5 ms·

> What if this entire sector just didn't exist and the money paid out to health insurance secretaries and janitors who clean their offices and the people in the

> What if this entire sector just didn't exist and the money paid out to health insurance secretaries and janitors who clean their offices and the people in the accounting department who handle their salaries just went into paying for actual healthcare instead? Then healthcare fraud would be 80% of GDP.

Teever 2y ago
Is healthcare fraud 80% of the Canadian GDP?
- onlyrealcuzzo 2y ago
  No. You're still paying the same people the same wages to work for the government. Or is your solution that we should pay health insurance workers less money? You originally proposed eliminating all the jobs. Now you've moved all the jobs to the public sector. So unless you're paying them dirt, all that money is still going to people working to make sure healthcare fraud isn't 80% of GDP. In a perfect world, you have 6% more money to spend on healthcare instead of corporate profits. That's not going to change the picture that much. And you're unlikely to arrive in a perfect world. You'll probably get a 10% more expensive system that's 9% more inefficient and has 0 profits.
  - Teever 2y ago
    Are you sure about this? I've proposed eliminating those jobs because they're bullshit jobs that have a net negative contribution to society because the American medical system is hopelessly inefficient and corrupt.[0] It is a curious thing watching people defend the undefendable. What makes you so confident in this system that so many Americans loathe and feel betrayed by? [0] https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_healthcare_spending.jpg https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_heal...
    - bpt3 2y ago
      Because (1) most Americans are satisfied with their healthcare and (2) the CBO doesn't think that a public option would decrease costs much if at all: https://www.cbo.gov/publication/57125 https://www.cbo.gov/publication/57125 In short, you're wrong.
  - dghlsakjg 2y ago
    Canada isn't hypothetical. It is very easy to compare costs and outcomes. I live in BC, Canada, and we don't have an entire industry built around claims processing, administration, etc. They still pay health care workers, but they don't have to have phone banks filled with people answering questions about claim denials. I'm not even sure if a claim denial is a thing here, or who I would call. We don't have healthcare insurance CEOs making 23mm per year. We don't have customer service reps, we don't have billing specialists in every medical practice, we don't have medical coding experts. These things kind of exist in a bare minimum way, but not anywhere at the scale that I have seen in the US. I go to the doctor, they make a medical determination about what my needs are, and we proceed from there. There is almost no fraud because the doctor has no real financial incentive to overtreat me, and since it is a single payer system, malicious patterns get picked up quickly and efficiently. Keep in mind that each province administers their own medical system, so there is no such thing as the Canadian health insurance system.
    - onlyrealcuzzo 2y ago
      > There is almost no fraud because the doctor has no real financial incentive to overtreat me The vast majority of healthcare fraud does not come from corrupt dentists convincing you to get root canals you don't need. The largest source is billing for services not rendered. That is: some provider just makes up that you came to see them and charges the insurance company and you don't even know about it. This is a non-trivial problem to solve. Even in the NHS in the UK - where the entire system, including the providers, are public - there is STILL a large billing for services not rendered problem!
      - Teever 2y ago
        It seems relatively trivial to crack down on the bulk of it by providing people open and transparent access to their digital medical records. In a situation like that many people can proactively look over their records to determine if such corruption is happening.
        onlyrealcuzzo 2y ago
- gruez 2y ago
  That's like arguing "there's no anarchy in the streets, why don't we get rid of cops?"
gosub100 2y ago
What is the purpose of a medical license then, if insurance can step in and deny the procedure? Who is right? I think dissolving insurance altogether is extreme (I agree but don't want to waste time on pie in the sky ideas). Why can't we start by removing insurances ability to deny anything from a licensed doctor? If doctors are padding their wallets or stealing, bring it up with the board of medical examiners or court just like any other malfeasance in any other regulated industry. If you are board-certified in X it means you are entrusted to do X. Insurance should never be involved.

Teever 2y ago

Is healthcare fraud 80% of the Canadian GDP?

onlyrealcuzzo 2y ago
No. You're still paying the same people the same wages to work for the government. Or is your solution that we should pay health insurance workers less money? You originally proposed eliminating all the jobs. Now you've moved all the jobs to the public sector. So unless you're paying them dirt, all that money is still going to people working to make sure healthcare fraud isn't 80% of GDP. In a perfect world, you have 6% more money to spend on healthcare instead of corporate profits. That's not going to change the picture that much. And you're unlikely to arrive in a perfect world. You'll probably get a 10% more expensive system that's 9% more inefficient and has 0 profits.
- Teever 2y ago
  Are you sure about this? I've proposed eliminating those jobs because they're bullshit jobs that have a net negative contribution to society because the American medical system is hopelessly inefficient and corrupt.[0] It is a curious thing watching people defend the undefendable. What makes you so confident in this system that so many Americans loathe and feel betrayed by? [0] https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_healthcare_spending.jpg https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_heal...
  - bpt3 2y ago
    Because (1) most Americans are satisfied with their healthcare and (2) the CBO doesn't think that a public option would decrease costs much if at all: https://www.cbo.gov/publication/57125 https://www.cbo.gov/publication/57125 In short, you're wrong.
- dghlsakjg 2y ago
  Canada isn't hypothetical. It is very easy to compare costs and outcomes. I live in BC, Canada, and we don't have an entire industry built around claims processing, administration, etc. They still pay health care workers, but they don't have to have phone banks filled with people answering questions about claim denials. I'm not even sure if a claim denial is a thing here, or who I would call. We don't have healthcare insurance CEOs making 23mm per year. We don't have customer service reps, we don't have billing specialists in every medical practice, we don't have medical coding experts. These things kind of exist in a bare minimum way, but not anywhere at the scale that I have seen in the US. I go to the doctor, they make a medical determination about what my needs are, and we proceed from there. There is almost no fraud because the doctor has no real financial incentive to overtreat me, and since it is a single payer system, malicious patterns get picked up quickly and efficiently. Keep in mind that each province administers their own medical system, so there is no such thing as the Canadian health insurance system.
  - onlyrealcuzzo 2y ago
    > There is almost no fraud because the doctor has no real financial incentive to overtreat me The vast majority of healthcare fraud does not come from corrupt dentists convincing you to get root canals you don't need. The largest source is billing for services not rendered. That is: some provider just makes up that you came to see them and charges the insurance company and you don't even know about it. This is a non-trivial problem to solve. Even in the NHS in the UK - where the entire system, including the providers, are public - there is STILL a large billing for services not rendered problem!
    - Teever 2y ago
      It seems relatively trivial to crack down on the bulk of it by providing people open and transparent access to their digital medical records. In a situation like that many people can proactively look over their records to determine if such corruption is happening.
      - onlyrealcuzzo 2y ago
gruez 2y ago
That's like arguing "there's no anarchy in the streets, why don't we get rid of cops?"

gosub100 2y ago

What is the purpose of a medical license then, if insurance can step in and deny the procedure? Who is right? I think dissolving insurance altogether is extreme (I agree but don't want to waste time on pie in the sky ideas). Why can't we start by removing insurances ability to deny anything from a licensed doctor? If doctors are padding their wallets or stealing, bring it up with the board of medical examiners or court just like any other malfeasance in any other regulated industry. If you are board-certified in X it means you are entrusted to do X. Insurance should never be involved.