Some countries have a split system. Partly public and partly private system. Would this be good for the US?
Technically the U.S. already has this. Medicare, which covers healthcare for anyone 65 or older, is essentially a type of single payer public insurance program. This represents a fairly big backdoor subsidy for private insurance since a large population with a greater likelihood of having significant health problems (old people) are taken out of the pool covered by private insurance.
Another big chunk of the U.S. population (active duty military, veterans who were discharged honorably, and their dependents) are covered by the Veterans Administration, which is a type of government provided healthcare similar to the NHS. It's not that the U.S. doesn't have public health care, it's that such systems are a patchwork that doesn't cover everyone.
When I said I did not have the time to look at other universal programs, I was pressed for time to go to church. Nonetheless, my point is that no health care insurance programs, private or public, is perfect. People are still dying. Even if we could get Universal Health Care coverage like the United Kingdom, France, Germany, Canada or elsewhere people are going to die because they could not get needed health care in time.
One of the reasons for more than a few of those deaths is that care is denied repeatedly by third or fourth party insurance company employees. This isn't bleeding out after a bad accident.
And just as an observation, but I would guess it's safe to say that the NYC shooter is the most popular assassin in American history?
I'd probably assume that Booth, in his day, was second...
I was thinking of Booth just now, while listening to some skeptic of the official narrative suggesting that no one of Luigi's ultra-comfortable socioeconomic status would throw it all away just to commit a murder for political symbolism. Specific mention was made of his impressive family tree.
I am aware that Booth was technically NOT a lone actor(sorry), but even so, he must have gone into the boardinghouse conspiracy with a radically altered concept of self-interest. He likely wasn't thinking in terms of "How can I increase my financial success in order to keep living the good life from here on in?"
(The above is based on the assumption that Booth was more-or-less doing okay at the time of his crimes. Open to correction on that.)
And if, like Booth, the Adjustor was assuming that murdering Thompson would spark some sort of massive sociopolitical alterations, he might have been assuming he'd be elevated to national-hero status, another factor that could possibly impart indifference to material fortune.
When I said I did not have the time to look at other universal programs, I was pressed for time to go to church. Nonetheless, my point is that no health care insurance programs, private or public, is perfect. People are still dying. Even if we could get Universal Health Care coverage like the United Kingdom, France, Germany, Canada or elsewhere people are going to die because they could not get needed health care in time.
But are they dying simply to make shareholders a dirty buck? (Or 10 million or so of them a year for the dear departed CEO, Mr. Thompson, as I understand it.)
Because that’s the real issue, isn’t it? I think it’s fair to say that no one expects a perfect system with 100% positive outcomes. But when the reason people get claims denied, medications not covered, etc. boils down to “line must go up”, something is deeply wrong. It’s immoral and unjust.
(Full disclosure: I’ve had to battle UHC over — thankfully — non-life-threatening issues for my child, and have opinions on them not suitable for all audiences.)
That said, I still would prefer either a universal health insurance or a not for profit system which we had before Ronald Reagan. However, we had gotten to the point where the insurance system could not keep with the increasing costs.
And I have also had my problems with insurance denials too, like when the insurance carrier we had denied our bills for one of our kids who had anorexia nervousa, and when the insurance also denied my request for a spinal cord stimulator. In the case of our child, he is now in full recovery. Much of the cost of treatment was forgiven. In the case of the denial of the spinal cord stimulator, we were referred to alternative procedures which has worked for the last few years. Now I have lost enough weight, I no longer need that procedure.
And I have yet to see any statistics about how many people have died because their claims were denied.
And I have yet to see any statistics about how many people have died because their claims were denied.
Well, I've been looking. I'm not sure anyone knows.
The number of claims that are denied is a mystery -- ProPublica tried to figure it out, and couldn't. There's a federal law requiring private insurers to reveal how many claims they deny, but it hadn't been implemented. KFF analyzed the data from Medicare and Medicaid and the plans issued through Healthcare.gov and found that "17% of in-network claims were denied in 2021" but that denial rates were extremely inconsistent, "ranging from 2% to 49%." A KFF survey says people with private insurance are more likely to have their claims denied than those with public insurance: for Medicare and Medicaid, the denial rates were 10% and 12% respectively, for private insurance the denial rates were 20-21% -- overall, 18% of those surveyed had had a claim denied. Value Penguin says denial rates range from 6% (Kaiser Permanente) to 33% (UnitedHealthcare) -- again, this is just data from plans administered through the Affordable Care Act. What's going on with plans people get through their employers no one but the health insurance companies knows.
So I don't know how many people died because of denied claims, because we don't even know how many claims were denied in the first place. But when Cigna denied over 300,000 claims in 2 months, with doctors spending an average of 1.2 seconds per denial (ProPublica again), I have a hard time believing no one died.
When I said I did not have the time to look at other universal programs, I was pressed for time to go to church. Nonetheless, my point is that no health care insurance programs, private or public, is perfect. People are still dying. Even if we could get Universal Health Care coverage like the United Kingdom, France, Germany, Canada or elsewhere people are going to die because they could not get needed health care in time.
But are they dying simply to make shareholders a dirty buck? (Or 10 million or so of them a year for the dear departed CEO, Mr. Thompson, as I understand it.)
Because that’s the real issue, isn’t it? I think it’s fair to say that no one expects a perfect system with 100% positive outcomes. But when the reason people get claims denied, medications not covered, etc. boils down to “line must go up”, something is deeply wrong. It’s immoral and unjust.
(Full disclosure: I’ve had to battle UHC over — thankfully — non-life-threatening issues for my child, and have opinions on them not suitable for all audiences.)
That said, I still would prefer either a universal health insurance or a not for profit system which we had before Ronald Reagan. However, we had gotten to the point where the insurance system could not keep with the increasing costs. <snip>
We couldn't keep up with costs, so we siphoned off billions of dollars to shareholders? Square that circle for me.
When I said I did not have the time to look at other universal programs, I was pressed for time to go to church. Nonetheless, my point is that no health care insurance programs, private or public, is perfect. People are still dying. Even if we could get Universal Health Care coverage like the United Kingdom, France, Germany, Canada or elsewhere people are going to die because they could not get needed health care in time.
But are they dying simply to make shareholders a dirty buck? (Or 10 million or so of them a year for the dear departed CEO, Mr. Thompson, as I understand it.)
Because that’s the real issue, isn’t it? I think it’s fair to say that no one expects a perfect system with 100% positive outcomes. But when the reason people get claims denied, medications not covered, etc. boils down to “line must go up”, something is deeply wrong. It’s immoral and unjust.
(Full disclosure: I’ve had to battle UHC over — thankfully — non-life-threatening issues for my child, and have opinions on them not suitable for all audiences.)
That said, I still would prefer either a universal health insurance or a not for profit system which we had before Ronald Reagan. However, we had gotten to the point where the insurance system could not keep with the increasing costs. <snip>
We couldn't keep up with costs, so we siphoned off billions of dollars to shareholders? Square that circle for me.
The argument at the time was that given the ability to make profit the newly invigorated health sector would ruthlessly drive inefficiency out and thus offer ever lower prices to the consumer (and connected to this - cutting the Medicare budget by a 5th wouldn't matter!).
The reality is a complex multi-level structure which is very expensive and where costs leak out at every level, while being very poor at delivering the desired outcome. What someone I know wrote up as a 'Coasian Hell':
When I said I did not have the time to look at other universal programs, I was pressed for time to go to church. Nonetheless, my point is that no health care insurance programs, private or public, is perfect. People are still dying. Even if we could get Universal Health Care coverage like the United Kingdom, France, Germany, Canada or elsewhere people are going to die because they could not get needed health care in time.
But are they dying simply to make shareholders a dirty buck? (Or 10 million or so of them a year for the dear departed CEO, Mr. Thompson, as I understand it.)
Because that’s the real issue, isn’t it? I think it’s fair to say that no one expects a perfect system with 100% positive outcomes. But when the reason people get claims denied, medications not covered, etc. boils down to “line must go up”, something is deeply wrong. It’s immoral and unjust.
(Full disclosure: I’ve had to battle UHC over — thankfully — non-life-threatening issues for my child, and have opinions on them not suitable for all audiences.)
That said, I still would prefer either a universal health insurance or a not for profit system which we had before Ronald Reagan. However, we had gotten to the point where the insurance system could not keep with the increasing costs. <snip>
We couldn't keep up with costs, so we siphoned off billions of dollars to shareholders? Square that circle for me.
The argument at the time was that given the ability to make profit the newly invigorated health sector would ruthlessly drive inefficiency out and thus offer ever lower prices to the consumer (and connected to this - cutting the Medicare budget by a 5th wouldn't matter!).
The reality is a complex multi-level structure which is very expensive and where costs leak out at every level, while being very poor at delivering the desired outcome. What someone I know wrote up as a 'Coasian Hell':
If it is medical care or trains or whatever, important services left to companies with shareholders always get more expensive and have worse service because of the emphasis on making profit for shareholders. In some situations it works, in public services it rarely does. The Post Office, Royal Mail and public transport have all suffered over here by going private. Not to mention water companies paying out to shareholders and not keeping the system up well.
Comments
Technically the U.S. already has this. Medicare, which covers healthcare for anyone 65 or older, is essentially a type of single payer public insurance program. This represents a fairly big backdoor subsidy for private insurance since a large population with a greater likelihood of having significant health problems (old people) are taken out of the pool covered by private insurance.
Another big chunk of the U.S. population (active duty military, veterans who were discharged honorably, and their dependents) are covered by the Veterans Administration, which is a type of government provided healthcare similar to the NHS. It's not that the U.S. doesn't have public health care, it's that such systems are a patchwork that doesn't cover everyone.
One of the reasons for more than a few of those deaths is that care is denied repeatedly by third or fourth party insurance company employees. This isn't bleeding out after a bad accident.
I was thinking of Booth just now, while listening to some skeptic of the official narrative suggesting that no one of Luigi's ultra-comfortable socioeconomic status would throw it all away just to commit a murder for political symbolism. Specific mention was made of his impressive family tree.
I am aware that Booth was technically NOT a lone actor(sorry), but even so, he must have gone into the boardinghouse conspiracy with a radically altered concept of self-interest. He likely wasn't thinking in terms of "How can I increase my financial success in order to keep living the good life from here on in?"
(The above is based on the assumption that Booth was more-or-less doing okay at the time of his crimes. Open to correction on that.)
And if, like Booth, the Adjustor was assuming that murdering Thompson would spark some sort of massive sociopolitical alterations, he might have been assuming he'd be elevated to national-hero status, another factor that could possibly impart indifference to material fortune.
According to the National Association of Insurance Commissioners, the profit margin of US health insurance is about 3.4%
That said, I still would prefer either a universal health insurance or a not for profit system which we had before Ronald Reagan. However, we had gotten to the point where the insurance system could not keep with the increasing costs.
And I have also had my problems with insurance denials too, like when the insurance carrier we had denied our bills for one of our kids who had anorexia nervousa, and when the insurance also denied my request for a spinal cord stimulator. In the case of our child, he is now in full recovery. Much of the cost of treatment was forgiven. In the case of the denial of the spinal cord stimulator, we were referred to alternative procedures which has worked for the last few years. Now I have lost enough weight, I no longer need that procedure.
And I have yet to see any statistics about how many people have died because their claims were denied.
The number of claims that are denied is a mystery -- ProPublica tried to figure it out, and couldn't. There's a federal law requiring private insurers to reveal how many claims they deny, but it hadn't been implemented. KFF analyzed the data from Medicare and Medicaid and the plans issued through Healthcare.gov and found that "17% of in-network claims were denied in 2021" but that denial rates were extremely inconsistent, "ranging from 2% to 49%." A KFF survey says people with private insurance are more likely to have their claims denied than those with public insurance: for Medicare and Medicaid, the denial rates were 10% and 12% respectively, for private insurance the denial rates were 20-21% -- overall, 18% of those surveyed had had a claim denied. Value Penguin says denial rates range from 6% (Kaiser Permanente) to 33% (UnitedHealthcare) -- again, this is just data from plans administered through the Affordable Care Act. What's going on with plans people get through their employers no one but the health insurance companies knows.
So I don't know how many people died because of denied claims, because we don't even know how many claims were denied in the first place. But when Cigna denied over 300,000 claims in 2 months, with doctors spending an average of 1.2 seconds per denial (ProPublica again), I have a hard time believing no one died.
We couldn't keep up with costs, so we siphoned off billions of dollars to shareholders? Square that circle for me.
The argument at the time was that given the ability to make profit the newly invigorated health sector would ruthlessly drive inefficiency out and thus offer ever lower prices to the consumer (and connected to this - cutting the Medicare budget by a 5th wouldn't matter!).
The reality is a complex multi-level structure which is very expensive and where costs leak out at every level, while being very poor at delivering the desired outcome. What someone I know wrote up as a 'Coasian Hell':
https://www.harrowell.org.uk/blog/2018/01/31/in-the-eternal-inferno-fiends-torment-ronald-coase-with-the-fate-of-his-ideas/
If it is medical care or trains or whatever, important services left to companies with shareholders always get more expensive and have worse service because of the emphasis on making profit for shareholders. In some situations it works, in public services it rarely does. The Post Office, Royal Mail and public transport have all suffered over here by going private. Not to mention water companies paying out to shareholders and not keeping the system up well.