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Comment by jlg23 | Hacker News Reader

As a German who had to take US-americans to the ER twice, once in Germany, once on Curacao, my observation can be summarized as "WTF?".

In both cases the patient initially refused treatment out of fear to receive a high bill. Both bills ended up being about 50 USD (a few stitches in the first case, lab analysis to confirm it were kidney stones in the second case).

In the first case, the patient's spouse told me not to worry, it ain't too bad. But she would stay with him to make sure he does not fall unconscious ("uhm.. ok...."; I got a taxi to pick them up for a trip to the ER); in the second case I ate my dinner while watching the guy scream in pain - being a doctor's child helps with that .. he finally agreed to let me take him to the ER.

Dear US-americans doctors, you lost me. Where again was the exit ethics took during your education?

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The doctors don’t create the bills, or even really influence billing. The billing issues are caused by hospital administrators who are mostly MBAs or Policy masters, and they’re negotiating with MBAs in insurance companies.

Do you think that the doctors or hotel administrators have more power?

Who's richer?

Doctors typically don’t work for hospitals. Their services are billed separately.

The AMA isn't even just complicit. It is pretty nearly a cause. There's plenty of blame to go around and doctors are not passive participants in the process.

I'm seconding scarejumba's position here. Doctor's are enormously powerful and effectively unionized through the AMA. They can influence both the operations of hospitals and the American government itself.

Like any aristocratic guild that provides a necessary societal function however, they as a block choose to profit from it.

This is not every doctor or even every ER doctor. But it's important not to let doctors as a class off the hook.

Why would you intentionally lower your income rate, particularly after racking up $500k in tuition? Doctors have no incentive to lower bill rates as long as they're pocketing a percentage.

It's unfortunately probably the case that these things have been feeding into each other. Some doctors charge more -> college's can justify higher tuition because people think doctors now make more -> now new doctors NEED to charge more to tuition debt and to get the benefits they were sold on. Rinse and repeat.

Similar experience, went to the ER with a friend in Taipei who had a busted lip and no coverage. Paid $20USD for the visit, prescription for antibiotics and the antibiotics filled on the spot.

They recently socialized their for-profit system.

I also paid out of pocket for a specialist visit in Canada last year, grand total $60CAD.

I’m not completely sold on socialized medicine —but in the US we definitely have a problem. Congress, or the admin should at least threaten “socialization” and get them to shape up, and follow thru if they don’t.

Perh a two-tiered system one basic for all citizens and another which could cover more advanced procedures along with elective choices of medicine, however, still reasonably affordable by most working people.

That is how most socialized medicine works. At least in Norway and Switzerland. Just because you have government guaranteed service doesn't mean it is illegal to sell more/better service. Perhaps shorter waiting lines, nicer hospital or better healing. You just have to try a bit harder to be worth it to people.

Most Canadian provinces significantly restrict or outright ban private healthcare for stuff that's covered by the public system. Since Canada is the closest example to US, and the one most people turn to first, that unfortunate quirk is given undue prominence in the healthcare debate here.

My girlfriend had an eye problem when we were in Germany. Went to the eye doctor and paid 25 Euro cash including an antibiotic.

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