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Stop having employer provided insurance and make health insurance like buying car insurance ("free market") or do single payer ("communism"). The current statu

Stop having employer provided insurance and make health insurance like buying car insurance ("free market") or do single payer ("communism"). The current status quo of insurance cartels is terrible for everyone involved--employers/employees get fleeced, providers get stiffed, and America gets more unhealthy.

like_any_other 2y ago
There are plenty of good healthcare systems, and they can be identified by looking at other countries and copying what works. That's not the problem. The problem is how to get there.
HumblyTossed 2y ago
This!! We will never have any form of HC reform as long as it's tied to employment.
- Spooky23 2y ago
  Yes. Health insurers are partially hired villains to take blame and ire. My employer has a multi-vendor plan that is mostly UHC. They even have specialist cancer care that will pay in full for just about everything, including travel and food. We have almost none of the issues that you hear about insurance nightmares. That's because they negotiated and paid for such a plan. My sister works for a similar large employer. They hired Cigna as the insurer/benefits administrator, and every interaction is a problem. Your two kids have an ear infection? Cool, we've determined that the second one is due to an auto accident. It's so bad that the company hired another company to argue with Cigna for you. End of the day, the employer controls the purse, and the insurer is doing what the employer paid for. It's cheaper to hire another company to argue for the folks who have noticed problems than to pay for a level of service.
alistairSH 2y ago
I agree but I don’t see a way to get there… Why would the donor class want that? They’d rather have medical insurance as a limit on job mobility for us peons.
burkaman 2y ago
> make health insurance like buying car insurance ("free market") This option doesn't work because healthcare can't be a free market. Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible.
- zeroonetwothree 2y ago
  (a) in most of the US not owning a car isn’t an option (b) if we had a reasonable market then some people could have an alternative like paying out of pocket
- SoftTalker 2y ago
  But things like deductibles and covered treatments are negotiable. The majority of health care is not “you will die without this specific treatment” there are usually options.
- gruez 2y ago
  >Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible. US healthcare has to compete against cheap healthcare in mexico or whatever
- franktankbank 2y ago
  Its the doctors who need to compete and fucking advertise 1 single price. We need a market first, not random ass prices based on some n-dimensional rubric which oh we don't actually follow anyway that was just there to confuse you. Now go sit on hold for a part-time job shitface.
- ndriscoll 2y ago
  This is nonsense that continues the status quo. We were recently trying to understand our options for something time-sensitive, and no one could tell us with any certainty it would cost $2k or $20k if insurance denied it. We were fully willing to pay thousands out of pocket (the price insurance apparently usually pays after "negotiations"), but couldn't get any assurance about the cost or even whether they could correctly bill just this one procedure at their out-of-pocket rate (and what that might be) when everything else was with insurance. It's not like we were the first to ever get it done. The system is just full of blatant unmitigated racketeering. A good first step would be banning price discrimination for medical procedures. Right now you get three different prices for "I pay", "insurance pays", and "insurance denies and I pay". People can't tell you what those prices will be. The whole point of insurance is supposed to be to derisk these kinds of decisions, not increase uncertainty and risk. Attempting to use insurance and getting denied can 10x your cost, so what is the purpose of the insurance?
mjevans 2y ago
Almost. Stop having employer provided insurance / benefits; just tax and then provide services. No more billing department. Just single payer (we the people) get what a patient needs healthcare.
- gsibble 2y ago
  [flagged]
  - TheDong 2y ago
    Let me give a small anecdotal story of american wait times. My doctor wanted to give me an MRI for a pain near the heart, and insurance told them they wouldn't cover it until they did various other forms of cheaper treatment, including taking antacids for one month, and 5 months of physical therapy. Which of course didn't work. The waiting time for the first appointment was 3 months. It took over 9 months for my doctor, the only person to actually properly know the details of my case, to be able to give an MRI that he thought was necessary because someone at the insurance company, who I never met, who had less medical expertise than my doctor, wanted to save the insurance company money. Anecdotally, all the people I know who live in countries with socialized medicine haven't ever had a wait time as long as that, and haven't ever had a simple MRI be delayed by their socialized insurance.
    - gafferongames 2y ago
      I grew up in Australia. You need an MRI your doctor simply refers you, you hand your medicare card over, and you get that MRI. No private health insurance is involved at any point. Australia has a combination of public and private health insurance, and they both work well together. The public health options provide the safety net, while the private health insurance is optional. Where the private option makes sense is if you want to go to specific private hospitals, or if you have elective surgery (the classic example being a knee reconstruction for sports injury) and you don't want to be in a queue behind people waiting for public hospital beds for more serious conditions like heart surgery and so on. My dad in Australia had open heart surgery 2 years ago, and is doing very well. His cost for the entire procedure? $0 and this was done by one of the very best heart surgeons in the country. He has private health insurance, but elects to go to public hospitals, which have excellent surgeons committed to the best care, because he's a patriotic sort and he's paid into the public health system through taxes for his entire life. Meanwhile I pay > $3k per-month for not even top tier care in Upstate New York for myself, my wife and my 10 year old daughter, with no serious pre-existing conditions, and I have absolutely no guarantee that any surgery or anything that any of us need in the future will be even covered, even if my primary physician says it's medically necessary. The rest of the world would do well to study how the combination of public and private health insurance is done in Australia.
aaomidi 2y ago
IMO at the very least we should have free catastrophic coverage covered by taxes. Otherwise we end up paying more anyway. Someone needs to bail out hospitals.
- gafferongames 2y ago
  This is exactly what is done in Australia. Medicare for all. Private health insurance optional on top of this for non-catastrophic care.
yardie 2y ago
Single payer isn’t communism because there is no payment. In communist healthcare The government owns every aspect of the market, healthcare providers are employees. Single payer the provider is free to open a practice just and send the bill to the government. It’s not quite elastic as free market since government doesn’t negotiate based on demand.

like_any_other 2y ago

There are plenty of good healthcare systems, and they can be identified by looking at other countries and copying what works. That's not the problem. The problem is how to get there.

HumblyTossed 2y ago

This!! We will never have any form of HC reform as long as it's tied to employment.

Spooky23 2y ago
Yes. Health insurers are partially hired villains to take blame and ire. My employer has a multi-vendor plan that is mostly UHC. They even have specialist cancer care that will pay in full for just about everything, including travel and food. We have almost none of the issues that you hear about insurance nightmares. That's because they negotiated and paid for such a plan. My sister works for a similar large employer. They hired Cigna as the insurer/benefits administrator, and every interaction is a problem. Your two kids have an ear infection? Cool, we've determined that the second one is due to an auto accident. It's so bad that the company hired another company to argue with Cigna for you. End of the day, the employer controls the purse, and the insurer is doing what the employer paid for. It's cheaper to hire another company to argue for the folks who have noticed problems than to pay for a level of service.

alistairSH 2y ago

I agree but I don’t see a way to get there… Why would the donor class want that? They’d rather have medical insurance as a limit on job mobility for us peons.

burkaman 2y ago

> make health insurance like buying car insurance ("free market") This option doesn't work because healthcare can't be a free market. Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible.

zeroonetwothree 2y ago
(a) in most of the US not owning a car isn’t an option (b) if we had a reasonable market then some people could have an alternative like paying out of pocket
SoftTalker 2y ago
But things like deductibles and covered treatments are negotiable. The majority of health care is not “you will die without this specific treatment” there are usually options.
gruez 2y ago
>Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible. US healthcare has to compete against cheap healthcare in mexico or whatever
franktankbank 2y ago
Its the doctors who need to compete and fucking advertise 1 single price. We need a market first, not random ass prices based on some n-dimensional rubric which oh we don't actually follow anyway that was just there to confuse you. Now go sit on hold for a part-time job shitface.
ndriscoll 2y ago
This is nonsense that continues the status quo. We were recently trying to understand our options for something time-sensitive, and no one could tell us with any certainty it would cost $2k or $20k if insurance denied it. We were fully willing to pay thousands out of pocket (the price insurance apparently usually pays after "negotiations"), but couldn't get any assurance about the cost or even whether they could correctly bill just this one procedure at their out-of-pocket rate (and what that might be) when everything else was with insurance. It's not like we were the first to ever get it done. The system is just full of blatant unmitigated racketeering. A good first step would be banning price discrimination for medical procedures. Right now you get three different prices for "I pay", "insurance pays", and "insurance denies and I pay". People can't tell you what those prices will be. The whole point of insurance is supposed to be to derisk these kinds of decisions, not increase uncertainty and risk. Attempting to use insurance and getting denied can 10x your cost, so what is the purpose of the insurance?

mjevans 2y ago

Almost. Stop having employer provided insurance / benefits; just tax and then provide services. No more billing department. Just single payer (we the people) get what a patient needs healthcare.

gsibble 2y ago
[flagged]
- TheDong 2y ago
  Let me give a small anecdotal story of american wait times. My doctor wanted to give me an MRI for a pain near the heart, and insurance told them they wouldn't cover it until they did various other forms of cheaper treatment, including taking antacids for one month, and 5 months of physical therapy. Which of course didn't work. The waiting time for the first appointment was 3 months. It took over 9 months for my doctor, the only person to actually properly know the details of my case, to be able to give an MRI that he thought was necessary because someone at the insurance company, who I never met, who had less medical expertise than my doctor, wanted to save the insurance company money. Anecdotally, all the people I know who live in countries with socialized medicine haven't ever had a wait time as long as that, and haven't ever had a simple MRI be delayed by their socialized insurance.
  - gafferongames 2y ago
    I grew up in Australia. You need an MRI your doctor simply refers you, you hand your medicare card over, and you get that MRI. No private health insurance is involved at any point. Australia has a combination of public and private health insurance, and they both work well together. The public health options provide the safety net, while the private health insurance is optional. Where the private option makes sense is if you want to go to specific private hospitals, or if you have elective surgery (the classic example being a knee reconstruction for sports injury) and you don't want to be in a queue behind people waiting for public hospital beds for more serious conditions like heart surgery and so on. My dad in Australia had open heart surgery 2 years ago, and is doing very well. His cost for the entire procedure? $0 and this was done by one of the very best heart surgeons in the country. He has private health insurance, but elects to go to public hospitals, which have excellent surgeons committed to the best care, because he's a patriotic sort and he's paid into the public health system through taxes for his entire life. Meanwhile I pay > $3k per-month for not even top tier care in Upstate New York for myself, my wife and my 10 year old daughter, with no serious pre-existing conditions, and I have absolutely no guarantee that any surgery or anything that any of us need in the future will be even covered, even if my primary physician says it's medically necessary. The rest of the world would do well to study how the combination of public and private health insurance is done in Australia.

aaomidi 2y ago

IMO at the very least we should have free catastrophic coverage covered by taxes. Otherwise we end up paying more anyway. Someone needs to bail out hospitals.

gafferongames 2y ago
This is exactly what is done in Australia. Medicare for all. Private health insurance optional on top of this for non-catastrophic care.

yardie 2y ago

Single payer isn’t communism because there is no payment. In communist healthcare The government owns every aspect of the market, healthcare providers are employees. Single payer the provider is free to open a practice just and send the bill to the government. It’s not quite elastic as free market since government doesn’t negotiate based on demand.