What amazes me is Americans doing this to themselves. Literally acting against their own best interests, putting their lives and wellbeing in the hands of companies only concerned about profit.
American health insurance? That’s not how it works in other countries
And then having to send emails back and forth for months talking to several people, taking days off work and spending hours on the phone for clearance to watch stranger things and having it be denied because of some obscure reason that is going to take you several more days off work to try to get clearance to watch the show again
And if you don’t watch Stranger Things, you die.
Yep because you got fired for missing too much work and lost your Netflix. This was Netflix’s plan the entire time
All this while being sick like a dog.
But hey, my doctor gets to brag about the multiple properties he owns while he barely pays attention to what I’m talking to him about. It’s a great system for doctors.
I don’t know if that’s the doctor, but definitely the CEO of the insurance company
Little bit of column a, lot of column B
I hear you. How does one pirate health insurance?
Sail the seven seas to medical tourism
Given how highly adaptable Americans are I am very surprised to not seeing more of you trying to make a life for yourself in Europe. A plane ticket to any eu country is far cheaper than an ambulance ride to er…
I’ve seen a lot of Americans in my life.
Most of them are not adaptable.
There was a movie about this called John Q.
Universal healthcare is so hard that only 32 of the 33 highly developed countries in the world do it.
Probably be 32/32 in the near future at the rate they’re going.
True that.
I stopped paying for health insurance years ago, no way I can afford it now. I just get it through my state system.
Maybe we should try voting harder for representatives that are owned by the corrupt insurance companies and their shareholders
After recently apartment hunting, I have a (slightly tangential) gripe to add on here.
When I was getting my income verification (to prove I could afford the proposed rent), it went off gross income - what you make before taxes and so-called “benefits” are taken out. The hundreds I pay each month for the “benefit” of being insured make a significant difference between what I make and what I take home. Do I make 3x a given rent? Well technically, by gross income, I do. But my net income is where that rent payment comes from, so the chunk of my take-home going toward rent is absolutely higher than 1/3 of the net income I can actually use.
I have no choice but to pay for this “benefit.” Notice I keep using quotation marks. That’s because I think the term is bullshit. I think a work-sponsored benefit should be something work provides. Yeah, maybe they got a “deal” to offer insurance to employees for lower than it’d cost to buy for ourselves, but come on. If work really wanted to call it a “benefit,” they should pay us more so the numbers even out on our take-home. We’re forced into these situations, yet employers have the nerve to use a term that implies they’re offering some special bonus to us.
Okay, enough ranting for now. No, wait - prescriptions! That’s another health-related cost that isn’t deducted, that I still have to pay for, despite having insurance.
The screws keep tightening around us workers and there’s no escape. I really hope Mamdani sparks inspiration across the country, because this shit is untenable.
https://www.yesigiveafig.com/p/part-1-my-life-is-a-lie
Basically, stuff that used to be cheap has been turned into “market” and now the entire middle class is teetering on the brink of bankruptcy.
Fantastic article! I’m bookmarking it to share.
The guy has a wonderfully idiosyncratic writing style. None of what he says is in any way new (there are videos on YouTube of Sen Warren saying the exact same things from 2008-2010 or so), but it’s certainly an interesting read.
It’s much worse because you can choose not to watch Netflix but you don’t have much choice if you are sick.
It’s more like receiving a bill for songs you hear on the radio in the grocery store, on the bus, in other people’s cars passing by. You didn’t ask for the benefit, could not really negotiate it, but it was useful to you when you got it. You could maybe avoid it by not leaving your house.
you can choose what hospital you go to
Not when you have a stroke and are found unconscious by the side of the road. You can ask my father about it, when he learns to talk again.
But u can’t choose whether u need to go there in the first place so that doesn’t matter at all
you can, it’s just not advisable
U can choose whether u do actually go there but u CANNOT choose whether u NEED to
Edit: why do u want to die on this hill so bad ur very clearly wrong
just as I can die on this hill people can choose to die instead of going to hospitals
But they still can’t choose whether they needed to go there, they js chose to not go. I’m assuming ur trolling, in which case, I feel bad for you. Although on the off chance ur not, it’s not my responsiblity to educate u and I won’t engage in this discussion further.
Not always
Americans are amazing. Their healthcare system is literally killing them and ruining their families, and they keep talking about how bad “socialism” is…
The amount of bullshit this people buy is incredible.
10 years ago, we almost had medicare for all as a public healthcare option. We were soooo close. But congress fucked it up necause they were lobbied by ins companies who knew everyone with a brain would flock to the public option.
And what the insurance companies got instead was literally a law forcing everyone to buy their shitty products. Imagine the tobacco companies being so successful at lobbying that they got a law passed requiring everybody to smoke.
Team Trump floated that as their healthcare plan a few days ago as well
What, requiring people to smoke?
Forcing everyone to pay premiums
TBF a shitload of us know how socialized health care works. We want it.
There’s a massive, massive industry that is working very hard to make sure that it doesn’t happen.
I work in healthcare. I feel like more and more people are wanting some sort of universal healthcare in the last few years, even if they are conservative, even if they’ll vote against it, and even if the term “universal healthcare” will have them up in arms. But the concept itself? They’re all for it, they complain that healthcare is too expensive and insurance companies aren’t covering things and the system needs to change. They’re getting there. It’s taking them getting fucked over for it to happen and most of us may be dead of completely preventable causes first, but they just might get there.
But the concept itself? They’re all for it
Its exactly the same if you ask most conservatives about Obamacare versus the Affordable Care Act.
I work the other side of this. We do everything we are legally permitted to do to get this shit paid but there are limits. A big one is while we can tell a provider what’s wrong with a claim and why it denied, we can’t tell them how to bill. It’s illegal. We have to be very careful how we tell them to correct a claim.
This process is inefficient and we hate it. But it’s so much worse when they hire overseas call centers to process their billing for them. I have no doubt there are many intelligent Indian people who can do this but a big local hospital in my area goes out of their way to avoid hiring them. So they fuck up a claim. We tell them, as much as we are legally permitted to, how to fix it. They either do not understand the language we are speaking (not a racist remark, a literal statement. Some of them can speak English but cannot understand it spoken to them.) or refused to follow directions and just keep telling us to do it again.
I get it. I work for the devil. But the overseas reps (and now AI bots) make this so much worse. Nobody is saving any money by doing it this way.
Please please please legislate us into obsolescence people. If I hear one more old lady tell me she can’t afford insulin anymore I’m buying a noose.
I have a question, how much leeway do you have to get things covered? If the old lady calls you and says her insulin was denied and she can’t afford it, can you “accidentally” hit the approve button?
I had to have surgery for a medical issue. It was technically being controlled with medication, but the medication was expensive, difficult to get, and the side effects sucked and some of them were known to cause permanent damage. The permanent fix was surgery, and while that surgery was listed as covered under my insurance I figured that I was going to have to fight like hell to get it approved because my symptoms were under control with medication. I got home from work one day to a letter from the insurance company and I remember thinking “oh boy, here we go” and when I opened it and saw “your procedure has been approved” I was genuinely so surprised I sat down on the floor and had to reread it. I’ve always wondered if whoever did the pre-approval from my surgeon’s office was just that good or if someone at my insurance company was having a great day.
There isn’t an approve button.
There’s a system that’s really fucking old but never ever breaks down so they absolutely refuse to upgrade it. It’s been modified to keep up with regulations over the years but it DOES NOT BREAK. I did some poking around and I think I have a decent idea of what this machine actually is and if I’m correct, it will outlast our patients, all employees, it will outlast their offspring, probably the damn company. It’s a bitch to use but it’s super reliable. It doesn’t get confused, it doesn’t do batshit insane things because an AI told it to. It doesn’t choke on windows updates or even run windows at all. It will survive the heat death of the universe. And we fucking hate using it. But the priority is patient care and this does that better than any of the modern shit so it stays and we suffer. It is rigid, inflexible, literal. It is brutally straightforward and that is the only thing I can truly appreciate about it. There’s no guessing why it rejects a claim. It tells you exactly what it’s pissed about and we can help you or your provider feed it what it wants within reason.
Generally it’s a matter of something was presented to it in a weird way legal wouldn’t like so it rejects it now rather than surprises people with lawsuits later. We actually catch a lot of things months before Medicare does. (If you are on Medicare, look out for catheters you never ordered from Florida. It’s a thing and our system is catching damn near all of them. Fuck these scammers.)
So rather than spend money on keeping up with everyone else, they spend the money on patient care and just brace for impact for the day all the developers of that old system die off. It’s a big priority here that we spend as much as possible on patient care, which leads to some annoying situations where some things get outsourced that really shouldn’t be, but less money spent here means more money spent on medical care.
That old system is the fastest piece of tech we have in the entire operation. It gets all the pampering and attention. And while that TUI is a bear it’s never been wrong. It’s battle tested. It basically says yay or nay based on how it’s been programmed to evaluate a claim. EVERY rule it uses to evaluate claims is in the documentation given to providers while they are signing contracts to go in network with us as well as the messages it tells us to relay to callers. It has no secrets. It has no magic approve button. It doesn’t need one. We know there are a lot of rules, that’s why both patients and providers can call us.
It’s the only damn thing that reliably works around here honestly. All the new shit bolted onto it sucks ass. We are changing the front ends used to access it to modernize but it’s a really broken Microsoft product trying to tie into this old IBM mainframe and it’s just awful at it. As janky as the old stuff is, it works. The new stuff is easier to use but broken in so many different ways we take forever boxing with it only to go back to the mainframe and ask it directly what it wants.
Could have been worse. They could have gone with Oracle.
Anyway to your situation. There are firm rules to these contracts. They are cold and lifeless. There is no humanity in them because we just can’t afford sympathy. We would approve everything that comes in. That’s why we have this system. It keeps things locked on to the terms of the contracts. But the contracts make things predictable, something our company can plan for and prepare for. While some companies can and do want to fuck you over to give your surgery money to some fucking shareholder, not everyone works that way, not even within those companies.
Fun bit of trivia you might appreciate: you know how insurance companies insist on physical therapy before certain surgeries? There’s actually a couple VERY good reasons for that.
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Sometimes, people don’t need surgery at all after physical therapy. That means far fewer risks for our patients as therapy is much less risky.
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Patients who struggle through physical therapy, no matter how badly it goes, have dramatically better outcomes after surgery. They heal better. They recover faster. They have fewer complications. Yes it’s an asinine thing to ask and in some cases seems ridiculous but nobody wants to fix this because we’ve seen the data and these people do so MUCH better long term when they put in the effort beforehand.
That didn’t just help the patient either. The surgeons numbers look better, meaning they are less averse to performing the surgery in the first place. Some surgeons outright refuse surgery without PT happening first. They don’t care how much improvement you get out of physical therapy. It’s more about preparing your body to heal. That means we can send more people their way to get care. It costs less for us too because the outcomes are better so we spend less on the individual patients, so we can cover a greater number of total surgery patients. It slows the rate of healthcare costs increases.
Unless you have exceeded some cartoonishly high limit, we will NOT turn down physical therapy. It’s the cheapest, most effective, lowest risk way to dramatically improve health outcomes. Seriously, if you saw the numbers you would understand why we have conversations like ”we understand your knees feel like sandpaper but the physical therapy will help, please continue.” It DOES help, but sometimes the benefit shows up later.
So yes, we know you need the surgery. Yes we know the bureaucracy is annoying. But in some cases, like physical therapy, there is a very good reason we do not change it. If it isn’t actively killing you, people, just do the PT.
How does this relate to your case?
Well you tried a pharmaceutical approach. It works for the most part but it sounds like it’s not fixing a problem so much as trading it for a different set of problems. That’s not helping you. It’s not helping your insurance company either. The surgery is a one-time expense whereas medication has to keep being paid out until someone dies.
You ever watch Mike Holmes back in the pre-flatscreen TV days? He was a Canadian contractor who had a TV show where he fixed houses and he was strict about do it right or pay more to do it twice. That’s kind of what’s happening here. It costs less to get the surgery than to drug you up forever.
At the end of the day, remember this: health insurance companies are very good at math. They all agree on one thing. Dead people don’t pay premiums. The more people you keep alive and healthy, the more additional people you can serve the same way and the lower your risk. It’s in our best interest to keep you well because your death means missing revenue not just for you but for everyone else we have to care for. It’s literally in everyone’s best interest we take care of you. And since my company has no shareholders, I get to focus on doing just that. :)
Wow, this was super interesting to read, thanks for taking the time to respond.
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I didn’t build this fucking hellscape. I was born into it and I’m doing my best. Unless all the boomers and billionaires die off, we are trapped like this.
Living amongst these people is a baffling and frustrating experience.
Their systems are killing them, their cops are killing them, their guns are killing them, their politicians are on record saying they hate them, their religious leaders are clearly stealing from them while they abuse their children, they hate traffic but refuse to do anything about including keeping cars but using roundabouts, and the propaganda that they claim is corrupting their minds is so pathetic that even a toddler should be able to see past it like it’s made of crystal-clear glass.
The reason I hate the US is because they have zero excuses and still fuck things up in so many obvious ways while anyone with more than a few braincells screams at them to please just stop chugging rat poison and all they can say is “but it’s different here, we aren’t Europe” as if that’s any kind of excuse.
You are consuming far too much of the exact same mainstream media narrative that got us into this mess. All you’re really telling me is that you are from a country Putin is not interested in, or your own friends and neighbors would be going batshit crazy too.
And before you excuse yourself thinking you’d never personally do that, that you are just way too smart for propaganda to ever be swayed by it, given your own propensity for unambiguously consuming media narratives and attaching your personal emotions to whatever caricatures of reality you’ve been shown, like you’ve just demonstrated in your comment, you’d probably be first in line to fall for the right-wing foreign-funded propaganda we’ve been flooded with for decades now.
EDITED a comma
Ok.
O and I’m sure you’re country is a bastion of moral superiority. Considering how well your English is I suppose you’re from western Europe? I’m sure I can dig up a whole bunch of shit on your country of origin.
Canada, and I will readily admit to us also being quite fucked up and getting worse. I’m disappointed in our behaviour, but at least we don’t go around acting like we’re hot shit. It’s not the US’s problems that piss me off, it’s their dogshit attitude about how great they are while sucking at almost everything they can’t just throw money at and then use to make even more money.
I wish you would have said that you were from France or Sweden or something it would have been a lot harder for me to find crap about your country because France and Sweden are better countries than America.
But you’re from Canada…
Throw money at it that’s absolutely beautiful Canada has some of the most predatory car loans probably in the world…
I grew up in Detroit so I’ve been to Canada a lot. You having anything bad to say about America is the most clinical definition of the pot calling the kettle black I have ever seen.
Your comeback is about predatory car loans…? Buddy we got all kinds of garbage here, especially bad shit imported from the US, and that was the first thing you jumped to? We also have a housing crisis that our leadership largely ignores, why not go after that?
I’ve already said, multiple times, that we are not doing great up here. The difference is that I can readily admit it but every time I say anything negative about the US one of you nasty weasels shows up and all you can do is deflect, deflect, deflect because you know that you have nothing to say.
The US is a shithole. Deal with it.
every time I say anything negative about the US one of you nasty weasels shows up and all you can do is deflect, deflect, deflect because you know that you have nothing to say.
You’re not actually saying anything so much as whining, throwing out pejoratives, and dunking NOT on the guilty, but on anyone who actually cares enough to do anything from the safety of your own porous border, while we have unmarked govt cars rolling through our streets picking up undocumented and citizens alike, and Palantir hoovering up our data, surveilling all of us.
You’re intensely critical of everyone and everything EXCEPT those actually tearing everything down. You talk about the danger the US represents to your country, but you have ZERO words of censure for the individuals actually creating the danger you speak of.
Why is that? Why so full of fire and brimstone for those trying to change anything, and none for the actual perps?
You have an exceptionally selective grasp on reality, crafted by the mainstream media, without ever guessing that Americans are no more the exact same person than Canadians. You are as propagandized as anyone south of you, and don’t even see it. You are exactly what you claim to despise, wrapped in a maple leaf. Congratulations, I guess that makes you better?
I’ve been saying that what the world is seeing is not the good people but instead the tens of millions of awful people. That said, I spoke mainly to the people who want me to pity them and their country just because they think that they’re nice. I have spoken on the fact, in this thread, that I do not believe Canadians are above criticism but I would also argue against other Canadians trying to do the same escape-plan bullshit. This is the primary difference between us, I can accept that the effect my country has on itself and others is something that I am tied to and I don’t expect other people to put up with our collective nonsense just because myself and my friends are good people.
You have no self-awareness and refuse to hear anything that won’t make you a victim. It’s enbarrassing, and I hope you do not try to come to my country while thinking you’re some highly desireable paragon of morality. Congratulations on barely passing the minimum bar of decency, and I’m sorry that your country has warped your perspective so badly, but I don’t really want you here if that’s how you’re going to behave.
Canada
I’m genuinely sorry to hear that, not just because I actually know how far our right-wing shit has reached into your country, but because I am aware that we never had a better friend than Canada, and without Canada to the north and Mexico to the south the 20th century would not have been nearly as meteoric as it was: without Canada we would have FAR less to brag about. I hope you are aware of just how many of us are on your side, how many of us are the ones telling you to “keep it up” with the boycotts and yelling “Elbows up!” when we see or hear another way Canada has decided to resist, because we are not represented in the media.
Canada has never been anything but the best friend my country ever had, from helping us in disaster to joining us in war, and you deserve far better than the neighbor from hell to the south. And while that does not make what you wrote correct or even anything less than arrogant and entirely dependent on stereotype, it does make me genuinely sorry, because we’ll never have a better friend on the national stage, and it will be a cold day in hell before Canada forgives us. Deservedly so.
I think you guys need to understand that no one gives a shit about the good individuals you have if the outward effects of your country are so violent and disruptive. Like, I’m sorry for the good people who live in the States but the instution of the US and the 100+ million people who either zealously support it or don’t think it’s that big a deal are big fucking problems. And far-right groups export that ideology all over the world, especially to my culturally similar country, and I am in no way obligated to pity you while your country threatens the safety of my own and others.
I do not care how many of you are “on our side” because you are effectively useless. Strongly worded letters and some sanctioned protests do nothing for us when you’re largely too cowardly to stand up for yourselves in even the smallest of ways. The US is a shithole country, and I’m sorry you live there, but I’m not gunna change my tune just because reality makes you sad.
I also have very strong words for my own country along similar lines. At least I know how to admit it.
When you cannot see individuals because of the group they are in, and you have grouped them that way in order to “other” them, to place on them the burden of your own anger and ill-will, congratulations! You are propagandized.
I saw it in your first comment, but now you’re tripling down like the best of the Fox News crowd, so okay.
that no one gives a shit about the good individuals…
Then who do you think is going to fix it, if not for us who care?
I do not care how many of you are “on our side” because you are effectively useless.
Then why are you battering the “useless” with your words, where they will either do no good at all or tire out what little goodwill we have left?
Where are your words when it comes to those creating and doing this great evil? Because I see ZERO in your screeds.
Strongly worded letters
I never said or even implied that the controlled opposition in Congress was or is “good”: they are as complicit as the openly destructive.
and some sanctioned protests
If protests are sanctioned, why are protesters being surveilled and jailed?
the 100+ million people who either zealously support it or don’t think it’s that big a deal
Here you are again, consuming media that serves your own partitioned worldview just as much as anyone on the right: this is what the media wants you to believe, that you should hate average people like yourself, believe no one can change anything, that all effort is wasted, and that the best possible outcome is that you personally get to shit out your own dissatisfaction with your own life via strong words that might as well have been scripted for you by Fox News were it not for the anti-authoritarian slant. You probably think that orange fungus got elected and we still have fair and aboveboard elections, lol.
And I note that you personally can’t do shit in Ottowa, or you’d be there doing it instead of dunking on the only people who can actually change anything for the better in the US: those of us who DO give a shit.
You’ve given up. And worse, you have an exceptionally selective idea of reality. You really need to pull your head out of your self-pity, because you are not helping, you are only dragging the people who actually care down, without having a single idea of how close you personally are to having your own government yanked out from under you in similar fashion. While you think it’s a matter of mockery to watch a country turn to full Nazism, you’re not exactly doing so from a safe distance: how long do you think you last if we lose?
And where, oh where, is your contempt for the actual doers of all this evil? You have plenty of shit to fling at anyone trying to effect change, but ZERO for the leaders of this filth. Where is that? And a better question is, doesn’t your lack of censure for people actually doing what you claim to hate just make you another lazy hypocrite of the kind you despise down here, another lounge chair warrior “too cowardly to stand up for yourself in the smallest of ways” when you personally have nothing like ICE cruising through your neighborhoods, picking people up on sight?
I may love your country, but your own position and actions are contemptible. When you can do something other than your personal best to discourage anyone else from even trying to change anything, even as you suck on the media’s warm tiddy of manufactured narratives and caricatured Americans, let me know. Until then, keep “doing your own research” and “telling it like it is” and “just asking questions” because what you claim to hate, you have already become.
K.
Hey, some of us Americans just elected democratic socialists as our mayors.
I’m confused as to who you think made this post. You figure it’s a French dude?
Stupidity is highly infectious
Christ on a stick. Universal healthcare has nothing to do with socialism. Government programs that serve the public are part of the government’s core purpose in the first place.
It is remarkable how many people on this platform champion “socialism” when what they actually mean is social democracy. The difference is substantial.
Socialism does not work. It has never worked. No nation has prospered under socialism, and none will as long as scarcity remains.
Why should only healthcare work if run by government? Government could run all industries.
I can’t tell if you’re being sarcastic or not… If you’re not that’s the most brain dead thing I’ve ever heard in a long time.
Why can’t the government serve the public and provide all needed goods and not just healthcare? Where is the limit that prevents socialism?
Socialism doesn’t preclude the end of Private Business.
If the government controlled all private businesses where would they get money to operate? How woukd they collect taxes? How do you encourage innovation? philanthropy?
Like in health care, the businesses continue to make money. The government can continue to tax its businesses or use all profits.
Innovation is usually the argument against government healthcare. If that is not a problem for you, why should there be one in other areas? However, most research is publicly funded anyway.
Philanthropy would also have to shift to the state. The state funds theaters and museums. It could take care of more causes.
Where do you see problems?
The system you describe only works when it is exporting goods and services.
It appears you’re arguing from a fundamental misunderstanding of the system you’re defending. You’re describing expanded government programs inside a market economy. That is not socialism. That is social democracy.
Under actual socialism, the state owns the means of production. There is no private sector to tax. There is no flow of revenue from independent businesses because those businesses no longer exist as independent entities. Your points about taxation, profit collection, and philanthropy only make sense inside a mixed economy, precisely the system you claim to be replacing.
In other words, you’re defending a model that isn’t the one under discussion. You’re arguing for more public services, not socialism. These are completely different frameworks, and conflating them is why your reasoning keeps circling without connecting.
So this sucks but you can avoid this with a simple trick. Call your insurance company first with the CPT codes for what you need done and where you plan to get it done. Your doctors office can give you the codes. They aren’t a trade secret or anything. Get diagnoses codes too if you can. Have the insurance company run the codes for you before you go. This does a couple things:
- You verify everyone involved is in network (be wary of anesthesiologists)
- You are getting a quote on a recorded line. The end price won’t be exact (especially is if the claim involves a hospital, fuck them, go to smaller providers whenever you can)
- if you get sticker shock anyway, you can call the insurance company back on that same recorded line and say the word “misquote”. This triggers an investigation that can strengthen your appeal.
- You now have evidence you can file internally with a quality of care/quality of service complaint if the provider did something shady with the billing, or with your state’s department of insurance if your insurance company is being bitchy.
Ideally, we would have single payer insurance, but we instead have a government that pays itself to make private enterprise do its job, then the shareholders in that private enterprise make sure nothing ever gets changed. -sigh-
In the mean time, if you really want to fuck them over, consider switching to health insurance company that does not have shareholders. In many states, they are legally mandated to refund any profit they make over a certain percentage at the end of the year and without shareholders, it’s harder to hide the money, which puts much more pressure on them to spend it on patient care.
United Health Care want you to believe their way is the only way to do this. They are wrong. A shareholder-free insurer still isn’t perfect but the pressures are different without the parasites.
is this seriously what you americans have to do?
Most of us bend over and die.
jfk. I had to take someone to the hospital yesterday for an acute problem (which turned out ok). When leaving, after 7 hours at the hospital, I started to reach for my wallet and the lady looked at me and said wtf are you doing put it away. And the two presriptions- free instead of the usual $5 each. I laugh when those repubs call my country a “social hellscape”
Yes. Everything is a fight against the rich.
Freedom isn’t free
Any tips on finding an insurance company in your state that doesn’t have shareholders? A big part of the insurance issue is that you have to practically be an industry insider to navigate… Anything in insurance, really.
The fact you have to jump through these hoops at all IS FUCKING STUPID AND ISNT HOW IT SHOULD WORK.
Agreed. But the fact is there is a lot of money in paying for medical expenses that keep going higher and not a lot of money going to the pot that pays it out. Single payer would address all of that instantly but the rich would be unhappy so we basically have to pay a survival tax to insurance companies every month.
I hate it here.
It’s like they’ve made the system so convoluted that you have to be an underwriter to receive services.
There are those of us in n this industry that want that changed but we don’t have as much power as the bigger companies do so the best we can do is play by their rules. :(
A shareholder-free insurer still isn’t perfect but the pressures are different without the parasites.
This is the first time I see this solution mentioned. It doesn’t seem to be known much. Why would a single payer insurance lower costs further?
Single payer moves the bargaining power out of the hands of the service provider party using the government’s power to set prices. It doesn’t give all of the power to the user side, since if the government tries to set a too low price, the providers can just choose to not offer that service, so it is still a negotiation, it’s just no longer based on “how badly do you want to live/get better?”
Single payer means more people are in the group, diluting risk further. There’s no way to compete with that. The costs are impossible to beat.
There must be a limit to the necessary size. Small countries can offer affordable health care. So an insurer of that size should be able to handle the risk as efficiently.
Well in a small country there’s not an incentive to raise prices endlessly for medical care. In America there is. So now you have the providers which always want more (don’t misunderstand this, it’s not always the doctor you are seeing that’s commanding a higher price. In fact, it rarely is. It’s the others down the line that want their cut for his work.) and insurers that need to pay for things but can’t just constantly demand more money themselves.
Enter the business majors.
They have decided the insurance companies just need to play chicken with the providers and deny paying for things they deem unreasonable. It does stop some scams, but it also backfires sometimes. So for things like insulin, we don’t have direct control over the price. So we will say “fuck them, if we start paying for insulin X, everyone’s prices go up, not just yours, and we won’t be able to covers everything. Get something more reasonably priced.” It doesn’t matter that insulin X would be perfect for you. Lots of other people need it too, and if we cover it, that money has to come from somewhere and people are financially strapped as is.
Drug companies don’t want to do us any favors. They price insulin like it’s a new fucking iPhone. Luxury insulin. It’s not a new thing. It’s been around forever. It’s settled. But they have the patent and the money to bribe congress critters to prevent regulating prices so here we are.
In other cases, like HIV medication, those drugs are incredibly expensive because they are ridiculously expensive to develop for. The drug company does have to recoup their costs. However they do offer patient assistance programs for a lot of those drugs where THEY will cover your copays. Plus in many countries they aren’t allowed to sell the drug there unless they agree on a reasonable price. And in India, their government said “fuck you” and just outright copied an HIV drug.
Then we get things like GLP-1 inhibitors. Those can be a blessing for diabetics that need them. But as many people as there are that legitimately need it, there are even more that can be sold to for insecurities in appearance and given it as a way to slim down. So guess who the drug companies market to? Demand surges and the price is high because they intentionally created a scarcity like they are selling the next PlayStation. And many insurance companies won’t cover it anymore. And the reason is surprising. Everybody wants this damn thing until they actually get it. Very few actually want to stay on it. They usually vomit constantly on it and they stop taking it. So that’s all that money getting spent on what’s basically TikTok marketing instead of patient care. And then for those that do stay on it, they have to stay on it forever. The longer they take it, the worse they are when they stop. All the weight lost comes back PLUS more. So they end up worse than they started and we paid for that instead of someone’s MRI.
It’s the scarcity that drives up the prices. More money coming in from single payer systems kills the scarcity, and the prices are forced to come down because they have to compete with eachother. But rich people are just business majors with hoarding issues. They always need more. They will never be happy. And they will make us all suffer over their endless persist to bleed the country dry.
We do what we can. This really is the responsibility of a larger entity with more resources than we have, like a fucking government, but they figured out all they have to do keep resources scare to keep us fighting amongst eachother. Add shareholders and you get cartoon villain evil shit like United Health Care. All the while tax dollars go in and do nothing but blame us for trying to make this losing game work.
Imagine your heath insurance just being part of your taxes. You pay them that way. Now imagine that that health insurance tax is less than a third of what you are paying for health insurance now to get better coverage. Thats the absurdity of it. We have a government that doesn’t want to do its job, so business majors swoop in and screw us all.
I hate it here.
It kinda scales. What’s the likelihood of 10 million people at once being sick in a country of 10 million? And what’s the likelihood in a country of 300 million?
The number of sick people also scales. The likelihood for 100 thousand sick out of 10 million is the same as 3 million sick out of 300 million.
What changes is the variation. If you have 10 people, it’s possible that all are sick at the same time. All being sick is much less likely for 10 million and even less for 300 million.
An insurance company must have a certain size to handle variation but after that point a bigger size is not needed for that but can help with other properties.
Just imagine living in a first world country where they provide free Netflix instead of maintaining an insanely large military.
As an American, I’d rather die a preventable death then share free healthcare with someone I don’t think deserves it! /s
How dare someone who is dying of cancer and is too sick to work anymore get free Netflix! They can work for it like everyone else! I’m not subsidizing their Netflix /s
I’ve heard people honestly defending paying more for healthcare rather than having “freeloaders”.
Do you ever ask them why they’re paying more to hurt people? I’d think they’d be on it just for the “you’re gonna pay less money” line, but racists gonna racist…
(It may just be my experience, but these types tend to be racist and that’s one of the driving factors, not paying for minorities)
i’m white as fuck and if they could only choose one minority to not be on their health plan, it’d be the disabled. has been said to my face, by someone who had been a friend before they moved to an extremely conservative locale, shortly after i had some semi-vital organs removed.
It’s not even racism. It’s just plain evil. There might be a bit of it, it was just not wanting anybody benefiting.
At first they rationalized it by saying is cheaper, but when they shared the costs it was brutal. They then said it was better and started ranting about how it’s actually not good either. It was a bit weird and he was kind of my boss so I didn’t want to push it.
This point is overdone, but Americans spend more than other developed countries on healthcare, so it’s not even an austerity thing.
I mean, it still counts as austerity when the money is coming out of your own pocket
I’m gonna need you to cite them sources boss, or I’m gonna assume you’re another liar spewing bullshit.
Appreciate you for the links!
Whoever down voted me, go back to your echo chamber where you can stay an ignorant dipshit that takes everything you see on the internet as factual.
Im just asking for citations to encourage spreading good information instead of AI generated hallucination trash and right-wing/cult/heresay nonsense.
If you don’t wanna be downvoted, maybe don’t be so aggressive when you ask for citations.
I’m gonna assume you’re another liar spewing bullshit.
is a bit antagonistic for “just asking”. A little civility will take you a long way.
You’re being downvoted due to being aggressive for no reason.
Whoever down voted me, go back to your echo chamber where you can stay an ignorant dipshit that takes everything you see on the internet as factual.
this isn’t reddit. you can ask for sources politely or you can get downvotes. we like to encourage civility.
"I’m going to aggressively call anyone talking about a widely known issue with American Healthcare a bullshit spewing liar!
Waaaah why am I being downvoted waaaah I fucking hate you socialists and your facts, you’re all ignorant dipshits even though you just proved I’m the ignorant one!"
As an American leftist, the above is the majority of my countrymen and it is fucking embarrassing and exhausting to live alongside them. It is incredibly frustrating how well our government has convinced the average person in this country to vehemently fight against their own wellbeing. The number of people I’ve come across who claim to be left politically but then call socialism the extreme right is just mind-boggling. It’s like they think other countries are just actual make believe and that the US is the only functional country on the planet
But then we wouldn’t be able to murder a bunch of random Venezualans or lose wars that we started against overwhelmingly inferior opponents.
Just imagine living in a first world country
Don’t be smug about it. American insurance companies will eventually also come to your country.
Maybe, maybe not. Our right wing idiots at least seem to value their own health and wellness enough to not approve of dismantling healthcare.
It’s not either/or. I think even if we joined all the other modern countries in providing universal healthcare for all our citizens, we’d still be spending more on our bloated, unaudited military than the next countries combined, but feel free to fact check that.
excuse me it is audited regularly, just they fail every time.
edit: for anyone wondering, that’s worse.
Imagine paying for Netflix.
In Taiwan, I pay for Universal Healthcare because I own a business. 5800nt(185usd) every 2 months for a familyof 4. It would be 3000nt(100usd)for 2 months if it’s just myself.
The copay is 10usd for everything. Fever? Food poisoning? Chemotherapy? All the same cost. This includes all the medications and all incidental costs.
If you worked for a Taiwan company, you don’t have to pay the 5800nt. But the copay is the same.
in Spain , if only one out of x people in their family works, all the rest of the family members are insured for universal healthcare, as long as they are legal residents or citizens of course.
In Canada, you pay nothing for anything that isn’t elective as long as you’re a resident. You just need to register for a healthcare number which can be done at admittance.
I am Canadian too. If I remember correctly, you had to get your family doctor to refer you to a specialist for anything major. During this time, your condition can get worse.
I haven’t heard much better about Americans waiting until they die for their insurance company to deny care, or wait for months to find a spot in network, and pay hundreds to thousands of dollars a month for the privilege. I think we do pretty good up here, as life expectancy and outcome comparisons would show.
American have it the worse. No competition. At this point I wouldn’t move back to the US anymore. I might move back to Ontario somewhere.
Taiwan sounds amazing!
My entire mindset of Healthcare had to change when I moved here. Previously in America, when I got a fever or a rash or a major allergy, I would see if its worth it to go to a clinic and sit for a few hours with other sick people and pay 75USD for them to tell me to go to a drug store and eat some Tylenol.
Now, I go into the clinic downstairs even if I have a cold. 10USD and they gave me a week’s worth of meds. It’s normal to go back to the doctor 2 days after if your condition worsens or if you just had a question.
I have yearly check ups and my doctor told me I needed to do a colonoscopy. If I opted for staying awake during it, its 10USD. But I elected to be put to sleep. It was 310usd.
Come visit us on your next vacation! The people here are very polite and pretty happy.
I guess I need to look into tiwanese citizenship
Sadly enough for you, the whole nation just died by syntax error.
I don’t follow.
They could be referencing your username
