The Company Behind Many Surprise Emergency Room Bills

Such survival rates are from date of diagnosis; IIRC, because prostate cancer detected early usually doesn't have interventions that are less harmful than the cancer is likely to be, there's considerable debate about the utility of screening; there has been considerable argument that the US tends to overscreen and over-intervene for prostate cancer.

If the UK doesn't do that and tends to screen in a way that tends to catch less of the less-imminently-dangerous prostate cancers, it would have a lower 5-year survival rate simply by not diagnosing prostate cancer where the diagnosis isn't usefully actionable; this doesn't mean they are actually worse at dealing with it.

> Prostate cancer is an incredibly treatable form of cancer; for most people, as long as it's detected early and managed appropriately, they will die with prostate cancer as opposed to from it

Prostate cancer is very often an extremely non-aggressive cancer with interventions that can have significant negative impacts, which is why, even when it's diagnosed “watchful waiting” or “active surveillance” are often the preferred management approaches; quite a lot of people will die with, rather than from, prostate cancer with no active intervention.

Population-wide 5-year survival rates from diagnosis are probably not a good metric for comparing countries with different screening practices; mortality rates are a better comparison metric, but also don't tell the whole story.

I don't think that anybody really believes that the mess we've made of billing/paying-for services via insurance + government + hospital/doctor is a good idea. At least nobody who has dealt with it for more than 5 minutes, which is most people over 25.

The problem is that nobody can agree on how to fix it. One side wants to socialize the whole thing, the other side wants to do... something else, I guess. Regardless, neither side has enough power to just do what they want, so we're stuck with this bizarre Frankenstein's monster instead.

Meanwhile it's almost impossible to escape from the mess. You can't just have no insurance and pay for yourself, because they've made the prices for most things ludicrously high and then basically rebated them to the insurance companies.

Actually, it reminds me just a bit of that paraphrase of the Laws of Thermodynamics: you can't win, you can't break even, and you can't get out of the game.

Except suppliers can engage in their own fiat prices, as the OP demonstrates.

But your narrative does show the basic situation - where you have an elaborate digraph of buyers and sellers, most of which have a more or less monopolistic position. These monopolistic suppliers initially/formally set their prices based on "what they could possibly imagine getting", expecting regulators/down-stream-buyer to be the ones who will push things back into sanity (or not).

American health care, of course, has bounced from regulatory regime to another, with all of the players having to adjust. And moreover, all the players are now adept at adjusting, able to switch gears to leverage whatever ad-hoc cost reductions might go with any new system (cautious enough to lay-low when the new system comes since they know the politicians need to point to gains but will move on - see the way Obamacare worker great for two years, etc, etc).

And with all the bouncing, the situation has gotten only broadly more catastrophic. Health care was ~18% of GDP a year or two ago and no doubt is higher still.

Not only does health care have a problem but the four or eight cycle of ad-hoc fixes to health care has itself broken. Which might relate to the general breakdown of the countries political system, and so-on. I assume when (part of) Rome fell apart, no had seen an empire disintegrate on quite those terms (where a lot of civilization still remained on higher terms than Rome's neighbors). Perhaps our descendants will look back on this era in similar terms.

--

My state's bad ass Insurance Commissioner is trying to mitigate this problem:

Surprise billing legislation passes state House of Representatives

https://www.insurance.wa.gov/news/surprise-billing-legislati...

Be sure to call and voice support. Public pressure matters.

Long-term fix is single payer, universal coverage. Remove the (worst) profiteering from our healthcare system (racket).