I'm paying nearly 20k (parents+child) on insurance I don't have time to use (and luckily no serious need) and once my son went to see his pediatrician and our 'private' insurance company (that i'm not going to name) sent us bill of $500, for a check-up. We disputed the charge with the insurance and they agreed to wave the payment next month. Next month comes and guess what? The same letter comes in mail. We disputed…
> And on top of it I get a better deal if I use no insurance at all for prescriptions.
Interesting. So is it also the case that you can "negotiate" medicine prices? Is the actual price then different from what is on the tag?
People seem to think that if you move to single payer that the single payer would behave like any of the existing payers, i.e. you call to fight for approval for everything you do, argue about fees for each item, denying things is routine, blah blah blah.
If you have a single payer system, it doesn't have to work that way. Not even close!
>Many procedures are made unavailable due to being considered cost effective by The Single Payer whether the insurance is coming from a single payer or a private company, access to health care does not mean unrestricted access to any medical procedure you want. Private insurers also deny treatments that aren't considered to be cost effective.
That's what I've never understood about the arguments against single payer: >You can't pick your own doctor I already can't. If they're in network, I'm good, but if they're out of network - like my doctor was - then I have to find a new one. >You can't pick your treatments My spouse was denied medication by an insurance company because it was too new. So. >You don't get to have all the healthcare you want I already h…
The whole premise of your argument is that single-payer is not only better than the insurance system (which I would agree is true) but also that it is the only other option. The latter is not true.
What I don't get is how do 37 million Americans not have health insurance when the ACA was suppose to fix that issue? All of the plans are adjusted based on your income level and you get a tax credit if you are low income. If you are very poor then you get free healthcare....
If you're willing to gamble on your health, it's still much cheaper to pay the fine than pay for healthcare that isn't through an employer. When I was unemployed for a few months a couple of years ago, I opted to not get any healthcare coverage from the state exchange while I was looking for work because it was going to be over $1000 a month to cover my wife and I, plus it only covered a percentage of healthcare cost…
I am sure, on paper, it is a brilliant plan. Unfortunately, reality and human behavior almost never follow the plan. Is waste, fraud, and abuse taken into account at all in this study? What about the inevitable changes to consumers' motivation, behavior, and decision making around healthcare? It will change drastically as the cost of their care is even further removed from them than it is now. People who have a procl…
> Why should I subsidize other people's bad decision making?
This is what you already do when you live in America. Other people made a bad decision to make healthcare a private industry, creating a billion dollar insurance business, and you are writing their paycheck out of yours.
I am sure, on paper, it is a brilliant plan. Unfortunately, reality and human behavior almost never follow the plan. Is waste, fraud, and abuse taken into account at all in this study? What about the inevitable changes to consumers' motivation, behavior, and decision making around healthcare? It will change drastically as the cost of their care is even further removed from them than it is now. People who have a procl…
My wife is a pediatrician and sees about 80% medicaid patients. People absolutely go in more often than they need to because they don't pay a single cent. I'm talking going to the ER because their kid has a cough or is running a fever. These are usually also the most demanding patients.
Medicaid is not the same as Medicare. Medicaid is literally Free stuff so yea, it can be abused. Medicare is not free. People pay into it through taxes. 2 different things.
I was in the hospital over Christmas because of a very severe infection. I was there for 2 weeks, and am lucky to be alive. The costs were over $150k, but I ended up paying $1500 in various deductibles to Kaiser, etc. I was happy to pay $1500 and am alive because of the care that I got. I pay about $6000 a year in medical insurance per year through my employer and it ended up being totally worth it. Not a few weeks p…
$6000/year sounds very low for healthcare in the U.S. When you say "I pay" are you really only counting the employee contribution? For purposes of analyzing aggregate healthcare costs for a whole country, we ought to be using combined employee+employer costs (W2 DD) and not just the (usually small) employee portion highlighted by HR at benefits season.
Not op, but you got me curious so I checked my W-2. $8,800 for me and I think mine is top notch (2,600 is my max out of pocket per year limit)
I worked in the EMR software industry and have certifications that involve hospital & lab billing, among others. I've been on site with healthcare providers, and there are entire buildings full of people whose job it is just to code and scrub claims, and cover disputes/negotiations with private insurance providers. Consumers do not see it because it's typically off-site from the main hospital care facilities, but bel…
I once worked at a US biotech startup getting paid by insurers where we would build ML models just to reverse-engineer the inconsistencies of CPT coding & claim reimbursement by insurers & hospitals so we could get paid. Basically trying to automate "learn that Karen at insurer X processing claims wiht code Y from hospital Z usually decides to reimburse $XX". This whole idea of "free market is more efficient for heal…
Yes! Perverse incentives are what is making it like this. And the incentives cross boundaries - relationships between providers, insurers, regulators, legislators, and consumers. There's no single guilty party that we can blame and fix. (Since insurance companies are such a target for blame, I've started to say blaming insurance is like yelling at the cashier.)
> The government has zero ability to control its expenditure, because the electorate vote themselves benefits. Could you give me some examples of this? Living in a nation with universal healthcare, I've never seen this.
What else would you call students voting for loan forgiveness? Point blank the candidate is effectively saying, "we will give you $xx,xxx" in the form of loan forgiveness. It is the same for healthcare. This is a literal voting for benefits; and, this creates perverse incentives for the electorate to vote for whomever will "pay them" the most for their vote. Candidates are simply buying votes by offering free stuff w…
Except that here in Europe (Germany and Austria) in each election, saving money on social programs by cutting cost overhead as well as services is a big topic and parties arguing for those cuts regularly get around half of the votes.
The one candidate tries to buy votes by offering free stuff pairs by taxpayer money, the other one tries to buy votes by promising to stop giving out free and lowering taxes.