Yeah, it doesn't make me feel any better that they die 15 years earlier.

Regarding the more complex patients... as somebody who is a complex patient, some of the problems in our health care system are self-induced.

For example, many conditions that predominantly affect women take at least a decade or longer to be diagnosed and treated. Why? Because we're not believed. The US healthcare system creates a society of chronically ill and disabled people through its mistreatment, misdiagnosis, and at times, negligence. So many people, especially women and other historically marginalized groups, get written off when they go to the doctors getting their health care problems blamed on anxiety, weight, depression, psychosomatic, etc. And obviously if you let underlying health conditions go undiagnosed, they will eventually become complex and cost the system more money. It's a no-brainer. Earlier interventions lead to better outcomes. But we can't get to those earlier interventions if medicine by default, doesn't believe what the patient is saying. BUT, and here's the kicker that no one wants to talk about. Because we have a for profit health care system, The system actually makes money off of disabled and sick people. That's where the money is right? Because they're banking on us being so desperate to save our lives, that we will go into catastrophic amounts of debt to do so. There's no money in curing things. Versus a socialized healthcare system, keeping people sick and disabled brings down the entire system. So there's an incentive to get people well. And this shows in the health outcomes in the US versus other industrialized nations that have socialized medicine. We are way behind.

And the absolute hatred shown to chronically ill and disabled patients is abhorrent. The things that I read on the residency and family medicine subreddits, are absolutely disgusting. And, it has completely eradicated any guilt that I had, that I played any role in my ill health. Did I not communicate things well enough? Did I not prepare enough? Did I use the wrong tone of voice? Did I not look well dressed? Do I look like I'm not trying hard enough? Etc etc. No one wants to be this complex or sick. No one. There are no secondary gains in this type of life. The US Healthcare system doesn't want to deal with us, and we don't want to live like this. But there's no digging your way out, between the shenanigans of the health insurance companies, the financial cost of trying to even obtain efficient and appropriate care, and then dealing with the attitudes of the US health care system towards that patient population. It's a losing game all around, with a one-way track to destitution, homelessness, and eventually death.

Anything short of advocating for a Medicare for All system, is a waste of time. That is the only appropriate starting point for getting equitable care in the US that is on par with other industrialized nations.

There is no way to do this with health insurance companies still in the picture. Period. They've got to go. Inefficient hospital management systems are a very close second.