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Healthcare services are not a free market. The idea that competition can drive down costs would be funny if it wasn't driven by such cynicism. Like a lawyer buying time with objections they know they will lose, the "let the market fix things" people push for price transparency, which they don't get, and then they'll push for time to let that work out. It won't because people who buy healthcare - you and me - don't shop. And we won't shop. Insurance companies don't shop either. Providers hire admins who's whole job is to game the system, which enriches the provider slightly, employs the admin, and extracts wealth from insurance companies and ultimately patients.

The hard truth is that, ultimately, providers, are to blame. Skilled professionals should NEVER say "I don't know how much it costs" to their clients and get away with it. It's your JOB to know how much it costs and to understand the experience of your patient. I get it that you don't WANT to know, that it's complicated and depressing. I get that because all patients get that. That is not an excuse for not paying attention to the details.

It is providers who regularly make their patients wait for hours after the appointment time. It's providers who order expensive and unnecessary tests for every condition, or who refer to multiple specialists. Each of these decisions increases the cost of care, the provider profit margin, and the stress on the patient. Because the provider is ultimately the one with the skill that the patient needs, I blame them for this systemic failure. If you're a doctor and you give in to the status quo, hire a large staff of billing agents and write scripts for all the tests and drugs you can, YOU are the problem. If you took your oath seriously, you'd never accept the way things are. Instead you advocate to maximize your profit margins instead of patient outcomes, and as a result you make the entire system sick. With any luck, it will get so sick it will die.



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