> the poorest people pay the price

In this case it was a middle class family losing their 4 bedroom house due to "$164,000 in medical bills for emergency surgery". It's not just hurting the poor, it's a relatively small number of people organized in a cartel ripping off the entire country.

Medical cartel needs to be investigated by FTC like any other cartel. Being under purview of HHS and state medical boards infiltrated with physicians is not working due to conflict of interest. Cartel can be broken down by rewriting scope of practice laws to focus on "standard of care" rather than "board certified license" as a gatekeeping regulation to practice medicine. Once the physician cartel falls everybody else leeching downstream (insurance, global pharma, PBMs, countless vendors, etc) will simply dry out.

Medicare for all (public option) could also have a similar effect if implemented properly in a way that strips power away from physicians. But if implemented by naively increasing taxes and throwing money into the current system it's going to do more harm than good.

I currently work at one of the largest hospitals in the country. Can confirm! The corruption in the healthcare sector is disgusting and hard to fight. I blew the whistle and got retaliated against, in complete violation of CA law. Tempted to go to the press.

This is also what I don't understand. Why tempted? You should have done it already

Easy. Doing so is career suicide.

This is indeed what I've learned.

Career suicide would imply that the corruption you're talkin about is the kind that gets people arrested. At least tip off the appropriate agencies off the top of my head I don't know who you are but the FBI sounds like a good one

Nothing arrestworthy, but definitely shameful behavior of a high-ranking hospital official allegedly defrauding a large multinational company and attempting to shift blame to low-level employees that had zero involvement.

MDs no less! Forget the Hippocratic Oath!

Perhaps white-coat fraud is the equivalent of white-collar-crime in the public health world. Nothing matters more than the bottom line. Not even human lives.

It's actually the middle class that pays the price, through insurance premiums, out-of-pocket co-pays, and high deductibles. Poor people have Medicaid.

Medicaid, which even happens to pay reasonable amounts for procedures performed. The entire system would re-adjust into a sustainable steady-state, if all prices were equivalent to Medicaid reimbursements. But I suppose that under such a model, the average middle-aged surgeon wouldn't be able to afford their third summer home...

Medicaid is probably the second best place to be in the US system after Medicare - but it suffers from extreme politicization of care (good luck trying to get HRT or an abortion on Medicaid), rationing, shortage of supply (not all providers are required to or will service Medicaid patients) and stringent requirements to ensure continued availability (these in particular are getting much worse under pushes to get rid of "welfare queens" _sigh_).

That said, the only way to win is to not play - never get sick and emigrate before you have any serious health issues.

My guess is that the current sweet spot is lower income ACA Silver plans.

OTOH, I'd say that the people who got really nailed with the ACA were the middle-class individual policy holders.

All of these problems come from Medicaid and Medicare paying a lot less for procedure performed (In line with what Canada, and Europe pays) than the public market. It's a drain on most hospital budgets.

If all procedures performed were done at Medicaid-like prices, hospitals and physicians, and pharma firms, and, by proxy, insurers and medical schools would have to tighten their belts, and figure out how to cut costs. That's the entire point of such an exercise. We can't let health costs grow in an unbounded manner.

100% agree with the drain on hospital budgets, at least so far as I know.

Dunno how 'Medicare for all' will work out if you simply start paying providers what Medicare currently pays. Dictating a price might work in the long run but would be plenty hairy in the short.

A lot of people that get paid a lot of money for doing absolutely nothing will lose their job - tough luck for them.

I can sympathize with the on-the-ground employees but the businesses they're keeping the lights on in are leeches on the healthcare market - I posted separately on this article going into the specific functions of PBMs, Pharmaceutical Manufacturers, Providers and Insurers if you're curious about the details, but there is a ton of inefficiency here.

I'm thinking partly in terms of paying US health professionals what they make in places like France. A certain amount of hilarity would ensue.

Medicare is only good if you carry a separate policy to cover the 20% copay. It's really not to difficult to run up a 100k copay with one serious illness.

Really poor people simply go to the doctor because they know the doctor has to treat them and they know no one will come after them since they have nothing.

Unless you are going to the ER, your doctor isn't obligated to treat you...

And if the ER thinks you're a deadbeat, they will give you the minimal treatment necessary to make sure that you won't die on the hospital grounds - and discharge you.

I know someone who continued to take her kid to the doctor every day until they finally gave in and diagnosed her kid with something and now she gets help.

Makes me ill to think of the cost.

This is an interesting peek into how you see the world. You're frugal?

Nothing wrong with her kid

Yeah, it is wrong from multiple perspectives.

Christian (judging others), logical (how much does she know), fiscal (most costs to system are not kids)

Forgot parenting (who else is supposed advocate for the kid?)

One anecdote doesn't make for statistics.

Its not just one anecdote. I grew up in that level of poor. It is a culture

Not really. Everyone not involved with healthcare pays the price.

If the US paid the prices for care that other countries pay (pick any developed country you want, it'll be less), everyone could get a tax cut and universal care. It would save US governments money.