6 ms·

All claims being reviewed by big health insurance conglomerates is the antithesis of privatized healthcare. It incorporates the worst part of public healthcare

All claims being reviewed by big health insurance conglomerates is the antithesis of privatized healthcare. It incorporates the worst part of public healthcare and destroys the best potential benefit of privatized healthcare.

emodendroket 4y ago
How is that so? The health insurance conglomerates are in private hands.
- dboreham 4y ago
  Parent probably means that those companies are part of a government sponsored cleptocracy.
  - emodendroket 4y ago
    I would say that there can't be any market without the government creating it (what does a contract or deed mean if there's no authority that recognizes it?), so there's a bit of "no true Scotsman" in trying to call it anything else besides a private market.
specialist 4y ago
What are some real world examples of beneficial privatized healthcare?
- pantulis 4y ago
  IMHO in privatized healthcare you are not the patient, you are the customer. As such, you should be having a better "customer journey" than in public healthcare: more immediate test/diagnostics, better experience in the hospital (like a room for yourself). And that's it. As a counterpart, it's not clear you are receiving the best medical attention. And of course you (through your employer) are paying for something that can be denied. Note: I happen to have private healthcare with Cigna in a country with a reasonably good public health system (Spain, though it varies between different autonomous communities), happy to pay the taxes and will defend that public health systems are a staple of any modern country.
  - LocalH 4y ago
    "Being the customer" doesn't matter one bit to most modern megacorps, because people are fungible to them. We constantly hear about big money screwing over little money. Small-time capitalism is quite good. Make a few millions, sure. I have no problem with that. But when the amounts concerned are in the billions? There needs to be massive oversight and regulation, regardless of the relevant field.
    - pantulis 4y ago
      > There needs to be massive oversight and regulation, regardless of the relevant field. Totally agree with that.
  - specialist 4y ago
    Would that be Cigna Global Health Benefits? https://en.wikipedia.org/wiki/Cigna#Cigna_Global_Health_Benefits https://en.wikipedia.org/wiki/Cigna#Cigna_Global_Health_Bene... From their wiki entry: "CGHB maintains its own, in-house international claims platform..." Which may explain your positive experience, compared to their USA customers. Further, wild speculation here, I'm guessing Spain does more to protect customers, not allowing CGHB to auto-deny claims en masse.
- firstlink 4y ago
  Concierge doctors. To be clear, we are talking about benefit to the patient; there's lots of reasons concierge doctors may not be the best benefit for society at large. But that's immaterial because this is just one example; if we hadn't gone for the worst possible way to scale private medicine, then there could be better examples. But the point is that you can't seriously look at concierge doctors and say that public healthcare would be better for those patients! And therefore this refutes any claim that public healthcare is the best system overall.
  - specialist 4y ago
    This is a great example. Alas, I'm pretty sure I disagree. I am an early adopter of concierge care. It's been tremendous. I had a bone marrow transplant +30 years ago. Continuity of care has been an ongoing challenge. From my reading and my own experience, having a patient advocate greatly improves outcomes. Someone who just keeps everything on track. Could be family member, friend, or a nurse / case worker. For me, it's now my concierge doctor. (Over the years, I've served as advocate for other patients many times.) My current issue with concierge (patient advocates) is that it's rare. Everyone should have this. In times past, it was a family's doctor. But as everyone knows, that relationship is no longer stable, due to how healthcare in the USA has been commodified and "optimized". Further, according to the research (like what Atul Gawanda has written about), specialty "wrap-around" practices greatly improve outcomes. Like for diabetes, cystic fibrosis, and other chronic life threatening conditions. Most all of a patient's care is done by these multidisciplinary primary clinics. One stop shopping. Instead of bouncing patients around, delegating the coordination and whatnot onto the patients themselves. Again, thank you for this example. It's an interesting edge case. Today, I think most concierge arrangements are private. Whereas it should be the default, public or private. FWIW, maybe about 10 years ago, Medicare and the VA had started to adopt the capitation model (preventative care vs fee-for-service). Now I'm curious what they (or any other large orgs) are doing wrt concierge (patient advocates).
harvey9 4y ago
The best potential benefit of privatised healthcare comes to those wealthy enough to just pay cash for what they need.
cmurf 4y ago
This is not properly referred to as health insurance. It is a sickness, aging, and death payment plan. There's no such thing as major medical anymore. It was private healthcare that backed public law forcing minimum coverage. Why? Because their pool was shrinking. They were getting sick people who needed care, but with premiums skyrocketing, what benefit is there for healthy people to buy in? But I agree that the private for profit health care system is an abomination only made much worse by making it public law requiring we buy into it. Instead of Medicare for all.
gentoo 4y ago
it's funny how whenever a big company does something bad that's actually an example of how socialism is bad
- kevviiinn 4y ago
  Mental gymnastics to avoid acknowledging that they've been brainwashed by capitalism
- johngladtj 4y ago
  A key component of the free market is the ability to say "no thanks" to an offer to do business. Can you explain to me how the government telling you "you must do business with one of these insurers or else" is in any way a free market?
  - AlexandrB 4y ago
    > A key component of the free market is the ability to say "no thanks" to an offer to do business. So a free market in health care is not possible because you can't consider your options and say "no thanks" when you need emergency treatment. Whatever the government does or does not do, you can't really get around the fact that at a moment of crisis health care providers have you in a coercive situation and could charge life changing amounts for care if they were permitted to.
glenstein 4y ago
What part of public healthcare is incorporated into health insurance conglomerates? And what potential benefits of privatized healthcare are we missing out on?
- thallium205 4y ago
  Who do you think run all state level Medicaid programs? Government employee health plans? Private conglomerates. That’s one of many many examples.
  - glenstein 4y ago
    The person I was responding to was suggesting it was a connection to public programs that made private health programs so stingy in denying claims, and I don't see how your answer gets me any closer to understanding what that means. I'm also not sure what you mean when there's plenty of other examples. Examples of what? I'm still trying to figure out what the "what" is. Private health insurance companies in America ruthlessly deny claims, this is supposedly because of something about public administration of healthcare, and I'm still waiting for an explanation of how that works.
    - firstlink 4y ago
      > The person I was responding to was suggesting it was a connection to public programs that made private health programs so stingy in denying claims I suggested no such thing. Please don't ascribe your own ridiculous ideas to other people.

emodendroket 4y ago

How is that so? The health insurance conglomerates are in private hands.

dboreham 4y ago
Parent probably means that those companies are part of a government sponsored cleptocracy.
- emodendroket 4y ago
  I would say that there can't be any market without the government creating it (what does a contract or deed mean if there's no authority that recognizes it?), so there's a bit of "no true Scotsman" in trying to call it anything else besides a private market.

specialist 4y ago

What are some real world examples of beneficial privatized healthcare?

pantulis 4y ago
IMHO in privatized healthcare you are not the patient, you are the customer. As such, you should be having a better "customer journey" than in public healthcare: more immediate test/diagnostics, better experience in the hospital (like a room for yourself). And that's it. As a counterpart, it's not clear you are receiving the best medical attention. And of course you (through your employer) are paying for something that can be denied. Note: I happen to have private healthcare with Cigna in a country with a reasonably good public health system (Spain, though it varies between different autonomous communities), happy to pay the taxes and will defend that public health systems are a staple of any modern country.
- LocalH 4y ago
  "Being the customer" doesn't matter one bit to most modern megacorps, because people are fungible to them. We constantly hear about big money screwing over little money. Small-time capitalism is quite good. Make a few millions, sure. I have no problem with that. But when the amounts concerned are in the billions? There needs to be massive oversight and regulation, regardless of the relevant field.
  - pantulis 4y ago
    > There needs to be massive oversight and regulation, regardless of the relevant field. Totally agree with that.
- specialist 4y ago
  Would that be Cigna Global Health Benefits? https://en.wikipedia.org/wiki/Cigna#Cigna_Global_Health_Benefits https://en.wikipedia.org/wiki/Cigna#Cigna_Global_Health_Bene... From their wiki entry: "CGHB maintains its own, in-house international claims platform..." Which may explain your positive experience, compared to their USA customers. Further, wild speculation here, I'm guessing Spain does more to protect customers, not allowing CGHB to auto-deny claims en masse.
firstlink 4y ago
Concierge doctors. To be clear, we are talking about benefit to the patient; there's lots of reasons concierge doctors may not be the best benefit for society at large. But that's immaterial because this is just one example; if we hadn't gone for the worst possible way to scale private medicine, then there could be better examples. But the point is that you can't seriously look at concierge doctors and say that public healthcare would be better for those patients! And therefore this refutes any claim that public healthcare is the best system overall.
- specialist 4y ago
  This is a great example. Alas, I'm pretty sure I disagree. I am an early adopter of concierge care. It's been tremendous. I had a bone marrow transplant +30 years ago. Continuity of care has been an ongoing challenge. From my reading and my own experience, having a patient advocate greatly improves outcomes. Someone who just keeps everything on track. Could be family member, friend, or a nurse / case worker. For me, it's now my concierge doctor. (Over the years, I've served as advocate for other patients many times.) My current issue with concierge (patient advocates) is that it's rare. Everyone should have this. In times past, it was a family's doctor. But as everyone knows, that relationship is no longer stable, due to how healthcare in the USA has been commodified and "optimized". Further, according to the research (like what Atul Gawanda has written about), specialty "wrap-around" practices greatly improve outcomes. Like for diabetes, cystic fibrosis, and other chronic life threatening conditions. Most all of a patient's care is done by these multidisciplinary primary clinics. One stop shopping. Instead of bouncing patients around, delegating the coordination and whatnot onto the patients themselves. Again, thank you for this example. It's an interesting edge case. Today, I think most concierge arrangements are private. Whereas it should be the default, public or private. FWIW, maybe about 10 years ago, Medicare and the VA had started to adopt the capitation model (preventative care vs fee-for-service). Now I'm curious what they (or any other large orgs) are doing wrt concierge (patient advocates).

harvey9 4y ago

The best potential benefit of privatised healthcare comes to those wealthy enough to just pay cash for what they need.

cmurf 4y ago

This is not properly referred to as health insurance. It is a sickness, aging, and death payment plan. There's no such thing as major medical anymore. It was private healthcare that backed public law forcing minimum coverage. Why? Because their pool was shrinking. They were getting sick people who needed care, but with premiums skyrocketing, what benefit is there for healthy people to buy in? But I agree that the private for profit health care system is an abomination only made much worse by making it public law requiring we buy into it. Instead of Medicare for all.

gentoo 4y ago

it's funny how whenever a big company does something bad that's actually an example of how socialism is bad

kevviiinn 4y ago
Mental gymnastics to avoid acknowledging that they've been brainwashed by capitalism
johngladtj 4y ago
A key component of the free market is the ability to say "no thanks" to an offer to do business. Can you explain to me how the government telling you "you must do business with one of these insurers or else" is in any way a free market?
- AlexandrB 4y ago
  > A key component of the free market is the ability to say "no thanks" to an offer to do business. So a free market in health care is not possible because you can't consider your options and say "no thanks" when you need emergency treatment. Whatever the government does or does not do, you can't really get around the fact that at a moment of crisis health care providers have you in a coercive situation and could charge life changing amounts for care if they were permitted to.

glenstein 4y ago

What part of public healthcare is incorporated into health insurance conglomerates? And what potential benefits of privatized healthcare are we missing out on?

thallium205 4y ago
Who do you think run all state level Medicaid programs? Government employee health plans? Private conglomerates. That’s one of many many examples.
- glenstein 4y ago
  The person I was responding to was suggesting it was a connection to public programs that made private health programs so stingy in denying claims, and I don't see how your answer gets me any closer to understanding what that means. I'm also not sure what you mean when there's plenty of other examples. Examples of what? I'm still trying to figure out what the "what" is. Private health insurance companies in America ruthlessly deny claims, this is supposedly because of something about public administration of healthcare, and I'm still waiting for an explanation of how that works.
  - firstlink 4y ago
    > The person I was responding to was suggesting it was a connection to public programs that made private health programs so stingy in denying claims I suggested no such thing. Please don't ascribe your own ridiculous ideas to other people.