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Our healthcare as a service is great. The problem is the cost and in some cases access related to cost.
The reason that we don't have real reform is that we don't have a real free market in the healthcare world.
Here are just a couple of things that hold it back:
1.Many insurance companies are only allowed to sell in specific areas. This often reduces competition and can raise the cost.
2. Big pharm has figured out ways to take advantage of the patent system (via lobbyists and other tools) so they can change outrageous prices for their medication. I use an inhaler that was first prescribed to me in 1978. Somehow that inhaler is still protected under the patent and there are no generics available for it.
3. Big pharm makes sure to put the squeeze on any kind of attempts to go around them. A few years ago there was a story in my local news about a guy who started business that helped people buy their medication online. He used a few different reputable online pharmacies and people would come in, he would help them create an account and order their meds and for this he would get a fee. He wasn't opened very long before he was forced out of business for violating various pharmacy laws.
4. Insurance companies stand to gain by having the cost of healthcare be very high. This allows them to scare people into making certain they have health insurance just in case something happens. If prices were low and reasonable, many people would just pay out of pocket and have no need for insurance.
5. General corruption among our elected officials. Healthcare companies spend a ton of money on lobbyists to get laws that benefit them passed. Many of those politicians who help those laws get passed end up with nice, high paying jobs in those big companies when they leave office.
These are just a few off the top of my head.
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