'It's a money game to them':son takes on UnitedHealth over elderly father's care

Original Article ↗ Hacker News Discussion ↗

US system complexity and patient experience

  • Commenters describe US healthcare as opaque and booby-trapped: in/out of network issues, incorrect directories, surprise billing, and wildly variable charges for the same service.
  • Even within one facility, some staff (e.g., anesthesiologists, assistants) may be out of network, generating huge unexpected bills.
  • Examples include thousands charged for minor care, providers refusing to itemize bills, and patients sent to collections while insurers pay arbitrary portions.
  • Many see confusion, data asymmetry, and friction as intentional tools to maximize extraction from sick, stressed people.

Profit motive, regulation, and system design

  • Broad agreement that for‑profit insurers and hospital chains are structurally incentivized to deny care or make it expensive; some call them “parasites” or “a tax” flowing to private entities.
  • Disagreement on root cause:
    • One camp blames privatization itself.
    • Another emphasizes regulatory capture and bad regulation, not privatization per se, noting better-regulated private systems abroad.
  • Employer-tied insurance is widely criticized for shackling workers and obscuring true costs.

Single-payer vs private: comparisons and tradeoffs

  • Many argue for universal or single-payer care on moral and economic grounds, citing positive experiences with Medicare, hospice, Canada, and other countries.
  • Critics of socialized systems point to long waits for specialists and underfunding (e.g., UK NHS), but others respond that similar waits already occur in US private care and are largely about provider supply and funding.
  • Some propose hybrid or alternative models: highly regulated private insurers (Netherlands, Israel), cash-based but cheap systems (Hong Kong), or direct primary care.

Medicare Advantage debate

  • Several warn strongly against Medicare Advantage, calling it an HMO-style scheme paid per head and incentivized to deny or delay care.
  • Traditional Medicare plus a supplement is framed as safer but more expensive.
  • There is concern about policy proposals to make Advantage the default option for seniors.

Politics and accountability

  • One thread blames partisan opposition to “free” government services; others say both major parties are captured by corporate donors.
  • There is debate over whether anger should focus on corporations “just maximizing profit” or on politicians who enable and legalize the current structure; many conclude blame belongs with both.

Anecdotes and partial fixes

  • Personal stories highlight skipped care due to unaffordable copays, job loss triggering unaffordable COBRA, and patients trapped in inferior treatments by pharmacy benefit managers.
  • Suggested reforms include stronger surprise-billing rules, price transparency, banning employer-sponsored insurance in favor of individual choice, expanding Medicare, and increasing provider supply.