41–50 of 189 posts
knowing back channels, having the 'village' mindset is much better
Knowing little about this - a genuine suspicion is - is this a feature, not a bug? As in - doesn’t this arise out of an incentive for health insurance companies NOT to cover procedures? I can only imagine that this bureaucratic tangle reduces insurance coverage by a very significant percentage. Aka - the kind of communication inefficiency must be profitable, no?
One of the things I've observed from lots of interaction with Doctors is that that US health care is FUCKING AMAZING, and that drives up cost. Everyone wants top quality health care, everyone wants tests, everyone wants scans, everyone wants to cover their fucking ass. Take multiple X-Rays when there is no good reason to, to prevent lawsuits. the guy who lied about taking Heroin gets a full lab workup for no good rea…
I've always thought that this is something basic that we need to address as part of any health care reform.
We can't afford to give everyone unlimited health care, so how do we determine the limits?
I assume that a lot of socialized health care systems end up using waiting lists, perhaps based on the patient's age, treatment cost, and probability of a positive outcome, with the option of going outside the system and paying for more/quicker care, for those who can afford it.
One person I discussed this with assumed that there was plenty of money to give everyone care as good as billionaires get. I don't assume that's true. Has it worked out that way anywhere else?
The USA spends more GDP on healthcare than any country on earth and the insurance companies are immensely profitable.
Every company involved is making money off the status quo and wants to maintain the current system. when a patient comes along who isn’t desirable and profitable, they’re screwed.
This is all well documented in research about modern USA healthcare and health economics. None of this is an accident and the fact that this situation persists should be a national embarrassment.
for people outside the sphere of US healthcare it can best be compared to the Warhammer 40,000 series Adeptus Administratum. Such is its immense size, that whole departments of the Administratum have been submerged by a sea of complex bureaucracy, becoming lost in loops of paper trails. Other departments have continued to dogmatically operate and carry out their founding function, even if the intent and requirement b…
Knowing little about this - a genuine suspicion is - is this a feature, not a bug? As in - doesn’t this arise out of an incentive for health insurance companies NOT to cover procedures? I can only imagine that this bureaucratic tangle reduces insurance coverage by a very significant percentage. Aka - the kind of communication inefficiency must be profitable, no?
One of the things I've observed from lots of interaction with Doctors is that that US health care is FUCKING AMAZING, and that drives up cost. Everyone wants top quality health care, everyone wants tests, everyone wants scans, everyone wants to cover their fucking ass. Take multiple X-Rays when there is no good reason to, to prevent lawsuits. the guy who lied about taking Heroin gets a full lab workup for no good rea…
I get your point - yes doctors have a lot of tools at their disposal, and yes using those tools comes at a cost, but wouldn't you want to use those tools if you were in that position?
X-rays are not exactly cutting edge- if a fracture is suspected they are fundamental. Bloodwork etc are key diagnostic indicators. Sure people lie ("Everybody Lies" - House [1]) tests are helpful to understand those lies.
It absolutely can be economical to give everyone the best possible health care - especially at the primary diagnostic stage. That being true, yes, every part of the system is independently determined to maximise their profit. From the X-ray operator to the blood-test-maker.
It's worth remembering that these common tools, that have been around for decades, are still more expensive (by a lot) in the US than elsewhere. Yes, health insurance makes massive profit. But so does precisely everyone else involved at any level.
So if it is "not economic" perhaps its more any issue of "greed" than math.
[1] House is an old TV show about computer support, using medicine as a metaphor.
Earlier quoted context omitted.
I can be down for this. To anyone who doesn't deal with the innards of US health insurance, this is better coverage than every health insurance plan in America despite the bar seeming so low. I do think your bar for catastrophic is far too high and should probably be ~$10k cumulative spent in any span of time less than 12 months because $49k is ruinous to almost every American.
My counterpoint is that for a family of 4 it’s $28k total per employee at my company for health insurance. If even half of that was put directly into an HSA the bar could be hit quickly. It’s just amazing how unbelievably expensive and wasteful US healthcare is.
Great article but the author is missing the fact that this is all designed on purpose. The insurance system is designed around a consistent strategy called “don’t pay out”. The USA spends more GDP on healthcare than any country on earth and the insurance companies are immensely profitable. Every company involved is making money off the status quo and wants to maintain the current system. when a patient comes along wh…
My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…
>rather than deal with faceless automata at health insurance companies
Would this not be replaced with faceless automata in government?
Just look at how the VA is run and complains about it. Looking at that I have exactly zero confidence in the government being able to run things better than the shit show at the insurance companies.
Businesses do need to compete with and overthrow the current middlemen in the medical world. It's just difficult and a very slow process.
American healthcare is an easy target, plenty to criticize. There are complicating factors here: We culturally, societally, and philosophically don’t really know how to make decisions about end-of-life care, and death in general. We also lack an agreed upon moral framework for how to care for people with diminished cognitive capacity (the extreme being permanent vegetative state).
It's a thing, even if ignored. We're paying big premiums for that to insurance companies as part of our wages and taxes.
I wonder if other countries do significantly better?
My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…
Why with single payer would there not still be instances of treatment being denied? >rather than deal with faceless automata at health insurance companies Would this not be replaced with faceless automata in government? Just look at how the VA is run and complains about it. Looking at that I have exactly zero confidence in the government being able to run things better than the shit show at the insurance companies. B…