The primary issue in healthcare is demographic collapse.
Healthcare is collapsing for a number of reasons, but chiefly because governments have refused to pay attention to the population pyramid for the last 20 years. We are now at the crossroads of increased numbers of patients, and decreased staff levels, both due to the same dynamic. For example, in Canada in 1950, we had 27.04 live births per 100000, by 2000, that was down to 11.1. Over the period of 1960 to 2022, the percentage of folks over 65 has gone from 7.7% to 18.1%. I would expect similar changes in the US population. In addition, health authorities have attempted to save money by reducing staff. The primary tool has frequently been to offer early retirement. COVID encouraged many others to cash out and stop working.
We have ignored the increased demand for long term care which has caused people to remain in hospital as they have nowhere to go. When I started my current job, we were 1600 LTC beds short inside the city limits. It is now estimated that that number has risen to 2400. This for a city that has about 2000 in-patient hospital beds. The knock on effect is that patients can't be admitted from ER, which in turn causes waiting rooms to back up. On the surgical side, the increased demand (need) for hip and knee surgery, coupled with COVID, has created significant increase in morbidity, which then has a knock on effect on primary and urgent care providers. Admittedly, I'm not sure how the other surgical services are impacted. Add to the mix the effect of the obesity, diabetes, cardiac disease in the last 50 years, and it becomes a crushing problem.