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Comment by munk-a | Hacker News Reader

Medicaid is probably the second best place to be in the US system after Medicare - but it suffers from extreme politicization of care (good luck trying to get HRT or an abortion on Medicaid), rationing, shortage of supply (not all providers are required to or will service Medicaid patients) and stringent requirements to ensure continued availability (these in particular are getting much worse under pushes to get rid of "welfare queens" _sigh_).

That said, the only way to win is to not play - never get sick and emigrate before you have any serious health issues.

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My guess is that the current sweet spot is lower income ACA Silver plans.

OTOH, I'd say that the people who got really nailed with the ACA were the middle-class individual policy holders.

All of these problems come from Medicaid and Medicare paying a lot less for procedure performed (In line with what Canada, and Europe pays) than the public market. It's a drain on most hospital budgets.

If all procedures performed were done at Medicaid-like prices, hospitals and physicians, and pharma firms, and, by proxy, insurers and medical schools would have to tighten their belts, and figure out how to cut costs. That's the entire point of such an exercise. We can't let health costs grow in an unbounded manner.

100% agree with the drain on hospital budgets, at least so far as I know.

Dunno how 'Medicare for all' will work out if you simply start paying providers what Medicare currently pays. Dictating a price might work in the long run but would be plenty hairy in the short.

A lot of people that get paid a lot of money for doing absolutely nothing will lose their job - tough luck for them.

I can sympathize with the on-the-ground employees but the businesses they're keeping the lights on in are leeches on the healthcare market - I posted separately on this article going into the specific functions of PBMs, Pharmaceutical Manufacturers, Providers and Insurers if you're curious about the details, but there is a ton of inefficiency here.

I'm thinking partly in terms of paying US health professionals what they make in places like France. A certain amount of hilarity would ensue.

Medicare is only good if you carry a separate policy to cover the 20% copay. It's really not to difficult to run up a 100k copay with one serious illness.

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