I’m relying on insurance because going to the doctor is such a financially risky gamble.
That's why I think banning non-catastrophic insurance would be helpful. I'm confident if insurance companies were kicked out of routine healthcare you'd see a very quick shift to price transparency.
There's one doctor here in town that mostly caters to undocumented immigrants and he has a price board in his waiting room for cash price of most of the common services. BCBS (which is 90+% of the insurance market in my state) actively prevents other doctors from doing this. He can only do it because most of his patients don't have insurance.
We visit the clinicas here in L.A. as well, paid $130 for X-rays recently. Reminds me of trips abroad.
That's all I want from health care, simple and transparent.
This is what's really strange about the American healthcare system. For everything else in America you can either get a price up front or an estimate of total costs up front. Why should going to the doctor be any different than going to a mechanic? Pay advertised flat rates for issue diagnosis, and get estimates for the problem.
Yes, in cases of emergency you can't really shop around too much, but the majority of the time you're going to a doctor, you could at least call and get estimates of how much things will cost. It's not even possible to do this with most healthcare organizations. If you call your doctor's reception and ask "how much will it cost for this visit?" they'll tell you they don't do billing and they won't know until it's processed by insurance.
Price transparency in the healthcare market - or at least some decent estimate of it - would be a great thing to see. American healthcare is ridiculously inefficient because it appears wholly designed to be byzantine.
For the parts of the country that are rabidly anti-universal healthcare, a more free market solution would be a nice consolation prize.
A large portion of the country working full time already has their employer offered health plans supplemented by Medicaid anyways.
I think that working class people in these regions wouldn’t be adverse to Medicare being expanded to include them. I’m sure the Republican Party base of upper middle income and wealthy whites would be, but again, not so much everyone else there. It’s a matter of how and what constituencies you recruit and activate.
It’s so strange, the people who would most benefit from universal healthcare (and those that currently do, like Medicare beneficiaries) tend to be the strongest objectors to it, citing hard-to-understand ideological reasons.
It's not so strange if you allow yourself to question the assumption that they'd benefit from it in the first place.
Medicare is a great example. Patients can opt to receive their Medicare inpatient and outpatient coverage through a private plan instead of through the government-managed plan. Since this program was introduced, it's gained popularity rapidly, over a third of Medicare beneficiaries receive their benefits from private plans. Many private plans are the same price as Medicare or cheaper.
From the data, the private plans beat government-managed plans on the three major metrics: medical outcomes, cost, and patient satisfaction. On the last one, the difference isn't even close: the worst of the major private plans (by patient satisfaction scores) still manages higher scores than Original Medicare does.
People who haven't ever dealt with Medicare themselves directly (which includes most HN commenters) find this hard to understand, but it really isn't: dealing with Medicare is awful. I could give you my personal anecdotes, but they'd overfill the comment length on HN, and again, at the end of the day, the numbers speak for themselves. Medicare beneficiaries themselves are turning to private plans to replace their government-managed plans, so it's really not surprising if they're not the biggest advocates of expanding government-managed plans.
No, they're much more than that.
> And their existence and popularity has more to do with their sponsorship by insurance funded politicians than anything else.
The programs are cheaper, provide better medical outcomes, and patients prefer them.
That doesn't mean they're perfect, but you have to bend over pretty far backwards to say that they're inferior and only popular because of "insurance-funded politicians".
> Dealing with these administrators isn't generally better or worse than dealing with the government directly. Exceptions exist, but that goes without saying.
It is monumentally easier to deal with private insurers than to deal with an Original Medicare plan.
It’s a corporate-controlled media narrative that these things are unpopular.
http://www.businessinsider.com/poll-medicare-for-all-public-...
It gets worse. Each entity in the system applies their own rules. eg a friend had an eye exam at the doctors and they took 11 months to bill[0]. The doctor group pointed out their small print says they have 12 months to bill. The insurance company had a shorter time frame and refused to pay. But it was a scam - the doctor had changed the diagnosis code to get more money, and the insurer would have refused to pay so they kept more money. My friend lost.
It is very easy to see which proposals will "fix" things. Look at which groups make less money due to the fixes (doctors, insurers, medical groups, equipment makers, drug companies etc). It is extremely rare for that to be shown, and all those groups will fight to keep what is "theirs".
> American healthcare is ridiculously inefficient because it appears wholly designed to be byzantine.
I like the word confusopoly https://en.wikipedia.org/wiki/Confusopoly
Confusopoly is an economic and marketing term referring to a purposeful
act by a seller or group of sellers to confuse the buyer in order to ease the sale
Totally right. Which means in practice insurance is covering the risk of pricing rather than the risk of you having health issues.
Average people only have one rational response to random prices: don’t go to the doctor voluntarily. But this can cost them their health in some cases.
You mean their life. People actually die without health care. American health care is murdering Americans for profit.
I recall seeing an article that Bezos was going to take on vertically integrated healthcare for his workers. And given Amazon’s history, the next step would be productizing that as a service for all comers with transparent a la carte pricing.