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Comment by rick888 | Hacker News Reader

I'm flabbergasted that Europeans won't admit that it's a failing system. Both France and Sweden need to scale back their systems because it's just not efficient or cost effective.

I know it's just anecdotal evidence, but everyone I know from Canada that has had to get any major surgery has come over to the US. The reason? the waiting list is too long (in the years). Most universal health care advocates will deny this, but I just can't ignore it when I've seen it happen so many times.

I would rather have a system with no insurance companies that we paid for ourselves. This way, Doctors would be forced to charge affordable rates.

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It's not "ancedotal evidence", it's just an ancedote. Every Canadian I know prefers their healthcare to the US one. Now that you and I have equally canceling ancedotes, look at some evidence.

http://theincidentaleconomist.com/wordpress/how-do-we-rate-t...

Great point. Right now, doctor's have to charge twice what they expect to be reimbursed by insurance companies. So, an individual who chooses to buy health care without a health insurance provider has to pay twice what doctor's even expect to get. I don't even think doctors get any reduction in transaction costs when dealing with large insurance companies over individual patients. In a lot of ways, it seems like doctors have to deal with the large insurance company and the individual patient.

Health insurance in the US is more like a payment plan to join a health-care purchasing group than health insurance. What's worse is that your purchasing group choice is chosen by your employer.

I think there's a serious reduction in job mobility because the US has chosen to provide tax incentives when health insurance is provided by the employer, but not when an individual purchases those.

Right now, doctor's have to charge twice what they expect to be reimbursed by insurance companies. So, an individual who chooses to buy health care without a health insurance provider has to pay twice what doctor's even expect to get.

The second does not follow from the first. What usually happens is doctors try to rip off the insurance companies as best they can (and the insurance company does the same to them), but prices magically become reasonable when you mention you don't have insurance.

Doctor bill: $100 splint (her finger taped to a piece of wood), total bill $350.

My uninsured mom: "This is ridiculous. You can keep it, I'll just have my son duct tape me to a dowel."

Billing girl: "Oh, you don't have insurance? I'm so sorry, my mistake. It'll be $75, let me print you a correct bill."

(I don't recall exact numbers, but that was the rough flavor of the interaction.)

your biased assumption is that under the $350 bill that the middle party that has to bill the insurer does not get paid..

Part of the bill inflation is the multiple payor billing system costs itself..non-insurance bills do not have that costs.

What would bring it down instead of universal insurance universal payor billing..it was one of Mrs Clinton's HealthCare reform bullet points..form years ago..

Talk with some private practice doctors some time. They often spend about as much time dealing with patents as they do with the insurance company. As to the initial bill, they need to inflate it because the insurance company will always try and drop the price on something. It's the same game purchasing departments at large company's play where it's easier to buy something for 75$ after the 25% discount than 500$ without a discount.

Ops, 750$

> Both France and Sweden need to scale back their systems > because it's just not efficient or cost effective.

What? Both countries have amazingly cost effective health care systems!

And now that both sides have made mutually contradictory and equally unsupported statements, I believe the first round is a draw. Galactus will have the honors in the second round. Proceed, gentlemen.

It's fairly easy to find supporting information for the galactus view e.g.:

http://ucatlas.ucsc.edu/spend.php

And frankly, it should be common knowledge that western europe has better/equivalent outcomes at less than half of our cost (very round figures to sidestep the nitpicking), meaning, at minimum, they're getting at least twice the value per cost that we are, and that's rounding every number in the direction that's unfavorable to europe. I could argue that let's just copy the system within europe that works best and we can go for 3x.

Unfortunately, doing things that have been empirically borne out to work doesn't seem to be on the agenda these days.

I'm flabbergasted you're still peddling the ridiclous notion that the single payer health care system that is working for every other nation in the Western World is broken.

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