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Comment by protocolture | Hacker News Reader

I find the US healthcare "system" to be an interesting topic. More nuanced than people think. It honestly seems like the worst way to run anything. Like I honestly cant see who its for, other than maybe US Corporations on the list of approved medical vendors. Like, putting on my "Lives in a free(ish) healthcare country" hat, it looks bonkers from that angle. But even from a more libertarian mode, the whole thing looks daft from that angle too.

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The US, today, is set up very well for wealthy people. The health care system works great for them. Their doctors are amongst the best in the world. Same with the hospitals they use. The costs are manageable if not reasonable for all of those people. And you can actually go beyond health care and find that almost everything in the US is pretty high quality for wealthy people. Housing, their neighborhoods, their schools, etc. That might help explain why the system is set up the way it is. Everything cascades from there.

> Housing, their neighborhoods, their schools

All of these can be great, but the class of people that make a neighborhood in "the heights" won't have dog barking, basketballs, drugs and gunshots. The people that don't live in "the heights" could decide tomorrow to no longer have those 4 things either - but they don't because - it's a different class of people.

A mate of mine (who allegedly has decent health insurance but that seems questionable) was trying to get a simple surgical procedure done, and the quotes he received ranged from anywhere between "We cant tell you" to multiple thousands, ultimately he found a small private hospital that sorted it out for him for 700 USD.

I actually think the 700 USD price is very reasonable. But I dont care how rich you are thats a terrible consumer experience.

There is no US healthcare "system" in the sense of having a cohesive entity pursuing a unified goal. It's a bunch of separate entities each pursuing their own goals, often in conflict with each other. If we were designing a healthcare system from scratch it obviously wouldn't look anything like what we have today. But we arrived here through a process that economists call "path dependence", and this makes it stubbornly resistant to systemic improvements.

https://en.wikipedia.org/wiki/Path_dependence

Thus the quotes, but thanks for the link about path dependance, thats a concept I have been aware of but unable to name for a long time. Lucky 10000.

Blame the misguided belief elevated to State motto that "private is always better than public". They've shoe-horned a profiteering class of parasites into an inelastic market, free to jack up prices of literally vital goods as much as they want. And the current administration, who holds much contempt for life, is perfectly happy to tear down the last poor band-aid the previous admin half-assedly put in place.

I am honestly convinced a purely private system would work better than the weird situation in the US.

I am also convinced likewise that a more public system would also work better than the weird situation in the US.

If you want to know whom US healthcare is for, look at who makes the most money from it. There's your answer.

>other than maybe US Corporations on the list of approved medical vendors.

Think I hung a lantern on that

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