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You are too weak, cowardly and divided to stop it. That’s why. Organize, grow a pair and empower each other. You must fight as a group or you will continue to be oppressed and exploited.
and manipulated to fight against each other, against your own interests
This is unironically Nixon’s fault.
It’s also unironically Reagan’s fault, as well as both Clinton and FDR.
Prior to FDR doctors and healthcare were run completely not for profit, and part of The New Deal included privatizing hospitals. Nixon did insurance. Reagan and Clinton mostly just took the government further out of healthcare by removing regulations.
Private nonprofit hospitals aren’t even that bad. Its private insurance thats the real problem
I attended an AI/ML training course provided by one of the major cloud providers (it was actually the first one they ever did). In the class were several private hospital executives.
All of them were absolutely giddy about the prospect of using AI to deny care to unprofitable patients.
Well if they are for profit so there’s the problem. All private healthcare companies should be non-profit.
Being non-profit doesn’t make a hospital immune to that sort of greed.
Can you point me in a direction for a source of the new deal hospital privatization aspect please?
I’m unfamiliar and want to lean more.
Looking into it, it seems to have been Truman, not FDR, though FDR may have helped create the bill. You’re looking for the healthcare reform act of 1945. I just remember my nurse grandmother going on multiple tirades about the privatization of healthcare starting around then, and healthcare in general being slowly suffocated by admins ever since. She didn’t live long enough to give me her opinions on the ACA.
Thanks. Yeah, I didn’t want to come off as a know it all umm actually guy so I figured I could be wrong and just ask for a source.
I had done my own search too but again, everyone is fallible so better to just ask.
Also I know it means nothing from some rando on the interwebs but good on ya for correcting yourself. In today’s age and all that…hope you’re as well as you can be. Take care! (Goes to look further into Truman’s war criminal ass lol)
Edit: it appears Truman actually tried to make a national health insurance act happen and was defeated by anti-communist sentiments, the American Medical Association, and republicans fear mongering and “they’re gonna raise your taxes!!!” rhetoric. It would have been a part of the social security expansion but alas, congress is corrupt and Americans are gullible (being generous).
Yeah, I wish health insurance was just “you’ll never pay more than 20k a year on medical bills” or something like that. Let me find my own damn doctor
If you have good insurance, this is absolutely what it can be. My work pays for mine, and the max out-of-pocket is $3.6k/yr. I had already hit my max, then wound up with a $4k ER visit, so it wound up being free. Unfortunately, most insurance is fucking awful unless your company is willing to pay a shitton for some very expensive plan.
Pretty much every plan has an annual out of pocket max, and in order to be listed on an exchange it has to be under $9,200 for an individual or $18,400 for a family. Balance billing is also now illegal, so whatever the insurance won’t pay can’t be billed to you. That’s the bare minimum, and it’s already the law.
So if you can find a plan that will cover any doctor you find (even if “out of network”), you can have what you’re looking for. It probably won’t be cheap, but what you’re asking for is in most plans in some way or another.
20k a year? That would be better that what you have now? Sincerly, a non-USAian
Well, most insurance is only for emergencies, and it is priced accordingly. For example, when I drove a car, I didn’t have to deal with my auto insurance plan at all while getting gas or normal maintenance. However, when I got into a few bad accidents, the car insurance was vital for continuing to have a car, and it paid towards helping me get it fixed. Car insurance is insurance against something catastrophic happening to a vital part of life in most of America, not something to use everyday, and is priced accordingly.
Health insurance here is very different from car insurance. Rather than an emergency contingency, health insurance is woven into most healthcare purchases in the U.S. Accordingly, it is very expensive, limiting, and inefficient. Due to the dynamics of the system it creates, Americans must usually pay through the nose for even everyday healthcare without insurance.
If health insurance was operated more like car insurance, except of course that a human life should never be “totaled out,” the system would eventually adjust and normalize.
Are you suggesting routine visits not be covered? That’s how it reads… Do we think less (because it costs) basic preventative care and planning will lead to less catastrophic/etc issues? Or by not covering it are we expecting “competition” to lower the price?
Yes, that’s what I’m suggesting. Keep in mind that in most other countries where insurance has less of a role, these are vastly cheaper than they are here. I expect more people will ultimately go then, especially the uninsured, because prices would no longer be artificially inflated by bureaucracy and for the purposes of negotiation with insurance.
The hard problem, the way I see it, would be taking us from here to there with minimal suffering during such a transition.
We could also go the opposite direction towards single-payer healthcare. That also can be more efficient than what we have if politicians don’t sabotage it, but I am concerned that here, they will, and we’ll end up with something like the U.K. NHS. Therefore, for the U.S. specifically, I don’t see this as a good option due to instability.
What we have now is a compromise that works for nobody.
I get what you’re saying and completely agree the current situation works for no one, but covering routine care is important. Sure, people probably could pay for routine care directly and it would be cheaper but all too many won’t. When it turns into a serious problem that could have been prevented, it’s not just their health affected but cost to the insurer and employer.
I’m pretty sure that 100% coverage of routine care has been proven cheaper than letting the person decide
They do, but of course it depends on your company offering it.
The combination of “high deductible health plan” (cover everything after $x,000) and a “health savings account” (set aside pretax money, accumulate and invest) really seem like a solid improvement over everything else. If your company offers it. If you can afford to keep at least the full annual deduction in an HSA
That being said I’ve never been able to take advantage so I could easily be wrong. I currently pay for “old fashioned insurance” which really is the way your parents remember it,covers everything, low deductible and copay no out of network nonsense, but oh so expensive. Y’all with crappy insurance can at least applaud not paying premiums I’m stuck with
The US should adopt the Dutch healthcare system. You could have medical treatment as an average Joe and also not be bankrupt or up to your tits in debt.
I’m still rooting for Danish healthcare! I don’t know anything about it, nor do I live in California but I’d welcome our new overlords
I mean if they picked a random country it probably has a good chance to be twice as good as the US system
yeah, but, like the lines are long
/s
Health insurance is a decent solution to no universal healthcare…on paper. But the way the US executed it is poor
Yep! Japan (only other country I have experience with) has a government run health insurance. Since the interests aren’t profit, the prices remain reasonable even without it
Health insurance is rent on your life. Healthcare should be provided by your government through taxes. It is the best interest of everyone to do it that way. That isn’t insurance. That’s just healthcare.
I agree with you. But I think you missed the point of my comment.
Capitalism is basically about making as much money as possible with as few products/services as possible. Health insurance is one of the best ways to achieve that.
ah that western bias again…
You forgot the most important part of capitalism which is exploiting labor.
Now imagine a country where there is public healthcare, but it is blasted and underpaid so often by crony politicians because “healthcare” companies AND medics have a large pool of crony politicians to pay
waiting for a medical group to bypass them and collect premiums directly. if only to end insurance paperwork costs. it is a drag on everyone’s bottom line. aside from price distortions.
Horrible place for a conflict of interest
conflict with insurance interest in taking your money. nurse i know spends 2 hours of insurance documentation for every hour on actual nursing.
I’m not claiming that’s a good thing but I’m fine with my medical provider being incented to provide proper care and to get everything they deserve from my insurance. I would not be fine with them being incented to provide only the care I can afford right now or being incented to maximize how much I’m stuck paying
the calculation i try to do. total insurance payments for a year minus healthcare received equals profits wasted building bigger office buildings and yachts for insurance execs. i’ll bet you a hundred dollars a month your house won’t burn down. or the extended car warranty scams are also same deal. house always wins because people don’t have common sense to save money for ‘rainy days’. schools don’t teach basic finance.
It sorta works for kaiser - they administer the insurance and the hospitals. Very convenient for people who both have the insurance and access to their facilities.
Nowhere near as good as a single payer system of course.
I don’t love Kaiser - the prices still suck. But they sometimes suck less, and their system is far more streamlined than I’ve had with other insurance providers. Still ridiculous to be trapped in a system with no control over or transparency into costs.
It would convert nicely enough to a single payer. Granted costs might suck but if they were just absorbed into the system, I wouldn’t really care. I could at least believe they are trying to be efficient. As it is, I’m left believing I get charged as much as they think they can get away with. And wth else am I going to do? Kaiser is much cheaper than my employer’s other option (there are literally 2), and I’ve had the other before. It just sucks (slightly) differently.
I’ve seen it with dentists, they have a membership plan that covers cleanings and certain things which can be useful and affordable if you don’t have access to affordable dental insurance.
I have something like that, sorta. I work for a very tiny company (literally 4 people), and so we couldn’t get a good insurance plan that covered vision and dental because insurance companies suck ass.
So my dentist has a thing where I pay a single price once a year and get 2 cleanings out of the deal. Though anything beyond that is still out of pocket.
A couple of my doctors did that before I left the US in 2021. They stopped accepting insurance and started charging a monthly “membership fee” that would cover a certain number of visits per year.
My parents are part of a clinic exactly like this. I legit thought it might be a scam at first because “how have insurance companies not shut this down?”
it would be known as usury in an earlier period, say, 13th century Italy
iirc, usery is a sin. says so in the manual
You are the product. When your liability outpaces your premium is when they decide to stop covering you.
Look at finance! They don’t make anything of actual value, they just bet what’s going to happen to the people that do
Isn’t that investing though? Or is that entirely different?
Companies can do things without investors, but investors can’t do anything without companies.
If I invest in stock on my toilet at home I’m technically helping the company financially, but I’m not actually developing or making things of real economic value. I’m just betting they will and that their numbers will go up.
Oh shit I have a toilet too how do I invest
You make periodic deposits
No way I’m doing that right now
“You know what the trouble is, Brucey? We used to make shit in this country, build shit. Now we just put our hand in the next guy’s pocket.”
If they did that, then they’d be contributing useful information about which ideas are good. But they don’t even do that anymore; the finance game has been rigged since the bailouts started.
Health insurers don’t contribute information. You don’t need to know what your odds of getting sick are because you’re going to want treatment either way. A choice where the alternative is death isn’t a choice.
When the US was having actual discussions of single-payer health care (i.e. the “public option” during Obama’s first term), one major argument against it was “do you really want the government between you and your doctor?!”
Even though insurance companies are literally already between you and your doctor, and they exist purely to extract money from that interaction.
It’s never made sense.
The old arguments were “Look how long they (the socialists) wait to get appointments and get seen!” Yep, we’re there now. I have insurance, I still pay a bunch, and seeing specialists is a luxury at this point. If I have an issue, I don’t even consider calling specialists, because I know it’s weeks til I can get in.
Weeks lol, try months to years round these parts
And then the same party decided to get the government in there too anyways
Ahaha that’s a good point. Tbh despite the nickname “Obamacare” it had slipped my mind that the ACA was the bastardized, castrated version of that whole thing.
They chopped it down to Romneycare
You forgot that Clinton tried as well.
https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993
I don’t trust the government, but I trust them a hell of a lot more than insurance companies of all people
during Obama’s first term
Lol this was just about the first thing Clinton tried to get done in 1993. It’s one of the things that led to the creation of Fox News.
It’s never made sense.
It makes perfect sense for the americans who have been conditioned for literal decades to react certain ways to certain things, while being kept ignorant of nice things that exist in the rest of the world.
For instance:
Government-run anything? It is mathematically and physically impossible for it to benefit society. It will, without fail, become a corrupt dumpster fire that furthers evil in our world.
Market-based solution that leans heavily on “personal responsibility?” Well that’s just great I tells ya! It lobs like the best, kindest, and most Christlike solution is to do nothing and let them fend for themselves! They will be stronger for it and will thank us!
I don’t want anyone between me and my doctor. Doctors should be deciding what care I require and billing the govt for it. If the government thinks something fishy is going on, they can audit them after the fact. I need not be involved. As it stands I don’t go to the doctor at all because I’m worried they’ll do some test or something that wasn’t actually approved by my insurance and I’ll get slapped with a bill for 1000s of dollars.
I’m pretty sure the ACA included at least some protection against that, although I don’t know if the current administration repealed that
Just as an aside, often the bill you first receive from stuff like that is the fake price they bill insurance for, so the insurance company can “negotiate” a better deal.
If you get a bill like this and insurance denies the claim, you can often call the billing department and get a significant reduction.
I knew someone who racked up like $250k in denied claims from cancer treatment. They went to the hospital to work out a payment plan, and the billing department was so surprised someone actually wanted to pay their bill they dropped it to $2500.
Obviously it’s still fucked that you have to do it, but the price can often be lower than the sticker price.
You can also call your doctor to ask what tests they’re going to run and which lab they use, then call your insurance to verify coverage. Or if the testing is done in house the office staff can check for you.
While true, it’s also just ridiculous that going through that whole process is even a possibility. So many hours of wasted time.
I don’t care. I’m not engaging with that system unless I think I’m dying. Even then I’ll probably try and sleep whatever it is off first and die anyway. At least my bank account will be intact to leave to my family.
imagine life if the people in power were engineers rather than lawyers
It probably started with healthcare being expensive.
Insurance is why it got expensive
Let me state up front I agree with you. A less charitable reading of what I’m about to say would try to make it seem like I’m putting the blame on other things to deflect. I’m not. Insurance companies fucking suck and are among the reasons it’s expensive.
Like everything it’s more complicated than a single factor. Tying healthcare to jobs is part of it. Boosting the number of people signing up for the military is part of it for both VA insurance and college. The cost of college (with its financial middlemen as well) for doctors is part of it.
Insurance is a huge reason. There are a hundred other little reasons as well, many of them also dealing with financial middlemen, that contribute to the issue. It’s a Gordian Knot of idiocy and when it gets sliced it’s going to be painful and, once the initial pain is done, necessary in hindsight.
An under-appreciated aspect of the insurance industry is the fact that there is typically a multi-year lag between the collection of premiums and the payout of claims. Insurance companies invest the premiums in the meantime and profit off the returns. This allows them (in some cases) to be profitable even when payouts exceed premiums. As a result, not only are health insurers not troubled by rising costs, they actually benefit from rising costs because the premiums rise at the same time.
That’s not entirely true. I mean, they’re one of the biggest parts of the problem.
I mean look at a new MRI machine at around 3 million. There is a point where such tech didn’t even exist.
It is the reason why healthcare is up to three times more expensive in the US compared to countries with universal healthcare.
They also have MRI machines in countries with universal healthcare, so that is a completely moot point.
I completely agree but “got more expensive” is a bit of a loaded phrase given what it costs to put together a hospital.
And I bet the MRI in those other countries cost money too, a cost that they will also wouldn’t have incurred a number of decades ago.
Special thanks to the people who made MRI exist! It’s a good thing they can each scan tens of thousands of people.
I suspect that is not the only reason but it definitely contributes. Insurance companies are like the bacteria growing on a festering wound making it worse. Otherwise medicine and biotech research/operation is not cheap, personalized medicine even more expensive. The R&D is many times carried out by private companies who mostly care for profit. So fixing healthcare requires more than just getting rid of insurance companies (though they should definitely be gone). Alot of goverment support and correct use of taxes is required too. If healthcare remains a profitable business leeches will always try to profit out of it even if it means average healthcare for most, ultra specialized cutting edge tech for rich (assuming insurance companies are gone but goverment does not support healthcare as much as it should).
It started with emergency life-saving healthcare being expensive.
If cancer treatments are costly, then insurance is useful to spread the risk among a large group of people - you know, the way other forms of insurance work. You pay some small amount a month, and if you get sick/injured in a way that is expensive to treat, you don’t suddenly get saddled with backbreaking debt because that pooled money goes towards the treatment.
But then employers started offering insurance as a benefit to entice workers. These insurance plans started to offer more and more, including reducing the cost of a regular doctor’s visit. In order to take advantage of this, doctors started charging more money so that they could get more of that insurance money - and the customer wouldn’t see the price increase, because the insurance company was covering the difference.
Insurance, already important to avoid getting saddled with medical debt, became virtually ubiquitous - and so did the increased prices to capture the maximum payout from the insurance companies. This resulted in the stupid prices for every little thing at a hospital; insurance companies negotiate specific prices for specific things, but different insurance companies have different negotiated prices, so the doctors and hospitals have some ridiculously high price to make sure they get the maximum possible from every insurance company.
If you don’t have insurance, you can often negotiate the price down yourself - but the hospitals don’t want you to. They want you to pay the ridiculous price because it means they get more money… so they don’t tell you that they have mechanisms in place for uninsured patients to negotiate the price down. Which results in the thousand-plus-dollar bills you see every time you have to go to the ER.
