> If it were as simple as getting the services you need in exchange for money, I don't think as many people would hate the system as much.

That's exactly how simple it is to be uninsured. The problem is the risk is not something people can absorb.

How many Go Fund Me sites were brought up because of high medical costs for some accident or cancer? Is foregoing insurance an improvement over that if it isn't even possibly one of the big causes?

And that the US is the only country in the world where hospital "deathbed divorce" is a thing, to try to avoid family being saddled with ship-anchor levels of debt.

> Is foregoing insurance an improvement over that

No, it isn't, which is why people want some form of insurance, whether public or private. To mitigate risk.

I was entertaining the comment about something being as "simple as getting the services you need in exchange for money". Which one certainly could do, but imposing that on everyone would also be a bad system for other reasons.

You missed the point of my comment. The "services" I was referring to was "health insurance," and the "for money" is the monthly premiums.

In too many instances, people pay the premiums and then do not get the benefits of the insurance.

An analogy in the travel industry might be if we had a system where at random, a double-digit percentage of air travelers were denied boarding and not refunded their money. No amount of legalese would make it acceptable, and in fact Congress regulates air travel such that practices like this hypothetical are not allowed.

Ah, I didn't interpret your comment that way.

Yes, people should get coverage under the terms of their agreement. I'd guess that the reason this is an issue with health coverage is because the sums involved are great, and usually the people on either side of the argument are either (1) unwilling or unable to effectively argue their case or (2) nonexperts who lack full understanding of the subject matter.

These aren't really an issue with airline tickets, not because we don't regulate insurance, but because the contract is exponentially more simple and understandable.

But I do think more should be done.

Air travelers are not expected to have a full understanding of how to operate a jet airplane, or an airline, in order to not be cheated out of their fares. Similarly, they are not expected to plead their case in order to not be cheated by airlines.

I use the colloquial "cheat" intentionally, as it is a valid descriptor.

Notably, however: most insurance delays/denials will have in common that the patient is represented by an expert (a physician) on their case, while the insurer will be represented by a person who has typically never spoken with or examined the patient and may not have ever practiced medicine. The quality of the argument and expertise of the interlocutor are red herrings.

> Air travelers are not expected to have a full understanding of how to operate a jet airplane, or an airline, in order to not be cheated out of their fares.

Correct. But it doesn't matter because the contract of carriage doesn't hinge on that. There's no confusion about what a ticket actually entails. If a ticket covers "one ride at the airport, from Cleveland to Omaha", it's pretty understandable what you are getting. If health insurance was just as simple, and covered "one ride at a hospital, from sickness to health", it would be likewise as accessible. But it isn't that way (although maybe it should be a lot closer)

> Notably, however: most insurance delays/denials will have in common that the patient is represented by an expert (a physician) on their case, while the insurer will be represented by a person who has typically never spoken with or examined the patient and may not have ever practiced medicine. The quality of the argument and expertise of the interlocutor are red herrings.

I understand but that's not what I'm talking about here. I'm talking about a broader information and accessibility disparity.

Having a physician isn't any help if your insurer is deadlocking you on coverage you legally have coverage for, you need a lawyer. That's a contract law problem, not a healthcare problem.

But if you don't actually have coverage for what you need, having a physician argue that you need it, isn't going to help you. Most people buy their health insurance policy all by themselves, without any legal or medical help.