Originally Posted by Gibonius
If you actually sat down and tried to build the least efficient health care system possible, it would be hard to beat what we have in the US (before and after Obamacare). It's startlingly stupid, on so many levels. Obamacare made it less painful for many individuals, but no less dumb and certainly not any more efficient.
Amazing that it all basically backtracks to WWII era salary restrictions. Employers couldn't go past certain salary limits, so they started offering benefits. Benefits didn't get taxed, and so the whole system grew up organically from there until it turned into this bloated monstrosity we have now. And to be fair, much of it is in how Americans use (overuse) healthcare.
But too many people are politically and financially invested in it for it to change any time soon, especially since the Democrats are going to be totally gunshy about going near health care again any time this generation. If the Republicans do anything, most likely it'll just be a repeal of Obamacare and we'll just go back to the slightly differently totally fucked system of six years ago.
it's because nobody in the US had the political power to sit down and design a health care system. every step of the way politicians had only enough power to implement a system that benefited a certain part of their constituents in the short term. whereas pretty much all other countries had a prominent politician or party that was able to get it done (eg bismarck in germany, labour party in the uk)
we almost got it done multiple times during the roosevelts and truman but america had relatively
decent healthcare through sickness funds (and later the blue cross/blue shield organizations) back then so people weren't in desperate need like the european countries. also the system then was so profitable to doctors that the AMA was able to help defeat any comprehensive reforms (which in hindsight seems like a brilliant move because LBJ only managed to pass medicare which turned out to be a huuuuge cash cow for the doctors, but also a really shitty decision for the entire society). later there were a lot of anti socialist sentiments. hard to pass a huge policy if all anybody has to do to defeat is label it socialist.