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Comment by sokoloff | Hacker News Reader

I’m not convinced that healthcare is a Machiavellian planned top-down threat.

The origin was in employers competing for labor during a time of wage controls.

The continuation is driven more by people who have good health coverage not wanting to lose that and the fear that their doctors visits will feel like DMV visits. That’s a powerful force.

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Of course it's not an evil plot formed by a small conference table worth of people. However when the majority of the US recognizes flaws with our medical systems and nothing changes, it's perceived as a threat, and perception is reality.

Also, while anecdotal, I've never met anyone who is actually opposed to changing the healthcare system. I understand that the main talking point on one side is the fear of lower quality medical care, but I've honestly never seen this brought up as a genuine point. I've seen it used as a straw man because it is a weak argument though.

Here's a Reason article on the origins of the US healthcare system: https://reason.com/2020/04/05/how-doctors-broke-health-care/

The origin of the current system was in the AMA and insurance companies lobbying to make everything except health insurance illegal, trampling all over the system put in place by employers, unions, and mutual aid societies.

The vast majority of people who have so-called "good" health coverage in the US are paying one to three orders of magnitude more for it, compared to the price of private health insurance in countries with a public health system.

The best thing that could happen to people who currently have private health insurance and wish to keep it is that a public health system appears, forcing the private health insurance oligopoly to actually be competitive.

> vast majority of people who have so-called "good" health coverage in the US are paying one to three orders of magnitude more for it, compared to the price of private health insurance in countries with a public health system.

I pay (employer plus employee amounts) just under $20K/year for a family of four. I doubt anyone in the “vast majority” is paying over $50K/yr. Three orders of magnitude less than that is $50/yr. How can anyone, anywhere provide meaningful private health insurance for an individual (let alone a family of four) for $50/yr?!

Six hundred euros a year gets you a no-copay plan for one person, all emergencies included. This is the top of the line, the most expensive individual plan available at this insurer.

A regular no-frills, some-copay insurance plan would probably cost around one to two hundred euros a year. So, yeah, two-ish orders of magnitude.

You pay $20k per year in premiums for a family of four to avoid paying more than the out of pocket maximum in a calendar year, and to have to an agent negotiate prices and appropriate services with the healthcare seller.

The likely amounts owed below your out of pocket maximum also have to be incorporated.

Also, my gold metal level BCBS network PPO plan is near $30k per year for a family of 4, so $20k seems like it might be sacrificing quantity/quality of in network providers.

Ours is a BCBS-MA plan, but where the company is self-insured financially (BCSC makes their profit on the administration side, but not on the risk side [or maybe not as much on the risk side; I'm not sure]).

Thing is - Our doctors visits already feel like DMV visits?

I've lived all over VA - Richmond, Fairfax, Alexandria. All felt like DMV. In Michigan now. Feels like DMV.

Thing is, too - by all accounts I can tell - people are largely satisfied with their State Healthcare, in those places that have it (Whichever form it takes). Sure people have critiques. But some people saying something can be an issue is not the same thing as the entire system being broken + in the other system everyone gets good instead of just a few + no reason to try + instead keep this system with the same problems but also costs more.

I would rather have a colonoscopy than go to the DMV here. My last colonoscopy was easily scheduled, had excellent communication, showed concern for my experience, and took a little under 2 hours on the day of. Few of my DMV encounters go that pleasantly.

My regular doctor’s office schedules appointments easily online, keeps to the schedule, communicates well and answers questions online within 24 hours, will follow simple instructions to help me get a script or something else basic, and clearly explains my situation and makes relevant recommendations based on test results. The DMV is (and most government services I’ve had to interact with are) pretty much whatever the relevant opposite of that list is.

We switched doctors in part because the previous didn’t have their shit together in terms of these basic interactions. The new one (4+ years now) is great.

Merely being able to fire your doctor and find another is reason enough for me to want to keep a significant private aspect.

I'm glad your experience with your colonoscopy was stellar. I just firmly believe everyone should have that experience. We can compare to the DMV all we'd like but the reality is that there isn't any reason the Single-payer system you're presenting is the one'd we'd have to go with? Public with a private option. Not Government 'run' but Government involvement in prices... not trying to split hairs on which system just pointing out that there's a lot of for improvement within our system.

I think "doctors visits feeling like DMV trips" is a hyperbole sold to us by people who are actually trying to keep people trapped in jobs. It's not entirely false, but it's definitely vastly overblown, as seen by current emergency rooms, where you don't need insurance to get emergency care, but do often need to wait several hours, and other countries' routine medical care, where it varies too much between countries to say that waiting lists are a consequence of universal healthcare.

I have relatively good health insurance from my (USA) employer and my doctor visit still feels like a trip to the DMV. Actually worse because I have to schedule them many weeks in advance. New Patient appointments in my area are currently backlogged 4 months out. When I finally get there, it’s clear I’m on a conveyer belt where I get a 5 minute chat with an actual doctor at the very end of the assembly line. The FUD that people spread about the horrors of socialized health care are already emerging in our free market health system, and I also have to pay through the nose for them.

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