Now that I don’t have employer-provided health insurance, I’m feeling the dysfunction of the healthcare industry in a new way. We pay about $8000 per year for health insurance that covers nothing until we pay $16,000. It’s basically a very expensive lottery ticket that keeps us from going bankrupt if we have a health catastrophe, but nothing more. Increasingly, we (collectively) have been seeing:
Outlandish costs
Healthcare quality is viewed as the lowest it has been in the past 25 years.
Supply chain disruptions of IV fluids, medications, gloves, masks, etc.
Overwhelmed clinics and ERs and hospitals at or above capacity.
An aging, sicker population
All of this, in addition of my experience over the past several years leads me to believe the healthcare sector is near collapse, if not collapsing now. Because of this, I wanted to learn more about collapse, in general, and collapse in the health care, specifically, from
, author of Collapse Curriculum, filmmaker, and wilderness survival instructor.We chatted a few weeks ago and I wanted to share that with you. I have included a few highlights below:
On collapse more generally:
If you're familiar with the Limits to Growth, the study that was published at MIT, that was 1972 when the book came out and they've done some follow-up studies to it. They did one at 50 years… It said, ‘What are the scenarios in which society would collapse in this century based on population growth, economic output or industrial output is how they characterize it. And then food supplies, material resources and pollution…For business as usual 2, they said, we'll just double that. We'll double the amount of resources that we'll extract compared to the past…So as the extraction peaks the population peaks, industrial output peaks, pollution peaks that's when we collapse in mid century.
On how Justin got interested in collapse:
There was a solar project and there was a wind project. These wind turbines would be 600 feet tall. You have golden eagles and bats and all kinds of different migratory birds that go through that area. They have to build these 25-foot roads, 25-foot wide areas that they just scrape for construction, and then there's all the other infrastructure, wires and stuff like that. Anyway, I never thought I would be opposing those kinds of projects, but it rapidly became me opposing renewable energy.
Unique aspects of collapse in healthcare:
Well, in general terms, I have a couple of thoughts. One is that, you know, supply chains, we've talked about that. And as well as like, it's highly technological based industry, right?…And, you know, and I think that's the first thing that comes to mind is financial collapse wrecking the medical industry as it is now anyways.
If the medical industrial complex collapses because of financial reasons, whether that's supply chains or capital, or even struggles or becomes inaccessible for most people because it's too expensive, then, people will need alternatives.
As the economy and the support of technological civilization, when that starts to collapse, which I believe it will, because it's unsustainable, then there's going to be certain things, like certain medications that some people rely on to live. And there's going to be certain surgeries…And so there might be things that just are out the window at some point. And then it becomes like a prioritization of what can we do and who can we help? And then, you know, what things are going to become part of normal reality again.
On allocation of scarce resources in healthcare:
I think that this is really where the intersection of politics and anything likethe medical industry becomes so clear and useful to look at because the response to a deteriorating society, a collapsing society, can go a lot of different ways. And one of them is fascism. And I think we already see that as a tendency.
On what skills and technologies become more important during collapse.
But then when we get into stuff that's a little bit more advanced, like medical skills and technology, what are things that can be preserved and or relearned even among medical professionals that are a backup system to the ones that could fail and I think that I'm sure they don't talk about that in the professional field but because no one thinks about what would happen if society collapsed.
Here are a few articles and topics that come up during our conversation:
Justin’s article about the types and stages of collapse.
I was wrong, the Department of Health and Human Services is able to track insurance company denial rates, but as far as physician and journalist, Elizabeth Rosenthal has found, they haven’t been doing so. Pro Publica writes more about this issue here. Rosenthal found that an insurer denied 49% of claims, but which insurer hasn’t been released. Surely, the public would be interested in avoiding such an insurer. The market forces would likely change the incentive to deny so many claims if that information was readily accessible to the public.
Justin was right, United Healthcare and AvMed denied about ⅓ of claims, with many other insurance companies having denial rates of 20-30%.
In a brief search, I was not able to find data on historical trends for health insurance claim denial rates.
Regarding the impact the wildfires in Los Angeles had on healthcare, multiple clinics closed, no hospitals closed, but several canceled elective procedures or postponed non-essential visitation.
After this interview,
shared his article about Emergency Physicians being crushed by a collapsing health system, so I'm not alone in feeling this is happening now.We had planned to discuss things that physicians and laypeople can do to help prepare for collapse, but didn’t make it there in our conversation. I hope to include a written interview or collaborative piece with Justin about that in the near future. If you have any questions about preparation for collapse of the healthcare system, I’d love to address them/include them in our discussion. Please comment below or email me.
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