Originally Posted by dippin

story time, so you can maybe envision a system with fewer overhead costs.

My brother lived in France for a while. One night, he was out with his girlfriend, and a drunk guy started hitting on her. He told the drunk guy to cut it out as she had company. The drunk guy sucker punched him and ran away. It was a friday night. He went to the ER. The triage nurse talked to him and sent him to the appropriate doctor in the hospital, where he had an xray done, was diagnosed with a fractured nose, and the doctor tended to him and gave him pain killers. The fact that he didn't have to pay a cent is beside the point, the point is that in his entire visit to the ER he talked only to 1- a nurse, 2- the doctor.

I live in the US. I have good health insurance provided by my university, which gets good rates since they operate what is generally considered a top 10 hospital in the US.
Playing basketball at a private gym once, I rolled my ankle and severely sprained it. I went to the ER, where after talking to the admissions person I was sent to the person in charge of insurance. After giving them my insurance information, I saw the doctor and was taken care of. At the time I didn't have to pay anything as they sent the info to my insurance. A few days later my insurance called to ask me where I got hurt, and i told them. They decided to go after the gym's insurance company to get the money for my treatment. Long story short, to deal with my ankle sprain, the billing depts. of the hospital and 2 different insurance companies had to get involved, and legal action was threatened by all parts, so we are also talking about lawyer costs. From the point of view of my insurance company, it made sense, as it cost less to them to go after the other insurance company (especially given follow up appointments and etc) than it did simply paying for everything. From a societal point of view, we are talking about severe overhead costs that drive prices up very fast.