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Comment by inglor_cz | Hacker News Reader

The thing is, American healthcare prices are horribly overblown. IDK why, maybe the need for malpractice insurance in a litiguous society, but I am always shocked when I learn how much do relatively routine things (LASIK, uncomplicated birth) cost in the USA. Usually at least ten times as much as in Europe.

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It’s a complex question but the problem is that _everyone_ that points out one reason or another is usually right - we disagree upon which factor is the biggest. Malpractice, bloated administrations in insurance and hospitals (just like our educational and corporate systems), a dysfunctional market leading to profiteering, bad / outdated regulations, Medicare being unable to negotiate costs, bad patient health across the country, and so forth. What I will argue against is that we have the best healthcare - maybe only if you exclude the outcomes for our poor, but even the outcomes for our wealthy are no better than the middle class in other developed Western countries.

LASIK is generally a few hundred dollars per eye. Is it really $50 in Europe?

As far as births, the lifetime cost of the injuries that do happen are built into the price. Maybe not a good system, but it's clear enough where the money goes.

Haha, nope ! As a convenience procedure, and as such exposed to liability risks, and because of the extremely high cost of the lasers, you'll have to pay 2-3000 euros for both eyes (in France, at least). It is in fact cheaper in the US.

However, I'm always surprised by the cost of health in the US. The most surprising thing is that it looks like most Americans seem to not realize that it is perfectly possible to have high quality medicine and well payed doctors if the insurances don't suck all the money between the healthcare system and the patient. Our system has flaws, sure, but the US system looks like crazy to me.

It's not just insurers, it's death of 1000 cuts. Poor regulation, misaligned incentives, greed, etc.

This is my fault, I have old info here.

I underwent LASIK in 2002. At that time, it cost me about 1000 USD here in Czechia. On American web discussions, mostly quoted amounts were USD 5-7000.

American health care prices are a constant series of traps. If you are not careful, the insurance won't pay, or the hospital will out of network doctors or they will run tests you don't need or want. And pretty much everything is way overpriced without the patient having a realistic chance to determine the fair price. All in the pursuit of sucking more money out of you.

And it's almost impossible to avoid these traps. It's basically a gamble every time.

The system is so convoluted that nobody knows where the money is going. Every player can point their finger at someone else and say: "Those people are gouging you." But every player has an investment stake in the other players[0]. It means, when it comes right down to it, they're all gouging us.

[0] For instance I read that the majority of stock in malpractice insurance companies is held by doctors.

One reason for this is the artificially limited supply of doctors. The AMA combined with the government keeps the number of doctors down by keeping the number of medical schools and medical residencies low, driving up prices.

Among many other big factors.

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