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Riddle me this about the US healthcare system

Posted on 7/9/26 at 2:45 pm
Posted by HailHailtoMichigan!
Mission Viejo, CA
Member since Mar 2012
74574 posts
Posted on 7/9/26 at 2:45 pm
This is in regards to the nurse strike up in Massachusetts

Americans pay up the wazoo for their health insurance, yet:

1) nurses cry poor
2) doctors cry poor (sometimes)
3) hospitals regularly write to congress claiming they are losing money
4) health insurance profit margins are usually only 5-10%, in line with economy-wide returns.


So, if all this is true….where is our money going? Somebody is making bank, yet almost groups within the healthcare industry say their bank account is barren.


Only alternative explanation is that Americans are unhealthy as hell and their treatment is where all the money is going
Posted by Ace Midnight
Between sanity and madness
Member since Dec 2006
96064 posts
Posted on 7/9/26 at 2:46 pm to
quote:

So, if all this is true….where is our money going?


Short answer? Politicians.

Long answer? Middlemen, bankers, lawyers and politicians
This post was edited on 7/9/26 at 2:47 pm
Posted by kingbob
Sorrento, LA
Member since Nov 2010
70901 posts
Posted on 7/9/26 at 2:48 pm to
Fraud, medical coding, insurance scams, drug companies, and high salaries for mid-late career doctor specialists and travel nurses.
This post was edited on 7/9/26 at 3:38 pm
Posted by B747Tiger
Member since Jul 2026
250 posts
Posted on 7/9/26 at 2:48 pm to
quote:

So, if all this is true….where is our money going? Somebody is making bank, yet almost groups within the healthcare industry say their bank account is barren.


HMOs and insurance companies are making bank.

quote:

Only alternative explanation is that Americans are unhealthy as hell and their treatment is where all the money is going


Poor Americans are unhealthy as hell so the middle class and wealthy pay for their treatment.


Our current insurance model is absurd. Most doctor visits should be paid out of pocket and insurance should be reserved for major injury or illness.
Posted by lowhound
Effie
Member since Aug 2014
10654 posts
Posted on 7/9/26 at 2:48 pm to
Travel nurses making bank.
Posted by Tigergreg
Metairie
Member since Feb 2005
27130 posts
Posted on 7/9/26 at 2:49 pm to
I'll bet a big part of it is medical malpractice insurance. That, and Medicare pays health providers pennies on the dollar on their billing. That said, they aren't poor. They just think they should be making more than they do.
Posted by Swazla
Member since Jul 2016
1950 posts
Posted on 7/9/26 at 2:49 pm to
quote:

Long answer? Middlemen, bankers, lawyers and politicians


Drug companies,
Posted by Powerman
Member since Jan 2004
175099 posts
Posted on 7/9/26 at 2:50 pm to
quote:



Only alternative explanation is that Americans are unhealthy as hell and their treatment is where all the money is going

Even with low margins the problem with health insurance could be the bureaucratic bloat. Medical billing departments alone within provider systems is a whole other bureaucratic mess.

I would say that you might be able to draw a parallel between the medical system and public education. School boards can eat up a lot of funds before the actual educators and schools themselves are factored in. Same with the medical system. The actual providers of care get crowded out by all the non care related labor in the system.
Posted by W2NOMO
Member since Jul 2025
2955 posts
Posted on 7/9/26 at 2:50 pm to
If you look around Baton Rouge you will see the expansion of OLOL. It’s a 501c so it has no shareholders or partners to pay. It pays its doctors and staff and such and the money leftover has to go somewhere. Expansion times Expansion. That’s where the money goes.
Posted by JCdawg
Member since Sep 2014
9659 posts
Posted on 7/9/26 at 2:54 pm to
What about all the uninsured going to the ER? That is being paid for by everyone else.
Posted by dchunk
NOLA
Member since Dec 2010
1015 posts
Posted on 7/9/26 at 2:56 pm to
Check to see what U.S. hospital administrators make compared to the rest of the industrialized world. Not a bad gig for paper pu$her$
Posted by LemmyLives
Texas
Member since Mar 2019
17067 posts
Posted on 7/9/26 at 3:07 pm to
quote:

| Organization Type | Typical Operating Margin |
Large physician groups | **2% to 8%** |
High-performing multispecialty groups | **6% to 12%** |
Hospitals | **0% to 5%**
Posted by lurking
Member since Nov 2022
2889 posts
Posted on 7/9/26 at 3:08 pm to
quote:

Only alternative explanation is that Americans are unhealthy as hell and their treatment is where all the money is going


This is part of it and why RFK (who I’m sure you hate) should receive a lot more support than he has. He’s the first person in my lifetime in such a high profile role seeking to treat the cause instead of the symptoms.
Posted by Rebel
Graceland
Member since Jan 2005
144472 posts
Posted on 7/9/26 at 3:10 pm to
Administrative costs and lawyers.
Posted by LSUFanHouston
NOLA
Member since Jul 2009
41350 posts
Posted on 7/9/26 at 3:11 pm to
Fraud / overtesting

Coding / billing

Naming rights for stadiums
Posted by CleverUserName
Member since Oct 2016
17932 posts
Posted on 7/9/26 at 3:11 pm to
No clue why they are crying. They were the biggest supporters of Obamacare. They got Obamacare. Everything should be absolutely rosey.
Posted by KingOrange
Mayfair
Member since Aug 2018
13485 posts
Posted on 7/9/26 at 3:11 pm to
Insurance Companies period
Posted by Lawyered
The Sip
Member since Oct 2016
38623 posts
Posted on 7/9/26 at 3:18 pm to
You got a lot of people paying for alot of people who never pay anything
Posted by omegaman66
greenwell springs
Member since Oct 2007
27465 posts
Posted on 7/9/26 at 3:20 pm to
quote:

This is in regards to the nurse strike up in Massachusetts

Americans pay up the wazoo for their health insurance, yet:

1) nurses cry poor
2) doctors cry poor (sometimes)
3) hospitals regularly write to congress claiming they are losing money
4) health insurance profit margins are usually only 5-10%, in line with economy-wide returns.


So, if all this is true….where is our money going? Somebody is making bank, yet almost groups within the healthcare industry say their bank account is barren.


Only alternative explanation is that Americans are unhealthy as hell and their treatment is where all the money is going


Good post. Part of the issue is drug companies. That whole system needs to be looked at. Taxpayers pay for the research and then the pharmaceutical companies act like they need to recoup all that money. Gross oversimplification but you get the point.

Ask anyone in the business and you will get it all boiled down to:

1. lawsuit prevention cost a trillion dollars and provides poorer care to the patient.

2. Insurance companies dictating what they will pay for, which often leads to crap like you have to exhaust all of these treatments before they will pay for surgery when the patient and the doctor both knew it was going to end with surgery in the end. Wasted money. More pain and suffering for the patient.

Throw on top of all that the pharmacutical companies have taken over what doctors are being taught in school now. The mantra is now why fix what you can treat for a lifetime!
Posted by Zach
Gizmonic Institute
Member since May 2005
117887 posts
Posted on 7/9/26 at 3:20 pm to
quote:

What about all the uninsured going to the ER? That is being paid for by everyone else.

True. The wife has told me tons of stories but this is my favorite:
Woman comes into ER and tells Dr. "My hairs hurt!" Him: 'You are having headaches?" Her: 'No, my head fine, it's my hairs dat hurt!' He gave her a shot as a placebo.
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