X thread by David Chavous
There is a lot to unpack in this very uninformed comment.
Right. That's why US healthcare is so much more expensive than all those countries with government-provided insurance or full govt-run healthcare systems. https://t.co/zooky6AQZZ
— James Surowiecki (@JamesSurowiecki) December 6, 2024
So, let’s dive into what James actually wants.
Let’s get one thing out of the way first. Obamacare did not contain costs. What it did do is make healthcare worse for certain groups. How?
Hidden in the ACA was a provision that penalized hospitals for readmissions in certain groups – myocardial infarction, heart failure, and pneumonia. It did this as a cost-saving measure masquerading as improving healthcare.
The result? Hospitals gamed the system to show fewer readmissions. What did many patients do? They showed up at emergency rooms due to not getting treatment. What did that cause?
An increase in mortality. Yes, you read that correctly. Obamacare started killing people to save money and hid it as “improving outcomes.”
Obamacare also caused a reduction in competition, which is leading to increased costs. How did it do that? Hidden in the ACA was another provision to force hospitals and doctors practices to consolidate. The architects of Obamacare thought this would streamline care.
Translation – reduce prices. Well, it didn’t because that’s what competition does. Competition also permits people to find an independent second opinion, which improves care.
Try doing that now. In Massachusetts, the heart of American healthcare, you have two independent options now. And insurers force people to pay out of pocket for out of network care.
Is that the insurance industry’s fault? No. Why?
Because Obamacare forced insurers to offer fewer insurance options. People decided it was economically better to forego insurance until they absolutely needed it and then to purchase insurance when they had the pre-existing condition.
What did this cause insurers to do? Charge more to the healthy people who were purchasing insurance. What is the healthiest group? Under 30. What did Obamacare do? It allowed college graduates under 26 to stay on their parents’ insurance instead of being paying customers.
Who paid for that? Everyone else.
What else did Obamacare do? It solidified the hold that PBMs have over healthcare.
What is a PBM? A pharmacy benefits manager.
What PBMs do is tell pharmacies what drugs can be prescribed. That’s a formulary. How do pharma companies get their drugs on the formularies? They provide PBMs rebates. That is, bribes. IOW, pharma companies have to charge patients MORE so that PBMs will prescribe their drugs.
That is what government did to healthcare in the US. Drug pricing is very complicated due to the arcane, and government driven, costs. Pharma companies see a fraction of the revenue of their drug sales. The rest goes into the hands of PBMs and wholesalers.
But what makes government run healthcare even more sinister is that those systems are cost cutting systems. They cut costs on the backs of patients.
The NHS is now so bad that if you have a stroke or heart attack, wait times for an ambulance are as long as a day.
IOW, an American having a heart attack in England would be better off taking an Uber to Heathrow, flying to Boston, and going to MGH.
And it is worse. Even if you get an ambulance to take you to a hospital, they dump you in corridors to wait for up to days.
Also, NHS survival rates for major potentially fatal diseases such as prostate and breast cancer are nauseating. For every 10-year snapshot, almost 100K more women would die in the US of breast cancer if the US had the vaunted NHS.
Now, the NHS is so bad that Britons are traveling to places like Lithuania to get medical care. How do wealthy Britons avoid these problems? They buy their way out of them.
If you are asking, “what about Canada?” The rich are buying private health insurance to get out of public system, which has the same crushing problems as the NHS.
And all of this is happening when the NHS and Canadian systems are leeches off of the US healthcare consumer. Any medical advances that Canada and the UK get are due to the US consumer paying for the innovation.
There are a lot of problems with the US healthcare system. Many are baked in due to regulations and Obamacare.
Those can be solved by increasing competition and forcing pharma companies to sell directly to pharmacies as well as forcing leech nations to pay for innovation.
That would require tearing down a lot of regulations and building a system that was a real market system. It would require less government intrusion.
The only thing that the government should do is ensure that healthcare is properly given and the field is level.
Canada has a “Two Tiered,” medical system???
Not really.
The gov’t system pushed medically assisted suicide for a hurt shoulder.
It pushes suicide for a way out of chronic pain or inconvenience.
The private medical care system offers real options, such as surgery and physical therapy, bed rest and effective medications.
UK has same issues over run with “migrants” they are now considering a tax break for putting your elderly to sleep.
I’d put the invaders to ‘rest’.
The left clings to and protects Obamacare because they simply cannot admit a mistake. Obamacare infected health care so thoroughly that it is difficult to get it out without damaging health care itself. This was by design, so that the only path forward would be to continue towards full government health care.
Obamacare is an excellent example of what single party rule would bring us. No debate, no compromise, no introspection, just mandated results based on ideology, and a grossly flawed ideology at that. It is noteworthy that those creating Obamacare wanted no part of it for themselves.
Obamacare at its worst we don’t need Big Brother Period