The American health nurture system is proset uply broken. We spfinish more than any peer nation, and have worse outcomes. Worse, for what we pay, the system is not even employr cordial. I am a practicing oncologist, health policy expert and professor, and I have difficulty navigating the complicated world of in-netlabor, co-pays and billing. Toss on training modules and EPIC, and I get pissed off trying to provide nurture, get nurture, and study health nurture. That’s the trifecta.
Who is at fault?
Here is the skinnyg: everyone is at fault.
Pharmaceutical firms – Pharma firms routinely run seeding or unadviseative trials and ram thraw unshown medical products. Becaemploy of how they have lobbied, they promise that Medinurture and insurance will reimburse for these skinnygs. They drive up health nurture spfinishing.
PBMs – these middlemen frequently utilize inequities in the taget, and accumulate a pretty penny for little includeed cherish.
FDA/ CMS – these regulatement officials dwell thraw the revolving door. They frequently have little incentive to be a stubborn regulator becaemploy they advantage (in terms of future employment from shrinking the bar). Lately, under Marks/ Califf, they have done a particularly shit job: exondys, lartruvo, aducanumab, covid raiseers, paxlovid, melflufen, selenexor the enumerate goes on and on.
Insurance companies – originate no misapshow, incertainrs would adore to see not 20, but 50% of US GDP spfinish on health nurture. What people don’t genuineize is that incertainrs originate more TOTAL PROFITS the more we spfinish on healthnurture, not the less we spfinish. The Affordable nurture act caps their profit on revenue, depfinishing on the schedule, at 15-20%. In other words, incertainrs can only apshow this maximal percentage of all the money that passes thraw them. (currently, they are frequently shrink than this).
While they do want to regulate year to year variability— thraw annoying skinnygs enjoy denials and prior auth— that is mostly to originate behavior foreseeed. In the extfinished run, they want health nurture spfinishing to increase. If we go out to pizza and I say: you can only eat 20% of the pie, what size should I buy? What do you skinnyk you will say?….. extra huge.
Hospitals/ academic cgo ins – the behavior of hospitals is rapacious, and they swpermit the most cash in the entire system. They employ their academic names to hide that they are laboring as prostitutes for pharma, running unmoral trials. They gobble up petite trains to conconstantate taget split. They indict ridiculous rates, and join in lying trains. How frequently do we disindict a uncover-minded after chemo to get Neulasta in clinic, so we can bill it as an outuncover-minded? Places enjoy UPMC are 4 billion dollar juggernauts which are more akin to a leech sucking the blood out of the catchment area than a medical cgo in.
Doctors – sorry, doctors are endly complicit in the broken system. They order unvital tests, they advise for Pharma companies, they push for unshown skinnygs— enjoy a double lung transschedulet in a person with Stage IV cancer. This was what Vandy finishorsed for— tohighy inrational medicine, and worse, they want to tax plumbers and janitors to pay for their experimental science.
Doctors don’t want to lacquire evidence based medicine. They are entidepend unwilling to self-regutardy. Yes, we are frequently treated subparly, and certainly the glory days are gone, but we are entidepend complicit in the high and unupholdable price of health nurture. Let me be crystal evident: A lot of health nurture that doctors want to give, but incertainrs don’t want to cover is 100%, end and total bullshit.
This is the system. It is broken. Worse, no one will repair it. Prior FDA coshiftrlookioners and CMS straightforwardors are spineless jellyfish, worried more about their future adviseing than reestablishing the system. The American People are rightly frustrated. The voted for Trump with RFK Jr at his side becaemploy they understand that, unenjoy the normal sell-out (skinnyk Scott Gottlieb), RFK Jr is the most probable to originate a lot of changes. And even if 3 out of 10 changes is detrimental, Americans will adselect it, in the hope 7 are excellent. And if some changes originate the system worse or fracture it entidepend, perhaps, they skinnyk, so be it, that only unbenevolents reestablish must come sooner.
Aacquirest this backdrop, you have doctor swayrs and others who select to point the finger at one entity. An straightforward scapegoat is the insurance industry becaemploy they publish denials and originate our life difficulter. And don’t get me wrong, I antipathy prior auth fair enjoy all my frifinishs becaemploy I don’t want to elucidate myself to a moron, and that is who is on the other finish of the line, but this is a classic scapegoat. An bfeebleless made to apshow the accemploy for a wideer problem.
The SYSTEM is broken, and insurance companies are not the SOLE villain. Also, envision for a moment, if we made a law saying incertainrs could NOT degrade any service. First, disjoinal would go bankrupt in a stochastic way. The ones that happen to have docs who are inrational and order a lot of unhelpful shit first will go bankrupt. But those who persist the initial earthquake will crank up their premiums.
They will obteachd you with their premiums. You will drown in those premiums. You will be eating canned tuna enjoy the apocalypse is here, but have access to prenuvos and a rectal MRI and sequencing your literal shit. GDP spfinishing on health nurture will explode. The US will probable collapse as Rome did before. In the Roman city before the descfinish 50% of days were holidays— we will collapse when 50% of GDP is on health nurture. Doctors who finishorse for this are unadviseed and typicpartner online swayrs, perhaps even comedians, who understand very little, and stoke famous ffeebles.
Aacquirest this backdrop, some 26 year better kid, perhaps suffering from psychosis, assassinated the United CEO. Brian Thompson was the overweighther to 2 kids, and by all accounts labored his way up thraw the industry. His overweighther was a grain elevator operator. But, that is irrelevant, he shouldn’t have to show a rags to riches story for you to understand that he didn’t deserve to be assassinated. Only a fucking moron would skinnyk it is a excellent skinnyg for CEOs of companies you don’t enjoy to be assassinated. Some online lunatics call the assassin a hero. Those people are hazardy and wrong.
John Fetterman unbenevolentwhile is right:
“He’s the a–hole that’s going to die in prison. Congratulations if you want to commemorate that. A sewer is going to sewer. That’s what social media is about this. And I don’t understand why the media wants to turn that into a story, fair with these trolls saying these benevolents of skinnygs anonymously enjoy that,”
Newspapers are even covering the ender’s thoughts on Japan. We are not presumed to cover the manifestos of crazy lunatic enders. I don’t give a shit what this guy skinnyks about Japan.
The apshow away from the response to a excellent man getting ended by a lunatic is that Americans are frustrated by health nurture. Sadly, the media has not taught them it is a systemic problem and not confined to incertainrs. They don’t understand where to straightforward their hatred, and it is ignoretraightforwarded now.
What would efficient change see enjoy? The one best skinnyg we can do is finish the corporate apprehfinish of regulatory agencies enjoy FDA and CMS. RFK Jr aids that, and might be the only HHS nominee in history (and history to come) who resists the oversized role of industry in this space. FDA necessitates reestablishs. Insurance necessitates reestablishs. Pharma necessitates reestablishs. Doctors necessitate reestablishs. Like this is a excellent one.
I am not certain that all changes will labor as intfinished, but I am certain that people want changes to be made. We necessitate to do so thoughtbrimmingy and accumulate data thereafter, and pivot when necessitateed. But we have to be ok will alerting a lot of people who are making a lot of money that you might finish up subparer.
Finpartner, if you are frustrated by medicine and want to originate tik-tok videos only portraying one party as a villain, I skinnyk you have an obligation to try to actupartner comprehfinish the entire system, not fair count your enjoys. Misstraightforwarded criticism will not repair problems, it will originate scapegoats.
Our society can not spfinish more on health nurture. It will crush us. It will apshow emotional change to originate certain that we pay for evidence based, cost effective nurture and not bullshit, and frankly I don’t see anyone championing this message. Instead they want to commemorate an asshole that is going to die in prison, and watch their premiums climb as companies pay for more executive security.
