Health Care – Personal and US

I looked down at my right calf and thought to myself, “wow, he just cut a hole in my leg, that’s cool”. Normally I am not that laidback when having a medical procedure, but the nurse had given me a Xanax a few minutes before the procedure. I understand why Xanax is addictive, but it certainly brings out the mellow in a day.

When the Doctor walked in I said, “Doctor, give me a it to me straight, what’s the survival rate on this procedure?” He just looked at me, the nurse said no one dies from this. Ok, interesting, I could be the first. In the interests of full disclosure, when the Doctor made the next hole I did say “SOB, that really hurt”. Xanex can only take you so far.

I’ve had problems with my right calf for years, but as long as I could bike, hike, and play pickleball I did the guy thing and just ignored it. However, last fall I got a pretty bad inflection in it and the Dermatologist said had to get treated. I thought it was related to my ongoing kidney infection, but actually was due to a pretty seriously blood clot I developed after biking across Iowa years ago. I was doing the RAGBRAI which is the largest bike tour in the world and decided to do the last two days in one, about 130+ miles and then drove back to Fargo.

The day after ride I developed significant pain in my right leg which as every guy understands, I ignored. My wife kept telling me to see a Doctor but I said it was just a muscle pull. After a couple of days I called my friend from college who was also my chiropractor who told me I had a blood clot you dumb S and go to the Doctor. Fun fact, if you ignore your wife and listen to your friend, the statute of limitations is forever. Anyway, I did have a clot and the initial treatment did not work so I was back in the ER two weeks later. After doing the scan, the technician told me I could not walk back to the ER as the clot was sitting on top of an artery and it went any farther, lights out. I thought to myself, if I die right now that’s going to ruin my wife’s weekend, however, on the plus side I won’t have to do any of the stuff she has planned. I would have the perfect excuse.

Anyway, under the influence of the Xanex, I found myself thinking about health care, personal and societal. This will sound arrogant and it is, but I have never met anyone who I thought knew more about state of health care in the US. Many who know about one part or more, but none about the big picture of US health care. I have been an employee receiving health care as an employee benefit. I have been an employer providing health care at no cost to my employees. Health care is a major risk management issue for clients of financial planning firms like mine. I had clients who had to take early withdrawals from their retirement assets to pay for health care. Now I am on Medicare and Medicare Supplement. I have had five nephrologists, multiple cardiologists, several GPs, oncologists, dermatologists, and now vascular clinics along with orthopedic clinic along with numerous urgent care visits and a few ER visits.

I have seen a lot of sides of US health care in several different states. My current AZ GP and specialists are all outstanding. In fact, I would say the vast majority of health care providers I have met over the years ranging from support staff to nurses to specialists have been excellent. Knowledgeable and professional along with dedicated to their patients. Yes, I have had a couple of experiences over the years which were not acceptable. And I have a couple of friends who were initially misdiagnosed by one or more staff members at a provider. This is never acceptable but I find it to be rare.

I do believe that the majority of complaints about health care I hear in AZ or anyplace are not really about the quality of health care but the US system of health care. Following are some facts:

• In 2024 the per capital cost of health care in the US was $14,775. This is almost a 100% higher than the average of other developed countries. For example, Canada is $7,301.
• For those on Medicare the per capita cost is almost $18,000 annually. Medicare beneficiaries pay 15% of total Medicare costs. Payroll taxes pay 34% of total Medicare costs and the balance is paid out of General Revenues.
• The CEO World Health Care Index ranked US health care as 15th in the world. Canada is ranked 4th by comparison.
• Health care is a leading cause of bankruptcy in the US. Over 40% of Americans have health care debt with 62 million Americans having debt that is past due or they cannot pay. A health care system that forces Americans to go into debt and/or bankruptcy is a failure.
• The Yale School of Medicine published a research paper in February, 2025 on profits in health care. They found over the past 20 years, health care companies spent 95% of their net income on shareholder payouts, totaling up to $2.6 trillion. Note in 2023 of the $5 trillion spent by the US on health care roughly 70% was funded one or another by taxpayer money. In short, tax payers pay for most of the health care costs while the net income from health care goes to stock holders, not back into health care.

The US is the only developed country in the world which does not have universal health care. This a primary reason why US health care is substantially more expensive and less effective than health care in other developed countries.

One of the by products of the chaos we now call the federal government, is rather then making our health care system more efficient and cost effective, we have done just the opposite. The recent cuts in subsidized health care for millions of people will not change the per capita cost of health, it will lead lower quality or no health care for low income Americans which will increase the deaths from lack of health care. In 2025 18 rural hospitals closes while more cut health care services. It is estimated that up over 400 rural hospitals may be closed due other budget cuts which again means the access to health care in rural will decrease significantly.

I am pretty sure I am alive because of the health care I have had over the years. My second nephrologist probably saved my life. The specialist who treated my blood clot years ago as was the vascular specialist who just treated the after effects were both excellent. There was a long time period when my heart rate was over 240 beats a minute when I work out. Thanks to my cardiologists, expecially my AZ one, it does not do that any more. I am also blessed that my little firm was sufficiently profitable to afford the highest quality health insurance for myself and family.

Now I am on Medicare and Medicare Supplement and can afford all the costs that are not covered by insurance. But many Americans, if not the majority cannot.

We can reduce the per capital cost of health care, make it both more affordable and more efficient. And that starts with Universal health care including a system that eliminates duplication and administration whose purpose is to deny claims. In short, eliminate for profit health care. Companies that develop better systems or treatments certainly should be for profit, but health care should not.

When I vote, health care is a top five issue for me, I would suggest that be true for all voters.