When Medical Debt Collectors Decide Who Gets Arrested

There's no such thing as a healthcare system where nobody profits in some way. Lots of people working in "non-profit" organizations are still lining their pockets.

> A Bismarck system (nonprofit govt sponsored insurance companies that all charge the same and are taken by all doctors) would be fine too, but that's not on the table in the US

You must be alluding to the German system. We actually have two-class healthcare: Private insurance for those who are self-employed or who earn well enough to afford it and public insurance for everyone else (15% of income).

Those with private insurance get preferred treatment at almost any level, because while price controls exist for both public and private treatment, the amount of money doctors get for public patients is a joke.

It doesn't stop there of course, salaries for all healthcare workers are extremely low, as is the budget for cleaning personnel. Pretty disgusting, but also dangerous. Our rates of MRSA are extremely high, for instance.

Lots of German healthcare workers are moving to Switzerland (private system, but compulsory), being replaced by Eastern-Europeans. That doesn't bother me per se, but if we didn't have that kind of cheap labor, the system would just collapse.

In effect, I can tell you how to get "affordable" healthcare, whether it is public or private: Just pay your healthcare workers dramatically less money. Instate price controls. You'll have a lot of frustrated workers in a system constantly working at the brink of collapse, but it does work.

I'm a fan of people being allowed to sell medical services regardless of qualifications, BUT being required to explicitly state and advertise their (lack of) qualifications. Have more continuous rather than binary qualifications too.

That would drive prices down for the poorest, allowing them to purchase healthcare, while not really affecting the rest of us who can afford the inflated prices.

And I wouldn't trade my current system. I'd rather have medicare than nothing, and know that the issues it has can be fixed. Just because something has problems doesn't mean that it isn't better than nothing and doesn't mean that it isn't a good starting point.

It might not be so bad being a doctor if we fixed some supply issues: For example, making sure doctors (and everyone else) doesn't have tons of student debt. We can do things about how expensive malpractice insurance is: My dentist here in Norway would like to live in the US, but won't because of the malpractice suits. We can do things to simplify the office work, such as standardising payment scales and coding. We can make good use of nurse practitioners, especially for children who generally have run-of-the-mill infections THese things make it cheaper to be a doctor and cheaper to run an office.

You'd think we might need to fire a lot of people... but not really. Single payer health care means we can do things differently because our resources are pooled. Norway, at least where I live, will send a home nurse to your house for free up to 6 times a day. Even if you are in a cabin in the mountains or living on a little island. This is all because overall, this is cheaper than a nursing home... which costs 80% of your retirement, no matter how much you make.

There is also a private system, which mostly gives bells and whistles. You might get into a non-urgent MRI sooner and so on.

First things first, you probably have little choice in where you are going to get things checked out, as there may only be one place in town or one place your insurance covers or one place that works with the hospital your doctor goes to. It isn't like you can opt out if you suspect things like breast cancer, which might kill you, or if you are getting anything done in an emergency fashion. AT best, knowing the cost might give relief or stress and at worst, it'll cause some folks to die a slow death because they can't afford the cure.

IIRC, they aren't always upfront about this stuff during surgery. You simply don't know or there might not be folks in your network available for a variety of reasons (like your anesthesiologist being sick that day).