It’s rotting from the bottom-up. The collapse has already happened for the lowest income people, and in regions where incomes are predominantly low. If you don’t have enough money, or a reliable car, or the ability to take time off work, that means you simply don’t get professional medical service. For a lot of people, medical services have effectively stopped existing in the USA; you just ask your friends and family what sort of remedies you can buy at a corner drugstore, and do what you can. We’re at the beginning of the process of drugstores starting to pull out of certain areas as well, which will basically just leave local corner convenience stores as the last place where you can acquire actual medical supplies.

This collapse is slowly creeping up the income ladder. It’s been hitting middle income people hard for awhile, who are regularly foegoing some important medical treatments. It’s even starting to creep into the lower eschelons of high income people, who are being hit long waits for scarce services, and are also at risk for bankruptcy for some medical issues.

It’s a good example of how collapses happen. Not overnight, dramatic collapse of a structure. More like gangrenous flesh slowly rotting away until there’s nothing left. The collapse of US medicine comes in the form of “guess I’ll just die”

Commodification of health care was guaranteed to bring this sort of thing.

Yo if i ever am dying of an infection i’m sorry but i’m gonna be robbing a pharmacy. I already hate the pharmacy system and do not respect the idea that I need some dipshit with a degree sanctioning my ability to buy something, if i’m going to fucking die then yeah I’m taking what I need

Time and again I see people who have what I know to be fairly routinely urgent medical concerns that do get told by the ER that they have to wait for a specialist… 6+ months out.

Well, there goes my father’s reasoning against the universal healthcare that he wants. He keeps talking to all these retired Tory civil servants in anglophone countries and they always complain about the wait times. I keep saying to him: " We have the same wait times and we have to give them way more up front."

yeah, it’s crazy fucked. i have/have been on “good” US insurance plans for over a decade and my previous employer was also the hospital (a ranked university teaching hospital) and even being on the good insurance there, it takes several months to get an appointment after a referral for something that is generally regarded as serious/debilitating. the insurance and employer are always finding weird little ways to negotiate the insurance down and claiming to be cash strapped, but have constantly rotating fine art displays, a grand piano in the lobby with a professional musician during several of the working hours, and the finest recruitment displays, entire floors dedicated to billing/account specialists chasing payments, and god tier outsourced/fee based catering/food services. not to mention all the exec level people of this non-profit make absolutely unjustifiably huge salaries. also, no one could ever, ever tell you how much something was going to cost. it was always a mystery. i remember going through every hoop i could find to get prior authorization for oral surgery my in-network/in-house dentist said i needed. i spent days getting various offices to email things to each other and eventually the biller said the insurance company finally agreed to cover everything after my $75 outpatient surgical co-pay. what that means was, after i paid by $75 and got the surgery, months down the line i had to pay a bill for about $300. i called the surgery office and apparently that was a totally different fee that insurance never covers that nobody told me about. i complained to some friends and they all said that i got off easy and i must have really bothered them, because their “after action” bill was like $500-600 for the same surgery.

i bet if i hired a lawyer and sent threatening letters i could have gotten that taken off, but who the fuck has time, energy, and money for that? and what if the in-network provider/billing system decided to boot me because i engaged in legal action against them, then i’d really be fucked for everything else healthcare related.

i remember a friend of mine fucked his ankle up on the job and with this good insurance going through all the protocols, it took months to get his ankle imaged for a diagnosis. and THEN, the imagery was digitally sent to an outsource firm in south east asia (where M.D. labor is cheaper per hour) to get the diagnosis, which was then typed up and returned to the US where someone read it to him over the phone and scheduled treatment.

it would probably take 1000+ pages to identify all the ways in which any specific hospital in the US has been completely hollowed out from actually generating the value of public health and reoriented to the administrative bloat surrounding the pursuit of revenue streams.