[LarThaL]

Medicine will never get fixed in the US until someone makes this one determination:

Is equal access to all healthcare a fundamental right of all citizens or not? If yes, then full government based healthcare is the only way it can happen. If, no, then, in one form or another, people will get what they can afford.

However, until we decide, philosophically, which way to go, nothing will get resolved. Right now we are in a mess because we are trying to do everything to please everybody. The result is that nobody is happy. We haven't made a firm decision as a society what health care should be within our society. Once that decision is made, we can then go on. At least somebody will be happy.

How can you ever fix something if you haven't even decided in which direction you want to take your first step?

The other issue is that because we are talking about human health and well being, there is more of a cost-be-damned mentality. The quality controls in medicine are so ridiculously stringent, that they are going to be hugely expensive. For instance, when I give anesthesia for ECT, I have to use a $300 ambu bag to ventilate a patient for literally 3 minutes. That device then gets thrown away. I can not use it on another patient for infection control reasons. In all likelihood, there would no issue, but that's just what the standards are. For you surgeons out there, think about the $2000 or so that a disposable surgical stapler costs. You use it once, for 5 seconds, then toss it. And, that is also more plastic trash going into the environment. And yet, because it is human health, it is somehow okay to be wasteful.

Likewise, as a society, if we are more willing to accept death in the elderly as a normal process, significant money could be saved. We seem so hell bent on preserving physical bodily function, and calling that "life". We will all die at some point. If you have lived to see your grandchildren, what more out of human existence do you realistically wish to strive for. Is 80 year old grandma going to go climb Mt. Everest if she makes it off the ventilator?

And what about prevention? We in medicine all know how much alcohol, tobacco and obesity contribute the the morbidity in the US. It is HUGE!!!!

I joke sometimes....I want more people to smoke, drink and eat at McDonald's because that's what keeps me in business.

In the end, it is easy to blame insurance companies, drug companies, lawyers, etc. While they do contribute to the problem, the general public is just as much to blame due their irresponsible over-indulgences, ridiculous expectations and disproportionate sense of entitlement.