But yeah, the one player in this market that has its profits capped statutorily, they're they're the whole problem, no matter what the numbers say. Sure.
I'm not telling you there's no problem. I'm saying that you've been conned into believing the problem is something it isn't.
They are, however, a large part of the system that no one likes to deal with and can be fully eliminated without obvious negative consequences.
Health insurance doesn’t provide health care and is a purely extractive rent-seeking business. The article I posted even explains how single payer can help drive health care provider rates lower, as you now have a single, powerful entity (Medicare) negotiating against doctors, hospitals and drug companies.
And this “one player” (health insurance companies) heavily lobby against the implementation of single payer health care system. And their profit caps ensure that their goal is to grow the cost of medical care so they can take an ever higher profit in absolute dollars.
Meanwhile: we are commenting on a story about someone murdering a health insurance executive.
Is this surprising? Motive is always of interest after a high profile crime. And apparently it requires assassination with manifesto to bring these robber barons into the spotlight. The only thing I find surprising is the use of a 3D printed gun instead of just buying one from a show or local gun store.
You’re choosing to avoid all of the other cost savings that will come from eliminating private health insurance and having a single payer who can effectively negotiate with providers without the goal of taking a slice of profits from an ever bigger pie.
Meanwhile: all insurance costs, in the whole economy, across all of national health expenses, total less than 10% of costs overall. Providers drive all the costs in our system, not insurers. But Breunig is fixated on his preferred solution, so he's not telling you that. But the numbers are right there if you want to see them; just search [National Health Expenditures by Type of Expenditure and Program: Calendar Year 2022].
I honestly don't care if you want Medicare vs. private insurance. I don't love my insurer. But if you zero out the total cost of insurance, public and private, you barely make a dent in our health costs. There is no way around it; the numbers are stark.
Personally, I think the balance we've struck in our payment system --- private markets until age 65, at which point the state steps in --- is pretty smart. Our system is fucked, of course, but that's because health provider chains have been ripping people off for decades.
I like your proposed solution that the state somehow engineer a way to drive down the costs billed by providers. Perhaps if the state operated a (pseudo-)monopsony wherein they exercise their leverage as the payer to drive down costs.
It could have a snappy name like if you combined medical and care? Or maybe medical and aid?
Anyway I also cannot fathom why anyone would hold ill will towards an industry that lobbies to stop that from happening. They are simply smol beans and the fact that there is no single payer monopsony means they are splitting a measly fraction of a trillion dollars per year. The fact that somebody else makes money too is proof that they couldn’t be a problem uwu
Health provider chains rip people off because that's how they maximize earnings from insurance companies. Insurance companies maximize denials because that's how they maximize profit. You remove one side from the equation and the problem of provider costs becomes easier to solve.
And as an aside, I dealt with my mother being denied healthcare from her insurance provider because they determined her stroke was a pre-existing condition.
There is simply no logical argument you can ever make that will change my opinion.
You can argue that health providers charge too much and that's true. But the core of the rot comes from the health insurance scheme we've cooked up. And people rightfully blame the insurers for this problem.
Maybe if they dislike it so much they can put a fraction of the billions they're earning towards bribing politicians for a public option rather than constantly spiking things like that whenever they get a chance.
I agree with a lot of what you are saying. Trying to demonstrate some common ground - my (somewhat shallow) reading of the Anthem Anesthesia issue aligns much more with your analysis than the pop narrative.
But how exactly is the denial of care suppose to function as a price feedback mechanism to form a working market between providers and insurers? Is an MRI provider supposed to be thinking that if they lower their prices by 10%, the insurance companies will increase the number of approved MRIs to make up for it? And this still ignores that prices are not the same as profit margins, which is a huge hand wave here. Also if those denied MRIs were truly unnecessary, then how would paying for them merely because they cost a little less make sense?
Which is the crux of where my original comment was coming from. The responsibility of deciding necessary medical care needs to be laid at one decision maker (eg the treating doctor serving the patient per their code of professional ethics while fundamentally still working for the insurance company), rather than this split-brain blame game between the patient-facing doctor having little downside to saying yes, and the back office "doctor" at an insurance company having little downside to saying no. An insurance company shouldn't really even have its own opinion on something decided by a medical professional they're already contracting with, especially when that opinion has been created purely based on formulaic paperwork processing. At most they should be able to refer the patient to a different provider to perform the service, or withhold some payment for the service per their contract with the provider (but invisible to the patient).
This is obviously not the only reform we need to get any sort of price signals and sane division of responsibility in this industry. Because yes, provider costs are the main problem and they've been marching ever upwards. But every one of these terrible dynamics that has been allowed to fester is in need of its own reform, especially if you aren't advocating for the blanket approach of single payer.