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Yea it’s complete horseshit why anybody with half a loving brain cell would take this poo poo over universal healthcare deserves the crippling debt they will get.
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Nov 3, 2019 18:34
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but people love their private insurance~~~~~~~
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Nov 3, 2019 19:06
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I am very, very suspicious of the Swiss system because it reminds me too much of the US system. Assholes always like to praise how innovative it is, but that again reminds me of the US system where the same rhetoric is used to justify profit versus performance.
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Nov 3, 2019 20:29
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hailthefish posted:but people love their private insurance~~~~~~~ I know you know this but that poo poo drives me inlovingsane. Any loving idiot who has ever said this either A) has never had to use their insurance or B) has a vested interest in the status quo. B is usually affluent enough for our hellish healthcare system to not affect them.
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Nov 4, 2019 00:33
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JustJeff88 posted:I am very, very suspicious of the Swiss system because it reminds me too much of the US system. Assholes always like to praise how innovative it is, but that again reminds me of the US system where the same rhetoric is used to justify profit versus performance. If you actually take a look at it, it's a thin veneer of private medicine over a strongly state-controlled system. And even with that, it's one of the most expensive systems in Europe.
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Nov 4, 2019 03:19
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BarbarianElephant posted:If you actually take a look at it, it's a thin veneer of private medicine over a strongly state-controlled system. And even with that, it's one of the most expensive systems in Europe. All the basic plans are the same and the only thing people can tweak is dial-a-deductible in Switzerland. Meanwhile the ACA curbed one or two of the worst excesses of the private individual insurance market while allowing all the other bullshit insurers were pulling. Not only that, the networks and plan names from ACA plans differ entirely from employer plans, so chuds working at the doctor's office are able to pick out who is on an ACA plan and treat you accordingly.
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Nov 4, 2019 03:23
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The last time anyone actually "liked their private insurance" was like, between 1943 and 1945 when it was a fringe benefit not subject to wartime wage controls. Ever since then it's been like making a law that you have to get kicked in the shin once a month or be summarily executed and then proclaiming that people just LOVE getting kicked in the shin.
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Nov 4, 2019 03:29
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hailthefish posted:The last time anyone actually "liked their private insurance" was like, between 1943 and 1945 when it was a fringe benefit not subject to wartime wage controls. According to the most recent KFF poll of employer paid plans, 1% of Americans still have indemnity plans that pay 100% of claims filed with no cost sharing. That 1% basically overlaps with the political and economic 1%-- indemnity plans are often negotiated by senior executives as part of their compensation package. It doesn't matter that the 99% get saddled with increasing and unbearable costsharing every year, not when rich people actually do like their private insurance.
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Nov 4, 2019 03:32
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And just to make it extremely clear: there's no question that we will be paying for it out of pocket (she hasn't met her deductible this year yet). There's no question that the procedure is covered under her insurance. There's no question that the doctor in question is in at least one of the networks for her insurance. The question is whether we should wait until next year so that she can apply that towards next year's deductible, since next year she will definitely meet the deductible, given the needed surgery that happens 2 to 3 months after the splint. A question that they haven't been able to answer because they cant agree if it is covered under medical or dental. Her deductible is $1500 and she hasn't used it at all this year. Her plan is a pretty expensive PPO.
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Nov 4, 2019 03:32
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I know that poo poo drives me up a wall. I had to get surgery a couple years ago and they literally waited till right before Christmas to approve it. So I had surgery December 27 a few more days and I would have had to pay up my deductible again after spending half a year spending up to it to begin with. gently caress you I spend a lot every month just cover whatever I need.
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Nov 4, 2019 05:45
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LeeMajors posted:I know you know this but that poo poo drives me inlovingsane. I do love our insurance -- my wife's induction and subsequent section cost us $300 including the entire hospitalization and immediate post-partum follow up -- but the fact of the matter is that the only reason one can love their insurance is because the thought of going without it is terrifying. I shouldn't have to love our healthcare coverage. It should just be a thing that is there that I appreciate when I need it, but which everyone else has as well.
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Nov 4, 2019 12:42
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tetrapyloctomy posted:I do love our insurance -- my wife's induction and subsequent section cost us $300 including the entire hospitalization and immediate post-partum follow up -- but the fact of the matter is that the only reason one can love their insurance is because the thought of going without it is terrifying. I shouldn't have to love our healthcare coverage. It should just be a thing that is there that I appreciate when I need it, but which everyone else has as well. Holy gently caress you have unicorn insurance. Our completely uncomplicated vaginal delivery with no high risk factors cost us around 6k out of pocket after insurance. We have ‘GREAT’ state health benefits with fairly low deductibles compared to common catastrophic plans. Those copays and 20% ‘coinsurance’ charges add up. Not to mention the itemized poo poo they refuse to cover and provide refuses to write off. And we felt lucky to have it—which is loving twisted. It’s astounding.
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Nov 4, 2019 13:03
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Yeah, and what's stupid is that even my so-far-great insurance is still bullshit when you consider that $300 is still a burden for many people. Unfortunately, the most detailed plan the Democratic candidates have come up with is Warren's plan, and "pay everyone Medicare rates" would unleash catastrophic budget problems in hospitals across the nation.
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Nov 4, 2019 15:59
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tetrapyloctomy posted:Yeah, and what's stupid is that even my so-far-great insurance is still bullshit when you consider that $300 is still a burden for many people. Unfortunately, the most detailed plan the Democratic candidates have come up with is Warren's plan, and "pay everyone Medicare rates" would unleash catastrophic budget problems in hospitals across the nation. Hospitals have come to rely on insurance as a piggy bank for capital projects and megabonuses under the guise of NONPROFIT HEALTHCARE SYSTEM. gently caress them. They should focus on healthcare instead. That is often not the case.
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Nov 4, 2019 16:05
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Yeah, in this thread usually the insurance companies are the bogeyman (I think a lot of this is because this is who everyone interacts with when it comes time to pay for health care, and so other causes of high cost in the system get projected onto them) and get the lion's share of the blame. I suspect that the cause of America's health care cost problem is more complicated than that, and to really do a good job of reducing cost, everybody in the industry would have to take a haircut.
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Nov 5, 2019 00:13
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silence_kit posted:Yeah, in this thread usually the insurance companies are the bogeyman (I think a lot of this is because this is who everyone interacts with when it comes time to pay for health care, and so other causes of high cost in the system get projected onto them) and get the lion's share of the blame. I suspect that the cause of America's health care cost problem is more complicated than that, and to really do a good job of reducing cost, everybody in the industry would have to take a haircut. The entire industry has gradually put profits ahead of outcomes. Labor has been decimated in this country and employers can basically hold employees hostage over benefits. Hospitals realized they could charge whatever because insurers will pay and pass costs onto consumers with gradually rising premiums. Insurers realized people couldn’t go without health insurance and have bribed regulators to allow endless cost-sharing increases. In each case the policy holder is devoid of options and squeezed tighter with every passing year and illness. I mean yeah, who knows what the explicit precipitating factor was—it is irrelevant. All their heads should be separated from their bodies, their assets seized and their industries nationalized. Anything less is complicity in the actual death and destruction they have caused.
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Nov 5, 2019 01:59
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silence_kit posted:Yeah, in this thread usually the insurance companies are the bogeyman (I think a lot of this is because this is who everyone interacts with when it comes time to pay for health care, and so other causes of high cost in the system get projected onto them) and get the lion's share of the blame. I suspect that the cause of America's health care cost problem is more complicated than that, and to really do a good job of reducing cost, everybody in the industry would have to take a haircut. they exist in the unique position of their value-add explicitly being jack poo poo. providers and pharma both gouge in unreal, horrific ways that need to be dealt with, but they provide a service beyond figuring out who it's most profitable to kill, and so require a response to 'b-b-but this would destroy our business model' beyond "GOOD, YOU loving CORPSE-EATING MONSTERS." American health insurance companies do not have that saving grace, and so make an easy primary target for regulatory intervention.
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Nov 5, 2019 02:12
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Yeowch!!! My Balls!!! posted:they exist in the unique position of their value-add explicitly being jack poo poo. Yeah, I agree 100%. There's an especially hearty gently caress YOU for an industry that literally exists to create administrative costs. I'm sure I look great in a black hood and have a strong lever pulling arm for the city-square guillotines when needed. My body is ready.
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Nov 5, 2019 03:02
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I'm a college professor, and to make a long story short administrative bloat has basically become the reason that faculty salaries are crap. I realise that American higher education, like everything else, is unsustainable and is going to messily collapse someday, but I'm on a committee that specifically addresses salaries, benefits, pay erosion etc, and the growth rate of administration to faculty over the last few decades is terrifyingly unbalanced. I could proffer some reasons why, but I guarantee people in this thread would not like it. I don't want to "punch downwards" like so many do on the admin assistants that are so helpful, but the administrators making a quarter million while other people have to take summer jobs are get roommates just to survive is appalling. I'm not saying that it's the same, but I see some parallels between health "care" and higher education. Speaking of punching down, I have to share this... the chair of my committee is also on the Faculty Senate, and recently saw a full professor stating that the university should fire a number of full-time non-tenurable (NTT) faculty and replace them with even more badly paid adjuncts so that he could have a pay increase. No prizes for guessing what school this rear end in a top hat was from, but expect no less from a capitalist.
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Nov 5, 2019 03:33
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The problem with fixing health care (and education) is that the solution is to cut out all the waste and that's going to put thousands of people out of work who's jobs are nothing more than faxing paperwork to other people to fax back. They're unaware hostages and any time any politicians try and help fix the system the board of directors lifts a gun to their employees head. No politician wants to be the person that puts thousands of people out of work and they absolutely use that to keep the status quo. Short of a catastrophic nation wide emergency that has mass casualties and forces our system to trim the fat by necessity of saving lives, I don't think we'll ever see change in our lifetimes. I'm talking like a WW3 on American soil, a large nuclear attack, or another plague.
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Nov 5, 2019 04:57
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SpartanIvy posted:The problem with fixing health care (and education) is that the solution is to cut out all the waste and that's going to put thousands of people out of work who's jobs are nothing more than faxing paperwork to other people to fax back. They're unaware hostages and any time any politicians try and help fix the system the board of directors lifts a gun to their employees head. No politician wants to be the person that puts thousands of people out of work and they absolutely use that to keep the status quo. I disagree. Employer paid healthcare is collapsing. Eventually it will cost just as much as an ACA plan in terms of premiums or cost sharing. At that inflection point "medicare for all" will be introduced to the population, which means getting rid of medicare A and B for new enrollees, institutionalizing medicare advantage plans as "medicare," and dumping formerly employer paid subscribers to medicare part C plans. The only people exempt will be people who work for huge corporations with existing union plans and the government.
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Nov 5, 2019 05:15
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I want to be hopeful but the medical insurance companies have rooms full of full time people with doctorates and masters figuring out how to extract more revenue from people and keep the juggernaut churning. In other news, my parents just paid for an appointment for a neurologist to read verbatim the notes that the testing physician wrote. They literally just showed up for an appointment to be read the notes they already had from the previous appointment, and it cost them hundreds of dollars. 
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Nov 5, 2019 05:30
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I got a $25 dollar gift card for generating an estimate on the insurance company's app saying that my procedure is not covered. Cool. Also I got some itchy and scratchy dollars to use one their website to buy fitness related crap.
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Nov 6, 2019 18:10
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LeeMajors posted:Hospitals have come to rely on insurance as a piggy bank for capital projects and megabonuses under the guise of NONPROFIT HEALTHCARE SYSTEM. I don't think you quite get how much "just focusing on healthcare" is hindered by lack of funds. Yes, some hospitals mismanage their money and distribute profits inequitably. But no joke, if M4A is implemented without a hard look at payments you're going to see a lot of closures, hospitals as well as primary care sites that already are far below the number needed to serve our population. Of course, cutting administrative bloat would help, as would it spending so much on end-of-life care. But administrators make the budget, and people nearing death vote, so ...
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Nov 7, 2019 00:09
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tetrapyloctomy posted:I don't think you quite get how much "just focusing on healthcare" is hindered by lack of funds. Yes, some hospitals mismanage their money and distribute profits inequitably. But no joke, if M4A is implemented without a hard look at payments you're going to see a lot of closures, hospitals as well as primary care sites that already are far below the number needed to serve our population. I work in healthcare. I am acutely aware of how much price gouging goes on.
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Nov 7, 2019 02:51
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LeeMajors posted:I work in healthcare. I am acutely aware of how much price gouging goes on. If you're that well-acquainted with healthcare finance, then you know full well that many primary care offices and hospital systems cannot operate solely on Medicare-level reimbursement. I can't focus on healthcare if my department doesn't have funds for staffing. Like I said, there are places to trim costs substantially, but they will involve firing a ton of people or enraging regularly-voting boomers who still think.Obama was creating death panels.
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Nov 7, 2019 03:42
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SpartanIvy posted:The problem with fixing health care (and education) is that the solution is to cut out all the waste and that's going to put thousands of people out of work who's jobs are nothing more than faxing paperwork to other people to fax back. The good news is that when they're all out of a job, they'll all have health care.  tetrapyloctomy posted:... enraging regularly-voting boomers who still think.Obama was creating death panels. Serious question - I assume the US has incredibly stupid end of life costs relative to other countries (just because I assume the US always has stupid high costs relative to other countries). If I'm right, how did that happen? How did the US get so bad at end of life planning?
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Nov 7, 2019 03:53
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tetrapyloctomy posted:If you're that well-acquainted with healthcare finance, then you know full well that many primary care offices and hospital systems cannot operate solely on Medicare-level reimbursement. I can't focus on healthcare if my department doesn't have funds for staffing. Like I said, there are places to trim costs substantially, but they will involve firing a ton of people or enraging regularly-voting boomers who still think.Obama was creating death panels. Sure. Family medicine isn't usually an attractive option for physicians because they are drowning in medical debt with bloated support staffs and triple- and quadruple-booked patient rolls. It combines all the worst aspects of practicing medicine and running a small business. The struggles aren't entirely the fault of govt reimbursement rates, you know. Boxman posted:Serious question - I assume the US has incredibly stupid end of life costs relative to other countries (just because I assume the US always has stupid high costs relative to other countries). If I'm right, how did that happen? How did the US get so bad at end of life planning? Our culture (such as it is) is really lovely at dealing with death. Doctors are not generally good at providing sound counsel for end of life options and families are really bad at accepting the fate of their family members. I've only lived and worked in the US healthcare industry, but we regularly have families defacing DNRs or requesting us to DO EVERYTHING POSSIBLE for terminal patients on hospice. LeeMajors fucked around with this message at 03:59 on Nov 7, 2019 |
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Nov 7, 2019 03:56
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LeeMajors posted:Sure. Family medicine isn't usually an attractive option for physicians because they are drowning in medical debt with bloated support staffs and triple- and quadruple-booked patient rolls. It combines all the worst aspects of practicing medicine and running a small business. what's going to change day 1 in this situation under M4A other than commercial insurance reimbursement rates being cut to medicare rates?
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Nov 7, 2019 04:58
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Hospitals will get paid for all ER visits.
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Nov 7, 2019 06:56
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tetrapyloctomy posted:If you're that well-acquainted with healthcare finance, then you know full well that many primary care offices and hospital systems cannot operate solely on Medicare-level reimbursement. I can't focus on healthcare if my department doesn't have funds for staffing. Like I said, there are places to trim costs substantially, but they will involve firing a ton of people or enraging regularly-voting boomers who still think.Obama was creating death panels. A lot of health care admin people are going to lose jobs, yeah. Also health insurance industry people. Unfortunately those jobs are not sustainable anyway. When a limb has gangrene, "you're gonna lose that foot" isn't good news but it also isn't avoidable.
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Nov 7, 2019 12:46
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KingNastidon posted:what's going to change day 1 in this situation under M4A other than commercial insurance reimbursement rates being cut to medicare rates? I’m advocating for top-down reassembly of the healthcare industry. Instead of being a literal money printing machine for middlemen and bureaucrats it’ll be a public service. Some of that involves subsidizing training of providers so it isn’t a prime directive to put every physician in crippling debt on day 1. It informs their decisions for the rest of their careers. Hieronymous Alloy posted:A lot of health care admin people are going to lose jobs, yeah. Also health insurance industry people. Unfortunately those jobs are not sustainable anyway. When a limb has gangrene, "you're gonna lose that foot" isn't good news but it also isn't avoidable. Also this.
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Nov 7, 2019 14:48
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tetrapyloctomy posted:If you're that well-acquainted with healthcare finance, then you know full well that many primary care offices and hospital systems cannot operate solely on Medicare-level reimbursement. I can't focus on healthcare if my department doesn't have funds for staffing. Like I said, there are places to trim costs substantially, but they will involve firing a ton of people or enraging regularly-voting boomers who still think.Obama was creating death panels. How many jobs do you think will be retained if the employer paid system collapses under its own weight and 60% of Americans are left holding the bag and having to pay cash and carry rates for healthcare? If Medicare is such an odious payer perhaps it should be abolished so doctors can finally get out from under the yoke of having a guaranteed payer for their elderly patients?
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Nov 7, 2019 14:48
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CAPS LOCK BROKEN posted:How many jobs do you think will be retained if the employer paid system collapses under its own weight and 60% of Americans are left holding the bag and having to pay cash and carry rates for healthcare? Won’t someone think of the geriatric primary care docs with 500 fatted calves....er, nursing home patients 
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Nov 7, 2019 14:56
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LeeMajors posted:The struggles aren't entirely the fault of govt reimbursement rates, you know. LeeMajors posted:I’m advocating for top-down reassembly of the healthcare industry.
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Nov 7, 2019 16:00
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tetrapyloctomy posted:And never did I say it was. What I did say is that Warren's plan of "Expanding Medicare coverage to everyone and paying the same rates" without addressing other issues was going to tank a bunch of hospitals and private clinics. And because of: Many of those hospitals (particularly rural ones) and private clinics are already tanking and taking their communities with them. Even private insurers are really, really lovely about reimbursements and collections are generally trying to get blood from a stone when it comes to patients in these communities. Even if we maintain the status quo there will be a reckoning in those particular spaces - we may as well figure it out in the context of providing additional coverage. And yeah, I think we mostly agree. I just don't think improving coverage is the precipitating factor for this failure. It is all already failing right now. All around us.
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Nov 7, 2019 16:20
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LeeMajors posted:Many of those hospitals (particularly rural ones) and private clinics are already tanking and taking their communities with them. Even private insurers are really, really lovely about reimbursements and collections are generally trying to get blood from a stone when it comes to patients in these communities. Even if we maintain the status quo there will be a reckoning in those particular spaces - we may as well figure it out in the context of providing additional coverage. In conclusion: Raise my taxes, pay for everyone's healthcare. Forgive future physicians' medical school tuition debts and pay us less. I've only got a hundred grand left, I'll live.
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Nov 7, 2019 16:28
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tetrapyloctomy posted:I'm likely oversimplifying as well, since even with a dramatic reduction in reimbursement simply not having to fight the loving insurance companies would have to reap huge savings. (My own hospital also would probably do pretty well under M4A, to be perfectly honest.) My apologies if I made it sound like I thought things would be better off just going on as they are right now -- that's a ludicrous suggestion, this burning pile of garbage can't exist in perpetuity. No need to apologize I never thought we were in total disagreement. I guess I just get worked up when there’s a suggestion that better things aren’t possible in the context of hospitals and administrators bearing the brunt of pain. Patients are the current cross-bearers and are the most vulnerable agents within the system. Like, that’s already happening because of predatory coverage practices. We may as well gut the whole thing! In short—yo, let’s do it.  
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Nov 7, 2019 16:34
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Boxman posted:Serious question - I assume the US has incredibly stupid end of life costs relative to other countries (just because I assume the US always has stupid high costs relative to other countries). If I'm right, how did that happen? How did the US get so bad at end of life planning? https://twitter.com/berniethoughts/status/1108026753690140675 
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Nov 7, 2019 17:18
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US end of life healthcare is designed to stop any generational wealth from being passed down. With the technology we have today, if they find out you have money they will force your dead heart to beat until everything you own is theirs through medical bills.
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Nov 7, 2019 17:22
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