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Comment by chaosmonkey | Hacker News Reader

> It has been a few months since I have seen a doctor, but I still receive some new goddamn bill every other day.

I went to a single visit to a hospital once and after the treatment, I got 4 different bills. I was amused why I was getting bills from places I had no idea about. Then I realized each entity had a different billing department - the hospital's bill, the doctor's bill, the tester's bill, etc. all related to the single visit to the same hospital.

I had to call each of the 4 departments and deal with insurance. It was a nightmare!

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I'm generally not in favor of single-payer, but take this as an argument against my position.

My mom had some big treatments last year. My dad is a probably-undiagnosed-autistic guy who loves spreadsheets. He set up a spreadsheet for every single visit, correlating exactly how much was paid, exactly how much insurance (including Medicare) paid, and when each provider was marking the bills as paid.

He's retired, so this was his full-time hobby.

He still got continuously yanked around by every single provider, some claiming paid in full (which my dad filed dutifully in a binder) and then later asking for more money.

It's a freaking mess.

So why doesn't this make you generally in favor of single-payer?

Given the choice between two systems[1], I can prefer one and still see the tradeoffs each has.

[1] Of course there are more than 2 choices.

It's not always like that. There are insurers like Kaiser that are vertically integrated that make the whole experience much smoother. At my last checkup, my doctor gave he an immunization, ordered blood tests and prescribed medication. The blood tests and pharmacy were both in the same building, so I just had to make two stops on my way out of the building that took an extra ~15 minutes. The immunization and checkup were covered by my insurance and I paid my copay for the blood work and prescription up-front just before having my blood taken and getting my medication. It was all very affordable, quick and easy and I never saw a total bill. I only got a receipt for my copay.

I've never needed any major health care from them, but I have a parent that has had both hips and a shoulder replaced with Kaiser who had a similarly simple experience.

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