this post was submitted on 19 Jan 2026
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It started with emergency life-saving healthcare being expensive.
If cancer treatments are costly, then insurance is useful to spread the risk among a large group of people - you know, the way other forms of insurance work. You pay some small amount a month, and if you get sick/injured in a way that is expensive to treat, you don't suddenly get saddled with backbreaking debt because that pooled money goes towards the treatment.
But then employers started offering insurance as a benefit to entice workers. These insurance plans started to offer more and more, including reducing the cost of a regular doctor's visit. In order to take advantage of this, doctors started charging more money so that they could get more of that insurance money - and the customer wouldn't see the price increase, because the insurance company was covering the difference.
Insurance, already important to avoid getting saddled with medical debt, became virtually ubiquitous - and so did the increased prices to capture the maximum payout from the insurance companies. This resulted in the stupid prices for every little thing at a hospital; insurance companies negotiate specific prices for specific things, but different insurance companies have different negotiated prices, so the doctors and hospitals have some ridiculously high price to make sure they get the maximum possible from every insurance company.
If you don't have insurance, you can often negotiate the price down yourself - but the hospitals don't want you to. They want you to pay the ridiculous price because it means they get more money... so they don't tell you that they have mechanisms in place for uninsured patients to negotiate the price down. Which results in the thousand-plus-dollar bills you see every time you have to go to the ER.