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Check out the book Overcharged if you want a fairly quick read that explains the healthcare scam from top to bottom https://www.amazon.com/Overcharged-Americans

Check out the book Overcharged if you want a fairly quick read that explains the healthcare scam from top to bottom https://www.amazon.com/Overcharged-Americans-Much-Health-Care/dp/1944424768 https://www.amazon.com/Overcharged-Americans-Much-Health-Car... Easiest way to get rich in America is to start a health clinic and start billing Medicare. Absolute trash from top to bottom.

jessaustin 6y ago
Perhaps it's easier to bill Medicare than private insurance, because at some point Medicare will actually pay for the work that physicians have already done? Most doctors would be happy to return to the old patient-pays-on-the-day-of-treatment model, and health care costs would be much lower, but in that case some provision would have to be made for poor people.
- simion314 6y ago
  A good solution for US problems is easy to fine, you create a competent team, you analyze 5 different countries with good health care systems(for ex you could have 10 scenarios and you analyze what happens and how much it costs). You make some decision and maybe reduce the possible implementation from 5 to 3 or 3, you then do some calculations on how much money is saved and how much people will have to pay. You create some educational/informational materials and then vote on it or do a referendum. But you need politicians to take this serious, have them nominate specialists int he team that will do the analysis and accept the conclusions and promise not to change their mind in 4 years. From what I read the current system is a lose=lose for both poor and rich and only a small number of people benefit.
  - jessaustin 6y ago
    We've been hoping for politicians to easily find this good solution for at least 30 years now. At this point we can safely say that's not going to happen. The system we have does not "fix" itself. The fact that we can clearly see who is stealing most of our money makes the problem harder to solve, not easier. The moment a credible threat of improvement arises (e.g. Hillary in 1993 or Obama in 2009) the insurance industry pulls out all the stops, blasting Capitol Hill with the combined volume of a thousand wailing lobbyists. Even if we could somehow overpower the insurers, we shouldn't underestimate the usefulness of a completely insecure workforce and consumer base to other sectors of the capitalist cabal. USA at its current size can't solve any of its real problems. There are too many brake levers installed within easy reach of too many cronyist assholes. Just look at this COVID-19 shitshow. After California leaves and takes a few other western states with them, New Mexico and half of Texas join "old" Mexico, much of New England tries to join Canada and then just go their own way when Canada won't take them, Florida is inundated, etc... perhaps the rest of us might have a chance to better arrange the crumbs with which we're left. We'll certainly be less of a danger to the Middle East...
spaetzleesser 6y ago
It’s hard to understand how the basically fraudulent billing practices in US healthcare are viewed as acceptable and nothing gets done to correct things. I know many people who have stories of people being overbilled by not a little but by a multiple of the normal price. Or the hospital bills for things that never happened. That while the patient never got an estimate upfront. There is basically no way to do it “right”. And even when you discover a problem you are expected to spend countless hours on the phone negotiating between provider and insurance. I can’t imagine any other industry getting away with such a persistent track record of bad behavior.
- ukd1 6y ago
  This is why I love Kaiser (kp.org) as they are the insurer and the provider. They haven't over-billed themselves with care for me or friends.
  - mnm1 6y ago
    Until they deny you your necessary cancer screening for a few months and your cancer comes back with a vengeance requiring an operation and some major chemo just to give you a chance at staying alive, this system is great. Then again, if you never get sick, any system is fine and they all work the same.
  - Osiris 6y ago
    I had a great experience with Kaiser (had to drop them when rates spiked after the last election). They made it easy to get answers without going in to the doctor. The primary care physician would just call/email specialist for you rather than sending you to another appointment (until it was necessary). It was obvious they wanted to keep their costs low but that also made a lot of things much more convenient for patients also.
  - athms 6y ago
    Except they don't provide adequate mental health care even with the parity law. It takes about a month for your consultation and they funnel everybody into group therapy and/or drugs. Only those with severe mental disorders are given access to a shrink and only every 3-4 months. If you want weekly or biweekly visits to a psychoanalyst, you will be paying out of pocket. Also, as much as Kaiser likes to call themselves a non-profit, the doctor group is for-profit. Kaiser is actually composed of three separate legal entities: insurer, hospitals, and doctors. Any profit left over at the end of the fiscal year is split evenly by the hospital and doctor groups, with the doctors engaging in profit sharing. There is an incentive to provide less care to those paying out of pocket for the insurance because the doctors will reap a bigger bonus. This is not the case for Medicare and Medicaid recipients because reimbursement is based off both treatment and outcome metrics.

jessaustin 6y ago

Perhaps it's easier to bill Medicare than private insurance, because at some point Medicare will actually pay for the work that physicians have already done? Most doctors would be happy to return to the old patient-pays-on-the-day-of-treatment model, and health care costs would be much lower, but in that case some provision would have to be made for poor people.

simion314 6y ago
A good solution for US problems is easy to fine, you create a competent team, you analyze 5 different countries with good health care systems(for ex you could have 10 scenarios and you analyze what happens and how much it costs). You make some decision and maybe reduce the possible implementation from 5 to 3 or 3, you then do some calculations on how much money is saved and how much people will have to pay. You create some educational/informational materials and then vote on it or do a referendum. But you need politicians to take this serious, have them nominate specialists int he team that will do the analysis and accept the conclusions and promise not to change their mind in 4 years. From what I read the current system is a lose=lose for both poor and rich and only a small number of people benefit.
- jessaustin 6y ago
  We've been hoping for politicians to easily find this good solution for at least 30 years now. At this point we can safely say that's not going to happen. The system we have does not "fix" itself. The fact that we can clearly see who is stealing most of our money makes the problem harder to solve, not easier. The moment a credible threat of improvement arises (e.g. Hillary in 1993 or Obama in 2009) the insurance industry pulls out all the stops, blasting Capitol Hill with the combined volume of a thousand wailing lobbyists. Even if we could somehow overpower the insurers, we shouldn't underestimate the usefulness of a completely insecure workforce and consumer base to other sectors of the capitalist cabal. USA at its current size can't solve any of its real problems. There are too many brake levers installed within easy reach of too many cronyist assholes. Just look at this COVID-19 shitshow. After California leaves and takes a few other western states with them, New Mexico and half of Texas join "old" Mexico, much of New England tries to join Canada and then just go their own way when Canada won't take them, Florida is inundated, etc... perhaps the rest of us might have a chance to better arrange the crumbs with which we're left. We'll certainly be less of a danger to the Middle East...

spaetzleesser 6y ago

It’s hard to understand how the basically fraudulent billing practices in US healthcare are viewed as acceptable and nothing gets done to correct things. I know many people who have stories of people being overbilled by not a little but by a multiple of the normal price. Or the hospital bills for things that never happened. That while the patient never got an estimate upfront. There is basically no way to do it “right”. And even when you discover a problem you are expected to spend countless hours on the phone negotiating between provider and insurance. I can’t imagine any other industry getting away with such a persistent track record of bad behavior.

ukd1 6y ago
This is why I love Kaiser (kp.org) as they are the insurer and the provider. They haven't over-billed themselves with care for me or friends.
- mnm1 6y ago
  Until they deny you your necessary cancer screening for a few months and your cancer comes back with a vengeance requiring an operation and some major chemo just to give you a chance at staying alive, this system is great. Then again, if you never get sick, any system is fine and they all work the same.
- Osiris 6y ago
  I had a great experience with Kaiser (had to drop them when rates spiked after the last election). They made it easy to get answers without going in to the doctor. The primary care physician would just call/email specialist for you rather than sending you to another appointment (until it was necessary). It was obvious they wanted to keep their costs low but that also made a lot of things much more convenient for patients also.
- athms 6y ago
  Except they don't provide adequate mental health care even with the parity law. It takes about a month for your consultation and they funnel everybody into group therapy and/or drugs. Only those with severe mental disorders are given access to a shrink and only every 3-4 months. If you want weekly or biweekly visits to a psychoanalyst, you will be paying out of pocket. Also, as much as Kaiser likes to call themselves a non-profit, the doctor group is for-profit. Kaiser is actually composed of three separate legal entities: insurer, hospitals, and doctors. Any profit left over at the end of the fiscal year is split evenly by the hospital and doctor groups, with the doctors engaging in profit sharing. There is an incentive to provide less care to those paying out of pocket for the insurance because the doctors will reap a bigger bonus. This is not the case for Medicare and Medicaid recipients because reimbursement is based off both treatment and outcome metrics.