The Astonishingly High Administrative Costs of U.S. Health Care

https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html

by digital55 • 8 years ago

232 166 8 years ago

nytimes.com

cozzyd• 8 years ago

"Your desire to live is my opportunity" - some health care administrator.

ethbro15• 8 years ago

Never ascribe to malice, what can be explained by apathy.

tedajax2• 8 years ago

If you're so apathetic as to be actively harmful that's still malicious.

Also, as they are actively looking to increase profits, I can't possibly see how this is "apathetic".

Quit making excuses for garbage people.

dredmorbius3• 8 years ago

Arendt's book introduced the expression and concept "the banality of evil".[6] Her thesis is that Eichmann was not a fanatic or sociopath, but an extremely average person who relied on cliché defenses rather than thinking for himself and was motivated by professional promotion rather than ideology. Banality, in this sense, is not that Eichmann's actions were ordinary, or that there is a potential Eichmann in all of us, but that his actions were motivated by a sort of stupidity which was wholly unexceptional.

https://en.wikipedia.org/wiki/Eichmann_in_Jerusalem#The_bana...

sp332• 8 years ago

http://i.imgur.com/ddU50.jpg

"We prefer your extinction to the loss of our job!"

"Too far-fetched?" "Not enough, really."

LyndsySimon7• 8 years ago

That is an awesome comic.

Bucephalus355• 8 years ago

I wish I had a link for this, but I believe as Obamacare was being drafted / the economy was in dire straits in 2009, the Obama administration had to make a choice about whether to radically streamline health care, but at the cost of killing employment in (at the time) the only growing sector of the United States.

They chose to not streamline it, which is understandable, but obviously a price had to be paid at some point.

Related story, went with my wife into a small but advanced local hospital where she has a surgical consult about her sinuses. This hospital was beautiful and fully loaded with all the latest technology, big screen TVs, tablets, etc. Nonetheless, in the waiting room there were 5 office admins each with dual monitors checking people in. It’s like they didn’t get any benefit at all from the technology......

ebikelaw• 8 years ago

This is the problem with common economic measures. We spend 18% of GDP on health care, but that's just overhead and we should be trying to drive it to zero.

toomuchtodo3• 8 years ago

The people who are that overhead do not want it to be driven to zero.

AnimalMuppet2• 8 years ago

If you have a way of driving the cost to zero without driving the delivery of healthcare to zero, we'd all love to see the plan. Too much of it is overhead, but not all of it, nor even close to all.

EliRivers• 8 years ago

Graeber in "Bullshit Jobs" quotes President Obama, but I can't find an independent source of the quote right now.

To account for that persistence, Graeber quotes President Barack Obama on the topic of privatized health care. “Everybody who supports single-payer health care says, ‘Look at all this money we would be saving from insurance and paperwork,’ ” the former President noted. “That represents one million, two million, three million jobs.”

https://www.newyorker.com/books/under-review/the-bullshit-jo...

bunderbunder4• 8 years ago

A more optimistic formulation would be that that represents millions of people who could be doing something a bit more generally useful than mastering the intricacies of the layers and layers of bureaucracy built up around medical billing. And probably wouldn't mind having a slightly less mind-numbing job themselves.

Too bad the US is also epically bad at supporting people in career transitions.

philipkglass2• 8 years ago

The source appears to be this 2006 article in The Nation:

https://www.thenation.com/article/mr-obama-goes-washington/

It's interesting that Obama's argument for protecting health insurance administration jobs precedes both his presidential campaign and the Great Recession. The whole article is a telling foreshadowing that future-President Obama was not going to be as progressive as progressives hoped (or as conservatives feared). It's also a painful reminder that propping up low-value or even negative-value activities to "preserve jobs" is a bipartisan sport.

oh_sigh2• 8 years ago

Propping up useless jobs is only unacceptable to some when it is blue-collar jobs in red states(eg steel and coal).

criddell• 8 years ago

Isn't Obama just arguing for a version of the broken windows fallacy?

phobosdeimos2• 8 years ago

I was watching the Expanse tv show and they were talking about how half the population was on Basic Assistance.

I am not sure if it will ever happen, especially not in America were work is sacred. But paying people not to have jobs seems like a good deal. Keeps them from fucking up and maybe they can do something productive for society like growing wine or teaching children in Bangladesh to read.

bnolsen• 8 years ago

And think of all the doctors who would be pissed off to become de facto slaves of the state. Of course they could get paid by catering to the rich who would pay them out of pocket...

btrettel• 8 years ago

How do you eliminate wasteful jobs without backlash? Stop hiring and let attrition take care of the problem?

In 2009, they'd have to look to increase employment elsewhere.

oh_sigh2• 8 years ago

That's still painful, because you have an entire pipeline of people feeding those useless jobs. Yes, the ones with the useless jobs get to stay, but the many people who were planning their lives around getting a useless job(with their useless skills) now need to find something to do.

Let me be clear: I don't support keep useless jobs around simply because it would be painful to the employee to lose their job.

ethbro15• 8 years ago

Based on my experience (working around insurance IT during ACA implementation), the best solution is setting performance goals, then rebating some of the savings to the party for exceeding them. With the rebates tailing off after a number of years.

This allows the party cutting costs the flexibility to reallocate now-redundant people directly to problem areas, without having to procure additional funding. The rebates cover the cost of retraining (maybe mandate this for for-profit parties).

LyndsySimon7• 8 years ago

I would argue that it simply isn't the responsibility of the state to ensure that there is a continuing market for a given set of skills.

Sure, it's a problem when industries and job classes disappear - but keeping them around doesn't solve the problem, it only defers it. In many (most? all?) cases it even makes it worse.

dragonwriter6• 8 years ago

In 2009, they'd have to look to increase employment elsewhere

A goverment-mandated major healthcare streamlining would reduce health administration and support (financing, management, IT, billing, coding, legal support, etc., etc., etc.) in the long term, but in the short term it would create lots of jobs—and mostly in the same general space—in a a surge that (with the most likely kind of implementation timeline) would ramp up over a couple years of implementation planning, stay steady for a few years of main implementation, and then taper off to the new, lower equilibrium as new systems and processes moved from implementation to routine operation.

Probably no better time for that than an economic downturn where employment was soft, if the government is deficit funding to subsidize the implementation costs. It's basically a short-term jobs program with long term dividends for the whole economy.

mac010212• 8 years ago

Foster competition?

If a company can capture a greater share of the market by offering the same service with a lower premium, isn't that what they'll do?

I don't know why that effect is not present now, but it could have much to do with the way most people get insurance through a group policy provided by their employer (and therefore get no chance to shop around).

lostlogin• 8 years ago

Insurance companies have cleverly handed off administration of their crappy system to the facilities that do the work. Their systems often betray a lack of understanding of what is being done and it’s time consuming to work through. A quick search suggests that 15% of US healthcare costs are due to this - $350 billion. Pretty sure that this isn’t news to anyone.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283267/

JacobDotVI• 8 years ago

I hope this is part of how Amazon / JPM / Berkshire goes after health care, by becoming a TPA and reducing these admin costs through an API layer:

https://blog.jacob.vi/amazon-as-a-tpa-or-how-amazon-solved-i...

ergothus• 8 years ago

This may be being handled off to us. I just got appts for both a nutritionists and a sleep specialist, and the clinics explicitly asked ME to find out if it is covered, mumbling something about the particular insurer (blue shield of AL) requiring it

cameldrv• 8 years ago

This is seriously obnoxious. The last few times someone in my family has been to see the doctor, something hasn't been covered for some inexplicable reason. It always turns out that according to the insurance company there is some disallowed code and the insurance company won't say what the right one is. The doctors office always acts annoyed that you're bothering them with petty details like a $2000 charge. It's infuriating.

dragonwriter6• 8 years ago

Obamacare was being drafted / the economy was in dire straits in 2009, the Obama administration had to make a choice about whether to radically streamline health care, but at the cost of killing employment in (at the time) the only growing sector of the United States.

The basic outline of healthcare reform that all the leading candidates in the Democratic side had signed on to well before the first of the 2008 privates had gained broad consensus among party elites well before that. It was not a reaction to conditions in 2009, unless there was a whole lot of parallel construction to cover up the Democratic Party’s access to a reliable crystal ball (an idea that the 2016 election would cast serious doubt on even if it was otherwise plausible.)

gerdesj• 8 years ago

"the economy was in dire straits in 2009"

I'm a foreigner but to me Obamacare appears to be an effort to ensure that everyone in the US can have reasonably priced access to healthcare. That seems a laudable aim. In the UK we have the National Health Service which has a similar aim.

The NHS was formed in 1948. The UK economy at the time could also be described as being in dire straits but perhaps with a little more emphasis.

wu-ikkyu6• 8 years ago

Did you know Obamacare fined you $695 or 2.5% of your household's income (whichever is greater) if you went for more than 2 months without health insurance? That doesn't seem very laudable.

duxup• 8 years ago

I think had they chosen a radical path... it wouldn't have gotten the votes.

conorh• 8 years ago

At my wife's practice they employ two people full time just to do insurance authorizations.

edit: actually one of those people does verification (checking to see what insurance patients have, what is covered, and estimate what they will owe) and the other person just does authorization (getting the insurance company to approve the procedure)

Spooky23• 8 years ago

I use my GP as the example. It's a fun tale.

When he was in a partnership with 4 other doctors, he started with a paper system. They had two receptionists, and three clerk/billers. I used to help him out with some tech stuff.

They implemented an EMR prior to the Medicare mandate, with an ROI driven by dropping 2.5 FTE. They ended up dropping the clerks and hiring IT expertise at a cost 50% higher than the clerks.

Medicare mandate came, and the EMR didn't meet requirements and had to be replaced. They joined a larger physician group, and paid for 0.2 IT FTE. But they had to hire two PAs and a NP to drive revenue and now have 6 clerical people. (+1 from paper)

Now they were acqui-hired by a sprawling medical network. Their cost center became a dumping ground for redundant hospital staff and they have 10 non-medical people (+5 from paper-based, independent practice). Now they run two EMRs and are transitioning to a third. They lost the ability to collect money at the counter, and now bill for every co-pay and lab. (My wife received a paper bill for $0.78 for a pregnancy test via postal mail)

In short, between bad policy, government encouragement of cartel behavior, and general stupid big company bullshit my doctor went from a progressive medical practice with talented doctors and medical staff to a bloated sales funnel for unnecessary specialist care over the course of about 15 years.

nojvek3• 8 years ago

Granted America’s love for ACA is sound. Poor people shouldn’t have to forgo medical procedures because they are poor and die.

But the execution is a giant shit show. Trump abandoned it but I highly doubt anything will replace it.

If Trump doesn’t cause another financial disaster, there are chances the next President can make some headway to get US a sane healthcare system.

It’s so ripe for disruption. Amazon’s insane valuation I bet is also based on the fact that they are going after Healthcare. If they can bring Amazon level service and convinience we may turn the tables.

Personal preference but even though I don’t support making Bezos accumulate so much wealth, Amazon prime service is unbeatable. It’s just so darn convenient. I don’t see any close alternative.

fma6• 8 years ago

What's interesting is I heard that if you pay cash, up front the doctor's office will charge you less. So I had this appointment (forgot for what) and they gave an estimate with my insurance. I asked...if I wanted to pay for all of it right now, how much would it cost...and she said it would be the same.

Of course I said ok, fine...run it through insurance. That year I wasn't going to meet deductible so I had no incentive to go through insurance.

randysavage2• 8 years ago

My wife needed an MRI last year. The hospital quoted us $4000 as self-pay, but would knock it down to $2000 if we paid cash up front. This was late December, so we picked up insurance through the marketplace and she had the MRI done in January, billed to insurance at $250.

This still boggles my mind... I understand the insurance provider negotiates bulk rates, but we were paying up front, in cash, and were still quoted 8x the insurance price.

LyndsySimon7• 8 years ago

What's interesting is I heard that if you pay cash, up front the doctor's office will charge you less.

I was a member of a "health cost sharing ministry" for about a year, while working for a startup that didn't offer insurance.

The idea was that I paid a monthly membership fee to the ministry, and in exchange they would cover my healthcare costs - minus a set amount, for which I was responsible directly. If I made the effort to negotiate a discount with the provider, that discount counted toward the part I was responsible for.

By inquiring about a cash discount and being able to provide a reasonable assurance that the bill would actually get paid in a timely manner, I never once paid out of pocket for a doctor's visit during that time.

FPGAhacker• 8 years ago

In Oregon it’s illegal to bill different amounts to different payers. So you have to be billed what they would be bill insurance for.

They can give you a processing discount but it is negligible and only applies to services rendered at that time.

Also they have to pay the insurance handling clerk whether you pay cash or not. The marginal savings are small.

maxerickson• 8 years ago

For how many doctors?

Ideally we'd be in a situation where your wife had time to do much of that stuff herself, so that she was cutting prices to attract patient load instead of paying 2 people to help increase the time available to serve patient load.

specialist3• 8 years ago

I usually link to this chart whenever this topic comes up.

Growth of Physicians & Administrators 1970-2009 http://gomerblog.com/2015/12/healthcare-costs/

TL;DR: Our overhead is ridiculous.

Any one who has worked inside the beast knows single payer is the correct next step, followed by replacing fee-for-service (treating disease) with capitation (incentivizing wellness).

Not a big mystery. Just look around at what other jurisdictions are doing, copy what works.

ryandrake• 8 years ago

Single payer will never be implemented in the US without massive political and social change. It is ideologically opposed here in at least three ways:

1. Healthcare is a luxury that must be earned. Giving it away to people who don’t deserve it is categorically bad.

2. Jobs are important. Universal healthcare would mean fewer people working in the various health industry bureaucracies, which is categorically bad.

3. Business is important. Universal healthcare would kill or cripple health insurance business which is categorically bad.

spydum• 8 years ago

That entire site seems clearly satire.. not sure if you were being serious or what?

tabtab• 8 years ago

As worded, it sounds like emulating the Switzerland or Germany model is the best solution. They offer decent patient choice but don't pay significantly higher for that choice than single-system countries. USA citizens on average prefer choice, and would probably agree to pay a little more to get choice.

mkirklions• 8 years ago

If you ever want to know why something sucks, just look at who is bribing politicians:

https://www.opensecrets.org/lobby/top.php?indexType=s

So here is the process it takes to get medicine that is legal in china.

Schedule appointment, talk to 1 person
Wait in the lobby, talk to 1 person and fill out government HIPPA + clinic paperwork
Go to back room, talk to nurse. Fill out paperwork
Wait
Talk to Physicians Assistant or Physician, get perscription
Pay office 120 dollars
forward perscription to pharmacy 1-2 people involved
Go to pharmacy
Talk to person at register
Pay

Remember that in China, you just go to the store to buy 4$ amoxicillin. And despite the Physicians in the United States screaming about superbugs, China and Mexico both havent made superbugs despite not having massive regulations.

This is a self made problem from corruption. The Medical profession milks the consumer because the consumer has no other option.

felix_nagaand• 8 years ago

Antibiotic resistant e.coli with mcr1 found in China.

https://www.scientificamerican.com/article/superbug-resistan...

fma6• 8 years ago

You're being downvoted probably because of the superbug statement...but my wife had surgery to remove a breast lump. It cost $3k and with all these appointments it happened over the course of 2 months. The cost does not include all these other scans and crap before.

My cousin went to China (family visit). Lump was discovered here...surgery in China. Got seen in one day, surgery the next. $800.

When my wife discovered a new lump...just doing follow up scans was $900. $500 for imaging center, $200 for the doctor at the imaging center...and $200 for her annual physical (they billed it as a problem visit and not an annual because she brought up the fact she has a lump, rather than the doctor finding it, even though breast cancer detection is part of annual!...still fighting, but I'll probably drop it because it's so stressful and time consuming)

madengr• 8 years ago

So that’s why I can’t be seen for a physical and problem at the same time. What a load of shit.

cepth• 8 years ago

Of all the healthcare systems to negatively compare the US system to, I don't really think China is a good pick. Comparing the times that I've had to use medical care in China to my general experience in the US, I would opt for the latter every time. For a simple outpatient visit, I showed up to a well-regarded hospital, where I was greeted with a 2-hour wait, an overwhelmed front desk staff, and a session with a doctor that felt too rushed.

For recurring mild headaches, the doctor prescribed medicine that a doctor in the US would have recommended only for migraines. I tossed that RX script in the trash as soon as I left the office. This was my first personal brush with the flip side of the easy access to drugs in China: the phenomenon of overprescription (https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010.... & https://blogs.wsj.com/chinarealtime/2015/04/02/chinas-health...).

If you've spent time in China (and it sounds like you may have), you've probably been exposed to the level of health supplement and "pharmaceutical" product marketing in China. It's prevalent on TV, on WeChat, and in newspapers. Supplements like "Nao Bai Jin", which is effectively just melatonin, get pushed on the public without government intervention. "Doctors" regularly appear on elaborate infomercials to promote supplements that claim to do everything from removing heavy metals from you blood to improving kidney function. All of these are available without a prescription.

---

This is not to mention that if you're too poor to afford private health insurance in China (i.e. the vast majority of the population), you're stuck with the bare bones basic health insurance the government provides.

For all the hysteria around Obamacare "death panels", it is actually the case in China that patients with terminal conditions are routinely sent home, since hospitals are so overcrowded (particularly in larger cities) and bed spaces are so limited. If the cost of drugs for a treatable disease or condition is too high, public insurance can refuse to pay for it outright.

If it's political corruption you're worried about, keep in mind that the Chinese FDA is only getting a much-needed reorganization as an independent agency this year, and has seen scandals like this: https://foreignpolicy.com/2014/08/13/a-whistleblower-goes-pu.... This is not to mention that still fresh in many people's memories are the massive coverup of SARS in 2003, and a coverup of avian flu in 2013 (https://www.theguardian.com/world/2013/apr/03/china-reports-...).

I'm no fan of administrative bloat, and it's somewhat ironic that access to drugs in China is in many ways more "free market" than in the US, but I don't think medical/pharma "corruption" is any less prevalent in China.

madhadron• 8 years ago

Your choice of amoxicilin is a very bad example.

Antibiotics aren't tightly controlled enough. We need international treaties that prevent this kind of over the counter sale and countries required to track statistics of the prescription of antibiotics. The utter disregard of the commons that is the effectiveness of antibiotics makes me despair.

assblaster3• 8 years ago

Administrative = bureaucratic.

Government-run healthcare has the same problems associated with heavily regulated sectors like our current healthcare system, but to a much larger degree because of lack of incentives to improve performance.

The way to decrease cost is decrease regulation and get rid of all the unnecessary paper pushers we have right now.

jjoonathan3• 8 years ago

Back in Health Care Policy class I dug through these numbers and the opposite was true: bureaucratic overhead was much larger in the US system. The US system also wound up being twice as expensive overall.

Has that changed or are you just repeating a talking point you heard somewhere?

Markets serve the person with bargaining power. If doctors and drug companies have all the bargaining power -- and in the most important health care situations, they do -- why do you think a free-er market will give you a better deal?

assblaster3• 8 years ago

The US system is a combination of heavily regulated private industry and government-run healthcare.

The US is ridiculously more expensive than other countries precisely because of regulations and government-run bureaucracy (and defensive medicine, and poorly run bidding for drugs and equipment, and fraud).

Government-run healthcare actually puts all the bargaining power in themselves, but they don't try to cut costs because that's not an incentive in government. Actually with government, the more you spend in one year, the more you get budgeted the next year. The worst way to run a government agency, in the eyes of bureaucrats is to run leaner than budget because your budget will be cut the next year.

Doctors have very close to no bargaining power.

chimeracoder3• 8 years ago

Markets serve the person with bargaining power. If doctors and drug companies have all the bargaining power -- and in the most important health care situations, they do -- why do you think a free-er market will give you a better deal?

Contrary to popular opinion, doctors have close to zero bargaining power in the US. That's why private practices have been rapidly shutting their doors over the last 10-15 years - they've been losing money, so they've had to sell their practices to large provider networks. But even those hospital networks don't have much bargaining power, which is why many of those have been going out of business and either shutting their doors or consolidating in the last 5-10 years.

Someone• 8 years ago

”If doctors and drug companies have all the bargaining power -- and in the most important health care situations, they do”

Not everywhere. It’s miles away from what people in the USA think they want, but governments can intervene on behalf of patients. https://www.government.nl/topics/medicines/keeping-medicines...:

”The Ministry of Health, Welfare and Sport and the Healthcare Institute of the Netherlands decide what drugs fall under the standard health insurance package […] The Netherlands and Belgium are going to jointly negotiate lower drug prices with pharmaceutical companies. Together, the two countries represent a larger group of patients. This will make it easier for them to negotiate lower prices with drug companies. They will especially try to negotiate lower prices for expensive medicines, including orphan drugs which are used to treat rare diseases.“

wu-ikkyu6• 8 years ago

If doctors and drug companies have all the bargaining power -- and in the most important health care situations, they do -- why do you think a free-er market will give you a better deal?

Much of that bargaining power has been given to them by the government which denies your human right to medicine without their blessing.

Patent laws, forcing you to go to a doctor to get medicine, and the arbitrary prohibition of unprofitable/unpatentable medicines like cannabis all contribute to their bargaining power.

wpdev_63• 8 years ago

Ideally you would be able to get a cash based health insurance policy where they would have a doctor diagnose you quickly/cheaply and then give you the cash to pay the doctor yourself. This way you could fly to different countries for cheaper care. That's what I would do anyways.

mhkool• 8 years ago

The reason that health care costs rise in almost all countries is that we are doing something wrong. The question is what? Can it be that doctors who do not try to find the root causes of diseases have no solutions ? Can it be that doctors who prescribe drugs to suppress symtoms cause problems in the long run ?

Cancer is a disease with high costs where a lot can be gained. Watch a documentary about Dr Burzynski who has a cure for various types of cancer: https://www.youtube.com/watch?v=rBUGVkmmwbk The documentary shows how officials and the National Cancer Institute work against him and hence continue the high cost.

On websites like https://drhyman.com and https://www.chriskresser.com you can find doctors who explain a lot about root causes of diseases and how to cure oneself. If all would read these sites the costs for health would drop more than 50%.

tathougies2• 8 years ago

Chris Kresser -- despite his many virtues -- is not a doctor. Moreover, he has never published any research indicating his findings or results are statistically significant. While his advice is often good, there is no reason to believe that it offers 'cures' to diseases hitherto considered uncurable. If anything, the fact that you think he's a doctor with magic cures suggests the need for ever more regulation, and thus bureaucracy.

LyndsySimon7• 8 years ago

If anything, the fact that you think he's a doctor with magic cures suggests the need for ever more regulation, and thus bureaucracy.

Why? Why should the state assume the burden of protecting someone from themselves?

I might see it differently if knowledgeable, well-researched care were difficult to find... but it's not. If someone decides they want to go to a homeopath to treat their terminal illness, why should we stop them?

Simulacra• 8 years ago

I think the biggest driver of healthcare costs is the middle-men. All of the people who pad the bill, add fees, etc. The doctors who step into the O.R. for a minute and charge a fee[0]. They all add to feeding at the trough, so to speak..

[0]. https://www.nytimes.com/2014/09/21/us/drive-by-doctoring-sur...

chadmeister• 8 years ago

Healthcare tends towards natural monopolies. Without competitive pressures, what incentives are there for them to slim?

richpimp• 8 years ago

I wonder with more frequency every day if there will ever truly be a solution to the problem of rising health care costs in the US. I see a lot of posts here suggesting that privatization should be removed, and any jobs lost that are related to the current industry will be unfortunate byproducts of getting rid of a broken system; a necessary evil that will ultimately make way for a health care system that is both cheaper and available to all.

It's tempting and easy to adopt that line of thinking given where, I would suspect most of us here, are at in our lives from a career and financial perspective. As a software developer, it's easy for me to switch jobs and make a good wage. I can weather most unforeseen costs. In the decade plus that I spent working blue collar jobs for a very low wage, I would've been screwed if I'd lost my job.

This speaks to a much larger problem that is consuming the US every day. I don't have any answers, but I can empathize with those who fear their livelihoods being taken away, even if saving those jobs has a net negative effect on the economy and job market. There isn't a day that goes by, especially in today's political climate, where I'm not thankful for having the opportunity to put myself in a better position. I'm the outlier, though. Most people can never bring themselves up out of poverty.

analog312• 8 years ago

...any jobs lost that are related to the current industry will be unfortunate byproducts of getting rid of a broken system

I'm tempted to argue that an equal number of jobs are lost every day to the opportunity cost of people not taking business risks due to the added risk of losing their healthcare, myself included. My optimistic vision is that the economic growth resulting from removing this burden will absorb the displaced workers, plus create even more jobs on top of that.

nojvek3• 8 years ago

We forget. This isn’t going to happen overnight. Sure people will lose jobs, but not millions overnight.

Imagine how many humans are spending their lives doing busy work. We can free them up to do better things.

Imagine how many good doctors have to join a medical factory where they churn out patients and slap big bills. Going solo doesn’t make sense.

Just the way cloud made it so Indie hackers can build great products with a small team, Healthcare needs this “cloud” like system which takes care of all the unnecessary bullshit related to insurance and payments so they can focus on the core of providing great service and making people healthier.

knuththetruth• 8 years ago

The problem with this logic is that things like insurance companies are making decisions that bankrupt and even kill people every day, for their own profit. That’s the reality of privatized healthcare.

I empathize with the people who would lose their livehoods as well, but not above people who are broke or dying, right now, because of how terrible the American healthcare system is.

throwaway37585• 8 years ago

That’s the reality of privatized healthcare.

What makes you say this a problem with "privatized healthcare" rather than a systemic problem with how it works in the U.S.?

brandonmenc• 8 years ago

If we had a similarly broken system for say, acquiring groceries, no one would even question firing everyone involved to replace it with something different for the greater good.

paulcole• 8 years ago

Trust me, if somebody was getting rich off of selling groceries and they had managed to convince the people who hadn't starved yet that things were fine and anybody who couldn't afford groceries was a freeloader, nothing would change.

snarfybarfy• 8 years ago

The health care and pharma industry is in serious need of some whistle-blowers.

The Astonishingly High Administrative Costs of U.S. Health Care

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