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Why can't healthcare be fixed? I'm self employed, pay a crap ton of money for "good" insurance, and it's horrible. It's very difficult to find good doctors in

Why can't healthcare be fixed? I'm self employed, pay a crap ton of money for "good" insurance, and it's horrible. It's very difficult to find good doctors in network. Everything gets rejected from insurance and the Dr has to appeal it multiple times in order to sometimes get them to budge. It's absolutely broken, and even more so for those on individual and family plans (ie not through an employer). Last year I was with United Healthcare, this year Blue Cross blue shield. Both are horrible. Both are massive companies.

kofejnik 4y ago
It is working as intended. All parts of the system co-evolved to extract maximum value from you.
eapressoandcats 4y ago
In the US at least the underlying problem is that we pay more for basically every medical procedure, drug, and device, so you end up paying more to get less. Largely this is due to having engineered a shortage of doctors combined with no negotiation on drug and medical device prices.
ratg13 4y ago
Once you get rich or in politics, healthcare is no longer a problem, so you don’t see it. Even this thread is full of Americans trying to tell other Americans that the US system is “better” than Europe
- camhart 4y ago
  Europe's healthcare isn't perfect like many Americans make it out to be. It has its own list of cons. Although it is very nice when you go to a Dr there and talking about money isn't even a thing. My wife is German. There are Dr's that refuse to work with insurance altogether. There are procedures not covered at all. The employer pays for half the insurance, the state (aka taxes... so you) pay for the other half. Self employed people who failed to pay their "half" can still end up with life crushing bills (personal experience in the family). Not sure what happens if unemployed (I assume the State does step in there to cover it 100%?).
javajosh 4y ago
>Why can't healthcare be fixed? Because doctors and patients won't fix it. Doctors can charge whatever they want. They could see more patients, charge less, and charge cash. They could do their own diagnostics during the visit. People from other countries will be shocked to know that US doctors never do their own diagnostics, and instead refer patients to other providers, which require their own payment and paperwork, another round of appointments. Putting the patient through all that for an ultrasound is "standard practice", which also happens to be maximally profitable for multiple providers and their associated office staffs, and the enormous industries that exist to service this deeply problematic "standard practice".
- olliej 4y ago
  No doctors cannot charge whatever they want. They can charge what insurance companies specify. Doctors in other countries don't do their own diagnostics: a GP isn't a radiologist, isn't a microbiologist, isn't a lab technician, etc.
d1str0 4y ago
Not trying to be a shill, and would happily discuss my entire healthcare experience with Kaiser, but I highly recommend them if you have the option. Obviously, don’t change unless you do research etc. and again happy to discuss my experience with them for anyone interested.
adrr 4y ago
What do you mean by fixed? Affordable? That means we would have to lower medical professional income and we have a shortage of them. Insurance have tried to push down their rates but they just stop taking insurance so we have to pay more to see a decent doctor. We could be more punitive to insurance companies for denying claims but the cost of insurance would become even higher. There is no easy fix.
- pyrelight 4y ago
  I doubt you'll find many other industries that have as many unnecessary employees as you would in healthcare. Given that they're for-profit, they have every incentive to hire as many people as possible to answer phones and create a bureaucratic nest of people who go to work to literally make it hard to use the insurance you're paying for. Compare to car insurance, where many companies tout how "easy" it is to file a claim, and in most cases it is pretty easy to get your car fixed, get a rental car in the meantime, and get back on the road in a few days. Everybody in the process gets paid, you can shop around every 6 months for cheaper rates, etc. By all accounts, car insurance is profitable. If healthcare was made simpler, with standard prices for procedures across all hospital systems and insurance carriers, and actual doctors who aren't of the same caliber of the ones prescribing Viagra from some random site in Albania, we could start to fix the system. As it stands now, and I'm sorry for the people involved who work these jobs, but if health insurance reduced it's bloat of unnecessary workers, many of whom go to work to specifically answer calls from people whose claims are denied, we could lower costs, cover more people's procedures, and keep physician pay the same. As it stands now, nurses do most of the work in the healthcare system, whether it's in the doctor's office or in the hospital, and unless you're in a niche field of nursing, they get paid less than an entry level PHP developer. A nurse can lose their license if they make a horrible mistake at work. Hospitals see nurses are replaceable and that's why many of them burnt out during COVID when staffing ratios were thrown to the wayside, raises and department transfers were halted, and techs and other low-skilled nursing positions were eliminated, increasing the burden on RN's. It's not correct that in order to lower healthcare costs, we have to lower physician pay. Healthcare is just not a business that can be left to the free market.
  - 4y ago
dennis_jeeves1 4y ago
A true free market is when anyone should be allowed to practice medicine including your barber. That would give your regular doctor a run for their money and have them perform better that the barber. Similar goes for pharmaceuticals, a true free market does not exist.
- fzeroracer 4y ago
  This already exists and we know what the outcome of it is. It's alternative medicine. Insurers will gladly and gleefully let you do holistic woo bullshit because it saves them money. A 'free market' as you state just results in people falling for bullshit care.
  - dennis_jeeves1 4y ago
    >This already exists and we know what the outcome of it is. No, you cannot prescribe mainstream drugs (some of it which are indeed useful) if you are not licensed. Cannot do surgery etc, either. All of it is 'illegal'. >A 'free market' as you state just results in people falling for bullshit care. True, what's different now?
olliej 4y ago
It can be. You make it a public service. Much like roads, public health a "loss making" industry, so the options are "a public service that treats everyone" or "a for profit industry that works to avoid treating people while charging as much as possible".
tim333 4y ago
Dunno exactly but pretty much every country on earth seems to get by without these sort of stories. American politics?

kofejnik 4y ago

It is working as intended. All parts of the system co-evolved to extract maximum value from you.

eapressoandcats 4y ago

In the US at least the underlying problem is that we pay more for basically every medical procedure, drug, and device, so you end up paying more to get less. Largely this is due to having engineered a shortage of doctors combined with no negotiation on drug and medical device prices.

ratg13 4y ago

Once you get rich or in politics, healthcare is no longer a problem, so you don’t see it. Even this thread is full of Americans trying to tell other Americans that the US system is “better” than Europe

camhart 4y ago
Europe's healthcare isn't perfect like many Americans make it out to be. It has its own list of cons. Although it is very nice when you go to a Dr there and talking about money isn't even a thing. My wife is German. There are Dr's that refuse to work with insurance altogether. There are procedures not covered at all. The employer pays for half the insurance, the state (aka taxes... so you) pay for the other half. Self employed people who failed to pay their "half" can still end up with life crushing bills (personal experience in the family). Not sure what happens if unemployed (I assume the State does step in there to cover it 100%?).

javajosh 4y ago

>Why can't healthcare be fixed? Because doctors and patients won't fix it. Doctors can charge whatever they want. They could see more patients, charge less, and charge cash. They could do their own diagnostics during the visit. People from other countries will be shocked to know that US doctors never do their own diagnostics, and instead refer patients to other providers, which require their own payment and paperwork, another round of appointments. Putting the patient through all that for an ultrasound is "standard practice", which also happens to be maximally profitable for multiple providers and their associated office staffs, and the enormous industries that exist to service this deeply problematic "standard practice".

olliej 4y ago
No doctors cannot charge whatever they want. They can charge what insurance companies specify. Doctors in other countries don't do their own diagnostics: a GP isn't a radiologist, isn't a microbiologist, isn't a lab technician, etc.

d1str0 4y ago

Not trying to be a shill, and would happily discuss my entire healthcare experience with Kaiser, but I highly recommend them if you have the option. Obviously, don’t change unless you do research etc. and again happy to discuss my experience with them for anyone interested.

adrr 4y ago

What do you mean by fixed? Affordable? That means we would have to lower medical professional income and we have a shortage of them. Insurance have tried to push down their rates but they just stop taking insurance so we have to pay more to see a decent doctor. We could be more punitive to insurance companies for denying claims but the cost of insurance would become even higher. There is no easy fix.

pyrelight 4y ago
I doubt you'll find many other industries that have as many unnecessary employees as you would in healthcare. Given that they're for-profit, they have every incentive to hire as many people as possible to answer phones and create a bureaucratic nest of people who go to work to literally make it hard to use the insurance you're paying for. Compare to car insurance, where many companies tout how "easy" it is to file a claim, and in most cases it is pretty easy to get your car fixed, get a rental car in the meantime, and get back on the road in a few days. Everybody in the process gets paid, you can shop around every 6 months for cheaper rates, etc. By all accounts, car insurance is profitable. If healthcare was made simpler, with standard prices for procedures across all hospital systems and insurance carriers, and actual doctors who aren't of the same caliber of the ones prescribing Viagra from some random site in Albania, we could start to fix the system. As it stands now, and I'm sorry for the people involved who work these jobs, but if health insurance reduced it's bloat of unnecessary workers, many of whom go to work to specifically answer calls from people whose claims are denied, we could lower costs, cover more people's procedures, and keep physician pay the same. As it stands now, nurses do most of the work in the healthcare system, whether it's in the doctor's office or in the hospital, and unless you're in a niche field of nursing, they get paid less than an entry level PHP developer. A nurse can lose their license if they make a horrible mistake at work. Hospitals see nurses are replaceable and that's why many of them burnt out during COVID when staffing ratios were thrown to the wayside, raises and department transfers were halted, and techs and other low-skilled nursing positions were eliminated, increasing the burden on RN's. It's not correct that in order to lower healthcare costs, we have to lower physician pay. Healthcare is just not a business that can be left to the free market.
- 4y ago

dennis_jeeves1 4y ago

A true free market is when anyone should be allowed to practice medicine including your barber. That would give your regular doctor a run for their money and have them perform better that the barber. Similar goes for pharmaceuticals, a true free market does not exist.

fzeroracer 4y ago
This already exists and we know what the outcome of it is. It's alternative medicine. Insurers will gladly and gleefully let you do holistic woo bullshit because it saves them money. A 'free market' as you state just results in people falling for bullshit care.
- dennis_jeeves1 4y ago
  >This already exists and we know what the outcome of it is. No, you cannot prescribe mainstream drugs (some of it which are indeed useful) if you are not licensed. Cannot do surgery etc, either. All of it is 'illegal'. >A 'free market' as you state just results in people falling for bullshit care. True, what's different now?

olliej 4y ago

It can be. You make it a public service. Much like roads, public health a "loss making" industry, so the options are "a public service that treats everyone" or "a for profit industry that works to avoid treating people while charging as much as possible".

tim333 4y ago

Dunno exactly but pretty much every country on earth seems to get by without these sort of stories. American politics?