Some US markets have become so dysfunctional that they drag us down:

First and foremost:

Healthcare

The US is an outlier (in a bad way): highest healthcare cost, lowest longevity of all large industrialized countries:

Americans:

1. Spend 5.5%-8% more of GDP on healthcare than other major industrialized countries – that is at least $3,600 per person per year.
2. Live between 2.5 and 5.5 years shorter lives than citizens of those countries

Crunchicrant starts coverage of the healthcare market in the US [Healthcare market in the US] by describing some of the characteristics that make it dysfunctional and by offering up a strawman list of reforms [Healthcare market – how to fix it] that would address that dysfunction (a list that will doubtless change and become more sophisticated, over time).

Fixing the healthcare market is an opportunity for the country, lifting a burden that is dragging us down:

1. Healthcare costs directly impact how much money we earn, net – the healthcare insurance checks may be cut by companies (employer sponsored healthcare) or government (Medicaid, VA and Medicare), but employers first deduct the amount from our pay; the government by first taxing that pay.
   • _{Little anecdote: Crunchicrant, as an executive at a company in the early noughties, figured out what we could afford to give by way of an annual pay review increase – 2% or 3% typically – and waited for the result of  the healthcare insurance negotiation to know how much of that increase would be swallowed by healthcare costs and how much could be paid as salary increase. In every one of 4 straight years: all of it was swallowed by healthcare.   Health insurance increases were coming through at double % digits – the employees in the company paid the price.}
2. Healthcare costs make us un-competitive in any market exposed to foreign competition – that is manufacturing, especially. It is said that ‘healthcare’ is a bigger cost component of an American made automobile, than steel. Little wonder that manufacturing located in the US has struggled to compete.
3. If all that ‘economic waste’ were captured by the federal government, it could:

Cut federal taxes by one third

OR

Allow a public spending bonanza – all of these investments:

1. Maternity leave for a parent for 12 months – paid at minimum wage x 2
2. A $6,000 per year payment for all kids, 0-5, supporting child care/pre-school
3. A $12,000 per year subsidy for every person attending higher education
4. $1,000 per US person additional infrastructure investment

OR

Eliminate the entire fiscal deficit, and generate a surplus.

Fixing the US healthcare market could free up the resources we need to fix all of Crunchicrant’s big issues: our bankrupt social programs; the restoration of opportunity; tackling of the environment; and re-calibrating our security/defense posture to address modern risks that we confront.

Healthcare market – making it work