Why American Healthcare Is The Worst In The Developed World

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[news clips of people talking about their absurd medical bills, bankruptcies, etc]


In a previous episode I briefly touched on the failures of the American healthcare system. That section of the video prompted all sorts of responses in the comments, mostly from Europeans who were horrified to learn that Americans have to pay for an ambulance ride to the hospital, but also a handful of brave patriots who claim – without evidence – that the American healthcare system is the best in the world. This video is for those people.


Let’s jump right in. I’m going to throw a bunch of statistics at you, and then we’ll look at the root cause of the problem. America spends more money per capita on healthcare than any other nation on earth. You would think that this expenditure would guarantee the best care in the world. That is not the case. In fact, despite being the most expensive healthcare system on earth, consuming over 16% of our GDP, it’s one of, if not THE  least effective in the developed world. We spend over ten thousand dollars per capita on healthcare, and not only is the quality of care sub-par, we don’t even cover everybody. Compare this to places like Germany who pay drastically less per capita and guarantee coverage to all their citizens. There were over 27 million uninsured Americans in 2018, and that number will have skyrocketed in recent months thanks to the millions of layoffs across the country. Even before the epidemic we had more uninsured and underinsured citizens than any other developed nation. In addition to not covering a large portion of the population, even those with excellent (by American standards) health insurance struggle to pay medical bills. Over 25 percent of insured people reported having difficulty paying for the exorbitant cost of their treatment. Of this group, 63 percent had to pay most or all of their savings to cover the medical bills, and 42 percent had to get a second job. Lifesaving drugs in America often cost 10 times what they cost in other countries. For example, in Canada, one vial of insulin costs 32 dollars. In the United States, the same drug, from the same factory, costs 300 dollars. And that’s not even an extreme example. Take the HIV drug Truvada. In Australia, it costs just 8 dollars. In the United States, it costs 2,000 dollars, despite US taxpayers footing the bill for its development. Every year, over half a million people go bankrupt trying to pay their medical bills. In a country where 40 percent of the population can’t afford a surprise 400 dollar expense, an ambulance ride to the hospital will cost you more than twice that amount. And all of this is happening in the richest country on earth. If we have the resources, and we’re so much better than all the other countries, why is our healthcare system so broken?


Here’s the thing. It’s not broken. It’s functioning exactly as you’d expect it to. America’s healthcare system is for-profit. That means instead of providing care because it’s the ethical thing to do, they only do it because there’s a big check involved. Back in the thirties, Blue Cross and Blue Shield were the two main health insurance providers in the US. in those days they operated as nonprofits, and wouldn’t turn anyone away for preexisting conditions. Then, after World War 2, employers started offering health insurance as a benefit, and between 1940 and 1955, the percentage of insured Americans jumped from 10 percent to over 60 percent. This new demand for health insurance caught the eye of many entrepreneurs, and the for-profit healthcare industry was born. By 1951, big names like Aetna and Cigna were major players in the industry, which continued to grow through the 70’s and 80’s. In the 80s, the country began to see its first for-profit hospitals, operated by large investors who owned multi-hospital chains. By 1981, 1 in 7 hospitals in the US was for-profit. Suddenly medical bills became a lot longer and more convoluted. Every little thing became an itemized expense, from tissues, to plastic cups, to being able to hold your baby after it’s born. The hospital’s transition from philanthropy to corporation was complete. This is not normal in other countries. America had taken the intensely cruel step of taking something sacred, the health and wellbeing of its citizens, and slapping a price tag on it. 


With this commodification of health came unsurprising side effects. Average american life expectancy is lower than other wealthy countries, and has actually begun to decrease in recent years, compared to other countries slowly increasing. The US has the highest infant and maternal mortality rates of any developed country. The US has higher rates of medical errors than other countries. Adults in most other comparable countries have quicker access to a doctor or nurse when they need care, contrary to what American healthcare advocates would have you believe. To make a long story short, in just about every study on the effectiveness of healthcare systems in developed nations, America scores very poorly. Most of the time at the very bottom. And other nations are taking notice. Towards the beginning of the coronavirus epidemic, one university in Norway urged its students to come home if they were studying in countries with poorly developed health systems – such as the US.


Part of the problem is the American obsession with “streamlining” or “optimization.” Anything that doesn’t immediately increase profits has to go. Take for example the practice of “just in time” delivery of essential equipment such as ventilators. Instead of having an emergency stockpile, including personal protective equipment such as masks and gloves, these items are instead delivered only when the need arises. The idea is to reduce overhead, but in reality it leaves us totally unprepared and under-equipped for a national pandemic. That’s why we see pictures of doctors and nurses wearing trash bags, because their hospitals haven’t provided adequate protective equipment, and just to be safe, they’re firing people who post those kinds of pictures.      


To their credit, the CDC was planning to address the national shortage of ventilators, but the company to whom they had given the contract was bought out by a larger company, who cancelled the project because it wasn’t going to be profitable enough. And of course that larger company’s name is Covidien, because the architects clearly put an intern in charge of our simulation. 


I could spend all day listing off instances of absurdly high medical bills, but at the end of the day, some people in America will still defend the practice of for-profit healthcare. Maybe the best way to get through to these people isn’t to show them the bills, but to show them what people in other, saner countries think of the bills. So here you go.


It’s okay to laugh. It’s a funny video. But these are the types of reaction you get when you explain to anyone in a developed country besides the US just how screwed up our healthcare system is. We’re not paying these exorbitant fees for quality care. We’re paying for executive bonuses, shareholder value, and lucrative contracts. Pharmaceutical and medical device companies can charge whatever they want, and the US government will never step in. We’re one of the only nations on earth that doesn’t regulate the cost of drugs and medical supplies, and companies negotiate directly with hospitals and insurers to get the best terms. Not best for the patient, best for them. Drug costs in America are many times higher than in any other country. Why? Because that’s how it works in a for-profit system. The dollar holds infinitely more value to these corporations than human wellbeing. The needs of the people are secondary to the profit motive.


The American healthcare system is a system that relies on people getting sick and coming in for treatment, which is why we don’t see any investment in public health initiatives. A program like Medicare For All would solve this and every other health problem produced by the coronavirus pandemic. Everyone would have been able to see a doctor and get tested, which would have given us more accurate data about the illness and its spread, hospitals wouldn’t have to waste energy dealing with private insurers fighting them on every little thing, and with the profit motive removed from the healthcare equation, the government would have an incentive to prioritize public health to prevent people from getting sick instead of counting on it. That in turn would make us better prepared for the next pandemic. But remember, the system that we have isn’t broken. It’s functioning exactly as it’s meant to. 


Why do we pay so much money for the worst care in the developed world? And, more importantly, why do we put up with it?


If you’d like to learn more about the virus that made it clear just how ill-prepared the US was for a pandemic, I highly recommend you check out The Coronavirus Epidemic on CuriosityStream. It’s a fascinating look at how the world responds to a rapidly spreading virus and the measures we can take to stem the tide of infection. If you watch my videos, you’ll know I’m a big fan of CuriosityStream. It’s an online streaming service with thousands of nonfiction titles from some of the best filmmakers in the game. You can find tons of great episodes like The Coronavirus Epidemic, and they’ve got a bunch of material on technology and outer space, which are some of my favorites. Their giant catalog includes content on science, nature, astronomy, technology and lifestyle, among others. Unlimited access starts at just $2.99 a month, and as a special offer just for you guys, you can get a free trial by following the link below. CuriosityStream is available on just about every platform you can imagine, so wherever you are, you’ll always have access to great, interesting content. As an added bonus, your CuriosityStream subscription now comes with a free Nebula subscription. Nebula is a new streaming platform built by and for creators like Wendover Productions, Real Engineering, Kurzgesagt and of course, Second Thought and many others. It’s a place for us to try new things and make Original content that just wouldn’t be possible on YouTube. Give CuriosityStream a shot and get free access to Nebula when you visit curiositystream.com/secondthought.


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