Jester and lt cap,

Don't get me started! Lol. 

Almost everything about healthcare is a double-edged sword these days. Except for the *really* bad guys (Big Pharma - increasing prices 500% when a drug is in demand - shame!)

On the one hand, people without healthcare are the ones most screwed:

Each hospital, pharmacy, and all the way down to doctors have their 'shelf price' - an ungodly high and unfair top tier price. Most all of these places and people are contracted with various insurance companies, and that 'shelf price' has been negotiated down (or more often, really, imposed by an insurance company (insurance company guys are near the top of the 'deserved most hated' list) from that 'shelf price'. So, for instance, if you break a leg, let's say. If you've got insurance, most likely the majority of your expenses will have a 'negotiated price' if the hospital has insurance contracts with negotiated prices.  *Some* of the cost is going to come down to you, because the anesthesiologist and/or whomever is not contracted with your insurance. They are allowed (but should not be, imho) to do what is called 'balance billing' - they collect the 'negotiate fee' from your insurance co. PLUS they send you a bill for the difference between that and the negotiated rate. You are *never* informed of this in advance, even if you ask, you'll just get a generic answer. (Or, perhaps more fiendishly, perhaps the anesthesiologist will whisper his rate in your ear just before he *really* turns the anesthetic up to full blast, sending you into oblivion, and unable to object.) 

But you are still on the hook for 'balance billing' and if you don't pay up, eventually you get sent to collections and from there, your credit is pretty much ruined. Medical bills are, by a huge margin, the largest cause of bankruptcy in the country, in part I believe because either people don't have insurance, or they simply don't have the money to pay what insurance didn't cover. Remember that anesthesiologist? (Well, chances are you don't because he was far along the way in sending you to la-la land when it occurred to you whether he was part of your network and what his bill might be.) But he's still got his hand in your pocket. 

And even if you can handle those costs, other entities are probably going to get you anyway: A 'shelf rate' for a Tylenol might be $50/pill. Or, if the hospital is contracted, 50 cents a pill. Or, if your insurance 'formulary' (constantly changing) doesn't include Tylenol, only aspirin, *how* many pills at $50 a pop did you take while you were there, lol? Heroin is cheaper. And when you get the 57 page computer generated bill when you get home (assuming that, you weren't turfed out of the hospital early to make room for the next sucker, um, I mean patient, and you can walk on that recently broken leg, you'll probalby want to get into some real good smack so you don't flip out trying to simply decipher it. 

And yeah, everyone abuses the system to some degree. From my point of view, I have Obamacare, and I'm darn glad I do, even not forgetting about its huge flaws in implementation. I don't worry anymore if I have a medical issue, that if I send it to insurance, rather than pay out of pocket myself (which I had done for years), they'll kick me off and/or raise my rates. I was at the pharmacy the other day, and I was waiting in line to get an Rx filled. The guy at the counter had an Rx for the same thing I did - really. They told him his price (no insurance, I guess) was $70 - and he went away because he couldn't afford it. My cost w/insurance - $8. (No, it's not missing any zeros). 

One other thing - I have a fair amount of friends who are doctors. And they're good doctors, and really spend time and take good care of their patients. But Obamacare is just killing them unmercifully with paperwork. They spent a lot more time on that than with patients. And that's a real shame. Or criminal. And some of that isn't at all Obamacare's fault: Your insurance company (or Medicare for instance) is *constantly* changing their formulary - if you're on a medication that's working, and they take it off their formulary (and this freaking thing sometimes happens *weekly*), your doctor has to write an 'appeal' to keep you on the same med, rather than switching to an equivalent, or more often, a generic. And they have to go through explaining why the old med is medically necessary and the patient does not respond well to the new med, blah, blah, and in the end, most of the docs just give up filling out these criminal forms and prescribe what's on special this week - and a lot of them feel badly about it. But there's nothing they can do. 

If only a single-payer system would work here: Fair compensation for fair work. The Europeans have this down, so it's not impossible - well, it is to us. How come? Someting in the water? (Yes, I realize rationing or triage comes into the European system. But like Sweden I think it is - 50% taxes for 100% assurance that your health care needs (and other needs) are covered for as long as you live - I'd take that up if it were available, probably)