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Medication in USA, it is interesting topic.  Shortage, No I have not experienced it.

Cost of medication, the label cost seems to be unreasonbly different. The same medicine made in US is sold in india for lot cheaper rate.

Dapagliflozin (forxiga) costs for 1 month supply around $550 in US and in india 1 year supply costs around $200 or so(The same medicine made in USA ).

Unless your insurance takes care of it, medication is not affordable in USA, but though on work visa's most of the time do have insurance and that takes care of it.  If your insurance is not good, then you get struck.

Fortunately, I did not need a lot of medicine. But the for ones I did, it s been a journey in itself understand the tiers for each drug  and how much a brand influences the price.

Never experienced a shortage, but I agree that if you do not have insurance you get easily stuck and no one will help. There is such a restriction on drugs that are common in other countries but no strict regulations when it comes to others that are actually important.

I would also mention the dosage. In the US I got several times, even at the dentist, this huge amount of anesthesia for example and could barely see and drive. Everything is very standardize and no one adjusts the standard to the patient (I assume from being afraid to get sued). There is so little prevention, most of the times I went to the doctor the main concern is how to get rid of the pain, not the actual cause of the pain. I understand in the US people believe it was not effective the visit unless they get out of there with medicine.

There is a lot of care when you first see a doctor, but way to many people involved in the process, which makes it very inefficient (a common visit would take up to 1.5-2 h) because one person gets your insurance info and then you wait, one person your blood pressure and then you wait, one person will welcome you in the room itself and then you wait, then you see the actual doctor and talk and then you wait again to be discharged.

I personally have started seeing doctors on Amwell -which is similar to facetiming with a doctor. Co pay is way less and it s quick. Now it only works for things where the doctor does not need to actually touch you, but still that cuts half of the visits.

Overall, the experience is that everyone is smiling and welcoming if you go with the system and have no understanding to ask questions. Once you are not in the standard rules, everything becomes complicated and you have to hold your ground so you don t get multiple xrays in the same week for the same issue, for example. The focus is on the business side of the medicine, not on the patient.

I cannot thank enough my mother that was a pharmacist and that helped me understand at a basic level how certain things works when it comes to health.