[rogerbinns]

> This is what's really strange about the American healthcare system ...

It gets worse. Each entity in the system applies their own rules. eg a friend had an eye exam at the doctors and they took 11 months to bill[0]. The doctor group pointed out their small print says they have 12 months to bill. The insurance company had a shorter time frame and refused to pay. But it was a scam - the doctor had changed the diagnosis code to get more money, and the insurer would have refused to pay so they kept more money. My friend lost.

It is very easy to see which proposals will "fix" things. Look at which groups make less money due to the fixes (doctors, insurers, medical groups, equipment makers, drug companies etc). It is extremely rare for that to be shown, and all those groups will fight to keep what is "theirs".

> American healthcare is ridiculously inefficient because it appears wholly designed to be byzantine.

I like the word confusopoly https://en.wikipedia.org/wiki/Confusopoly

  Confusopoly is an economic and marketing term referring to a purposeful
  act by a seller or group of sellers to confuse the buyer in order to ease the sale

[0] those fortunate enough not to deal with USA healthcare are probably wondering how this could happen. The answer is that any visit now results in a blizzard of electronic and paper communication, including satisfaction surveys, "courtesy" statements with many dollar numbers all over them that don't add up, stuff telling you legal information, and more saying one party has done stuff (eg billed or paid) on your behalf but you are still liable if it doesn't all complete, co pays, deductibles, random others because of in and out network nonsense etc. And this is a superficial description - how would anyone know?