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Comment by lotsofpulp | Hacker News Reader

Without taxpayer funded healthcare, the consumer is at a disadvantage against healthcare providers as they are completely unknowledgeable about what they are buying, and have low ability to shop around.

If everyone was forced to use healthcare.gov to purchase health insurance, then we could have a viable market similar to auto or home insurance, where consumers reward the insurance companies that negotiate lower healthcare costs by signing up for their lower premiums.

It is the obfuscation of costs by way of the tax advantage given to employers subsidizing healthcare that greatly reduces the insurability of the people on healthcare.gov since many healthy people are silo’d out into lower risk employer pools, and therefore reduces the amount of insurers that can exist and compete for business.

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I've said it before, but if I were allowed to make one rule in the current healthcare landscape it would be "consistent pricing". No charging different prices depending on who is paying.

Agreed, the “charge master” system is crazy. In college I had to fight off debt collectors coming for a $3000 ER bill. $3000 to be given propofol and have my shoulder stuck back in the socket twice (they failed to restrain my arm after the first reduction, my arm flailed upon regaining consciousness and redislocated so they double charged me)

I also wonder what a world where we removed almost all medical regulation would look like.we would at least get true competitive market dynamics. Why do I know exactly what I’ll pay at mcdonalds, but not what I’ll pay for a medical procesure?

Instead we have just enough regulation to prevent healthy market dynamics, but not enough to have a single payer type system

> we have just enough regulation to prevent healthy market dynamics, but not enough to have a single payer type system

this seems like a very concise summary of the problem. and insurance companies see the profits of this no-mans land

At McDonald's you pay for a completely standardized product, delivered by a non specialized workforce. Healthcare is almost the exact opposite.

Interesting. McDonalds defines quality by consistency. Health care defines quality by the credentials of the providers. Maybe healthcare could learn a lot from quickserve?

> I've said it before, but if I were allowed to make one rule in the current healthcare landscape it would be "consistent pricing". No charging different prices depending on who is paying.

Along these lines, POST THE DAMN PRICES ON A MENU FOR EVERYONE TO LOOK AT AND MAKE CHOICES!

If people are "willing" to give you a blank check, why on earth would you do that?

It took me the longest to come to the realization that was exactly what I was doing every time I signed one of those financial responsibility forms unaltered/unquantified.

That would have HUGE ramifications to the provider side of things and would likely increase costs.

Right now, insurers typically reimburse higher for larger practices (due to volume), but smaller rural providers can have amazing leverage as well because they are the only game in town. Generally, the smaller providers would get reimbursed less.

If you force insurers to have only one "price", then they are going to set their reimbursement rates for the largest customers which would also apply to the smaller customers (so they'd get a bump).

Force providers to have one price.

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