True but “there’s no one boogeyman to blame” should read as “there are many, many boogeymen, all of whom bear blame, and all of whom need to corrected/removed/circumvented/improved.”
If only we could take our money elsewhere, but we are mandated to pay with insurance, which makes them the defacto customer, to decide with the doctors, cutting us out of the process (which is handy under circumstances where the patient can't talk; There's a use case for everything, but coercion and blanket enforcement seems to ruin everything)
We can't even choose our insurance - it comes from your employer with no choice (or no real choice - I have two slightly different choices from United Health Care). All the negotiation on how it works is done by HR not me, and HR likes the current rules as it makes it hard for me to leave.
In theory I can bypass my employer insurance - but if I do I throw away thousands of dollars that my employer is paying directly and so anything I find elsewhere either cannot be as good, or is has to cost a lot more money.
Even then, good luck... I couldn't find a personal plan either the Health gov compliant plans or out of pocket that matched my employer insurance... I'm pretty sure if I try again, I'll wind up creating a company again, using one of the HR based collective payroll options just for better Insurance options.
The system sucks a lot, and for a lot of different reasons. Namely is that there's no room for individual negotiation, and there are dozens of pricing models for the same drugs, procedures, etc.
We don't do that in America. We pick whichever boogeymen are more scary to our given political team and make that the only cause while arguing back and forth and not actually doing anything while we all get robbed fucking blind and pay our politicians six figure salaries for doing fuck-all.
Not really. The current administration has been going after healthcare on several fronts: lots of FTC enforcement against PE in healthcare; increased number of funded medical residency slots; allowed Medicare to negotiate prices directly with drug companies; attempted to stop excessive consolidation in healthcare businesses.
All of these are reasonable attempts to solve big, important problems and I don't think it's helpful to throw your hands in the air and say no one is trying to do anything.
The Medicare negotiation allowed has still been VERY limited. It should be granted full out by congress, as well as combined for federal employee and VA coverage as well as congress itself... they should all have the same coverage, thus the same incentives. Open/public pricing models would be a good start. As would domestic production and multiple supplier requirements for medications and devices just from a security stand point.
In general the current FTC is better than most in my lifetime, that said, there are plenty of other areas of Govt that are really bad, and even the FTC and SEC could be doing much, much more. It's a mixed bag.
Contrary to a lot of replies, I don't think that another Trump presidency would be particularly worse in these areas as they are pretty populist in nature. Trump isn't a die hard conservative, he's really a populist first.
Agreed it all can and should be better. That doesn't mean "it doesn't matter which administration" etc. There are meaningful differences and the sane thing is to prefer the better option over the worse option, even if neither is particularly perfect or downright evil.
When it comes to improving systems like these, incompetence, hamfistedness, and inaction can be plenty damaging by themselves. "I will roll back ACA and replace it with [crickets for 4+ years]" is a worse alternative.
If course there are differences between different administrations. Unfortunately, the best I can hope for is one that I agree with even 60% of the time.
And even then, some issues are far more important and foundational than others.
I do. We have the Democrats who are mostly alright and well meaning, with exceptions but in practice are not capable of handling what the Republicans have become, which is theocratic-fascists. And the Republicans are filling the legislature with dipshits who scream about Jewish space-lasers and want to regress us socially to the 1920's.
