Remember a few years ago when articles about neural networks scanning for cancer found stuff before human doctors did? That's a form of AI I'm afraid will get defunded too when that hammer comes down on all this "LLM in everything" bullshit.

Oh definitely. That's exactly why I specified that it needs to be explicitly transcription software. Even speech to text on my phone gets it wrong with enough regularity that I check it every time. I can't imagine what it would be like if I was using less common words In a medical setting. I don't love the idea of every word said in a doctor's office being recorded and that recording being on record forever, but to a certain extent I can understand doctors who might think that would be helpful. What I don't think would be helpful is having anyone except the doctor or another trained medical professional summarize that information. I do understand that doctors are human and mess up and miss things and might even take worse notes than AI would, but at least it is a Doctor who is doing that. It is a human being who met the other human being and sat in a room with them who is making these decisions.

Insurance… that is the issue.

The government could mandate that all insurance companies use the same codes Medicare does, standardized coding would cut out a lot of actual waste in the healthcare system.

I understand different things need different codes, otherwise the labs or other doctors don't know what they need to do, but the fact a doctor can order a test and then a random person with no medical background, or even just a machine, can tell the doctor "no, that's not needed" is a waste in the system and a waste of people's, often sick people's, time. There is no code for homeopathy tests or procedures, so there's no way for them to be prescribed. A doctor can't order 10 ccs of water danced on by fairies, so I don't see that being an issue. My point is that whatever a doctor orders shouldn't need that much oversight. If at the end of the year the government wants to run a "how many MRIs per patient" check on providers they can still do so, but that doesn't require every MRI to be justified in the moment. Then you can investigate the practice for potential fraud if they're not actually doing the MRIs and just charging for them, or if they're being ordered unnecessarily. Doctors should be trusted to do right by their patients. If the government had a going rate for procedures and there was one place where people can see everything that was billed as part of their care things might not need as much oversight.

I admittedly don't work in the field, and I'm aware Medicare/medicaid fraud does happen, but considering the waste (on all sides including patients) created by all the overhead I think we'd come out ahead by just trusting doctors and checking end of year stats.

Also, through the ACA people do technically get quite a lot of choice in their healthcare benefits. I don't think it's a good system because in my opinion your income shouldn't dictate your quality of care or coverage, but if you're looking for more choice in the US and have not looked at the marketplace I recommend doing so. I personally think single payer is better, but definitely look there if you're looking for HSA or deductible differences.