The worst part, simultaneously soul crushing and apocalyptic rage inducing is that we get these outcomes after spending more per capita on healthcare than pretty much any country on the planet.

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ceejayoz 2 hours ago | parent | next [-]

Worse, we spend more in tax dollars on it than any other country total, and then add on the private spending on top. We do the worst of both worlds.

https://commons.wikimedia.org/wiki/File:OECD_health_expendit...

(And we’re middling in outcomes!)

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recursivecaveat 30 minutes ago | parent | prev | next [-]

A family member recently got a routine physcial blood test panel taken. The company made 3(!) separate overcharge billing errors associated with this one screening. Their doctor had to be pulled in and wasted a considerable amount of time clearing this up, doing stuff like affirming to their support that the documentation from their own front desk was accurate. Maybe for every $100 of doctor time they waste they collect $101 from patients who give up. No wonder its a black hole of money.

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tptacek 2 hours ago | parent | prev [-]

... and that money isn't going to insurers.

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psadauskas an hour ago | parent [-]

... nor the providers.

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tptacek 39 minutes ago | parent [-]

In fact it's overwhelmingly going to the providers.

https://nationalhealthspending.org/

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ceejayoz 8 minutes ago | parent [-]

https://sph.brown.edu/news/2025-11-10/unitedhealthcare-optum...

> Today, many of those practices have been bought up by large corporations, including hospitals, private-equity firms and even health-insurance companies. It’s a shift that not only has changed how money moves through the health care system, but may also be helping some insurers boost their profits, according to new research published in Health Affairs.

> A study from researchers at Brown University’s Center for Advancing Health Policy through Research and the University of California Berkeley found that UnitedHealthcare, the nation’s largest health insurer, pays doctors who work for its own physician network, Optum, more than it pays independent practices for the same care.

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tptacek 7 minutes ago | parent [-]

This isn't a response to anything I just said. I really don't understand why people collapse into all this handwaving when people point out the obvious: the money in our system is going to providers, and, in particular, it's going to practitioners.

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ceejayoz 6 minutes ago | parent [-]

The insurers are buying the practices so they can eat at both sides of the trough.

(And the independent practicioners are having to use a significant portion of the money they take in to… fight the insurers!)

	▲	tptacek 2 minutes ago \| parent [-]
		What difference is that supposed to make? The money is still going into the pockets of practitioners. And: no, the claim you're making here about practitioners fighting insurers: closer to the opposite thing is true. The idea that the problem with our system is health insurers is just slopulism. We have grave problems with our system! But they start with the providers, where the majority of all the funding in our system goes, not to the scapegoats they've stoop up in our insurers.