[andutu]

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. Luckily through their job they have some of the best medical insurance in the state and have been getting treatment at UT Southwestern. They pay little, but there was an instance where one of their physicians had to appeal to insurance to get a scan done (thankfully the insurance acquiesced). It doesn't make sense and all this debate around single payer healthcare is just obfuscation and distraction from investigating actual solutions. The vast majority of doctors genuinely want to help people and are more I interested in practicing the skills they've honed for decades rather than deal with faceless automata at health insurance companies who deny claims upon a mere glance. As long as people like Rick Scott can not only get away with introducing inefficiencies in the system, but defraud people and get away with it with no consequences other than personal enrichment, we are doomed.

[spondylosaurus]

> The vast majority of doctors genuinely want to help people and are more I interested in practicing the skills they've honed for decades rather than deal with faceless automata at health insurance companies who deny claims upon a mere glance.

Not only that, but doctors also have to fight tooth and nail to get reimbursed by insurance companies (some worse than others... I have doctors who won't even take UHC anymore because the reimbursement rates are too low to break even on practice costs). So we end up with this bizarre arrangement where patients get their wallets drained and doctors have to hunt down their paychecks for services provided... all while the middleman gets richer.

I hope your boyfriend's doing okay. Dealing with a major medical issue like cancer is already hard enough on its own without the added financial nightmare in this country, but at least it sounds like they're in good hands between you and the doctors they're seeing.

[Projectiboga]

Single payer would lower costs by greatly reducing liability insurance both for the doctors themselves but also for car insurance and business liability coverage. All those would still exist but not for the actual medical treatments. The estimates are it would start to save money nationally the first year, and once the medical industry reorganized around delivering care that plus savings from preventive care and less lags getting scans. It isn't just the insurance providers against single payer, all the big pharma and medical technology providers don't want that. The saving would come from having most every health care outcome in one place along with every treatment and medicine. We would start to really see what works and is worth the money. Second even the most affluent would benefit from less crowded emergency rooms that puts us all at risk.

[ufocia]

Not an ad hominem attack or a microaggression, but hopefully constructive criticism. Your use of the "them" pronoun makes the post confusing. Does it refer to "they," presumably the doctors, the employer (job), the insurance, UT Southwestern, or to the gendered "boyfriend." Since you already decided to use a gendered noun, perhaps use it instead of the "they/them" or use a matching gendered pronoun "he/him" to distinguish the particular person from the other "them."

I'm glad that your boyfriend has a wonderful and caring person like you to lean on.

[spondylosaurus]

It's not the most common, but some people do go by they/them and still use certain gendered terms like boyfriend/girlfriend where appropriate. (Full disclosure that I'm one of them, lol.)

I think part of it is that there isn't a great neutral word to take its place. "Partner" is probably the best option overall, but it can mean anything from "person I've been married to for 15 years" to "person with whom I opened an LLC," whereas boy/girlfriend is pretty specific. And the only neutral term of that specificity I've seen proposed is "joyfriend," which I find unbearably silly because I'm not 15 years old :P

[Jcowell]

It would make it more clear, but in this case each Use of They was used right after the subject was mentioned. it stole only be confusing if They was used after multiple subjects are mentioned at once. But all pronouns can suffer from this.

[nicwolff]

Oddly, the writer used "he" in "they determined he had Stage 2 bladder cancer" because they had already used the plural "they" in the same clause – showing that they know how confusing the singular "they" can be. Sometimes ツ

[specialist]

https://en.wikipedia.org/wiki/Singular_they

[addicted]

> They pay little, but there was an instance where one of their physicians had to appeal to insurance to get a scan done (thankfully the insurance acquiesced). It doesn't make sense and all this debate around single payer healthcare is just obfuscation and distraction from investigating actual solutions.

Single payer is literally a complete solution to the problem you’re mentioning before.

So why is it obfuscation and distraction? Especially when single payer systems in Europe have proven to have better outcomes at a fraction of the cost?

I find the thought process here fascinating. Single Payer, which is actually delivering results in nearly every other developed country is an “obfuscation” and we need to find “actual solutions”. Doing what every other country that doesn’t seem to have the problem in question is not an “actual solution”. No, we must invent one out of thin air or it doesn’t count.

This seems like a Not Invented Here syndrome taken to its extreme.

[ianburrell]

Single payer is actually pretty rare in developed countries. Canada and UK are the main ones. Hybrid public/private models are more common.

Universal healthcare, where everyone has coverage, is what people usually want.

[dsign]

It’s an ideology issue. I’m writing from the future. Here in Swerway we have transitioned to a health system that makes people twenty-five years old forever. On the other side of the pond, the last few US administrations have gotten elected on the basis of convincing Americans that it is evil and morally corrupt to live forever, specially if you haven’t earned an ethical dispensation by becoming a billionaire first.

[colechristensen]

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.

Businesses do need to compete with and overthrow the current middlemen in the medical world. It's just difficult and a very slow process.

[flatline]

The government is mostly just there to manage contracts, the actual work would be done by the same doctors that are doing it today. You would just pare n profit-seeking entities down to one principally administrative entity. If you wish to pay for your own medical procedures out of pocket there will be nothing stopping you. That is not to say this does not have problems.

Insurance is anti-competitive on top of that. You have a Sophie’s choice of who you want to pay to buy into this crazy system. There’s no transparency in how services are priced or provided. You as a consumer have no insight into how prices are negotiated between the insurer and providers, nor how providers are paid out. Good luck making an informed decision.

[cyberax]

> Why with single payer would there not still be instances of treatment being denied?

The most common failure mode for single-payer is scarcity. You won't be denied, but you'll have to wait many months for an appointment.

> Would this not be replaced with faceless automata in government?

They are controlled by politicians, who are directly responsible to their electorate. Brexit is a good example, using money sent to EU for NHS was one of the more influential ads. Of course, the outcome turned out to be... different.

With the current insurance system, you don't have ANY levers. You can't usually change your insurance company because it's provided by your employer. And even if you want to buy medical insurance yourself via the ACA, you can switch it only once a year. With no way to tell in advance if your new company is going to cover your treatment.

You also can't even sue your insurance company if it denies you the treatment because _all_ insurance companies require binding arbitration. And arbitrators basically always side with the insurance company, because your contract says that the insurance company is always right. That's how UnitedHealthcare can get away with just randomly denying treatment.

[cyberax]

> Just look at how the VA is run and complains about it.

The VA system has on average delivers better outcomes than private insurance: https://www.rand.org/news/press/2018/04/26.html

It's the usual "review effect", you only see negatives about the VA, not positives.

[light_hue_1]

So you've never used VA healthcare. Compared to the insanity of the rest of the system it's pretty amazing. Some locations are better than others though.

[op00to]

The denials would not be based in a profit motive in a single payer solution.

[dukeyukey]

> Why with single payer would there not still be instances of treatment being denied?

Typically no - what treatment is used might be different, but that treatment is needed and will be supplied is not usually up for discussion.

> Would this not be replaced with faceless automata in government?

In 29 years living in a single-payer system I've never needed to do this. The government does not get involved in healthcare, they just fund it.

[justin66]

What was your experience like with the VA?

[whutsurnaym]

Looks like they used both "he" and "they". My guess was that the boyfriend might use either set of pronouns.

[junek]

Why does it matter to you?

[randomdata]

They as in he and his bladder.