[tptacek]

Literally the same thing is true of health care providers, which is why we have artificially constrained supply of physicians, sky-high delivery of procedures other countries don't routinely do, and integer multiple compensation across the board for practitioners.

[cs702]

Yes. I almost added a comment about that too. In my experience, all doctors, nurses, and other caregivers with whom I have interacted at hospitals have told me they feel treated like "factory workers" who must meet stringent "quality of care" KPIs, set by hospital executives far removed from actual patient care.

[tptacek]

So why are we putting jerseys on and taking the field against the insurers when virtually all of the actual money is going to providers? We could zero out all insurance costs, putting insurers into literal de jure indentured servitude, and get nothing more than a grocery store circular coupon discount on health costs, because insurers are not in fact where the costs are.

[tbrownaw]

Shooting the messenger is a rather common hobby.

[cs702]

They are an integral part of the mess we're in, and they have a vested interest in the status quo.

Otherwise, I agree with you.

[tptacek]

I'm certainly not going to valorize insurers, but I find it deeply frustrating the providers are getting a pass here. You can see it on this thread, where there are commenters expressing surprise that I'd even suggest providers are the primary beneficiaries of the current system.

[cs702]

Yes, I see what you mean about the comments elsewhere on this thread/page. For what it's worth, I was only trying to avoid going off-topic ¯\_(ツ)_/¯

Regarding providers overcharging, the following article by Atul Gawande (from 15 years ago!) had a big impact on me -- it agrees with you:

https://www.newyorker.com/magazine/2009/06/01/the-cost-conun... / https://archive.ph/g8zXl

[huttyoop]

But why are you bringing it up, tptacek?

You’re even replying this to a comment that literally contains “I agree with you”.

It’s like stepping between your friends complaining about jet lag to talk about how your corner bodega raised the price of bubble gum.

If you just want to talk about providers then write a screed on it. People will comment their opinions on the subject you want to discuss.

[tptacek]

Because people are killing insurance company executives in the hopes of getting a maybe 5% savings break on their health insurance costs?

[joe_the_user]

The entire health care system is broken but insurance companies tend to be the pain people experience so that's what people lash out at.

But you don't expect someone dying from losing health care to shut up until they come up with rational cost management system? The point isn't that the average person needs to how to portion blame but that the health care system needs to stop treating people in the fashion it does.

[tptacek]

That's a problem though when the blame is so screwy, because it leads people to solutions that are not solutions. Medicare itself drastically overpays for medical services compared to the G20. The biggest problem is with providers, and it's exactly stuff like anesthesiologists overbilling for surgeries.

[joe_the_user]

Yes, the blame apportioned by the average person is screwy. But that should be clue to the experts with a more sophisticated view. What it should tell them is that health care reform schemes that rest on the average person exerting or responding to incentives are not going to work.