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The US healthcare system is wildly complicated and inefficient because it is a double-bureaucracy; pubic and private. The government bureaucracy makes a bunch o

The US healthcare system is wildly complicated and inefficient because it is a double-bureaucracy; pubic and private. The government bureaucracy makes a bunch of rules and also provide healthcare through Medicare/Medicaid. The private bureaucracy compete with each other, and hospitals, and pharma companies, ect. Many of the private health providers are for-profit and lobby against rule changes that would reduce complexity and save the system money. It know this may sound glib, but if you are trying to understand the US healthcare system and something seems strange, usually it's because it makes someone money and they'll fight hard to keep it that way.

KennyBlanken 4y ago
> Many of the private health providers are for-profit and lobby against rule changes that would reduce complexity and save the system money. This is almost certainly an anti-competitive move. By keeping many rules and regulations, you need more staff to deal with them - and smaller insurers have fewer patients to amortize those salaries over.
deleted 4y ago
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spaetzleesser 4y ago
"usually it's because it makes someone money and they'll fight hard to keep it that way" And it's not just some money but very BIG money they make.
refurb 4y ago
Canada is the only country I know of that has only one system - public. So your claim of public + private being the issue makes no sense when almost every country has that.
- abrichr 4y ago
  Also Cuba and North Korea.
- geenew 4y ago
  The Canadian system is a mix of private and public, with a mix of national and provincial funding, some national standards (tied to funding), and provincial jurisdiction. For procedures covered by provincial health programs, doctors in private practice (GPs, at least some surgeons) give the service to the patient and then bill the government for that amount. For services that aren't covered by provincial health programs, GPs/surgeons bill the patient. Provincial health care programs cover anything medically necessary. My general understanding is that you cannot pay to have a service done which is covered by a provincial health program. The intent is to prevent the establishment of a two-tier health care system. It's probably less complicated than the US system, but it's still complicated.

KennyBlanken 4y ago

> Many of the private health providers are for-profit and lobby against rule changes that would reduce complexity and save the system money. This is almost certainly an anti-competitive move. By keeping many rules and regulations, you need more staff to deal with them - and smaller insurers have fewer patients to amortize those salaries over.

deleted 4y ago

[deleted]

spaetzleesser 4y ago

"usually it's because it makes someone money and they'll fight hard to keep it that way" And it's not just some money but very BIG money they make.

refurb 4y ago

Canada is the only country I know of that has only one system - public. So your claim of public + private being the issue makes no sense when almost every country has that.

abrichr 4y ago
Also Cuba and North Korea.
geenew 4y ago
The Canadian system is a mix of private and public, with a mix of national and provincial funding, some national standards (tied to funding), and provincial jurisdiction. For procedures covered by provincial health programs, doctors in private practice (GPs, at least some surgeons) give the service to the patient and then bill the government for that amount. For services that aren't covered by provincial health programs, GPs/surgeons bill the patient. Provincial health care programs cover anything medically necessary. My general understanding is that you cannot pay to have a service done which is covered by a provincial health program. The intent is to prevent the establishment of a two-tier health care system. It's probably less complicated than the US system, but it's still complicated.