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Wow. Every time I read a story about how the business of health care in america really works, it makes me really angry. It seems to me that one of the central

• humbleMouse 10y ago
  "It also strikes me that the companies that aid in coding/billing for providers are an example of software with unintended evil consequences. If you are a developer at one of these companies, how can you justify your role in making healthcare more unaffordable for everyone?" 6 figure salary and recession proof employment?
• cmurf 10y ago
  It's derived from a perverse combination of cowboy era "git the F away from me, I will do it myself!" individualism; and classist aristocracy "I am better than you because of bloodline, family name, and money, I can pay to get better health care and I'm not waiting in a line with the likes of the rest of you." A third group genuinely believes an inherently anti-competitive business, with deeply irrational and price inelastic buyers, can magically squirt out unicorn poop in a free market. And they've succeeded at getting the above two groups to use this "choice" and "free markets" nonsense as their messaging, whether they believe it or not, it gets them what they ultimately want. And what we have now, is a highly protected industry that whether before or after ACA, is in no possible way approximating either a free market, or socialized care. It is a legalized cartel, with a massive economic momentum such that even if the politics were to turn on a dime, the health care economic system would resist the changes. There's also conflation between insurance and payment plans. Insurance is risk management for random, unpredictable events like cancer. It wouldn't cover having a baby, that's predictable. Free market health care would mean you pay out of pocket, or out of savings, or you get a loan and have a payment plan. What we have from our health care "insurance" industry, is all the peasants and serfs are on a payment plan. Adding to the amusement is Medicare, after age 65, covers only 64% of the bill. You're on the hook for the rest. And it covers 0% dental, and old people have lots of on-going dental maintenance. If you're dying of a dental related brain disease, you can just go die if you can't pay. And people do. It cannot be understated how classist this system is. And it's a box canyon, near as I can tell.
  • awongh 10y ago
    Yeah, and from what I understand the crazy thing is that no one even really makes that much money, or as much money as a 2-300 percent increase in costs over other countries would suggest... It's mostly just an unbelievably inefficient system.
    • cmurf 10y ago
      It is the exact opposite of an ant colony. It's almost directionless at a societal scale, cooperative only at a narrow tribal scale. America has many tribes. This is a natural consequence of its diversity. The diversity moderates many things, good and bad mood swings, including efficiency because we're simply not all on the same page, often not even on the same book. The county has gotten a lot of rope to hang itself because baby boomers have charged a massive pile of debt to the country's credit card. That card was built by the silent generation, who also gave the U.S. the gift of the dollar being the world's reserve currency. And in some sense that reserve currency's status is better secured by Brexit, because it demotes the EU and Euro as being a direct equivalent competitor to the dollar. All of the things going on are interrelated, and make complete sense. The way they're happening is about the only way they could happen because as crazy as they seem, they're still the path of least resistance forward from where we are now.