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With recent events in the American healthcare industry, let’s hope this can be a rallying call to end privatization of healthcare. Profiteering by holding patie
by xyst 2y ago
With recent events in the American healthcare industry, let’s hope this can be a rallying call to end privatization of healthcare. Profiteering by holding patients and their families hostage with overly complex payout schemes, “deny, delay, defend” policies aimed at squeezing max profits, and complicating the relationship between patient care, doctors, and hospitals/clinics is beyond unethical. It’s inhumane.
- tokioyoyo 2y agoNot to be a doomer, but we have very short attention span. News will move on roughly within 2 weeks once we have something more “fun” to discuss. Most of the NA capital understands this, so no change will be experienced. There are very rare exceptions, but if I was a betting guy, i’d bet against.
- stackskipton 2y ago>Not to be a doomer, but we have very short attention span. Yea, fixing this would require decades long effort that is extremely difficult without catalyst. Most of European Health Care came about after periods of extreme difficulty like WWI, Great Depression or WWII. Closest US ever came was Great Depression and unlike Europe, US didn't experience massive hardship after WWII.
- tokioyoyo 2y agoPretty much, yeah. Also, since the system technically works, and produces decent results compared to other countries' results... it's a hard sell to rile up super majority of the population for some change.
- OnlineGladiator 2y ago> and produces decent results compared to other countries' results What metrics are you looking at?
- tokioyoyo 2y agoI'm not saying it's better! I'm saying it's not that far worse off that it would start an introspective for people to question the current state of affairs. Most people get a decent amount of care, despite all the negative side effects (debt, premiums, uncovered areas due to lack of private hospitals and etc.).
- OnlineGladiator 2y agoA healthcare CEO was just murdered and the killer is considered a hero. Many are even referring to the dead CEO as a serial killer because of all the preventable deaths he profited from. You're not paying attention if you think people aren't already introspective about healthcare in this country.
- xboxnolifes 2y agoThe killing could have happened to nearly any CEO and the response would be similar. The issue is of wealth inequality, not strictly healthcare, though it certainly exacerbated the response in this particular case. See the social media response to titan submersible deaths.
- tokioyoyo 2y agoPeople say a lot of things, but given there's no action, it's just... words. It's weird for me to say this, as I consider myself a general optimist. But when it comes to navigating layered political structures that involves trillions of dollars, it's hard to believe that anything of significance will be done.
- int_19h 2y agoThe assassination itself is one hell of an action, though. Also, police has already said that they are concerned about the lack of cooperation from the public at large when it comes to success of the manhunt. The people who usually jump onto that kind of stuff are explicitly disengaging. You can argue that this all does nothing wrt navigating the politics that would actually lead to change. But I think that, at the minimum, it creates some incentive for the people who work with those structures on a day to day basis to do so. If CEOs of healthcare companies are now a socially approved assassination target, apparently, what does it say about healthcare lobbyists?
- jareklupinski 2y ago> we have very short attention span > News will move on it's not up to the news (the media and their owners) to tell us what is important...
- tokioyoyo 2y agoMaybe yes, maybe no, but people will need something new to talk about, so media will move on.
- jareklupinski 2y agocause and effect may be getting conflated. is the media driving people's attention spans, or are people naturally careless? i'd prefer to think people care about themselves and others, and are otherwise distracted by trivialities to take their mind off of things, sometimes (hopefully less than 49% of the time) to excess
- tokioyoyo 2y agoYeah, you might be totally right! But in this specific topic, it really doesn't matter. That's much bigger topic of discussion. My point was, most likely people will move on and forget about it once a new hot topic comes up. Everything that could've been said online, has already been said. Markets and people have decided multiple times within US policy making that the way it is structured right now is what people want. It would change a huge outrage to start changing the infrastructure around it.
- jareklupinski 2y ago> a huge outrage to start changing the infrastructure around it that's my "tuesday" :) (infra)
- tokioyoyo 2y agoOh, it's my today :( (infra)
- throwaway743950 2y agoI agree with the problems. I'm a bit uninformed, but in theory ending privatization isn't the only option, right? Hasn't there been problems with corruption in centralized healthcare as well? It seems like regulation could be an option (though I know that it has its own trade-offs as well). Also, healthcare isn't the only industry suffering this pain though obviously a very important one. Also, there's a question of how much of this is a cultural problem. How has this sort of thing been addressed in the past? Is the same solution even possible now with the power imbalance created with the current state of capitalism and technology?
- whoitwas 2y agoregulation is what caused this nonsense. there's no reason for our medical care to be inaccessible for most people in the US. it's sort of like kidnapping or enslaving the entire population who isn't rich.
- ethbr1 2y ago> there's no reason for our medical care to be inaccessible for most people in the US. A limited number of physicians, especially general practices? High cost therapies and treatments? Capital-intensive diagnostic devices? Lack of access outside of cities? There are certainly a lot of things that could be done better, but this isn't 1950 -- some available medical technology is incredibly expensive. Simply unshackling Medicare/aid and allowing it more freedom to negotiate costs would go a long way towards reducing US health care expenditures. I.e. doing for more payments what the Inflation Reduction Act allowed Medicare to do for (a limited number of) drugs: https://www.cms.gov/files/document/fact-sheet-medicare-selected-drug-negotiation-list-ipay-2026.pdf https://www.cms.gov/files/document/fact-sheet-medicare-selec...
- whoitwas 2y agoumm... what? do you think there was free healthcare in the 50s in the US? every single other country has free healthcare, lower costs, and better outcomes than USA.
- zzzeek 2y agoum, that's kind of....the diametric opposite of what a majority, somewhat historic in the context that no Republican president has won the popular vote in 20 years, of Americans just voted for. Look forward to alarming levels of healthcare privatization in the next four years unfortunately with players like Dr Oz (who is explicitly looking to make Medicare Advantage more the default) and Jay Bhattacharya in leading key healthcare roles https://prospect.org/health/2024-11-26-dr-oz-stealth-destruction-of-medicare/ https://prospect.org/health/2024-11-26-dr-oz-stealth-destruc... > A key part of that strategy is to expand the private Medicare Advantage program and push more and more Medicare recipients into it, leading to a death spiral of traditional public Medicare. The details are spelled out in the Project 2025 blueprint.
- llamaimperative 2y ago> um, that's kind of....the diametric opposite of what an overwhelming majority of Americans just voted for. Not really. ACA, Medicare, Medicaid, and VA's health insurance programs are all extremely popular among voters. There are lots of issues on the ballot, and approximately no one was voting for Trump's nonexistent "concept of a plan" for healthcare. Feel free to post evidence of "an overwhelming majority" of people voting for Trump's healthcare plan to back up your initial claim, if you'd like. By the way, the popular vote had less than a 1.5% margin. There was no "overwhelming majority" in any sense. This was the 49th largest "overwhelming majority" victory ever by popular vote and the 44th largest victory by Electoral College vote. That is to say: an extremely tight race by any measure.
- zzzeek 2y agoOpinion polls arent the same as elections and the people voted in favor of expansion of Medicare Advantage whether that's their preference or not. Considering no Republican president has won the popular vote in 20 years, the relatively small majority popular vote margin is nonetheless quite dramatic in the context of recent history.
- llamaimperative 2y ago
- johnnyjeans 2y agoI'd much rather follow Germany's model of healthcare (which is privatized) than the UK or Italy's (which is nationalized), having experienced all three and the US's.
- frmersdog 2y agoI'd wager that America is culturally closer to the UK and Italy than Germany (ironically enough), particularly with regard to our attitudes towards social welfare. A decade after ACA's full implementation, I'm thinking that we maybe can't be trusted with Germany's model. It's all-or-nothing, as far as the greater system goes; sprinkle some private coverage on top for the wealthy, if you must.
- stogot 2y agoBefore revolutionizing the system, why not start with capping insurer profits and pay it back to policyholders? That will put a limiter on the greed machine
- MrLeap 2y agoAs I understand it, the ACA caps profits by requiring that insurance companies spend 80% of their revenue on "medical care and quality improvement". Therefore, the only ways for insurance companies to make more money is if they get a lot more customers OR if the price of medical care skyrockets. I suspect the reason why UHC has decided to deny so many claims is that this will allow them to marginally lower he price of their premiums relative to their competitors. This'll get them more money via method 1. The whole industry is working around the clock on method #2. Anyone more informed, feel free to correct me.
- ethbr1 2y agoThat's broadly correct. One of the most under-appreciated wins of the ACA was capping non-care premium costs (read: admin, et al). From working on automation inside the system at insurers at the time, I can definitively say this spurred health insurers to streamline and lower operational cost overheads. With regards to the denials, I think you're right too. People like to point at insurers and blame them, but it's easy to forget they're just the middleman. There's "cost of care" on the other side of them. At the end of the day, premiums need to balance with costs... (somewhat, in aggregate) There are probably some edge cases where there are opportunities to profit, mostly to do with privately-administered but publicly-funded areas of health insurance (read: FEP and Medicare Advantage), but generally it's trying to get premiums lower for competitive reasons.
- jsheard 2y ago> let’s hope this can be a rallying call to end privatization of healthcare It would be pretty funny if it ends up being another Shinzo Abe moment where the predominant takeaway is "wait a sec, that murderer kind of had a point".
- adolph 2y ago> end privatization of healthcare 100%: Nationalize all healthcare providers and facilities. Forgive any outstanding student loans. Expropriate all property used in healthcare delivery. Make medical licensing contingent on public employment. Set up compulsory public housing accommodations at healthcare facilities for every person involved in healthcare delivery. Establish healthcare unions to negotiate working conditions and wages. Use evidence based scientific measurement of expected quality of life years to justify any treatment allowed on a first come first served basis. Anything less is anti-ethical and unhuman.
- deleted 2y ago[deleted]
- frmersdog 2y agoThis reads like the poison pill (mis)characterization of the original version of ACA that killed it. Most of the ideas are good, but you've snuck in a few obvious non-starters. It's clear that there needs to be some degree of nationalization, though. Middlemen are literally killing us (and now, in a shift that might actually induce a change, getting killed).
- adolph 2y agoTypists like you killed a person with lies like “Middlemen are literally killing us.”
- eesmith 2y agoSome things don't seem practical. Like, "Expropriate all property used in healthcare delivery." wouldn't work for my old dentist who had an office in a retail mall. Or, what of a rural nurse who uses her personal vehicle (reimbursed) to make house calls. A car is property. Or the on-site medical office for a large factory? (True story: I feel off the bike on the way to work on day, doing some contract programming work for a large company. Not only did the medical office check me over, but I got a tetanus shot, both free since I was working there.) Are acupuncturists part of healthcare delivery? > Make medical licensing contingent on public employment. The TV series "The Love Boat" taught me that a large oceangoing cruise ship has a doctor on board, and that seems to be true still. Will this doctor be a public employee? State or federal? Or perhaps a joint employee? > compulsory public housing accommodations That sounds like you want to force all health care people to live at their workplace. Plus, what does "involved in healthcare delivery" supposed to include: the janitorial staff? The IT support staff? The food services staff? > Establish healthcare unions I've learned that's entirely too underspecified. A company union isn't an effective at negotiating for workers, for example. Plus, repeal Taft-Hartley. > to justify any treatment allowed on a first come first served basis That too needs some examination. How does one measure 'quality of life years'? Do rich people have a higher quality of life than poor? Do blind people have a different quality of life than sighted? What about someone bedridden? In a coma? How are error estimates incorporated? How do we justify a novel experimental treatment which has no use evidence? Is cosmetic treatment included? How do we measure quality of life for a nose job? For Lasik surgery? The goals are great, don't get me wrong, but the taskforce is going to need work out the details better than an HN comment, and you might use my feedback to tweak your wording.
- SamuelAdams 2y agoTo quote a great play: “what comes next”? What’s always missing from these calls to action is: what are you replacing it with? There are a number of healthcare programs across the world and every country has a variety of different problems. There are no silver bullets. If you want a great read about a few different countries, I recommend The Healing of America by T.R. Reid. It has some suggestions, but in general it is great at illustrating how treating the same illness in different countries can be varied in terms of treatment and cost.
- bradleyjg 2y agoThis is true, but some of the problems show up in outcomes and some don’t. Sure, I’d rather not wait six weeks for an appointment. But if you can’t show me any sort of worse health outcomes related to those waits, then that seems like a reasonable tradeoff for single digit percentages of gdp.
- hx8 2y agoWe have one of the worst healthcare systems in the developed world. "What comes next" doesn't matter when most alternatives would be better.
- chung8123 2y agoMost people won't agree on what that next system is so there isn't enough momentum to change it.
- peterldowns 2y agoDo you have a source for that — what makes our healthcare systems "one of the worst"?
- helsinkiandrew 2y agoLower life expectancy, higher infant and mother mortality, large numbers of untreated diabetes and other treatable illnesses For example: https://www.kff.org/health-policy-101-international-comparison-of-health-systems/?entry=table-of-contents-introduction https://www.kff.org/health-policy-101-international-comparis... But a basic google search returns hundreds of sources
- ReptileMan 2y agoUS healthcare problem is cost disease starting around 50 years ago. You just can't beat O(2) function with linear policies. You must make it cost less - but making it costing less means everyone in the healthcare is making less. So there will be massive resistance to any kind of change. You could achieve slightly more healthcare for money spent, but you can't meaningfully reduce costs.
- ethbr1 2y agoCounterpoint: there are opportunities for harvesting efficiencies by eliminating middlemen (read: private insurers and price negotiators) The US system is convoluted enough that I wouldn't be surprised if they're bringing negative value simply by existing. Especially since with computerization, there's no need to have an entire company to track and route paper.