I think there's another culprit : not letting patients see a doctor, and the general quality of doctors.

I was admitted to the hospital recently at 2am with a stomach (I think) issue. It hurt like hell. This was in a big hospital in the middle of a huge city. It was extremely clear what the issue was, but without a doctor, policy is, no diagnosis will be made, and of course that means, you can't get so much as a drink of water, never mind medicine.

Of course, there was no doctor anywhere near me until well past 11am (effectively the day after). He did a blood test, which showed mild inflammation, and otherwise nothing. He gave the industrial strength version of an anti-inflammation med and some stomach drugs. An hour later, everything had disappeared.

Analyzing the situation, I can only conclude that the doctor only had a few negatives to go on, and that's why he took this action. It wasn't appendicitis. It (probably) wasn't acidosis (a leak in the stomach). It wasn't an actual wound, either visible or internal bleeding. It wasn't ... But zero positive diagnoses. So he gave something against stomach cramps and a milder painkiller, and patient (me) happily goes home, not because the pain stops but because I was unable to detect the pain any longer. I don't know how they work, but I am sure he gets to add 1 to his "patients cured" tab for the quarter and the government and my insurance (and me, of course) will get billed for that.

Needless to say, issue restarted the very next day. I still have no idea what the problem is, but why go back to the hospital or GP (GP is worse than hospital).

So you might wonder, what is done to someone who is admitted to the hospital with painful, but trivial complaints, to avoid having to allocate a doctor to them ? Well, large doses of morfine (enough that I couldn't walk without toppling) combined with other painkillers (not sure which). Because that's the only thing they have permission to do.

But this allowed me to put the pieces together of things I already knew : Unfortunately there are a ton of painful ailments (just wait until you're 45 and you pull your back. It will happen, I guarantee it. But there's stomach problems, there's hairline fractures (ouch), there's heart issues, there's blood vessel obstructions (ie. the dr. house problem), there's unfixed "mild" allergic reactions, ...). They won't entirely prevent you from moving or even working, but they hurt like hell, all the time 24x7x365. You'll find out that the pain easily exceeds what you can reasonably work with, even at a desk. But there is no obvious problem.

Pray tell, what is a patient supposed to do who fails to get a decent diagnosis, but has an unidentified long term painful ailment ? Other than getting strong painkillers on a regular basis ?

Of course, these people will fight for their painkillers.

But we, as a society, have decided that saving costs by sabotaging the training of physicians, resulting in far too few available physicians (and too incompetent), and even when you have a physician, they don't have easy access to diagnosis equipment, or labs. Everything has to be shared, accounted for, and nothing can be done by the doctor. It must all instead be done by people who, in the worst cases, have no knowledge of what they're doing beyond the safety instruction video (but even in the best cases never have a physician's knowledge). I am not against specialization, but having blood tests done by people who would not be able to recognize a heart attack from a test result is strictly not an efficient use of resources. It's killing people to save 5$.

The consequence of this is a LOT of older people undiagnosed, and utterly dependent on very strong painkillers.

I am also convinced we won't fix it.