This whole healthcare conversation is so fucked up, that people aren't even talking about anything that matters... just abstractions of abstractions of abstractions.

When I first started working a real job, in 1987, I had insurance through my employer.

If I needed to go to the doctor, dentist, optician, whatever, I went. I paid for the services I received.

If it was a lot of money, then I set up a monthly payment plan with my Doc, and then filed an insurance claim to get some portion of my money back.

Most care you just paid out-of-pocket for. That was it. Insurance was for when something major happened - you broke a leg, needed a root canal, or whatever - and all other medical services were paid for on the spot with whatever cash you had, or they billed you in monthly installments.

Then, in the 1990's, heathcare costs began skyrocketing. A broken arm wasn't $1500 any more, it was $15,000.

I never really understood why. Was it just Doctors realizing they COULD charge that much? Was it Tort Law and Malpractice insurance now costing them $10k/mo for protection coverage?

I have no idea.

So then, somehow, the narrative changed. You didn't know what any procedure would cost any more... you'd just get the care you needed, sign a piece of paper, pay your $20 co-pay, and about a month later the insurance company would send you a completely incomprehensible form that said you owe them $2300. There was never an itemized list of expenses, or what was covered, or what the total amount was, and how much insurance was paying for, and how much you were paying for. It was completely opaque.

Then Generic drugs came around, and there were Options. The Insurance company would force the doctor to go with the cheaper option, but if the patient wanted "the good stuff", then Insurance wouldn't cover anything. "Your choice!" They crowed! "Now you get to CHOOSE the healthcare that is right for you! Want generics? We will cover you? Want brand-name? You can have that too! (If you pay for it yourself.)"

And now, somehow, we have gotten to the point where everyone just expects all heathcare to cost a $20 copay, and somehow "Insurance" is supposed to cover the rest?

There are obviously humanitarian issues, and questions around how a society cares for those who have chronic or terminal diseases, and how those services get paid for... but nobody is actually talking about that. They are talking about giving tax credits to pay for your healthcare ... which is fucking moronic, because if you have a terminal disease you ain't working a 9-5, and therefore not making a salary, and therefore not paying huge taxes, and definitely not making enough to offset the cost of your $250k in chemo treatments.

The conversation around healthcare is so fucked, it can't actually accomplish anything!

What the hell....?!?