Perhaps we could use M/M to have DOGE enter thr healthcare industry itself. The fact that our Healthcare is approximately double the cost of other developed countries could be key to saving our country from the financial mess we're in. Not only would it address M/M costs, but the savings to everyone else thats not on M/M would be a huge stimulus

jamey said:

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flashplayer said:

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fauxstradamus said:

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flashplayer said:

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Twisted Helix said:

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Shareholder lawsuits incoming. Those Medicare advantage plans are popular and plenty. Wonder what will happen.

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My prediction is not much ultimately. Some settlement with the government to recoup some of the perceived fraud losses. What they're doing is common across the healthcare industry. Every patient is up coded and over coded to maximize reimbursement. Fraud is rampant.

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Insurance companies dont input the CPT codes when billing. You are implying fraud at the physician level. I think you are just spouting nonsense.

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I am implying fraud at all levels of the system. Including the physician level. And I am an insider on all those processes so I would know. Some of it is more subtle. Some of it is almost the culture of modern healthcare. But it's a lot of BS and I would love for the government to do a takedown of all the bad actors. It ain't happening though. Too many people stand to lose their livelihoods.

That said, I will not use this thread past this post to defend what I know on the topic. To keep my eye on the ball, I will probably buy some shares of United Health if they continue to drop over the next week or two.

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Ive been saying the single biggest DOGE savings could be the root of Medicare / Medicaid which is healthcare itself. Throw in everyone not in M/M and whipping healthcare into shape would be huge with a significant impact on everyone and take a big bite out of the never ending gov budget fiasco

Our costs are a multiple of other developed counties

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From Grok

The United States spends significantly more on healthcare per capita than other developed countries, yet it often ranks lower in health outcomes. Below is a comparison based on available data, focusing on per capita spending, key cost drivers, and outcomes, with figures primarily drawn from OECD data and other reliable sources up to 2025.
Per Capita Healthcare Spending
United States: In 2023, the U.S. spent $13,432 per person on healthcare, accounting for approximately 17.6% of GDP. By 2024, estimates suggest this rose to $14,570 per person, with total national health expenditure reaching $4.9 trillion.
Comparable Developed Countries (e.g., Australia, Canada, Germany, France, Japan, Netherlands, Sweden, Switzerland, UK):
Average: Around $7,393 per person in 2023, roughly half the U.S. figure.
Switzerland (second highest): $9,044 per person in 2022.
Germany: $7,383 per person in 2021.
OECD Average: Approximately $6,850 per person in 2022 (excluding the U.S.).
Key Cost Drivers in the U.S.
The U.S.'s higher spending is primarily driven by prices rather than utilization, as service usage rates (e.g., hospital discharges, procedures) are similar to peer nations. Major factors include:
Administrative Costs: The U.S. spends significantly more on administration, at $1,055 per person in 2021, compared to $245 on average in comparable countries. This includes costs for insurance overhead and government health programs like Medicare and Medicaid.
Prescription Drugs: U.S. drug prices are nearly double those in other developed countries, with $1,635 per capita spent on pharmaceuticals in 2021 versus $944 in peer nations. Lack of government price regulation is a key factor.
Physician and Hospital Costs:
U.S. generalist physicians earn $218,173 on average, compared to $86,607$154,126 in peer countries. Emergency room physicians earn $306,640, far exceeding Germany ($183,000) or the UK ($138,000).
Hospital services, like hip replacements ($28,167 in the U.S. vs. $16,622 in New Zealand), are pricier due to higher charges and administrative inefficiencies.
Inpatient and Outpatient Care: Nearly 80% of the spending gap between the U.S. and peers comes from hospital-based care, driven by higher prices for services.
Lack of Universal Coverage: Unlike other developed nations with compulsory universal healthcare, the U.S. relies on a voluntary, fragmented system, leaving 26 million uninsured in 2024 (9.2% of the population). This increases costs through uncompensated care and delayed treatments.
Health Outcomes
Despite high spending, U.S. health outcomes lag behind many developed countries:
Life Expectancy: The U.S. has the lowest among high-income nations at 78.6 years (2021), compared to the OECD average of 80.8 years.
Infant Mortality: Higher in the U.S. than in peer nations (e.g., 5.4 per 1,000 live births vs. 3.6 OECD average).
Maternal Mortality: The U.S. has the highest rate among developed countries, with 23.8 deaths per 100,000 live births (2020).
Avoidable Deaths: The U.S. leads in deaths from treatable causes, reflecting issues with timely access and quality care.
Chronic Diseases: The U.S. has the highest rate of multiple chronic conditions, partly due to higher obesity rates (double the OECD average).
Structural Differences
Healthcare System: Most developed countries have universal, government-regulated systems ensuring near-100% coverage. The U.S.'s reliance on private insurance and limited public programs (Medicare, Medicaid) results in inefficiencies and coverage gaps.
Price Regulation: Peer nations regulate drug and service prices, while the U.S. allows market-driven pricing, leading to higher costs.
Social Spending: The U.S. spends less on social services (e.g., 18.7% of GDP vs. 20% OECD average), which impacts health determinants like poverty and access to preventive care.
Why It Matters
High U.S. healthcare costs strain household budgets, contribute to 23% of working-age adults skipping care due to cost, and drive national debt, with Medicare spending projected to grow from 3.1% of GDP in 2023 to 5.5% by 2053. Meanwhile, poorer outcomes highlight inefficiencies, with the U.S. ranking last among 10 high-income nations in health system performance.
Sources
Peterson-KFF Health System Tracker, 2025
Commonwealth Fund Reports, 20232024
OECD Health Statistics, 20222024
Johns Hopkins Bloomberg School of Public Health, 2021
Posts on X reflecting public sentiment
For further details, explore the Peterson-KFF Health System Tracker (https://www.healthsystemtracker.org) or OECD Health Statistics (https://www.oecd.org). If you'd like a deeper dive into specific metrics or reforms, let me know!

fauxstradamus said:

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I have been a physician for 17 years. About half in the hospital system and half in outpatient setting. I do not claim to be an expert on the healthcare system but I can offer some insights based on my experience.

1. Chronic disease is obviously a major problem and a huge driver of costs. Prevention of chronic disease is where huge savings come. Our society in general has little interest in this. While I don't agree with everything from RFKJ, the MAHA movement is a good step in the right direction. The other side of that coin is managing chronic disease to limit secondary and expensive complications. Think controlled diabetes versus uncontrolled with a host of secondary problems. This leads me to point 2

2. Primary care access. There are less and less medical students who want to enter primary care. Falling reimbursements and massively increased patient loads. Less docs and shorter visits is less effective management. MIPS (quality scores) are now tied to reimbursements and encourage more comprehensive screening and preventative measures. It's a stick and not really a carrot by the way. We will see if that helps?

3. Physician salaries/Debt. Only 8% of annual healthcare costs can be attributed to physician salaries. Not sure what that number is outside US. Average medical school debt is 2-3x higher in US than other first world countries. As I stated in the other thread my reimbursements typically decline YoY. 30% in last 5 years. Part of that has gone to increasing reimbursement into primary care so as a whole that may help our shortages. (don't love it personally but it hopefully will be good for the system as a whole)

Anyway, this is obviously a very complex problem beyond above. But just some insights from my perspective.

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I think AI might be able to help doctors through put on patients and as a result earn more to offset school costs and make it more worthwhile


I say that because my wife has a lengthy medical record with some things i felt were missed by numerous Dr's as a result. She's has the homogeneous MTHFR mutation and a West Nile infection...etc in which along with covid antibody testing were curious. Long story short I'm no Dr but stayed at a holiday in with BIMS degree from 30 years ago and started researching and brought it to the Drs attention and got her on D3, Lmythylfolate and IvIg.

We also need medical history to travel with patients on a computer system or on an ID card so they aren't trying to remember a long history such as my wife's case. I can see AI picking up on things that could help in preventative medicine too.

jamey said:

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fauxstradamus said:

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I have been a physician for 17 years. About half in the hospital system and half in outpatient setting. I do not claim to be an expert on the healthcare system but I can offer some insights based on my experience.

1. Chronic disease is obviously a major problem and a huge driver of costs. Prevention of chronic disease is where huge savings come. Our society in general has little interest in this. While I don't agree with everything from RFKJ, the MAHA movement is a good step in the right direction. The other side of that coin is managing chronic disease to limit secondary and expensive complications. Think controlled diabetes versus uncontrolled with a host of secondary problems. This leads me to point 2

2. Primary care access. There are less and less medical students who want to enter primary care. Falling reimbursements and massively increased patient loads. Less docs and shorter visits is less effective management. MIPS (quality scores) are now tied to reimbursements and encourage more comprehensive screening and preventative measures. It's a stick and not really a carrot by the way. We will see if that helps?

3. Physician salaries/Debt. Only 8% of annual healthcare costs can be attributed to physician salaries. Not sure what that number is outside US. Average medical school debt is 2-3x higher in US than other first world countries. As I stated in the other thread my reimbursements typically decline YoY. 30% in last 5 years. Part of that has gone to increasing reimbursement into primary care so as a whole that may help our shortages. (don't love it personally but it hopefully will be good for the system as a whole)

Anyway, this is obviously a very complex problem beyond above. But just some insights from my perspective.

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I think AI might be able to help doctors through put on patients and as a result earn more to offset school costs and make it more worthwhile


I say that because my wife has a lengthy medical record with some things i felt were missed by numerous Dr's as a result. She's has the homogeneous MTHFR mutation and a West Nile infection...etc in which along with covid antibody testing were curious. Long story short I'm no Dr but stayed at a holiday in with BIMS degree from 30 years ago and started researching and brought it to the Drs attention and got her on D3, Lmythylfolate and IvIg.

We also need medical history to travel with patients on a computer system or on an ID card so they aren't trying to remember a long history such as my wife's case. I can see AI picking up on things that could help in preventative medicine too.

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completely agree. AI should be huge and if we could integrate the medical records on-chain (like we were promised 10 years ago) accessing and interpreting data could be lightyears more efficient

I can't believe in 2025 medical history isn't digital and easily accessible for Healthcare providers.

We should be entering an era where AI is already reading medical history and helping with patient through put along with solutions in cases like my wife.

My wife's life expectancy is probably lower than it would have been if healthcare computer systems weren't effectively in the 1970s

jamey said:

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I can't believe in 2025 medical history isn't digital and easily accessible for Healthcare providers.

We should be entering an era where AI is already reading medical history and helping with patient through put along with solutions in cases like my wife.

My wife's life expectancy is probably lower than it would have been if healthcare computer systems weren't effectively in the 1970s

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And you have your government to thank for that because of the programs I mentioned and the fact that software vendors spend more time checking boxes to please the Medicare overlords instead of accomplishing what doctors and nurses actually need and want.

flashplayer said:

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jamey said:

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I can't believe in 2025 medical history isn't digital and easily accessible for Healthcare providers.

We should be entering an era where AI is already reading medical history and helping with patient through put along with solutions in cases like my wife.

My wife's life expectancy is probably lower than it would have been if healthcare computer systems weren't effectively in the 1970s

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And you have your government to thank for that because of the programs I mentioned and the fact that software vendors spend more time checking boxes to please the Medicare overlords instead of accomplishing what doctors and nurses actually need and want.

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If DOGE dipped a toe into Medicare / Medicaid they'd probably need a whole 30 seconds to see this is a major problem, not just for M/M but the entirety of Healthcare in the USA

And just imagine what AI could do sifting through the population of the US, finding correlations to disease never thought of, but that may require a quantum computer but we're close there. Throw in genetic testing and damn..


If we get quantum computers before digital medical records, thats down right criminal imo. Just f'in stupid

The record is digital, and we don't need quantum for advanced real time analysis. Some of the big names, including Google and Oracle have already been looking at AI and what it can do for healthcare but they are still 2-5 years off from making a meaningful impact there for the wider population in my opinion.

Yes its digital but not in a useful way, otherwise you wouldnt have to ask patient history. Perhaps network or captured on an ID card is more accurate


I'm thinking quantum would come in with genetic data, aligned with medical histories. Patients adding information like dietary and other relevant habits would add more data

Most healthcare service by quantity is made up of doctors acting as drug dealers. Need antibiotics? See your drug dealer. Many many other problems with inefficiency and totally unnecessary restricted access for individuals to make their own decisions. Everyone should have digital access and a profile of their entire health CV. Almost all PCP services can already be handled by an multimodal LLM today - if we want to continue an anti-liberty approach assuming that folks cant make their own health decisions.

The only thing most people need to see a doctor for, and the last corner of expertise in medicine, is for surgery. Not meds, not imaging, etc etc etc

yes we are past pure analog long ago, BUT none of the EMR's (electronic medical records) communicate with one another. It is really stupid.

TXTransplant said:

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I'm certainly no expert in the field, but just observing situations with elderly family members, the cost of end of life care (especially in the absence of any health care directive) is significant.

Estimates are 10% of total health care costs are for end of life care.

While you can't put a price on another few minutes, days, weeks or months with a loved one, the costs of keeping someone who is terminally ill alive are staggering, particularly in a hospital setting.

If a patient doesn't have a clear end of life directive, family members will typically resort to extreme life-savings measures, even if they ultimately do more harm than good.

There are certain illnesses that have an extremely low hospice utilization rate, as well. For example, only 20% of patients terminally ill with kidney failure utilize hospice.

Our medical system has actually gotten pretty effective at keeping people alive much longer than they would live without medical intervention, and that comes at a steep cost.

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I'd like to know if this post and the post above it are somehow linked. Does all the chronic illness and inflammation lead to end of life care that is drawn out and expensive? Do seniors in other countries live better at older ages without the drag of a lifetime of carrying too much fat or inflammation, then die somewhat suddenly? Or, is the percentage of $$ spent on end of life care similar in other countries?

It is my belief that US medicine is carrying the weight of the world in terms of pharm development costs and simultaneously making said development very time consuming and expensive. Then companies recoup that cost here while making profits at the margin overseas.

Ending the link, including any and all tax benefits, between employment and health insurance would be a huge development as well. The prohibition on 'Cadillac plans' was perhaps the only idea from Obama care that I could get behind, but its largely meaningless in practice.

Mr.Milkshake said:

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Most healthcare service by quantity is made up of doctors acting as drug dealers. Need antibiotics? See your drug dealer. Many many other problems with inefficiency and totally unnecessary restricted access for individuals to make their own decisions. Everyone should have digital access and a profile of their entire health CV. Almost all PCP services can already be handled by an multimodal LLM today - if we want to continue an anti-liberty approach assuming that folks cant make their own health decisions.

The only thing most people need to see a doctor for, and the last corner of expertise in medicine, is for surgery. Not meds, not imaging, etc etc etc

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I agree some things should not require a Dr visit but over prescribed antibiotics isn't good either. Perhaps AI can answer those calls, add in a home tests from walgreens...etc. We used a home flu a/b and covid test on my daughter this winter.

But push it, make it an easy walk though on a call/internet with Dr AI and show the cost difference in a financially painful way

Too may people go to the ER or clinic for anything.

Horse with No Name said:

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TXTransplant said:

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I'm certainly no expert in the field, but just observing situations with elderly family members, the cost of end of life care (especially in the absence of any health care directive) is significant.

Estimates are 10% of total health care costs are for end of life care.

While you can't put a price on another few minutes, days, weeks or months with a loved one, the costs of keeping someone who is terminally ill alive are staggering, particularly in a hospital setting.

If a patient doesn't have a clear end of life directive, family members will typically resort to extreme life-savings measures, even if they ultimately do more harm than good.

There are certain illnesses that have an extremely low hospice utilization rate, as well. For example, only 20% of patients terminally ill with kidney failure utilize hospice.

Our medical system has actually gotten pretty effective at keeping people alive much longer than they would live without medical intervention, and that comes at a steep cost.

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I'd like to know if this post and the post above it are somehow linked. Does all the chronic illness and inflammation lead to end of life care that is drawn out and expensive? Do seniors in other countries live better at older ages without the drag of a lifetime of carrying too much fat or inflammation, then die somewhat suddenly? Or, is the percentage of $$ spent on end of life care similar in other countries?

It is my belief that US medicine is carrying the weight of the world in terms of pharm development costs and simultaneously making said development very time consuming and expensive. Then companies recoup that cost here while making profits at the margin overseas.

Ending the link, including any and all tax benefits, between employment and health insurance would be a huge development as well. The prohibition on 'Cadillac plans' was perhaps the only idea from Obama care that I could get behind, but its largely meaningless in practice.

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Based on my experience with my family, absolutely yes. Americans are eating and drinking their way to kidney and liver failure. You can't be diabetic for 40 years, eating whatever you want and allowing your blood glucose to spike and only bring it down with insulin (without any diet modifications), and not expect that to take a toll on your body. Same thing with excessive alcohol consumption.

flashplayer said:

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fauxstradamus said:

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yes we are past pure analog long ago, BUT none of the EMR's (electronic medical records) communicate with one another. It is really stupid.

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This is primarily because as EMR's evolved, hospital systems wanted too much control over configuration of the system. They wanted the power to make decisions about what the system would do and what it would not. This resulted in a need for a bunch of disparate silo systems that varies from one client to another for the same EMR.

In other words, if you get Athena or Cerner or Epic or Meditech, it's not like Microsoft Office, where everybody is using the same product that gets updated at the exact same time and functions in the exact same way.

In order to get something truly useful, the power of hospital systems to customize the software exactly the way they want it has to become a thing of the past and everything keep moving towards a standardized cloud based product, which has been slowly happening.

Cerner and Athena experimented with sending data back and forth to one another and it was a disaster from a maintenance and feasibility perspective. Cerner (now Oracle Health) had also been trying to pull in useful external data on patients going back to some pilots I worked on 3 years ago, but the problem they were having was trying to de-duplicate data and present mostly useful information instead of so much noise. Meanwhile Epic doesn't really play ball in the information sharing space because they're more worried about conquering more market share.

There are a lot of spokes to the technology wheel and healthcare, and the biggest wrenches in that wheel are put there by both the government and existing healthcare/hospital systems.

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This topic amuses me only because my first career was Healthcare Administration and the changes in the Balanced Budget Act of 1997 made EMR's a topic. They were all the rage back then; how we were going to have EMR's that were easily portable yet secure.

And here we are 30 years later still filling out paper forms in doctor's offices. And in many cases then filling out the same damn forms at the same damn doctor's office any time I go back to see the same damn doctor.

It's insane we have to do this.

Agree. EMRs had just about the exact opposite impact they should have had. Made care more expensive and less portable

Interesting, I worked in numerous hospital/labs back in the mid 1990s and they all had Cerner as I recall

Sounds like it became big business

Lets also think about this from a patient perspective. All the health data points (labs, imaging, notes, procedures etc) is THEIR information. Have you ever tried to get a copy of your CT scan? "Heres your CD sir". Great thanks but my computer doesnt even have a drive for that

Why cant we have a blockchain "wallet" with our own health history. Fully transportable, immutable and accessible to any physician with permissions.

fauxstradamus said:

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Lets also think about this from a patient perspective. All the health data points (labs, imaging, notes, procedures etc) is THEIR information. Have you ever tried to get a copy of your CT scan? "Heres your CD sir". Great thanks but my computer doesnt even have a drive for that

Why cant we have a blockchain "wallet" with our own health history. Fully transportable, immutable and accessible to any physician with permissions.

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That is pretty damn funny and sad. I haven't even purchased a CD in 20+ years, but you are right. Last time I had an MRI/CT I was handed a CD and I remember thinking: Really?

We had to buy a CD holder at a garage sale for all of my wife's CDs no doctor was ever going to spend the time to look at in total. One day we'll feed it into Dr AI

fauxstradamus said:

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2. Primary care access. There are less and less medical students who want to enter primary care. Falling reimbursements and massively increased patient loads. Less docs and shorter visits is less effective management. MIPS (quality scores) are now tied to reimbursements and encourage more comprehensive screening and preventative measures. It's a stick and not really a carrot by the way. We will see if that helps?

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PCP/Family Medicine isn't nessicarly dying, as it is shifting. I guess it depends on the market, but almost every clinic Ive seen is now a mid level provider, paid on retainer and whatever merit based volumes or patient satisfaction score algorithm.

Primary Care has become a referral base these days, since it isn't specialized. High BP that hasn't been resolved? See a Cardio. Ear infection? ENT. Most patients go straight to the specialist these days, and PCP last if they can't book an appointment. Any wonder why Urgent Cares with PAs and FNPs have started to dominate in the space. I couldn't really say what the solution could be, since they keep cost low.

Tend to agree that Primary care seems to be more rote these days. Run the bloodwork and review the results.

I will say technology has improved healthcare in some ways for sure. We have two primaries - we kept our long standing primary at Baylor in Dallas simply because they have a great app that lets you do video appts. We are seven hours away from Dallas now m, but if I have something minor to look at I can typically schedule a video appt within a week, discuss over video, and get a medication, if I need one.

Our other primary (also in Dallas) is where medicine is going if you can afford it and counters the rote statement I made above. Concierge. We take one day out of the year and go to Cooper for one stop shopping.

Bloodwork
Stress test
Head to toe dermatology assessment
Diet consultation
Radiology
Ears
Eyes
Mammo if you are female

All in one day for cash price. It's not cheap but it's damn convenient to get your head to toe bill of health in one day for the year.

The biggest benefit I see to having a PCP in a system is that makes it easier to get an appt when you need one.

I've had several instances over the last couple of years where the waiting list was much longer, or an appointment was even refused, because there was no "history" with a PCP.

My insurance does not require PCP referrals for coverage, so it's frustrating to me when a hospital system does. Especially since I don't really have or need a "traditional" PCP - I just either see my gyn for most of my needs, or use the mobile imaging and bloodwork services offered at my place of employment.

I do think the system is set up to encourage (and bill for) a lot of unnecessary "consultation" appointments - that are a waste of time and money.

For example, I went to an annual/preventative exam and my provider recommended something that required a small procedure. We discussed the pros and cons, and I said I wanted to think about it. A few months later, I called back to schedule the procedure, and was told I needed a "consultation" appointment first. I explained to the appointment person that I'd already had a consultation - at my last annual. Well, that was not what she expected to hear. I insisted I did NOT need to waste time and money on a consult that I'd essentially already had, and I guess I was annoying enough that she agreed to look into it. They called me back and agreed to "waive" it and just schedule the procedure.

After said procedure, there were also a number of unnecessary but required "follow-ups" that were also billed to insurance as part of the total cost of the procedure. How do I know they were unnecessary? Well, the drs office cancelled one, and when I called back to reschedule, they told me it wasn't necessary.

I wouldn't call this fraud, but it certainly is excessive billing. Not to mention, there is a shortage of a lot of different doctors, and scheduling all of these "consultation" just makes it harder and harder for patients get an appointment when they actually need medical care.

I also think that the uncountable number of benefit "management" companies that have inserted themselves between the doctor, insurance and patient have increased cost. Everyone gets a fee. Wife had a monthly chemo visit for a year and every time they made us sit for an hour or more while someone had to approve it.

What do you want DOGE to do? Find fraud? There is already a program for this, and it recovered $7.13 billion in FY24. Since DOGE hasn't exactly been a smashing success, I am not sure how much value they would bring.

The calls to abolish insurance and completely switch to a fee-for-service model are a bit silly and way oversimplified. That only benefits people who don't use healthcare very much, but eventually we all will, regardless of how healthy we eat and exercise. If you get cancer or need surgery for something that wasn't preventable, you are totally screwed if you have to pay out of pocket.

Elder and end-of-life care are incredibly expensive, and a fee-for-service model doesn't fix that. Like anything, the less you spend on something, the less expensive it will be. Everyone freaked out about "death panels" when ACA was being floated, but when there are limited resources, certain decisions have to be made.

Captain Winky said:

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What do you want DOGE to do? Find fraud? There is already a program for this, and it recovered $7.13 billion in FY24. Since DOGE hasn't exactly been a smashing success, I am not sure how much value they would bring.

The calls to abolish insurance and completely switch to a fee-for-service model are a bit silly and way oversimplified. That only benefits people who don't use healthcare very much, but eventually we all will, regardless of how healthy we eat and exercise. If you get cancer or need surgery for something that wasn't preventable, you are totally screwed if you have to pay out of pocket.

Elder and end-of-life care are incredibly expensive, and a fee-for-service model doesn't fix that. Like anything, the less you spend on something, the less expensive it will be. Everyone freaked out about "death panels" when ACA was being floated, but when there are limited resources, certain decisions have to be made.

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The bolded is 100% wrong. Taking out a middle man is a net gain for everyone regardless of how much they use the system. Insurance adds a significant cost to care currently.

Health insurance is literally a wasteful welfare program in poor disguise and you will never convince me otherwise.

Captain Winky said:

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What do you want DOGE to do? Find fraud? There is already a program for this, and it recovered $7.13 billion in FY24. Since DOGE hasn't exactly been a smashing success, I am not sure how much value they would bring.

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DOGE bigger success has been updating how computers systems are used

Our Healthcare industry's use of computers systems and networks is laughable as been discussed in this thread

And yes, finding fraud or inefficiency in Healthcare is low hanging fruit

The answer probably lies somewhere in between. I'm on an HDHP with a max family OOP of $9k. This has made me a MUCH more conscientious health care consumer.

In 10+ years, my son has only hit his deductible twice, and I've never hit mine. I've been maxing out my HSA and have over $80k saved.

Everything that's not preventative is OOP until I hit the individual deductible. I do get negotiated in-network rates, and those are usually pretty good, but I often would prefer to not even file on insurance and just pay cash, leaving the insurance paperwork out completely. More often than not, insurance is just a headache that causes problems that take too much time to resolve.

In TX, you can do that and still file the claim yourself, to meet your deductible. But my son is in school in MS. BSBC MS has a reciprocal agreement with BCBS TX, but if a provider is in-network in MS, they are REQUIRED to file with insurance. If they do not, then you cannot get credit of expenses to your deductible. This caused us a HUGE headache last year when he had an unexpected medical issue and we hit our deductible.

I also find that, with the HDHP, I have to watch my billing from many small clinics/doctors offices. I've questioned bills before, only to have office staff say "But you haven't met your deductible, yet", as though that's my goal. I tell them I don't want to meet my deductible! It's more work on my end, but at least I feel like I have some semblance of control of costs.

I honestly don't mind paying for routine doctors visits, lab work, generic medications, and other things that are part of routine/preventative care. I want insurance to cover hospitalizations, surgery, and got forbid, life-threatening conditions like cancer.

Health care is a $4.5 trillion industry, and everyone has their hand in the pot trying to get a piece of that, often to the detriment of the patient.

Here's another good example of what my experience has been. Better do your due diligence on your own and loved ones healthcare

At least until the data is networked and AI is looking at it too.

Well, my dad had another surgery yesterday so im off to check his health care. Found several misses yesterday and now he's getting a CT scan

US healthcare is unwell imo

My oncologist tried to stop my chemotherapy* treatment last week because of a one-page synopsis he had read regarding my recent MRI, which mentioned that one of my brain tumors had progressed.

It turns out he had never actually looked at the MRI itself; and the specialist who…

— Jeremiroquai (@Jerematic79) May 25, 2025

Not surprised - examples of this everywhere. At this moment I'll take AI over the charlatans that usherd Covid response. Completely fraudulent and inept profession right now.

I think I would prefer to have a human cut out my tumor over AI. Not all docs went crazy with COVID.