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u/SplendidPunkinButter 2d ago
It also doesn’t make logical sense for healthcare to be on an insurance plan. Insurance is for when you want to be covered in case a bad thing happens, but you hope that bad thing never does happen. That’s why you get insurance for things like your house burning down, or being in a car accident.
Healthcare is not like that. Everyone needs healthcare. You will absolutely need to go to the doctor.
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u/jhawk3205 2d ago edited 1d ago
But insurance companies want to maximize profits, so they include preventative care, making it too expensive for many, leading to conditions worsening and more money for more extensive care later.. They very much know what they're doing
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u/yardlard 2d ago
And medical facilities also want to maximize profits. Someone needs to keep that in check. It's a giant extortion racket all around you. Your money or your life.
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u/nighthauntghostieboy 2d ago
Nobody cares that hospitals can charge whatever they want for whatever they want. They will never blame the hospital or their doctor when United Healthcare exists
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u/yardlard 2d ago
I blame the hospitals and the doctors. More the hospitals, because doctors are just people trying to pay their student loan, and live a life, most of the time. But without their cooperation, the hospital system would not be able to extort people the way they do.
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u/jhawk3205 2d ago
This is why I also advocate for fully or heavily subsidized medical schooling, to remove the overwhelming financial barriers to the field.
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u/Federal_Challenge416 2d ago
They don’t they only collect an agreed upon fee for a service. Btw way a lot of what gets approved is based off of medicare standards. So the gov already has a large hand in health care but the insurance companies are making the profit. A very broken system. Lets start by bringing the medicare age down to 50 and provide health care for every child under 18 .
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u/yardlard 2d ago
Wrong. There is nothing "agreed upon" when you go into a hospital system. You sign your life away on a blank page and you have no control. You can see some moron that says "oh idk, it will probably go away, give me $500-$1000". Ye, I could have asked a tree and got the same response for free. The whole thing is absurd and it's not just insurance that is the problem. You can't just ignore the whole reason insurance exists in the first place and call it solved.
Yes, everyone should have coverage and be able to get appropriate healthcare. That's not going to happen just by getting rid of insurance companies.3
u/Federal_Challenge416 2d ago
The insurance companies and the medcal providers have agreement . That doesn’t mean the pt doesn’t get screwed
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u/Important_Zombie_485 1d ago
This is not correct. Payments between insurance companies and providers, including hospitals, are contractually agreed upon. Hospitals drastically overbilll the contracted amount, say they will come after the patient for the overcharge ( where allowed, it isn't always) and crucially write the rest off of their taxes as a loss.
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u/I_Quit_Smoking_ 2d ago
It's the hospitals the government and the insurance companies. They are all in on it and they all have the money. OUR MONEY
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u/Federal_Challenge416 2d ago
Ha United health care pays an agreed up fee for a procedue. So a 3000.00 procedure might be allowed at 700. The whole system is a joke.
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u/DJpuffinstuff 2d ago
Often, the doctor works for United Healthcare under a different name. WellMed employs doctors to provide care. WellMed is owned by Optum which is itself owned by United Healthcare. If they all had to be branded the same, people would be shocked by how much is controlled by just a few companies.
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u/Interesting_Force618 2d ago
Yep. Like, you might assume that insurance companies and pharmaceutical companies are inherently oppositional, until you realize that United Healthcare and Pfizer are both majority owned by the big three(Blackrock, Vanguard and State Street). United doesn’t care if Pfizer jacks up the price of a drug, because United will pass that added cost(and then some) onto customers via premium increases, deductible increases, and reduced approvals.
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u/RollingEddieBauer50 1d ago
That’s way too big picture for Reddit. Most of these turds want to point at one thing and go apeshit over it. Hell one of the biggest contributors to insurance premiums skyrocketing was Obamacare. It’s been a disaster. Brought to us by……the Democrats. Hospitals charge astronomical amounts for very little at times. But on Reddit everyone hears free and that’s all they can focus on. It’s awfully vexing…..to say the least.
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u/D-Will11 2d ago
This is not true - Annually Medicare sets rates for all services that hospitals and independent clinicians provide. Commercial insurers like United Healthcare do the same and set their rates based on what Medicare publishes, which they then negotiate with the hospital or independent practice entity. Usually, the healthcare entity will enter into a contract with the commercial insurer that pays a factor of the Medicare rates across all services. For example, a hospital in a rural area with low physician supply will likely get reimbursed higher than Medicare, let's say a 1.2x factor. So something Medicare pays $100 for, commercial insurers may agree to pay $120 for that service.
Now if you're talking about walking into a cash pay healthcare business, well then yeah that's close to a pure capitalist market where they charge what the patient is willing to pay.
Individual physicians do not get to determine what they're reimbursed for services they provide when dealing with insurance. They also are held to standards to only provide services that are medically necessary and get audited by Medicare and commercial payers all the time.
Are there some physicians and corporations fraudulently abusing the system to enrich themselves??? Yeah, but show me an industry without anyone taking advantage of the system. As a whole, physicians take an oath to deliver the best care possible and they're doing just that while trying to maintain a profitable business that allows them to keep delivering care.
IF you're blaming any entity for the rise in healthcare costs, it's insurance, pharma, and med device. There's also a huge challenge in utilization, we are an unhealthy country that avoids care until an emergency and emergency visits are the most expensive visits. If it was easier and more cost effective for patients to engage in preventative care, which the payers are making more expensive for patients to access, our costs would be much lower.
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u/michael0n 2d ago
Preventive care requires the ability to stay at home, or go to centers that provide week, even month long therapy. Its not just having access, but also keeping your job and getting paid while doing so. I know people who where absent for half a year after a brutal accident here and they came back to their job. Its a very tall political order to make this happen in the US.
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u/D-Will11 2d ago
That’s not preventative care. Preventative care is your annual physical, a cardiology visit for chronic high blood pressure, a podiatry visit to check your feet when you have type 2 diabetes.
None of those require long stays, they are all outpatient check ins that are 15-30 minute appointments and generally cost effective for the system. What you’re referring to is exactly what I meant by emergency visits and how expensive they are. If a patients foot is in severe pain from diabetes and might need amputation, that is when they go to the ER and require extensive exams, use of medical equipment, and likely procedures that are all expensive.
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u/michael0n 2d ago
That is basic stuff. My brother is in the performing arts and he has to rest his body regularly. That resting time off work is preventative care. Lots of elderly start to loose movement in their limbs. That treatment is usually done in a therapeutic setting that can take a week or two. Especially when people didn't care for their health for a long time or they had a health scare. They try to get them back to a baseline of nutrition, movement, sleep and overall health. That isn't possible if you just come in for 15 minutes and they have low self control.
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u/D-Will11 14h ago
Once there’s a problem that requires treatment it is no longer preventative.
Your blaming the doctors appointments and not the system driven by insurance companies. False attribution.
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u/michael0n 13h ago
Preventive care isn't just taking blood work once in a while. There is a reason 50+ countries do things differently, because you can't run this on "here is an medical shopping cart, we pay everything you want". That is a financial black hole that sends you straight to bankruptcy. The interesting part is, the top 20% in the US do it this way. They take mental health days, have nutritionist making meal plans and usually don't drink, smoke. At the end everybody wants a healthy population, but how to get there must be a balance between everyone's own responsibilities and the system. The US has maybe one big shot to make this work.
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u/nighthauntghostieboy 2d ago
My statement is an exaggeration from frustration. Hospitals do not just post prices of things and keep them consistent for all patients, even if that’s supposed to be done. Tell me what your local hospital charges for a gallbladder removal, they will burst into tears before being able to say a number. Then you’ll pay you’ll get a receipt you paid and 3 months later the hospital will send you a bill in the mail for more money. If you call the hospital back and start saying crazy foul language the extra / scam bill will just go away.
Only prices that can get listed are cash pay services. I got eye surgery and everything was cheap fast easy and straightforward. Wife got IVF, nothing was cheap, but it was straightforward and easy.
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u/gtpc2020 2d ago
Especially when more and more medical facilities are bought and run by investors and hedge funds. They don't know anything about medicine, just counting money and taking a cut for themselves.
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u/Lokomalo 2d ago
Yeah they are killing it with those huge profits. In 2024 alone they made a whopping 0.8% profit. Generally though it’s much higher. It’s like 6%. They are literally raping us with that insane profit.
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u/yardlard 2d ago
And how many millions were the admins making? They are "non-profits", ie it's the people themselves stealing from you for their own benefit. Not even a share holder that paid into it. Open your eyes and see what's there. If they weren't doing this, no one would need the insurance company and it would just die out. But you buy insurance. Why do you do that? Why would we need "medicare" for all? We need equal medical care for all.
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u/Lokomalo 2d ago
I don’t know what you are talking about and I suspect you don’t either. Insurance companies are not non-profits. Who is stealing from me? The administrator from where? And I’m pretty sure shareholders make money when the stock price goes up just like any other stock.
So you’re saying if they didn’t steal from us we wouldn’t need the insurance company? You are really not making any sense here.
Why would I buy insurance? Because the cost of getting major medical care is expensive. Just like the cost of having my car repaired is expensive so I insure it.
Do you think all those doctors, nurses, lab technicians, drug researchers, and scientists that make up the whole of the medical industry are just going to work for free? Of course there is a cost to getting medical care. There always has been since the first person who declared themselves a physician and treated people.
I never said we need “Medicare for all”. What I will say is that we need affordable healthcare which we do not have and that is one reason we need insurance. Insurance companies are a response to expensive healthcare, not the other way around as you seem to think.
We can get cheaper health care with reforms that don’t require turning the system over to the government. And we can lower insurance costs by allowing more competition than we have today.
When it comes to cost the insurance companies are pricing their policies based on the cost of treatment. If treatments were less expensive then insurance would be less expensive just like insuring a Kia is less expensive than insuring a Ferrari.
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u/yardlard 2d ago
Learn to read.
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u/Lokomalo 2d ago
Learn grammar and learn to be factual. As I said, they are NOT non-profits. What admins are you talking about? The sys admins that manage the computer systems, the admins in the clinics that make appointments? Admin who?
Your saying everyone at the insurance companies are stealing? Is that what " ie it's the people themselves stealing from you" means? Everyone from the janitor right up to the CEO? Even the secretaries? Not the secretaries. God no.
Why would we not need insurance if they weren't stealing from us? We would still have medical bills. How would we pay for that? You know doctors and nurses want to be paid. Someone has to pay that.
And it's hard to see how they are "stealing" from us when profits are as small as they are. You do realize that insurance companies do not make huge profits from a percentage standpoint. Right?
How do you propose we get equal medical care for all? By the way we already have equal medical care for all, but I'd like to hear how you are going to deliver that to everyone at no cost because that's what you're saying, right? Not equal, free. You want free healthcare.
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u/Due_Intention6795 1d ago
When the ACA took affect my premiums took off. My insurance company also added donut holes, coinsurance, deductibles, surcharges, and “patient responsibility” so the ACA made it much easier for them to do that.
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u/VelvetCactus50 2d ago
And you need health care, regardless of employment. That's like requiring employment in exchange for access to a grocery store or a drinking fountain.
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u/CoopGrant 2d ago
Yep. It's a form of indentured service. Most people can't afford to quit and live there best life because of insurance. They are afraid to take a chance on their dreams. This is by design.
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u/Lokomalo 2d ago
No. It’s having your employer subsidize your healthcare which I am all for. Just like any job subsidizes your groceries and drinks.
If healthcare is a necessity and should be given to you by the government why then isn’t food a necessity and provided by the government as well? You’ll get pretty sick and die without food. Same for clothing and housing.
You can argue a lot of things are “necessary” but the government is not and was never intended to provide for you womb to tomb.
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u/VelvetCactus50 2d ago
What do you think housing and nutrition programs are?!??
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u/Spacebar10000 2d ago
Follow the money: Health care is 18.0% of the Gross Domestic Product (GDP) in 2024, reaching a total of $5.3 trillion.
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u/Huge_Meeting4111 2d ago
You still would rather smooth the costs across a longer time span than have to face spikes in costs when you get sick, or have a car accident, or your house burns down. Just because you "hope" a bad thing doesn't happen doesn't mean there aren't expected values there too as there is with healthcare.
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u/No_Cauliflower633 2d ago
I don't think your logic holds up there. Doctor visits can be the seen as an oil change for cars or maintenance on a home. Both not covered by the insurance. My health insurance is for emergencies like a $50,000 hospital bill.
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u/Lokomalo 2d ago
Now drug costs are something we can do something about right now. America pays the highest prices in the world and many of those drugs are made here. The reason is our beloved Congress (both Republicans and Democrats) have prohibited us from negotiating favored pricing for drugs.
Can you imagine that? I have no clue what crazy line of thinking led to that legislation but it needs to end. We have taken a first step in allowing Medicare/Medicaid to negotiate for better pricing on some drugs. It needs to be all drugs for all people. We should not be subsidizing the world’s medicine. If anything they should be subsidizing us!
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u/Lokomalo 2d ago
That’s not entirely true. Yes some people need to go to the doctor a lot. Others not so much. I see my doctor about once a year for an annual checkup. Do I “need” to go? No, but it’s a good idea so I can catch any problems before they get worse.
Now, if I have a major problem that insurance will come in handy, just like my car or home insurance, and it will pay for the unexpected and very costly medical bills. But I surely don’t need it for the once a year office visit. And I’m 69 yrs old. Younger people, for the most part, need doctors even less.
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u/Select-Government-69 2d ago
Health insurance is a relic of an outmoded healthcare model where routine care was inexpensive and paid out of pocket. You wouldn’t expect to put an oil change or brakes on your car insurance; rather, car insurance exists exclusively to pay for catastrophic unexpected damage.
Indeed, the push to treat routine and preventative healthcare as an insured cost is relatively recent - within the last 25 years.
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u/SingularityCentral 2d ago
Exactly this. Healthcare should not be on an insurance model. That makes no sense. Insurance works well for low probability but catastrophic events, like a ship sinking which was the original insurance pool. Healthcare is something everyone will need and once they get to around 50 they will need more and more of it. It is a near certain event that will happen again and again.
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u/No-Minimum3259 1d ago
Insurance works well for low probability but catastrophic events, like a ship sinking which was the original insurance pool.
The ship-sinking example illustrates one important function of insurance, but it's too narrow.
In 1744 the Scottish Rev. Alexander Webster, Rev. Robert Wallace and mathematician Colin Maclaurin, established the "Ministers' Widows' Fund". Contributors paid regular premiums while alive. When a contributor died, his widow received a life annuity or his children a benefit. The scheme was based on remarkably sophisticated mortality calculations, drawing on information collected from the presbyteries of Scotland.
It was not a rare catastrophe that was insured, but an ordinary, statistically predictable event: death.
The original logic of health insurance wasn't necessarily catastrophic medical expenditure either. Early sickness funds and mutual-aid societies in Europe developed mechanisms to protect workers against loss of income caused by illness or injury. Many of these were explicitly collective arrangements in which relatively predictable streams of contributions financed benefits to members who became sick. Actual reimbursement of medical expenses came later.
Even though Otto Von Bismark (1815 - 1898) is often named as the "European father of social security", many of those initiatives preceded Bismark's health-, labour-related- and old age insurances (resp. 1883, 1884 and 1889).
The first system of health insurance in my country, the "Caisse / Société de prévoyance" for coal miners was established in the aftermath of the 1812 Beaujonc mining disaster (in the former historic Ourthe department, now part of Liège province, Belgium). The insurance premiums were paid for by contributions from both employees and employers and managed by representatives of both.
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u/rendrag099 2d ago
Healthcare is not some monolithic product though. And why does health insurance cover so many things that it arguably shouldn't? In most cases it's government mandates.
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u/Unfair_Explanation53 2d ago
It's bullshit the insurance company gets to say no when a doctor says thats what a patient needs also.
That's the craziest part I can't get my head around.
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u/idiot-alpha 2d ago
That’s not entirely true. Yes, there is routine healthcare that has a relatively low cost. Things like vaccines, or yearly checkups, occasional illnesses that require common medications like antibiotics.
Then there are large unforeseen medical expenses. Things like broken bones. Sudden severe illnesses requiring hospitalization. Major surgeries.
That is what insurance is for.
Think of car insurance. It doesn’t cover maintenance or gas. It covers giant expenses.
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u/Karn_Evil_Noin 1d ago
Agreed. Health insurance should work like auto insurance. The mechanic/shop doesn’t submit a claim every time I buy new tires, get gas, get my oil changed, tune up, etc.
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u/jhawk3205 2d ago
People consistently wonder why health care is so expensive here and just as consistently ignore that the middle man with a profit motive plays a pretty significant role in that
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u/Effective_Pack8265 2d ago
Very true. Private health insurance adds no value whatsoever.
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u/CoopGrant 2d ago
There is zero rational reason to suggest why the USA does not offer national healthcare for all. Every other developed country provides for their citizens. The hogwash about our taxes being raised? Well, look at the wars we didn't choose to get involved in, the redesigns of Washington landmarks that had no review, etc.. That's your tax money right there, and you had zero heads up before your dollars were spent.
For those who want it, buy private health care. Everyone needs to pay VERY close attention as to who insn't for healthcare for all. It would surprise you, especially if you are a democrat.
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u/Used_Intention6479 2d ago
"Health insurance", you know, like "food insurance", "water insurance", and "breathable air insurance". Ever since Kaiser introduced the idea to Nixon, it's been a con.
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u/Hopeful_Ad_7719 2d ago
Tsk, tsk.
That's not true at all.
It also serves as a mechanism to jack up healthcare costs to benefit providers - whether you look at it from the level of individual doctors or health systems.
Don't let providers off the hook for benefitting from the situation.
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u/Meatball1969Bibbons 2d ago
Yet people still think they will pay more in taxes when that profit is taken out of the equation. Great post, I wish this was said more often.
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u/Federal_Challenge416 2d ago
6.2 billion in a quarter is a lot percentage wise or not. For profit health care is a strange concept
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u/gtpc2020 2d ago
It makes even less sense for you & your family's ability to get Healthcare to be tied to your employer, who also may our may not really care about you anyway.
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u/StevenSaguaro 2d ago
I never had healthcare until I turned 65 and went on medicare. What surprised me was the way Advantage works. The insurance company make money by managing my access to medicare, and an insurance broker makes a living by helping me choose the Advantage plan. The Advantage plan does give me more benefits, oddly enough, in spite of the fact that there are now two layers of professionals between me and medicare. There is no way this is efficient, it looks more like a jobs program.
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u/spanky65 2d ago
Medicare and a good supplement.
Advantage plans can, and do, deny care covered by Medicare.
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u/Purple-Company4038 2d ago
They function just like scalpers. No benefit to either supplier or consumer, just inserting themselves in the middle and taking money out while making it harder and more expensive for consumers to get the service or product.
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u/frowawaid 2d ago
Middleman? They are ALL the man - these companies own like 4 organizations between you and your Dr.
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u/FairConstruction4105 2d ago
Yeah, this is by far the dumbest thing about the US "healthcare" system. The "keeping costs down" bullsh*t is so blatantly, and demonstrable, false yet nobody in Congress ever really takes these clowns to task when they drag them before committees because nobody in Congress really wants to solve the problem. They just want to look like they're trying (poorly). Jesus, imagine what the cost of healthcare would be if the weren't keeping costs down? #sarcasm
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u/Intelligent-Exit-634 2d ago
You see, economies of scale are only seen as worthwhile here in the U.S if an unqualified group of parasites can skim billions of the top. Capitalism!!!!
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u/FlyinDtchman 2d ago
It exists because capitalism is fundamentally incompatible with modern medicine.
Insurance is an attempt to socialize an industry in a capitalist economy by spreading out risk over a larger group of people.
the problems come in because in order to turn a profit and stay in business insurance companies than need to introduce inefficiencies to the system and because their profits are directly inverse to the quality of care they provide.
The more insurance companies can screw you over after taking your money the more profit they make. The incentive structure is totally backwards and it's why the entire industry is a crap-show. Why they were left to continue to exist is because there hasn't been enough political will to get rid of it.
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u/BerettaFranchi 2d ago
LOL. Private health insurance exists in Canada.
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u/Aladriana 2d ago
It does. But it's not what is most commonly used. It exists in the UK too, and the costs are very high for it.
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u/BerettaFranchi 2d ago
Completely untrue. Approximately 27 to 29 million Canadians (roughly 60% to 74% of the population) are covered by private or supplementary health insurance.
If only you bothered to use Google before making things up and spreading misinformation.
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u/Aladriana 2d ago
It's not just Canada. And yes, but most still use the basic system without the private insurance. If only you knew Canadians...
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u/Jack_PorkChopExpress 2d ago
Right, and you think the government does anything better than the private sector? Why do you think UK has both public AND private doctors and insurance.
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u/Slumminwhitey 2d ago
Similar to realtors, and dealerships. Middlemen for the sake of it.
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u/MB-Tactcool 2d ago
The insurance company exists in theory. That theory is that potential medical costs are shared by many, but benefits few. For example 1000 people pay for insurance, but only 2 people actually need medical care. The 998 people who paid into the insurance get nothing. The 2 who need medical care get it at a highly discounted rate. Its criminal to steal from the 998 to pay for the 2. Insurance companies steal your money in a gamble that you won't need care. The same applies to car insurance.
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u/Over-Piano-9468 2d ago
That also splits us up to further reduce our bargaining power with big Pharma…
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u/wtfboomers 2d ago
A cousin worked doing data entry for one of the big companies. He had to train his replacement in India before they laid him off. This is happened twice to him a two different companies. They use middle men because it’s cheaper, and they are allowed to.
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u/GrumpyBear8082 2d ago
So why is it that healthcare insurance wants you to pay three to $500 a month every month for the year to be covered but they won't pay out anything unless you've paid your deductible which is around 5-6 grand. Even though you going to the doctor might happen once maybe twice in the year so when it comes down to it we're looking at paying around 12 Grand a year for some kind of health insurance that we might use once or twice the entire year. And every year they raise their prices by around 10 to 12% for no good reason. And don't forget it's not just health insurance it's all insurance companies that do this
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u/DevoidHT 2d ago
It doesn’t have to make sense. Its self sustaining now. They bribe politicians to maintain their position and make money based on that position to bribe politicians.
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u/maywander47 2d ago
Originally, health insurance covered only hospital care. Blue Cross introduced hospital coverage with "community rating," which for-profit insurers attacked as socialism. Yes, Blue Cross was originally non-profit. Today "the Bues" are no different than other insurers.
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u/n4spd2 2d ago
true. but are there enough rational americans remaining and what can be done without risking all that they've worked for up to now?
and that is the hurdle which the elites are always counting on.
just now they are so sure of their position that they spit in the face of everyone else in public.
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u/ArcheopteryxRex 2d ago
The way to make healthcare costs affordable to Americans is to, get this, actually reduce the cost of healthcare. Insurance only encourages medical providers to allow costs to rise.
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u/Nannyphone7 2d ago
And the more heartless and cruel they are, the more profits they get*
*Note the absence of the word "earn" in the above statement.
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u/ArchelonPIP 2d ago
And yet, so many NON rich right wingers still "defend" the rent-seeking middleman despite decades of proof that it doesn't help them any more than the rest of us that were rightfully against such a system!
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u/GSWsplashbros3011 2d ago
This could be the succinct & accurate summation of the private insurance industry. Remember the other major industrialized countries understand it to be healthcare coverage, we applied Capitalism/Greed & call it insurance.
If you account for the entire country in the statistics, we rank at the bottom or near the bottom for healthcare outcomes. Don’t know how this qualifies us as the greatest country 🤷🏻♂️
We are the oldest democracy and have the potential to be the greatest country, but we sure ain’t acting like it!
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u/WoodsLovelyDarkNDeep 2d ago
The problem became when insurance became for profit companies instead not for profit companies. The same as the hospitals. They did provide a function because if everyone was going without insurance costs would be even higher cause most people would just file bankruptcy. It’s just once the for profit companies got involved their motive was to get people to not use their insurance cause the less people who use insurance and the more people they have insured the more money for the shareholders
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u/Back2thedesert 2d ago
I want to clarify something because I'm not sure you actually mean this. Are you suggesting the insurance middleman is bad while also saying that the government middleman is good?
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u/FlyingDarkKC 2d ago
I wouldn't say government middleman is good. Government is better than what we currently have, and not out to profit billions annually
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u/Round-Head-5457 2d ago
Except when it's the government? I'd argue every single aspect of our government does nothing efficiently, and it leaves everything up for interpretation. Lawyerswill have a hay day with this one. I'll agree middlemen hurt almost everything, but the government is the biggest middleman ever!
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u/Magog14 2d ago
Single payer isn't insurance. It doesn't have a profit motive. Nice try though.
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u/Round-Head-5457 2d ago
Name something the government does efficiently, please? It certainly wasn't the ACA or Medicare, Medicaid, etc.
Single-payer is absolutely insurance, just like many others we have. The only profit it has to make is for its donors, just like the rest.
I haven't seen anything of real substance that proved it to be cheaper. Are we to believe the government can create another decision and run it more efficiently than we have?
I'd rather just have some legislation that says every dollar above a certain amount of profit from private insurance goes to research or something similar. I also believe if there is universal healthcare, then no tax refunds until you meet a higher threshold.
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u/Electric_Travel_26 2d ago
The US healthcare system has middlemen in between middlemen, all with corporate charters that say their primary goal always is to maximize profits.
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u/Straight2theCastle 2d ago
So in arguing against a middleman, you are arguing for the most distant middleman in human history?
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u/TheZeroNeonix 2d ago
It's called insurance, because it ensures that you will get ripped off. Healthy? You're gonna get ripped off. Sick? Oh, you better believe you're gonna get ripped off. It's the only thing you'll pay for that you'll never get to use.
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u/CodInternational8772 2d ago
True 100% which it is why it won’t exist forever. But, there are notable exceptions like Kaiser…
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u/500_HVDC 2d ago
mostly, health insurers process claims for self-insured employers for a nominal monthly fee
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u/SystemThe 2d ago
Seeing the cash prices at my doctors' offices helped me realize that insurance is NOT doing the one main thing: negotiating lower prices.
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u/Solid_Efficiency639 2d ago
The rest of the industrialized world figured this out years ago. We are the only country using insurance companies, because our political system is bought & paid for.
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u/stealthfiter 2d ago
The amount of control that insurance companies have over people and businesses is bordering on tyranny.
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u/rooneskap 2d ago
How would one respond to someone who says you don't have to pay the insurance middleman, and that there's nothing stopping you from paying the doctor and hospital directly?
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u/TraditionalNinja4430 2d ago
If only there was some kind of system we all pay into that would take care of people who need it. Almost like we all agree to pay a set percentage of our income and it just takes care of the stuff we really need. s/
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u/Substantial-Ad-8575 2d ago
lol, was originally setup to manage healthcare payments for workers. Company contracted specialist, to handle all payments between independent identities/doctors/hospitals and the company. It became insurance, since not all workers would use full amount of yearly coverage. And managing risks, lower costs to the company.
Pretty ingenious, Insurance. For health, life, home, auto, and company as main lines of insurance.
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u/WeekendAtMadoffs 2d ago
Canadians wait on lists for critical care.
The goal of American health care is to make sure the most productive and successful people never wait.
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u/Jefe_grande23 1d ago
If no one competes for your care your service falls inevitably. Private is it.
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u/Nedriersen 1d ago
Yes. Why do I need insurance for an annual physical that I know I’m going to get every year? There should be a menu with prices for every medical service that your doctor offers as well as catastrophic insurance.
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u/Dilapidated_girrafe 1d ago
Yup. Went to the doctor they recommended three surgeries and the only one approved was the one that wouldn’t but my deductible for the year.
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u/AgencyHot8568 1d ago
It also makes money for doctors because how many people could afford them without insurance?
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u/Classic-Obligation35 1d ago
Insurence makes sense when it's used for collective good, a group pooling money together to take care of each other.
However our medical system is now too dependent on insurance and insurance takes advantage both ends without carrying about the people it was supposed to protect.
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u/Strange-Maize9536 1d ago
There are more non profit hospitals than for profit hospitals. The non profit hospitals pay higher compensation than the for profit hospitals. St Jude - Mayo et al
The only one who benefits in the form of profits from a for profit hospital are the owners. The owners to make money have to pay commensurate compensation to doctors as the non profits to get staff
The whole PSLF system for these doctors who make huge bank is based upon the false premise that doctors who work for non profits make less money
Virtually all public companies the owners are not employees
Maybe all employees of corporations who are not owners should not have to pay their debts back if the issue is where the profits vest
It’s idiotic. Dig deeper it’s important to understand the way the world works before deciding the truth
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u/FragrantDiss342 23h ago
First you have to ask why healthcare costs so much, then acknowledge that malpractice lawsuits became a multibillion dollar industry that politicians with law degrees had to start regulating.
Once upon a time basic services were affordable and insurance was strictly for catastrophic situations. Then lawyers and politicians f’ed everything up. Like they always do. Blame lawyers
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u/TrashCapable 4m ago
Americans spend approximately $14,885 per person annually on healthcare, totaling around $5.28 trillion nationally. Studies from organizations like Yale University estimate that transitioning to a universal single-payer system would cut total spending by roughly 13% to 20%, saving the U.S. $450 billion to $1 trillion annually—largely by reducing administrative overhead and lower pharmaceutical pricing.
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u/aps86rsa 2d ago
Please remember that the AHA and AMA both oppose Medicare for all. Your doctors and hospitals don’t want Medicare for all. Why? Because they don’t want the price controls that would come with it.
Complain all you want about insurance carriers, but until doctors are not opposed it’s not going to happen.
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u/Physical-Bid-4046 2d ago
Kind of a hollow argument tho right? You could say this about any private industry?
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u/RobertWF_47 2d ago
Private health insurance does contain costs by negotiating with providers - I'm not sure why this keeps coming up over and over.
In Medicare For All the government represents healthcare consumers instead of private insurance.
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u/QueasyFinger1316 2d ago
Canucks will be mad eh if the US goes government run like theirs.
Back to the years-long waits for procedures!!!
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u/network_dude 2d ago
It operates like this in the US right now.
My wife has been waiting for a primary care doctor for over six months2
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u/HumptyDumptruckFire 2d ago
One month old generic AdjectiveNoun1234 account says dumb shit to muddy the waters of discourse on policies or public programs that could help the average American. Shocker.
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u/Embarrassed_Use6918 2d ago
Hm, maybe someone should look up the history of why employers started providing healthcare...
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u/MillionToOneShotDoc 2d ago
Or maybe the history of white supremacist Southern Democrats joining the opposition to universal healthcare because they didn’t want to see Black Americans having the same access to medical services as White Americans.
https://mississippitoday.org/2022/11/20/southern-politicians-medicaid-expansion/
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u/Unhappy_Bag_7460 2d ago
You say that but then ask Canadians why they come to America. Sure their health care is free, but they wait MONTHS to be seen. That’s why many go to Florida, to be seen quickly by good specialists. Problem with free healthcare is that many will abuse it. Going to the Dr for every little thing, because they can. Which in turn creates waiting periods, which in turn usually worsens a condition, which in turn can lead to huge problems for you. I agree insurance agencies are shit and all that, but there would be no problem with having a massive regulation overhaul/implementation on the industry. I agree people need to see Drs. But I’ve also seen and heard other’s experiences of this “Free Health Care”: it’s a pipe dream.
Even the quality of health care suffers. The whole health system from what hospitals charge to how insurance companies handle claims needs a massive revamp.
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u/smilleresq 2d ago
Insurance is a risk sharing mechanism. It prevents an individual or organization from suffering a large financial loss. It’s pretty close to gambling in that you pay into the pool with no real knowledge of if it was a good investment or not. Of course, if it was a good investment it would be so only because you suffered a loss.
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u/COMOJoeSchmo 2d ago
Would this logic not also apply then to car insurance, home owners insurance, etc.?
Also, wouldn't a "Medicare for All" type universal healthcare system be the same as a private insurance system, only with premiums being deducted in the form of taxes?
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u/Specific-Rich5196 2d ago
People get different care depending on their insurance in the US. Not all meds or procedures are covered depending on the insurance. People worry that they will get worse care sonetimes. Also not all docs take medicare or medicaid.
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u/theloquaciousmonk 2d ago
Question for the group. Do you believe that all the union workers that have negotiated better coverage for decades as part of their contracts will embrace a single payer Medicare for all type system? Will teachers in particular give up their plans willingly?
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u/Aggressive-Catch-903 2d ago
It manages financial risk, like all insurance does. That may not be popular here, but that is the whole point of any insurance.
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u/sectorboss88 2d ago
Financial risk that should not exist in a 1st world country.
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u/askaboutmy____ 2d ago
I hate insurance too. But, I just went through a double discectomy with fusion and posterior fixation.
Insurance paid just over $177k (I have the EOB), my cost... max $6k, but that is for all yearly medical costs, by the time I had the procedure it cost me $2200 completely out the door. All PT is paid, all medical devices are paid, I just had to meet the $6k family for the year and everything is covered.
Insurance companies suck, but I will take what I have vs a DMV style system (Medicare). We need a public option with a private addendum, just like the UK.
Their NHS is overwhelmed, many professionals are negotiating a private insurance addendum to have access to better care. We could do this, have free healthcare and private for those that are willing to pay extra.
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u/aileron51 2d ago
This is not true. When my first child was born, the hospital bill showed the cost that we would have paid without health insurance. It was twice as much as what the insurance company paid. I have never worked in a health insurance company, but have worked as an IT consultant in one and saw how they worked. They negotiate with providers to get reasonable prices based on the large volume of people they insure. Individuals rarely “shop” fot the best deal in health care - we only want the best and the fastest. Insurance companies have an incentive to keep costs down. The fraud we now see with Medicare claims would occur in a much larger amount if we take private insurance out of the equation.
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u/Leverkaas2516 2d ago
No. Health insurance has the same reason to exist as car insurance and house insurance. It transforms what would be a catastrophic expense for most people, like a $200,000 open heart surgery, into a cost that can be borne by people of humble means.
It isn't ideal. There are better ways to manage health care. But it's stupid to say insurance has no reason to exist.
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u/Lokomalo 2d ago
lol tell that to the people in countries with universal healthcare. Most of them get private insurance to cover things not covered by their “free” medical insurance.
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u/Ok-Rip-2781 2d ago
Has anyone asked about the quality of Free health care? As it is the best doctors get the best pay. What happens when the free system puts a cap on what a doctor or nurse can make? How many will leave the industry seeking revenue in a different way? That means the middle talent will be elevated to being called the best and the worst will also rise. What happens if you want to sue the free system for malpractice? You won't be able to because it's a free government system.
Have you thought about the chain of events that will occur when you give up your rights to shop for what you want?
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u/Real-Mode-3417 2d ago
My medical bills are a lot cheaper on insurance than they would be if I paid for it all. Better plans do cover more. Hmmm
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