I'm not American and grew up (and work) in Western Europe.
Everyone is born, and, at some point, will get sick and die. Why does each of these cost tens or hundreds of thousands of dollars? I've heard American doctors at conferences describing their system as "the worst imaginable". Every American I know hates their system. It costs a lot more, has worse outcomes and shovels money and privilege towards the rich.
Why don't you change it? What are the reasons why moving to a single payer system is so bad? Denmark has the same system as the NHS, puts more money into it than the Brits do, and has some of the best health outcomes in the world. If a politician seriously suggested copying them -- with an income tax deducted at source with employee and employer contributions -- what would happen?
Everyone hates “the system”, including the people in it. But every party of the system is perfectly fair and reasonable for the people benefitting from it, even if they hate every other part. So every part of the system will have people fighting for it—and if you try to change the whole system, the entire system will fight you. It’s an equilibrium, even if it’s obviously far from optimal.
You’re making the classic mistake of assuming the US works like the average European country: a functioning democracy where if something makes sense, politicians will promise it in their manifestos, and then implement it once they get elected.
In reality the US works completely differently and is not a functioning democracy. Making any major reform in any area is, to a first approximation, impossible.
Health culture in the US and Danemark are complete opposites. I mean how common people think about the system, and their expectations. Americans basically do not want to pay for anyone else than themselves. Europeans expect a strong social safety net, and accept higher taxes. So, you can't apply the danish system in the US. It would be anathema for a large part of the US population.
The payment model probably isn't the biggest problem with the US system.
My belief is that it's the relatively complicated regulation of capacity (federal and state regulations on facilities and providers), which pairs poorly with government programs that increase access to care with direct subsidies.
We should train lots more providers and eliminate barriers to entry (so for instance, if someone wants to open an MRI suite, let them).
> Why does each of these cost tens or hundreds of thousands of dollars?
Because money is just a tool for allocating resources. And having well trained people with equipment ready to attend to every person in that situation requires a lot of resources.
I’m not justifying our systems inefficiency - let’s just be clear that medical care costs a lot of money.
So the challenging political question is how to manage access and costs (often devolves into rationing) and who should pay for it.
Our healthcare system is complicated by the fact America has much larger wealth disparities and more complex regulations stemming from a republican government with disparate laws among the states. Also the baumol effect: America has a significantly more developed tech and finance sectors compared to Europe which inflates the cost of less productive service based industries like healthcare.
The system can't be "just changed" because it's a very complex issue with a lot of entrenched interests. There has to be sufficient political will at the top levels of government that simply doesn't currently exist (in either the Democrats or Republicans).
> What are the reasons why moving to a single payer system is so bad?
Half the country (or at least, half the voters, which is only like 2/3rd of the country because so many don't vote) believes in rugged individualism and a Just World.
They see single payer as their tax dollars going to paying for someone else's health problems that they caused themselves. In other words, they'll complain about their dollars paying for a smoker's lung cancer treatment or an overeater's diabetic treatment. They think everyone's health problems are their own and don't want to pay for it.
The fact that when they pay for health insurance but don't make claims means their money goes to other people is completely lost on them.
Healthcare is incredibly complex because currently all technologies we have just make living longer exponentially more expensive with every added year.
But one thing is clear: it's easy to improve the nutrients that people in the USA take.
Whenever I travel in to USA, in the airports I can't even find a simple salad or any real food, even though I can see lots of pictures of salads, which drives me crazy.
Last year I went through Atlanta airport, I bought a hamburger because they didn't have literally any other food at 10pm, and I thought I would just throw away the buns and eat the salad + maybe the meat (depending of the ingredients). Then I looked at the ingredients and it was like 50 things that I didn't even know what they mean. It didn't smell or taste like food at all, so at the end I found 1 year old nuts in my bag that my mom packed a year earlier, and I ate that.
Any single payer system would significantly impact American's ability to choose their doctors, specific drugs, and procedures. Just look at the difference between dealing with an MRI for an injured knee in the US vs Canada - you're going to wait much longer in Canada.
Americans really value choice and access, so they resist anything that hints at “rationing.” As a result, costs keep climbing, and there’s an insane amount of money tied up in administrative overhead.
For anyone looking for a nuanced perspective on this, I highly recommend Peter Attia's interview with Saum Sutaria (McKinsey's formed healthcare lead).
Physicians are largely why the US doesn't have single payer.
They've been funding a massive influence campaign against government health insurance and most cost containment efforts for nearly a century under the guise of "protecting patients" (in reality protecting their pocketbooks).
The questions that I like to ask first when comparing systems to the US is, what is Denmark doing to reduce/prevent obesity and drug use, and what does elder care look like? There are certainly things that could change in the system, and it would be great to see what practices other countries have for some of our biggest cost drivers.
> The implicit question is – if everyone hates the current system, who perpetuates it? And Ginsberg answers: “Moloch”. It’s powerful not because it’s correct – nobody literally thinks an ancient Carthaginian demon causes everything – but because thinking of the system as an agent throws into relief the degree to which the system isn’t an agent.
not an American, but it seems to me that the reason is purely ideological. They like a small state, especially the federal government. This would give too much power to the government. The idea of federal government providing care for citizens is not acceptable to people.
Now, weird thing is this doesn't work for the military somehow.
All of our systems are made by and for the rich. Not the doctors and certainly not the patients. This isn't limited to healthcare. When I say all systems, this includes government who make laws for lobbyists (who represent big business, like the insurance companies) and this also includes the media who ridicule the idea of socialized healthcare & the politicians who back it for all Americans as childish, impossible to pay for & socialist (as if that's a bad thing), among others. Even the political parties will withhold support from the few candidates who are realistically trying to make this happen.
Against these odds, our current healthcare system is very unpopular [0], and if you put it to a vote, we would probably get a more sane healthcare system, but again, realistically, it's not up to us, unless, over the course of ~6 years we constantly show up to both primary and general elections and vote for representatives who support it, and leave the corporate backed candidates in the dust.
Combo of the truly wealthy buy politicians AND many professionals and union employees have employer-subsidized health plans AND 100 years of “socialism bad!” messaging from the political right.
A couple of things. We've spent the last three generations systematically deconstructing our public education system while certain billionaires raid our journalism and social media businesses. Fully half of America actually and fully believe any lie put in front of them by someone with enough power (money) and who says it scary enough.
Americans don't want universal healthcare because then "bad" (read: not-white) people will have it. That's it. Giving something to the benefit of everyone is untenable evil because it's "communism". If you weren't lucky enough to be born into a social class that already has socioeconomic benefits, you simply don't ever deserve to have those things.
This country has spent the last half century pillaging the commons and masterfully convincing just enough of the population that it's a good thing, actually.
Why don't we just change things? Because we no longer own the government. Several billionaires own the government. Democratic change is next to impossible because the game has been rigged so well for so long and nobody with any power has any interest in fixing it. The US government no longer exists to serve the needs of the people, it exists solely to funnel the maximum possible amount of money from the working class to the ultra elite
> Why don't you change it? What are the reasons why moving to a single payer system is so bad?
The best way I can describe our healthcare is that it's freakishly complicated, so complicated that pretty much every argument made by any side at any given time is both correct and incorrect.
For your example about single payer, with that scheme costs will likely be much lower but on the flip side, we also would not get immediate access to care (that is you can't attend a doctors appt within 72 hrs of scheduling) and we also would not get access to the latest and greatest drugs and therapies because those are always expensive and SP schemes typically do not cover that.
Now with that said is single payer good or bad? Well it all depends on who you ask. If you ask a 20 something that just visits the doctor once a year for a checkup and maybe calls into urgent care once every few years when the get the flu or food poisoning, that person will be all over the moon about a single payer system.
Now contrast that with someone in their 50's or 60's that has pre-existing conditions, sometimes chronic conditions, and needs constant care and access to the latest drugs. Well for that person single payer is dogshit and won't cover half their needs.
And that is the essence of the problem, two sides with vastly different needs from the healthcare system and a government that has to make one decision that will somehow satisfy both parties, even though that could really never happen. You're either going to pick the 20 year old and screw over grandma or you're gonna pick the grandma and screw the 20 year old.
Ironically, I think that the increased attention to the denial of claims plays straight into insurer's hands. Healthcare isn't expensive because insurers don't pay enough to healthcare providers. In fact, it's the opposite. The ACA mandates that at least 80% of premiums must go towards medical expenses. This means that insurers are actually incentivized to overpay for care to maximize the size of their 20% slice. If we want to decrease healthcare costs in the US, we need to focus on how insurers are failing to negotiate on behalf of consumers.
Nobody, not this article or any other reasonable person, thinks that claim denial is the reason healthcare is expensive. Rather, they think it is fundamentally fraudulent that someone can pay their premiums, etc. and then when they need treatment, be arbitrarily denied by an in-house doctor employed by their insurer to deny treatment.
This is a story of the fraud in the health insurance industry, not the racket part of the industry.
> The ACA mandates that at least 80% of premiums must go towards medical expenses.
This is not precisely accurate. The medical loss ratio (80% for individual plans) can also be spent on quality improvement. There is a blurry line between administrative costs and QI initiatives. For example, a plan-provided coordinator could be QI rather than administrative.
> incentivized to overpay for care to maximize the size of their 20% slice.
This.
You see it anytime you mandate some profit cap or limit as a percentage of revenue. Companies will just manipulate the other variable to get more profits. Or they'll buy other related companies so they can do sneaky internal pricing shenanigans.
> This means that insurers are actually incentivized to overpay for care to maximize the size of their 20% slice.
I'm confused. If that's the case, then why would they deny coverage? Wouldn't that be an easy way to overpay?
Heck, they could simply allow everything through and use rising costs as a justification to increase premiums.
This nefarious scheme of course requires insurers to have no competition. After all, if your competitors don't overpay, then they can lower rates and steal your customers.
The truth of the matter is that hospitals and doctors try to maximize their profits through excessive billing and care little about cost efficiency. They don't try this at the same rate with medicare/medicaid both because the government does not generally negotiate - reimbursement schedules are largely fixed and because defrauding the government is a criminal rather than civil offense.
There are some easy fixes here and there. We could, for instance, ban price discrimination by healthcare providers. Every payer would then pay the lowest accepted rate - which is usually medicaid or medicare's. This won't prevent billing for medically unnecessary or inefficient services, but it would eliminate the negotiation problem.
The problem is political. If you save a trillion dollars a year in healthcare costs, the GDP gets lowered by roughly the same amount. Healthcare providers would, of course, fight to prevent any reduction in reimbursements from happening - which they've been extremely effective at historically.
I mean I guess but it would still be a huge improvement in real people's lives if the burden was flipped and insurance companies had to prove fraud to deny a claim.
I think we want the opposite when it comes to negotiations and want instance companies to all have to pay out the cash price. The first step to making it possible to not need insurance for most care is making everyone pay the same.
This is one of the drivers of cost disease[1] in healthcare, which is a huge problem that won't completely go away even if insurance is radically reworked.
You can negotiate all you want but ultimately the productivity improvements have to come from providers (hospitals, pharmaceutical companies) if you want to lower costs. There are ways to make insurers better agents (one simple step would be to make their customers the actual patients, rather than the employers of patients) but I'm not sure how much power they actually have to keep costs low
This seems like a good spot to start with policy changes:
> In interviews with ProPublica, federal judges criticized a system that fails to address problems that arise in court case after court case. They faulted the Employee Retirement Income Security Act, which governs many insurance claims in court, for not allowing for punitive damages, the sort that can rise into the millions of dollars and deter companies from bad conduct.
> To one federal judge, who like others spoke about cases on condition of anonymity, doctors and the insurance companies they work for essentially get off scot-free. “They might have to pay 10 claims,” the judge said, “but if they can avoid paying a thousand claims, then why would they change anything?”
Middle class Americans have been dealing with this awful middleman for decades. Peaceful protesting got us nowhere. Politicians are bought by these conglomerates. Court systems give these companies a slap on the wrist.
Only thing I have seen work: full sending 3 bullets into a healthcare industry CEO. The subsequent public indifference was quite eye opening. Didn’t matter if you identified as Liberal, Democrat, Progressive, Conservative, Republican - it was a unified response across the nation. Conservative talking heads getting ripped apart by own audience for being “out of touch.” Democratic leaders (Tim Walz for example) getting ripped a new one for fake sympathy.
We are well beyond “policy changes”, especially as we go into this next administration.
These "doctors" should be barred from practicing medicine. I am not a lawyer, but it would seem that this practice also borders on criminal negligence.
More light needs to be brought to this, and serious action needs to be taken on behalf of insurance policy holders, NOT on the behalf of shareholders of "insurance" corporations.
In many jurisdictions in the US, there is a requirement for the casino and lottery operators to pay a certain percentage (typically 90+%) back as winnings.
Do health insurance companies have to follow similar requirements? If so, individual cases of insurances denying insurance would be bad, but would indicate that the overall system is still working reasonably well.
Question for the techies here: Due to lack of political will and deep-seated corruption I believe a lot of issues in the US system are almost unfixable but I always wonder why it has to be so convoluted (besides being hyper-expensive).
Why can't the insurers have an app where the patient (or the provider) can type in the procedure codes they are planning to use and then the insurer returns the co-pay, co-insurance and other cost based on the plan the person is in? The insurer must have these systems already internally so why not mandate to give access to the calculations to patient? I had several occasions where I tried to figure out how much something would cost and the answer was "we can only tell you after the procedure was done".
Insurers have an app where the patient (member) can type in a procedure code and see prices for local network providers. It's literally right there in every member web portal! Every health plan has sent out multiple notifications to their members! How are people still not aware of this?
In my experience this behavior is due to the fact that they don't really know on the insurance side how the care provider is going to code something until they have actually done the procedure and have submitted it with the coding. And there is a very high wall between the insurance/patient billing side and the care providers, even in a case like Kaiser where they're all employees of the same company.
Trump actually forced hospitals to release their prices during his first admin. There are a few problems. First, quite a few hospitals refused and just took the fine instead. More importantly though, theres no standardization of codes. Your procedure might sound routine but there are usually quite a few different things being billed and there usually isnt a one to on relations hip between codes at different providers. Even if there was standardization a lot of the time unforeseen stuff comes up so you cant just get an out the door price before the procedure.
The absurdity of American healthcare industry can be summed up by this series by “Dr. Glaucomflecken” on YT. Some of the videos are even based on Propublica journalism.
The entire medical system when it comes to the court system is unbelievable. I live in one of the largest medical centered cities in America.
Yet I had multiple doctors tell me and did things to me other doctors told me should be considered medical malpractice.
When I went to try to sue I found there's literally one judge who could deal with it but they refuse to even try to deal with my case in the court system.
Then the doctors try to shame me for dealing with my issues without taking the meds which the Doctors themselves told me would make my situation worse.
Instead I get a ride through Charlie's Chocolate factory showing me how America works.
<< To do so, court records reveal, the insurers have turned to a coterie of psychiatrists and have continued relying on them even after one or more of their decisions have been criticized or overturned in court. >>
...ok? Is ProPublica seriously trying to assert that they should be barred after a single decision ("one or more" includes "one") has been criticized ("criticized or overturned" includes "criticized but upheld")?
[+] [-] azalemeth|1 year ago|reply
Everyone is born, and, at some point, will get sick and die. Why does each of these cost tens or hundreds of thousands of dollars? I've heard American doctors at conferences describing their system as "the worst imaginable". Every American I know hates their system. It costs a lot more, has worse outcomes and shovels money and privilege towards the rich.
Why don't you change it? What are the reasons why moving to a single payer system is so bad? Denmark has the same system as the NHS, puts more money into it than the Brits do, and has some of the best health outcomes in the world. If a politician seriously suggested copying them -- with an income tax deducted at source with employee and employer contributions -- what would happen?
[+] [-] afthonos|1 year ago|reply
[+] [-] umanwizard|1 year ago|reply
Who do you think should change it, exactly?
You’re making the classic mistake of assuming the US works like the average European country: a functioning democracy where if something makes sense, politicians will promise it in their manifestos, and then implement it once they get elected.
In reality the US works completely differently and is not a functioning democracy. Making any major reform in any area is, to a first approximation, impossible.
[+] [-] rscho|1 year ago|reply
[+] [-] maxerickson|1 year ago|reply
My belief is that it's the relatively complicated regulation of capacity (federal and state regulations on facilities and providers), which pairs poorly with government programs that increase access to care with direct subsidies.
We should train lots more providers and eliminate barriers to entry (so for instance, if someone wants to open an MRI suite, let them).
[+] [-] liontwist|1 year ago|reply
Because money is just a tool for allocating resources. And having well trained people with equipment ready to attend to every person in that situation requires a lot of resources.
I’m not justifying our systems inefficiency - let’s just be clear that medical care costs a lot of money.
So the challenging political question is how to manage access and costs (often devolves into rationing) and who should pay for it.
[+] [-] mightyham|1 year ago|reply
The system can't be "just changed" because it's a very complex issue with a lot of entrenched interests. There has to be sufficient political will at the top levels of government that simply doesn't currently exist (in either the Democrats or Republicans).
[+] [-] londons_explore|1 year ago|reply
I suspect because nobody can agree on what the new replacement system should look like.
[+] [-] asdf6969|1 year ago|reply
There is no general “you” with agency. The few people who have the ability to change it have no incentive to do that.
[+] [-] Sohcahtoa82|1 year ago|reply
Half the country (or at least, half the voters, which is only like 2/3rd of the country because so many don't vote) believes in rugged individualism and a Just World.
They see single payer as their tax dollars going to paying for someone else's health problems that they caused themselves. In other words, they'll complain about their dollars paying for a smoker's lung cancer treatment or an overeater's diabetic treatment. They think everyone's health problems are their own and don't want to pay for it.
The fact that when they pay for health insurance but don't make claims means their money goes to other people is completely lost on them.
[+] [-] xiphias2|1 year ago|reply
But one thing is clear: it's easy to improve the nutrients that people in the USA take.
Whenever I travel in to USA, in the airports I can't even find a simple salad or any real food, even though I can see lots of pictures of salads, which drives me crazy.
Last year I went through Atlanta airport, I bought a hamburger because they didn't have literally any other food at 10pm, and I thought I would just throw away the buns and eat the salad + maybe the meat (depending of the ingredients). Then I looked at the ingredients and it was like 50 things that I didn't even know what they mean. It didn't smell or taste like food at all, so at the end I found 1 year old nuts in my bag that my mom packed a year earlier, and I ate that.
[+] [-] unknown|1 year ago|reply
[deleted]
[+] [-] serjester|1 year ago|reply
Americans really value choice and access, so they resist anything that hints at “rationing.” As a result, costs keep climbing, and there’s an insane amount of money tied up in administrative overhead.
For anyone looking for a nuanced perspective on this, I highly recommend Peter Attia's interview with Saum Sutaria (McKinsey's formed healthcare lead).
[+] [-] Aloisius|1 year ago|reply
Physicians are largely why the US doesn't have single payer.
They've been funding a massive influence campaign against government health insurance and most cost containment efforts for nearly a century under the guise of "protecting patients" (in reality protecting their pocketbooks).
https://citationsneeded.medium.com/episode-134-the-80-year-p...
[+] [-] giantg2|1 year ago|reply
[+] [-] namuol|1 year ago|reply
Bribery is legal.
https://en.m.wikipedia.org/wiki/Citizens_United_v._FEC
[+] [-] cute_boi|1 year ago|reply
> The implicit question is – if everyone hates the current system, who perpetuates it? And Ginsberg answers: “Moloch”. It’s powerful not because it’s correct – nobody literally thinks an ancient Carthaginian demon causes everything – but because thinking of the system as an agent throws into relief the degree to which the system isn’t an agent.
[+] [-] bgnn|1 year ago|reply
Now, weird thing is this doesn't work for the military somehow.
[+] [-] dfxm12|1 year ago|reply
Against these odds, our current healthcare system is very unpopular [0], and if you put it to a vote, we would probably get a more sane healthcare system, but again, realistically, it's not up to us, unless, over the course of ~6 years we constantly show up to both primary and general elections and vote for representatives who support it, and leave the corporate backed candidates in the dust.
0 - https://news.gallup.com/poll/4708/healthcare-system.aspx
[+] [-] alistairSH|1 year ago|reply
[+] [-] mystified5016|1 year ago|reply
Americans don't want universal healthcare because then "bad" (read: not-white) people will have it. That's it. Giving something to the benefit of everyone is untenable evil because it's "communism". If you weren't lucky enough to be born into a social class that already has socioeconomic benefits, you simply don't ever deserve to have those things.
This country has spent the last half century pillaging the commons and masterfully convincing just enough of the population that it's a good thing, actually.
Why don't we just change things? Because we no longer own the government. Several billionaires own the government. Democratic change is next to impossible because the game has been rigged so well for so long and nobody with any power has any interest in fixing it. The US government no longer exists to serve the needs of the people, it exists solely to funnel the maximum possible amount of money from the working class to the ultra elite
[+] [-] Workaccount2|1 year ago|reply
[deleted]
[+] [-] thrillgore|1 year ago|reply
[deleted]
[+] [-] Eumenes|1 year ago|reply
[+] [-] _fat_santa|1 year ago|reply
The best way I can describe our healthcare is that it's freakishly complicated, so complicated that pretty much every argument made by any side at any given time is both correct and incorrect.
For your example about single payer, with that scheme costs will likely be much lower but on the flip side, we also would not get immediate access to care (that is you can't attend a doctors appt within 72 hrs of scheduling) and we also would not get access to the latest and greatest drugs and therapies because those are always expensive and SP schemes typically do not cover that.
Now with that said is single payer good or bad? Well it all depends on who you ask. If you ask a 20 something that just visits the doctor once a year for a checkup and maybe calls into urgent care once every few years when the get the flu or food poisoning, that person will be all over the moon about a single payer system.
Now contrast that with someone in their 50's or 60's that has pre-existing conditions, sometimes chronic conditions, and needs constant care and access to the latest drugs. Well for that person single payer is dogshit and won't cover half their needs.
And that is the essence of the problem, two sides with vastly different needs from the healthcare system and a government that has to make one decision that will somehow satisfy both parties, even though that could really never happen. You're either going to pick the 20 year old and screw over grandma or you're gonna pick the grandma and screw the 20 year old.
[+] [-] Aunche|1 year ago|reply
[+] [-] cool_dude85|1 year ago|reply
This is a story of the fraud in the health insurance industry, not the racket part of the industry.
[+] [-] clcaev|1 year ago|reply
This is not precisely accurate. The medical loss ratio (80% for individual plans) can also be spent on quality improvement. There is a blurry line between administrative costs and QI initiatives. For example, a plan-provided coordinator could be QI rather than administrative.
[+] [-] londons_explore|1 year ago|reply
This.
You see it anytime you mandate some profit cap or limit as a percentage of revenue. Companies will just manipulate the other variable to get more profits. Or they'll buy other related companies so they can do sneaky internal pricing shenanigans.
[+] [-] Aloisius|1 year ago|reply
I'm confused. If that's the case, then why would they deny coverage? Wouldn't that be an easy way to overpay?
Heck, they could simply allow everything through and use rising costs as a justification to increase premiums.
This nefarious scheme of course requires insurers to have no competition. After all, if your competitors don't overpay, then they can lower rates and steal your customers.
The truth of the matter is that hospitals and doctors try to maximize their profits through excessive billing and care little about cost efficiency. They don't try this at the same rate with medicare/medicaid both because the government does not generally negotiate - reimbursement schedules are largely fixed and because defrauding the government is a criminal rather than civil offense.
There are some easy fixes here and there. We could, for instance, ban price discrimination by healthcare providers. Every payer would then pay the lowest accepted rate - which is usually medicaid or medicare's. This won't prevent billing for medically unnecessary or inefficient services, but it would eliminate the negotiation problem.
The problem is political. If you save a trillion dollars a year in healthcare costs, the GDP gets lowered by roughly the same amount. Healthcare providers would, of course, fight to prevent any reduction in reimbursements from happening - which they've been extremely effective at historically.
[+] [-] Spivak|1 year ago|reply
I think we want the opposite when it comes to negotiations and want instance companies to all have to pay out the cash price. The first step to making it possible to not need insurance for most care is making everyone pay the same.
[+] [-] throw10920|1 year ago|reply
[1] https://slatestarcodex.com/2017/02/09/considerations-on-cost...?
[+] [-] teknikl|1 year ago|reply
[deleted]
[+] [-] derektank|1 year ago|reply
[+] [-] ceejayoz|1 year ago|reply
> In interviews with ProPublica, federal judges criticized a system that fails to address problems that arise in court case after court case. They faulted the Employee Retirement Income Security Act, which governs many insurance claims in court, for not allowing for punitive damages, the sort that can rise into the millions of dollars and deter companies from bad conduct.
> To one federal judge, who like others spoke about cases on condition of anonymity, doctors and the insurance companies they work for essentially get off scot-free. “They might have to pay 10 claims,” the judge said, “but if they can avoid paying a thousand claims, then why would they change anything?”
[+] [-] xyst|1 year ago|reply
Only thing I have seen work: full sending 3 bullets into a healthcare industry CEO. The subsequent public indifference was quite eye opening. Didn’t matter if you identified as Liberal, Democrat, Progressive, Conservative, Republican - it was a unified response across the nation. Conservative talking heads getting ripped apart by own audience for being “out of touch.” Democratic leaders (Tim Walz for example) getting ripped a new one for fake sympathy.
We are well beyond “policy changes”, especially as we go into this next administration.
[+] [-] nothercastle|1 year ago|reply
[+] [-] hahamrfunnyguy|1 year ago|reply
[+] [-] NickC25|1 year ago|reply
Well done, Propublica. Keep it coming!
[+] [-] paxys|1 year ago|reply
Doctor.
[+] [-] Yeul|1 year ago|reply
[+] [-] ShinyNewFeature|1 year ago|reply
Do health insurance companies have to follow similar requirements? If so, individual cases of insurances denying insurance would be bad, but would indicate that the overall system is still working reasonably well.
[+] [-] rqtwteye|1 year ago|reply
Why can't the insurers have an app where the patient (or the provider) can type in the procedure codes they are planning to use and then the insurer returns the co-pay, co-insurance and other cost based on the plan the person is in? The insurer must have these systems already internally so why not mandate to give access to the calculations to patient? I had several occasions where I tried to figure out how much something would cost and the answer was "we can only tell you after the procedure was done".
This seems to be totally doable to me.
[+] [-] nradov|1 year ago|reply
https://www.cms.gov/healthplan-price-transparency/consumers
[+] [-] patja|1 year ago|reply
[+] [-] HDThoreaun|1 year ago|reply
[+] [-] xyst|1 year ago|reply
https://youtube.com/playlist?list=PLpMVXO0TkGpdvjujyXuvMBNy6...
[+] [-] toasted-subs|1 year ago|reply
Yet I had multiple doctors tell me and did things to me other doctors told me should be considered medical malpractice.
When I went to try to sue I found there's literally one judge who could deal with it but they refuse to even try to deal with my case in the court system.
Then the doctors try to shame me for dealing with my issues without taking the meds which the Doctors themselves told me would make my situation worse.
Instead I get a ride through Charlie's Chocolate factory showing me how America works.
[+] [-] unknown|1 year ago|reply
[deleted]
[+] [-] unwise-exe|1 year ago|reply
...ok? Is ProPublica seriously trying to assert that they should be barred after a single decision ("one or more" includes "one") has been criticized ("criticized or overturned" includes "criticized but upheld")?