Yes. Health insurers are partially hired villains to take blame and ire. My employer has a multi-vendor plan that is mostly UHC. They even have specialist cancer care that will pay in full for just about everything, including travel and food. We have almost none of the issues that you hear about insurance nightmares.

That's because they negotiated and paid for such a plan.

My sister works for a similar large employer. They hired Cigna as the insurer/benefits administrator, and every interaction is a problem. Your two kids have an ear infection? Cool, we've determined that the second one is due to an auto accident. It's so bad that the company hired another company to argue with Cigna for you.

End of the day, the employer controls the purse, and the insurer is doing what the employer paid for. It's cheaper to hire another company to argue for the folks who have noticed problems than to pay for a level of service.

(a) in most of the US not owning a car isn’t an option

(b) if we had a reasonable market then some people could have an alternative like paying out of pocket

But things like deductibles and covered treatments are negotiable. The majority of health care is not “you will die without this specific treatment” there are usually options.

>Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible.

US healthcare has to compete against cheap healthcare in mexico or whatever

Its the doctors who need to compete and fucking advertise 1 single price. We need a market first, not random ass prices based on some n-dimensional rubric which oh we don't actually follow anyway that was just there to confuse you. Now go sit on hold for a part-time job shitface.

This is nonsense that continues the status quo. We were recently trying to understand our options for something time-sensitive, and no one could tell us with any certainty it would cost $2k or $20k if insurance denied it. We were fully willing to pay thousands out of pocket (the price insurance apparently usually pays after "negotiations"), but couldn't get any assurance about the cost or even whether they could correctly bill just this one procedure at their out-of-pocket rate (and what that might be) when everything else was with insurance. It's not like we were the first to ever get it done. The system is just full of blatant unmitigated racketeering.

A good first step would be banning price discrimination for medical procedures. Right now you get three different prices for "I pay", "insurance pays", and "insurance denies and I pay". People can't tell you what those prices will be. The whole point of insurance is supposed to be to derisk these kinds of decisions, not increase uncertainty and risk. Attempting to use insurance and getting denied can 10x your cost, so what is the purpose of the insurance?

This is exactly what is done in Australia. Medicare for all. Private health insurance optional on top of this for non-catastrophic care.