Thread by @doctorow

Attention foreigners! Allow me to describe the efficient market process of American private health care!

My daughter got her teeth cleaned.

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Four weeks later, our dental insurer sent us a note saying that they were paying for $235 out of the $236 bill (as our economist friends like to remind us, a co-pay gives the patient "skin in the game" and prevents frivolous teeth cleaning).

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A week after that, they mailed us a check, like, a piece of paper. I paid that check into our checking account and waited.

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Today, the kid's dentist sent us a bill for $236. For reasons understood only by the American medical profession, this bill - like all health-related bills - could not be settled by entering a credit-card into the dentist's website.

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No no! Like every efficient yeoman small businessperson, every medical professional in America has a deal with a payment processor you've never heard of, whose account creation process is onerous, bizarre, even...delightfully kafkaesque?

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This one involved entering a URL into my browser, then entering my phone number into a web-page, getting a text with another URL that opened mobile Firefox and loaded the Google Play store page for an app. That's...not how you install apps.

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However, I hold an honorary doctorate in computer science AND a research appointment at MIT, so I was able to figure it out.

Kinda.

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Three screens into the signup process, I bailed and spoke to a lovely receptionist who had me read my credit card details aloud over the phone so she could key them into the PIN pad on their payment processing terminal.

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All told, settling this bill only required, uh, three letters sent through the US mails, an SMS, an app install, half an account registration, cutting a check, depositing a check, clearing a check, 15 minutes on hold...

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...and then someone across town taking dictation over the phone and typing a bunch of numbers into the PIN-paid of a locked-down payment terminal.

Ladies and gentlemen...THE FREE ENTERPRISE SYSTEM!

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Obviously, this system requires some tweaking. I'm sure that, even as I type these words, some cryptocurrency huxter is "pivoting" to medical payment processing...on the blockchain.

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"Did you learn to buy crypto while paying off your ransomware attackers? Now, collect the dividend of your hard-won expertise by settling your dental bills using the power of blockchain!"

eof/