They just go to the doctor. They never talk about paying for it. They never get a bill. medicare for all sounds great. But I still end up paying and getting bills and everything with Medicare.

I may watch the series all over again.

I would have loved to live in Portwenn if it really existed.
But alas, I would never fit into a traditional small village in Cornwall.
(NY Jew here) Everything revolves around the church.

My brothers both went over to England,Herfordshire. I think it was, to visit some of our cousins that still live over there. My brothers said they looked like us and lived in a small town. I would like to go over there someday, because I really can’t get the geography of that place straight in my head. Being raised in Delaware I think every place should be about 100 miles long and on the coast.

must be prepared for every eventuality. But it seems wonderful to imagine just going to a doctor and not getting a bill.

I blame the insurgency of insurance for our high costs. I'm seeing it happen, now, in veterinary medicine. Pet insurance is available and vet prices are going up. Two friends (without pet insurance) who live in different states just paid out thousands for their sick cats. It's getting rare to get out of a vet visit with less than a $300 bill. It's the thin edge of the wedge.

vs. them or their clinic getting a kickback from Big Pharma for prescribing a newer, costlier drug.

Do you think all doctors are on the take from big pharma?

on the take from big Pharma. And absolutely every other entity they could be on the take from. (See: private equity and health systems)

I have been dragging my feet on getting a new doctor, because I've been busy with other things. I liked my previous doctor (who I had for years, before the current ownership), but then my doc retired and I haven't moved on yet, but need to. Especially now that the new ones want to change my meds all around and coincidentally want to move me to a newer shinier thing. (Shinier for THEM, costlier for me, and the old meds are working fine as far as I can tell).

So yep, when it comes to these guys in this situation, I am cynical as all hell.

I've been taking Warfarin for about 30 years, prescriptions cost less than $10 for three month supply. Every time I see a new doctor, they want to know why I don't switch to one of the newer blood thinners. The cost for those are hundreds of dollars per month.

I ask them if there's an antidote readily available to the newer drugs - answer "no." The antidote for Warfarin is vitamin K -cheap and easy. One doc finally said to me that they only prescribe Warfarin (Coumadin) for people who are needy. Since when is income level of a patient the criteria for prescribing a medicine?

My thoughts - good for "poor people" they're less likely to bleed out from taking blood thinners.

I’m “on the rack” all the time. Tests etc. I just got a phone call two days ago to schedule my annual heart CT scan next November.

I have great health insurance. I had a $28K hernia surgery two years ago - $175 out of pocket

I see a dermatologist every 6 months just so I have a dermatologist should I need one. Initial wait times can be 6-9 months.

Of course people put it off and sometimes this costs them their lives.

Other times it's our health care "system" itself that kills them with expensive and grossly inappropriate medical treatments.

That doesn't seem efficient.

I don't think this stat tells us much, it's lacking granularity.

My daughter, with two major chronic, progressive diseases (and a host of minor ones) and free healthcare after the first month of the year (so no financial barrier to visiting the doctor) sees a doctor around 8-10 times a year.

I have two cancers (one very aggressive), and a total annual out of pocket for care of around $300 - so again, no financial barrier to seeing the doctor as many times as my heart desires. This past year I saw a doctor 7 times (twice more than usual, since two of them were ER visits).

I can't imagine using a nationwide average of 16 visits a year as a measure of healthy system (or a system that effectively keeps it's population healthy).

role of mid-level providers in primary care.

He states that 'doctor' visits are down in the U.S., and then says it may be due to patients visiting with mid-level providers like Nurse Practitioners and Physician Assistants (like me.) That is tantamount to implying that 'doctor' visits mean more or are more important than those with mid-level providers.

That seems to fall into the "You're "just" a P.A." misperception that a patient is going to get different and superior care with a doctor than with a mid-level. This is not the case. We don't "assist" the doctor, or take the load off of him or her. We have our own patient populations, and are as fully-qualified to provide health care as an MD. And, of course, there are PA's and ARNP's in specialty care, like cardiology or gastroenterology, too. And they can't perform those duties without being assessed and approved by MD's in those specialties.

As follow up for ACC cancer. He sees a cancer doc once a year. His PA is the one who he trusts.