American taxpayers footed the bill for at least $1.8 trillion in federal and state health care expenditures in 2022 — about 41% of the nearly $4.5 trillion in both public and private health care spending the U.S. recorded last year, according to the annual report released last week by the Centers for Medicare and Medicaid Services.
On top of that $1.8 trillion, third-party programs, which are often government-funded, and public health programs accounted for another $600 billion in spending.
This means the U.S. government spent more on health care last year than the governments of Germany, the U.K., Italy, Spain, Austria, and France combined spent to provide universal health care coverage to the whole of their population (335 million in total), which is comparable in size to the U.S. population of 331 million.
Between direct public spending and compulsory, tax-driven insurance programs, Germany spent about $380 billion in health care in 2022; France spent around $300 billion, and so did the U.K.; Italy, $147 billion; Spain, $105 billion; and Austria, $43 billion. The total, $1.2 trillion, is about two-thirds of what the U.S. government spent without offering all of its citizens the option of forgoing private insurance.
But if we had universal healthcare, how would all the useless middlemen make their money?
Won’t anyone think of the shareholders?!
They would move on to other amoral enterprises like cars/insurance/real estate/televangelism/etc
I get the sentiment, but it actually would be a positive thing. Most people in these industries are there because the jobs were available and paid well, even if those jobs only existed to produce more unjustifiable profits for the bloated system.
Remove the jobs, and those people might actually go on to play productive rather than parasitic roles in society.
Corporations are people. Didn’t you know?
By contributing to the building up of the productive forces. Fuck this stagnation bullshit, invest in infrastructure and urbanization, invest in clean energy, and automation. Cut out meaningless jobs.
I feel vindicated. Not 15 days ago I complained about paying more in taxes AND health insurance. And I’ve been saying it for over a decade. Fuck private healthcare, it serves no purpose for the people.
Yep, this is why I argue with people who say, we should raise taxes to fund it…no fuck that, we can afford it now already without having to raise taxes even a penny.
We would save a significant amount of money. And private insurance almost always doesn’t provide good healthcare. Imagine no copays or deductables.
Imagine not having to argue with a massive corporation about whether you should be able to take the medication your doctor told you to take.
Imagine not having to choose between taking your kid to the doctor for $300 and a sick note for sniffles or letting him tough it out and get marked truant.
I have to say, being on Medicaid through college showed just how true this is. Being able to put my health first, rather than worry about if I could afford a doctor visit (or an ER visit), was great. The peace of mind of knowing that I would pay $0 for ANYTHING medical lead to me putting my health first.
The one potential charge you could get was for going to the ER for something deemed a “non-emergency.” Even then I didn’t worry about whether I could go to the ER after whiffing it off my longboard and smacking my head into the pavement because… well, the non-emergency charge was $8.
This was very eye-opening for me as an American into the world of public healthcare.
Yeah that’s pretty informative. I am not sure how well the recommendation for implementing it in the US would work though. It’s probably the best chance anyone in the US has for government funded healthcare, but it would mean people in the poorest states would get the worst healthcare. It would probably still be a step up and we could give solutions to that problem later.
This may not be a popular question, but: Would Americans be willing to pay less?
No really. This would mean a lot of good jobs being cut. Yes, they are jobs that provide no benefit to the public (rather the opposite), but thinking about the big picture isn’t very American. Americans like to side with the little guy.
It gets worse. It would mean a huge pay cut for doctors. They are way overpaid compared to doctors anywhere else. Would Americans side with
themselvesthe peoplethe government or those nice family doctors?First of all what? Typically the highest paid members of hospital staff of “Administrators” who have completely shifted health care into a for-profit business. If the government regulated them out of their jobs and there were price caps set in place instead of wasting hundreds of hours decoding billing and fighting insurance companies doctors would very likely make more. They would also be more likely to actually try to help you versus hit unrealistic patient exam quotas to try and extract as much money from insurance to benefit the administration staff. Hell new doctors in medical school are pretty much unpaid and forced to work hours that somehow circumvent labor laws. The whole medical industry needs to be overhauled. Getting rid of middle management would free up capital that could be properly reinvested into the hospital for better equipment, wages etc.
doctors would very likely make more
I expect that’s politically the way to go; not that I know anything about that. You get rid of a few inefficiencies and pay off other stakeholders with most of the gains.
The fact remains, if you want to lower health care costs to levels comparable to other countries, you have to lower all the costs to comparable levels, including doctor’s pay.
I don’t think you understand just how much bloated administrative costs and bureaucracy account for the U.S.‘s healthcare spending. It’s absolutely NOT doctors’ salaries accounting for the literally billions we are spending and no doctor’s shouldn’t be paid less to do the same job. Remove the middle men and ghoulish profiteering from healthcare.
The US can pay doctors as much as it wants. If Americans think that doctors deserve more than they get in other countries, that’s not for me to judge. Mind, that it does imply that the US is more unequal than other countries, because Americans want it to be.
True, merely lowering the administrative overhead will also go some ways to lower costs. But here, too, I wonder if Americans are really willing to do that. Sure, everyone wants to get rid of the useless middle men, but that’s not anyone’s job description.
Education costs in the US are also astronomically higher than other countries, which when you’re indebted 250-500k as soon as you graduate medical school, you are going to command a higher wage to make payments. The Education system in the US suffers from the same “we should run this like a business” greed that the medical industry does and should absolutely be reformed. Cause freedom isn’t free but it can be financed 🙄
BUT, small businesses would benefit, and entrepreneurs, if they didn’t have to worry about health insurance. Doctors offices costs would come down without a lot of complicated billing stuff to do. Billing specialists would lose their jobs. Of my circle of people - husband would lose his job unless it was a Germany style system, and two other people I know.
If you want some sort of employment program, the medical system here is a shit way to go about it. Why not pay people to do something with a good impact on the land or the people?
And again - universal, tax-paid coverage would favor small business, it’s easier to take a risk when it doesn’t mean you might go bankrupt from a medical issue.
small businesses would benefit, and entrepreneurs,
Quite possible. Rates of self-employment are higher in France and Germany (2022 OECD stats). I’m not sure if that figure should be taken at face value, though.
unless it was a Germany style system
You mean a system with mandatory insurance? Administrative costs are substantially higher in US health care. Anything to bring quality and costs more in line with peer countries would mean a substantial hit, regardless of the system adopted.
Why not pay people to do something with a good impact on the land or the people?
Good question. Just a cursory glance into the statistics will tell anyone that the US system is dysfunctional. It’s been that way for decades or longer. I don’t even know when it became obvious that it wasn’t doing as well as its peers. And yet, there hasn’t been a lot of effort to improve it (Kudos to Obama, though). Maybe Americans just don’t want to do what it takes. Maybe they just want a better outcome, without all the small, necessary steps to get there.
On Unless it was a Germany style system (sorry I don’t know how to do the inline quotes yet)
I mean that Germany uses highly regulated private insurance plans to get to universal coverage. That would probably be an easier sell here, than a one plan to rule them all NHS. Not saying it’s a better idea. I have argued for YEARS that single payer would be a good idea here because we already have Medicare, just expand it to everyone and audit the fuck out of the providers would be cheapest and most efficient.
I don’t know how to do inline quotes yet
Use the “greater than” symbol: “> teehee I’m a quote”
Use the “greater than” symbol: “> teehee I’m a quote”
Thanks!
Are you calling for profit insurance the little guy? I don’t know why people think doctors would be the ones taking the hit and not the for profit corporations.
No. I am asking if Americans would actually be willing to see cuts happen.
To answer your implied question: Because corporations don’t consume. They don’t go on holidays, live in mansions, … There is nothing there which can take the hit.
Corporations do consume, go on holiday, live in mansions… The executives wouldn’t lower their standards or travel on their own dime.
If you think for profit corporations don’t have excess then you must not live in the same reality.
Executives are employees, not corporations.
Corporations give things to their executives. Company retreats? Company jets? Company cars? Do none of these exist in your reality?
Americans like to side with the little guy
As you americans tell it: That’s bullsh*t. I see you guys getting fucked everyday by corporate. It’s hard to believe this is the U.S that holds international power… it looks like a Circus on fire looking inside from the outside.
As somebody trapped in this circus, lemme tell you, I want the fuck out of this clown car.
Private health care is literal vampirism.
Benefiting from the ill health and suffering of others? Yeah that sounds right
Year over year my insurance at huge companies would get both worse and costlier. It was to the point that the insurance that was costing me $200/mo was literally just acting as a safeguard against something costing me $10,000- which would have financially ruined anybody at those jobs anyway
How timely! American here who just received a bill for scoping my sinuses by an ENT specialist: insurance covered $28 out of the $415 procedure. This is on top of the $70 copay I owe for the $195 office visit. So all accounting factored in, I owe $450 for what I thought was going to be $70.
Because it was billed through insurance, the provider’s hands are tied in terms of further negotiation. I would bet if I had gone in as a cash patient, I’d be much better off.
The icing on the cake is that the scoping procedure was non-conclusive.
The US healthcare insurance system is the ultimate way to make money fast, for little effort. As long as you’re on the right side of it, that is.
copay is such a bullshit word, like i’m somehow equal partners with this trillion dollar corporation of ghouls
Try telling them you decline to pay the bill because it’s outside network and see how much they value your partnership.
The worst is that insurance companies “cover” things and that’s all they can say before anything is done. After, when billed, they can say “we cover 5% of the final bill. See? We covered it.” And we have no idea how much we will need to pay for standard necessary procedures.
Fuck. Canadian here who is just aghast at the charge. Had a friend go through the same procedure but essentially never paid a dime. We don’t even pay MSP any more but back when we did it was locked to your income bracket and while I had some bumpercrop years (my base rate is 33 bucks an hour and I work 12 hour days standard with time and a half applied for everything past 8 hours for 2019 I worked 11 months with routine 60 hour weeks) my payments never crested $250 for a quarterly payment. Heck I didn’t even realize that they stopped charging for two years because I had the thing rigged to autopay.
Heck a friend of mine’s Dad needed emergency hospital transfer from a small town and they used a helicopter ambulance and the family was never charged.
People want to complain that we’re slower and that people have to actually wait in waiting rooms and sure, non life-threatening stuff needs to be put in a queue but from what I have heard from my US buddies wait times at least are pretty comparable.
I swear people who talk about waiting have never visited an ER for something mundane because it’s the only option opened after 6, or who never had to meet with a specialist, or get a procedure that requires one.
Story time. January 2019. I have a 6 month old baby with mysterious rash. Pediatrician has us cut out common allergens and he clears up. Tells us to book with a pediatric allergist.
Now, I don’t live in BFE. I live in Southeastern MA. By no means an area underserved by doctors. The doctor refers us to Boston Children’s Hospital. It’s an hour and a half away without traffic, or 2 hours and 3 transfers on public transit.
The first appointment available was in October. Kids 7 months old at this point and already getting appointments for longer than that out.
We get put on a cancellation list and around March we get a call for him to be seen and get a scratch test. We take it, we are going on vacation 3 days after that and we’d love to know exactly what to avoid.
Kid lights up like a damn Christmas tree, but only one food allergy (peanuts) and it comes in like 1.5x the diameter of positive control.
Next, because of his age, they want to get him into an exposure therapy study, but he needs a good challenge first and they would call us when we got back from vacation.
Well, we came back from vacation the first week of March, 2019. BCH was now not scheduling any challenges due to the pandemic. Try again after Easter when the whole thing blows over. Then a month later. And another month.
Eventually they are booking again and after getting through the backlog of people that were cancelled due to the pandemic , the next appointment is 14 months out. By that point he’s too old for the study and we neeed to wait till he’s 4.
Well, now he’s 4. We book an appointment for his food challenge. The old scratch test is no longer good. He needs another one. Next booking for that is 10 months out, again. As luck would have it, though, we called back over and over again and eventually got a booking for his scratch test.
That was back in August. We booked his food challenge while we were in the office. It will be next October, barring any more global catastrophes or blind luck on the cancellation list. He will be five.
It’s amazing to me that there’s a person who can beat me at Smash Bros who has been waiting for a doctors appointment for nearly his entire life. And people tell me healthcare in America is fine. Those motherfuckers don’t know about this. They don’t know how much it costs every time he’s out of school for a couple of days with a fever and the school wants a doctor’s note. They don’t know that after wages, the single biggest part of their compensation package is their employers portion of their health insurance. In fact, depending on their job, it may even be more than their wages.
That last bit is important. People don’t realize how much their healthcare actually costs. They see the pre-tax line item for their share of premiums, never their employers. They see that as separate from the Medicare pre-tax item, and the vision and dental, all of which they don’t see the employers portion. They might see the bills if they got the high deductible plan, but they’re somewhat expected because “they got the ‘cheap’ plan”.
See up here people go all “I had to wait six months for a specialist! Bloody socialized medicine!” lt’s a blindness caused by not having anything to compare to and buying into the American political lies about our own system. That kind of wait time for a scratch test is insane even by our standards.
Yeah the ENT specialist I saw was three months after I was referred by my general physician, because that’s the earliest they had available.
There’s nothing admirable about US heathcare (at no fault of the healthcare workers, let me be clear).
I admit that I technically have a horse in the US healthcare system. The industry I work in contracts our labour vs the US market because they don’t have to pay in to sponsor our medical insurance policy coverage. Technically speaking if the US fixed it’s healthcare my job would be less competitive.
But fuck, my job ain’t worth anybody suffering.
Get your jaw checked bro. TMJ can cause a lot of similar issues
For those who are interested, the population of those countries combined is roughly the same as the US: 331,137,369 compared to 339,996,563 for the US.
I came here to ask this; an argument commonly made by proponents of the US system is that the population sizes are different.
These stats are easy to find. The US spends a much higher percentage of its GDP on health care (16.6%) than anyone else. The difference is bigger than the entire US military budget. If the US cut its health care spending to the level of France (12.1%) or Germany (12.7%), it could more than double its military spending.
It terms of actual resources, the difference is even bigger, as US-Americans work much more than Europeans. I’m not sure what for.
ETA: At the same time, the US has a younger population, which should not really need as much care.
You mean to tell me we can have better healthcare and more guns, and save money doing it?
Are you running for president?
Actually proposing that would be political suicide.
Only in a backward country like the US it would.
Plenty of Americans are against their best interests.
Which shouldn’t go ignored.
But the cost of the US Healthcare generally shouldn’t be ignored either. And it seems to be by a good majority of our politicians.
IMHO, our population should give us MORE leverage to get cost reductions but it’s just not going to happen. We need a severe overhaul of our healthcare system and the people who benefit from our current system have too much power and influence.
It should though because economy of scale works to make things cheaper, not more expensive. They’re literally ignoring basic economics to make that argument.
Not always, and not that I disagree with your point either. The US healthcare system is so over bloated with administration that it’s likely experiencing diseconomies of scale instead
Well that’s the issue. We don’t have a single system. We have an industry. I also love how that link completely dodges the motivation to raise prices purely for profit. But even with that, we already know the legitimate cost problem is due to multiple middle man companies that provide no value and just take money. And the more care they deny, the more money they make. So it’s a combination of problems. We have to pay them enough for them to employ people to find reasons to deny care.
Thanks for clearing that up. The headline is badly written and needs that information.
I work with companies in the health care space globally. The percentage of their profits that come from the US business versus others is just astonishing.
When you do a half assed public insurance option, you get a shitty result - terrible care, at quadruple the price. We need true single payer and more importantly, single system costs negotiator.
Those mega yachts and Hawaiian bunkers aren’t gonna pay for themselves!
The American “Healthcare” system is a money-making venture, first and foremost. Health care is simply the structure the corporations use to wring as much money from the masses as possible.
“But where would the money come from?” My ass, that’s where.
I keep posting this article because I’m tired of hearing this statement as an excuse why we can’t do things for the American people.
If it is something that the leaders want they seem to always find the money.
Somehow you have more money for Israel, bailing out banks, covering police with pension, spending on stadiums, buying lavish gifts for SC Judges, and PPP loans but not enough to pay your citizens who built your country and shoulder it everyday?
And as long as we continue to shoulder and maintain for peanuts, that’s all we’ll get.
I saw a commercial for healthcare.gov. It talked about how people only paid a few bucks for healthcare. It was all after government assistance.
The fact that you need heavy government assistance to get healthcare shows how much of a failure things are here.
Also in Mexico they have legal price limits on drugs. They’re printed on the box so you know if you’re getting a deal or paying the max. Also can see a doctor for like 40 pesos (about 2 to 3 USD). It’s much cheaper than my post insurance copay. I understand it’s a different market, but they have better general healthcare than the US.
Also as a side note, most drugs don’t need a prescription. You can tell the pharmacist what hurts and they can tell you what should help (or when to see a Dr). If I want to see my Dr, I’m on hold for 20 minutes then get an appointment in 2 weeks. Once again: viva Mexico!
In the US, when I want to see my doctor I drive 15 minutes to get there and tell them I need to be seen for whatever and then I wait 15 minutes and then talk to the doctor. If they say I need to talk to a specialist, that may take 1-2 weeks after making an appointment though. It’s not cheaper, but at least I can get care when I need it.
Of course, not everyone can afford healthcare in our country. That’s the biggest problem. But it’s generally fast and competent.
Man this is less and less the experience I’m seeing. Months to see my primary. Urgent care I can get in same day, but I work at hospital that saves slots for their employees
Where I am in the US, dentist schedules 6 months out, doctor likes you to schedule annual exams a year out and non urgent a couple of weeks at a minimum but there are some urgent care appointments available each day (or most days). Dermatologist and GYN a couple months wait for routine care. But there are lots of independent urgent care standalone clinics, including for orthopedic stuff, so for broken bones I did not have to go to the emergency room and incur that cost.
It’s uneven I would say. Definitely not worth what we are paying in taxes, insurance premiums and payments to providers, though.
So about the same waiting times as developed nations with a healthcare system, but with 10 000 times the cost.
I pay like 5€ in Belgium to go see a doctor, the rest is paid by my insurance. I can walk into a hospital right now and get service. As long as the issue warrants urgency of course. And a call to my house doctor can be met with a half hour wait time if it is less urgent.
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Most people cannot see their primary care physician just by driving up and being like, hey, I need to be seen for x issue. You pretty much have to make an appointment unless you go to a minute clinic or something. And that’s with insurance. Your experience is very much an outlier.
No kidding. There’s at least a month long wait to see any of my doctors. Same with my dentist unless it’s urgent. Usually it’s closer to two months.
If I need immediate attention, I have to go to an urgent care clinic or emergency room.
The nice thing is that in the year 2023, all of my doctors are reachable via the hospital system’s app and they respond to questions relatively quickly. So there’s no need to schedule a 15 minute appointment that ends up taking hours just to ask a simple question or two or to get a referral.
Which proves the point, It’s not about money or the economy. It’s about inflicting suffering.
What? It’s absolutely about money: more of our on the pockets of middlemen.
oh it’s about the money. it’s about funneling money from both the government and directly from the citizenry into the hands of private medical death panel operators
“That’s terrible! That’s money that should be going towards the military!”
what’s fun is for all this extra money we get a lower (and dropping) life expectancy and a higher infant mortality rate. that’s right, we pay more to bury our kids and then die sooner. FREEDOM BAYBAY!
It has always been known that more money could be saved with Universal health care. But, this couldn’t be done in Congress. Nothing new here.
The insurance companies want their cut
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