Comment by sershe

this narrative is basically a lie

1) Americans spend less than OECD average out of pocket as a percentage of healthcare costs. This is much larger in absolute terms but the multiplier - cost of healthcare is nearly entirely due to provider costs.

2) Health outcomes are really different between states despite having basically the same system. demographically controlled iirc outcomes are not different and sometimes better (e.g. japanese americans).

3) Insurance company profits are pretty low relative to cost of healthcare. while the bureaucracy is more expensive its not "catastrophically" by any means and iirc there are oecd countries with similar overhead although im too lazy to search on myvphone.

4) Rationing healthcare has to and does happen in all advanced economies. again modulo cost in the us, id rather it happen via money than government or inforrmal scarcity (like in Canada).

4a) Frankly while i dont have evidence for this 4a, lookinng at us spending by age (and eg the enormous money usg spends on kidney dialysis for people thay mostly just die in a few years anyway), I wonder if an important reason US providers are so expensive is, we ration limited supply properly for most people but then don't ration keeping a bedridden grandma alive for 6 more months at extreme cost, cause hey, the govt pays.