Do you have an 8 year old writing your jokes?

This is a little known secret. We can negotiate cash out of pocket and sometimes it is LESS than the copay if we go through insurance. That’s how screwed up the system has become.

Also screwed up is the whole idea of “PCP”. Your general doctor used to handle most of your issues and you had a close relationship with him with mutual trust. Not any more. Dealing with the PCP these days is getting more difficult. People are turning to doc in a box for minor things. They take walk ins, they don’t grill you about your whole health picture other than the basics necessary to treat your minor ailment, and they act like they appreciate your business. The last three visits I made to urgent care were a pleasure. In and out in an hour. The last three times I moved and just tried to get in with a new PCP were a nightmare. I had to pull teeth just to get the first appointment.

Under the dims plan of "healthcare for all" it will be illegal to pay for your own healthcare.  These "doc in a box" locations would all go away.  Instead we would get government buildings in a "district" that you would be assigned to.   The doctors and other health professionals will be employees of the government, at government wages.   1 case or 100 cases, the pay is the same.  Also, all decisions on treatment go to a panel of bureaucrats to decide, not the treating physician.

 How anyone could see this as a viable alternative is just crazy.

At one point all medical care was paid for on the spot just like anything else.  At that time doctors really couldn't do much, but they made house calls and medical care was inexpensive.  As some point, once medical capabilities increased, that medical care got too expensive.  I don't know when that was.  But at that point insurers began offering coverage, and it went from being a luxury to a necessity for most.

There are still plenty of places you can show up and pay cash for simple medical issues, broken bones and the like.  But if you get into any kind of complex medical issue it can get expensive very quickly indeed.  I know people ruined by medical issues.  It sux to be financially ruined just because you got sick.

 It also sucks to be financially ruined because an institution that someone invest their money into goes under.  It sucks to be financially ruined due to such things as earthquakes, hurricanes, cyclones, fires, etc.

 Originally health insurance was just that, insurance.  It was there for the expensive items that would potentially destroy someone financially.   Then it morphed into being "health care", i.e. pay for anything health related.   The real downfall began when government got involved.

 Open up insurance where it can be bought across state lines would be a huge benefit for the consumer.  Bury the disastrous ACA.  Put health insurance back in the free market where it belongs and prices will adjust accordingly.

 Government is not the solution.

IBTL

Problem is always in figuring out what’s “catastrophic” and what isn’t. Medical costs aren’t meristic or threshold, they’re quantitative. Should your illness fall just short of “catastrophic” you could be royally fucked.

Under our current quagmire, yes.   Under a free market system without government intervention, not so much.

Problem with medical care is it really doesn't work according to the economics that govern other things.  If you want a car, you wait until  you have the financial wherewithal, you then shop for the car that meets your specifications for the lowest price.

You never know when you're going to get sick or how bad.  You simply can't plan for it.  Moreover, once you're sick you're in no position to shop or bargain.  You really can't be an informed consumer when it comes to health care. Market economics don't work for medicine, they never have.

What no one really realizes is the system we have was put in place to solve a problem, that's why it's there.  The funny thing is it was put in place at least partially through the efforts of Richard Nixon, who I think would be regarded as a flaming liberal today, were he regarded at all.

So once again we have the perfesser pontificating on life from within his bubble.

Funny how "medical tourism" has increased.  These are people that need or want a specific procedure, and rather than pay an over inflated cost go to another country and pay cash, saving thousands. 

 I have a good friend that had a surgical procedure done in Colombia for pennies on the dollar compared to the cost here.  And it was a quality procedure.  Back many years ago I was traveling and working in Asia.  I broke a crown on a molar, went to a local dentist.  Had the tooth base prepped and a new porcelain crown made and installed.  Cost?  $130us.  Here in the US that's a $1500 procedure.

As previously mentioned, Lasik is another example.  With competition that market is actually reasonable to have the procedure done.

Try getting a hospital or doctor office here to quote a procedure.  Good Luck.  The Insurance industry in cooperation with government has it so convoluted it's nearly impossible.

Take a look at what's happened to college education cost.  Once government got into the student loan business, college cost escalated.  Are we getting better education to go with that inflated cost?  Nope, just more money and bureaucracy.

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