eli5: How come health care cost so much more in America vs. other countries?

Question

I understand that insurances covers part of the cost. However, the total cost (before coverage) is still much higher in America. Why?

Is the supply chain different? Are doctors and staff paid better in America?

In: 188

Answer 1

Because there is no “system”. A system is designed. What we have are a thousand short term solution and “patches” to solve small parts of the problems. Now it is so complex, intertwined it is almost impossible to replace it with a “system” because the thing is so large and disorganized.

For example hospitals need money to help people. An individual has insurance. So now the hospital has to hire people to argue with the insurance people to argue who pay what. That all cost money which drove up cost.

Doctors work in “networks”. So your insurance agrees ahead of time low cost with their partner. But a hospital might not have enough staff so they hire doctors out of network. That results in high cost.

A hospital has a patient who can’t pay so the hospital has to raise more mo ey from those that do pay to cover those who can’t.

A doctor has to have insurance in case he makes a mistake. Medical lawsuits are super expensive so insurance rates go up. That them drives up cost.

Doctors start with hundreds of thousands of debt. So they can’t accept lower salaries. So that raises cost.

There is a shortage of doctors and nurses. This drives up cost.

Supply companies that sell bandages and medicine willl always charge the most they can. This can result in medicine being thousands of dollars a pill.

It has always been expensive so people expect it to be expensive so people accept it being expensive.

Insurance is paid through work so people don’t shop. They just accept what is handed to them. The business buying the insurance isn’t always interested in the lowest cost to the employee but the cost to themselves. Which push cost to the user.

Hospitals are run as a business so they need to make a profit.

It’s a thousand small problems. And lots of rules that were supposed to fix it but only sorta fixed it and made other problems.