[mitchellst]

"Charging the maximum allowed by private insurance" is the same thing as competing on price. You're just competing to please insurance plans, not consumers. Admittedly, the insurance plans have every incentive to play ball: they want to brag on large provider networks in order to sell themselves to employers/consumers, and every corporation and person in the US is legally obligated to buy health insurance, so they don't lose customers by failing to deliver value for money.

[alexanderstears]

And health insurance companies have capped profit rates - the only way to return more money to shareholders is to cover more expenses. A $10 treatment means the insurance company gets to send about 80 cents to the shareholders, a $100 treatment means they get to send $8 to the shareholders. Is it any surprise that they don't really care about prices when they're incentivized to make prices more expensive and the law stipulates that you must buy health insurance if you can afford it?

[uberduber]

Yep. Before the ACA passed, 50% of my claims (of which I had many) would come back denied and I had to go through and appeal all of them. After the ACA, no denials.

However, the actual prices have gone through the roof. Before the ACA, the total amount paid to Labcorp for some bloodwork was about $28 a few years ago, same bloodwork today I get a bill for $300. This year I needed some labs where my doctor normally charges $60. However, there was one test he couldn't do and I'm a hard stick, so he told me I should just get it all done at the hospital. I know hospitals are expensive, but I figured paying another $200-300 would be worth not getting stuck twice. When the bill came it was $1150 with the special test only being about $30 out of the $1150. Insurance never would've allowed this rate before but now they're incentivized to make prices higher.

[nojvek]

America never ceases to surprise me. It’s amazing how many people have probably died and committed suicide because they couldn’t afford healthcare.

It’s really a shame how the wealthiest nation on the planet can’t provide for its citizens.

Or it means that to become the wealthiest nation, you’ve got to be ruthless and screw the poor. This means America will be a wealthy country, shitty healthcare, literally shit on the streets and will do absolutely fuck all when natural disasters hit.

[alexanderstears]

American healthcare isn't universally crappy, it's just expensive at every quality level.

I don't think America became wealthy because it has crappy social services, but I think that a crappy social safety net and a big upside to personal success makes it an environment that really gets peak performance out of driven people.