4 ms·

Few things: only one doctor visit is allowed and for some insurance companies asking about health problems voids that. Preventative is very narrowly defined to

Few things: only one doctor visit is allowed and for some insurance companies asking about health problems voids that. Preventative is very narrowly defined to exclude anything considered a sickness in anyway. Getting something done that will ensure you don't get more sick might be considered preventative naively but is considered fixing a problem and so not covered. So basically this covers vaccines (make sure if you get multiple you don't see a doctor past the first or you are paying) tests unrelated to medical problems and a single non diagnostic visit to the doctor per year.

goodkittie396 3y ago
This is an extremely valid and overlooked point. I feel frustrated when it seems that so much money somehow is going to preventive care… But when they quantify it, it’s just looks like screening. They ask if I feel safe at home they ask if I want to attend a group weight loss class, when I’m 95 pounds. They, the gatekeeping front desk clerks or nurses, just screen screen screen and check off items on a checklist earning them loads of credit. All that screening results in an approved amount of preventative treatment.
- tekknik 3y ago
  At least you’re not in need of care, are overweight, and have state medical records. I need something looked at, and the first Dr I went to noticed my weight obviously and told me my issue is weight related and I need to lose weight before getting any further care. They then entered this info into my medical record that synchronizes with every other provider in the state. Now anybody I go to says the same and I still have pain. How I love socialized medicine!
TheOtherHobbes 3y ago
IME the point of health insurance is simply to collect premiums and not to pay out. It is very much not to support health in any way whatsoever. In fact the industry loves ill-health, because it's far more profitable than wellness. Public not-for-profit health systems change that motivation into something that actually makes sense from a healthcare pov instead of just being an exercise in piratical opportunism. Profiting from suffering without the slightest hint of altruism or empathy is simply sociopathic.
- gruez 3y ago
  >IME the point of health insurance is simply to collect premiums and not to pay out. ACA's medical loss ratio provisions basically makes this impossible: https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio https://www.cms.gov/marketplace/private-health-insurance/med... That's not to say they're not incentivized to deny claims. If you are loose with what you pay out, you could lose money by paying out more than you take in.
  - throwway120385 3y ago
    They don't though, because I can buy an insurer and also a medical provider, and pay the medical provider the 80% and then collect my profits through my pet medical provider.

goodkittie396 3y ago

This is an extremely valid and overlooked point. I feel frustrated when it seems that so much money somehow is going to preventive care… But when they quantify it, it’s just looks like screening. They ask if I feel safe at home they ask if I want to attend a group weight loss class, when I’m 95 pounds. They, the gatekeeping front desk clerks or nurses, just screen screen screen and check off items on a checklist earning them loads of credit. All that screening results in an approved amount of preventative treatment.

tekknik 3y ago
At least you’re not in need of care, are overweight, and have state medical records. I need something looked at, and the first Dr I went to noticed my weight obviously and told me my issue is weight related and I need to lose weight before getting any further care. They then entered this info into my medical record that synchronizes with every other provider in the state. Now anybody I go to says the same and I still have pain. How I love socialized medicine!

TheOtherHobbes 3y ago

IME the point of health insurance is simply to collect premiums and not to pay out. It is very much not to support health in any way whatsoever. In fact the industry loves ill-health, because it's far more profitable than wellness. Public not-for-profit health systems change that motivation into something that actually makes sense from a healthcare pov instead of just being an exercise in piratical opportunism. Profiting from suffering without the slightest hint of altruism or empathy is simply sociopathic.

gruez 3y ago
>IME the point of health insurance is simply to collect premiums and not to pay out. ACA's medical loss ratio provisions basically makes this impossible: https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio https://www.cms.gov/marketplace/private-health-insurance/med... That's not to say they're not incentivized to deny claims. If you are loose with what you pay out, you could lose money by paying out more than you take in.
- throwway120385 3y ago
  They don't though, because I can buy an insurer and also a medical provider, and pay the medical provider the 80% and then collect my profits through my pet medical provider.