[ExI] Why is “cost of living” such a big problem?

[Ben Zaiboc]

On 03/11/2026 16:23, spike wrote:
> Ben, our medicine costs a ton of money.  It is developed and qualified at enormous expense.


Yes, exactly.
Expense that other countries seem able to avoid.


> Other countries can duplicate the medication for low cost and buy the machines invented here.


Are you saying that the US is the only place in the world that medicines and medical equipment is developed, tested and approved?
It's not. It's just the most expensive place, and there's one reason for that: It generates massive profits:

"Yes, the U.S. healthcare system generates massive profits, with large health care companies returning 95% of their net income to shareholders over the past 20 years, totaling up to $2.6 trillion." (DuckDuckGo AI Search assistant)

"The U.S. health care system stands as a stark outlier among wealthy nations, with annual spending surpassing $17,000 per person—a figure that towers over counterparts in Europe and Canada, highlighting a deeper issue of prioritizing financial gain over patient well-being. This staggering statistic underscores a market-based, profit-driven model that often neglects the core purpose of health care. Unlike publicly oriented systems elsewhere, the American approach has entrenched corporate interests at the core of care delivery, creating a complex web of stakeholders focused on revenue rather than health outcomes.

This model is shaped by key players such as large insurers, hospital conglomerates, and vertically integrated corporations that dominate the industry landscape. These entities wield significant influence over access, pricing, and service availability, often sidelining patient needs in favor of shareholder returns. The contrast with other nations, where universal coverage and government oversight ensure broader access, highlights a fundamental divergence in philosophy about health care’s purpose." (https://healthpoint.com/public-policy/u-s-profit-driven-health-care-fails-costs-lives-and-money/)

https://www.uncovered.health/evidence/the-hidden-hands-in-healthcare-where-profits-are-really-going/

https://www.linkedin.com/pulse/profits-sickness-how-greed-drives-americas-healthcare-sharma-ron--fzpyc

"Health care in the USA: money has become the mission" (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01669-1/abstract)

https://thefulcrum.us/health/profits-over-patients-us-healthcare-system-costs-outcomes

"Who profits most from America’s baffling health-care system?" (https://strategichealthcare.net/wp-content/uploads/2024/02/10-08-23-Economist-Article-on-PBMs.pdf)

... and many many more.


The perception that "Massive Profits" are not only a good thing, but actually /necessary/ to drive healthcare is 180 degrees from reality. It's the massive profits to be made that is causing the problem in the first place. Yes, developing drugs is an expensive business (but rapidly getting cheaper to do, which will predictably NOT translate into cheaper drugs), but the US makes it as expensive as possible, and the results of that are clear to see: The poorest health outcomes in the entire developed world (and that's not as a result of americans being 'wealthy enough to afford bad habits'!).

-- 
Ben
"The world will not be destroyed by those who do evil, but by those who watch them without doing anything." - Pablo Casals, via Albert Einstein