It's supposed to be that insurance converts inherent risk into a predictable cost, but health insurance is not really doing that. The costs remain unpredictable.
The costs remain unpredictable.
I wholly disagree. I predict that the costs will be unnecessarily high.
But predictably. Give me a real fucking number, not just "high." You can't do, can you, fuck-face???
Ugly cries angrily and shamefully in the corner knowing that the wrong person just got yelled at
Stop knowing about my face.
But they know that, which is why healthcare costs have consistently increased higher than inflation.
Healthcare is one of THE MOST demand inelastic commodities or services. People do not say “oooh that’s a lot of money - is there a worse doctor who is cheaper?”, instead they say “100% yes I will remortgage my home and sell assets to pay for the cancer treatment my child needs.” Nobody is at the free clinic by choice, they’re there because they cannot afford or borrow to pay for better care.
Capitalism is incompatible with ‘rational consumer purchasing choices’ that apply to clothes, food, TVs, etc. because when there’s death or life altering negative outcomes, the only rational decision is to pay WHATEVER the price demanded is. Healthcare has a demand wall, not a demand curve.
Insurance is, at its core, a reasonable halfway measure towards public control of a critical resource. If you need something only very rarely, but it's something that needs to exist ALL THE TIME just in case, insurance allows you to pool your resources with other people in the same boat and afford to keep an industry around just in case. Somebody will always be using it right now, and it'll be there when you need it, because you paid into the pool.
The problem is, as always, the insertion of capitalism into the solution. If someone has to profit from this set of relationships, the motivation to provide the resource is in competition with the motivation to extract more profit. This is what happened to healthcare.
Insurance is only a halfway measure because we already have an organization capable of managing common resources that individuals use only rarely but which the public needs all the time: that organization is the government, or the governments at various levels. We manage lots of things this way: fixing roads, stopping houses from burning down, pulling people out of floodwaters, that kind of thing. You don't need it all the time, but it's there when you need it because you're paying taxes to a government that has no profit motive from it. Insurance should only ever have existed temporarily while government infrastructure was debated and organized, but the for-profit industry managed to capture enough of the government to keep itself alive indefinitely.
In short, insurance isn't inherently bad, just not meant to be a permanent fix. Capitalism is bad.
Private insurance should only exist for things that are both a) completely optional, and b) not inevitable (so... evitable?).
Auto insurance? Well, if it's the law to have it, why is a private company involved whose sole model is to collect money and deny payments?
Health insurance? Well, it's optional, but you will absolutely need to pay for Healthcare at some point (or you die early). Why, again, should we put an institution in charge whose sole purpose is to make the average person pay more than they get out of it?
Famous athlete leg insurance? High value possession insurance? Have at it, private insurance.
And these cunts get to say 'doctor is wrong you don't actually need that'
I just thought of a funny concept which is that when you're born in the country you're automatically given life insurance. Then when a doctor says "you need this operation" and the health insurance company is like "your doctor is wrong" your life insurance company can come in and be like "you can't kill my guy, because he'd be owed a gigantic payout!" and then go to war with each other.
It would never work in reality, but I find the idea funny.
What would predictably happen is that the health insurance company would still withhold care, and the life insurance company would deny the payout based on the care being withheld. Then they both would be like "sue me".
And eventually they would merge and be just one company.
Insurance must be the only industry that actively tries not to deliver the service that its customers pay them for.
Want to hear something crazier? They don’t even have doctors. Non doctors are telling your doctor what is medically necessary.
I had an issue with my foot and the doctor requested an MRI as an ultrasound wouldn't show them anything they needed to see. The fucking insurance company says no, do the ultrasound... So I paid for a fucking useless ultrasound and then they refused to move forward with anything else... The issue kinda went away thankfully but there's still something odd with my foot that I guess I just won't fix until I can pay completely out of pocket.
I'm so fucking happy that at least $1,200 monthly is taken out of my potential pay to cover a fucking useless insurance scam, because remember even if your employer "pays" it's factored into your total compensation so you're still the one paying.
I'll do you one worse. Sometimes, they do have doctors. In cases where people are trying to get coverage, especially for a severe workplace injury with lifetime effects, the insurance company will send you to a doctor who barely passed med school. They'll have you do a "physical" that's basically turn your head and cough. Then they write up a report that says you don't need coverage.
Since they are technically a licensed doctor, this is still considered "expert" opinion in court (if it comes to that). The doctors involved can make way more money at this then they can working their mediocre asses in any real capacity.
their profits only exist when human beings are denied care. humans have to suffer for that stock price.
Well, they also profit from healthy people who don't use their insurance much.
Is this a US thing that I’m to Europe to understand?
Yeah in the United States of Billionaires healthcare is a product to extract profit from in every way possible.
Pharma companies get public funding for research and then turn around and charge insane prices for the final product infuriatingly referring to research costs to justify their pricing.
Hospitals are bought and run by investment companies.
"Insurance" ~~scammers~~ corporations have their own fiefdoms that they control so there's very little competition and their sole reason for existing is to take your money and deny coverage for absolutely anything they can possibly deny you for so they keep the most money possible.
We have The Best System In The World™ (for the ultra wealthy)
Apparently, yeah.
You probably haven't even shot up a school or anything have you.
TBH Hospital Boards aren't all that innocent, either.
The largest hospital in my region owns the largest health insurer in the region.
Pooling everybody's money so that the ones who are unfortunate get money to help with their situation definitely is a product. Just because you don't understand something doesn't mean it doesn't exist.
Where do you find Insurance like this? Because all of American Health insurance is just about pooling everybody's money into the pockets of shareholders will denying as much coverage as possible
That's what the concept of insurance is, but health insurance very much does not match the concept.
Healthcare isn't something that only the unfortunate need. Healthcare is something every person needs. If you live long enough, it will be costly. This is why insurance as a concept is fundamentally unable to handle healthcare. It is antithetical to the concept of insurance.
When I had top surgery (getting the fat sucked out of my tits so I could put an “M” on my drivers license, funny how many jobs fell through right I9 verification…), I did a lot of research into what I needed to do to get it covered. I got letters from doctors and therapists, I’d been in hormone therapy for a while, and my policy said it covered it. I checked with a rep, they said yeah, you just pay for it up front and submit for reimbursement.
So I took out a $5500 loan, had surgery, and then attempted to file for reimbursement. Turns out that my specific policy, from my step-dad’s employer had a rider that exempted it. Somewhere buried in the fine print, didn’t come up until after I had taken out the loan.
It’s pretty common for trans people to end up turning to sex work to finance their medical care (and tbh, survival in general). That’s how I joined that statistic.
I've been fighting with my insurance company since May. My wife had a medical emergency and I had to take her to the ER at 3AM on a Sunday. The team of doctors treating her all agreed she needed to be hospitalized and have emergency surgery. She was admitted and underwent surgery and was out in three days.
A week after she was discharged we received a letter from the insurance company letting us know they had decided not to cover the $67k hospitalization bill because they had decided it wasn't medically necessary.
So yeah, that's great. Not to mention we had finally hit our $6,000 deductible (after I had cardiac issues and ended up in the ER the previous month) so insurance would finally have had to actually pay something.
So glad we pay them $1500 a month for them to make decisions on what is medically necessary and what constitutes an emergency after the fact.
What's this "we" bullshit? You and I never had a say in it. It's not like we get to vote on this stuff.
Disclaimer: I think the current U.S healthcare system is hilariously bad and should be heavily reformed.
Insurance is not a bad thing, and there is a clear product involved in it. To demonstrate, you can go to a doctor in the U.S and pay in cash for the treatment. As I've understood it, you can even negotiate lower prices than the list prices if you are paying in cash. Still, it's probably going to be expensive to the point of potential financial ruin.
This is the product that insurance offers in any domain it operates - buying your way out of risks you cannot accept. Fundamentally, the concept is sound, albeit very poorly implemented in the case of U.S healthcare.
It's basically just a bunch of people pooling their money together and having that pool of money pay in the case of an adverse event.
One of the primary alternatives to the mess that is U.S healthcare today is in fact another form of insurance - it's just that enrollment would be mandatory and as such the risk spreading would be as uniform as possible, along with subsidies for people carrying higher amounts of risk. That's fundamentally what universal healthcare is in other countries.
Health insurance companies sure seem like socialized healthcare but with some rich guys that steal money out of the pot
If you squint your eyes just enough, insurance is like gambling... You are betting that something is going to happen to you, the insurance company is betting against that. The insurance company can improve their chances by adding conditions to that something.
That's the part that makes the US system insane.
In countries with a public health care system, the goal of the patients and the doctors is the same. Everybody's goal is to prevent diseases and sickness, and to treat it when it isn't prevented. The administrators just estimate how much funding is needed to achieve that goal.
In the US system, the patients are trying to prevent and treat their sicknesses and diseases. The administrators are trying to find ways to avoid paying for any treatments, and the doctors make more money if they can find a way to bill more things.
And, what's especially insane is that healthcare really isn't a normal market like other things. If you're buying a truck, you can shop around, haggle with salespeople, etc. If you're hit by a truck, you're not going to be comparison-shopping emergency rooms.
Same as student loan "servicers" collecting billions in interest to just keep track of peoples' debts.
All health care costs then also are greatly inflated just so these a-holes can make money without affecting what the doctor gets.
And doctors have to hire extra people to deal with insurance and trying to get their money...
My favorite is when they send me and letter in the US mail for the sole purpose of telling me they decided to cover our medication the doctor prescribed. The language they use is infuriating.
As if we should call them back and praise them, be grateful for their service, and just ignore that I’m paying them.
This! Health insurance is the reason why medical costs in the US are so ridiculous. Health insurance, and IMO all insurance, is a scam. And since the "customers" (people who NEED care) can't see the price of service beforehand, there is no way for them to choose the most cost efficient option, which allows providers to charge whatever they want. Then the insurance company can come up with reasons not to pay and put the client on the line for the cost.
Insurance transition from protection against highly unlikely emergencies to our default payment system is the biggest scam in world history.
No no no! Their product is keeping the system operating properly. You know, checks and balances. And by that I mean check you bank balance because your medical care just cost more than anywhere else in the world.
My ex suffers seizures. After years of bad doctors, he managed to see a neurological specialist who helped him manage his issues. His doctor informed his insurance that treatment was working and his symptoms had regressed - he even managed to earn his driver license back. His insurance took that as "he's better now" and kicked him off. They sent him a bill for thousands of dollars that he had to pay before he could try to get back on his plan. He wasn't able to afford his medication, nor his therapy, and his symptoms came back swinging. I still have a photo of his rejection letter somewhere that I keep as a reminder of how backwards and awful the insurance system is.
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