> “Patients go to providers for care. Providers provide that care. Patients get a bill and if they can afford it, they pay that bill.”

Well. I have good news for you, that’s how my policy on the NYS of Health works. AKA. Obama Care

Visit https://nystateofhealth.ny.gov/individual/ Find, "Compare Plans & Estimate Costs". You can get insurance plan cost estimates, including Obama Care Tax Credits. Just enter a zip code in NY, and "hypothetical" family size and income and away you go.

I don't hold it against you for not knowing (hehe). You're not alone. Short story--I had a bout of bursitis. My Bronze level health plan lets me make an appointment directly with a Orthopedic/Sports Med doctor. I live on Long Island NY and rent in the affluent North Shore.

I collected a list of doctors, increasingly further from my home, and start calling nearby offices. My first question, What does it cost to see the doctor? OFFICE: I can't answer that question, because I don't know what the doctor might order. ME: Lets hypothetically assume whatever the doctor orders, I will not be taking that service. Now how much to just walk in the door and see the doctor?

They just won't accept the premise; This goes back and forth for a minute too long. OFFICE: I thought you said you have have insurance?

Yes. I have an Obama Care plan from NY State. Maybe you don't realize how many of these plans work, I explain. I have ~8k/y deductible. In other words, I have to spend 8k on health care before insurance co-pays kick in. Otherwise, I pay the full amount of the agreed service's price--the price agreed by doctors and insurance in my health plan's network. OFFICE: How did you get our number? ME: From my insurance's list of in-network providers. OFFICE: <click>

Did you catch that? They're in-network, but don't know how the insurance their office accepts actually works for patients. I had similar situations as I moved through the list. Ultimately it was a large network provider that accepted the premise and gave me the "see the doctor cost". It was actually very reasonable.

[EDIT: clarity on health plan details]

Skip the office doctors. Use the best AI instead. Pay the local testing lab or facility directly for the tests advised by the AI.

If a non-urgent intervention is needed, competitively pay directly at 1/10th the current price by virtue of competition. If an urgent intervention is needed, you need insurance to pay, otherwise throw the bill in the trash.

Stick to low cost generic meds only.

This actually is a sustainable model.

We should just have catastrophic health insurance and it should be fairly healthcare dumb.

Not completely dumb you have to analyze the risk, and make sure you are getting scammed, and should be able to negotiate. But it should basically be, if your costs for an event go above a $ threshold we pay for all of it above that threshold up to a certain point.

Whatever that costs to insure should be what health insurance costs.

One of the problems is America loves cheapening things so much. It's why ad companies run everything, it's why TVs are so terrible but huge, and it's why health care costs more.

Yeah, hard disagree with the conclusions in the linked article.

For reference: where I live, we have what can be summarized as "Obamacare as originally envisioned by Romney", i.e. a functioning insurance marketplace without too many carve-outs.

And... It does not Work! As in: everyone ends up paying pretty much the same, ever-increasing, and hardly reasonable premiums. Because: whatever your national/regional healthcare budget is, 80+% goes to fixed costs for mostly elderly (but sometimes just really unlucky) residents that simply cannot remain alive otherwise.

So, I see two options here: -The extended nuclear family, where each takes care of their own. Potentially workable, but very unpopular, and not just for fiscal reasons: who wants to change the nappies of their parents? -Outright socialism, where elder-care is part of a social-conscription program. Also highly unpopular (mostly amongst young voters), but maybe the only viable option? You do your 2/3/4 years of nappies-changing, and get your student debt wiped out? (Not that I think that student debt should be a thing, but, yeah)

Thoughts?