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".

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.

Even this thread is full of Americans trying to tell other Americans that the US system is “better” than Europe

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%?).

There is no easy fix.

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.

https://www.kff.org/report-section/ehbs-2022-section-1-cost-...

Similar goes for pharmaceuticals, a true free market does not exist.

A 'free market' as you state just results in people falling for bullshit care.

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?