Originally published at: https://boingboing.net/2019/08/01/making-a-killing.html
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The Free Market should never have been attached to healthcare. For it to not gouge people for every dime they have, the people running it would have to be good people. These aren’t good people. They are wallet rapists. They fuck your wallet because they want to, they can, and you can’t stop them. Shhhh. It’ll be over soon.
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We cannot afford for-profit healthcare. It is destructive and evil.
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Like education, healthcare is too important for private-sector profit-and-loss rules to apply. There’s no reason for Private Insurance. None, full stop.
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Our massive medical bills are making bank for everyone. Politicians, for instance. I was surprised to find that 13 of the top 20 recipients of healthcare money were Democrats.
I was not surprised to see that contributions to Democrats spiked massively in 2008, when they began seriously pursuing healthcare reform. Not surprising that what started as a possible public option ended up as “you have to buy health insurance or we’ll fine you.”
All that to say the Dems are the better horse in the race, but they’re unlikely to be our horse when they cross the finish line. Please write your representatives and let them know you’re watching.
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Hey, Envision. We do some of their print material.
But…but…if the Democratic candidates talk about single-payer universal health insurance that will obviate the need for most private insurance they’ll scare off independent voters! /s
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OMG, single payer will raise your taxes! also /s
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Everyone knows that higher taxes is the biggest single atrocity against humanity! /s
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The free market can be great, but I don’t understand people who think it works everywhere without restrictions. Even if you like the free market for healthcare, emergency services should have price controls and hospitals should only be allowed to have in-network sub-contractors and doctors.
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I will be absolutely honest. I think that allowing private sector health insurance is a good idea.
Let’s say that we have a government default healthcare plan that covers 100% of medical costs, including prescriptions and durable medical goods, with no or minimal co-pays. (ie., go to the doctor, pay $5. Go to the ER, pay $10.) Lets say that on average this costs $X per person for coverage.
For everyone, if a company can provide that exact same coverage or better for less than $X per person, then they should be allowed to offer their services to the public and they can split the difference between the cost of their services and $X with their customers. (Alternatively, if an insurance company wants to try to charge people for the same or better coverage, then feel free, as long as they don’t lie about their coverage.)
For people above a certain income level, who wish to lower their coverage in exchange for more risk, letting insurance companies offer less featured plans (such as what we have now, high-deductible plans, down to emergency care only plans) with a rebate of the difference between the cost of their plan and $X (NOT the difference between the cost of their plan and the taxes they pay) is acceptable, given that they understand that we will let them die if they can’t pay.
(The reason why I am saying to give this choice only to people above a certain income level is to make sure that no one needs to choose between medical care and other basic human needs. Now and in the future, it is unethical to force people to choose between medical care and other basic human needs.)
In order to promote cost savings and drive efficiencies at the doctor and hospital levels, everything should have a coordinated standardized cost reporting element which is transmitted to one location and broken out there by insurance company. This standardized cost reporting system should be easy for the doctors to use and would ideally be generated by the patient management systems based on the nurse’s and doctor’s encounter notes. We really should have a standardized medical records system so that if a patient authorizes a doctor to see their records, they see all the patient’s records, regardless of source. (Basically, a universal MyChart.)
Oh, and it’s illegal for an employer to not pay their share or specify what insurance company their employees use. Any person can use any listed public insurance company. Taxes are based on wage and a 40 hour work week; a part-time employee is taxed the same as a full-time employee or salaried employee; an employer cannot get out of paying taxes by hiring two half-time employees instead of one full-time employee. (I think this change should be made to all employment taxes, tbh. Pro-rate for hours worked if hourly based, but no exemptions: work one hour, get taxed for one hour.)
That’s my wish list. And yes, I would expect the insurance companies to moan and complain that competing under those rules is impossible and it’s unfair and crazy. And if they go under and we only have one single payer healthcare system, hey, that’s OK too. This way they get a shot at actually proving that they add value to the situation; and if they can, they get to stay around.
Also, I fully expect that this is going to increase my taxes, hopefully less than my current insurance premium. Although honestly I also know that it may increase more to cover those who are currently uncovered; and I am OK with that too.
I think the complication from figuring out how to make this work doesn’t really make up for the benefit it brings.
For basic examples: what is your cutoff for income? People that live in Seattle, New York or the Bay Area are all going to make more money than the national average, but won’t have more spendable income necessarily. This is somewhat solveable but not easily: figure out ways to match local spending power, and then key off that. But that’s not the first or last problem to solve.
Compare that to: You have national health insurance. It’s tax-funded. It covers everything.
And what’s the real benefit to your plan? So that rich people can make bad decisions? I don’t really give a fuck about rich people’s bad decisions, certainly not enough to turn a relatively straightforward plan into a mire.
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Which it will be in a country full of temporarily embarrassed millionaires.
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Every cloud has a silver lining: your leukemia is buying a third home for someone you’ve never met!
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I can’t get behind private healthcare. Sorry. You can’t have Platinum Service and Ordinary Shlub service for a human f**king right.
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A huge wall of text demolished by a few simple facts. For-profit healthcare and insurance are monstrously inefficient. They extract as much money as possible from patients and deliver worse results than single,payer or single provider. The one rich country which has them (the US) has the worst outcomes at the highest prices as a result of this.
The alternatives aren’t new or radical. They work better everywhere else.
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There’s no complication. Every developed country manages just fine. The US is not a developed country for the majority of its citizens.
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I can’t really understand what you mean, unless you misunderstood my point as ‘Single-payer health care will not work’, which is the opposite of what I said.
My point is that setting up some arbitrary system for private healthcare but only at a certain income level doesn’t really do much to fix anything - and since my discussion and reply was about giving the ultrawealthy the option to ‘opt out’ of single payer healthcare, I don’t really understand what you’re getting at.
See, the big thing is: there is a good chance that Republicans will have a big hand in shaping what the government plan pays for or not. Stuff like medically necessary “abortions”, birth control, gender dysmorphia treatment, stuff like that.
I’d like for there to be at least theoretically a choice that I can make that will include funding for things that Republicans don’t like. Even if I have to kick in a few more bucks a month for me and my family.
Why outlaw abortion when you can just make sure that in order to get one you have to pay $10K up front? Avoids that whole sticky “but I still want my mistress to be able to have one” problem that keeps cropping up for Republican leadership… and if they control the healthcare system this is possible.
Everyone would hopefully have a choice. Most people will choose the government plan. But by having a choice we keep the government plan more honest. And, honestly, there is a potential that private enterprise could be more efficient and cheaper than a government service while not cutting care standards (because they won’t be allowed to).
In all seriousness, I have a project in the works to help divert companies away from private equity. DM any serious interest.
