The insurance system and perverse incentives embedded in it is the primary reason healthcare is expensive here. Also many countries have price controls on drugs, and US does not (thus subsidizing RoW in regards to new drug research).

https://www.chiefhealthcareexecutive.com/view/hospitals-losi...

I think this line is BS propaganda by the pharmaceutical industry. I am 100% sure the US would be way better off if they controlled prices and then subsidized research directly instead of paying outrageous prices.

As far as hospitals losing money, this doesn't mean that they are using their money efficiently. My ex used to do auditing of hospitals and a lot of them showed a circle of friends consisting of local construction company, architects, business consultants, doctors and others. They all lived well on charging a lot of money to the hospitals and the hospital execs didn't check because they were all buddies.

But... if they're already losing money because they're inefficient, with a 'profit motive' in place... it's obviously not enough of a motive to be efficient. They may be losing money not because of inefficiency anyway, but assuming so... existence of 'profit motive' coupled with inefficiency should be evidence enough that they're not linked.

If I had the choice between system A with excellent community health outcomes, but didn't turn a profit, was heavily subsidized, and ran with operational bloat, versus system B which ran lean/efficiently but produced poor health outcomes I would choose A every single time and I imagine most people would

Currently in the US we have neither. We have a bloated/inefficient system that also produces poor community health outcomes. But at least a few private equity firms might turn a profit, so at least there's that??

This comes up in every thread about healthcare and it's just plain wrong/backwards.

The reason they appear to be losing money or close to losing money is by design, because of the incentive to be inefficient. It's a way to balloon the "costs" in their accounting and demonstrate to the outside observers that they are "oh so poor" and need help, whereas in reality, they charge exorbitant amounts for procedures and then mark it off as "losses" when consumers can't pay.

e.g. MPW

Hospitals are not the same as Medical Office, which tend to be more profitable. Where are the facts to corroborate your statement?

https://www.cnn.com/2023/01/23/uk/uk-nhs-crisis-falling-apar...

The model works just fine. The reason the NHS isn't working is because the Conservative government has intentionally underfunded it (UK per capita spending on healthcare is significantly lower than other European countries).

> Explanations for the current crisis “have to start with a consideration of Covid-19,” Ben Zaranko, an economist at the Institute for Fiscal Studies (IFS) whose work focuses on Britain’s health care system, told CNN. “There’s the simple fact that there are beds in hospitals occupied by Covid patients, which means those beds can’t be used for other things.”

If you're against hospitals being for-profit businesses (which I think is a perfectly reasonable stance), it seems to me the real alternative would be government-run hospitals. Then you'd have a centralized, well-resourced organization that is generally incentivized to keep people healthy running things, rather than just hoping that enough non-profits get involved to serve the medical needs of the country.

I'm not opposed to a government system, but it needs to be a redesign and re-haul of everything we've done so far and the reality is that it's just not likely to happen.

There are some exceptions to quality at the VA, notably when the VA is co-located with a school such as Stanford in Palo Alto. There they often have great medical providers and support.

However non-profit does not mean non-revenue.

Hospitals have real costs, and it is entirely possible the emergency department was a money sink. No one can be turned away, so it is used as the healthcare of last resort for those without other access, who, almost by definition, cannot pay.

Then elide "profitable" since that is the goal of every business.

Health care larger is not a competitive market. Lots of customers only have limited options (i.e. rural hospitals) and the urgency of some purchases don't support competition (i.e. ER visits)

Optimize what? Certainly not costs, since for-profit hospitals have every incentive to push for unneeded expensive operations.

Maybe you’re mistaking healthcare for a market where meaningful competition and information symmetry exists?

The reason for this is opiates. Any time any place in the US sets up free or low cost shelter, the dope addicts move in.

Other industrialized nations don't seem to have as many addicts as the US, or maybe they still have real heroine instead of fentanyl.