How Big Is the Underground Cost of Health Care?

I should preface this post by saying that it’s serious. This is not just a rant of some kind.

For some time I’ve been wondering about the cost of health care in the US vs. other similar countries. As we all know, the US has by far the highest cost among rich countries:

This is bad enough. But it includes only the money cost of professional health care provision. As such, it misses a big part of the picture.

I was finally prompted to write about this because I’ve had a higher than usual engagement with the health care system over the past few weeeks. It’s gone the way it always goes: it’s massively inefficient and prone to errors, most of which end up falling on patients to fix. There’s the hours spent on hold making appointments. There’s the constant checking for medication errors. There’s the endless arguing with insurance companies. There’s the back-and-forth process of telling doctors what some other doctor said because they never talk to each other. There’s the miscommunications caused by the fact that doctors typically know nothing about the actual operation of their own industry. Etc.

These are all things we’re familiar with, and they’re basically elements of the health care system that are outsourced to patients themselves. It never gets accounted for, but for all practical purposes the health care system relies on the unpaid labor of patients to keep itself in operation. It’s a real cost, but it’s hard to measure.

I have never seen a study that tries to compare this underground cost among countries. This makes me curious: Is the US system unusually inefficient? Does it produce more work for patients compared to other countries? Or is this just the nature of dealing with a big and highly complex industry?

It would be difficult to study, but probably worth it. Who would be a good candidate?

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Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

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And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

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WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

“Great journalism really does make a difference in this world: it can even save kids.”

That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

Wow.

And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

If you can, please support the reporting you get from Mother Jones—that exists to make a difference, not a profit—with a donation of any amount today. We need more donations than normal to come in from this specific blurb to help close our funding gap before it gets any bigger.

payment methods

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