I understand this, but don’t understand why millions of people are ok with the system. It has a lot more in common with a protection racket than with patient care in my view.
It's not that millions of people are "OK" with it, but that in practice democratic elections aren't actually about policy. Suppose Alice's policy is to do X, and Bob's policy is to do Y, we might suppose voters who overwhelmingly want X will go vote for Alice, but nope, the Bob voters will still vote Bob and then be annoyed that Y happened, independent of continuing to support Bob. That doesn't make sense, but it's what happens.
This would be a grave defect if the purpose of democracy was to achieve good government, but in fact we haven't the faintest idea how to get good government, democracy is a fix for bloodshed during the inevitable power transitions. So, a bunch of idiots with no clue are still in charge, but now a _different_ bunch of idiots can take over without having to murder a bunch of people to do it.
Not true, because people actually hate insurance companies. The best propaganda is by the hospitals because no one ever seems to complain much about them.
There's been a lot of revealing reporting over the past decade but people don't seem to care: the price of a procedure in two different hospitals in the same city can vary by 10x because they literally pull prices they charge from their asses. They tend to justify this by saying "no one ever pays that price".
But when I got a bill for my wife's surgery that included 15k for 1 hour in a recovery room, another 25k for 1 hour in a surgery room, and 9k for an overnight stay (on top of the 20k from the surgeon, 3k from the anesthesiologist, and 3-5k from random doctors we saw for a few seconds) those words sure as shit were not reassuring.
All my past attempts to get an idea of what something might cost me, even when I knew insurance wouldn't cover it, have failed. It takes days worth of time on the phone only to get the wrong answer. One even told me that I only get the cash price if I don't have insurance even if my insurance won't cover it - and I must have insurance because its illegal to not have insurance so I can't get the cash price. What the fuck man?
Hospitals can fuck off. I have no idea why they don't get more blame in this mess.
I think it's something in the American mindset. It's been said before, but Americans think of themselves as "temporarily embarrassed millionaires" when voting (hence why they consistently vote in the interests of the rich - everyone thinks they'll benefit from those tax cuts when they win the lottery/sell their startup/etc).
Same situation here; "health care costs are for those sick losers. I'm not going to get sick, so it doesn't matter to me how much it costs, and I don't want to pay more tax to reduce healthcare costs for those losers".
I exaggerate, but it does seem like there's something like this going on...
I agree with you in part, but in my opinion propaganda and lobbying are the problem because this is the source of the disconnect. When people got increased protections from the ACA, nobody complained. The insurance and hospitals deliberately shitcanned the healthcare marketplace and MOST pepole don't put much thought into why the mandated insurance became unconscionably expensinve, they just thought "Obamacare is worhtless" because that's what they were told.
I don't think it's specifically an American thing to avoid much thought about becoming really ill. It's an uncomfortable subject.
It is partly a cultural thing - a kind of cult of narcissism.
But those attitudes are carefully cultivated by the media. They don't just happen.
Congress and the Senate are full of corrupt leeches, and both parties are equally guilty.
Votes make no difference. Corporate money buys political careers, and it pays for both sides.
There are a few exceptions, cultivated to maintain the appearance of representative democracy, but they're rarely - if ever - allowed anywhere near policy.
Those aren't the equivalencies I'm asserting. My position is that members of both parties expend far too much energy working on re-election fundraising versus working for the people. That's the equivalency I'm asserting.
I don't think millions of people are okay with it. I think the vast majority are unaware, those who are aware have no agency, and very powerful interests seek to maintain the status quo.
yeah. Can you refuse treatment from an OON provider in a hospital? Because that would be my first question if approached by a doctor who could potentially bill me $100K
For ER agreed. For anything else that is serious / non trivial, you also want to consider the repuation of the department. Some doctors are world specialist of something, or treat dozens of a particular condition every year. Others rarely do or are simply not good. I don't think there is any way for a layman to know. You kind of need to ask relatives in the profession, who can themselves ask around. I have a few doctors as relatives and they systematically check the reputation.
