As a European I still can’t understand the American health insurance, as why is it like this? Who profits with this system? As far as I know a vast majority of the population has to pay exorbitant bills while not having the funds, so why it is still going and hasn’t changed to a more affordable one?
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> vast majority of the population has to pay exorbitant bills while not having the funds
That happens, but not nearly as often enough to be called “vast majority”. The literal majority of politically active people do not feel that they need to worry about cost of medical care. And there is a feeling that government healthcare will be worse than private one (not without reason), and fear that it will require substantial increase in taxes.
Decent insurance will take care of the most of cost, and decent jobs come with health insurance. People over 65 get free insurance from government (Medicare). There are ways to keep cost reasonable, by going to hospitals that are covered by your insurance, understanding how deductibles work, using tax-deductible medical savings account. Also taking care of things before they become an emergency, which gives you time to figure out best way to do it.
If you are very poor, you can get “free” care at emergency rooms. They will try to bill you for it, but if your credits score is already messed up, there is very little consequence for not paying. Collectors will come, but it will take years, and they cannot do much if you do not have anything.
So people who pay the high bills are low-income, or not very organized. That keeps them from putting pressure on politicians.
As for profits, they are split between all parts of healthcare system. Overpriced drugs make the news, but drugs are less than 20% of healthcare cost.
Biggest component is hospital fees, but hospitals have to maintain very high standards, and pay high salaries to doctors, and provide free emergency treatment to anybody who cannot pay for it.
Doctors are paid very well, but they also have huge student debt from spending like 10 years in school.
People who make and sell medical equipment and supplies make good money. In part because of patents, which are reward for innovation.
Private insurance does add it’s profit margin, around 3%.
Nurses are not paid very well, although they can get educated into almost-a-doctor (CRNP).
Proper solution would require government to regulate and subsidize all of these components of healthcare system, and fight lobbyists of everybody who loses their profits. This is way to complex for our congress.
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