6 ms·

Our collective reaction to this event makes it clear that there is substantial support for massive changes to the for-profit insurance industry. But every time

Our collective reaction to this event makes it clear that there is substantial support for massive changes to the for-profit insurance industry. But every time we've tried to make it a public benefit, those attempts have fallen flat. Sure seems like the industry is able to lobby and market it's way to staying alive, despite the ire of the people paying them. Decades ago I recall a previous attempt at moving towards a one-payer system, and it having some traction. My mother had some fairly serious health issues, and had many battles with getting insurance claims paid, living month to month in a single mother salary. Yet she also was firmly of the opinion that a one-payer system would be terrible, parroting the marketing of the industry advertising campaigns. Despite having a daughter in law that was Canadian, who's mother went through cancer and had superb care under a single-payer system.

fasa99 2y ago
It's a frying pan or the fire situation. The frying pan is government healthcare. The collective US thinks the government run program is a garbage fire. Obvious reasons are that (1) it's really hard to fire bad employees government wise since employment is seen as a right and (2) it's really hard to get anything done since people think of 9999 ways to "be nice" as rights. Then, clearly for-profit institutions are also a garbage fire since they make that extra 10% revenue off of unnecessary suffering. There is a great counterexample that is Kaiser. They are a private health insurance org that provides massive savings by simultaneously also running a network of hospitals and outpatient facilities. Notably they are not-for-profit. So that's perhaps what we're shooting for "all the goodwill of government, without the mucuousy bureaucratic slop in any government institution" If only all the private sector orgs were Kaiser, not for profit and for the well being of humanity. Kaisers of the world are a flash in the pan, "don't be evil" googles only to become "be evil" googles. I would simply recommend to look at how Singapore does things and copy that, after all, that's what China did and look how well they have done economically.
throwaway48476 2y ago
It's complicated. Health insurance is expensive because healthcare is expensive. Different countries have approached this differently. In the UK the doctor will see you in 5 years, in China the government sponsors snake oil ( traditional Chinese medicine), and in Canada they introduced MAID (the 'just kill yourself now' health plan).
- jademohnahan 2y ago
  [flagged]
- kerpopulous 2y ago
  [flagged]
  - throwaway48476 2y ago
    I think drugs should be manufactured by state run non profits.
- linsomniac 2y ago
  But it seems obvious that inserting a group of middlemen into an already expensive system is going to make it more expensive. The complexity of dealing with all the insurance companies is literally overwhelming. It is so confusing to me that "socialized healthcare" is such a dirty word, when the whole purpose of insurance is, a it's core, introducing socialism into healthcare. If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. :-) Sadly, we in the US seem to be sliding in that direction with the noises being made about "healthcare pools".
  - vondur 2y ago
    Most working people in the US are on private healthcare. What you are saying makes no sense. Most everyone agrees our current system isn’t working and needs fixing.
  - Ajedi32 2y ago
    Yes, insurance is effectively a form of voluntary socialism implemented on top of the free market. That's why it sucks so much in the first place. (Which isn't to say a purely market based system would be better; people buy insurance for a reason.) As I see it, health insurance is uniquely bad for a few additional reasons: 1. People don't treat it as insurance against catastrophic events so much as a subscription for ongoing care, which greatly expands the scope of what costs are socialized. 2. It's often paid for through employers, which reduces consumer choice in deciding what plans to purchase. 3. Demand for healthcare services is relatively inelastic and with modern medicine there's often almost no limit to how much it can cost. If you wreck your car, at most your car insurance company is on the hook for the cost of the vehicle (and perhaps some additional costs up to a fixed limit). But if you're suffering from some disease with no known cure, you could easily spend tens of millions trying hundreds of different procedures trying to find something that will work to mitigate the effects of the disease, and that's an ongoing cost that goes on forever until you're either cured or dead. Somebody has to decide which procedures are worth it or not, and if you're not paying for it yourself that "somebody" isn't going to be you, which creates lots of inefficiencies and is heartbreaking for everyone involved. This is also why we end up with systems such as "in network" and "out of network" providers, and government regulations intended to make things more fair at the cost of even more layers of inefficient bureaucracy. A few other thoughts: > If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. Even for those who might be inclined to do so, this often isn't viable because of #2; they'd be leaving a bunch of free money on the table. I've also heard stories of some healthcare providers charging private individuals many times what they'd charge an insurance company for the same thing, though I'm not sure how common that still is today. > inserting a group of middlemen into an already expensive system is going to make it more expensive This is true, though note that government healthcare just replaces one set of middlemen with another.
rrrrrrrrrrrryan 2y ago
> Decades ago I recall a previous attempt at moving towards a one-payer system, and it having some traction. Obamacare had a public option up until the last moment before passage. It was dropped because they were one vote Senate vote shy of the required 60 votes. Lieberman was heavily lobbied by the insurance industry and promised to join the Republicans and filibuster Obamacare entirely if they kept the public option in.
mikewarot 2y ago
I blame Rahm Emanuel, Obama's chief of staff, who threw public health on the pyre as a sacrifice to Mammon, and his minions in the Donor Class.
- throwaway48476 2y ago
  He comes from a country that does have single payer but doesn't think it's worth doing for people in this country.
nradov 2y ago
You are confusing two separate issues. A single-payer system would also deny many claims (or refuse to authorize many expensive treatments). Every socialized healthcare system rations care. It might be a net improvement overall, but we see a lot of affluent Canadians coming to the USA as medical tourists to skip the queues back home. For cancer care, the USA generally has better 5-year survival rates than Canada.
- nickff 2y ago
  Example of rationing in Canada (posting because I saw the article yesterday): https://ca.news.yahoo.com/halifax-woman-waited-3-years-100000021.html https://ca.news.yahoo.com/halifax-woman-waited-3-years-10000...
Ferret7446 2y ago
What collective reaction? Sounds like you're in a bubble. I have observed both responses. There are lots of people basically celebrating murder (sometimes veiled behind thin excuses and wordplay). There are lots of people condemning it too. Most people (not terminal social media dwellers) seem to be in the latter group, thankfully.
- antifa 2y ago
  > basically celebrating murder of a guy who basically runs death panel...
- xvector 2y ago
  The vast majority of people I've talked to IRL, conservative and liberal, are thrilled about this. "American hero" is the phrase I've heard tossed around quite often. Can't say it wasn't the best news of the week, maybe even the past month.
- consteval 2y ago
  It's a problem of definitions. When you kill hundreds or thousands of people indirectly, as in you do not literally pull the trigger, that is not murder. But if you shoot one person, that is murder. I've seen people advocate the death penalty for much, much less. If anyone stopped and did the math on how many people this CEO has killed, undoubtedly he would never see the sun again. However, our system is specifically designed to maximize personal liability while minimizing collective liability. So, one is murder, and the other is good business. Whether or not this particular propaganda has seeped into an American mind depends on the person.

fasa99 2y ago

It's a frying pan or the fire situation. The frying pan is government healthcare. The collective US thinks the government run program is a garbage fire. Obvious reasons are that (1) it's really hard to fire bad employees government wise since employment is seen as a right and (2) it's really hard to get anything done since people think of 9999 ways to "be nice" as rights. Then, clearly for-profit institutions are also a garbage fire since they make that extra 10% revenue off of unnecessary suffering. There is a great counterexample that is Kaiser. They are a private health insurance org that provides massive savings by simultaneously also running a network of hospitals and outpatient facilities. Notably they are not-for-profit. So that's perhaps what we're shooting for "all the goodwill of government, without the mucuousy bureaucratic slop in any government institution" If only all the private sector orgs were Kaiser, not for profit and for the well being of humanity. Kaisers of the world are a flash in the pan, "don't be evil" googles only to become "be evil" googles. I would simply recommend to look at how Singapore does things and copy that, after all, that's what China did and look how well they have done economically.

throwaway48476 2y ago

It's complicated. Health insurance is expensive because healthcare is expensive. Different countries have approached this differently. In the UK the doctor will see you in 5 years, in China the government sponsors snake oil ( traditional Chinese medicine), and in Canada they introduced MAID (the 'just kill yourself now' health plan).

jademohnahan 2y ago
[flagged]
kerpopulous 2y ago
[flagged]
- throwaway48476 2y ago
  I think drugs should be manufactured by state run non profits.
linsomniac 2y ago
But it seems obvious that inserting a group of middlemen into an already expensive system is going to make it more expensive. The complexity of dealing with all the insurance companies is literally overwhelming. It is so confusing to me that "socialized healthcare" is such a dirty word, when the whole purpose of insurance is, a it's core, introducing socialism into healthcare. If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. :-) Sadly, we in the US seem to be sliding in that direction with the noises being made about "healthcare pools".
- vondur 2y ago
  Most working people in the US are on private healthcare. What you are saying makes no sense. Most everyone agrees our current system isn’t working and needs fixing.
- Ajedi32 2y ago
  Yes, insurance is effectively a form of voluntary socialism implemented on top of the free market. That's why it sucks so much in the first place. (Which isn't to say a purely market based system would be better; people buy insurance for a reason.) As I see it, health insurance is uniquely bad for a few additional reasons: 1. People don't treat it as insurance against catastrophic events so much as a subscription for ongoing care, which greatly expands the scope of what costs are socialized. 2. It's often paid for through employers, which reduces consumer choice in deciding what plans to purchase. 3. Demand for healthcare services is relatively inelastic and with modern medicine there's often almost no limit to how much it can cost. If you wreck your car, at most your car insurance company is on the hook for the cost of the vehicle (and perhaps some additional costs up to a fixed limit). But if you're suffering from some disease with no known cure, you could easily spend tens of millions trying hundreds of different procedures trying to find something that will work to mitigate the effects of the disease, and that's an ongoing cost that goes on forever until you're either cured or dead. Somebody has to decide which procedures are worth it or not, and if you're not paying for it yourself that "somebody" isn't going to be you, which creates lots of inefficiencies and is heartbreaking for everyone involved. This is also why we end up with systems such as "in network" and "out of network" providers, and government regulations intended to make things more fair at the cost of even more layers of inefficient bureaucracy. A few other thoughts: > If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. Even for those who might be inclined to do so, this often isn't viable because of #2; they'd be leaving a bunch of free money on the table. I've also heard stories of some healthcare providers charging private individuals many times what they'd charge an insurance company for the same thing, though I'm not sure how common that still is today. > inserting a group of middlemen into an already expensive system is going to make it more expensive This is true, though note that government healthcare just replaces one set of middlemen with another.

rrrrrrrrrrrryan 2y ago

> Decades ago I recall a previous attempt at moving towards a one-payer system, and it having some traction. Obamacare had a public option up until the last moment before passage. It was dropped because they were one vote Senate vote shy of the required 60 votes. Lieberman was heavily lobbied by the insurance industry and promised to join the Republicans and filibuster Obamacare entirely if they kept the public option in.

mikewarot 2y ago

I blame Rahm Emanuel, Obama's chief of staff, who threw public health on the pyre as a sacrifice to Mammon, and his minions in the Donor Class.

throwaway48476 2y ago
He comes from a country that does have single payer but doesn't think it's worth doing for people in this country.

nradov 2y ago

You are confusing two separate issues. A single-payer system would also deny many claims (or refuse to authorize many expensive treatments). Every socialized healthcare system rations care. It might be a net improvement overall, but we see a lot of affluent Canadians coming to the USA as medical tourists to skip the queues back home. For cancer care, the USA generally has better 5-year survival rates than Canada.

nickff 2y ago
Example of rationing in Canada (posting because I saw the article yesterday): https://ca.news.yahoo.com/halifax-woman-waited-3-years-100000021.html https://ca.news.yahoo.com/halifax-woman-waited-3-years-10000...

Ferret7446 2y ago

What collective reaction? Sounds like you're in a bubble. I have observed both responses. There are lots of people basically celebrating murder (sometimes veiled behind thin excuses and wordplay). There are lots of people condemning it too. Most people (not terminal social media dwellers) seem to be in the latter group, thankfully.

antifa 2y ago
> basically celebrating murder of a guy who basically runs death panel...
xvector 2y ago
The vast majority of people I've talked to IRL, conservative and liberal, are thrilled about this. "American hero" is the phrase I've heard tossed around quite often. Can't say it wasn't the best news of the week, maybe even the past month.
consteval 2y ago
It's a problem of definitions. When you kill hundreds or thousands of people indirectly, as in you do not literally pull the trigger, that is not murder. But if you shoot one person, that is murder. I've seen people advocate the death penalty for much, much less. If anyone stopped and did the math on how many people this CEO has killed, undoubtedly he would never see the sun again. However, our system is specifically designed to maximize personal liability while minimizing collective liability. So, one is murder, and the other is good business. Whether or not this particular propaganda has seeped into an American mind depends on the person.