Why Healthcare Is in a Death Spiral: Follow the Money

 The severe problems facing the U. S. healthcare system, describing it as being in a "death spiral" due to financial mismanagement and structural issues. It emphasizes the need for real reform instead of superficial changes.

1. Healthcare's Two-Tier System: The U. S. is moving towards a two-tier healthcare system, where only those who can afford it receive high-quality care while others get low-quality, limited services.

2. Profit Mechanisms: Healthcare systems profit through real estate and patient data sales instead of actual medical care, leading to a focus on financial management over patient health.

3. Insurers as Utilities: Insurers are functioning merely as administrators of government programs, lacking the ability to manage risk effectively due to changes introduced by the Affordable Care Act (ACA).

4. Impact of the Pandemic: The COVID-19 pandemic exacerbated existing issues by reducing healthcare throughput, and systems had to rely on government bailouts that are now ending.

5. Consolidation Trends: Increasing consolidation in the healthcare sector is expected, pushing smaller systems out and resulting in fewer major players.

6. Failure of the ACA: The ACA has not fulfilled its purpose as a universal risk pool, leading to a system dominated by only the sickest patients, undermining its effectiveness.

7. Resource Migration: More healthcare resources are moving to cash-pay markets because they often provide better compensation than government programs.

8. Need for Structural Reform: Proposed reforms include eliminating laws that restrict cash-pay options, prohibiting non-profit entities from participating in certain payment systems, and renewing anti-trust enforcement to address monopolies.

9. Critical Questions: The article poses significant queries about whether the current insurance structure is genuinely private and how the system can improve health outcomes when it fails to address fundamental health factors.

The article concludes that without addressing the core issues in healthcare delivery and organizational structure, any financial reforms will amount to pouring money into a failing system without genuine improvements. The author warns that the current trajectory could lead to considerable national financial strain.

https://charleshughsmith.blogspot.com/2025/12/why-healthcare-is-in-death-spiral.html