I have a wife with a rare disease and think about this a lot, in combination with jobs that shouldn't exist. My wife spends 5-10 hours a week dealing with insurance paperwork. Multiple times a year we deal with insurance companies denying claims because they faxed it to themselves and it's now unreadable.

Here are two real examples of the mess we've collectively created. It will be painfully stupid to read, and it's filled with people in jobs that simply shouldn't exist in the first place. They aren't bad people, but every minute they spend at work is deadweight loss to the economy, and then they use up OUR time on top of it.

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I (1) got laid off in September, and switched to COBRA coverage on my previous health plan. The HR folks (2) at my old company worked with an insurance broker (3) to both set up the health plan (4), vision plan (5), dental plan (6), and set up the COBRA plan (7) on different companies.

I set up auto-pay with the COBRA middle-man (7) whose contribution to the process appears to be collecting $1800 from me every month, splitting it up, and sending parts of $1800 to the three different insurance companies.

Issue 1: One month in, we tried to schedule an appointment with the dentist (8). The dentist told us the dental insurance said we didn't have coverage. Neither insurance nor the COBRA plan would return my calls. I had to talk to HR at my old company and sic the insurance broker on them. She came back more than a month later and said that both companies agree that the money was sent and I now had coverage for the previous month. I pointed out that retroactively saying I had coverage was completely useless since I had been unable to USE the coverage in real time. She went back and negotiated a reimbursement for two months coverage. The dental insurance carrier would send a check to my old employer who would then send it to me. This wasted the time of at least a half dozen people, most of all mine.

Issue 2: In early December, my wife had appendicitis that lead to an ER visit(9), CT scan, emergency surgery, and a 5-day hospital stay. 2 weeks later she was back at the ER with significant pain, and got another CT scan. Thank god for COBRA, right? lol.

When we got home from the second visit, I found a letter in the mailbox from the COBRA company saying that the monthly premium for december medical insurance had gone up by $100, and I would have to pay more to retain my coverage. This letter was dated a week after the month started, so I couldn't have paid the correct amount without inventing time travel. I was given until the end of an un-specified "grace period" to pay. They then *retroactively* cancelled all 3 insurance plans a few weeks later, but kept the $1800.

I didn't know this happened - I had just started a new job whose medical benefits kicked in 3 hours too late for us, and thought I had another couple weeks to figure out what was happening. Meanwhile, I got separate bills from the surgeon (10), anesthesiologist (11), and radiologist (12) for trivial amounts. I then got an $8000 bill from the ER, which included no indication (other than the amount) that my insurance coverage had retroactively lapsed between them checking my coverage and submitting their claims. The medical insurance never notified me it was being cancelled, and the website implied I had never had coverage in December.

I contacted everyone and after hours on the phone finally got hold of the COBRA company, who will process a grace period extension over the next two weeks, at which point the ER and all other providers can have their office staff re-submit claims and then bill me - which I will have to pay on different online portals except for the ones where I can only mail or pay by phone.

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This is insanity. 12 different entities, many of which had multiple people actively involved. US healthcare costs are the highest in the world because every bullshit job creates an equal and opposite bullshit job, and they all also use up unpaid and undocumented patient time.