[dragonwriter]

> What we really need is automated administration and billings to really move the needle

Right, because every other developed countries gets similar outcomes at lower costs (poor capita, per GDP, or on any other reasonable basis for comparison) because they are far ahead of us on automated administration and billing.

There might be countries where that's what's needed, but in the US there's clearly a lot of lower hanging fruit that doesn't require any new technology.

[PButtNutter]

Yeah, so I work at a huge health tech company. A lot of the issue is actually private insurance.

Currently in the US the largest health insurance provider is actually medicare/medicaid. When a patient with medicare goes to the doctor, the government says "This is what we will pay for that procedure, no exceptions." The hospital has a choice to either accept that rate, or to lose out on the massive medicare market.

Private health insurances plans have vastly fewer subscribers, and don't have the power to negotiate prices like the government does.

But regardless, why is health care and insurance a for-profit industry? It creates incentives to put profits ahead of people's health.

[dragonwriter]

> Currently in the US the largest health insurance provider is actually medicare/medicaid.

Medicaid is more 50 different insurance providers (it's run by each state—with separate programs for, at least, D.C., Puerto Rico, and Guam, and it's not even a single insurer in every state, e.g., California uses a number of county-level managed care plans as well as a traditional fee-for-service plan.) And all of them are separate from Medicare. Which also is less of a single insurer with common coverage policies than it seems on the face (even excluding Medicare Advantage, which is just publicly subsidized private insurance), since whether any given procedure in reasonable and necessary and therefore covered in any given geogrpahical area in Medicare depends on local coverage determinations made by the private insurer that is the Medicare Administrative Contractor for that region and claim type (there are separate contractors, with different geogrpahical regions, for regular part A&B claims, home health and hospice claims, and durable medical equipment claims.)