At the end of the day, much like housing cannot be both affordable and a good investment, healthcare cannot be both affordable and a lucrative career. Avoid going to an MD if you can get the same care from someone else.

by voting for trump, haven't americans actively decided against solidarity-based health insurance?

This is effectively what function health is trying to solve -> https://my.functionhealth.com/signup?code=JELSISI10&_saasqua...

I experienced exactly the same only even more expensive: $1300! The US health care system has deeply entrenched players:care providers,insurers, hospitals, pharma industry. All make a lot of money from it. Several startups tried to tackle it. Even the combination of Amazon& Buffett &JPMorgan that set out to change it eventually caved. https://www.cnbc.com/2021/01/04/haven-the-amazon-berkshire-j... Hopeless case.

Can't speak for your location specifically, but some places in the US have cash only doctors charging low fees for routine/easy visits. Some urgent cares offer primary care similar to that too. My guess is it will still be more expensive where you are due to cost of living. Most insurers have cost estimator tools on their website that help you price compare providers, so that might be an option for you.

"Is anyone working on viable alternatives?"

Have you tried calling your local representative?

The scalable way forward is to vote, and to get your friends and family to vote. Not just national, but local elections.

Don't ever accept a provider's bill or invoice at face value. Did you communicate with your insurance carrier? Their major function is to negotiate those billed charges down to something reasonable.

My provider billed $411 for the same CPT. My insurance slashed it by 50%. My copay was $40. No deductible applied, due to the plan's provision for a PCP visit.

You'll need to ensure that your insurance did their job and issued an EOB. Once the insurance has ruled on it, then you can proceed to negotiate with your provider. If the provider directly sent you a balance bill and you've not heard from your insurance carrier, then you need to reach out to insurance, not your creditors.

The creditor will also have avenues you may pursue, such as financial assistance or self-pay plans. Some may not be available due to your insurance coverage. Some people fly without a parachute and rely on the self-pay. You'd be surprised how zero-sum that can be.

Most notices demanding payment are subtly deceptive, even from legitimate creditors. I always rely on the online billing portal, or a human being who can pull up my account over the phone. Always get the latest statement. Compare all the paperwork, because timing and wording always matter a lot, especially when they're wrong!

most things have two codes. dr visit. dr visit extra expensive. blood work blood work extra expensive.

i kid you not. everyone in health care knows this. and a patient have no way of knowing.

if it goes to your plan, they just pay the cheap code and the provider doesn't even say anything. if it's on your copay only, the plan will not help you and will laugh at your face. and it's all legal.

New primary care doctor did the same to me recently.

Made me wait 30 minutes for a 60 minute new patient appointment (based on the billing code) when the actual time with them was 10-15 minutes (and spent discussing history).

They didn’t even possess an Otoscope for looking inside the ear.

Charged >$400 and still cost me over $250.

I’ve seen other specialists that charge $100 for a visit.

In the Bay Area:

- A 10 min visit to a specialist office, where I was seen by a nurse practitioner who was able to refer me to an exam without involving the main physician, costed $800 (just the visit, not the followup exam), which also went through deductible.

- A routine colonoscopy came at $19k with bills that kept coming for the next 6-12 months from various parties. Consumed my deductible in one shot as the first bill came.

- A visit to the ER that lasted 10 mins with an XRay costed me $5k, also sent in tranches for the next 6 months, to the point where I thought I was victim of some scam (I wasn’t). Maxed my deductible as well.

I have a couple non-critical health concerns right now I’d like to consult a doctor about, but I won’t drop another huge deductible just for that.

I am a dual citizen from a European country with a high quality healthcare public system (but admittedly longer waits than the US ). I’m not eligible for it since I’m not a resident anymore (I will when/if I move back), but as I went visiting family I booked a private appointment with a well known cardiologist and he spent a good 50 minutes with me, for a total of EUR 100.

Yes it’s broken. The solution is and has always been a comprehensive single-payer system combined with price controls.

Roosevelt tried to do it almost a century ago in 1935, but the moron greedy traitor racist fascist conservatives blocked it.

The uninsured pay the highest rates.

And because poor paying jobs tend to lack health insurance (and all gig economy work does), healthcare is a primary cause of personal bankruptcy.

I mean $867 is more than three weeks full time gross at the Federal minimum wage…but most minimum wage jobs don’t offer full time and the working poor have payroll taxes.

Concierge models? Subscription care?

These are premium products for people who can afford premium service.

Could this be a startup opportunity

No. Venture capital seeks above market rate returns. What you describe is below market rate. Or to put it another way, capitalism can’t fix capitalism because capitalism assumes capitalism is not broken.

whether there's a scalable path forward

Don’t get sick is one option.

Work for an employer offering good health coverage is another.

Be wealthy is the third.

Change your phone number to avoid collections is a fourth.

Or pay the bill if you are lucky enough to have that kind of money…and be glad its not your child and the condition is not serious. Good luck.