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Comment by bottom999mottob

1 year ago

What a dystopian world we live in where oligarchs controlling anti-trust companies deny medical coverage [0]. Am I surprised this happened...

[0] https://www.propublica.org/article/unitedhealth-healthcare-i...

[flagged]

  • It's wild that we let insurance companies label government triage as "death panels" while for-profit denial innovation got a free pass.

  • And insurance companies want us to need more or pay more for health care, not less. Insurance is regulated and the companies can only hold on to a certain percentage of the premiums.

    They would rather hold on to 20% of a huge number than 20% of a big number.

    • Agreed, the incentives are horribly misaligned throughout the entire healthcare market. We desperately need legislative overhaul but again congress is completely broken.

  • My insurance denied me a MRI and physical therapy because having 2 working arms was a luxury. Had to pay out of pocket to be able to lift my arm above my head. Private insurance can go shove it.

  • "Americans consume too much healthcare"? I'm afraid to guess the logical conclusion to this, but I will counter with "Americans are offered two little preventative healthcare", because in more advanced countries where that is an option, the costs are lower.

    • The conclusion is that we need to get rid of fee for service so that doctors stop prescribing things that dont work. Getting rid of fee for service also increases the amount of preventative healthcare people receive as providers realize its cheaper to do preventative than massive surgery down the line.

      1 reply →

    • Also americans are fed horrifying food products that are outlawed in civilized countries.

  • The primary reason for the cost difference is the massive network of middlemen injected into the system, and rampant profiteering by for-profit healthcare companies.

    Average cost of 1 vial of insulin in France: $9.08

    Average cost of 1 vial of insulin in the US: $98.70

    HDThoreaun: huffing some libertarian shit "The people are using too much insulin."

    https://www.rand.org/pubs/articles/2021/the-astronomical-pri...

    https://www.visualcapitalist.com/cost-of-insulin-by-country/

    https://aspe.hhs.gov/reports/comparing-insulin-prices-us-oth...

    • It’s not middlemen. The middlemen (managed care organizations, aka health insurance companies) earn low single digit profit margins.

      In the US healthcare chain, the ranking of profit margins goes (and this is public info from public financials):

      Pharmaceutical companies

      Healthcare software companies (based on other software company margins)

      Healthcare providers (doctor groups)

      Hospitals (HCA, tenet, etc)

      Managed care organizations and retail pharmacies at the very bottom.

      The big one I don’t know is legal, which I assume slots between hospitals and healthcare providers, but could be higher. Those millions and tens of millions of dollar judgments don’t come from thin air.

      Go ahead and get rid of MCOs, and at best you will reduce costs by 5%. That’s an objective fact. They are just allocating the very limited resources among more and more demand.

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    • > the massive network of middlemen injected into the system

      Does anyone have a good reference for this? It's something that I inherently assume exists but would love to see a flowchart of how rampant it is and where different layers are siphoning their penny.

      Would that even be possible?

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  • > The US spends over 17% of GDP on healthcare

    It doesn't have to be 17%, it can be an arbitrary number because the ones who decide on the nominal pricing are the ones who make money on them being extremely high. These same procedures can in some cases cost even 2-3 orders of magnitude less - and not in another country but in the same hospital but with a patient willing to pay in cash.

    • list prices are high to scare Americans into buying [more expensive] insurance plan.

      they want Americans be scared of going bankrupt from medical bills.

      on the backend, between insurance and hospital, these giant list prices are automatically lowered by factor of 10 to the actual cost of procedure

      the business model is: 1. insurance scares people with huge prices 2. healthy americans buy a lot of expensive insurance 3. money is injected into healthcare system from healthy patients 4. money is split among insurance/pbm/providers/pharma

  • >The main reason for that is because Americans consume too much health care.

    No, come on man, this is easily googleable. Americans go to the doctor less than other countries, they stay in the hospital less than other countries, they have lower life expectancy, infant and mother mortality than other countries. If you want to know why we spend so damned much, it's because we're billed 2-3x as much for the same care as other countries.

    • A more apt statement might be that we spend more, even if our quality of care is not better. And the reason we spend more is because of profit-maximizing companies in the middle.