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

Jacob Fox6 said:Honestly, better that way.🙂

The only thing is that dentist you used was still getting paid by Medicare, and man, that's not exactly pocket change...

$45 for the whole year, or $3.75every single month.
That amount isn't just large—it's pathetic.

Susan Rodriguez4 said:$45 for the whole year, or $3.75every single month.
That amount isn't just large—it's pathetic.

Man, that really is a tiny amount...😲
I had no clue.
And I mentioned someone more informed could jump in to clarify, but honestly, I thought we were talking about some serious cash... this is just straight-up pathetic, just like you said. It's honestly embarrassing...

Jacob Fox6 said:Man, that really is a tiny amount...😲
I had no clue.
And I mentioned someone more informed could jump in to clarify, but honestly, I thought we were talking about some serious cash... this is just straight-up pathetic, just like you said. It's honestly embarrassing...

Yeah, exactly.
Generally speaking, principal amounts vary depending on the age group. For the 18 to 65 demographic, the figure sits at approximately... $67 Maybe bump up the annual coverage slightly for the older crowd.
OB-GYNs have some nerve. $29 Annual cost per patient: 86 / 12 = 7.17$2.50 Every single month!
Big Pharma is basically running the ultimate scam against hardworking primary care doctors. It’s a brilliant setup for anyone looking to dodge work—the less you actually do, the more money stays in your pocket.
It’s a joke, really. Nurses have their salaries locked in by collective bargaining agreements, yet I’ve walked into more than one clinic where the doctor’s paycheck at the end of the month is nowhere near what the nursing staff is pulling in.

Susan Rodriguez4 said:Yeah, exactly.
Generally speaking, principal amounts vary depending on the age group. For the 18 to 65 demographic, the figure sits at approximately... $67 Maybe bump up the annual coverage slightly for the older crowd.
OB-GYNs have some nerve. $29 Annual cost per patient: 86 / 12 = 7.17$2.50 Every single month!
Big Pharma is basically running the ultimate scam against hardworking primary care doctors. It’s a brilliant setup for anyone looking to dodge work—the less you actually do, the more money stays in your pocket.
It’s a joke, really. Nurses have their salaries locked in by collective bargaining agreements, yet I’ve walked into more than one clinic where the doctor’s paycheck at the end of the month is nowhere near what the nursing staff is pulling in.

Oh yeah... now that you mention it, you just reminded me... I heard that general practitioners make their biggest bucks from Medicare specifically by targeting older patients, so they try to stack their schedules with as many seniors as possible...

Jacob Fox6 said:Oh yeah... now that you mention it, you just reminded me... I heard that general practitioners make their biggest bucks from Medicare specifically by targeting older patients, so they try to stack their schedules with as many seniors as possible...

True, but they’re also the ones spending the most of it. On average, older folks definitely need medical care way more often than younger people do.

Jason Howard9 said:You’ll be paying for that different approach just like you do when you visit a private specialist. And if every doctor starts getting paid based on "incentives," believe me, that shift is going to be funded directly out of your own pocket.

Do you REALLY think I don't pay doctors through my Medicare premiums?
I mean, every single month, with every paycheck, regardless of whether I actually step foot in their office or not, right?
Is that really how you see it?
Because if that’s your logic, then who exactly do you think is footing the bill for those doctors?!

dustymarlin10 said:Do you REALLY think I don't pay doctors through my Medicare premiums?
I mean, every single month, with every paycheck, regardless of whether I actually step foot in their office or not, right?
Is that really how you see it?
Because if that’s your logic, then who exactly do you think is footing the bill for those doctors?!

My point was specifically about private practice and providing better access to physicians (much like veterinarians), because financial incentives drive performance. I am arguing that if doctors in public service were incentivized the same way—for instance, receiving bonuses for high success rates or excellent patient communication—that extra cost would fall directly on the patient in this system of empty coffers. This translates to either higher taxes or increased insurance premiums.

What exactly did you think I meant? That a great doctor gets their full salary while an average one gets half? 🙂
Quality is built through addition, not subtraction.

Jason Howard9 said:My point was specifically about private practice and providing better access to physicians (much like veterinarians), because financial incentives drive performance. I am arguing that if doctors in public service were incentivized the same way—for instance, receiving bonuses for high success rates or excellent patient communication—that extra cost would fall directly on the patient in this system of empty coffers. This translates to either higher taxes or increased insurance premiums.

What exactly did you think I meant? That a great doctor gets their full salary while an average one gets half? 🙂
Quality is built through addition, not subtraction.

No, I was talking about the doctor-patient relationship in both human and veterinary medicine. Plus, I made a little observation as to why human doctors are cranky 90% of the time while vets usually aren't.
Try actually reading what's written here.
If we incentivize good doctors, it doesn't drive up costs. Why? Because you're just shifting the money from the underperformers to the ones actually doing the work.
It’s exactly like any American corporation with a bonus structure. The total payroll stays the same; it’s just a matter of how you distribute it.

Kate Collins67 said:Oh sure, those "mystical" home visits—which in my neighborhood usually just mean the doctor decided to take a field trip to his own house, leaving you wondering if anyone is actually available after 3 PM to deal with patients, or if you're just getting handed off to some random replacement.

Some people just don't work in clinics, and frankly, they have no idea what they're missing out on...

These so-called "surprise visits" are nothing more than excuses to hit up local bars, wander through retail stores, drop by a friend's house, or track down a lover. Is that really all there is to it?
The wealthy and the well-connected get priority treatment. Meanwhile, everyone else? If they can't afford a private specialist, they're stuck waiting in an ER or simply dying. Is that the system we've built?

Kate Collins67 said:

I can't believe I even have to address this—it’s like talking to a brick wall sometimes. Honestly, does anyone else feel like we're just spinning our wheels here? It feels like every time we try to make sense of things, someone comes along and throws a wrench in the works. Is it just me, or is the level of common sense dropping by the day? It’s exhausting, truly. You try to have a logical conversation—a real, measured discussion—and suddenly you're met with nothing but noise. Why is that? Why is it so hard to find people who actually want to dig into the details instead of just shouting slogans? It's infuriating. kaže:
And you—as a doctor—you’re just going to sit there and stay silent about this? Seriously?
Report her to the Chamber.👍

They tried to take her out—someone way more influential than me, at that—so, you know... nothing happened.

If they couldn't even manage to take down a judge who registered someone else's property under different names on an island—only to have her return to work (whereas if she were abroad, she’d be facing ten years plus returning the stolen assets)—then why would anyone bother removing incompetent doctors?
Why bother? There is zero oversight regarding general practice (they only track the number of referrals and prescriptions) or specialists like OB-GYNs. If there were actual accountability, someone might ask a gynecologist why a fibroid that persisted for ten years suddenly ballooned from a few centimeters to 20x20 cm after regular checkups, forcing a patient into emergency surgery.
He is still practicing as a gynecologist in a coastal town. My surgeon knows he messed up, and likely won't even hold it against him; paperwork just disappears when people realize someone might end up grieving.
The only solution left: a baseball bat, if someone decides they've been wronged enough to seek vengeance. I'm still weighing my options...

Kate Collins67 said:I honestly don't follow you. Half the time, everyone is preaching about how the patient has a "right to know" this and that.
But now, if I were to look a patient in the eye and tell them—based on my actual medical expertise—that they have maybe six months left to live and that I don't even know of a treatment that could change that outcome, suddenly that's considered wrong too.
I just don't get what exactly you're looking for here.
And frankly, I don't see why you'd bother getting someone banned over this; personally, I don't take offense that easily.

But, dear Kate Collins67, I find myself getting too involved.
If someone tells a child's parents that there are metastases and explains exactly where and how, what should come next?
The parents ought to be told what their options are:

- how to reduce the tumor mass (palliative care),
- who to contact and how to manage pain control,
- how to access therapy and whom to consult,
- what to expect and what supplies they need to have ready at home.
A few comforting words wouldn't hurt to soothe a parent's heart and shift their focus toward practical matters.

Once again, I am warning you: there is absolutely no decent psychological care available for any demographic, for any reason whatsoever.

- It's non-existent for pregnant women,
- it's missing during miscarriages,
- it's absent during D&Cs,
- it's nowhere to be found during major gynecological surgeries or various cancers,
- it's gone during iatrogenic postmenopause,
- it's missing when a patient is given the worst possible news,
- and it's absent when parents are told about a child's terminal illness.

So where are all the psychologists and psychiatrists? Is it only acceptable to talk to addicts and murderers? Or perhaps when a woman is sent to a mental asylum?

Wait, so Kate Collins67 isn't a guy? 🤔
...

Jacob Fox6 said:Wait, so Kate Collins67 isn't a guy? 🤔
...

Sometimes.

My wife set up the account, but I'm the one actually using it.

Now that we’ve all cooled off a bit and the heat of the moment has died down, I figured I’d drop a little guide for all you patients out there looking for the fastest way to actually get your problems solved.
When you walk into a doctor's office, for heaven's sake, just focus on the actual issue that brought you there—stop dancing around the point and let the physician lead the conversation.
If patients would just answer my questions directly when they walk into the exam room, the initial part of my job would be wrapped up in minutes; instead, people start rambling about things that have nothing to do with the issue at hand, and then the appointment drags on forever depending on how much they love the sound of their own voice.

When we ask why you're here, one single sentence is plenty—just stick to the facts and answer the follow-up questions.
It's simple: "I'm here because of pain in my lower right abdomen" (or just point to where it hurts), and that's been going on for two days. That's it. I already know exactly what I need to ask you to reach a diagnosis.

Once the conversation wraps up, if you honestly feel like you missed something vital, feel free to mention it—though, let's be real, it usually turns out to be irrelevant anyway, but hey, at least we won't miss anything.

Look, this probably doesn't apply to every single doctor out there, but in my opinion, starting this way is your best bet, and you'll see where it leads from there.

Kate Collins67 said:Now that we’ve all cooled off a bit and the heat of the moment has died down, I figured I’d drop a little guide for all you patients out there looking for the fastest way to actually get your problems solved.
When you walk into a doctor's office, for heaven's sake, just focus on the actual issue that brought you there—stop dancing around the point and let the physician lead the conversation.
If patients would just answer my questions directly when they walk into the exam room, the initial part of my job would be wrapped up in minutes; instead, people start rambling about things that have nothing to do with the issue at hand, and then the appointment drags on forever depending on how much they love the sound of their own voice.

When we ask why you're here, one single sentence is plenty—just stick to the facts and answer the follow-up questions.
It's simple: "I'm here because of pain in my lower right abdomen" (or just point to where it hurts), and that's been going on for two days. That's it. I already know exactly what I need to ask you to reach a diagnosis.

Once the conversation wraps up, if you honestly feel like you missed something vital, feel free to mention it—though, let's be real, it usually turns out to be irrelevant anyway, but hey, at least we won't miss anything.

Look, this probably doesn't apply to every single doctor out there, but in my opinion, starting this way is your best bet, and you'll see where it leads from there.

You forgot to mention:

Once the consultation ends, do not offer us envelopes; we do not accept them. ☕

Jason Howard9 said:You forgot to mention:

Once the consultation ends, do not offer us envelopes; we do not accept them. ☕

Okay, so now I’m thinking Kate Collins67 was actually a guy, just like most of the recent posts unless his wife is typing in the masculine form...🙂

Blah, blah, envelopes... when did you even deal with that? I have never, ever been in a situation like that in my life. Honestly, I wish those little "gifts" didn't play such a huge role with local town halls, or instead of envelopes, people weren't handing out favors from $333, coffee, or boxes of chocolates and stuff like that...

With certain procedures, surgeons will actually tell patients straight up to buy their own supplies if they want higher quality materials than what the hospital provides. I know of a specific case, but that isn't the surgeon just lining their own pockets. As for the ones who actually demand bribes, just report them to the FBI, call a news station so they can run a story and ruin their reputation or at least cast doubt on them... rather than just talking generally and dragging all doctors through the mud. In all my years, I have literally never once been in a position where I had to give anyone anything extra or pay under the table—not me and not anyone close to me. And if what you're claiming is really that common, then I should have run into that opportunity at least once by now, don't you think?!

ruggedscout91 said:These so-called "surprise visits" are nothing more than excuses to hit up local bars, wander through retail stores, drop by a friend's house, or track down a lover. Is that really all there is to it?
The wealthy and the well-connected get priority treatment. Meanwhile, everyone else? If they can't afford a private specialist, they're stuck waiting in an ER or simply dying. Is that the system we've built?

So, funny how I'm still breathing then? Both me and my parents had a GP show up at our door every single time we called.

Luckily, most doctors are actual professionals with hearts.
Unlike some people whose logic is about as sound as your average troll in an online parlor (clearly seen in this thread).

And yeah, I agree with the post above—not once have any doctors asked me or my family for money, directly or otherwise, and we’ve certainly never offered it. We got the treatment we needed, plain and simple.

ruggedscout91 said:But, dear Kate Collins67, I find myself getting too involved.
If someone tells a child's parents that there are metastases and explains exactly where and how, what should come next?
The parents ought to be told what their options are:

- how to reduce the tumor mass (palliative care),
- who to contact and how to manage pain control,
- how to access therapy and whom to consult,
- what to expect and what supplies they need to have ready at home.
A few comforting words wouldn't hurt to soothe a parent's heart and shift their focus toward practical matters.

Once again, I am warning you: there is absolutely no decent psychological care available for any demographic, for any reason whatsoever.

- It's non-existent for pregnant women,
- it's missing during miscarriages,
- it's absent during D&Cs,
- it's nowhere to be found during major gynecological surgeries or various cancers,
- it's gone during iatrogenic postmenopause,
- it's missing when a patient is given the worst possible news,
- and it's absent when parents are told about a child's terminal illness.

So where are all the psychologists and psychiatrists? Is it only acceptable to talk to addicts and murderers? Or perhaps when a woman is sent to a mental asylum?

Sadly, there just aren't enough of them.
A lot of psychiatrists focus strictly on biology and medication; actual talk therapy isn't really their thing.
Then you have psychiatrist-psychotherapists who actually do the work, but they're so rare they can barely meet the demand. For instance, there's currently a clinic providing psychological support for women with breast cancer, and the entire load falls on one psychiatrist who handles them alongside her regular patients.

As for everything else... like eating disorders, we're barely even scratching the surface.
I honestly don't know where all the psychologists are hiding—but keep in mind, someone with just a bachelor's degree isn't actually qualified to provide counseling or real psychological help without specialized training.

Jacob Fox6 said:Okay, so now I’m thinking Kate Collins67 was actually a guy, just like most of the recent posts unless his wife is typing in the masculine form...🙂

Blah, blah, envelopes... when did you even deal with that? I have never, ever been in a situation like that in my life. Honestly, I wish those little "gifts" didn't play such a huge role with local town halls, or instead of envelopes, people weren't handing out favors from $333, coffee, or boxes of chocolates and stuff like that...

With certain procedures, surgeons will actually tell patients straight up to buy their own supplies if they want higher quality materials than what the hospital provides. I know of a specific case, but that isn't the surgeon just lining their own pockets. As for the ones who actually demand bribes, just report them to the FBI, call a news station so they can run a story and ruin their reputation or at least cast doubt on them... rather than just talking generally and dragging all doctors through the mud. In all my years, I have literally never once been in a position where I had to give anyone anything extra or pay under the table—not me and not anyone close to me. And if what you're claiming is really that common, then I should have run into that opportunity at least once by now, don't you think?!

Of course they don't ask directly; it's a matter of... style. But they certainly don't complain if you "discreetly" thank them for something in the future. And which doctors are we talking about? They are in the minority, and it doesn't change the system. In every profession, there are individuals who deviate from basic ethics.
And why are you getting so worked up? Has anyone actually pointed a finger at you? 😕

For example, Dr. Ognjen Šimić is certainly not a stranger to the public.

Raymond Nguyen5 Kevin Garcia12 said:Look, anyone who hasn't actually stepped foot inside one of those Mill systems as a patient has absolutely no clue what they’re talking about, let alone having the nerve to post about it...
Of course you won't find doctors posting here about how Big Pharma lures them away to "educational symposiums" at the world’s most glamorous vacation spots—where, by some hilarious coincidence, the lectures always seem to take place right on the beach... but look, we’re all human, and frankly, what you’re saying is just pure theory that doesn't hold up in the real world. Anyone still actually working in this field has to stay on top of new breakthroughs, shifting regulations, and updated protocols just to keep their head above water. As for those administrative types who can't seem to respect deadlines or federal mandates? Well, the government has plenty of ways to deal with them; every single law comes with penalties for anyone failing to comply. Being a specialist doesn't mean you're somehow exempt from keeping up with medical advancements, unless, of course, a representative from a pharmaceutical giant—the kind of company pulling in $8 billion a year just from an MS drug—shows up and tells you, "Hey, listen up, we've got a new treatment, and we're hosting the launch party in Thailand..."
And then, once that's all settled, they just go ahead and tell the patients—as if it’s some kind of massive breakthrough—that this whole thing is actually revolutionary news...
You really have to look at this thing from every possible angle if you want the full picture, because that old saying about "not trusting a full stomach" is just way too obvious and frankly a bit lazy in this context...

Thanks, beautiful... I’ve seen enough of how these systems work from the inside since I was just a kid. Like one time, I went to a small town in the Midwest back in October to get some blood drawn for allergy testing, and they straight up told me they couldn't run that specific test anymore that year because they had "hit their limit" and I'd just have to wait until the new year... so what am I supposed to do with that now?
So, I had to go through medical school just to end up prescribing my own treatment plan because, apparently, nobody else could get it right... which is pretty much the only way I’m finally seeing some actual—if only partial—relief after fifteen years of being fed absolute garbage therapies that did nothing but make things worse. Genius, right?...
And for the record—I never even bothered going in to get that test done, and honestly, I didn't need the results for anything at all anyway... ☕

Look, just because there are systemic flaws doesn't mean the whole concept is garbage. And honestly, just because you see some people out there catching rays on a beach doesn't mean that’s what everyone is doing... It’s not a monolith. Besides, if we actually changed the laws to stop prohibiting direct donations for training—if we just let people contribute to education funds, or better yet, gave every employee a dedicated $1,000 annual stipend specifically for professional development where they get to decide how to spend it... I mean, if that was their only budget for learning, they’d probably think twice about whether lounging poolside is more important than actually sitting through a course they paid for themselves...

It’s honestly idiotic to think anyone is going to blow their hard-earned paycheck on some fancy continuing education course that offers zero return on investment... I mean, you aren't getting a raise for having more certificates, and let's be real, you don't even get any extra "prestige" in the eyes of the public because 99.99% of patients couldn't care less how specialized you are unless it directly fixes their immediate problem. They just want to feel better right now. And God forbid you have one bad day or a treatment gets a little complicated—suddenly, all the brilliant work you've done leading up to that moment is completely erased in their minds. They’ll drag your name through the mud just as fast as they would someone who’s been killing people their whole career out of pure incompetence and laziness... To me, making a mistake isn't the catastrophe here; the real disaster is when someone fails to learn anything from that mistake to make sure it never happens again...

Look, besides the constant climate of finger-pointing over every little thing, this whole culture of calling people out is exactly what’s killing the very ideas you guys are pushing here—I mean, let's be real, experimental methods are inherently tied to a non-zero chance of failure or complications, and almost nobody is willing to step up and face the public shaming and character assassination that *always* follows when things go sideways... because it’s the same damn story every single time. First, they go after someone with a lawsuit, then once they realize the patient signed a waiver acknowledging the risks of an experimental trial, the yellow press swoops in like vultures looking for a headline, and they don't care about anything except a juicy scandal. By then, the reputational damage is permanent, and if you’re someone who already has a reputation to protect, you aren't going to risk it all just to prove a point... you'll stick to the conservative, tried-and-true methods where there's virtually zero chance of everything blowing up in your face...

By the way, my employer has NEVER once covered the cost of my pharmacy certification courses—honestly, nobody ever has. It’s technically their responsibility, but I’ve sent four separate formal requests and been rejected all four times; they couldn't even bother to send a simple reply... So now I'm stuck paying for them out of my own pocket just to stay compliant, because they know damn well I need those credits to renew my license, and if I don't, they can basically force me into a corner where I'm paying for my own forced inactivity. What am I supposed to do at this point? Demand the course be paid for by force and risk getting fired at the first opportunity, or just shut up and deal with being completely frustrated by a broken system from a professional standpoint?

Look, I don't do this job out of some grand sense of altruism or a desire to save the world; I do it because I need to make a living. I show up to work to get a paycheck, nothing more and nothing less, just like pretty much every other worker out there. I’m not some saint or a messiah, I'm just an employee, and my level of "satisfaction" with my position and my job is directly proportional to how thick my wallet feels on payday, while being inversely proportional to how much extra labor I have to grind through for that same amount...