Mapping Every Dollar of America's $5T Healthcare System
8 days ago
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- #healthcare
- The US healthcare system is a complex, $5 trillion behemoth with financial flows that are difficult to comprehend.
- The system was built piece by piece, with programs like Medicare, Medicaid, and employer-based insurance, leading to a fragmented and inefficient structure.
- The UK's Beveridge model is a single-payer system funded by taxes, with low administrative costs and universal coverage, but it has issues like wait times.
- Germany's Bismarck model uses regulated competition among 140 insurance companies, with universal coverage and cost controls, but it has complexity and payroll tax pressures.
- The US system lacks a coherent philosophy, resulting in high costs, inefficiency, and 27 million uninsured people.
- Americans pay for healthcare multiple times through taxes, payroll deductions, and out-of-pocket costs, making it more expensive than single-payer systems.
- A significant portion of US healthcare spending goes toward the elderly, with Medicare and Medicaid covering nursing homes and long-term care.
- The US system reflects deep ambivalence about whether healthcare is a right, an earned benefit, or a market commodity.
- Reforming the US system is challenging because every change affects multiple stakeholders, from insurers to hospitals to patients.
- The diagram of US healthcare financial flows reveals the hidden disorder and complexity of the system, raising questions about what to do next.