Comically overcomplicated healthcare -- that can also be cruel

A heck of a way to get to a napkin ...

I know I don't understand US healthcare policy. That's in part because I am personally fortunate enough to enjoy a reasonable facsimile of access to adequate medical care via Medicare and the Kaiser Permanente system. 

And it is also because the whole thing is a "Rube Goldburg machine," defined by Wikipedia as "a chain reaction–type machine or contraption intentionally designed to perform a simple task in a comically overcomplicated way."

We can't seem to enact a better way, though I give Democrats credit for sporadically trying to get us there.

But I can refer here to Katelyn Jetelina and Hayden Rooke-Ley's totally lucid description of our mess at Your Local Epidemiologist, timed for the season when many of us have to make decisions about how we'll try to protect ourselves for another year.

5 ways our health care system has become utterly insane

1. Costs vs. wages: A 20-year disconnect. 

Over the past two decades, the cost of employer-sponsored health insurance—how the vast majority of privately insured Americans obtain their health care—has skyrocketed. Premiums, deductibles, and out-of-pocket costs have all soared—far faster than wages. ...

2. We pay the most and get the least.

The United States spends far more on health care than any other wealthy country yet achieves worse outcomes, less access, and a more demoralized workforce. ...

3. Americans don’t “overconsume” health care. Prices and private bloat drive costs.

There’s a common myth, especially amongst policymakers, that we spend too much on health care because we consume too much of it. A similar narrative has taken hold about doctors: because they get paid for each service, they provide too much care. Certainly, there is low-value care in the U.S. health care system. And as profit-seeking corporate actors own more and more of the system, they’re finding ways to bill for more—and more expensive—services.

But Americans don’t visit the doctor more, we don’t go to the hospital more, and we don’t stay in the hospital for longer. ...

4. Corporate and financial firms have taken over care. 

Perhaps the most underappreciated transformation of the past 40 years is the corporate consolidation and financialization of medicine. Care delivery—once local and community-based—is now dominated by corporations. ...

5. Existing approaches have failed—and the latest proposals are more of the same. 

None of this happened by coincidence. Our current governing approach began in the 1980s, when a bipartisan consensus emerged around how to address accelerating costs in the system. The idea was to embrace more free market principles in health care ...

If you want to take a stab at understanding why you hate your health insurance and sometimes even your medical providers, I can't recommend this article too highly.