State of the healthcare system in America: Let's discuss why it's failing

Jacob Fox6 said:My God, I honestly can't wrap my head around how anyone—including you—could actually think like that...

What you just said goes completely against the Hippocratic Oath, the entire foundation of medicine, and basic human decency. And let me tell you, I'm not even speaking as a layperson here...

There are always specific criteria used for selection in every medical situation. Like... if you're waiting on a bone marrow transplant, nobody is asking if you're a smoker or not, you just get the transplant. The right to life isn't some individual choice made based on someone's personal opinion, and honestly, thank God you aren't the one making those calls, because you'd clearly just be treating teenagers while personally organizing funerals or tossing everyone else into the first available grave... it's just shameful. Everyone gets treated without exception, and then doctors step in more aggressively depending on how urgent the situation is...

You missed the point. There is no need for extremes here.
The right to live primarily rests on the individual's choice to protect their health if they want longevity.
All over the world, transplants go to those in greatest need, and those who participate in the healthcare system do so according to their own choices—specifically regarding how much they save through healthy living. Meanwhile, insurance premiums everywhere are skyrocketing alongside rates of alcoholism, smoking, and all forms of drug addiction. Consequently, those people contribute more to the system, so they can then utilize it when they eventually need it.
Hippocrates intended for conditions to be equal for everyone, not favoring one at the expense of another.
It is obvious, for example, that a sex worker will face higher rates of gynecological issues. It is perfectly logical that the system spends more on her care, so it is only fair that she contributes more to that system. This applies to any other lifestyle choices that cause self-inflicted damage.

It is high time Americans sobered up.
Because of issues like this, the lines at the OB-GYN clinic were so long that I could barely get my surgery scheduled the first time I needed something from the system, despite being a constant contributor to it. And it wasn't even related to a communicable disease. I nearly didn't make it out alive.

Jacob Fox6 said:My God, I honestly can't wrap my head around how anyone—including you—could actually think like that...

What you just said goes completely against the Hippocratic Oath, the entire foundation of medicine, and basic human decency. And let me tell you, I'm not even speaking as a layperson here...

There are always specific criteria used for selection in every medical situation. Like... if you're waiting on a bone marrow transplant, nobody is asking if you're a smoker or not, you just get the transplant. The right to life isn't some individual choice made based on someone's personal opinion, and honestly, thank God you aren't the one making those calls, because you'd clearly just be treating teenagers while personally organizing funerals or tossing everyone else into the first available grave... it's just shameful. Everyone gets treated without exception, and then doctors step in more aggressively depending on how urgent the situation is...

Just a few months back, if I recall correctly, over in England, a younger patient was denied a liver transplant simply because they couldn't convince the doctors they were going to stop drinking.

So, even in highly developed countries, your utopian little theory doesn't hold water; there are protocols, and resources aren't just handed out equally to everyone without reason.
If I’m reading you right, you’re still stuck in med school? Well, get ready for a massive reality check once you actually start working and having to make real-world decisions on your own. If you keep thinking like this, after just one year grinding in an ER seeing all the absolute madness that goes down, you’re going to need professional mental health support just to keep from losing your mind... our system will break you.

But hey, I don't want to act like I have all the answers. Why don't you come back and post here in a few years? It'll be interesting to see how much you've changed.

Jacob Fox6 said:Totally agree.

And you just gave the perfect example of exactly what I've been saying... All these people—your grandma, current retirees, folks out of work—they've all been paying into the system, so where is that money now when they need the healthcare they earned??? That’s my whole point: if that money wasn't being stolen, there would be plenty for everyone, but instead, it turns out the very people who spent their entire lives paying for healthcare are left to fend for themselves while others are out driving luxury cars with their cash...

The "solution" they're pushing? It'd be much simpler if they just handed everyone their invested cash in cold, hard cash and told us to switch over to a totally private system. Then you'll see exactly where the money goes—you'll blow through it in a heartbeat and then just drop dead because you can't afford the next round of treatment.

Jacob Fox6 said:My God, I honestly can't wrap my head around how anyone—including you—could actually think like that...

What you just said goes completely against the Hippocratic Oath, the entire foundation of medicine, and basic human decency. And let me tell you, I'm not even speaking as a layperson here...

There are always specific criteria used for selection in every medical situation. Like... if you're waiting on a bone marrow transplant, nobody is asking if you're a smoker or not, you just get the transplant. The right to life isn't some individual choice made based on someone's personal opinion, and honestly, thank God you aren't the one making those calls, because you'd clearly just be treating teenagers while personally organizing funerals or tossing everyone else into the first available grave... it's just shameful. Everyone gets treated without exception, and then doctors step in more aggressively depending on how urgent the situation is...

Ugh, this overhyped Hippocrates guy... I honestly can't stand him.
You can't just call someone else's stance "incorrect" when we're talking about an opinion rather than hard facts.
Unless you're actually out there on the front lines—I mean, working in an ER or a high-pressure trauma center at a major hospital—you don't really have any professional experience to back up these claims. You're basically stuck in the "semi-amateur" category because, while you might be studying medicine, right now it's all just theory to you.

Jacob Fox6 said:Totally agree.

And you just gave the perfect example of exactly what I've been saying... All these people—your grandma, current retirees, folks out of work—they've all been paying into the system, so where is that money now when they need the healthcare they earned??? That’s my whole point: if that money wasn't being stolen, there would be plenty for everyone, but instead, it turns out the very people who spent their entire lives paying for healthcare are left to fend for themselves while others are out driving luxury cars with their cash...

The thing is, their money was used for healthcare for whoever needed it at the time. Just like how my own money is being used right now for someone else's needs—like, say, kidney dialysis.
Btw, do you even realize how much a single year of dialysis costs?
We can't just paint everything with the same brush—sure, there's wasteful spending and probably some theft involved (especially back in the nineties), but it's not like the whole system is a total disaster...

I was reading an article in The New York Times yesterday about healthcare spending, and it really got me thinking... It mentioned that here in the US, we're looking at about $1,000 per person annually. But then you look at other places—like Austria, where it's three times that amount, around $3,500, or Sweden at $3,000, and even Germany at $3,250. I think those figures were from back in 2007, though. It just seems like nowhere else in the Western world allocates such a tiny fraction of resources to healthcare compared to us. I guess that might be where the real issue lies.

Kate Collins67 said:Ugh, this overhyped Hippocrates guy... I honestly can't stand him.
You can't just call someone else's stance "incorrect" when we're talking about an opinion rather than hard facts.
Unless you're actually out there on the front lines—I mean, working in an ER or a high-pressure trauma center at a major hospital—you don't really have any professional experience to back up these claims. You're basically stuck in the "semi-amateur" category because, while you might be studying medicine, right now it's all just theory to you.

I learned plenty about patients while working in pulmonology. Believe me, it wasn't rare to see families leave a long-term asthmatic patient—someone who wasn't even close to having an attack—sitting in a hospital hallway just so they could head off on vacation or a weekend getaway.
Naturally, the patient would be cared for, and the family would return days later without offering a single word of apology.
They turn hospitals into glorified nursing homes because, frankly, our country lacks sufficient specialized facilities for the elderly, though we desperately need them.

Furthermore, I know many elderly people who are swimming in cash, living in mansions, yet their lifetime contribution to the healthcare system has been zero. They exploit the system constantly: diabetes this, hip surgery that, bile duct procedures, endless scans, constant hospital visits.
There was one woman who lived in such filth at home, yet every twenty days she would show up at the pulmonology clinic just to bathe, eat, socialize, and stay for a bit, only to disappear for a month before repeating the cycle.
In the end, she leaves her entire estate to relatives who couldn't care less about how she lived. And what does the healthcare system get? Barely anything compared to what she would have spent on a bus fare.
But fine, let the social safety net handle it. We are a wealthy nation, so we will pretend everything functions perfectly on paper while maintaining a veneer of class in our private lives. That is, until someone’s life is lost because of poorly maintained equipment due to massive costs, or because there isn't a surgeon available—since nobody wants to spend their whole life studying and trembling under surgical lights in a country where every reality TV circus act earns more than a doctor, or even a highly paid commercial sponsor.

ruggedscout91

I feel like you're making a lot of things up here. I mean, you can't just walk into a hospital and decide to stay. There has to be some kind of medical necessity for being admitted. Most people show up on a specific day because they have a scheduled surgery or something. They don't just wander in whenever they feel like it. And even then, patients often end up waiting hours just for a bed to open up. So, honestly, it seems pretty unbelievable that someone could just show up at a hospital and stay simply because they wanted to.

I know quite a few elderly people who were very ill and ended up passing away either at home or in a private assisted living facility that they paid for themselves.

And just because you say someone lives in a mansion, that doesn't mean they haven't been paying into the healthcare system. It's almost as if you think only people living in apartments contribute anything toward medical costs.

Personally, I am more interested in the internal dynamics within the healthcare system itself.
For instance, consider the moment a patient is admitted and begins receiving care. If we meet the criteria I previously outlined regarding systemic profitability, health preservation, and triage—where we evaluate treatment efficiency through a lens of actual patient benefit rather than just catering to their relatives

that relationship should be NEARLY FLAWLESS. Once those standards are met, the interaction with the patient—from the moment they walk through the hospital doors until their discharge—should reflect a true standard of service. This applies to both the material and the human element.
Only then does it make sense to worry about lawsuits or demanding repressive measures to ensure a patient is treated with respect from start to finish.

Look at it this way: you cannot claim to be a good mother playing with your toddler if you haven't first provided food, hygiene products, and all the basic necessities for that child.
The definition of a "good mother" is complicated. It isn't just about saying, "I love my baby." You have to love the baby when they are messy, when they are sick, or when they are being difficult. There are mandatory responsibilities and there are extras in life. The mandatory requirements must come first; everything else I mentioned is secondary.

I feel like my actual points haven't really been addressed here. Instead, the conversation has drifted toward babies and some vague, undefined topic. And honestly, nobody even brought up lawsuits. We were talking about healthcare allocations. I was just citing data from The New York Times regarding how much the government allocates to healthcare.

mistyjackal842 said:ruggedscout91

I feel like you're making a lot of things up here. I mean, you can't just walk into a hospital and decide to stay. There has to be some kind of medical necessity for being admitted. Most people show up on a specific day because they have a scheduled surgery or something. They don't just wander in whenever they feel like it. And even then, patients often end up waiting hours just for a bed to open up. So, honestly, it seems pretty unbelievable that someone could just show up at a hospital and stay simply because they wanted to.

I know quite a few elderly people who were very ill and ended up passing away either at home or in a private assisted living facility that they paid for themselves.

And just because you say someone lives in a mansion, that doesn't mean they haven't been paying into the healthcare system. It's almost as if you think only people living in apartments contribute anything toward medical costs.

It isn't coming from some random list of excuses—it's exactly what was said above, and it's one of the reasons why our healthcare system is such a mess (not the main culprit, but definitely a big part of it). In reality, those "old chronic" patients almost always meet some clinical criteria for hospitalization within a few days of being discharged, because once they get back home, their condition usually spirals. They don't follow the treatment plans, they ignore the doctors' orders, nobody is there to look after them properly, and everything just falls apart...

I could give you endless concrete examples right now, but there's really no point since we'll just end up circling the drain with more empty rhetoric. I'll just say this: everyone who screams so loudly about "system efficiency" and "strict admission protocols" tends to turn into a total nightmare the second you actually try to enforce those rules, threatening lawsuits, getting violent, or calling in the news media to make a scene...

mistyjackal842 said:ruggedscout91

I feel like you're making a lot of things up here. I mean, you can't just walk into a hospital and decide to stay. There has to be some kind of medical necessity for being admitted. Most people show up on a specific day because they have a scheduled surgery or something. They don't just wander in whenever they feel like it. And even then, patients often end up waiting hours just for a bed to open up. So, honestly, it seems pretty unbelievable that someone could just show up at a hospital and stay simply because they wanted to.

I know quite a few elderly people who were very ill and ended up passing away either at home or in a private assisted living facility that they paid for themselves.

And just because you say someone lives in a mansion, that doesn't mean they haven't been paying into the healthcare system. It's almost as if you think only people living in apartments contribute anything toward medical costs.

Everything they wrote is spot on.
And you, mistyjackal842, are dead wrong if you think otherwise.
People in our healthcare system basically do whatever they want, however they want, and whenever they want. A "medical indication" isn't some magic prerequisite for getting a hospital bed—and honestly, that lack of oversight is exactly why our hospital system is such a disaster, largely because our primary care system is completely broken.

If you actually believe this is all made up, fine—let me give you some real-life examples that I run into on a daily basis.
Here are a few:
1. Two younger relatives bring their grandmother in and start acting aggressive, claiming she lost consciousness or was vomiting or whatever else they need to say. Grandma just sits there silently, not really answering any direct questions. So, what do you do? You take the patient's word for it, admit her to see what happens—because once she's admitted, you can't just discharge her until some processing is done—only for them to tell you, "Oh, can she stay for a couple of days? We have a wedding to go to and it's a hassle to look after her..."

2. It’s 3:00 AM, and someone rolls into the ER without a referral, yelling at every doctor in sight until they land on me demanding help. What happened? He *thinks* he got bitten by a spider somewhere about 30 hours ago. By the time he gets here, there isn't a single symptom—he just thinks he was bitten.

3. An old man comes back to the same clinic where he was treated ten days ago, complaining of shortness of breath (fluid buildup in his lungs). The thing is, he hasn't been taking the meds they prescribed him. Why? Because those drugs make him pee constantly to flush the fluid out of his lungs, and he doesn't want to deal with running to the bathroom or getting up all night when he wants to go to the local market. So, he stops taking them, ends up back in the ER, and you're stuck giving him the exact same medication he refuses to take because it's inconvenient for him.....

If you want more, I can keep going.

Kate Collins67

I mean, I guess people really should be getting help just to figure out what's going on and get an actual diagnosis... especially looking at that first case you mentioned involving that elderly woman. If it turns out she isn't seriously ill, then sure, they should obviously just send her home right away. I think there was actually some discussion here on the forum before about how doctors in the US always start from the assumption that patients are genuinely sick, and then they run the necessary tests to rule things out and confirm whatever it is.

I don't think I'm delusional at all. Besides, those people you're bringing up—they have health insurance, so why shouldn't they be provided with medical care? According to your logic, most people are just making things up, that nothing is wrong, and that illnesses don't even exist. It feels... I don't know, a bit inhumane, especially considering your profession. That whole stance of yours seems really unreasonable to me.

Look, what you just said is the textbook definition of an entitled mindset—basically, "I have my insurance card, so that means I’ve bought the right to be treated like royalty every single time I walk through the door." They think you doctors and nurses should actually feel honored that they even bothered to show up to see you losers, and they expect a full-body, top-to-bottom inspection to fix every little thing from their squinty eyes downward, while everyone else who might actually be in a life-or-death situation can just go jump in a lake because they don't give a damn about anyone else...

And honestly, because of that exact attitude—which mostly comes from the older crowd or their relatives—combined with the massive staffing shortages we're facing, primary care has basically devolved into nothing more than a glorified prescription factory and a constant, pointless argument over whether it's "normal" for a 70-year-old to have aching joints or wonder why they can't hike all day like they used to. Of course, not every patient is like this, but there are enough of them to completely clog up the system—mostly because they never leave it...

Not to mention how many times I've dealt with someone showing up alone, or being dropped off by a relative, who just flat-out tells me, "I don't have health insurance, I don't have coverage, so you better just take care of me anyway or..."

I'll leave the rest unsaid—feel free to pick whatever threatening method you want to imagine...

And who do you think ends up footing the bill for those people (and there are more of them every day)? Go ahead, take a guess.

Also, please stop lecturing me about how things work in the States or how wonderful and perfect everything is over there; if it were actually so great, they wouldn't be constantly fighting for reform. Just look at Sicko from M. Moore—now THAT is the reality of America...

mistyjackal842 said:Kate Collins67

I mean, I guess people really should be getting help just to figure out what's going on and get an actual diagnosis... especially looking at that first case you mentioned involving that elderly woman. If it turns out she isn't seriously ill, then sure, they should obviously just send her home right away. I think there was actually some discussion here on the forum before about how doctors in the US always start from the assumption that patients are genuinely sick, and then they run the necessary tests to rule things out and confirm whatever it is.

I don't think I'm delusional at all. Besides, those people you're bringing up—they have health insurance, so why shouldn't they be provided with medical care? According to your logic, most people are just making things up, that nothing is wrong, and that illnesses don't even exist. It feels... I don't know, a bit inhumane, especially considering your profession. That whole stance of yours seems really unreasonable to me.

Well, in the first case, the whole thing was a lie. The grandmother didn't have any issues at all; they basically just colluded to lie so they could hold a wedding without any drama... And look, lying is easy to catch—eventually, when you're talking to the grandmother, something slips out, right? It's not hard to figure out what's happening, especially when she starts denying the very symptoms that got her brought in in the first place.

As for the second case, I have no idea what kind of "medical assistance" I'm supposed to provide to someone who was MAYBE bitten by a spider and hasn't shown a single symptom in the 30 hours since the alleged bite...

And in the third case, the person was already given help and everything was explained ten days ago. But he's consciously choosing not to take his THC? Well, sorry, but I don't think someone like that deserves more help at the taxpayers' expense because of their own sheer negligence... He got the help he needed, he arrived in a state where he needed hospitalization, and now we're back to the fact that he took up a bed that should have gone to someone who actually acts responsibly regarding their own health.

So, it seems like the only issues being brought up are those three specific instances you mentioned. And everything else is just... well, it's being framed exactly like those three very real-life examples you're citing. I guess maybe there's a bit of overgeneralizing going on here? Why not mention the other cases where patients weren't just making things up, and they actually weren't at fault? Or is it your view that everyone is just lying? I also noticed some rather inappropriate language being used here—not necessarily directed at the forum members themselves, but still.

mistyjackal842 said:Kate Collins67

I mean, I guess people really should be getting help just to figure out what's going on and get an actual diagnosis... especially looking at that first case you mentioned involving that elderly woman. If it turns out she isn't seriously ill, then sure, they should obviously just send her home right away. I think there was actually some discussion here on the forum before about how doctors in the US always start from the assumption that patients are genuinely sick, and then they run the necessary tests to rule things out and confirm whatever it is.

I don't think I'm delusional at all. Besides, those people you're bringing up—they have health insurance, so why shouldn't they be provided with medical care? According to your logic, most people are just making things up, that nothing is wrong, and that illnesses don't even exist. It feels... I don't know, a bit inhumane, especially considering your profession. That whole stance of yours seems really unreasonable to me.

Look, that’s just the first thing that hits you once you actually get out there and start working. If you had asked me these exact same questions back when I was still grinding through college—or even before that—I probably would have been nodding along with you. But now? Now that I've seen the other side of the coin, it’s hard to say anything remotely intelligent without sounding absolutely brutal.

mistyjackal842 said:So, it seems like the only issues being brought up are those three specific instances you mentioned. And everything else is just... well, it's being framed exactly like those three very real-life examples you're citing. I guess maybe there's a bit of overgeneralizing going on here? Why not mention the other cases where patients weren't just making things up, and they actually weren't at fault? Or is it your view that everyone is just lying? I also noticed some rather inappropriate language being used here—not necessarily directed at the forum members themselves, but still.

Look, out of the roughly 30 patients passing through that specific ER specialty unit on any given day, maybe five of them should even be our concern. The other 25? That’s either basic primary care stuff, situations they’ve already been discharged for, or just plain old stupidity like what I mentioned earlier.

I can think of three such cases off the top of my head from just one single shift.

It looks like we’re still stuck in this endless loop debating whether or not people should actually get help.

Look, there are three distinct levels of care here—primary, secondary, and tertiary. It's basic stuff.

But here's where the whole system breaks down: when patients from primary care start overflowing into secondary, and then that overflow hits tertiary, you run into a massive bottleneck.

Take a guy like the grandfather I mentioned earlier—if he’s coming from somewhere like Washington, D.C., he ends up taking up a bed at the Mayo Clinic. But he doesn't actually *belong* there yet. He’s firmly in the primary care stage while things are manageable, moves to secondary when things take a turn, but under no circumstances should he be categorized as a tertiary case. We're talking about heart failure caused by ischemic cardiomyopathy here—which, let’s be honest, is basically the medical equivalent of an incurable cancer that drags on for years.

The whole thing boils down to this: if you have a patient with an unclear diagnosis, and after all the testing they find something that can't be explained by primary or secondary care—maybe a rare disease or something requiring highly specialized procedures—that's when they *should* be sent to a facility like the Mayo Clinic. But that isn't happening. We technically have tertiary care, sure, but in practice? It’s becoming nearly impossible for the people who actually need it to ever reach it.

Look, we can't just point fingers at patients and act like they’re the sole cause of all this chaos. Let’s be real—there are plenty of doctors out there who honestly don't know what they're doing, and their incompetence leads to a massive wave of unnecessary tests and redundant screenings. It’s a vicious cycle that just ends up bloating those endless waiting lists even further.

Now, I realize I shouldn't be lecturing people about physicians from a patient's perspective—I haven't exactly been a "serious" patient myself yet, so I don't deal with the system's headaches quite the way you guys do. And honestly? If I ever do run into medical trouble, I’ll probably just breeze through the red tape and get it sorted quickly—but hey, I guess that's just one of the perks of working within the system.