U.S. Healthcare Isn't Broken...Its 'Fixed'

Authored by Charles Hugh Smith via OfTwoMinds blog,

Healthcare/sickcare will bankrupt the nation by itself.

If you want to understand why the U.S. healthcare system is bankrupt, financially, morally and politically, then start with this representative anecdote from a U.S. physician. I received this report from correspondent J.F. on the topic of direct advertising of pharmaceutical products to the public (patients).

As background information, pharmaceutical companies were not allowed to advertise directly to consumers (patients) in the good old days. Now, as we all know, half the adverts on TV are for pharmaceutical products, and many of the remaining half are advertising lawsuits relating to pharmaceutical products that harmed or injured the patients who received them (or clamored for them as a result of endless direct-to-consumer adverts).

Here is J.F.'s report:

This morning, I read a report on augmentation of antidepressants. It seems folks who get a little better, but not a lot better on an antidepressant may improve if a drug in the class of second generation antipsychotics is added. Three of these drugs have been tested, with pretty much equivalent benefit - quetiapine, aripiprazole, and brexpiprazole. As the names suggest, the last two are very similar in chemical structure.

- quetianpine and aripiprazole are available in cheap generic for. Brexpiprazole is not, it's sold only as branded Rexulti.

- shortly after reading the piece, I walked past the waiting room TV which was playing an ad urging folks to "ask your doctor about Rexulti".

- lowest costs for a month's supply in my neighborhood, courtesy of goodrx.com:

quetiapine - $6.80

aripiprazole - $22.60

Rexulti - $1,120.20 (!)

- so the ad is urging folks to "ask their doctor" about a drug that is 16,473% more expensive than a similar drug that may work just as well.

Thank you, J.F. There you have it in a nutshell: U.S. Sickcare is organized to maximize profits by any means available, including adverts aimed at patients, adverts aimed at physicians, lobbying to include costly medications in the list of what Medicare pays for, and so on, in an endless profusion of crony-capitalist skims and scams, starting with research that's funded to reach the conclusion the funding pharmaceutical company desires, all the way through masking the real-world consequences of medications.

U.S. healthcare isn't broken, it's fixed--fixed to exploit the many to benefit the few, fixed to maximize profits in a we-win, you-lose system of perverse incentives.

AS I have long held, healthcare/sickcare will bankrupt the nation by itself. Endless wars of choice, unaffordable pensions and rising costs of soaring debt will only speed the arrival of insolvency and systemic collapse.

How Healthcare Is Dooming the U.S. Economy (Three Charts)

Are Profit and Healthcare Incompatible? (August 18, 2017)

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LawsofPhysics Wed, 05/16/2018 - 11:34 Permalink

"there has been low to no inflation for years, therefore we must continue to allow the bankers and financiers to have access to trillions at zero to negative interest rates" - Ben Bernanke

Certainly Ben wouldn't lie to congress, but if he did then he needs to be promptly and publicly executed.

hedgeless_horseman boattrash Wed, 05/16/2018 - 11:41 Permalink


Health care in the USA isn't broken.

Health insurance in the USA is broken.

Our politicians broke it by giving away "free" healthcare to buy votes with our money.

What can you do?

How to negotiate directly with physicians and hospitals.

As the post-vasectomy head of a healthy household, do I really want to be swimming in the Obamacare risk pool with millions of morbidly obese, perpetually pregnant, HIV infected drug abusers?


In reply to by boattrash

FireBrander WolfgangCire Wed, 05/16/2018 - 11:45 Permalink

I don't see the problem? 

Isn't this Capitalism; advertising to gain customers and maximize profit?

Should it be illegal to charge more than the competition? 

How is this different than an iphone vs an LG phone? Both work the same, but one costs 5x more than the other. 

Isn't the real problem the Doctors?

Shouldn't the most expensive drug only be used if the least expensive fail?

In reply to by WolfgangCire

pods bluecollartrader Wed, 05/16/2018 - 12:06 Permalink

Our insurance renewed, so I have to wait till near the end of the year for our ginormous deductible to be met to have my ass sewn up again from my yearly reaming.

Can't take much more winning.  The cunt who tells us about our next year's health plan is finding it really hard to even lie anymore.

Can't wait till she looks at her sheet, looks up, blankly says "You're fucked," and walks out.



In reply to by bluecollartrader

Miffed Microbi… pods Wed, 05/16/2018 - 15:25 Permalink

Well you could always consider a life of crime. My hospital had the contract for the county jail for a number of years and those SOBs got premium care. Plus they were granted 100% anonymity. All their lab reports were only numbered, I never got any of their names. So if I had a positive TB result I could only see a number, not a name which made it extremely difficult to follow these cases when they returned which was quite often. I questioned this and they responded " This is for their safety." I had a difficult time wrapping my head around that. 


Crime does pay it would appear.



In reply to by pods

Okienomics bluecollartrader Wed, 05/16/2018 - 12:32 Permalink

Firebrander has a point about unfettered capitalism.  That being said, one of the aspects of a "perfectly competitive market" is perfect information.  I can think of no more egregious example of non-transparency in pricing than healthcare.  Any of us could site hundreds of inane examples of it.  The big revolution, whether by regulation or voluntary action, will be the posting of prices for services, supplies and drugs.  Once informed, consumers can make good decisions.  Absent information, sound decisions are impossible.

In reply to by bluecollartrader

glenlloyd Okienomics Wed, 05/16/2018 - 13:21 Permalink

Coordinates perfectly with the dumbing down of Americans.

You can't have a 'perfectly competitive market,' but at the very least you need to have a rational and inquisitive consumer who isn't herded to the butcher shop like cattle.

I would claim that part of the problem is that a whole host of people have just accepted what the doctor spouts (or drug maker pumps out in pr) as gospel without even a question.

Let's not blame the system for the failings of those who don't dig even a little.

In reply to by Okienomics

Faeriedust bluecollartrader Wed, 05/16/2018 - 19:37 Permalink

The internet is helping.  It's possible to become almost as educated as most doctors on just about any particular issue with about 3 hours of internet time.  The real problem is that the system is rigged so that it doesn't matter what you know -- you aren't allowed to make your own decisions.  You are legally required to get a permission slip from a Licensed Doctor in order to purchase just about any effective drug (good old-fashioned aspirin would be prescription-only if discovered today).  Even if you could buy the drug without a Doctor's Order, the insurance you pay an arm and a leg for won't cover it without one.  And due to those same insurance requirements, virtually no doctor will prescribe a drug on a symptomatic/empirical basis.  Instead, they must run a half dozen pricey tests to verify that the diagnosis (often a 10-day trial of a $4 drug will provide much more effective diagnosis).

It doesn't matter if you know all of this and EXACTLY what your issue is and how to treat it.  The system is legally mandated to assure that all the insiders get to shake you down for their piece of the action before you can get treatment.

In reply to by bluecollartrader

Faeriedust pods Wed, 05/16/2018 - 19:43 Permalink

Speaking of slavery, you could start with the legal cartel that forces young doctors to work 80-hour weeks with 72-hour rotations at lower wages than a high-school graduate secretary or blood-sticker in the same hospitals, under the facade of "on the job training/internship".  If hospitals and practices had to compete for the services of these young graduates without the professional monopoly guaranteeing a complete lack of bargaining power for the interns, hospital stays would be far less dangerous -- something about the attending "doctor" having actually been able to sleep the night before does wonders for judgement and reasoning.

In reply to by pods

Kidbuck FireBrander Wed, 05/16/2018 - 12:40 Permalink

The problem is that the drug companies now own the televisions in the doctor's offices. They run a closed circuit program constantly that cannot be turned off. It is 100% programming designed to sell drugs. The doctors or their clinic owners must be getting paid to run this crap. The volume cannot even be turned off. It is the worst form of brain washing. I wait outside in the parking lot until they call me.

In reply to by FireBrander

BlindMonkey FireBrander Wed, 05/16/2018 - 13:19 Permalink

"Isn't this Capitalism; advertising to gain customers and maximize profit?"


Capitalism is using your own money and the individual buying decision as the rationing mechanism.  Drugs are not paid for by the consumer of the drug in a typical American scenario.  How does capitalism work when the rationing mechanism is fundamentally broken?  It doesn't. 


Imagine if you wanted a new car but someone else paid for it.  What would you go to the dealer and get?



In reply to by FireBrander

MoralsAreEssential WolfgangCire Wed, 05/16/2018 - 12:50 Permalink

I listened to an interesting video with a guest, Wayne Jett, who described the "origin" of the specific idea to kill most of as in the meeting with Theodore Roosevelt in 1901 during which a Manifesto to murder the Middle Class and go back to the 2 Class system of feudalism was implemented.  Probably part of the Deal for lending money to USG since we were bankrupt.  The 1918 Flu was an engineered virus to that end.  The engineered Great Depression killed about 25M Americans through starvation, disease, etc., which is NEVER ACKNOWLEDGED and the mime of "government doing everything it could" just another big lie as real estate was gobbled up for pennies on the dollar.  Just like One World Government, methinks Middle Class elimination is still very much on the agenda even as some specific revealed schemes like the Georgia Guidestone one has been stopped.  

In reply to by WolfgangCire

Faeriedust MoralsAreEssential Wed, 05/16/2018 - 19:51 Permalink

The 1918 Flu "engineered" itself.  It hit a European population that was decimated by war, with appalling levels of malnutrition and sheer physical exhaustion after 4 years of hell.  It started in an Austrian basic-training camp, where the very last -- and least desirable due to health or mental issues or extreme youth -- young Austrian men left alive were being herded together and exposed to bad food, lack of sleep, psychological stress and terror that they might still be sent off as cannon fodder.  It spread from them to camp support staff, and then to the local civilian population.  The virus was powerful and nasty, but above all, it hit a host population that was severely weakened and ripe for infection of any kind.

In reply to by MoralsAreEssential

LawsofPhysics hedgeless_horseman Wed, 05/16/2018 - 11:42 Permalink

Let people who make unhealthy CHOICES fucking die or PAY MORE FOR THEIR OWN CHOICES!!!!!!

The ONLY way such "insurance" works is if the pool of healthy people is greater than that of the sick.  It is just math and the laws of nature and physics for fuck's sake. Stop rewarding bad behaviors!!!

Regardless, nobody is getting out alive people, but for fuck's sake, I should not be paying additional costs for other people's stupidity.

In reply to by hedgeless_horseman

Snaffew LawsofPhysics Wed, 05/16/2018 - 12:02 Permalink

it's not a matter of sick or healthy, it's a matter of generous insurance benefits.  There are tens of millions of retirees and general public who frequent their doctors a couple times a week just because they can at very low or zero cost to them because they are insured.  They are addicted to the services and I have seen many people who literally have shoeboxes packed full of prescription meds for a plethora of "ailments" that they believe they have and received the medicine designed to treat it.  Everything from watery eyes to watery anuses...from depression to hyperactive disorders.  People simply abuse the healthcare system and in return, the healthcare system abuses the people.  If they removed prescription reimbursement from the insured policies, then attendance at doctor's offices would plummet and people would not need the scripts they think they need.  In turn, prescription prices would dramatically fall across the board as all these blood sucking biotech firms would scramble for a tiny piece of a massively shrinking pie.  There are way, way too many drugs out there for ailments that are more dreamed up than reality.

In reply to by LawsofPhysics

LawsofPhysics Snaffew Wed, 05/16/2018 - 12:05 Permalink

Bullshit.  show me the data to support any of your claims, a larger pool of healthier people paying premiums versus a smaller pool of sick people requiring services that are paid for by those premiums is the bottom fucking line. Healthier people won't require as many drugs either. Personally, I think education and healthcare should be things that should be not for profit as soon as the fuckers accept government grants (as both sectors do!!!).

In reply to by Snaffew

Snaffew LawsofPhysics Wed, 05/16/2018 - 12:28 Permalink

the US has the most abused healthcare system in the world...why the fuck do you think premiums are so fucking high?  You can fly to Japan and get an mri there and still save money versus getting one in the US.  Mri's are $160 in japan.  In france, the average person receives the same mount of healthcare as the US, but it costs 60 percent less for the country as a whole.  The US healthcare system is a massively overcharged and abused system.  The numbers don't lie...like everything in the US---the military, healthcare, political establishment, government, pension system----they are all out of touch with reality and on a peer to peer basis, radically more expensive than any developed nation in the world. 

In reply to by LawsofPhysics

MoralsAreEssential Snaffew Wed, 05/16/2018 - 13:07 Permalink

And WHY do you think that is?  Hmmmmm.  It's part and parcel of the USG selling out the US population to the healthcare corporations (pharma, insurance, hospitals, docs, etc.) to subsidize the socialist systems and PRESCRIPTION DRUG DEALS in most if not ALL OTHER COUNTRIES ACROSS THE PLANET on the financial backs of the US population.  That Plan and the ability of US citizens to do that has reached it zenith and gone into Phase 2 which is sheer population elimination through no access to care, toxic foods, toxic lifestyles such as RADIATION from your electronic devices from in utero today.  You're blaming the victims and guess what?  Your number will eventually come up also when you run out of ethical treatment options from people you know.  Examples:  You have an accident on vacation and it is not an option to transport your loved one.  You catch one of the engineered viruses like Lyme disease.  You get what was once a rare brain cancer (has doubled in UK) from your cellphone.  You catch a contagious AIRBORN disease.  Like it or not, the contamination and corruption of our health in this country is a societal problem and your money, your "brilliance," your luck will not always keep you and yours safe.

In reply to by Snaffew

Triple A LawsofPhysics Wed, 05/16/2018 - 12:16 Permalink

Absolutely agree with all that, "healthcare" is sick care and it all comes down to what we put in our bodies. If you eat a raw vegan diet mostly fruits and vegetables you won't believe how much better you look and feel mentally and physically. I have not even had a mild cold in several years while everyone around me is getting sick and their allergies are out of control. Clean out your system and stop eating unnatural foods.

In reply to by LawsofPhysics

hedgeless_horseman boattrash Wed, 05/16/2018 - 12:07 Permalink


 is it all done so they can "claim a loss" for tax purposes?

No.  The tax law prohibits medical providers from doing that.  

Clearly you have either not read or not comprehended my article.  In it, I explain exactly why the providers have such high usual and customary billed charges.

The purpose of this overpricing by the medical providers is to force the insurance companies to the negotiating table.  The insurance company is bringing a large volume of patients to the medical providers, the members in their network, so they are able to negotiate a lower discounted allowable fee from the medical providers.  However, if the insurance carrier is not able to negotiate a contractual allowable fee schedule, then they will end up paying the higher billed charges of the out-of-network provider for the members that still end up being treated by that medical provider in emergencies when precertification is not required. 




In reply to by boattrash

zeropjbaggot boattrash Wed, 05/16/2018 - 17:24 Permalink

for a "minor surgery" the doctor will get paid less than five hundred dollars. 


its like i took my car to the garage to fix transmission.

its was $300 to fix transmission.

It was $5000 to use the garage.


so the patient went to the hospital only to have surgery.

without the surgeon the hospital makes no sense.

Out of the $273,000

much went to nursing care

the rent for the bed (hospital charges)

laboratory-many thousand to cover blood tests

doctor interprets them for free.


yes a lot of its done to claim a loss for tax purposes

so hospital makes oodles of tax free money

while doctor can barely make expenses supporting the gargantuan hospital


what insurance company means by "negotiating" prices

if a doctor says a three hour operation should be worth $3000

insurance company says its only worth 300

take it or leave it


as deuctibles and co pays rise

insurance payment goes down 


thus after the patient pays a fortune for insurance

high co-pays and deductibles mean

all they get for giving their money to insurance is

the oppurtunity to pay the $27,000 themsselves


insurance makes most of their money by not paying what they are supposed to pay






In reply to by boattrash

FireBrander vietnamvet Wed, 05/16/2018 - 11:58 Permalink

Needed a tooth capped. 

Dental visit #1: $145 & cap denied by insurance; Dentist said denial is normal. 

Dental visit #2: $225 for more pics/xray of bad tooth...cap denied.

Dental visit #3: $195 for more pics of the tooth with a special dye to show the crack. Cap granted.

$425 added to the bill for no reason!

Asked the dentist why didn't we do it all the first visit...ins would deny "all the unecessary tests".


In reply to by vietnamvet

DjangoCat FireBrander Wed, 05/16/2018 - 12:28 Permalink

These insurance products are idiotic unless covering catastrophic conditions only.  How much of this bill did you have to pay?  50%?

Probably cheaper to get the job done and pay cash up front.  Forget the damn insurance.

In reply to by FireBrander

snblitz vietnamvet Wed, 05/16/2018 - 13:57 Permalink

There are alternatives to health "insurance" used by millions of people in the US.

In the past they were called "mutual aid societies" and they still exist.

I participate in a  "health sharing ministry", as they are called today, and pay $450 per month for a family of 4, with a $1500 annual AUP (like a deductible) and a $1 million limit per incident.  That is about 75% less than my old fortune 100 provided health policy and 75% less than the obamacare offered in my state.

Since you interact with providers as a self pay or cash pay customer you easily get 75 to 90% discounts.  El Camino Hospitals give 75% off their master charge list just for asking and paying cash.


It really is up to you which type of system you want to participate in.

In reply to by vietnamvet

Nunyadambizness vietnamvet Wed, 05/16/2018 - 14:24 Permalink

Back in the day (like the 60's) people bought catastrophic insurance to cover things like cancer, or heart attack, etc., and they bought accident insurance, life insurance, etc.  If they got sick they went to the Dr. on their own dime, which meant they didn't go unless they really needed someone to look after them.  This is essentially the same system that had been around for decades, if not centuries. 

Then, in the early 70's some friggin' genius came up with the type of plan that most people have today (originally the PPO, then the HMO, or vice versa), and Nixon signed the HMO act in '73--the idea was to eliminate the individual insurance plans.  (One could ask "who profits from this?", but I think we all know.)  Mostly through employers, they started covering doctor visits, prescriptions, etc., at various levels until we have what we have today...a clusterfuck that costs more and provides less than what we could have otherwise.  

So, now think about this:  If you bought car insurance that covered oil changes, the type of gasoline you bought, all repairs and maintenance, and tires, how expensive do you think it would be?  THAT IS THE PROBLEM.

In reply to by vietnamvet

snblitz Nunyadambizness Wed, 05/16/2018 - 17:34 Permalink

Nixon imposed wage and price controls. Companies began offering perks such as paid health insurance as a way around the limits.  Can you believe this whole horrible nightmare was invented by Nixon?

On Aug. 15, 1971, in a nationally televised address, Nixon announced, “I am today ordering a freeze on all prices and wages throughout the United States.”

After a 90-day freeze, increases would have to be approved by a “Pay Board” and a “Price Commission,” with an eye toward eventually lifting controls — conveniently, after the 1972 election.


In reply to by Nunyadambizness