Comment by yalogin | Hacker News Reader

Comment by yalogin | Hacker News Reader

This is right, the problem with healthcare has to be insurance. The biggest pocket of customers for health care companies don't pay out of pocket. They are covered by their employers. So they don't see money going out of their pocket and in a perverse way the higher the amount the insurance company pays the better the customer might feel thinking they got good service or a great treatment. So there is no incentive for the health care company to reduce costs at all. Since people don't care about the costs of procedures there is no set/prescribed cost for any procedure and everything just gets bloated every year.

More so, these pocket of customers have no idea how the other pocket, that pays out of pocket, feels. They have never experienced it and will never know, so they have no incentive to fight for them. The health care lobby and republicans are putting a good spin that these out of pocket people are causing the costs to rise. IF the majority of the people actually pay out of pocket the costs will immediately come down for everything. Both hospitals, doctors and medicine. I have seen things in India where most of them pay out of pocket and the costs are very low. I heard, these days insurance is screwing things up there as well. Extending that logic, a single payer health care system where one party has the power to negotiate could actually help a lot in bringing the price down.

Insurers don't care. I recently got mono. It took three visits to a doctor, who just prescribe two back to back courses of antibiotics, a referral to see an ENT on the last visit (which did not seem right and would have taken three weeks to get an appointment for). And finally me deciding "fuck it" and making a trip to the ER to get to the bottom of it. At the ER I sat in a chair four or five hours. They took some blood and ran a simple test and it was done. Total cost to my insurer was something around $4000. I paid about $160 all up. I tried contacting my insurer and the provider to explain this was ridiculous cost to sit in a chair, give some blood, and have a test done. My insurer is Cigna. They literally have no online way of sending them email or a message. And their call center is useless. So I gave that effort half an hour and gave up.

> Extending that logic, a single payer health care system where one party has the power to negotiate could actually help a lot in bringing the price down.

Which was another big argument for single-payer. Medicare is know for negotiating the lowest prices, and practices prefer higher rate negotiated insurances than Medicare.

Medicare does not have market forces guiding it. Consumers are a massive repository of localized knowledge. Once government takes them out of the picture, the industry's dynamism is severely limited.

> the problem with healthcare has to be insurance.

It's a big part of the problem. For example, I believed that a certain medical procedure was in my best interests. I was told that insurance often doesn't cover the costs (i.e., the considered the procedure "elective." When I asked the price, I was told $700 – but if I forego insurance claims it's $400. And this was a super-reputable medical establishment. (Half of Silicon Valley probably uses it.)

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