diseases such as obesity have been extremely effective in reducing mortality from downstream causes such cardiovascular disease (e.g. statins).
It continues to baffle me that Americans put up with such an inferior and expensive system.
There’s always talk of freedoms and being brave and being the best country in the world to live in, but very, very little effort of action to improve anything.
The French riot in the streets if a single day of their extremely generous (by US standards) leave is taken away. Meanwhile Americand can’t get off the couch to protest, or are afraid of their own government if they do.
There are plenty of American protests happening all the time (see the ICE protests for a recent, well-known example). Americans aren't lazy about protesting, they just have a different understanding of merits protesting. Like it or not (I don't), a right to quality healthcare isn't one of the freedoms in our constitution or bill of rights, and therefore isn't going to get people turning out to protest.
Our country is captured by the top 1% of wealthy donors who are making a killing off the healthcare industry. Americans as a population aren’t putting up with anything, they just have no control. A citizen shot a healthcare executive in the street a couple years ago, that’s what people are resorting to now.
>There’s always talk of freedoms and being brave and being the best country in the world to live in, but very, very little effort of action to improve anything.
What's new is that health insurance is about to become an even bigger problem.
24 million Americans are insured under ACA. The current president has issued several executive orders that undermine the provision of ACA insurance and increase its cost. Millions are dropping coverage as the increases kick in. (https://www.nytimes.com/2026/05/01/business/obamacare-enroll...)
That "stupidly expensive" system provides extremely nice campaign donations, executives bonuses, stock appreciation, dividend checks, and paychecks to a stupidly large number of insiders. Even when they're (say) just medical billing clerks, who'll spend their entire careers arguing with the Denial Departments at various insurance companies, without every seeing an actual patient.
The system is bad but the average American is obese, out of shape, and pre-diabetic, an atrocious diets and very little exercise. That doesn’t explain everything, but it does strain the system, which has to treat a lot more disease than a similar system with a fit population.
There’s a fascinating case study on how this happens - Mexico had population much less overweight than USA until NAFTA was agreed to and cheap USA processed foods began inroads so that now Mexico has close to the same obesity issue that the USA has.
The entire healthcare system seems to be built against the population. I've come to see healthcare providers like doctors, nurses, technicians, and the like, as a conniving, essential part of the scheme. They're incentivized to make you wait hours unnecessarily, rush every visit, and involve as many different people as possible in your care. And then, in the end, send ridiculous bills to both your insurance provider and to you at home. The person who spends the most time with you is usually the one trying to collect the payment. It's absurd.
There is absolutely no reason for a doctor to make over $1000 for a 15 minute conversation.
There is absolutely no reason for a medical equipment provider to bill more than the retail price of a piece of equipment, especially after insurance has already paid more than the full cost of the equipment on each installment.
There is absolutely no reason for a family to receive a bill of almost one million dollars because their baby was premature and was in the NICU (see @thepasinins on instagram).
There are too many layers in the system making a fortune off the public's back while adding little to no actual value.
USA population will never know peace.
When basic exams cost them easily US$100k, you know the system is broken.
Health system is a business model in the US, and people who are organ donor are literally being murdered to have their organs removed.
Don't trust my owners, you won't need much to find that out.
The main problem the US has is food. As a Spaniard myself, every time I go to the US it is really hard for me to eat well. Good quality food is extremely expensive and inconvenient (full of friction) compared to Japan or Europe.
The solution are not better Hospitals to deal with your diabetes or cancer after all your food has sugars it should not have like corn syrup because sugar is cheap. You have so much additives in your food for preservation. Meat is full of Hormones.
Antibiotics on your vegetables that destroy your microbiota. Genetically Modified to fill the fields with pesticides.
Now Americans are obese as they process the growth hormones from their meat and their microbiota dies from the antibiotics they eat in their vegetables and their meat.
Waiting until your children has autism or asthma or cancer is not the solution.
Zero mention of wait times in the US compared to other countries. Pretty sure that's the chief complaint in most countries that have free-ish healthcare.
You're exactly right but it runs contrary to the narrative being spun.
A quick search reveals the best ER wait times worldwide are in the US, Germany, and Switzerland, with most the rest of western Europe dead last along with Canada and Australia.
Everyone likes to say how great Canadian healthcare is, but talk to actual Canadians and the cracks start to show, you're waiting months for a CT scan, and most need employer-provided health insurance anyway to fill gaps in coverage.
Wouldn't you expect to see that reflected in outcomes? TFA mentions that the only studied country with more avoidable mortality than the US was Mexico. If you aren't seeing it, maybe its not as big a problem as all the people who cannot afford any access to care at all while the country spends more per-person.
Anecdotally, I spend a lot more time literally in waiting rooms in Germany than I did in the US, but getting a specialist appointment is much faster here (getting a therapist absolutely excluded, but I was able to get a psychiatrist to write prescriptions for ADHD meds within a month).
US wait time for many: infinity. why? because current system is profitable.
I mean, in rural America short of a trip to the ER with whatever wait time they have, getting a primary care doctor is barely possible and only affordable if your employer provides medical care, which many many don't.
I think generally Americans are happier dying. They want this differentiator between themselves and other countries. They genuinely enjoy the misery it brings to the poorer elements of their society. This is not accidental it appears to be designed that way. Investigating it is a waste of time and not going to change anything until Americans actually want change. (and not just "want" in terms of making facebook posts about wanting it)
Among many, there is a zero sum attitude. This goes back to the founding and slave owning in the south.
As an American, no. Well aside from - yes a significant part thrives on seeing others than them suffer. Years ago, I spent multiple times a year at a B&B on the Hilo side of the big island. The host was one of the last "Grand Dame's" of Hilo. She was a cattle rancher that knew Roosevelt; her husband had been a friend of Linus Pauling. She did hikes in her 70s and 80s few in those ages can do now.
She was grandfathered under a form of medical insurance - I think older Blue Cross/Blue Shield - none can access now. At one point, the US did have better health care than we do at the moment. The fcking idiot boomers (including my parents) bought into the BS from Nixon, Reagan, etc. Hey - (good or bad) - let's stop allowing one to write off debt, but allow companies to do so, etc.
This country does have it's head up it's ass and a significant number blame everyone but themselves and how they vote.
We pay more (as a country) by a lot* and get significantly less for our medical coverage. Want to go self employed with a family of 3? Want a PPO? $4-6k/mo in California right now. Deductibles will be high.
you seem jealous at american stock market and high tech salaries. european?
I challenge you to be more obvious with your attempt at baiting
europoors coping on us healthcare posts is nothing new
The US has half the number of medical school graduates compared to the average. Instead of creating a lunar base, maybe create more residencies to graduate doctors?
Quote:
The market can't solve healthcare. It must be public. Americans shouldn't need to kill healthcare CEOs.
But prisoners have socialized medicine?
Yeah but have you considered how good it is for the US gdp!
It's to be expected from a for-profit system.
There are many examples of for-profit systems that don’t have this problem, it’s really the heavily regulated for-profit systems that have this “cost disease” issue. It seems to happen whenever there isn’t a transparent market, like the tuition price of a university, the cost of your surgery, or the cost the government will pay for some infrastructure. The buyer doesn’t know what they’ll pay or what product they’ll get for it, so it’s basically not a free market at its most fundamental level.
If it's expensive and in a for profit system, why aren't competitors on the supply side undercutting each other to increase sales?
Healthcare insurance markets are fundamentally broken due to information asymmetry. The situation is aggravated in the USA by vertical consolidation among providers and regulatory failures. (https://www.nber.org/papers/w34928)
It’s also a pretty inelastic good(most people don’t want to die or be sick ever) and decisions can be made without your consent if you are unconscious, sometimes even when you are conscious but it’s been decided that you aren’t competent at the moment.
Because that holds true only for efficient markets.
Barriers to entry are real
many different things. to cite a few
1. way too many regulations and lobbies that prevent any relaxation by scaremongering
2. unions that artifically constrain labor supply. doctors lobby to keep number of doctors low and regulatory capture preventing forign doctors from entering workforce. Uk for example imports doctors from india.
both political parties have their own agenda to not disrupt above . democrats love regulation and unions. republicans love corporate profits from regulatory capture.
healthcare is exterme opposite of freemarket despite the veneer
Not every for-profit system is this way so it doesn't fully explain it.
Every country has for-profit elements in their healthcare system. The USA is uniquely dysfunctional in its governance. There is regulatory capture at every level.
> Every country has for-profit elements in their healthcare system
You’re right. The Swiss system is deeply privatized, down to compulsory private insurance [1]. It just isn’t as opaque and corrupt as the American one.
Part of the problem with the American system is everyone is cynical with respect to reform, and has a singular bogeyman they’re convinced explains all of the problem, with zero room for multiple causation.
[1] https://en.wikipedia.org/wiki/Healthcare_in_Switzerland
> and has a singular bogeyman they’re convinced explains all of the problem, with zero room for multiple causation
Not sure about that. But each person tends to have something like a single sentinel flag. E.g.: does medicare negotiate drug prices? And if there's a change for the better, they won't believe it's anything but a short term grift until they read it back as "true" from at least 16 different threads over the course of, say, 9 consecutive years.
Given that their representatives currently use phrases like "medicare advantage" to mean "off traditional medicare and on private insurance," that caution seems warranted.
This is an obtuse comment because it doesn't mean anything. Yes we all know that every country has for-profit elements. We also all know that every country has social elements in their system. And non-profit elements.
Correct. My comment is in reply to an assertion that is uninformative for exactly this reason.
I find it remarkable that most comments either criticizing the US healthcare system or expressing bewilderment at how Americans seemingly accept this have already been downvoted into dead territory.
It's hard not to see those downvotes as copium or cognitive dissonance given no arguments have been presented to the contrary.
US healthcare industry needs to drop more non-essential workers, and invest more in workers that produce value. the industry is so bloated no wonder its costs are high. Just to get my ears checked i had to be processed by 6 different people including phone systems doing precheck-ins. one person does the actual work!
That's almost entirely due to how our private insurance industry works.
Any given health provider has to deal with thousands of different insurers, and it's not uncommon for individual patients to have primary, secondary, tertiary, and even quaternary insurers the provider then has to deal with to get paid for a procedure.
To keep health care workers focused on providing health care, providers hire a bunch of administrative workers whose job is to offload the work of haggling with insurance onto cheaper workers, but because there's so many insurers, and patients have so many layers of insurance, you end up with something close to 10 administrators per doctor.
Alas, because there's so much money sloshing around in the system, and because the US government is so thoroughly corrupt with bribes from special interests, there's no movement to correct the problem. The system is unsustainable, though, so it will inevitably collapse in on itself at some point, causing a lot of misery and probably death before anything is fixed.
> US healthcare industry needs to drop more non-essential workers, and invest more in workers that produce value.
Only problem is you can’t destroy the jobs program. Someone pointed out to me that
For someone without and particular skills, credentials, network, medical industry jobs provide one of the last few steps to a stable, middle class life that’s also accessible to working class. In other words, it’s one of the last vessels for any sort of social mobility.
Right, most of those 6 are not medical staff, they are probably there for insurance and billing. And compared to Europe we don't even have a lot of doctors, US has fewer per capita. So the money is going to the billing layer, not to actual care.
Those people may actually be saving money by offloading work from a $250/hr doctor to a $25/hr secretary.
Medical assistants and nurses work with you before the doctor to increase billable events for the doctor. You could describe this as saving money, but it's not the goal.
Phone and front desk stuff is just administrative burden, scheduling the appointment and making a paper trail.
Except the work saved should not be done at all.
I think the industry itself would be more than happy to classify nurses and doctors as non-essential and drop them.
Imagine the profit margins where you don't have to pay salaries to them.
Probably 3 of them just working to prevent you from going.
It will not change on your time horizon. If you want better healthcare, move to a developed country today. It will take a half decade or more for US healthcare to improve in any meaningful capacity, assuming the necessary events take place to enable improvement in the system.
(to improve US healthcare, laws will need to change; when those laws change is a function of election outcomes and cadence; those election outcomes are a function of the electorate, who they vote for, and the rate of cohort turnover; think in systems)
> It will take a half decade or more for US healthcare to improve in any meaningful capacity,
This timeline seems wildly optimistic
Did you mean half a century? Meaningful change in 5 years would be pretty amazing.
I want to agree with this, but these studies usually make a big mistake - they don't control out for the non healthcare reasons for low life expectancy.
Americans drive cars and most live in unwalkable places. These impart significant risks that the healthcare system, no matter how good, wouldn't impact.
Has anyone dug into this to identify whether they tried to account for built environment? Or food system?
If you research "amenable", "avoidable", "preventable", and "treatable" mortality, you will find similar conclusions from studies that focus on specific aspects of the effects of healthcare on mortality.
The results are not all that different. The USA lags other rich nations, and even middle income nations like Costa Rica and Chile. https://www.oecd.org/en/publications/health-at-a-glance-2023...
> The US had the second-highest avoidable mortality rate—deaths caused by conditions that can be prevented with primary care or treated with timely medical intervention. Only Mexico had higher avoidable mortality. Similarly, the US also had the second-highest rating on years of potential life lost, a measure used to estimate premature death. Again, only Mexico had a higher rating.
About 41k people die on the road in the US per year. While this is very high, and worse than pretty much any other developed country, it’s not going to move the needle _that_ much.
Driving everywhere has the collateral effect of ensuring that people get less exercise. Mexico has an astonishingly high obesity rate (a bit higher than the USA last time I checked), and this increases the risks of many non-car-related causes of death (and illness).
Yeah, I’d buy that car-dependence is a problem there, especially for older people.
Though, in Ireland, for instance, the worst parts of the country for car dependency would be close to as bad as the US. Their life expectancy is a little lower than the national one, but it’s not dramatic, and certainly not as low as the US one. There’s something else going on.
Not car accidents; obesity from lack of exercise.
40% of Americans are obese and 75% are overweight. This is largely outside of the control of the medical system, but has a significant impact on mortality and life expectancy.
As a sibling comment pointed out, the medical community consider prevention part of the medical system. It took me a while to understand what I thought was some weird (and potentially intrusive[1]) behavior of some doctors/clinics that they indeed do feel it is within their purview.
Not just discussions with a patient, but advising the government, pushing for regulation on things related to obesity, etc.
Arguably, the problem in the US isn't that these are outside the control of the medical system, but that most Americans believe they should be outside the control of the medical system.
[1] Throwing in questions like "Is there a firearm in your house?" and "Is there a swimming pool in your house" intermixed with "normal" medical questions.
> This is largely outside of the control of the medical system
I assure you that preventative medicine does exist, even in the USA. Moreover, healthcare interventions for people with "lifestyle" diseases such as obesity have been extremely effective in reducing mortality from downstream causes such cardiovascular disease (e.g. statins).
Statins help a bit (and are widely prescribed in the US) but they don't fix the problem.
Diet and exercise are huge health variables that doctors don't really have the tools to do anything about.
It continues to baffle me that Americans put up with such an inferior and expensive system.
There’s always talk of freedoms and being brave and being the best country in the world to live in, but very, very little effort of action to improve anything.
The French riot in the streets if a single day of their extremely generous (by US standards) leave is taken away. Meanwhile Americand can’t get off the couch to protest, or are afraid of their own government if they do.
There are plenty of American protests happening all the time (see the ICE protests for a recent, well-known example). Americans aren't lazy about protesting, they just have a different understanding of merits protesting. Like it or not (I don't), a right to quality healthcare isn't one of the freedoms in our constitution or bill of rights, and therefore isn't going to get people turning out to protest.
[delayed]
To be fair, the French riot in the streets when one of their teams win the Champions League[0]. I'm not sure it's a good metric.
[0] https://www.bbc.com/news/articles/c0r2ejg1w9xo
Eagles fans riot when they win the super bowl (2022, 2025) and also when they lose the super bowl (2023).
The issue is not that Americans are insufficiently violent.
Our country is captured by the top 1% of wealthy donors who are making a killing off the healthcare industry. Americans as a population aren’t putting up with anything, they just have no control. A citizen shot a healthcare executive in the street a couple years ago, that’s what people are resorting to now.
Correction: Americans as a population have been led to believe they have no control. They've forgotten what "we the people" means
> Americans as a population aren’t putting up with anything, they just have no control
So do something to get control.
Americans have been conned that they live in the greatest country and that nothing needs to improve. And now you say they have no control.
They are the workers. A six month general strike would literally change everything about the entire country, forever. They just lack the will.
>There’s always talk of freedoms and being brave and being the best country in the world to live in, but very, very little effort of action to improve anything.
Its all just talk.
And not just the US healthcare, but the US education also...
Did someone do something that made people think that was going to change any time soon?
What's new is that health insurance is about to become an even bigger problem.
24 million Americans are insured under ACA. The current president has issued several executive orders that undermine the provision of ACA insurance and increase its cost. Millions are dropping coverage as the increases kick in. (https://www.nytimes.com/2026/05/01/business/obamacare-enroll...)
That "stupidly expensive" system provides extremely nice campaign donations, executives bonuses, stock appreciation, dividend checks, and paychecks to a stupidly large number of insiders. Even when they're (say) just medical billing clerks, who'll spend their entire careers arguing with the Denial Departments at various insurance companies, without every seeing an actual patient.
The system is bad but the average American is obese, out of shape, and pre-diabetic, an atrocious diets and very little exercise. That doesn’t explain everything, but it does strain the system, which has to treat a lot more disease than a similar system with a fit population.
Until the obesity problem is solved nothing will change. You can spend an unlimited amount of money - if people are morbidly obese it's game over.
Americans blame everyone but themselves. Americans who do not have high rates of obesity have similar mortality to western europe.
Take Massachusetts who has one of the lowest rates of obesity- similar to Japan.
Sadly this line of thinking makes people angry.
Which only leads us to another problem: food.
You can't have a healthy society if all policies are dictated by corporations.
There’s a fascinating case study on how this happens - Mexico had population much less overweight than USA until NAFTA was agreed to and cheap USA processed foods began inroads so that now Mexico has close to the same obesity issue that the USA has.
Could it also be highest per-capita calories from sugary drinks?