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Maybe HN isn't the best site to discuss this on, I'm guessing most of you work for some large tech sector business that offers good insurance. But most of the world is not made up of tech workers.
I really don't understand why the US doesn't have a grown up healthcare system. Do you just not see how much better healthcare is in the rest of the developed world?
The only thing I hate is dealing with Byzantine clerical processes in the occasions they make a mistake. Have to waste 3 hours on back and forth phone calls because a low-level nurse made a typo is obnoxious.
To the hospital systems and insurance companies, the confusion is a feature, not a bug. They assume most patients and their families will just knuckle under and pay what they're told they owe. Since the health care sector is one of the largest political donors, elected officials have little incentive to fix anything, so they nibble at the edges and call it reform.
It’s not donations. It’s the fact that the largest employer in nearly every congressional district is a healthcare system. Heard this from a guy who worked on the ACA.
In the same way that tourists bring tourists dollars, sick people bring government dollars.
To the hospital systems and insurance companies, the confusion is a feature, not a bug. They assume most patients and their families will just knuckle under and pay what they're told they owe. Since the health care sector is one of the largest political donors, elected officials have little incentive to fix anything, so they nibble at the edges and call it reform.
You pay politicians, and you get the outcomes you want.
Every other country in the world calls it bribery.
Exactly the same happened to me & my family, and we've also appeared on NPR for a similar situation: > https://www.npr.org/sections/health-shots/2022/09/22/1121612... My daughter died. Our story aired a year later. Another year later, so around 2 years after my daughter's death, I received a hospital bill for a little over $3,000, for her initial few weeks of ICU care. I never acknowledged it. I couldn't bring myself…
- sticker shock from the bill - like, holy fuck, I was supposed to have insurance. Why is my provider taking back its coverage a year later? (May be called a "takeback" as customer support told me over the phone)
- Called customer support about the bill, and they were mostly supportive and believed what I said about being covered at the time. This was a relief to speak to nice people, but at the same time why make me fight an uphill battle? Why force so much confusion and fear on the patient at once?
I really don't understand why the US doesn't have a grown up healthcare system. Do you just not see how much better healthcare is in the rest of the developed world?
- principal-agent problems - health-insurance and hidden cost mean the people paying aren't the people getting the product
- concentrated benefits, diffuse costs. There are tons of actors (pharmas, hospitals, insurers, doctors, etc.) each skimming off the top. Each of these is a small enough effect that it's not worth anybody's time to stop it, especially when it's worth it for the skimmer to fight to the death to protect their cut, and together they all add up to massive amounts of waste.
- the US healthcare system is a Frankenstein's monster of public and private elements, and has ended up with the worst parts of both
- the US healthcare system probably would be better (at least in terms of cost-effectiveness) if it become either more libertarian or more socialized, but since moving a little in either direction would be seen by half the population as the top of a slippery slope towards a dystopia they hate, everybody fights hard to keep it in the local minimum
I really don't understand why the US doesn't have a grown up healthcare system. Do you just not see how much better healthcare is in the rest of the developed world?
I love my quality of care in the US. My insurance is quite reasonable compared to what my increased tax burden might look like overseas. I can’t imagine living in a nation that would make me wait months for something like an MRI, I love living in a nation where I can get an MRI for myself and my dog in the same day. I also enjoy living in a nation that doesn’t suggest I kill myself over trivial situations and backlog…
You love living in a nation where millions of people can't afford basic healthcare for themselves but your dog can get an MRI same day.
I really don't understand why the US doesn't have a grown up healthcare system. Do you just not see how much better healthcare is in the rest of the developed world?
I love my quality of care in the US. My insurance is quite reasonable compared to what my increased tax burden might look like overseas. I can’t imagine living in a nation that would make me wait months for something like an MRI, I love living in a nation where I can get an MRI for myself and my dog in the same day. I also enjoy living in a nation that doesn’t suggest I kill myself over trivial situations and backlog…
You being able to get an MRI in a week might have the social cost of 3 people not being able to get an MRI at all.