One thing that I hear all of the time from patients and even fellow heath care workers is how the US health care system is broken because it is expensive, yet my fellow workers all say that we are underpaid for what we do.
Medical care is a finite resource. Therefore, you cannot give everyone all of the care that they desire or need. There has to be a way to ration care. In the US, we do that through cost. If you want more or better care, you pay more for it. In many other countries, the oes with so-called “free care,” they ration it by allowing government officials to decide who gets care when. That’s how a woman in the UK with a mass on her ovaries is forced to wait 9 months to have it removed, only to discover that it has become cancerous, which results in a complete hysterectomy and a long course of chemotherapy.
Heath care isn’t cheap, especially when you demand that the people performing it have to be flawless in its execution. Everyone involved in the delivery of care from the janitor, to the nurse, the technicians, and the doctor have to have high levels of training. That raises costs. Starting nurses are making $75k a year in my area, and yet there is still a shortage. With 5 or more years’ experience, nurses in certain specialties are making more than $100k. Florida has pushed a lot of people to go to nursing school and even subsidized people in attending school, yet all this has accomplished is to increase the failure rate of the nursing exam.
Pay is set by market forces- employers pay for good employees. When demand is higher than supply, market forces cause a bidding war for the product- in this case, nurses and other highly skilled workers, which causes pay to rise. We are seeing that here in Florida, and have been since COVID. Nurse pay is rapidly increasing. My employer recently announced a 20% increase in shift differentials and a 5% raise in base pay for nurses.
Your only other choices are:
- Lower standards. This will allow you to pay less, and also allow the hiring of more workers, albeit at a lower skill level. The cost is more accidents and medical mistakes.
- Ration care through waiting lists. This is the path that many nations like Canada and the UK have followed. The cost here is people dying while on the waiting list.
There is no such thing as a free lunch. There is a bill to be paid, the only question is how it will be paid. No matter what, someone is going to pay these workers. The patient can pay for healthcare at the point of sale, or everyone can pay for it when it is deducted from your paycheck, but we are going to pay for it regardless.
16 Comments
Francis W. Porretto · March 27, 2025 at 5:39 am
“Socialism hides its faults by making people wait.” — Crozier and Seldon, “Socialism: The Grand Delusion.”
oldvet50 · March 27, 2025 at 6:50 am
The sickness/injury system is in the shape it’s in now because of insurance and the government. I don’t refer to it as healthcare since that is something each individual is responsible for. There is absolutly no incentive to control costs since “it’s free”. Most of the time you have no control over what insurance you have, what it will cover or what doctor you can see. There is no discount for actually caring about your health (exercise, eat right, not engage in reckless behavior, etc.) or a premium increase for being a drug using, obese, risk taker. We’re all the same in the eyes of the providers. You are right in that we all pay for it, but what gripes me is that the least contributing members of our society get the better care (Narcan isn’t free, as an example). Forgive my rant, but I grew up in the era of doctor’s house calls.
Steve · March 27, 2025 at 11:49 am
If you are looking for an inflection point, you could do a whole lot worse than the Health Maintenance Organization Act of 1973.
Skyler the Weird · March 29, 2025 at 7:07 am
I miss my Cadillac Medical Plan. Thanks Barry.
Steve S6 · March 27, 2025 at 8:08 am
Fast, good or cheap. Pick 2.
JimmyPx · March 27, 2025 at 9:36 am
There are so many problems with the US health care system these days and cost is just one of them. In my opinion people have unrealistic expectations for healthcare.
People think that the doctors and nurses have a magic drug, pill or treatment that will make all of their medical problems go away and they’ll feel like they were 20 years old again.
Medical science can only do so much depending on the condition and that’s it.
But people DEMAND this and get pissed when they don’t get it.
People refuse to face reality !! People come into the doctors and are in their 50s, 100 pounds overweight, sedentary, smoke like a chimney and drink like a fish and haven’t seen a doctor in years.
They then expect the doctors and nurses to “make them better” because they feel like shit.
But besides medication when life style changes are recommended, they blow that off.
They are then SHOCKED when a few years later they have a massive heart attack and they say “I went to a doctor and they sucked, I should sue”.
Then of course there is the issue of spending a fortune on a terminal patient.
A person with stage 4 cancer is terminal and should get their affairs in order and be ready to call hospice when the time comes. Instead, “I’m a fighter, I’m gonna beat this, I want every treatment possible”. So 100s of thousands of dollars are wasted and someone who had 6 months left to live with the new treatments lives 6 months.
JNorth · March 27, 2025 at 11:26 am
From the multiple folks I know in the hospital industry, in the US we have much of the same problems there as we do in the education industry, it’s not the doctors, nurses, or teachers, to rein in costs we need to take all the administrator and cut them in half. Horizontally or vertically, doesn’t matter, just so long as they are gone and not replaced. A lot of administrators are there due to government regulations so those need to be removed.
Rick T · March 27, 2025 at 11:55 am
As long as the companies actually paying for health insurance are the customer nothing is going to change. The WWII end-around wage limits is long overdue for removal.
Health insurance should be handled like auto insurance: Individual purchases, you choose your coverage and know exactly what the coverage is.
Medical care providers should also be required to publish their billing rates like nearly every other business entity in the US.
Steve · March 27, 2025 at 3:24 pm
“Medical care providers should also be required to publish their billing rates like nearly every other business entity in the US.”
What business entities have to do that? Most companies I do business with, Distributor and Retail price lists are closely held secrets.
Rick T · March 27, 2025 at 4:22 pm
Automotive repair shops as an example. I help resell HPE equipment and one of my primary tools shows the retail price of every product and component. Nobody actually pays retail but there is an upper limit listed.
We now have two hospital chains in my area, I’d much prefer to go to the cheaper one all things being equal but I have no way to know which one that is.
Tanfj · March 28, 2025 at 11:56 am
Steve, I set customer pricing for over a decade at LilHoseCompany. Retail price list and your price as customer, I will send you that all day.
You are correct, our wholesale price was company confidential. However I can tell you, we were making 70% profit on walk-in customers; and generally 55% was the start of our bulk pricing. An old management rule of thumb, assume the price doubles with every middle man. (Double the price, 50% profit.)
In our particular industry, 25% profit is the bare minimum to meet the overhead in addition to the cost of goods sold.
Aesop · March 29, 2025 at 8:06 pm
Apparently, you’ve never been to a restaurant, even one that sells fast food.
Last I looked, retail prices were posted prominently at all of them.
But you knew that.
The thing is, health care isn’t fast food.
And people don’t want McDonald’s-quality care.
They want fancy restaurant steak, and they want that at fast food burger prices.
Best wishes with that plan.
Crap in one hand, and wish in the other, and tell us which one fills up first.
But if you want McDonald’s-level quality, I’ll be happy to point you to the bottom-level hospitals in my area. 10:1 odds they’ll also have the lowest prices for service.
Let health care providers start recommending people to the quality levels of care they say they want, and dogs in space will be able to hear the resultant whining and howling from the people who earnestly believe that they’re entitled to top-quality care and bottom-quality prices. They’re usually the dumbest fucktards we see every single day, who take no responsibility for taking care of themselves 24/7/365.
We – society in general “we” – call these people idiots.
Inside health care, we call them “job security”.
Divemedic · March 29, 2025 at 10:18 pm
Not exactly. People want elite, Michigan star quality, served at the speed of fast food, but at rock bottom prices.
Then, when you tell them to stop the behavior that brought them in, like using drugs or diabetics eating jelly donuts, they complain that you can’t just give them a pill and send them on their way, all in 5 minutes and for free.
Stealth Spaniel · March 27, 2025 at 12:08 pm
I will go with lifestyle changes. I have seen it up close and personal for years; including with myself. I have a friend who is type 2 diabetic. She absolutely refuses to take her blood sugar readings, or restrict her diet. “But I like my coffee with 2 tablespoons of sugar and lots of cream!” she whines. Okay then, have at that headache, feeling lousy, and your eyes are blurry. This woman argues with her doctor about needing insulin. Her husband is 250 pounds overweight, has sleep apnea, heart problems, etc. What do they love more than anything? Going to Golden Corral and loading up. Of course he can’t work now because of his “health problems”. I gave up saying anything and I leave them to their misery. I will say that any insurance company should take lifestyle into consideration when calculating you premiums, and any doctor should be able to say “Out of my office. You are unwilling to help yourself.”
“Healthcare” is a 2 way street.
I can say this because my grandfather was the father of 29 children, he was 72 when my mom was born. He never did anything but walk everywhere for miles. He had one good German beer a week, my grandmother always cooked from scratch, and they survived the Depression because they were debt free.
@HomeInSC · March 27, 2025 at 10:43 pm
Deporting millions of illegals might relieve some of the pressure on schools, police, housing costs, medical services…
Aesop · March 28, 2025 at 5:33 pm
FWIW, my annual salary is more than what we pay a U.S. congressweasel or senator, or a one-star general/rear admiral-lower half in the U.S. Navy with 20+ years of service.
Then again, I not only work harder than they do, i also do more good for society than most of them ever have or ever will, so fair is fair.
Also, the amount Califrutopia goes into debt each year is generally just about exactly the amount of all the money they waste on everything they do for illegal aliens and their anchor-baby spawn.
I’m sure that’s just a coincidence…
And I don’t refer to what I do as “lifeguarding in the shallow end of the gene pool” for nothing.
I I were emperor-for-a-day, what would be carved in stone over the entrance to the ER would be
“Make Better Life Choices“