- Defunding the IRS is nothing but an effort to reduce tax enforcement. People that have relatively straightforward finances can be trivially audited in a formulaic way with data that's on hand - a lack of human auditing resources tends to benefit those with more complex finances which also tend to be the people with a lot of money who can afford to lobby for less enforcement funding.
Also for reference, in 2024 the IRS had a rate of return of 415:1, they'll obviously target the lowest hanging fruit first but for every dollar of funding received they collected 415 dollars of tax revenue that would have been missed. This is an obscenely efficient organization.
- Implied in your statement - it benefits those who can create more complex financial situations. Often the complexity of the situation is largely synthetic.
- I agree that the complex financials are generally intentionally created for sheltering and that complexity is only possible because of our overly complex tax code which has been made significantly more complex by tax preparer lobbyists from Intuit and others.
- The reflex when people hear "complex" in this era: "Can we use AI for it?".
Next month's headline: "IRS signs 200-million dollar deal with Grok to use AI to analyse tax returns, determine who gets audited".
- You’re thinking too far behind. They can just use the AI to generate what your taxes would’ve been.
Just have a script with “what are the taxes owed by $name” and print the output
I’ll take $5M now and you can own 50% of my startup: GenTaxAI
- I suspect something like this may already be in place.
- Half-joking but this is genuinely the trajectory. The problem is that tax analysis requires understanding intent behind complex structures — is this a legitimate trust or a shell game? That's adversarial reasoning, not pattern matching.
The real risk isn't that AI can't find anomalies — it's great at that. The risk is that the people creating complex avoidance structures will use AI too, and they'll iterate faster than a government system updated on procurement cycles. You end up with AI vs AI where one side has a 3-year upgrade timeline and the other ships weekly.
- In both cases though, mostly rich people.
- That “415:1” is misleading and manipulative. The target rate of recovery is ~10:1, which is roughly what the IRS actually achieves.
Audits are not an infinite money glitch. I used to work for a Federal audit agency that also recovered ~10:1. The reason we target 10:1 recovery on audits is because the return on funding additional audits beyond that falls off very sharply. Furthermore, more aggressive auditing greatly increases compliance costs which ultimately come back as costs to the Federal government, so the net recovered revenue is even less than the headline figure.
Audit recoveries tend to be about sloppy compliance, not people trying to cheat the system. People with more complex taxes are more likely to screw up the exponentially more complex compliance aspects. Auditors are mostly fighting entropy.
- Is that 415:1 the rate of return of an audit, or the expense:revenue ratio of the IRS as a whole? I remember hearing some time ago that the expense ratio was 11% for the IRS? But 415:1 is way way less than 11%.
- Captured revenue : cost to capture (could be an audit, billing for interest/fees due, etc. lots of avenues to capture revenue that is being missed).
The problem is these metrics aren't really scalable productivity metrics. If you doubled cost, it might go to 100:1, if you tripled cost, it might go to 0.5:1
Each dollar generally gets more expensive to capture.
- They could also simplify tax law and they wouldn't need so much enforcement. There shouldn't be 5000 types of taxes spread all over the place.
Get rid of sales tax, property tax, exemptions, IRAs, 401ks, short capital gains, long capital gains, medicare, state, all of that bullcrap. Annualized, non-annualized, credits for having an EV on the 4th day of the second Tuesday while being a fisherman, married and single filing differences, end all of that.
Just have one income tax. It should be the sigmoid of your income normalized to the median income in your zip code, then scale it so that the total of everyone's taxes added up makes up for all the other types of tax that we're getting rid of.
The IRS should then distribute whatever is needed to the states. The states are part of the country, their hierarchy is not my problem; give me one number to pay. My tax return should be no bigger than a postcard.
Done.
- > Get rid of sales tax, property tax, exemptions, IRAs, 401ks, short capital gains, long capital gains, medicare, state, all of that bullcrap. Annualized, non-annualized, credits for having an EV on the 4th day of the second Tuesday while being a fisherman, married and single filing differences, end all of that.
I agree with your overall point of simplifying taxes by merging more things into income tax, but some of the taxes you mentioned are levied by local governments to fund themselves. The United States has a federal system; it would be a much bigger change to centralize all of the funding.
- I... don't understand how that excuses complexity?
what stops "local governments" from applying same type of tax as higher levels? why would they need taxes specific for them?
- I tend to agree with this. The logic should be the same with different rate tables for each taxing body. What I don't want though is the Fed govt being the collector and distributor of all the funds. They already weld too much power with their various funding influences for transportation, healthcare, etc. The states and local govts shouldn't need to pander so heavily to the federal govt for funds.
- > The United States has a federal system
That doesn't prevent there being a single point of collection and distribution.
- It sorta does, that's one of the primary points of a federal system.
- It literally does, this is one of defining differences of a federal system, that the states have a right to set and collect taxes.
- By definition, a federal system does prevent a single point of collection and distribution. If states could not or did not collect taxes on their own authority, it would not be a federal system. States would just be adjuncts of a national government.
- You’re absolutely correct. For income taxes many states and the federal government offset each others debts.
In Canada provinces can choose to harmonize taxes or collect independently.
- Which misses the point. If the point is to reduce the number of taxes, having the federal government collect 10 different types of taxes instead of state governments collecting 7 types of taxes won't change all the different taxes we have.
There is no singular place we can change how many different taxes you pay. There's... thousands? Tens of thousands? Once you factor in city, county, state, federal, special districts, etc.
- Didn’t they just get rid of the IRS automated filing app? You’ll have to kill off TurboTax and siblings to simplify the tax code.
- Ok what about for the people that mainly earn their living not from an income paid by a job; ie the richest people in the country?
- Taxes aren't just there to provide an income stream to the government. It's also a mechanism to guide behavior via incentives (or punishment). Right or wrong there we're providing an incentive to hold assets longer, or use less fuel or buy from domestic producers etc.
- IIRC, this was one of the main arguments for the Articles of Confederacy, the states were pretty nervous about this exact situation.
This was reaffirmed by Marshall [1] with the famous “the power to tax involves the power to destroy."
[1] https://www.archives.gov/milestone-documents/mcculloch-v-mar...
- This misses the point that tax exemptions are the way politicians campaign for voter blocks. Having different kinds of taxes makes it easier to target a voter blocks more precisely.
- > Get rid of sales tax, property tax
The very first things you list aren't related to the IRS at all. They're local and state taxes, and to get rid of those would require a radical rewriting of the Constitution itself. Not to mention it would destroy all fire department, county hospital, school, city park, state park, etc. funding.
- Of course they're not, but this is how you smell someone that doesn't really want to enforce paying taxes, but just wants to evade them as much as possible.
How quickly people show their colors.
- I don't think that's fair. The US has so many administrative layers with taxing powers - federal, state, county, and municipal, and in many cases administrative bodies also charge massive filing fees, and courts charge large fees to finance themselves because they're consistently under-funded by legislatures.
So Americans get taxed a lot at many different levels of activity. The cognitive load of having so many different points of taxation is annoying and exhausting to a lot of people. It makes household budgeting a lot more work than it really needs to be.
But it is this way because of the Constitution
They maybe we should change that and have a simpler system with much less complexity. Dismissing people who object to the painful complexity of the US tax regime as 'evaders' is npt insightful or helpful.
- > maybe we should change that and have a simpler system with much less complexity
Wholeheartedly agree, but I see the root cause of the issue being income tax itself. As soon as you tax income, you'll go down and endless rabbit hole of what's fair to tax, how much, what kind of income, investment income vs wage income, percentage vs flat rate, etc...
That gave us the mess we have.
I like the idea of consumption tax exclusively (would require an amendment). You're taxed on your purchases.
It's easy to drive behavior (more tax on some things... tax on cigarettes, yachts and private jets) and easy to make more fair (exclude grocery staples).
- Why would you simplify the tax code if the whole point of the tax code is to create loopholes so you can pay way less taxes than the public would vote for?
The tax code exists for Welfare Queen Billionaires like Elon Musk.
- Well see, you actually missed the catch that by eliminating everything except income tax people like Elon wouldn't have to pay any tax, it's even better for them. He's not getting a W-2, virtually all of his income is actually capital gains or similar.
- Well it's a retort on the 2022 IRA bill, which increased the IRS budget by 80 billion over 10 years, and paved the way to hire 87,000 people. There has been a lot of hiring recently so it's hard to tell one thing from another but this isn't so much of mass layoff as an attempt at returning to normal.
- Please provide evidence for what you considered to be normal to be an effective workforce for the ongoing task at hand (nation state tax collection).
- The evidence was the baseline before the increase
- The baseline was there was significant tax evasion by high net worth individuals. The staff up was to counter that, staffing down puts us back at reduced enforcement.
Someone has to pay to operate a nation state, you can’t borrow forever to fill the gap and there’s nothing left to cut.
- I'm starting to realize that an LLM isn't gonna take my job, but it's beginning to make the job aggravating enough to quit anyhow. So many managers have decided they're going to have an AI Miracle and aren't interested in hearing otherwise, no matter what staff tells them.
- Unfortunately the big players are pretty entrenched so the degraded quality that appears once AI fails to replace laid off workers will have minimal impact on their bottom line. And the bar for government is literally as low as "Is this such bad UX that it will cause a revolution?".
So why would they care whether its Covid, AI or a Recession that gives them the excuse to do less and less. The system keeps on rolling, the rich get richer, normal peoples lives get incrementally shittier.
- > So many managers have decided they're going to have an AI Miracle and aren't interested in hearing otherwise, no matter what staff tells them.
Managers' manager convinced them they should expect an AI Miracle. Now your job is to put on a show to pretend to create an AI Miracle so your manager and their manager can pat themselves on the back.
Under enough pressure to use AI people will just produce code as before but LLM-ize it with more comments and verbose crap to look like AI did it. "See boss, I am using AI, so happy you got us this tool".
However, if you do it too well the next step will be "we don't really need so and so, we'll just replace them with an AI agent since it was working out so well".
- An LLM may take the interesting parts of my job but the parts that suck (dealing with people) will never be taken over by an LLM.
- Phone and chat support has already happened, robotic law enforcement is the future. Now pick up that can citizen.
- Notably that isn't an accurate reference. The Combine officer is not a robot, so no robotic law enforcement happened.
- The part I don't understand is why can't they wait for the efficiency gains to materialize before firing people? Better pay a few people for a few months extra than be wrong. If AI is going to bring in all this efficiency, this would be peanuts.
- Because, for white collar jobs, that is so rare that it's reasonable to say that it never happens.
- Its like the "throw him into the deep end" method of teaching kids to swim. (I don't endorse it, but it has worked for many people.)
- Does this have anything to do with AI push? It is fairly straightforward that billionaire class cooperating with Trump admin dont want to pay taxes. Republicans want IRS incapable so that tax fraud flourish. Bonus point is that they will be able to pretend worry about it with minorities.
- > Naturally, AI is expected to play a significant role in all this, making people better at their jobs and more end-user-focused, he said.
> However, Pandya said IRS leaders are telling employees that AI won't endanger their jobs.
Not much of trump supporter myself, but I check HN for tech news rather than politics
- > Republicans want IRS incapable so that tax fraud flourish.
That's wildly hyperbolic.
- They literally put a tax cheat as head of the IRS last year.
People considering speaking frankly about reality as hyperbolic is how we got here.
- It's not hyperbolic, it's factual.
- I started a new LLC in December and applied for an EIN (company taxpayer ID, required for doing essentially anything else, like opening a bank account). Normally this is done online and takes two minutes. This time the online process failed and I had to fax the form in. Six weeks later, they faxed back the number.
To be clear: when it failed, I just got an error code and was told to fax in the paper form. Which contains exactly the same information I had just typed into the website.
I don’t think the IRS needs fewer tech people.
- The headline say 40% based off something a single person said at a conference while the same article says the federal inspector general is saying a 16% reducation, as well as this quote:
> According to a report by the US Treasury Inspector General for Tax Administration, the IT department had 8,504 workers as of October 2024. As of October 2025, it had 7,135.
- The thing that makes me nervous is the statement that they plan to use AI. AI? The thing that is mathematically incapable of perfection, on finance information, for which perfection is table stakes? Not to mention all the privacy issues (although that boat has sailed).
- The people in charge have a pathological hatred for the IRS. AI is just an excuse to continue destroying the capabilities of the IRS. In the meantime, they’ll keep borrowing to fund the government while telling everyone it’s ok because they slashed programs that make up a tiny portion of the budget. This can go on until there is a major economic shock related to US debt, but honestly, most of them will be dead by the time that happens.
- I thought I would give the Treasury the benefit of the doubt for a moment and check whether they meant LLMs like we're all assuming, or possibly a more specific finance-focused type of AI. Like how we have specialist neural net AI helping with radiology.
Looking at their official info document[1]... "a secure AI-based chat solution"... "AI-assisted code development"...
Okay they mean LLMs, carry on.
[1] https://home.treasury.gov/system/files/136/Treasury-AI-Strat...
- I am not following, a lot of things get turned into python calculations, so the LLM is not doing the precise math.
- If you think the state of the average tax return is "perfection as table stakes"..... you might be disappointed.
- Most tax returns these days are prepared and submitted electronically so the basic work of the arithmetic involved should be as close as possible to perfect already. Evaluating that is going to be pretty mathematically intensive though and LLMs have been pretty bad at that. Tool usage has gotten it better so maybe they'll just hand off the validation to the existing traditional computing and mostly be vibes based, 'does this return look legit?' evaluation.
- Consist strategy in hampering income:
> "Starve the beast" is a political strategy employed by American conservatives to limit government spending[1][2][3] by cutting taxes, to deprive the federal government of revenue in a deliberate effort to force it to reduce spending. The term "the beast", in this context, refers to the United States federal government and the programs it funds, primarily with American tax money, particularly social programs[1] such as education, welfare, Social Security, Medicare, and Medicaid.[3]
* https://en.wikipedia.org/wiki/Starve_the_beast
Of course the GOP isn't very good at cutting spending, so deficits (and debt) tend to go up under their administration.
- I hope when someone else owns the whole government the beast becomes the us military.
- Nah, it won't because ANY cuts to DoD will be met with
"Don't you support our troops"
Which is completely unrelated but it works very well as an attack line
- It always sets off my spidey sense when people say 'leadership' because too many conflate management with leadership, and that is unfortunately not always true.
Few managers are actually leaders. Many are trumped up scribes. And many leaders are not managers.
- They can always learn a new skill like programming.
- AI audits for everybody. Of course they're going to do it.
- Remember when the Biden administration massively increased IRS funding and the Right collectively lost their minds? They fairly successfully pushed the idea that these agents were going to go after average citizens. They never were and you're way too gullible if you ever believed that.
Every $1 spent on the IRS returns roughly $12 in revenue [1]. This revenue doesn't come from W2 employees. It comes from exposing tax fraud from complicated tax schemes used by the very wealthy and corporations. That's why the Right lost their minds about it.
The idea that you save money by cutting IRS funding in the budget is just so laughably false that I'm surprised anybody believes it.
[1]: https://budgetlab.yale.edu/research/revenue-and-distribution...
- My good friend Sam Corcos is leading these efforts as the CIO of the Treasury Department. I know a good conspiracy theory about lowering taxes for the rich is much juicier, but if anyone is interested in learning more, he did an excellent interview on Chris Williamson’s podcast about how inefficient the IRS is:
- Your good friend Sam is hanging out with a shitty crowd... read the site for yourself.
- Vinay Hiremath has a blog post titled “I am rich and have no idea what to do with my life” so I’ll be charitable and say he’s willfully ignorant about what’s going on.
- I am on the same site. It’s trash and doesn’t even come close to detailing the internal dynamics.
People have no idea what’s actually going on inside, but I guess it’s simpler to just be upset and take sides. There are people associated with DOGE (Sam included) who are tirelessly doing unsexy and thankless work while not being sensational like Trump or Elon. But they still get trampled on by people who simply want to be upset and ignorant.
- Yeah, when you associate with liars, con artists, criminals, and pedophiles in their attempts to dismantle our democracy for their own personal gain, people are unlikely to thank you for your hard work. Your friend can go fuck himself.
- I’m getting downvoted for posting a multi-hour interview where the guy leading these efforts is spelling out why and how. Makes me sad because HN used to be a place where, regardless of politics, people appreciated any new information and perspectives on the thing being discussed. Now it’s an echo chamber
- People have literally started revolutions and wars over taxes. Empires have fallen because of taxes. People are often emotional and don't even want to think logically about taxes. I suspect that it's been like this since taxes were invented :-)
- Starve the beast in action. The less employees the IRS has, the lower the chance there are enough staff on hand to audit the truly uber rich properly.
- This follows the same logic as the claim that Biden bulldozed the border wall to make immigration law unenforceable. If you deliberately weaken enforcement capacity (and also burden/cripple government with unsustainable debt), you can then point to dysfunction as proof the system doesn’t work.
The only difference is that in this case, the stated goal of ‘starve the beast’ is intentionally sabotage the entire government as policy goal. Underfund agencies, expand deficits through tax cuts, then cite the resulting debt and institutional breakdown as justification to dismantle more of government.
It almost makes the people who were outraged at the idea of sabotaging border enforcement seem disingenuous that they don't now care that undermining federal capacity is public strategy.
- The low income (under 25k) with EITC, were the largest audited group with 298,485 of 626,204 audits performed in 2022. The rest of those earning under 200k had 250,391 audits.[]
48% of audits were under 25k income. 87% of audits were people under 200k income.
Kind of interferes with the idea these audits were all about going after the uber rich. They were way more about going after the poor than they were about going after the rich.
[] l IRS management audit reports obtained via FOIA by via TRAC / https://tracreports.org/reports/706/
- The point of prior recent investments in tax police (that the GOP worked to claw back) was specifically to enable the enforcement of complex cases (rich people) that they didn't have the bandwidth to engage.
- The audits of people under that are going to fall under 2 or 3 categories:
a) People who filled in the wrong number on the spreadsheet that is taxes for whatever reason, and the audit is informing the filer that they filled it out incorrectly. I mean, really, taxes should start with the government sending me the form of what it thinks I owe and I should be making corrections to that, since the government already has this information and has done it, and that would make many of these audits go away.
b) People who misunderstood eligibility requirements and claimed deductions they weren't entitled to.
c) So I don't know how these people are counted, but there are absolutely millionaires and billionaires out there cheating on their taxes and claiming no income (e.g., the current president). It's totally plausible that they get listed in the "under 25k income" audit section despite the fact that they are in fact the uber-rich that is the intended target of the outrage.
- It's super weird to believe auditing a normal person and auditing "the uber rich" is in any way comparable. In both cases the thing being done can be referred to as an "audit," but that's it.
- I mean, $200k puts you well above the 90th percentile of earners in the US, so the IRS is (if only slightly) focusing extra resources on the wealthy. Audits go after people who have relatively obviously incorrect information on their taxes. For people under $25,000, there's a good chance they forgot a W2 or something, which means it's a quick identification and fix for the IRS.
- Do you think gutting the IRS is going to improve that ratio?
- How many of those <25k audits were completely automated? Going after the poor with an automated script at scale is basically free money for a government without compassion.
- It's not "going after" the poor. You have to be out-right negligent to end up with any penalty at all, and the penalties involved are relatively small (20% of how much extra you owed them anyway). The vast majority of these low-income audits consist of "hey, we know you made money X, you didn't report it on your taxes. Fix it".
- Cheating on tax credits also comes to mind
- ‘We know you’re trying to survive in your low income, but we want to extract more money from you so the billionaires don’t have to pay as much tax’
- I make above median wage in the US and pay like 13% income tax on average.
Poor people pay very little income tax, as is the entire point of a progressive set of tax brackets and a large standard deduction.
It is trivial to not do your taxes wrong if you have legal employment. If you for some reason doubt your ability to do a couple calculations and copy over 6 numbers to a simple form, Turbotax will do that "hard work" for you for $30.
Even using Turbotax, I once failed to report a W2 (because I technically had more than one job) and the "penalty" was a letter that said "Hi, you missed this, we fixed it, give us $270 + $1 interest", which I never responded to because I am disordered, so they took my state income tax return.
No court. No threat. No serious penalty. I didn't even have to talk to anyone.
If we are talking about poor people, who by definition have minimal income, how do you think they supposedly would get hit by some giant IRS penalty? What is the magical pathway?
- If you're not asking, "how many of these people did nothing?" you've never worked in the public sector.
- This is the case in all layoffs. Is there a bottom 10% of employees at OpenAI? By definition yes. If you do your absolute best to try and make redundant the bottom 10% of employees at OpenAI, how many of them do you think will actually be in the bottom 10%? I bet it's not all of them, it's probably not even close to half of them.
First you've got the good people who don't like the environment, they'll bite your arm off for the redundancy, then you've got the people who are doing fine but for whatever reason are happy enough to take their chances elsewhere, they'll be happy to be top of the redundancy list. Then you've got the good strong performer who pissed off the wrong person, they'll be on the list too. Then you've got the entire team that is really good and hardworking but senior management figure it's easy to just cut the entire team because their project isn't politically valuable. Before you know it the redundancy list is full and it has no correlation to the bottom 10% of performers, but because it's pretty much an almost random sample it does reduce your company's capability by 10%.
- Not all public sector jobs are the same. Working for a defense contractor is not the same as working for the IRS. Defense gets money dumped on it year after year. The IRS gets starved year after year.
- This is just the lazy comment of someone who believes all the right-wing propaganda about government. In my experience, government employees take pride in doing a job worth doing and doing it well.
- 8,500 IT workers in the IRS is insane.
They barely have any products, and they contract externally for so much other work
- They have worked recently to implement a self-hosted tax submission system and given their rate of return while there may be some mismanagement it is one of the most provably efficient organizations in the government netting 415$ for every dollar of funding in 2024.
- Isn’t that a completely bizarre metric though in this instance??! It is specifically the revenue generating arm of the government. If it wasn’t running at a “surplus” that would be very concerning indeed.
- I did no verification on whether that metric is correct or not, but I would suspect the metric would be only measuring the amount of revenue the IRS "generated" from doing manual work like audits. The regular, I owe 1,000 in taxes, and I paid 1,000 in taxes. Wouldn't be considered +1,000 in that case, it would be excluded from the metric altogether. Only the additional "findings" from audits would be counted.
- No the point is that if the IRS was at maximum efficiency, more funding wouldn't increase revenues because tax law is tax law: you can't market it or expand the customer base.
But if every new dollar currently produces much more then a dollar in returns, it means it's underfunded because taxes that should be collected, that by legal analysis would be planned for in budgeting, aren't.
And that matters for a great many things, but one reason is that if you pay taxes and want a tax cut then one reason you're not getting it is because actual revenues are lower then they should be due to uncollected taxes.
AKA tax fraud steals from the honest tax payer.
- I'm not saying we shouldn't have an IRS, and I think IRS agents are probably one of the best ROI gov't employees possible, but 8,500 IT engineers and managers (who I have heard literally didn't even know how to code) makes no sense at all
- They built IRS Direct File which was a huge improvement. Then the administration killed it to serve tax prep companies.
- Already could file free with free tax usa.
Not that impressive.
I'd be more impressed we got rid of income tax on salaried people entirely, or permit families the same type of deductions that businesses get, and only tax my actual profit - I can't deduct my overpriced housing, or my utilities unless I have a home office for ny own business.
- Do you know how many people 8,500 employees in IT alone is? Google, all of it, has 60,000 engineers
IRS direct file is just not that complex, I promise you, and are you sure it was even built in house vs contracted?
- The tax code is complex and Direct File isnt the only IRS digital service. It was built by F18 and USDS. You should inform yourself instead of being hysterical about numbers. If you inform yourself the numbers aren’t so scary.
- They have 150 million paying "customers" (not including businesses) and bring in $5 trillion+ yearly.
- Consider that many millions of those "customers" need to hire a professional for hundreds/thousands of dollars to properly interact with the IRS.
- That's not the IT department's problem. Well, they'll get blamed, but that's pretty on-brand for IT departments.
- It's not the IT department's fault, but it makes one wonder if the IT department needs to actually be that large, since customers need to do so much on their own.
Per capita the UK has 2.5x the IT workers in tax collection compared to the US (~25 IT per million vs 65 IT per million). But, those tax collection IT workers help create a system which means UK citizens don't spend hundreds of billions of dollars every year just to file their taxes.
- I don't think this is the current administration to fix the IRS, given the whole Social Security scam SNAFU.
- The public sector is where you need 12 people (and a project manager) to build an Access database.
- And the private sector is how the US has arrived at a miserable, unworkable healthcare system and an out of control carceral system.
- Today's Health insurance and health care is entirely a product of government intervention on multiple layers.
Health insurance being tied to employment benefits is because the IRS taxes money, but not benefits, for example.
- Is there a single private sector more removed from market incentives than healthcare?
- And yet all countries with socialized systems pay less per capita for healthcare than we do and pretty much all have better health outcomes. Further privatizing our system will only make it more dis-functional. Healthcare isn't a normal marketplace. * When you really need it, you can't shop around. * There is a knowledge asymmetry built in. * A civilized society can't just let poor children die of preventable causes.
- I’m going to drop my doctor this year because he abuses appointments. I call in about an issue and he charges me $75 for telehealth. Then he wants me to come in to run labs for the telehealth call. Another $75 at least. Then another telehealth call for the results. And another one for the results from the radiology department. I told him I have a high out of pocket and he says “I’m sorry to hear that.” Then books me for a follow up.
Doctors do not care about the healthcare system one bit.
193 points by freitasm 3 hours ago | 114 comments