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Comment by teslabox | Hacker News Reader

Doctors want to bill insurance for as much as they can. Insurers don't really care about medical costs either, because the percent they keep as profit grows as they spend more.

Patients are the victims in the trench warfare between doctors and payers.

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Isn't there any competition between health insurers in the US? If it's a free market and consumers care about costs, then you'd expect that at least some health insurer would start looking for ways to put their insurance premium down.

The market is riddled with adverse selection problems. The easiest way to reduce costs is to reduce coverage!

Consolidation quickly takes care of any smaller company that tries to compete, in addition to the other issues mentioned here.

Most health insurance is provided via subsidized employer plans so consumers can either take the plan they're offered or pay 2-3x as much on the open market.

The healthcare system in the US is fundamentally broken, overpriced and cruel. It is one of the worst things about living in this country.

Employers are the "consumers" in that case, and they do switch plans if they get a better offer.

Under the ACA you can't even go out and buy insurance at any point in the year (from a large number of companies) unless you meet a minimal list of conditions that most people won't.

This problem existed far before the ACA so while some stuff in it really needs to be changed I don't think it's fair to blame it for this scenario

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