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Comment by latta | Hacker News Reader

It sounds like most of the US population simply can't afford that level of care, yet is forced to "go with it". In a way this may subsidize those who can afford it.

If patients had an option - a la you can get an appointment now with an external consultant for $X, or wait two weeks - then that would make sense. But instead you pay for health insurance to literally insure against catastrophically expensive health-care costs (that's the point of insurance - "socialize" risk so that the individual doesn't get "wiped out" in case of an extraordinary event), yet you may still go bankrupt even if you do everything right!

Also, most other countries have a two-tiered system. Public health insurance, possibly worse and slower (don't necessarily agree), or you pay extra for private health insurance and get nicer hospital suits, better doctors and short wait times.

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I have one of the best health insurances, it costs dearly, and yet I have no way I could get an appointment for anything without weeks wait. Perhaps with exception of emergency room. And it's expensive as hell. And not in a single place I see a price list, and no physician would ever tell me their cost upfront. That's what you call "standards"?

Because "health insurance" is not designed or used as "insurance" anymore. Real insurance takes into account numerous factors which rate your risks of something bad happening to you and comes up with a rate tied to your particular set of circumstances that influence that risk.

Unfortunately, when "health insurance" covers day to day conditions, procedures, etc and costs the same for everyone regardless of circumstances, then it's no longer "insurance" but effectively pre-paying for access to a set of services.. and hopefully, it's services that you want and might actually need.

In the US, it's more of a "healthcare access fee" than "health insurance."

This sounds like armchair musing rather than a determination from actual data. It generally costs a lot more to treat problems as they arise than it does to prevent them. Paying up front for day to day procedures would significantly reduce the burden that guaranteed emergent care places on society already. It also potentially makes federal programs such as SSI/medicare cheaper as previously insured people are much more likely to be healthy.

The numbers are subject to some debate, eg the arguments over the Mercatus Medicare For All paper, but hand waving and claiming insurance that covers day to day procedures isn’t actually insurance is dubious. Not to mention, many modern plans have high-deductibles and function as you suggest, to where a healthy person may receive little covered service but also pay less out of pocket.

https://www.amsa.org/wp-content/uploads/2015/03/CaseForUHC.p...

I think you misunderstood me. I'm not proposing any policy or treatment changes. My point is calling what we have "health insurance" is confusing at best and deceptive at worst, so let's call it by a better name.

That may cause policy changes if people's mindset and behavior shift but at least we're building on better models of the world.

Here in germany if you have a private insurance you will kinda get scammed. Cause hospitals can make more money out of you they will make all kinds of tests on you, cause private insurance will pay it. This wastes your time and doesn't actually benefit you. On the plus side, the waiting times are reduced greatly, you are basicly a high priority patient for them cause, again, you make them more money. In theory everyone could get a private insurance but in practice only very rich people, self employed and people working for the government (the latter two are not eligible for public insurance) do actually get one. I don't know anyone here complaining about healthcare, it generally works great.

You can get gesetzlich versichert (for example with the TK) if you are self-employed. You pay a ton, probably as much as private insurance, but you do get insured.

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