They not only make the patients life worse but the doctors and hospitals as well. Dealing with insurance means small practices need a dedicated office staff to file the right paperwork and get paid for each patient visit.
In the last 30 years we went from affordable ambulances and insurance that worked to people too scared to use ambulances and insurance that our doctors encourage us not to use. Glad we are letting the free market work it's magic. Thankfully the market worked in our small town, the ambulance company went broke and we joined together as a community and now have county services that are not only better but much much cheaper and don't see peoples' emergencies as a profit center for some located elsewhere mega-corp. Weird how inefficient small town hick local government can now make work (and work better) what mega corp for profit 'big brains' couldn't.
Side note: USE SUNSCREEN PEOPLE! I wish I could go back and slap dumb 'too cool for sunscreen' Santa Cruz surfer kid me.
The healthcare market was arguably freer 30 years ago than it is today.
One of my coworkers took advantage of the L1 Visa (which I can still qualify for) and she ended up moving back to my home country Uruguay even though she made 50% higher salary in USA.
She did live some of the worst stuff in USA like Texas electricity failures, 20.000 dollar healthcare bills, etc.
Me, in Europe - I need healthcare, I go wherever I want, public or private. Public is free and good, but usually you have to wait a few weeks or months for non-critical care, and private can usually see you tomorrow. My insurance will cover it, no question - everyone is in network with everyone, and I’ve yet to find an exception. I pay €600 a year, and it covers all the root canals and colonoscopies I can handle. No copay. No excess, except on dentistry, which is like €25.
Lots of doctors only service patients with private insurance, so I sometimes just have to pay it out of pocket.
Specialty Care like skin is usually massively overbooked that you can't even get any appointment, as they don't accept any more patients.
Your experience in Germany is likely >10yrs ago before the system was sabotaged for private profits by our current health minister
I just remember getting some receipt for a very low sum from my insurance (Big Gesundheit) which was negligible (I think about 300 Eur) . All then other stuff was economically inconsequential. And I was on a Research Assistant salary. It was amazing.
It was not better than NHS (lived in the UK for some time as well) , but it was pretty good.
I will rely on my 600/mo insurance for minor injuries and major health crises, everything in between is out of pocket, the alternative is not worth the high blood pressure.
The reason it works is because the doctors do not have to staff a billing department. the office runs like a '2 pizza team.' Just delete bureaucracy, it isn't helping us.
Far too often, she knows that a certain treatment plan is going to be the only and most effective plan for a patient. However, insurance will require her to exhaust several other options first.
It seems the hope is enough patients give up on treatment that they never actually seek the proper care. They'll just get chucked the "cheap" option again in the future.
I wonder if for a public provider if the incentives are better.
should be generally. the NHS in england was viewed more favorably than the queen and they loved the queen.
The NHS probably has a much lower approval these days and in the past, and the NHS failing to provide care has become a political topic in England after years of budget cuts from conversative governments.
This is what I got from chatgpt:
“PAGA claim (Private Attorneys General Act) in California allows employees to file lawsuits on behalf of the state for labor code violations.”
How would that apply here?
The only for profit business where you pay the company to give you a "service". But the company's main objective is to do EVERYTHING in their power to AVOID giving you the service. They will spend $100,000 to avoid covering g your $100,001 claim; that's $1 to their shareholders, which is what matters to a Corp ultimately.
Insurance business is a scam.
I lived in Russia before, and I've had even better experience. I don't remember how much I paid (on the same order of magnitude), but home visits costed me may be around $20 a pop. (Personally, I'm buffled why more health systems around the globe don't have home visits, I'd gladly pay a reasonable extra fee). I've also used private health insurance subscription when I lived in Israel and had to see doctors in Turkey, Georgia, Serbia and Peru, paying out of pocket; in all these instances, prices were reasonable and the whole system very nice to interact with. For instance, in Georgia, my ex had to ride an ambulance and spend week in a hospital. The whole thing cost me around $300 out of pocket.
Anyway, in any of these systems where I had a subscription, I've never had to pay and then file a claim; doctors were employees of the organisation that I paid my insurance to.
Public health insurance, on the other hand, have always been an abysmal experience, with doctors and nurses not giving f about you. It was more expensive, too: you had to bribe people so that they actually did their jobs, and it didn't improve their attitude much. Nobody in that system has any incentives to help you. And, of course, it's much more expensive in the end.
It’s definitely hard to cancel them and the expense adds up to pay premiums for two
Was it a possibility?
Additionally, it sounds like he picked what appeared to be the best rated plan available to him on the market. Others may have been even worse or prohibitively expensive.
Adding in the last minute flights and commitments throughout this article, I would say for other people that at some point the calculus can be re-evaluated to find that paying the premiums would be worth it. The loved ones can pay for that instead of last minute flights and time off
This can’t be for real. The only reason you pay for insurance is in case something happens. It has no value outside of that. That’s why it’s called insurance. And medical insurance in the US is very expensive, so much that a large part of the population can’t afford it. If you don’t get care when you need it, it’s worse than no insurance - now there’s less money left to pay out of pocket to the only places that will take you on in time. The solution to being scammed is not to sign up for another scam.
Glad we have folks willing to do the hard work of defending negligent insurance companies <3
It wasn't blame and I wrote that specifically for that reason
So yeah, you have a 'choice'
Nothing like this would ever happen in a Kaiser hospital.
Kaiser’s mental health services were so bad that their providers went on strike a couple years ago. They’re paid a fraction of what they could make in private practice.
https://www.healthcaredive.com/news/kaiser-strike-mental-hea...
As a non-American I assume that Kaiser implements some sort of barriers to stop smaller competitors from rising up?
That plus as the insurers vertically integrate all the way down to care providers, they’re making it harder and harder for external providers to join their insurance network.
Capitalism doing capitalism things, and we have enough rightwingers to neuter any possible intervention.
FTC's attention on non-competes in healthcare:
* https://www.sheppardhealthlaw.com/2024/04/articles/antitrust...
* https://gi.org/2024/05/03/ftc-finalizes-ban-on-non-competes/
For vertically integrated payer-providers pushing non-owned physicians out of their insurance networks, you need only read the quarterly filings or listen to investor calls for any of these entities. They brag about it as an efficiency gain.
Regarding rightwingers neutering interventions:
* The FTC vote on non-competes was precisely on party lines
* Obviously the Trump admin would not allow FTC (or anyone else) to go after vertical integration + expansive, market-degrading non-competes in healthcare
* There is no GOP proposal anywhere to solve this, nor is it mentioned in the GOP platform whatsoever
* Project 2025 explicitly says the FTC should have no authority to analyze vertical integration as an enforceable anti-competitive behavior
FWIW, Kaiser isn’t cheap for employers or individuals but it offers a no BS system for claims and great care.
https://nuhw.org/therapists-demand-action-in-response-to-tra...
Or the one in San Diego in 2021.
https://www.sandiegouniontribune.com/2021/03/31/kaiser-patie... (https://archive.is/wF1bD)
Or maybe you're referring to the incident in Santa Clara in 2022.
https://www.medpagetoday.com/nursing/nursing/98534
Of course, those incidents aren't like the one mentioned in the article. The ones I linked are just a gross failure of Kaiser's mental health resources leading to three people's deaths instead. At least they didn't have to deal with a ghost insurance network though!
For instance, I pay 10% of my income for it and in some cases queues just to start treatment are for few years. And it does not cover teeth, implants, vaccines.
If case is urgent, like a cancer, it can take 6+ month to actually start treatment due to all paperwork and queues everywhere.
Private insurance has all the wrong incentives, and IMO profit should never be linked to the health of a human for that reason.
I don’t know if removing all profit from the system results in an optimal outcome, but I suspect it does not.
I’d sure rather pay a little extra and have 2024 equipment than 1984. That 2024 equipment exists because someone imagined they could make a profit if they successfully created it.
https://www.npr.org/sections/money/2019/10/15/769792903/how-...
The perfect system is a public healthcare with true abundance.
Government-led services are almost always inefficient. From my point of view the best is a private insurance but with heavy government regulation. Looks like Switzerland is going that way.
And private is not covering surgeries! For that there are queues for years, if not emergency.
That said, my experience in BC is that my tax burdens are much, much lower than my tax burden + insurance cost in the states. I’ve never had issues accessing healthcare in a way that impacted my health (which is not true in the states), although I have had to wait, since it is a triage system based on need, rather than ability to pay.
> The Graduate Medical Education National Advisory Committee convened by the Secretary of Health and Human Services (HHS) issued a report in 1980 warning that there would be a “surplus of 70,000 physicians by 1990” if steps were not taken to bring supply and demand into balance.
> This near freeze was enforced by the Association of American Medical Colleges (AAMC) and the American Medical Association (AMA), the two sponsors of the Liaison Committee on Medical Education, which is the sole accreditor of allopathic medical schools recognized by the U.S. Department of Education. The decision not to expand the number of slots in U.S. allopathic medical schools remained in place until 2005, when the AAMC and AMA changed their minds from declaring an impending doctor glut to warning of a looming doctor shortage.
https://www.heritage.org/education/report/why-dont-us-medica...
You can avoid the insurance problems with the same number of doctors or you can have the exact same insurance problems with 100x the number of doctors.
AFAICT, no health system on the planet, with or without controls on doctor supply, has achieved what you describe. If you have evidence that equilibrium can be found at "no need for insurance whatsoever," I'm interested to see it. It looks to me like equilibrium is nowhere near that.
Well, yes, one way or another, the market would reach in equilibrium. Like in physics or chemistry, you can't always exactly predict how exactly the equilibrium would be reached, but you can calculate where it is nevertheless.
However, right now in US it is not in an equilibrium, because the supply of doctors is artificially limited. Therefore, the natural equilibrium between supply and demand lies to the side of more doctors and more affordable healthcare.
A more direct solution is to just fine them $10,000 every time a patient is told a doctor is in network and they are not.