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this post was submitted on 28 Feb 2024
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The "healthcare" system isn't broken, it works perfectly.
You're just mistaken about what its purpose is.
It's one of the most beautiful examples of capitalism working as intended: When you're hurting or dying, your demand for healthcare is unlimited, and you're in no position to compare prices or services, so cost is determined by the maximum amount that can be squeezed out of you during your remaining lifetime.
To spell out the point here - healthcare isn't the point of the healthcare industry under capitalism - profit is. Any healthcare delivered is going to be the bare minimum required to separate you from your money.
I've worked in hospital systems since I graduated from college. There has been one meeting (out of all the meetings!) that I have absolutely never forgotten due to something that was brought up.
They thought it was super cool to talk about how much cash our new surgical center was bringing in. I know it was small in the scheme of things, but in my head a hospital should be super happy when they don't have to perform surgery on a person. They shouldn't be happy to perform surgery so that they can make money.
For me it was a quarterly town hall with hospital leadership and they kept pushing “we are a business…” and all I could think was “no, we are a hospital…” because being a business is indicative of being profit motivated. I know, I know, that’s exactly what it is, but it just really bothered me to hear that line over and over.
When you have an actual functioning competitive market the money you bring in correlates with the value of the service you provide, so it makes perfect sense to be happy about the money the new surgical center is bringing in. That means it's useful.
The problem is that the health care market is regulated and subsidized in so many ways, many of them conflicting with each other, that competition is very limited and price discovery is reduced to "whatever the patient (and their insurance) can afford to pay" since they can't go anywhere else. Fix that and there won't be any reason for hospital owners or employees to feel guilty about making money.
Most healthcare systems in the US are non-profits. To run a non-profit, you still need revenue to operate no matter where you are or what you do. They have to pay their own bills just like anyone else.
Bring on the downvotes. Then go ahead and take all of your local hospital’s funding and see what happens.
Edit: maybe people misunderstood my point? People are replying and saying that profit shouldn’t be part of healthcare. Yes, but that doesn’t solve the problem of funding. Every hospital gets money. Pick your favorite country, the hospital still gets money.
Non-profits need revenue, true. But many non-profit hospitals are not acting like nonprofits. Here's a NYT opinion piece about it
Here’s an actual study on the issue.
You’re largely right about nonprofits not contributing enough, but that’s a systemic issue that reflects the poor quality of the system and how it’s funded in the first place, such as the way we allow insurance companies to take huge chunks of our money.
Non-Profit or Non-Taxed? - Economic Update with Richard Wolff
Yeah that's not what it's about at all. Hospitals need funding. Hospitals do not need a profit motive. Remove the profit motive and socialize the costs of healthcare. Just like every civilized country does it.
You say I’m wrong and then you go on to reiterate my exact point about money. Hospitals require funding and they are funded in every developed nation. Nonprofits do not have a profit motive. They argue with your insurance company for more money, just like every other developed nation, regardless of whether it is directly single payer or a system like Germany or Japan, which largely rely on private companies.
you're arguing for profit to remain a focus within the healthcare industry. That's anti-people, and why everyone is downvoting you. Everyone knows a hospital requires funding, we just want our tax dollars to pay it.
You’re putting words in my mouth. I never said that. I said anything needs money to run, even a nationalized system or a single payer system.
Did you have an actual response to the fact that hospitals need funding?
The short answer is no. You may stop reading now as the next sentence is similar to the last one.
If it wasn't clear to you, I'm busy dismissing your opinion as uninformed and without merit. It is clearly, objectively wrong, and the idea that you deserve a voice in this discussion with the level of information you own currently? Patently ridiculous.
Your sense of self worth would be admirable is it weren't so misplaced.
It’s wrong that hospitals need money to operate? Bud, I got a master’s in this… which hospital are you aware of that doesn’t pay for electricity or pay its providers with money? Talk about patently ridiculous.
Just have the state pay for it?
Apologies in advance, my app doesn’t seem to want to show me what context this is in, so I might be off base in my reply, but yeah, that’s a good solution. The problem is that in the USA, if you raise taxes by .0001% people throw temper tantrums. They’d rather pay out the ass for private insurance. I know people on Lemmy don’t feel that way, but that’s how Americans are.
A masters in...?
Healthcare administration. Why did you dodge my question? Where do hospitals not pay for their electricity or pay their workers money?
Holy shit dude.
C'mon.
If you are an intelligent human being, as i assume you are despite your ridiculous opinion, (and despite your ridiculous joke of a degree), can you step outside what you've been taught, rise above my provocations, and explain why, objectively a reasonable human being shouldn't be skeptical of the opinion of some person whose existence depends on their being right? A goddamn hospital admin degree? Foreal?
Why Not ask the ceo of kellogs what we should eat for dinner?
Im not gonna ignore you like i do most of the shitbirds who argue by insinuating and suggesting intelligence rather than replying first with a cogent, interesting proof of economic understanding. I actually can't wait to hear what you've got to tell me. I think it's going to be entertaining. I also think you should actually cut your losses and use your degree to understand that you're in over your head, but i suspect they this conversation that kinna smarts isn't taught in college anymore.
Wow that’s a lot of words to say you can’t think of how to run a hospital without paying people.
And I agree, the fact that you need a master’s to understand how a healthcare organization runs is absurd, but that’s the state of things in the USA (to be clear, the MHA is my secondary master’s, but it’s the field I ended up in). However, my existence doesn’t depend on anything. If we were nationalized, I’d still have my job, just like the janitors or the administrators everywhere else in the world. You can’t just run a medical practice with a doctor and no other staff. I’m sure you’re creative enough to think through this and understand that maintaining a building, checking people in, running computer systems, etc. requires more than just a doctor.
To add to this, I could make more money doing a very similar job at a random company. Take Kellogg’s as an example. But I don’t, because I like working with patients and providers. But keep on assuming I’m an asshole because I work in healthcare and I’m not a clinical staff.
Now, back to my original point, which I’m really fascinated to hear the answer to. Since you seem to argue that I can’t pay my docs, janitors, nurses, or utility bills, how do I keep things open? Even a nationalized system pays salaries. A healthcare system needs money, unless you’re in a society that doesn’t rely on money.
I apologize, I think you’re too smart for me. May I ask you to dumb down your point for someone who has such a low IQ that they got stuck working at a hospital? I jest in how I say that, but I legitimately do not get what you’re so angry at me for.
You’re free to block me, although I’m not clear why you’re so mad that I criticized the US healthcare system when you also seem to be angry at the same system.
Maybe this is all my fault for wording my original post poorly, sorry.
It's not your fault at all, I am also confused what exactly caused them to adopt such a hostile tone.
I have noticed that many Lemmings have a strong preference for explanations which emphasize the dysfunction of capitalism as the ultimate source of all worldly suffering. Your suggestion that even in the absence of capitalist incentives, running a modern healthcare system is still an incredibly expensive endeavor that must be funded somehow, disrupts that worldview. Thus, the hostility.
Common ownership of the means of production would provide a lot of revenue that could be used for healthcare. Therefore, without capitalism, this would be easier @news
One of the most perfect parts of how powerful lobbies constructed it is that, unaffordable as it is, there IS no free market for care, you are forced into networks and PPOs, etc. so if someone DID offer a better price outside of your consumer funnel(sorry, insurance plan), your insurer would just deny the claim at the providers standard 20x cost price for uninsured procedures. Also, 100% price obfuscation so comparison shopping is impossible. It is end-game capitalism.
I want to downvote you simply because i hate this truth. I hate it, so, so much.
That's not how capitalism is meant to work at all.
Its obviously and uncompetitive market and something needs to change.
History shows us that capitalism inevitably tends towards monopolies