How would you decrease the costs of healthcare?

[Blue3]

Besides subsidizing the costs of healthcare for individuals and families...
how would you actually decrease the costs of healthcare?





Why is this important?

The U.S. budget surplus changed to a deficit because:
-wars in Afghanistan and Iraq, unpaid for
-Medicare expansion, unpaid for
-Bush tax cuts, unpaid for
-the Financial Crash and Recession, and the temporary measures for recovery

The military budget in Afghanistan and Iraq is now a small fraction of what is used to be. Medicare expansion was paid for, and even more people have access to healthcare now, because of ObamaCare. The Bush tax cuts for the very rich were left to expire. The financial world has rebounded and the recession has been over for a while now, with unemployment rate back down too, even if it's not where it should be yet. The temporary measures taken in response to the crash and recession, like the bailouts and stimulus, were temporary and are no longer part of the deficit.

As a result, the budget deficit has significantly shrunk.

But the deficit still remains. And it's projected to grow again because of Medicare, with the retirement of more Baby Boomers and the high costs of healthcare. This is a structural problem in the deficit.






We can talk about single-payer healthcare all we want, but... regardless of whether you think it's a good or bad idea, that would just shift who's paying for the costs of healthcare. Hence the name. Sure, some administrative costs are projected to be eliminated due to improved efficiency, but not nearly enough.




We can talk about completely privatizing healthcare all we want, but,,, regardless of whether you think it's a good or bad idea, that would also just shift who's paying for the costs of healthcare. Sure, it wouldn't be a budget deficit problem for the government anymore, but it would still be a huge burden for individual and families, probably bigger than it already is now.




The actual problem seems, to me, to be figuring out how to actually decease the costs of healthcare. Make medicine less expensive. Make hospitalization less expensive. Make doctor visits less expensive. Make insurance less expensive.

So, how?






Some of my ideas (though my ideas shouldn't be the focus, I want to hear everyone's ideas)
*allow imported prescription drugs
*allow Medicare to negotiate for cheaper drug prices
*prevent drug companies from blocking generic drugs
*medical malpractice reform
*find ways to decrease the costs of college too, so doctors/nurses/etc. don't need to be paid so much just to pay back their student loans

[🦀🎂🦀🎂]

[Murica!]

Democratic ownership of healthcare services by the healthcare workers themselves.

[SWE]

Abolish capitalism

[FEMA Camp Administrator]

Lower prices.

[angus]

I had my first surgery about four years ago.  I was on a boat in the Caribbean, in the Straits of Cozumel about two miles off the coast of mainland Mexico, and I bent down to rinse my mask off in the sea.  This was something I had done a thousand times before.  I was wearing about fifty pounds of gear:  tanks, weights, BCD, fins, flashlights, etc.  As I put my knee down and turned to bend toward the water, we hit a big wave.  Bam!  A searing pain shot up through my leg.  I may have winced but I doubt it.  I remember that I bit my lip to keep from showing any pain.  They always tell you not to dive if you're sick or in pain, and I knew that the captain or the divemaster would not let me go if I showed any pain.  I sucked it up and said, "estoy bien" or something like that and took a giant stride off the back of the vessel and enjoyed my dive.  I was finning with only one fin, because it hurt to move my right leg, and so I was sort of going in circles, but it was fun.  We dived on a sunken tugboat, and I enjoy penetrating as much as I can on submerged vessels.  Lots of reef fish and a few fairly large pelagic fish, with some recent coral and sponge growth. 

When the dive was over and I got back to the condo we had rented, my wife noticed my limp.  I told her what had happened and she insisted that I seek medical attention.  As it happened, there was a diving specialty clinic about two blocks from where we were staying, so we walked there.  When we arrived, I told the receptionist/nurse that I had a great sadness in my little squirrel.  She looked at me with a strange look, and then I understood my mistake and immediately became very embarrassed.  (Those who speak spanish will appreciate the mistake.)  Then I said, very clearly, that I had great pain in my knee.  She explained that el medico had an emergency last night, and was out until about 3AM, so even though the clinic was open, she did not expect him until later.  She gave me some good advice, most of which I followed, and I tried to enjoy the rest of our vacation.  Luckily, this happened about two and a half weeks into a three-week vacation.

Upon my return to the United States, I went to the clinic a few blocks from our house and saw the general practicioner there.  He ordered an X-ray, even though I assured him that there were no broken bones or anything else that would show up in an X-ray.  He then explained that there was probably some ligament damage--actually he narrowed it down to three, and explained the possibilities in some detail--and said that if I were a septegenarian he would advise me to live with it, but if I were an NFL starting quarterback, I'd be ready to play by next week.  I was somewhere in-between, and I'd have to decide how much I wanted to do.  I couldn't even extend my leg fully!  Surely this will not work for me.  It just doesn't suit my lifestyle. 

I decided to see an orthopedic surgeon.  Not having any experience in this arena, I talked to my neighbor Carol, asking her for a recommendation.  She was about eighty years old and probably knew all the physicians and specialists.  Also she was very, very picky--I've seen her fire landscapers for choosing the wrong type of woodchips--so I thought that anyone that she would recommend would be really experienced and effective.  She recommended Chris X.  (Let us leave his last name out.)  He's wonderful, she said.  Well, if Carol recommends him, then he must be good.

It turned out that Chris X. was very popular.  I had to wait almost a month for an appointment with him.  Finally, when I saw him, he ordered an X-ray.  An X-ray?  I just had one.  Can't you get it from the other place?  No, he needed his own X-ray.  Then he ordered an MRI.  Ever had one of those?  Really loud, really weird.  Neither the X-ray nor the MRI showed what was wrong.  But Chris knew what he was doing.  He told me what he thought was wrong--I would later learn that a football injury when he was 16 caused exactly the same problem for him and it was what inspired him to go into orthopedic surgery.  He said he wouldn't know for sure till he got inside, so we set a date for surgery.  I was a terrible patient.  Impatient is probably a better word for it.  I was rude to the nurses and the technicians, but to be fair the had me disrobe and put on a little dress that tied in the back, then they shaved my leg.  Well, a part of it anyway.  I never felt so emasculated in all my life.  (One high point was that my neighbor, Luis, showed up.  Apparently he was the anesthesiologist on call that day.  I felt comforted when I saw a familiar face.  I had been stuck and had a manifold already and when I saw him put a needle in a jar and asked him what it was, he said, "It's propyphol?  Ever heard of that?"  I said, "no."  He then said, "That's what killed Michael Jackson."  That was the last thing I remember.  Then I woke up and saw that it was 9:30AM.  Two hours later!  For me it was like an instant.  No REM sleep, no dreams, just an instant later it was two hours later and I was in another room.  Really, really weird.  But I digress...

Long story short, Chris was spot on.  He called it.  They made two little holes in my leg--you can't even see them now--one was for a crow bar and a camera, and the other was for a sewing needle and pick.  They pried the bones apart and took some photos.  Later Chris emailed them to me.  Apparently my medial meniscus was torn.  They removed about 20% of it and it will never grow back, but I'm 100% recovered now.  I can run and jump and ride a bicycle and swim.  And there are no scars.  Modern medicine is definitely amazing.  And expensive, apparently. 

Afterward, I saved the bills.  I reckoned that the whole thing cost about $2600, at least on paper.  My out-of-pocket expense was much lower, of course.  Around 35 dollars as I recall.  But the bills were very, very detailed.  One from the X-ray specialist.  One from the MRI people.  One from the GP.  One from the orthopedic specialist.  One from the therapist.  One from the hospital.  Etc., etc.  And they were all very, very detailed.  It had line-item explanations with costs.  One agent apparently asked my insurance company for $301.52 for a certain service or product, and my insurance company would write them back and say, "Well, we think that is only worth $162.57, of which we will pay $159.98," so I would get a bill for $2.59 for that, and every little item was like that.  2600 dollars worth of charges went back and forth between many medical service industry agents and my various insurance agents, and they'd agree on a price, of which I'd pay a tiny fraction.  How many man-hours went into this billing procedure?  How many clerks and postal agents were involved in the transfer of all this information?  And how many X-rays does it take to tell a man who is certain that he has no broken bones that he has no broken bones?  It's all very wasteful. 

Well, at least I have some really cool images of the inside of my right knee, both before and after the surgery.  I posted them on Facebook, of course.

[TNF]

Abolish capitalism

[PJ]

Healthcare should be socialized along the lines of the Cuban model and be free from the point of usage.

[VPH]

Well, aside from a single payer system, other fixes may include:
-Direct government negotiation with drug companies
-An audit and crackdown on waste in medicare
-Taking big pharma's money out of politics
-Emphasizing preventive care/education to lessen issues with obesity, diabetes, etc
-Allowing importation and sale of cheaper medicines from Canada
-Changing patent laws to prevent overpricing by threatening companies with a loss of the 20 year rights if they charge too much (Art Gardner's idea. Read more here: http://politics.blog.ajc.com/2014/05/03/an-exit-visa-out-of-bumper-sticker-land-perhaps-past-obamacare/)

[Blue3]

Any other ideas?

[Antonio the Sixth]

I had my first surgery about four years ago.  I was on a boat in the Caribbean, in the Straits of Cozumel about two miles off the coast of mainland Mexico, and I bent down to rinse my mask off in the sea.  This was something I had done a thousand times before.  I was wearing about fifty pounds of gear:  tanks, weights, BCD, fins, flashlights, etc.  As I put my knee down and turned to bend toward the water, we hit a big wave.  Bam!  A searing pain shot up through my leg.  I may have winced but I doubt it.  I remember that I bit my lip to keep from showing any pain.  They always tell you not to dive if you're sick or in pain, and I knew that the captain or the divemaster would not let me go if I showed any pain.  I sucked it up and said, "estoy bien" or something like that and took a giant stride off the back of the vessel and enjoyed my dive.  I was finning with only one fin, because it hurt to move my right leg, and so I was sort of going in circles, but it was fun.  We dived on a sunken tugboat, and I enjoy penetrating as much as I can on submerged vessels.  Lots of reef fish and a few fairly large pelagic fish, with some recent coral and sponge growth. 

When the dive was over and I got back to the condo we had rented, my wife noticed my limp.  I told her what had happened and she insisted that I seek medical attention.  As it happened, there was a diving specialty clinic about two blocks from where we were staying, so we walked there.  When we arrived, I told the receptionist/nurse that I had a great sadness in my little squirrel.  She looked at me with a strange look, and then I understood my mistake and immediately became very embarrassed.  (Those who speak spanish will appreciate the mistake.)  Then I said, very clearly, that I had great pain in my knee.  She explained that el medico had an emergency last night, and was out until about 3AM, so even though the clinic was open, she did not expect him until later.  She gave me some good advice, most of which I followed, and I tried to enjoy the rest of our vacation.  Luckily, this happened about two and a half weeks into a three-week vacation.

Upon my return to the United States, I went to the clinic a few blocks from our house and saw the general practicioner there.  He ordered an X-ray, even though I assured him that there were no broken bones or anything else that would show up in an X-ray.  He then explained that there was probably some ligament damage--actually he narrowed it down to three, and explained the possibilities in some detail--and said that if I were a septegenarian he would advise me to live with it, but if I were an NFL starting quarterback, I'd be ready to play by next week.  I was somewhere in-between, and I'd have to decide how much I wanted to do.  I couldn't even extend my leg fully!  Surely this will not work for me.  It just doesn't suit my lifestyle. 

I decided to see an orthopedic surgeon.  Not having any experience in this arena, I talked to my neighbor Carol, asking her for a recommendation.  She was about eighty years old and probably knew all the physicians and specialists.  Also she was very, very picky--I've seen her fire landscapers for choosing the wrong type of woodchips--so I thought that anyone that she would recommend would be really experienced and effective.  She recommended Chris X.  (Let us leave his last name out.)  He's wonderful, she said.  Well, if Carol recommends him, then he must be good.

It turned out that Chris X. was very popular.  I had to wait almost a month for an appointment with him.  Finally, when I saw him, he ordered an X-ray.  An X-ray?  I just had one.  Can't you get it from the other place?  No, he needed his own X-ray.  Then he ordered an MRI.  Ever had one of those?  Really loud, really weird.  Neither the X-ray nor the MRI showed what was wrong.  But Chris knew what he was doing.  He told me what he thought was wrong--I would later learn that a football injury when he was 16 caused exactly the same problem for him and it was what inspired him to go into orthopedic surgery.  He said he wouldn't know for sure till he got inside, so we set a date for surgery.  I was a terrible patient.  Impatient is probably a better word for it.  I was rude to the nurses and the technicians, but to be fair the had me disrobe and put on a little dress that tied in the back, then they shaved my leg.  Well, a part of it anyway.  I never felt so emasculated in all my life.  (One high point was that my neighbor, Luis, showed up.  Apparently he was the anesthesiologist on call that day.  I felt comforted when I saw a familiar face.  I had been stuck and had a manifold already and when I saw him put a needle in a jar and asked him what it was, he said, "It's propyphol?  Ever heard of that?"  I said, "no."  He then said, "That's what killed Michael Jackson."  That was the last thing I remember.  Then I woke up and saw that it was 9:30AM.  Two hours later!  For me it was like an instant.  No REM sleep, no dreams, just an instant later it was two hours later and I was in another room.  Really, really weird.  But I digress...

Long story short, Chris was spot on.  He called it.  They made two little holes in my leg--you can't even see them now--one was for a crow bar and a camera, and the other was for a sewing needle and pick.  They pried the bones apart and took some photos.  Later Chris emailed them to me.  Apparently my medial meniscus was torn.  They removed about 20% of it and it will never grow back, but I'm 100% recovered now.  I can run and jump and ride a bicycle and swim.  And there are no scars.  Modern medicine is definitely amazing.  And expensive, apparently. 

Afterward, I saved the bills.  I reckoned that the whole thing cost about $2600, at least on paper.  My out-of-pocket expense was much lower, of course.  Around 35 dollars as I recall.  But the bills were very, very detailed.  One from the X-ray specialist.  One from the MRI people.  One from the GP.  One from the orthopedic specialist.  One from the therapist.  One from the hospital.  Etc., etc.  And they were all very, very detailed.  It had line-item explanations with costs.  One agent apparently asked my insurance company for $301.52 for a certain service or product, and my insurance company would write them back and say, "Well, we think that is only worth $162.57, of which we will pay $159.98," so I would get a bill for $2.59 for that, and every little item was like that.  2600 dollars worth of charges went back and forth between many medical service industry agents and my various insurance agents, and they'd agree on a price, of which I'd pay a tiny fraction.  How many man-hours went into this billing procedure?  How many clerks and postal agents were involved in the transfer of all this information?  And how many X-rays does it take to tell a man who is certain that he has no broken bones that he has no broken bones?  It's all very wasteful. 

Well, at least I have some really cool images of the inside of my right knee, both before and after the surgery.  I posted them on Facebook, of course.

Tldr

[True Federalist (진정한 연방 주의자)]

This should work:

https://www.youtube.com/watch?v=LSUAAKFLoL0

[TNF]

socialize the entire medical sector, including big pharma

[bedstuy]

You can't lower costs by making something free.  Come on. 

But, the problem with healthcare is basically three things.  It's an aging population, monopolies and the over-use of medicine as opposed to healthcare. 

You can't really do anything about an aging population.  Except there are things on the margin like so-called death panels, aka conferences with your doctor when you're about to die.  People need to be better informed about end of life care and whether it's worth it to spend $400k to live an extra 2 weeks in extreme pain.

We have a system where doctors and health providers get paid when they provide medicine, procedures, surgeries, devices, etc.  So, we over-incentivize medicine, procedures, surgeries, etc.  For that reason, we give people tons of unnecessary healthcare for no good reason.  On top of this, normal economic competition doesn't happen because people lack information and the ability to choose.  Here's a great article that explains this point: http://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

The final thing is the big monopoly problem.  The medical profession is a monopoly that prevents new medical schools from opening to protect doctor salaries and keep them artificially high.  Big Pharma is a big oligopoly.  And, within each area of the county, a few big providers/health systems and insurance companies are usually monopolistic.  You have to get control of those monopolies and professional cartels with better regulation.

Basically, we need a basic health insurance that provides access to very cost-conscious care provided more by nurses and lower-credentialed health professionals as a basic line of defense.  That ought to be free to everyone, no exceptions.  Then, you have Obamacare type exchanges for supplemental insurance that provides more care.  This ought to provide tons of information about providers, cost, patient reviews and outcomes.  Finally, you find a way to deal with the monopolies, either by breaking them apart or some other sensible regulation.

[Blue3]

Free Healthcare, provided by the government. Drug expenses brought down through government subsidies.

You didn't read the OP...

[Antonio the Sixth]

socialize the entire medical sector, including big pharma

This.

[DC Al Fine]

You can't lower costs by making something free.  Come on. 

But, the problem with healthcare is basically three things.  It's an aging population, monopolies and the over-use of medicine as opposed to healthcare. 

You can't really do anything about an aging population.  Except there are things on the margin like so-called death panels, aka conferences with your doctor when you're about to die.  People need to be better informed about end of life care and whether it's worth it to spend $400k to live an extra 2 weeks in extreme pain.

We have a system where doctors and health providers get paid when they provide medicine, procedures, surgeries, devices, etc.  So, we over-incentivize medicine, procedures, surgeries, etc.  For that reason, we give people tons of unnecessary healthcare for no good reason.  On top of this, normal economic competition doesn't happen because people lack information and the ability to choose.  Here's a great article that explains this point: http://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

The final thing is the big monopoly problem.  The medical profession is a monopoly that prevents new medical schools from opening to protect doctor salaries and keep them artificially high.  Big Pharma is a big oligopoly.  And, within each area of the county, a few big providers/health systems and insurance companies are usually monopolistic.  You have to get control of those monopolies and professional cartels with better regulation.

Basically, we need a basic health insurance that provides access to very cost-conscious care provided more by nurses and lower-credentialed health professionals as a basic line of defense.  That ought to be free to everyone, no exceptions.  Then, you have Obamacare type exchanges for supplemental insurance that provides more care.  This ought to provide tons of information about providers, cost, patient reviews and outcomes.  Finally, you find a way to deal with the monopolies, either by breaking them apart or some other sensible regulation.

Basically this.

The only thing I'd add is that a focus on more/better palliative care would help quite bit. So much money is spent painfully treating people who are going to die shortly anyway. At that point we could provide better healthcare by trying to make such patients as comfortable as possible as they die.

Of course I have no idea how to make more people get palliative care that doesn't involve wholesale culture change, callous pricing methods, or creepy bureaucracy.

[Blue3]

Hillary Clinton just announced her plans on this, which includes importing pharmaceuticals and allowing Medicare to bargain, among other things.

http://www.reuters.com/article/2015/09/22/us-usa-election-clinton-idUSKCN0RM08D20150922

[/]

By being Bernie Sanders.

Also:

[Blue3]

So this is back in the news as a major issue in Democratic Party politics... any new ideas?

[DavidB.]

I had my first surgery about four years ago.  I was on a boat in the Caribbean, in the Straits of Cozumel about two miles off the coast of mainland Mexico, and I bent down to rinse my mask off in the sea.  This was something I had done a thousand times before.  I was wearing about fifty pounds of gear:  tanks, weights, BCD, fins, flashlights, etc.  As I put my knee down and turned to bend toward the water, we hit a big wave.  Bam!  A searing pain shot up through my leg.  I may have winced but I doubt it.  I remember that I bit my lip to keep from showing any pain.  They always tell you not to dive if you're sick or in pain, and I knew that the captain or the divemaster would not let me go if I showed any pain.  I sucked it up and said, "estoy bien" or something like that and took a giant stride off the back of the vessel and enjoyed my dive.  I was finning with only one fin, because it hurt to move my right leg, and so I was sort of going in circles, but it was fun.  We dived on a sunken tugboat, and I enjoy penetrating as much as I can on submerged vessels.  Lots of reef fish and a few fairly large pelagic fish, with some recent coral and sponge growth. 

When the dive was over and I got back to the condo we had rented, my wife noticed my limp.  I told her what had happened and she insisted that I seek medical attention.  As it happened, there was a diving specialty clinic about two blocks from where we were staying, so we walked there.  When we arrived, I told the receptionist/nurse that I had a great sadness in my little squirrel.  She looked at me with a strange look, and then I understood my mistake and immediately became very embarrassed.  (Those who speak spanish will appreciate the mistake.)  Then I said, very clearly, that I had great pain in my knee.  She explained that el medico had an emergency last night, and was out until about 3AM, so even though the clinic was open, she did not expect him until later.  She gave me some good advice, most of which I followed, and I tried to enjoy the rest of our vacation.  Luckily, this happened about two and a half weeks into a three-week vacation.

Upon my return to the United States, I went to the clinic a few blocks from our house and saw the general practicioner there.  He ordered an X-ray, even though I assured him that there were no broken bones or anything else that would show up in an X-ray.  He then explained that there was probably some ligament damage--actually he narrowed it down to three, and explained the possibilities in some detail--and said that if I were a septegenarian he would advise me to live with it, but if I were an NFL starting quarterback, I'd be ready to play by next week.  I was somewhere in-between, and I'd have to decide how much I wanted to do.  I couldn't even extend my leg fully!  Surely this will not work for me.  It just doesn't suit my lifestyle. 

I decided to see an orthopedic surgeon.  Not having any experience in this arena, I talked to my neighbor Carol, asking her for a recommendation.  She was about eighty years old and probably knew all the physicians and specialists.  Also she was very, very picky--I've seen her fire landscapers for choosing the wrong type of woodchips--so I thought that anyone that she would recommend would be really experienced and effective.  She recommended Chris X.  (Let us leave his last name out.)  He's wonderful, she said.  Well, if Carol recommends him, then he must be good.

It turned out that Chris X. was very popular.  I had to wait almost a month for an appointment with him.  Finally, when I saw him, he ordered an X-ray.  An X-ray?  I just had one.  Can't you get it from the other place?  No, he needed his own X-ray.  Then he ordered an MRI.  Ever had one of those?  Really loud, really weird.  Neither the X-ray nor the MRI showed what was wrong.  But Chris knew what he was doing.  He told me what he thought was wrong--I would later learn that a football injury when he was 16 caused exactly the same problem for him and it was what inspired him to go into orthopedic surgery.  He said he wouldn't know for sure till he got inside, so we set a date for surgery.  I was a terrible patient.  Impatient is probably a better word for it.  I was rude to the nurses and the technicians, but to be fair the had me disrobe and put on a little dress that tied in the back, then they shaved my leg.  Well, a part of it anyway.  I never felt so emasculated in all my life.  (One high point was that my neighbor, Luis, showed up.  Apparently he was the anesthesiologist on call that day.  I felt comforted when I saw a familiar face.  I had been stuck and had a manifold already and when I saw him put a needle in a jar and asked him what it was, he said, "It's propyphol?  Ever heard of that?"  I said, "no."  He then said, "That's what killed Michael Jackson."  That was the last thing I remember.  Then I woke up and saw that it was 9:30AM.  Two hours later!  For me it was like an instant.  No REM sleep, no dreams, just an instant later it was two hours later and I was in another room.  Really, really weird.  But I digress...

Long story short, Chris was spot on.  He called it.  They made two little holes in my leg--you can't even see them now--one was for a crow bar and a camera, and the other was for a sewing needle and pick.  They pried the bones apart and took some photos.  Later Chris emailed them to me.  Apparently my medial meniscus was torn.  They removed about 20% of it and it will never grow back, but I'm 100% recovered now.  I can run and jump and ride a bicycle and swim.  And there are no scars.  Modern medicine is definitely amazing.  And expensive, apparently. 

Afterward, I saved the bills.  I reckoned that the whole thing cost about $2600, at least on paper.  My out-of-pocket expense was much lower, of course.  Around 35 dollars as I recall.  But the bills were very, very detailed.  One from the X-ray specialist.  One from the MRI people.  One from the GP.  One from the orthopedic specialist.  One from the therapist.  One from the hospital.  Etc., etc.  And they were all very, very detailed.  It had line-item explanations with costs.  One agent apparently asked my insurance company for $301.52 for a certain service or product, and my insurance company would write them back and say, "Well, we think that is only worth $162.57, of which we will pay $159.98," so I would get a bill for $2.59 for that, and every little item was like that.  2600 dollars worth of charges went back and forth between many medical service industry agents and my various insurance agents, and they'd agree on a price, of which I'd pay a tiny fraction.  How many man-hours went into this billing procedure?  How many clerks and postal agents were involved in the transfer of all this information?  And how many X-rays does it take to tell a man who is certain that he has no broken bones that he has no broken bones?  It's all very wasteful. 

Well, at least I have some really cool images of the inside of my right knee, both before and after the surgery.  I posted them on Facebook, of course.

Just being curious, how long did this take you?

[Oldiesfreak1854]

Open up the markets and allow insurance companies to compete across state lines.

[🦀🎂🦀🎂]

invest in social services, preventative care etc.

[Blue3]

Any new thoughts on this?

I posted one in the US General Discussion... but a new idea could be that the government limits the amount you can spend on healthcare to 10% of income.