[maxerickson]

If the amount to bill the patient's insurance is determined after the complication, it's not an unpredictable risk, it's a fact. If it can't be predicted, then it more or less exists for each procedure, but that isn't reflected in the cost, the patient that has the bad experience gets charged extra for it.

[riceart]

Insurance exists to cover losses from unexpected events. Medical complications are unexpected events.

Your hungover surgeon is a bullshit strawman - most complications have nothing to do with provider malice or incompetence. Again since that seems to be the angle you are starting with you clearly have no interest in a grown up discussion or too ignorant and also full of hubris to understand any of this (which fits in perfectly well on this site).

If you throw a massive clot after a surgery and stroke out who’s fault was that if all the standard protocols for clot prevention were followed. Maybe you’re a smoker (or not) and 5 years later that unknown cancer will finally declare itself.

> more or less exists for each procedure

This is extremely misleading as it does not exist in any meaningful level of risk across the entire patient population.

[bandrami]

I think you're getting hung up on a joke about the hung-over doctor. The problem is that whatever the complication is, it should be amortized over all the deliveries of that treatment, not the one case where it happens to occur.

[maxerickson]

If they can predict the complication, they can bill for it ahead of time.

It is all insurance in the end, but the incentives created by pushing the providers to bill ahead are better than the ones created by letting them bill for what they do.