Why is American health care so expensive?

After 5 years of doing bedside ultrasound, I'm still excited about it. Bedside, or Point-of-Care ultrasound is using an ultrasound machine during the physical examination of a patient in order to make a diagnosis. I use a pretty tiny machine that fits in my pocket. As an internist who works in the hospital and in rural clinic outpatient settings, I get to use my ultrasound all the time, and it's still lots of fun. (For more on adventures in ultrasound see this  or  this  or  this .) Those of you who have read this blog for awhile can skip the intro and go to the cool cases. When I talk about it, most people who haven't already heard me wax eloquent say, "you mean you look at babies?" Ultrasound has been used as a bedside tool for looking at pregnant wombs for a very long time. It is extremely useful for that, since you can see if the baby is alive, about how old it is, whether their are two, what position it is in and a number of other useful things. I would n

The British National Health Service (NHS) was born in 1948, based on legislation passed that year mandating free high quality healthcare for all paid by taxes. In contrast, the US started Medicare in 1966 to provide healthcare to the elderly and the State Children's Insurance Program (SCHIP) in 1993 to fund healthcare for children whose parents were unable to afford it. Healthcare in the UK is still almost entirely funded by the government (through taxes, of course), which it is not in the USA. Britain is proud of the NHS, and rightly so. They have it figured out. Or so it would seem. Everyone can get care and nobody goes bankrupt because of huge medical bills. Brits do have to pay for prescriptions but everything costs the same, the equivalent of $11 per month. So why would the Economist, the global news magazine based in London, call it a mess? This article  says that the NHS is in trouble, and needs to learn some new tricks in order to stay effective. It turns out that Bri

A few months ago I had a clever idea about how my husband could use my cell phone in England, because getting cell phone service across the Atlantic can be expensive and inconvenient.   So I had this bright idea. I have an unlocked smartphone that I use in Africa or Haiti with a sim card that I can buy there cheaply and with no difficulty. T-mobile, the cellular phone provider that began as a German company and has provided competitive service in the US, advertised that their service would also work in the UK and Europe and that it would include unlimited data. Or something like that. It sounded great. I would just buy the T-mobile sim card in the drugstore here, get the service and be good to go. But not so fast. T-mobile does have the no fuss pre-paid option, but to get the international service requires a different plan, with a monthly fee. After attempting to do this online, then converting to the monthly service, nearly losing the money I had mistakenly spent on prepaid m