The Pitfalls of Cost Sharing for Healthcare
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- เผยแพร่เมื่อ 21 ก.ค. 2024
- Cost-sharing is the practice of making individuals responsible for part of their health insurance costs beyond the monthly premiums they pay for health insurance - think things like deductibles and copayments. The practice is meant to inspire more thoughtful choices among consumers when it comes to healthcare decisions. However, the choices it inspires can often be more harmful than good.
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The very idea deterring of “unnecessary” healthcare is absurd. A patient can’t tell the difference between necessary and unnecessary care. Nobody in the US goes to the hospital unless they think they absolutely have to.
I would disagree. When I was in college and the health service was free, I went in for something that I probably should have just taken care of myself. An abrasion on my hand after I tripped and fell could have been taken care of with antibiotic ointment and some bandages from Walgreens rather than having a highly trained nurse practioner examine me, diagnose me with a mild abrasion, document the diagnosis and order another highly trained nurse to come and show me how to apply a bandage using . I was kind of a wimp about it, but the fact that it was totally free meant I had no second thought about engaging multiple healthcare professionals in my care. I'm more judicious with my healthcare consumption now, but making a resource totally free does encourage unnecessary consumption.
@@tylerpeterson4726 The issue is statistics. It's not a matter of if abuse ever happens, but how often and how you can account for it. Time and time again, the savings of making sure people visit when it's necessary vastly outperform the small proportion of abuse that inevitably happens. That is, this same kind of abuse you described still happens in the US on a daily basis anyway. It's impossible to create a system where nobody can abuse it one way or another, but making a system where the exploit still exists AND the majority can't get the right kind of care is what the current US system is one of the reasons why the US system is among the lowest performing health care systems per capita in the entire developed world.
@@tylerpeterson4726 But having a nurse bandage your hand really doesn't, or shouldn't, cost much. And why would avoiding nurses bandaging minor injuries save lots of money? A knee replacement in the US costs over $32,000. In Great Britain, it's less than 1/2 that much. There isn't a European country where it would cost more than it would in the US.
Telling people not to see a provider for minor bumps and bruises just won't have much effect on costs in the US.
I live in Québec, Canada. We do get lots of patients in hospital emergency rooms with non-urgent or even inexistant health issues.
This is why there is a 5-levels triage system.
1- immediate intervention needed
2- serious issue, must be monitored and prioritized
3- most of the cases end up there. You have something real and probably serious, and you belong to the ER, but you're not about to drop dead. You will likely wait a few hours before seeing the doctor.
4- Yeah you have something nasty, but you could get back home, get a good night of sleep and get an appointment in a clinic. If you stay here, you will see the doctor... Eventually.
5- your condition is not concerning and doesn't require any urgent consult and you should take an appointment with your family doctor or in a clinic.
With efficient triage, people in categories 4 and 5 are encouraged to go back home and have appointments in clinics or with their family doctor.
But plenty of people do in Canada.
Plenty of people also probably do in the US if they have more money then sense.
Corporate insurance has absolutely no place in basic necessary medical care.
Making the patient decide "if it's worth it" to see a doctor is part of the problem.
Of course there are statistics on "over-care" (which would favor the insurance industry's perspective), but there are no stats brought up on how many are insufficiently cared for? I think that would be a much more interesting number, and probably show the costs are overly exorbitant.
why are non-medically trained consumers, who are in desperate situations of being sick or injured, the targets of blame, and not the medically educated doctors consciously recommending and ordering these excessive tests or treatments?
Preventative care is good. we should encourage it. It costs less than dealing with costly treatments when things are more severe later.
This whole system is nonsense.
part of the problem is that the way the US healthcare system works, there is no way for doctors to figure out how much a given treatment will cost for the patient
As a doc, it is really hard to get folks to accept they need less care rather than more. If I refuse to write a script or refer to a specialist, a few of them will wreck my clinic on Facebook or yelp or on their patient satisfaction survey. One person tried to get me in trouble with a supervisor for even suggesting that her mom maybe should not be on all these meds that were likely doing more harm than good. Most of the time I work very hard to counsel and educate to avoid care that just isn't necessary, but that also pushes me behind schedule and upsets the other patients. Fortunately most of my patients do understand if I explain clearly what my thought process is, but I have to take that time...and I'm only given 15 minutes to do everything, including document, review records, labs, preventative care, etc. So no matter what, a patient either feels like they have been dismissed without getting the care they think they need, or several patients are frustrated by having to wait. Like it or not, a significant amount of doctors pay and even employment is tied to "patient satisfaction," which is measured by surveys that patients are mailed awhile after I see them...which creates a pretty significant response bias.
I love my job, don't get me wrong, and how patients feel about their care is really important. People should be able to be seen on time AND leave understanding the rationale behind the care (or lack of). But the current situation of squeezing primary care docs for productivity while forcing them to worry about two angry patients destroying their patient satisfaction rating maybe needs some tweaking.
Canadian diabetic here. I don’t have private insurance, just the public pharmacare program to ‘help’ me pay for my medications, using a deductible system. For most of the year, it’s great, practically all of my medications are covered at no cost to me. But every year in april, when the year starts over, I spend months barely able to afford anything, because my medication costs are basically the same as my housing costs, which already take up half my income. Then, one magical day, I hit my deductible, and suddenly I can afford to be a human again.
But hey, hospital care is free, so when I can’t afford my insulin, I can go wait in the ER for 7 hours every day.
For some reason, physiotherapy works the other way around in the Netherlands. First of all, you need an addon to basic insurance to even cover physio (including osteopathy). And then only the first 6 or so (may depend on the insurer) are free. After that, you have to pay for it yourself. Which means people for whom it's a luxury get super cheap physiotherapy, while people who break their neck can't afford to get healed and just have to start all over again every year. My neck has been busted for a year now, and I have to wait a couple of months before I can get a new appointment, since I've already spent my free sessions.
That's a shitty system. Which province is that? In Québec it's a monthly cap for gov. insurance.
@@GregTom2 Manitoba
The $75-100 billion in "waste" is impressively miniscule when compared to the total amount spent on healthcare. An estimated 3.8 Trillion. As in 3,800 billions.
Yeah, promising to cut waste is always used by politicians as a way to pretend they're offering a bipartisan solution while actually doing nothing. Unless there's severe systemic structural problems with an organisation, it'll already do pretty much the best it can to cut waste.
I mean, it’s still a lot tho
Wait, are you saying healthcare costs $1000 a month per US citizen?
Thats terrifying.
Don’t forget that co-pays a lower in other countries.
I live in Germany and we pay 10% of the price of the medication with a minimum of 5€ and a maximum of 10€.
In addition, people with chronic illnesses only have to pay co-pay in total of up to 1%* of their income after tax.
With this amount no one is forced into debt for their medication.
*Correction: 1% for people with chronic illnesses, 2% for everyone else.
Correct me if i am wrong. I do think it is 1% for chronic and 2% for other illness.
@@paxundpeace9970 you are indeed correct. Thank you
In Ontario, Canada, prescription drugs costs are capped at 4% income. I am so grateful for this, as my prescription costs can range from 10-25% of my income.
…this is INSANELY low for me…an American…ugh, our healthcare is so broken 🤦🏽♀️. I spent more than that THIS MONTH.
Cost sharing for health care costs is one of, if not the greatest failed experiment in US health care. Tinkering with it, as Dr. Carroll suggest toward the end of the video, is simply another instance of insisting that people change to make economic theory work instead of economic theory having to change to reflect the way people act in the real world.
Dr. Carroll's friend and colleague, Austin Frakt, wrote a column for the NY Times headlined: Shopping for Health Care Doesn’t Work. So What Might? Subtitle: "It’s often too complicated. And even when it isn’t, almost no one does it."
"A body of research - including randomized studies - shows that people do in fact cut back on care when they have to spend more for it. The problem is that they don’t cut only wasteful care. They also forgo the necessary kind. This, too, is well documented, including with randomized studies."
Let's cut the insistence that shopping for care will result in lower costs. It's not working, it's harming people's health and the costs drive lots of people to bankruptcy even when insured. Other countries are much closer to getting this right than we in the US are. Let's learn from them.
That arbitrary yearly reset also nearly doubles the out of pocket price for people who have a baby in January 1st compared to December 31st. It's complete nonsense.
It's profitable nonsense
It's even worse for chronic diseases since it resets EVERY year.
I would say it's not arbitrary but by design when they looked at the statistics. Nothing quite like screwing people over when they need it the most.
@@nyralotep That sounds like a great way to maximize quarterly returns. Great work Farley.
A major barrier to using something like reference pricing is the lack of price transparency in US health care. A patient, most times, cannot know how much something is going to cost until they get it, nor do they know what or if lower cost options are available. So, the cost is seemingly arbitrary. Another barrier is those cases where the lower-cost options are not viable for a given patient. At that point, you are just putting an arbitrary burden on patients with special needs.
3:02 That Ventolin inhaler you showed on the screen.. Where I'm from, Australia, generally speaking they end up costing the patient somewhere between $4.98-$10.58 each. If you're paying anything more than that in USA, then I'd dare say you're being ripped off.
The US healthcare system sure seems to resemble a shakedown
Less the medical system than the insurance and drug companies.
@@abqmalenurse insurance hasn't been a significant added cost since the ACA enforced the 80/20 rule. The real issue is capitalism and nonstandardized costs. But there is a trade off there too, did you know 30% of all medical workers are foreign born? And that number is expected to rise, not shrink. And not just from countries like China or India with substandard healthcare syatems ... I've come across many workers who come from countries with socialized healthcare like the UK, NZ, AU, specifically because the pay for the workers is not competitive with US jobs. And those are also often countries that provide free or low cost college education. Who then migrate to the US and make bank. Next time you see a doctor, dentist, or specialist ask them if they could survive on Medicare rates for every patient. Medicare for all will lead to shutter most smaller providers and drive away a large percent of the foreign born talent.
The solution: mandate employer sponsored coverage for all employees part time and full time (like we do for unemployment) and insurance companies crafting group policies that employers can join in at an industry level. Combine that with federal funding for certain high value and high risk industries otherwise the rates are suck for arborists and linemen.
@@sethsevaroth In Canada most of our hospitals and Drs practices are private businesses.
@@sethsevaroth You make a good argument for not lowering wages for providers, but I see no argument against medicare for all in your comment. Could it be that you just think that you just think that the two are mutually exclusive?
@@sethsevaroth employer driven healthcare forces people to keep shitty jobs, and fucks over the unemployed.
If a cost / fee / fine is a specific money amount, it only exists for the lower class.
I really wish the US would join the rest of the countries that have universal healthcare (heck, show us how to do it better by covering teeth and eyes!)
Universal may have its problems but the different versions of it are by far the best systems out there
On the 25% of tests being deemed unnecessary thing.
Here in Australia, when I go to the doctor and get HbA1c, Blood Glucose, and Insulin tests to help monitor for Type 2 Diabetes, the doctor also orders things like Uric Acid, Lipid Ratio and Cholesterol, and Vitamin D tests, because if I'm getting blood drawn anyway, I might as well check these other things too, as they're tested from the same type of vial, and there's plenty of blood leftover. You could describe these tests as unnecessary, especially something like Vitamin D or Uric acid, being for Ricketts and Gout respectively, are not required testing in a patient you are monitoring for Type 2 Diabetes. They may have some comorbidity, but given that I did not bring up Gout or Vitamin D to my doctor during that visit, technically they are unnecessary.
As such I would ask if some of that unnecessary testing are things like that, which I would argue are more of a cost-saving and time-saving measure. It would be interesting to know if the PLOS One study accounted for this in their surveying of doctors. If they didn't, then it would be good to know why, maybe this practice isn't common in the US, because maybe US blood vials are smaller and therefore only useful for single tests, or if this kind of practice is discouraged by insurance companies for some economic perverse-incentive reason.
The amount of blood drawn is not the limiting factor when it comes to efficient consumption of healthcare resources, it's the time of the lab technician to run the test using medical grade test kits, then read and report the results. Unless the diabetic monitoring kit comes with those other tests all in the same package, it is adding costs to run the hospital for little therapeutic purpose (assuming you are correct that there is no indication that you need those other tests).
@@tylerpeterson4726
Correct me if I am mistaken but most blood tests are pretty automatic. The blood is put into a machine, and the machine gives out the results. I don't think the additional workload would make much of a difference. It is the same reason that when you take your car in for anything there are some standard tests that are run regardless of the problem you are having, those tests still take time from the mechanic even if they are not always strictly necessary.
It is better to maintain your car and get regular checkups on it so that it lasts longer and any problem that develops is caught quickly to minimize costs of repair than to do the bare minimum and miss developing problems until it fails completely and it is more cost-effective to just scrap it and buy a new one. You can't throw away your body and get a new one so not only is preventative care generally cheaper in the long run, realistically there is no proper alternative if you care about your long term health.
@@Subjagator That's fair, but going from 3 tests to 7 tests is more than doubling the number of tests and could very well be double the amount of time the robot spends on the procedure (possibly requiring multiple robots) and the cost of the test kits is still there, and medical grade test kits are universally expensive.
Testing lipids and cholesterol in a diabetic isn't unnecessary I would say, although uric acid and vitamin D probably if there aren't indications. There is benefit to knowing the cardiovascular disease risk in a high risk patient.
However giving a patient a head MRI because they've had a headache for a couple days is the kind of unnecessary test that really adds to cost of healthcare.
Deductibles act more as a barrier to receiving any care among the lower income scale. I've had jobs with insurance, but they didn't pay me enough to be able to afford spending through the deductible so I never got to see a doctor.
A prescription in the UK is £9.35 (free if you are 60 or over) if you get a lot of prescriptions you can get a £30 three month prescription prepayment certificate. Many people on low incomes pay nothing as well.
Nothing is free. Someone else is paying… and as the Iron Lady said, “…eventually you run out of other people’s money.”
@@DinoRamzi We all pay, that's what taxes are for.
As a Canadian I only understood about half these words. Y'all have a crazy healthcare system.
I'm sick, I go to the Dr. Easy.
I don't understand how Americans don't riot every day.
We are too busy trying to get our medications.
I pay so much for my insurance per month that I can't use it because I don't have enough at the end of the day to pay my copay.
Exactly.. they brag about how many people are now insured but fail to mention how many people can't afford to use their insurance because they are broke and deductibles are astronomical. So basically they forced people to pay for something they can't use. Before Oblundercare I paid $125/month with a $600 deductible. I got 3 doctor visits a year no copay. After Oblundercare the least expensive plan cost $310/month with a $8,000 deductible. So I just didn't get insurance. Never paid that penalty either.
@@mrdonetx That's a pretty harsh perspective. I'd instead stay that the regulations are inadequate (single payer may be the only way to make them so), and as a consequence private for-profit middle men continue to screw things up for everyone else.
My health plan will pay you to get an annual physical. Great! But if your physical turns up something that needs a specialist referral and possibly more tests you still have jump through these dissuasive hoops the video's about, despite it being a doctor-initiated transaction.
Perhaps we should update the old joke to be, "What do you call 1,000 insurance executives at the bottom of the ocean?"
@@belg4mit it's not a harsh perspective it's actually what I am still dealing with. Going from having insurance that covered my needs to paying for insurance I can't afford to use or no insurance at all which is/was my choice. All because people who eat a gallon of ice cream and smoke two packs of cigarettes a day and only exercise they get is trying to light their cigarettes with child proof lighters could get cheaper insurance.
I think it is sweet that you think insurance companies want to keep people with expensive chronic diseases alive. When cost of care exceeds premiums, insurance companies don’t want you. Their profit will suffer.
I’d sure love to know what amount of “unnecessary care” was a direct result of our cost sharing system! Unnecessary labs drawn in ED because someone hasn’t seen an outpatient doctor in years. Unnecessary surgical interventions because inconsistent healthcare access makes prescription options for disease management too unreliable. Unnecessary pharmacy fills of medications both the patient and the provider know will not be effective just because it’s required as part of a prior authorization ladder (often with a parent’s chronic condition progressing or relapsing in the meantime due to inadequate management).
To add a precision about the French system, in the list there are extremely generic terms like "malignant tumor", "organ translant consequences", or "invalidating cerebal vascular accident", moreover there is a mechanism to ask for it if your affection is not on the list. The common idea is that these are long duration affections.
Here in the UK co-payments only exist for non-nationals. No one else plays co-payments.
Do the royals get special treatment over their subjects?
I was given an EKG last time I went to the ER for an asthma attack not controlled by my albuterol. I'm fairly certain it was unnecsary but thats hard to say when your gasping for air.
With my Dutch insurer, I can only get 6 free physiotherapy sessions. Which means I've been walking around with a busted neck for a year now. I'm going to make a lot sof healthcare costs just by not fixing my neck in a timely manner.
Well, I don't see how "cost-sharing" in any shape or form will cure $800 bags of saline or $55k SARS-CoV2 PCR tests we recently heard of.
My insurance plan, thankfully, does offer rebates for using a specific list of lower cost providers.
I assume it would be off-topic for Aaron to have mentioned that the only lens through which the current cost-sharing structures make sens is the lens of for-profit health care, where people are trying to compare the benefits of plans, and thus those plans do what they can to sell themselves as low-cost (or competitive on cost) while also appearing easy to understand and compare, yet slipping enough deception that the insurer can make money off the sick people.
All the schemes for controlling health care cost seem to either result in too little or too much treatment which leads to worse outcomes. It seems incentives need to be aligned with outcomes. But doing that will lead to patients with poor prognosis to be abandoned. Or maybe the profit motive isn't the way to run a health care system?
I've skipped an ambulance twice because of the cost, one of those times signing a waiver :( but it wasn't a very good decision on my part. Plus I wasn't really in a frame of mind to make the decision well.
Would you do a show about cancer treatments in US v other countries? I currently have stage IV cancer and am I treatment. Someone mentioned how some patients are 'living with cancer' like people nowadays can 'live with HIV' and not due as quickly as in the '80s.
Hence the importance of shared decision making.
I wish there had been examples of when and how cost sharing is effective. Maybe for a future video! What unnecessary care are people getting, and why are doctors providing it? Why does insurance cover unnecessary care at all?
I'm a Canadian pharmacist. I think your questions are very interesting and I'll try to answer them.
"I wish there had been examples of when and how cost sharing is effective".
Patients that have a no-copay insurance plan will regularly fail to notify me that they've stopped taking a drug and keep it in their dispill for months until I realize they're discarding it, regularly making their insurance pay for thousands of dollars in wasted care. The drug being free of charge, they often assume it's not valuable. Same with care in general, they get a dismissive attitude. Some patients are also gaming the system in hopes they can sell it on the black market at some point, or just because they think "the system is fucking me, fuck the system". Let me tell you that if they pay 1$ out of pocket they will stop wasting immediately. The insurance is of course not paying for that abuse, the premiums of all the people subscribing to that insurance are. Add a 50$ copay per month, save 100$ in premiums per month.
"What unnecessary care are people getting, and why are doctors providing it?"
If you show up to the ER because you want an antibiotic for your cold, you've already wasted everyone's time, including the doctor's. That's very expensive for the healthcare system. (Colds are viral, antibiotics are against bacteria). Whether or not the doctor prescribes you an antibiotic, you've already wasted hundreds of dollars in time from the secretaries that put you in the system, the nurse that screened you, and the doctor you bothered. The antibiotic was just 20$. It's not very professional for the doctor to outright refuse to see you after you waited hours in line. Patients will also regularly insist on getting tested for conditions that they clearly don't have, and doctors tend to think there's no harm in humoring them (unlike the useless treatments, where the harm is more obvious). Patients also often have peculiar beliefs about drugs that aren't founded in reality; many of them insist to have original brand drugs, instead of generic brand, and will hound their prescribers into making sure they are covered (a good insurance won't accept). Many patients think the less expensive drugs cause them more side effects, etc. You get plenty of actual hysterics who take time from healthcare professionals because they want the attention. You should see how often my office's phone rings and it's the same 5-6 people who only want to cry about their landlord.
"Why does insurance cover unnecessary care at all?"
Private insurances are garbage. They have no incentive to reduce costs at all, in fact higher healthcare costs allows them to increase their premiums and increase their legal profit. Public insurances have to answer to taxpayers and do reduce costs as much as they can, but it's not always easy. If you haven't spent an hour poring over the patient's file, it's not easy to say whether this expensive 3d imaging technique is really at risk of providing information much more helpful than a regular xray; so the government publishes guidelines that aim at reducing costs, but doesn't have the resource to police the prescription of tests and imaging. They will typically try to reduce drug costs, for instance making sure that a patient has attempted MTX before going on adalimumab for arthritis. Sometimes it's a bit blurry though, where some organisations might consider SGLT-2 before sulfonylureas to be wasteful, and other prescribers might consider sulfonylureas to be dangerous and just dislike prescribing them.
Hope that answers some of your questions.
100% My ACA insurance forced me off of my psychiatric meds by putting up so many barriers, and repeatedly making me go without them for weeks at a time, while they adjudicated if they'd allow me to get a refill of one or another. You couldn't get a refill until days before you ran out, multiple pharmacies refused to tell me when there was a problem, and then approval took weeks. They were meds that warn you to never go off them without a doctor's oversight, and never suddenly, because of severe side including death. With my disability the barriers to care were beyond my ability to manage, and I actually paid the annual fine instead of fighting to be on and stay on the free option since my only benefit would be not paying the fine.
My wife has a bad gallbladder and went to the hospital for three days. Cost? 40k! The Cost Sharing organization she is at paid ALL of it in about a week.
Focusing on how much “over-care” there is seems besides the point to me. Sure, there is some money wasted, but there’s also a lot of money wasted due to the insanely high healthcare costs in general in the US. In the US we receive the worst care out of all developed countries while paying the most for it. Implementing universal healthcare is the only way out of this nightmare of a medical system
Do people actually hit their deductible any more? Our plan is essentially impossible for us to ever use. Long ago 250 and 500 dollar deductibles just don't exist any more.
People with chronic conditions hit their deductible. I usually hit mine in April, but it hurts in the wallet quite a bit until then, when suddenly my $875/month pills (for a generic!) become $15/month.
It's crazy how there is all this waste in the system when people are afraid to go to the doctor in the first place becaouse of how expensive it is.
My husband and I both suffer from chronic conditions and I never knew that cost sharing and deductibles where supposed to be doing something. I just always assumed it was another way for insurance to skrew us over and was only legal because the insurance companies poured a ton of money into lobbying.
I'm a Canadian pharmacist. If I had to chose between an insurance with copays and an insurance without them, I would 100% chose the insurance with copay every single time no questions asked.
People abuse the shit of insurances without copays. I had a dead patient's family bring me tens of thousands of dollars in un-used drugs that she hoarded over the years (she would scream at us when we didn't give her every single thing in her prescriptions). These costs get shoveled unto everyone insured. Pay 50$ per month in copay, save 100$ per month in premiums.
@@GregTom2 as an American patient I have to meet tens of thousands in deductibles for things like migraine medications for debilitating chronic migraines, physical therapy appointments for recovery from injuries, surgery to repair torn ligaments and sick visits to the pediatrician. Each sick visit for my son cost $175 until we met a $7,000 deductible. That's insane!
@@GregTom2 so it's like the insurance didn't cover anything until we met like a $3,500 deductible and then covered I forget what percentage after $7,000. There's another tear in the like $10,000s range where they start covering an even larger percentage. I see you were talking about copays. I don't have a problem with copays generally, it's the deductibles that I have a huge issue with.
@@HaShomeret Ah yes, in Québec the deductible is 22$ per month for gov. insurance, and I think there are limitations on what it can be for private insurances. (And those only apply to drugs, not to consultation, for which physicians bill the government directly). That's an entirely different situation.
I generally find that some skin in the game is enough to discourage abuse, and that large copays or deductible are not more effective at preventing waste, and are just shitty coverage.
💚💚💚
What is cost sharing?
0:31
Carbon Tax for companies putting burden on public climate and Healthcare Tax for companies putting burden on public health. You break it, you buy it.
Exception from cost sharing or considering it as a disability and running it over to social security is urgently needed.
Very few people are engaged in their healthcare. They just follow instructions. And the question of using the insurance mechanism for low-cost claims drives very high premiums and makes “insurance” a pre-paid health plan.
Direct care plus a cost-sharing company (not the topic of this episode) can bring the costs down tremendously. You still need to make sure the cost-sharing company is reputable and pre-existing condition exclusions can be problematic.
As a non american, i dont know what cost sharing is. I thought i did from the name, but the video shows i am really in the dark. Guess this video is just not for me
I'm Dutch, and we have deductibles. Unfortunately, it's not just Americans that have it. But what really grinds my gears is that I can't get physiotherapy covered properly. I have to pay extra to get any coverage, and even then only the first 6 or so appointments are covered. Meaning you still need to walk around with a broken neck for months after you've had your sixth appointment instead of getting treatment.
If it was covered by a deductible, then I'd just have to pay for the first few appointments, but then not pay for subsequent appointments. But instead, it's only covered for people who don't really need therapy. And people who do need it still can't afford it.
When the amount of waste is only $100 Billion out 3000 Billion spend each year don't consider this that much as many people might think.
Dr. Carroll cites a study that says physicians believe that over 20% of all care in the US was unnecessary. That's $600 billion of the $3000 billion.
disconnect capitalism from healthcare like many other countries have.
Most Americans seem to think that if your not doing capitalism, you will automatically slide into the USSR.
Doctors are terrible at determining what is needed care.
Patients are terrible at determining what is needed care.
Just an aside, as someone with ADHD, it makes it difficult to focus on what you're saying when there's text on the screen that isn't what you're reading out loud. It'd be easier to pay attention and listen if you only bring up the quote when you're actually about to read it.
Or mute your video and read the text. Then just listen to the video. You already have the means to watch the video how you need to.
getting sick is only for the rich, ill just drop dead some day in my 40's
Cost share causes people to take control of their own health ... that's what this guy is against.
first
In for-profit healthcare, how much goes to profits and who decides? Really starting to hate your channel.
Eat your vegetables.