Comment by tptacek
3 days ago
Sure, I'll defend them, conceptually at least. I think most actors in this system are in some sense corrupt, and I don't think insurers are the most corrupt. Pull up the 2022 National Health Expenditure table, "National Health Expenditures by Type of Expenditure and Program: Calendar Year 2022" and look at combined hospital and physician expenses compared to insurer expenses; it's pretty black-and-white.
One should not profit from denying care. All health systems ration care. Doing so in a way that people profit from denying care is immoral.
If you believe that, you should have a bigger problem with what providers bill, because that's the ultimate origin of the constraints.
I take it then that we agree that for profit health insurance companies profiting from denying care is immoral. That there are other immoral actors is not germane to the discussion.
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Your argument would be more convincing (well, not really because it’s typical bad faith contrarianism) if insurers weren’t also some of the largest hospital and clinic owners in the U.S. and use this to rob people blind on both ends.
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And inefficient to boot!
It follows that providers should provide care for free. Anything else is profiting from denying care. I guess you're just a full communist? If that's the case, just come out and say it so we can agree to disagree and move on.
> look at combined hospital and physician expenses compared to insurer expenses; it's pretty black-and-white
I mean, yeah. They're doing all the work.
And billing us 4x more for it than Europeans, and, further: a lot of that work is wasteful and unnecessary (see: spinal fusion surgeries, back imaging). There were more MRI machines in Massachusetts in 2023 than there where in all of Canada.
No, they're billing insurance companies that much. For-profit insurance companies are incentivized to drive up the cost of care because of the cap on their profit margins. More expensive care equals more profits as a bigger pie means a bigger profit even if the percentage remains the same.
Medicare's rates are about a half to a third of what private insurers have managed to negotiate. Funny how that works.
Doctors are not the problem with American health care, for-profit insurance is.
> And billing us 4x more for it than Europeans
In part, because dealing with insurers is immensely costly in staff and time.
(Other parts include the immense cost of twelve years of secondary education here; a million bucks in student loans isn't uncommon.)
> a lot of that work is wasteful and unnecessary (see: spinal fusion surgeries, back imaging)
Which makes the "insurers are there to reduce waste!" argument especially tough to stomach.
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> I don't think insurers are the most corrupt
Lol, nice defence