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Government health care subsidies and purchasing programs have completely destroyed the market for services. It's an incomprehensible mess of products with a bl

Government health care subsidies and purchasing programs have completely destroyed the market for services. It's an incomprehensible mess of products with a bloated middle layer that only exists to extract value out of the actual Consumer + Expert Care Provider equation to the extreme detriment of both of them. How anyone stays alive and wealthy in such a system is beyond me. Very few, apparently, are fortunate enough to enjoy this. We need to completely rethink this entire model.

jonhohle 2y ago
It’s almost as if people warned about this very thing. It’s almost as of anything the government touches turns to crap for most while a few, especially those in Congress, ride off with a huge pay day. I’m not sure why people continue to fall for it.
- monero-xmr 2y ago
  We just need to create more agencies, throw more money at the existing programs, establish new programs, and add more regulations. This time for sure
  - jonhohle 2y ago
    Probably a few commissions as well. And adjust for inflation.
- Hnrobert42 2y ago
  I assume this is a criticism of the ACA. How, specifically, did it lead to this outcome? And why is your criticism reserved for the government and not the perpetrator of the fraud, namely Ambetter?
- karmajunkie 2y ago
  yes, things tend to turn to crap when you have half the government composed of a party dedicated to ensuring that everything government touches turns to crap or benefits the wealthy. not sure how this is a valid point or makes the case that allowing industry to police itself will work.
  - jonhohle 2y ago
    When that’s the game, don’t let them play. The party you’re referring to is ambiguous. Democrats seem to make an awful lot representing their constituents[0]. Health insurance shouldn’t exist. When the government mandates it, now there are two problems. If this wasn’t obvious prior to the ACA, I have a bridge to sell you. 0 - https://ballotpedia.org/Changes_in_Net_Worth_of_U.S._Senators_and_Representatives_(Personal_Gain_Index) https://ballotpedia.org/Changes_in_Net_Worth_of_U.S._Senator...
- GendingMachine 2y ago
  Christ, reading Americans declare that the issue with American healthcare is "too much government" always completely floors me. The system did not work well before the ACA, the system does not work now. The only countries in the world with strong, consistent and equitable healthcare systems have government health systems. Here in the UK our NHS is a goddamn mess, it's cracking and creaking and bureaucratic, but every American expat i have ever known who now lives in the UK has horror stories about how much worse it is over there. In our monthly social classes (PSHCE) we watched documentaries of poor Americans unable to afford healthcare, and it horrified us all. You can't run healthcare as a profit seeking enterprise, it just doesn't work, the financial incentives of healthcare providers just fundamentally do not align with their customers. Government run institutions can often fall into a state of bureaucratic atrophy but if this and countless other stories make clear - that's an issue with institutions in general, whether they be government run or not. This problem will not improve until you get over your ideological commitment to trying to solve every problem with markets. Healthcare must be socialised, anything less is barbarism.
  - jonhohle 2y ago
    Health insurance is the problem and always has been the problem. Having the government mandate insurance is far worse than a public health system. Currently we have the worst of all of the options (and if an insurance company has bought all of the smaller providers in your area, it’s even worse)! Healthcare hasn’t been a “market” in decades. It’s completely captured by monopolies which have captured regulation to prevent any alternatives. I do know that the mashup of government mandates for for-profit entities is about as corrupt a system as could be conceived.
  - akira2501 2y ago
    > The system did not work well before the ACA It wasn't nearly as corrupt. > we watched documentaries of poor Americans unable to afford healthcare, and it horrified us all. A system so good shouldn't need such propaganda to justify it's existence. > you get over your ideological commitment The ideological commitment that are the underpinnings of our system of government and the core of our very constitution? Why don't you just "get over" your ideological commitment to entertaining that absurd royal family?
- ok_dad 2y ago
  If I didn’t have healthcare on the Obamacare market today, my special needs son would be without care because I can’t afford his care myself. Furthermore, his healthcare would have been impossible to even get privately because of all that preexisting conditions BS. People like you probably don’t care about anyone else, but ACA is a life saver for so many people.
  - jonhohle 2y ago
    You pay for insurance, which pays for Dr’s insurance, which pays other people absurd amounts for malpractice. If you weren’t having to pay two insurance companies with awfully large buildings, naming rights to stadiums, etc., maybe you could pay for that without government assistance. Somehow people did it successfully for millennia.
    - dragonwriter 2y ago
      > Somehow people did it successfully for millennia. No, they didn't. People with unusual medical needs just died. Heck, people with what we now view as pretty routine medical needs just died.
    - FireBeyond 2y ago
      > which pays other people absurd amounts for malpractice Many states now cap malpractice insurance. Also, malpractice insurance is not as crippling to physicians as some would have you believe.
- AtlasBarfed 2y ago
  OMG it was truly paradise before the ACA. That is sarcasm if you can't tell. As someone that used the open market plans before the ACA, it basically changed nothing, added subsidies, and removed the lifetime limits, at least from my perspective. But this is all pointless accounting bullshit, we simply need a medicare-for-all plan.
  - jonhohle 2y ago
    I was on employee plans until recently. I knew I would eventually need private health insurance and watched it for 5-10 years, during which ACA took over. For most, premiums rose and coverage fell. Maybe that would have happened regardless, but that wasn’t the ACA promise. Prior to ACA, growth of per capita health care costs were slowing.[0] 0 - https://www.healthsystemtracker.org/chart-collection/u-s-spending-healthcare-changed-time/#Average%20annual%20expenditures%20growth%20rate%20for%20select%20service%20types,%201970-2022 https://www.healthsystemtracker.org/chart-collection/u-s-spe...
    - AtlasBarfed 2y ago
      The ACA was a disappointment, don't get me wrong. It should have been medicare for all but... Fucking Joe Lieberman. Granted, whenever democrats are in power, they rotate the "bad guy" to give in to the corporate demands and side with the Republicans, but Joe Lieberman was the reason we got a washed out reformed healthcare. Sure it could have been some other democrat senator turncoat, but he wasn't being the surreptitious underminer while the Republicans did the public PR, that a-hole was front and center hollowing out the ACA. Joe Lieberman probably killed hundreds of thousands of Americans as a result. Maybe a million. Maybe more.
Terr_ 2y ago
Hold up, how does this type of fraud require any government action at all? (Except for prosecuting the fraud after-the-fact, of course.) The core situation isn't specific to healthcare either: Someone's offering you a long-term contract service based on the strength of a menu of available services and options, but their offering is effectively fake. It's a similar concept to subscribing to a mostly-fake library of repair manuals or something, only the popular/cheap ones are there, and the others are permanently temporarily unavailable.
- akira2501 2y ago
  > Hold up, how this type of fraud require any government involvement at all? Hold up (seriously hold up and stop serially editing your comments), where did I say it did? > It's a similar concept The government has decided, without much input from actual citizens, that copyright should exist for life plus 70 years. Government interference in copyright has created the fraudulent market conditions you've just related. We can do this all day if you like.
  - immibis 2y ago
    I can still give you a fake repair manual subscription with or without copyright.
    - Terr_ 2y ago
      To move this false-advertising example even further from copyright, imagine a subscription-based Ice Cream of The Month club, where 24 months of continuous membership entitles you to The Super Expensive Awesome Flavor that never actually existed.
    - akira2501 2y ago
      Technically.. sure.. you can also sell buggy whips. If there's no market for what you are selling then why would anyone buy it?
mindslight 2y ago
Why are you putting the word "government" in there? The main perpetrator of this particular problem is the health "insurance" cartel with their closed "networks". This regime was directly created and nurtured by government-based regulatory capture, but that does not mean that removing government from the equation will cause the "insurers" to spontaneously dismantle their lucrative positions. So directing the ire at "government" seems like it's directly detracting from focusing on the problem, which is a complete lack of sensible regulation of these "private" corporate extraction machines. At a minimum this "network" nonsense needs to be outright banned for the restraint of trade scheme that it is, and "providers" need to be taken to task for shaking down patients with fraudulent bills not based on any sort of contract (the latter being the main thing driving people into the arms of these "insurers" to begin with).
nitwit005 2y ago
> Government health care subsidies and purchasing programs have completely destroyed the market for services. No it hasn't. People will happily take cash. Some of the offices called in this article suggested they only took patients who pay cash.

jonhohle 2y ago

It’s almost as if people warned about this very thing. It’s almost as of anything the government touches turns to crap for most while a few, especially those in Congress, ride off with a huge pay day. I’m not sure why people continue to fall for it.

monero-xmr 2y ago
We just need to create more agencies, throw more money at the existing programs, establish new programs, and add more regulations. This time for sure
- jonhohle 2y ago
  Probably a few commissions as well. And adjust for inflation.
Hnrobert42 2y ago
I assume this is a criticism of the ACA. How, specifically, did it lead to this outcome? And why is your criticism reserved for the government and not the perpetrator of the fraud, namely Ambetter?
karmajunkie 2y ago
yes, things tend to turn to crap when you have half the government composed of a party dedicated to ensuring that everything government touches turns to crap or benefits the wealthy. not sure how this is a valid point or makes the case that allowing industry to police itself will work.
- jonhohle 2y ago
  When that’s the game, don’t let them play. The party you’re referring to is ambiguous. Democrats seem to make an awful lot representing their constituents[0]. Health insurance shouldn’t exist. When the government mandates it, now there are two problems. If this wasn’t obvious prior to the ACA, I have a bridge to sell you. 0 - https://ballotpedia.org/Changes_in_Net_Worth_of_U.S._Senators_and_Representatives_(Personal_Gain_Index) https://ballotpedia.org/Changes_in_Net_Worth_of_U.S._Senator...
GendingMachine 2y ago
Christ, reading Americans declare that the issue with American healthcare is "too much government" always completely floors me. The system did not work well before the ACA, the system does not work now. The only countries in the world with strong, consistent and equitable healthcare systems have government health systems. Here in the UK our NHS is a goddamn mess, it's cracking and creaking and bureaucratic, but every American expat i have ever known who now lives in the UK has horror stories about how much worse it is over there. In our monthly social classes (PSHCE) we watched documentaries of poor Americans unable to afford healthcare, and it horrified us all. You can't run healthcare as a profit seeking enterprise, it just doesn't work, the financial incentives of healthcare providers just fundamentally do not align with their customers. Government run institutions can often fall into a state of bureaucratic atrophy but if this and countless other stories make clear - that's an issue with institutions in general, whether they be government run or not. This problem will not improve until you get over your ideological commitment to trying to solve every problem with markets. Healthcare must be socialised, anything less is barbarism.
- jonhohle 2y ago
  Health insurance is the problem and always has been the problem. Having the government mandate insurance is far worse than a public health system. Currently we have the worst of all of the options (and if an insurance company has bought all of the smaller providers in your area, it’s even worse)! Healthcare hasn’t been a “market” in decades. It’s completely captured by monopolies which have captured regulation to prevent any alternatives. I do know that the mashup of government mandates for for-profit entities is about as corrupt a system as could be conceived.
- akira2501 2y ago
  > The system did not work well before the ACA It wasn't nearly as corrupt. > we watched documentaries of poor Americans unable to afford healthcare, and it horrified us all. A system so good shouldn't need such propaganda to justify it's existence. > you get over your ideological commitment The ideological commitment that are the underpinnings of our system of government and the core of our very constitution? Why don't you just "get over" your ideological commitment to entertaining that absurd royal family?
ok_dad 2y ago
If I didn’t have healthcare on the Obamacare market today, my special needs son would be without care because I can’t afford his care myself. Furthermore, his healthcare would have been impossible to even get privately because of all that preexisting conditions BS. People like you probably don’t care about anyone else, but ACA is a life saver for so many people.
- jonhohle 2y ago
  You pay for insurance, which pays for Dr’s insurance, which pays other people absurd amounts for malpractice. If you weren’t having to pay two insurance companies with awfully large buildings, naming rights to stadiums, etc., maybe you could pay for that without government assistance. Somehow people did it successfully for millennia.
  - dragonwriter 2y ago
    > Somehow people did it successfully for millennia. No, they didn't. People with unusual medical needs just died. Heck, people with what we now view as pretty routine medical needs just died.
  - FireBeyond 2y ago
    > which pays other people absurd amounts for malpractice Many states now cap malpractice insurance. Also, malpractice insurance is not as crippling to physicians as some would have you believe.
AtlasBarfed 2y ago
OMG it was truly paradise before the ACA. That is sarcasm if you can't tell. As someone that used the open market plans before the ACA, it basically changed nothing, added subsidies, and removed the lifetime limits, at least from my perspective. But this is all pointless accounting bullshit, we simply need a medicare-for-all plan.
- jonhohle 2y ago
  I was on employee plans until recently. I knew I would eventually need private health insurance and watched it for 5-10 years, during which ACA took over. For most, premiums rose and coverage fell. Maybe that would have happened regardless, but that wasn’t the ACA promise. Prior to ACA, growth of per capita health care costs were slowing.[0] 0 - https://www.healthsystemtracker.org/chart-collection/u-s-spending-healthcare-changed-time/#Average%20annual%20expenditures%20growth%20rate%20for%20select%20service%20types,%201970-2022 https://www.healthsystemtracker.org/chart-collection/u-s-spe...
  - AtlasBarfed 2y ago
    The ACA was a disappointment, don't get me wrong. It should have been medicare for all but... Fucking Joe Lieberman. Granted, whenever democrats are in power, they rotate the "bad guy" to give in to the corporate demands and side with the Republicans, but Joe Lieberman was the reason we got a washed out reformed healthcare. Sure it could have been some other democrat senator turncoat, but he wasn't being the surreptitious underminer while the Republicans did the public PR, that a-hole was front and center hollowing out the ACA. Joe Lieberman probably killed hundreds of thousands of Americans as a result. Maybe a million. Maybe more.

Terr_ 2y ago

Hold up, how does this type of fraud require any government action at all? (Except for prosecuting the fraud after-the-fact, of course.) The core situation isn't specific to healthcare either: Someone's offering you a long-term contract service based on the strength of a menu of available services and options, but their offering is effectively fake. It's a similar concept to subscribing to a mostly-fake library of repair manuals or something, only the popular/cheap ones are there, and the others are permanently temporarily unavailable.

akira2501 2y ago
> Hold up, how this type of fraud require any government involvement at all? Hold up (seriously hold up and stop serially editing your comments), where did I say it did? > It's a similar concept The government has decided, without much input from actual citizens, that copyright should exist for life plus 70 years. Government interference in copyright has created the fraudulent market conditions you've just related. We can do this all day if you like.
- immibis 2y ago
  I can still give you a fake repair manual subscription with or without copyright.
  - Terr_ 2y ago
    To move this false-advertising example even further from copyright, imagine a subscription-based Ice Cream of The Month club, where 24 months of continuous membership entitles you to The Super Expensive Awesome Flavor that never actually existed.
  - akira2501 2y ago
    Technically.. sure.. you can also sell buggy whips. If there's no market for what you are selling then why would anyone buy it?

mindslight 2y ago

Why are you putting the word "government" in there? The main perpetrator of this particular problem is the health "insurance" cartel with their closed "networks". This regime was directly created and nurtured by government-based regulatory capture, but that does not mean that removing government from the equation will cause the "insurers" to spontaneously dismantle their lucrative positions. So directing the ire at "government" seems like it's directly detracting from focusing on the problem, which is a complete lack of sensible regulation of these "private" corporate extraction machines. At a minimum this "network" nonsense needs to be outright banned for the restraint of trade scheme that it is, and "providers" need to be taken to task for shaking down patients with fraudulent bills not based on any sort of contract (the latter being the main thing driving people into the arms of these "insurers" to begin with).

nitwit005 2y ago

> Government health care subsidies and purchasing programs have completely destroyed the market for services. No it hasn't. People will happily take cash. Some of the offices called in this article suggested they only took patients who pay cash.