The US health care/insurance industry needs to die

Health Care and Insurance Industries Mobilize to Kill ‘Medicare for All’

I recently needed to see a doctor. A Northwestern clinic told me I can't see a specialist without first seeing a primary doctor. And then, they said because I don't have insurance, the visit to a primary doctor would cost at least $500 out of pocket. This amount did not include tests.

I told them I'm not paying $500 for a consultation and they said they wouldn't help me then. No negotiation.

Money came first. Care came second.

The US health care system needs to die and be rebuilt into something less greedy/profiteering.

As many of you guys are already aware, I tend to lean free market on most issues. On health care, however, I'm not as convinced, for two reasons:
1. There is no possibility of a free market for emergency care for unconscious patients. In order for free market competition to work, the customer needs to be free to shop between multiple competing suppliers. This is obviously impossible if the customer is unconscious. I understand that this is why health insurance exists, but even without a law it's functionally mandatory — either you agree to pay a fixed amount regardless of whether you need services or not, or you're at the mercy of the hospital to charge whatever they please, without your consent, and hit you with the bill when you regain consciousness.
2. Untreated chronic conditions eventually create unconscious patients, putting time on the hospitals' side. Although free-market actors who are conscious CAN shop between various providers to get the best combination of price and service, providers are financially incentived to take a hard negotiating stance because it's much easier to negotiate with an unconscious person, or someone under duress due to a worsening condition, than it is to deal with a healthy negotiator. Thus the kind of behavior one sees in the opening post.

Because of these reasons I can certainly see the appeal of single-payer/Medicare-for-all. It's not that unusual to socialize specific industries, such as policing or arbitration, when the nature of the industry is problematic.

That said, I don't advocate that particular solution myself. Why? Consider the market for foods. Because there is a high degree of competition between suppliers, suppliers can't just hold out on a good deal and charge ridiculous prices until starving folk desperately pay a huge bill. While I think emergency care should unequivocally be socialized, as far as chronic conditions go it should be possible to achieve a free-market solution by increasing the number of competitors.

However, even this solution requires robust government intervention. The healthcare industry has been allowed to devolve into oligopoly, at times even assisted by government. We have antitrust laws already on the books, so new legislation isn't necessarily required (excepting the repeal of laws worsening the situation); what is required is the will, in the form of political capital, to go after these oligopolistic corporations and break them up into something that better serves the American people. Ending the blatant collusion between the hospitals and the health insurance companies who are supposed to be negotiating the lowest prices for their customers would be a great place to start.

By nature, I'm not as intellectual as you Scrotie. I didn't understand a lot of what you posted. That's on me. Not on you. You do write well. All I know is 2 things.

1) Being inspected by a doctor for approx. 2 minutes should not cost a minimum of $500.

2) Being able to maximize profits off of human death/suffering is not ethical. The health care industry should not be able to charge Americans whatever they want. For example, I have a choice whether I want to shop at Starbucks and incidentally make Howard Schultz rich. I have a choice whether I want to purchase Activision/Blizzard's games and incidentally make Bobby Kotick rich. I DO NOT HAVE A CHOICE about aging, getting sick more and more frequently and eventually dying!

Right now, the US health care system is rigged. It's rigged because human mortality is allowed to be treated like it's a commodity.

What a sweet commodity the drug companies/for-profit hospitals/insurance companies all have. How can they ever go out of business with an unlimited black-hole commodity like human mortality? And on top of having access to an unlimited commodity, they are allowed to charge Americans whatever prices they want. Every year prices get more and more expensive.

If you are an administrator/executive that is part of the health-care industry you are part of a pretty sweet money-making scheme. How can your business lose when all humans are fated to get old, sick and die? If you can't lose and your place in society is of paramount importance to the functioning of the society, should you be able to operate like a for-profit business and be able to set your own-prices to make as much money as possible? Doesn't seem ethical to me.

Social health-care is great for "run of the mill" stuff.

It's really not that solid if you got some quirky problem nobody is familiar with and requires very narrow attention.

If i was playing civilization's or something i'd go for a mixture of both privatized healthcare and social support.

Hospitals are great for "trauma" and "common ilnesses", but i reckon that same social system fucks up a lot of mental care and more serious cases by trying to force them in a box they are familiar with.

As for the america comment from Charan, i don't suggest them to look at england or the EU in general for any examples of identity, we got our own crisis going on.
Our social systems are under extreme presure at the moment and extremely fragile my parents for example are not expecting to have a pension when they retire. We don't need it thankfully but other people are not so lucky and we all know what the end result of that presure is going to lead to.

Peace,

-Boem-

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鬼殺し wrote:

Think bigger.

If i remember correctly you have crohn's disease.

How is that not "run of the mill" in medical therms exactly?
(current records for north-america is 44 men per 100.000)

Another question would be, are they curing your disease or stabilizing it which are two entirely different things.

Maybe you don't have crohn's and i'm remembering incorrectly, if so apologies.

Peace,

-Boem-

nice forum.

Peace,

-Boem-

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鬼殺し wrote:

None of this really contradicts my main claim that if social health care can handle run of the mill stuff, the more unusual stuff is also easier to handle because the system isn't overloaded with dealing with run of the mill stuff.

I know two nurses and both tell me the system is under extreme pressure where i live and hospitals are severely understaffed.

because the system is a social health-care the pay reflects that which means a massive downwards trend of new staff.

Most new influx of nurses and doctors are starting privatized busineses so they can secure payment and "solid hours".(mostly the personal care sector)

Fun fact : the traditional working hours for doctors are based on somebody that was on constant coke due to coke related test trials when he was a young sholar in the field.(which resulted in him being hooked by the end of the trials)
He became a famous doctor and they simply copied his hours and standardized them for the entire practicing field.

Thought i'd throw that in as to not entirely waste your time and perhaps hint at the current system not being solid as is due to institutionalized flaws of the past.

Last time i talked to one of them she was talking about being responsible for an entire hall by herself.(16 people all bedridden)
Similar story's include having a couple of vacation weeks left over by the end of the year(overtime hours) and a refusal to allow them to be taken by the head-nurse due to being understaffed and no option for compensation pay etc.

I guess we both have different views on what a good system looks like.

It's functional for sure, but my argument would be that it still requires attention to perfect it and an aknowledgement that it is not a good institution to deal with things like mental health and other specific cases of "human illness".

I am happy it's working out for you specifically.

Peace,

-Boem-

Yes, it sounds awful, in the USA, with the health stuff. Becuase you can't self-refer to a specialist, coatofarms - that system is stupid, for many things. Did you get it sorted out?

Charan's account is right, we are fortunate by world standards. The Australian public system is pretty good, but for serious mental health it's woefully under-resourced. I've seen such drastically different outcomes for people with and without private cover. Private = start declining, confer with supports, and check into a private clinic for some extra support/medication management/rest/nice food, come out in 2-4 weeks stable. Public = not admitted until you are in serious crisis, which can take years to recover from. The stories I have, oh boy. People are discharged still so messed up. There are step-ups but too few. Plus, a lot of psychosis is drug-induced, adding complexity.

Staying out of hospital should be the main goal, with community support often does work that way but sometimes people just spiral way too far too fast to catch.

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Boem wrote:

Hospitals are great for "trauma" and "common ilnesses", but i reckon that same social system fucks up a lot of mental care and more serious cases by trying to force them in a box they are familiar with.

I agree. That's a huge topic, but yes. I don't think MH should be so medicalised, and hospitals with the restrictive practices and human rights abuses cause a lot of trauma to people with MH. There's some work being done to change the way people are treated; it's slow going though. It shouldn't be the first line of solution to emotional and mental distress to "see your doctor".

...but the reality is that's where we are at at this point. So yeah, if you're in Aus (or other similar systems) and have a chance of getting really unwell mentally, hope that you're able to afford private cover and get it.

Back to general healthcare - it's cheery that Monsato is now absorbed into Bayer, isn't it?

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鬼殺し wrote:

Most healthcare professionals I've read regarding a good system agree a combination of socialist and capitalist methods is best (and that's precisely what I'm advocating). But isn't that true of most things? Extremities tend to have extreme flaws and weaknesses. So shore up the weaknesses of one with the strengths of the other.

While I think the core idea behind this is eminently sensible, one could call the ACA (AKA Obamacare) a mix of socialism and capitalism based on "expert opinion," and it was/is a disaster. It's possible to mix things in a way where strengths cover each others' weaknesses, but also possible to mix things in a way where weaknesses cover each others' strengths.

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erdelyii wrote:

Back to general healthcare - it's cheery that Monsato is now absorbed into Bayer, isn't it?

And the market gets a little less competitive. Every merger of megacorporations is a detriment to consumers.

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鬼殺し wrote:

Yeah, it's one of three big blemishes on our system overall. The other two are how we treat our asylum seekers and domestic abuse. For another thread though, that. I'd argue at least we allow asylum seekers but eh, that last one strikes me as increasingly unforgivable. The statistics for domestic abuse are truly horrific in our country.

Indeed. For another thread, I agree.

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Charan wrote:

Back to mental health: From my perspective as someone on a sort of chronic health care plan through medicare, I am entitled to a number of subsidised mental health care visits that I believe I might take this year, in lieu of equally important things on the same plan such as physio and pain management. I would rather just bottle it all up and maybe take it out on one of you randomly now and then, but let's face it...there just aren't enough of you for that.

Ah, life gets to the best of us, mate, and that's on a good day.

I won't bore you with the access and referral stuff. You'll work it out with your medical team. Know if you didn't already that diagnosis is for the purpose of medication; you don't need a diagnosis to get therapy.

If you're new to therapy, I'd suggest you do your research thoroughly beforehand.

Overwhelmingly, most psychologists here will do Mindfulness, Acceptance/Committment* Therapy (ACT) and CBT in some sort of combo. Do look into those to see if they appeal.

Alternatively, something like this practice offers a wider range.

Personally, I think existential therapy sounds great. Gestalt is pretty cool. You'll decide, and yeah, nothing like a paid stranger to sort through stuff with. That sounded glib, but it's not. I recently had three sessions of Employee Assistance Counselling for work-related stuff that was impacting my MH. She was fantastically helpful.

Take care of your mental and emotional well-being, Charan, you're a good egg.