8 ms·

I think the reason is that people know it is a problem but ideologically they really disagree about what to do about it. The impasse creates an opportunity for

I think the reason is that people know it is a problem but ideologically they really disagree about what to do about it. The impasse creates an opportunity for profit driven actors to fight reforms. Also, democracies do dumb things sometimes. See Brexit. But also, sometimes people from other countries-- I am thinking parts of Europe-- underestimate how well paid people in the US often are. They compare the averages, like the US only makes 20% more per household, why do they put up with this or that. But that comparison is for the whole country, so imagine if you were comparing all of Europe or China. I had a friend in Spain at a similar company as mine say, how can you put up with no safety net, etc. But I look at his company and every one at my company at any level gets paid 2-5x as much. So like these are less serious issues if you are paid an extra $1-200k/ year. It doesn't explain the inaction, but I believe it is why a lot of politically influential people don't care.

nkmnz 1y ago
> ideologically they really disagree about what to do about it I really don't understand this sentiment. It's not like the current state of the US insurance market were based on the principles of a free market. On the other hand, not coupling your health insurance to an employment contract that can be cancelled at will has nothing to do with socialism.
banku_brougham 1y ago
Wrong - sorry. The reason is that politically the US public is very skillfully managed from above via divide and conquer strategies and beaureaucratic techniques (i.e. identity politics, gerrymandering voting districts). The public polling is very clear about US citizen preferences, but US Govt policy is rarely aligned that way.
- tptacek 1y ago
  No, it's not clear at all: it's been tested in actual referenda and failed. What's actually happening is people don't intuitively grok the distinction between opinion polling, where questions are asked in the abstract (and often in the best light preferred by the org sponsoring the poll) versus actual voting, where the questions are very specific and include details like "your taxes will increase by X%" or "you will lose access to your current insurance plan".
selfmodruntime 1y ago
In fact, US Americans are paid so well, the GDP per capita of the poorest state (Missisipi) is about the GDP per capita of France. In fact, the gross average wage of Missisipi is just barely lower than the average salary in Germany. Americans are paid really, really well.
tverbeure 1y ago
I think you are underestimating the number of Americans who make less than what Europeans make. In both systems, the upper X% can afford it. But it makes no sense to focus on that. What matters is how many don’t have access. That number is much larger percentage-wise here than in Europe. And it will only increase the way things are going.
- georgeecollins 1y ago
  Probably true. But if you think about who votes, professionals and home owners have much higher participation rates. I am not saying this is good.
testing22321 1y ago
You could offer me 10x my current salary and I wouldn’t take it if it meant I had to stress and be terrified about the life of my 6 year old daighter because a company wants to make more money. That is the definition of not worth it.
keybored 1y ago
A Princeton study showed over a decade ago that the policy preferences of the vast majority of Americans have no correlation with actual policies. That you put forth these completely detached theories is quite impressive. I don’t know if this a case of ideological delusion to go along with political impotence or just the usual upper middle class playing their part in obfuscating the on-the-ground realities. Structurally the latter is more likely.
danpalmer 1y ago
As with many things, in the US if you're part of the privileged minority you do well. The top 10% of earners in the US earn a lot more than the top 10% in Europe – that covers tech, high end knowledge work, that sort of stuff. But the bottom 90% do badly. Society is very divided, and most people lack social mobility, they lack a voice on the national and international stage, they lack the security that either a social safety net or high pay would give them. The UK is similar, although much less pronounced. I moved to Australia about 18 months ago and society here is much flatter, the difference between the top 10% and bottom 10% is much less. There are still problems here, it's not a utopia, but it's very noticeable how most people are struggling less, and how the top 10% of earners aren't living that different a life.
tptacek 1y ago
Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. So when you're talking about how bad the American system is, you're really talking about a minority of its users. That doesn't make everything OK, but does highlight the political difficulty of enacting seemingly-popular changes.
- wing-_-nuts 1y ago
  >the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. If you had said the median tech worker? I might have believed you, but the median family? No way.
  - tptacek 1y ago
    The median family of 4 with private health insurance has a household income of around $115k not counting the gross cost of their employer-provided health care. Remember: being on private insurance puts you in a cohort that: * Excludes everybody on Medicaid * Excludes fixed-income seniors on Medicare * Makes it overwhelmingly likely you have subsidized employer-covered health insurance. Figure your employer "covers" half the gross cost of your $24k/yr health insurance (they aren't, really: that's money they'd be paying you directly without the distortion of employer-provided health care). Do the take-home pay math. Put them in, like, Ohio, or Iowa, or Colorado; just not SFBA or NYC. Now move that same family to Manchester, take the wage hit for moving to the UK labor market, and work out the take-home pay. They'll of course pay $0 for the NHS. Are they better off or worse off? I'm not valorizing the arrangement, I'm making a point about how political tractable changing it is.
    - linehedonist 1y ago
      You’re moving the goalposts. How many families have private insurance? Considering both families with and without private insurance, is the median family better off in the US?
throwaway0123_5 1y ago
> So like these are less serious issues if you are paid an extra $1-200k/ year Ok but to be fair most people in the US aren't making "extra $1-200k / year" over a person in Europe. They aren't even making $100k / year to begin with.
- mothballed 1y ago
  Almost 40% of the USA is on medicare, medicaid, or entitled to VA benefits or military healthcare. It's only a narrow majority that depends on unsubsidized private healthcare, and those people skew in the upper income levels.
  - yieldcrv 1y ago
    And while European countries have various forms of nationalized welfare, their salaries are so low that they would be automatically eligible for the US' welfare too! our blocs aren't that different except in the US middle class and upper middle class
  - deleted 1y ago
    [deleted]
  - nosianu 1y ago
    So what about this? It is a question, not meant as a counter. Although I have to say the rosy picture some paint here about the high incomes is counter to anything I ever heard - and saw, although I left the US in the early 2000s, after having lived there for almost a decade (still mostly paid from Germany, never ready to make a complete move). "Medical Bankruptcies by Country 2025" https://worldpopulationreview.com/country-rankings/medical-bankruptcies-by-country https://worldpopulationreview.com/country-rankings/medical-b... "Healthcare Insights: How Medical Debt Is Crushing 100 Million Americans" https://www.ilr.cornell.edu/scheinman-institute/blog/john-august-healthcare/healthcare-insights-how-medical-debt-crushing-100-million-americans https://www.ilr.cornell.edu/scheinman-institute/blog/john-au... By the way, Europeans don't quite all have a "nationalized healthcare system". Germany, for example, has "Krankenkassen" but also private insurance, and the "Krankenkassen" are private organizations. We pay health insurance and get to choose the provider, those with higher incomes can switch to complete private insurance. We also have lots of our own problems and increasing costs because of immigration but more so aging population. However, I personally know several people who had severe illnesses for a long time, and their normal "Krankenkassen" insurance never made any problems. One person with plenty of money, whose wife was dying, even asked US medical experts if he should come to the US with her, and those US experts said he should stay where he is, the German univ3ersity hospital right next door had some of the leading therapies in the field. She lived five more years instead of dying after less than half a year with the standard therapy, every single expense paid for with the standard insurance, additional private insurance unnecessary. Similar with my stepfather, who had soooo many severe conditions, and yet every single item down to the special medical bed brought into our house so that he could finally die at home was paid without question. The problems are with more mundane expenses, e.g. glasses, or the dentist, where only some of the treatments are covered. The really expensive illnesses seem to be better covered than the more common and much simpler problems.
egorfine 1y ago
> they really disagree about what to do about it What is there to disagree with? Are there any option other than introduction of universal healthcare?
- epistasis 1y ago
  Universal healthcare is a very different thing from controlling costs. Obamacare attempted to make the US healthcare system into a universal system by mandating that people purchase coverage, heavily subsidized to become affordable to every income level, in addition to massive expansion of Medicaid to those with the lowest levels of income or no income at all. Automatic enrollment in health insurance exchanges, even if people did not make their own choices on the health insurance exchanges, is what would make the US system universal health care. Universal means that everyone has coverage, that the question to the patient is "what insurance plan are you on," rather than "do you have insurance." And making coverage universal has no connection to lowering costs. We need larger structural changes in the logistics of how care is delivered and how the money flows. Single payer is another choice to be made, but that doesn't necessarily mean that health insurance is cheap, that all the care gets delivered that people want delivered, etc. Medicare is often cited as one direction for this, but most don't realize that private health insurance costs are partially high because they help subsidize the care of those who are covered by Medicare, because Medicare reimbursement rates are far lower than any of the private insurers have been able to negotiate. Other routes are full decoupling of insurance from employment, full price controls that normalize Medicare and private insurance rates, which either make health care more free market or less free market depending on how you define those terms. However every year that passes makes any of these reforms more difficult because administration of the costs and billing is getting more complex each year. ICD codes, PLA codes, all that stuff grows in complexity. HMOs, like Kaiser, may provide a route towards greater simplicity of administration of health and costs. But implementing any large change will require political buy-in of people, and when we have our current low-trust, high-misinformation political system there's been no way to make any political traction for changing anything. Until we regain a functional democracy or turn to full dictatorship, it seems unlikely that we will see structural changes that improve anything. Hell, we had Republican states actively trying to prevent poor people from receiving coverage from federal dollars. How can we ever come to terms with a change unless that sort of attitude no longer has traction?
kwanbix 1y ago
As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. If you are sick you are sick, either the company or the health insurance pay. You have between 20 and 30 days of paid holidays. This is why quality of life in Europe, is so superior. And again, I am saying this as a non-European.
- arwhatever 1y ago
  Perennial “What Armenians should know about life in America (2014)” from days of HN past https://news.ycombinator.com/item?id=22777745 https://news.ycombinator.com/item?id=22777745 And which today must be read via internet archive https://web.archive.org/web/20200404172130/https://likewise.am/2014/12/26/what-armenians-should-know-about-life-in-america/ https://web.archive.org/web/20200404172130/https://likewise.... Basically explaining to Armenians at home why their relatives who moved to America don’t send better remittances back home despite their $X pay rate. Here’s why …
- selfmodruntime 1y ago
  > University was cheap or free Ha! I wish. It's not free. You will pay the same that Americans pay for Uni over your life many times over since tax rates in the EU are really high. Healthcare isn't exactly cheap either. And everything you wrote is just the result of decades of prosperity that are now coming to an end. This will be a shock for many.
- stronglikedan 1y ago
  > This is why quality of life in Europe, is so superior. That's very subjective, and I would rather have my freedoms instead of your/their liberties, thanks!
  - vecinu 1y ago
    [flagged]
nawgz 1y ago
> people know it is a problem but ideologically they really disagree about what to do about it Can we really say this is true about individuals in the US? I think it's pretty clear the propaganda machine has successfully privatized health care to the great detriment of the populace and have the clamps on it. After all, if you told everyone you had a solution where insurance rates would be cheaper, their healthcare system would cost less overall, and the health outcomes would be superior, they would all be like "sounds great". Then, when you reveal this solution is the complete destruction of the insurance "industry", insurance payments are "tax", and the health provider is the government, they would balk, scream about socialized healthcare, and say how they don't trust the government. That's a trained response, not a real thought.
epistasis 1y ago
Oddly enough the big rhetorical push against a universal system from prior decades was about "death panels" deciding what care somebody would get. And guess what's happened with insurance? Death panels! The propaganda spin on the health care system in the US has been on overdrive ever since Hillary Clinton wanted to implement some reforms in the 1990s, leading to absolutely massive resistance to any change whatsoever. Even the changes implemented by Obama, which were a HUGE improvement in access, barely made it across the legislative line, and dismantling that access to the health care system has been a huge rallying cry for one of the major political parties. I won't say which one because mentioning that fact results in people turning off their brains and downvoting. The US healthcare has optimized for availability and higher access to the most treatment options. This does not mean evenly distributed treatment options, but that people have the chance to get access to things more quickly. And for most people, the healthcare system works fairly great. There are exceptions, like the denial described in this thread, and they usually get lots of attention because holy hell is that a messed up situation. But the everyday care that most people get is better than adequate.
- xnx 1y ago
  Like Ticketmaster, health insurance companies get paid to be the "bad guys". This is a reasonable function since Americans can't seem to understand that someone must decide where limited resources go. However, there's no reason their cut should be so large.
  - epistasis 1y ago
    Health insurance companies have had their profits capped at a percentage of revenues. That means that to grow profits, they must increase revenue. Which means incentives to increase care and increase costs. Oddly enough, all the plots I have seen of cost increases don't show a massive skyrocketing of costs since the profit caps were introduced. If anything, they have been somewhat reduced. However a reckoning must happen at some point, health care can not consume the entire economy's efforts.
  - tptacek 1y ago
    Their cut is in fact very small; it's around 6.5% of total US health care spending. https://nationalhealthspending.org/ https://nationalhealthspending.org/

nkmnz 1y ago

> ideologically they really disagree about what to do about it I really don't understand this sentiment. It's not like the current state of the US insurance market were based on the principles of a free market. On the other hand, not coupling your health insurance to an employment contract that can be cancelled at will has nothing to do with socialism.

banku_brougham 1y ago

Wrong - sorry. The reason is that politically the US public is very skillfully managed from above via divide and conquer strategies and beaureaucratic techniques (i.e. identity politics, gerrymandering voting districts). The public polling is very clear about US citizen preferences, but US Govt policy is rarely aligned that way.

tptacek 1y ago
No, it's not clear at all: it's been tested in actual referenda and failed. What's actually happening is people don't intuitively grok the distinction between opinion polling, where questions are asked in the abstract (and often in the best light preferred by the org sponsoring the poll) versus actual voting, where the questions are very specific and include details like "your taxes will increase by X%" or "you will lose access to your current insurance plan".

selfmodruntime 1y ago

In fact, US Americans are paid so well, the GDP per capita of the poorest state (Missisipi) is about the GDP per capita of France. In fact, the gross average wage of Missisipi is just barely lower than the average salary in Germany. Americans are paid really, really well.

tverbeure 1y ago

I think you are underestimating the number of Americans who make less than what Europeans make. In both systems, the upper X% can afford it. But it makes no sense to focus on that. What matters is how many don’t have access. That number is much larger percentage-wise here than in Europe. And it will only increase the way things are going.

georgeecollins 1y ago
Probably true. But if you think about who votes, professionals and home owners have much higher participation rates. I am not saying this is good.

testing22321 1y ago

You could offer me 10x my current salary and I wouldn’t take it if it meant I had to stress and be terrified about the life of my 6 year old daighter because a company wants to make more money. That is the definition of not worth it.

keybored 1y ago

A Princeton study showed over a decade ago that the policy preferences of the vast majority of Americans have no correlation with actual policies. That you put forth these completely detached theories is quite impressive. I don’t know if this a case of ideological delusion to go along with political impotence or just the usual upper middle class playing their part in obfuscating the on-the-ground realities. Structurally the latter is more likely.

danpalmer 1y ago

As with many things, in the US if you're part of the privileged minority you do well. The top 10% of earners in the US earn a lot more than the top 10% in Europe – that covers tech, high end knowledge work, that sort of stuff. But the bottom 90% do badly. Society is very divided, and most people lack social mobility, they lack a voice on the national and international stage, they lack the security that either a social safety net or high pay would give them. The UK is similar, although much less pronounced. I moved to Australia about 18 months ago and society here is much flatter, the difference between the top 10% and bottom 10% is much less. There are still problems here, it's not a utopia, but it's very noticeable how most people are struggling less, and how the top 10% of earners aren't living that different a life.

tptacek 1y ago

Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. So when you're talking about how bad the American system is, you're really talking about a minority of its users. That doesn't make everything OK, but does highlight the political difficulty of enacting seemingly-popular changes.

wing-_-nuts 1y ago
>the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. If you had said the median tech worker? I might have believed you, but the median family? No way.
- tptacek 1y ago
  The median family of 4 with private health insurance has a household income of around $115k not counting the gross cost of their employer-provided health care. Remember: being on private insurance puts you in a cohort that: * Excludes everybody on Medicaid * Excludes fixed-income seniors on Medicare * Makes it overwhelmingly likely you have subsidized employer-covered health insurance. Figure your employer "covers" half the gross cost of your $24k/yr health insurance (they aren't, really: that's money they'd be paying you directly without the distortion of employer-provided health care). Do the take-home pay math. Put them in, like, Ohio, or Iowa, or Colorado; just not SFBA or NYC. Now move that same family to Manchester, take the wage hit for moving to the UK labor market, and work out the take-home pay. They'll of course pay $0 for the NHS. Are they better off or worse off? I'm not valorizing the arrangement, I'm making a point about how political tractable changing it is.
  - linehedonist 1y ago
    You’re moving the goalposts. How many families have private insurance? Considering both families with and without private insurance, is the median family better off in the US?

throwaway0123_5 1y ago

> So like these are less serious issues if you are paid an extra $1-200k/ year Ok but to be fair most people in the US aren't making "extra $1-200k / year" over a person in Europe. They aren't even making $100k / year to begin with.

mothballed 1y ago
Almost 40% of the USA is on medicare, medicaid, or entitled to VA benefits or military healthcare. It's only a narrow majority that depends on unsubsidized private healthcare, and those people skew in the upper income levels.
- yieldcrv 1y ago
  And while European countries have various forms of nationalized welfare, their salaries are so low that they would be automatically eligible for the US' welfare too! our blocs aren't that different except in the US middle class and upper middle class
- deleted 1y ago
  [deleted]
- nosianu 1y ago
  So what about this? It is a question, not meant as a counter. Although I have to say the rosy picture some paint here about the high incomes is counter to anything I ever heard - and saw, although I left the US in the early 2000s, after having lived there for almost a decade (still mostly paid from Germany, never ready to make a complete move). "Medical Bankruptcies by Country 2025" https://worldpopulationreview.com/country-rankings/medical-bankruptcies-by-country https://worldpopulationreview.com/country-rankings/medical-b... "Healthcare Insights: How Medical Debt Is Crushing 100 Million Americans" https://www.ilr.cornell.edu/scheinman-institute/blog/john-august-healthcare/healthcare-insights-how-medical-debt-crushing-100-million-americans https://www.ilr.cornell.edu/scheinman-institute/blog/john-au... By the way, Europeans don't quite all have a "nationalized healthcare system". Germany, for example, has "Krankenkassen" but also private insurance, and the "Krankenkassen" are private organizations. We pay health insurance and get to choose the provider, those with higher incomes can switch to complete private insurance. We also have lots of our own problems and increasing costs because of immigration but more so aging population. However, I personally know several people who had severe illnesses for a long time, and their normal "Krankenkassen" insurance never made any problems. One person with plenty of money, whose wife was dying, even asked US medical experts if he should come to the US with her, and those US experts said he should stay where he is, the German univ3ersity hospital right next door had some of the leading therapies in the field. She lived five more years instead of dying after less than half a year with the standard therapy, every single expense paid for with the standard insurance, additional private insurance unnecessary. Similar with my stepfather, who had soooo many severe conditions, and yet every single item down to the special medical bed brought into our house so that he could finally die at home was paid without question. The problems are with more mundane expenses, e.g. glasses, or the dentist, where only some of the treatments are covered. The really expensive illnesses seem to be better covered than the more common and much simpler problems.

egorfine 1y ago

> they really disagree about what to do about it What is there to disagree with? Are there any option other than introduction of universal healthcare?

epistasis 1y ago
Universal healthcare is a very different thing from controlling costs. Obamacare attempted to make the US healthcare system into a universal system by mandating that people purchase coverage, heavily subsidized to become affordable to every income level, in addition to massive expansion of Medicaid to those with the lowest levels of income or no income at all. Automatic enrollment in health insurance exchanges, even if people did not make their own choices on the health insurance exchanges, is what would make the US system universal health care. Universal means that everyone has coverage, that the question to the patient is "what insurance plan are you on," rather than "do you have insurance." And making coverage universal has no connection to lowering costs. We need larger structural changes in the logistics of how care is delivered and how the money flows. Single payer is another choice to be made, but that doesn't necessarily mean that health insurance is cheap, that all the care gets delivered that people want delivered, etc. Medicare is often cited as one direction for this, but most don't realize that private health insurance costs are partially high because they help subsidize the care of those who are covered by Medicare, because Medicare reimbursement rates are far lower than any of the private insurers have been able to negotiate. Other routes are full decoupling of insurance from employment, full price controls that normalize Medicare and private insurance rates, which either make health care more free market or less free market depending on how you define those terms. However every year that passes makes any of these reforms more difficult because administration of the costs and billing is getting more complex each year. ICD codes, PLA codes, all that stuff grows in complexity. HMOs, like Kaiser, may provide a route towards greater simplicity of administration of health and costs. But implementing any large change will require political buy-in of people, and when we have our current low-trust, high-misinformation political system there's been no way to make any political traction for changing anything. Until we regain a functional democracy or turn to full dictatorship, it seems unlikely that we will see structural changes that improve anything. Hell, we had Republican states actively trying to prevent poor people from receiving coverage from federal dollars. How can we ever come to terms with a change unless that sort of attitude no longer has traction?

kwanbix 1y ago

As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. If you are sick you are sick, either the company or the health insurance pay. You have between 20 and 30 days of paid holidays. This is why quality of life in Europe, is so superior. And again, I am saying this as a non-European.

arwhatever 1y ago
Perennial “What Armenians should know about life in America (2014)” from days of HN past https://news.ycombinator.com/item?id=22777745 https://news.ycombinator.com/item?id=22777745 And which today must be read via internet archive https://web.archive.org/web/20200404172130/https://likewise.am/2014/12/26/what-armenians-should-know-about-life-in-america/ https://web.archive.org/web/20200404172130/https://likewise.... Basically explaining to Armenians at home why their relatives who moved to America don’t send better remittances back home despite their $X pay rate. Here’s why …
selfmodruntime 1y ago
> University was cheap or free Ha! I wish. It's not free. You will pay the same that Americans pay for Uni over your life many times over since tax rates in the EU are really high. Healthcare isn't exactly cheap either. And everything you wrote is just the result of decades of prosperity that are now coming to an end. This will be a shock for many.
stronglikedan 1y ago
> This is why quality of life in Europe, is so superior. That's very subjective, and I would rather have my freedoms instead of your/their liberties, thanks!
- vecinu 1y ago
  [flagged]

nawgz 1y ago

> people know it is a problem but ideologically they really disagree about what to do about it Can we really say this is true about individuals in the US? I think it's pretty clear the propaganda machine has successfully privatized health care to the great detriment of the populace and have the clamps on it. After all, if you told everyone you had a solution where insurance rates would be cheaper, their healthcare system would cost less overall, and the health outcomes would be superior, they would all be like "sounds great". Then, when you reveal this solution is the complete destruction of the insurance "industry", insurance payments are "tax", and the health provider is the government, they would balk, scream about socialized healthcare, and say how they don't trust the government. That's a trained response, not a real thought.

epistasis 1y ago

Oddly enough the big rhetorical push against a universal system from prior decades was about "death panels" deciding what care somebody would get. And guess what's happened with insurance? Death panels! The propaganda spin on the health care system in the US has been on overdrive ever since Hillary Clinton wanted to implement some reforms in the 1990s, leading to absolutely massive resistance to any change whatsoever. Even the changes implemented by Obama, which were a HUGE improvement in access, barely made it across the legislative line, and dismantling that access to the health care system has been a huge rallying cry for one of the major political parties. I won't say which one because mentioning that fact results in people turning off their brains and downvoting. The US healthcare has optimized for availability and higher access to the most treatment options. This does not mean evenly distributed treatment options, but that people have the chance to get access to things more quickly. And for most people, the healthcare system works fairly great. There are exceptions, like the denial described in this thread, and they usually get lots of attention because holy hell is that a messed up situation. But the everyday care that most people get is better than adequate.

xnx 1y ago
Like Ticketmaster, health insurance companies get paid to be the "bad guys". This is a reasonable function since Americans can't seem to understand that someone must decide where limited resources go. However, there's no reason their cut should be so large.
- epistasis 1y ago
  Health insurance companies have had their profits capped at a percentage of revenues. That means that to grow profits, they must increase revenue. Which means incentives to increase care and increase costs. Oddly enough, all the plots I have seen of cost increases don't show a massive skyrocketing of costs since the profit caps were introduced. If anything, they have been somewhat reduced. However a reckoning must happen at some point, health care can not consume the entire economy's efforts.
- tptacek 1y ago
  Their cut is in fact very small; it's around 6.5% of total US health care spending. https://nationalhealthspending.org/ https://nationalhealthspending.org/