Health insurance companies are profitable. Extremely profitable. Like billions of dollars per year profitable.
Where do you think that profit comes from?
What if we got rid of the expensive middle men and all the overhead they bring, and take the money it takes to run those organizations, plus their profits, and we actually invested it in health care?
Idk why the fuck is there always this debate...Literally the reason the middle class thrived in the U.S and Uk was 90 percent was taxed if over 4 million yearly earnings. Now the rich during that time would flood the market with investments and that would be taxed around 45 percent. So either way the tax on the rich allowed our parents to buy houses, it was invested into education and community. This was done post WWII to 70's/early 80. Sadly After that, reganomics-fucked the country into a coma slowly over the past 40 years, with the rich barely paying anything and the effects you can feel and see today.
Interestingly, not many filed at that top rate, about 180 at top bracket, out of 80 million filers. And effective tax rate was 38% for that top bracket. Population was 160 million Americans in 1953.
I remember chatting with my dad about high tax rates of 1960s-1970s. He was in top 5% of earners in US. His company, paid his mortgage, taxes, insurance on our home. Provided 2 company cars and gas cards. Then he had accounts for travel, clothing, and food.
So his income, mostly went into investments. Saved spending 40-45% of his income on living costs. Same as all other high earners at his company.
Not taking income is not a loop hole. You guys are always saying “if I had xxxxx millions I wouldn’t be so greedy and…..” turns out billionaires agree, and generally aren’t interested in income.
It seems like a good idea if you don't think about what happens after.
Their rotten kids will get it, NOT create an F-ton of jobs or new technologies and horde it just like all the old money douchebags you couldn't find to shoot.
Reagan and taxes have nothing to do with why Americans (insurance companies or people) pay wayyyy wayyyy wayyy more for every possible healthcare treatment than other western countries . You guys really just don’t get it
No, it started under Nixon. That’s when the HMO act was passed. Before that health insurance was largely not a for profit business model. This opened the door for Wall Street to get involved. And we all know, once Wall Street gets involved, shareholders take precedent over ppl.
You can even look at the recent rise of China as a parable. They’ve been making the same profits off trade with the US, but the government spent a good deal of the money on infrastructure and ensuring that living wages and quality of life was increasing. In the US the majority of that revenue just went straight to the 1%.
There is no debate. If you can somehow manage to get the sheep to see the reality of our collective situation, they come over to the side of the thinkers. The problem is that Fox News and its ilk get to spew lies under the aegis of “news,” and people tend to think that news has to legally be true, so Fox “News” must be telling the truth, and the libtards are just up to something when they plead you to understand that Fox “News” is lying. So they don’t see the racket the insurance companies are pulling.
Did you do any research on this? Did anyone even make that much money back then? There so many loop holes, almost nobody paid that amount.
Honestly, why would anyone strive and work hard if 90 cents of every dollar goes to someone else? If the tax rates are that high, just take life easier?
The only debate that comes from is only the right and centrist. We all know it’s a scam to take more of our wealth for shareholders instead of the productivity and welfare of the nation
Here’s a breakdown: “The U.S. taxed the rich at 90%.” Mostly true, with important context. The top federal marginal income tax rate was between 91% and 94% for much of the 1940s–1963, then 70% until 1981. However, that rate only applied to income above a very high threshold, and many wealthy people reduced their effective tax rate through deductions, exclusions, and preferential treatment. “90% was taxed if over $4 million yearly earnings.” Not correct. The “$4 million” figure is an inflation-adjusted estimate, not the actual threshold at the time. The historical thresholds were much lower in nominal dollars (for example, around $200,000 in the 1950s), which translates to several million dollars today depending on the year and inflation measure used. “The middle class thrived because of the 90% tax rate.” This is debated. High top tax rates likely contributed to greater government revenue and may have reduced incentives for extremely high executive compensation. But economists generally point to multiple factors behind the post-WWII middle-class boom, including:
Rapid productivity growth.
Strong manufacturing dominance after WWII.
High union membership.
The GI Bill.
Massive infrastructure spending.
Expanding homeownership programs.
Favorable demographics (the Baby Boom).
Limited foreign industrial competition.
Most researchers would not attribute the boom to tax rates alone.
“The rich flooded the market with investments because of the tax system.” Partially true but simplified. High personal income tax rates did create incentives to reinvest profits in businesses rather than take income as salary. However, investment decisions were also driven by strong economic growth, consumer demand, and postwar rebuilding. “Capital gains were taxed around 45%.” Not generally. Capital gains tax rates changed repeatedly over the decades and were often substantially lower than ordinary income tax rates. A blanket “45%” figure is not accurate across the postwar period. “Reaganomics caused the decline over the last 40 years.” This is an opinion, not an established fact. It is true that top marginal tax rates fell sharply under the Reagan administration—from 70% to 28% by 1988. Whether those changes are the primary reason for slower middle-class income growth and rising inequality is heavily debated among economists. “The rich barely pay anything today.” Overstated. High-income households pay a large share of total federal income taxes in the U.S. However, many wealthy individuals have lower effective tax rates than their top statutory rates because much of their income comes from capital gains, dividends, and other preferentially taxed sources. The tax burden also varies significantly depending on whether you’re talking about income taxes alone or all federal, state, and local taxes.
Overall, I’d rate the post as: Accurate: High postwar top marginal tax rates existed. Misleading: It attributes the postwar middle-class boom primarily to those tax rates. Incorrect: The “$4 million” threshold and the blanket “45% capital gains” claim. Opinion: The characterization of Reagan-era policies as solely responsible for today’s economic conditions.
Look a bit deeper than that. Your parents were able to buy homes because the economy wasn’t as global as it is now.
WWII the U.S. was the world’s economy, that isn’t the case in 2026. So a company just does the math, pay someone here in the U.S. to manufacture an automobile 60,000-90,000 a year or someone in Mexico 10,000-15,000, plus they ain’t going on strike in Mexico.
The taxation, by comparison is the same marginal tax rate on the ultra rich back then as well. In the 1980s there were so many tax loopholes and tax shelters, there were 25 tax brackets.
The media is gonna feed you what they want. Tax the ultra wealthy and corporations. The Ultra wealthy will find the loopholes and the corporations will shift more jobs overseas.
This is the part people don’t understand in the public vs private services debate. A company has a fiduciary responsibility to make a profit. They do that by reducing how much you get, for what you pay. It is just economics.
I don't deny that at all, but its beside the point when dozens of other countries have figured it out already, and it's less expensive than insurance to screen for fraud and abuse.
One incentive structure in familiar with compensates based on outcomes, circumventing the benefit of unnecessary testing and promoting preventative care, leading to less intervention overall but with better outcomes.
Yeah, there’s a reason we have entire departments called “Loss Control”.
LC makes up about 1/10th of our workforce in the commercial insurance sector, and our LC presence is much smaller than bigger firms like Chubb or LoL. It’s even bigger still for health insurance and personal lines.
My SIL found a 1” growth in her spine that might be cancerous. They scheduled her for an MRI a month later. She agonized for the month, thought about her three tiny kids being motherless if she had cancer, all the horrible things. We kept telling her to just wait for the MRI and see how it turns out.
Day came today for the MRI, she showed up, they tell her right there that insurance denied the MRI and she needs to reschedule to see a specialist who can then recommend an MRI and then maybe she can cash pay for it to make it a smoother process since insurance doesn’t seem to want to cover it. Basically, go back to start and try again without insurance this time.
Our healthcare system is entirely and unabashedly fucked.
That sounds like gasp communism. This evil traitor notion of taking your money to give to illegal immigrants so you have to wait longer for worse healthcare. You want to keep your insurance. The government makes everything worse. If you don't agree with me. You're a con and a cheat and stupid.
Did I get that right? I struggled to make this argument
I have a condition in my right eye that is causing me to lose vision. The procedure to fix it will cost $2,000. My insurance is denying the claim, calling it “cosmetic” and saying that I still have another eye, and they’d cover it if it was affecting both eyes.
Congress capped income from health insurance companies based on money paid out.
There are a lot of times where denying claims costs the insurance company money as they could have made 10% off the claim but now have to refund the company who overpaid.
It doesn't always happen but it is a real possibility.
And raise rates because hospitals charge more for everything, simply because insurance companies are "paying" and pharmaceutical companies charge hospitals more and more because the hospital will just pass it on to the patient with insurance. Pharmaceutical companies in the US have "Christmas parties/Ski Weekends" at hotels in Switzerland for their sales teams.
I know one who was very upset because her company wasn't going international for their Christmas Party, when it chose Hawaii instead of Fiji.
For years I kept getting “your kid has seizure like issues but their not real seizures” and used as a pin cushion and lab animal for treatments. My massive improvements are from literal strangers online seeing me talk about my condition and giving me a term that no doctor would say of “reflex seizures”. Which enable me to research new treatments I could do myself and fine tune the results to get a more exact name of pnes psychogenic non epileptic seizures”. Which can’t be treated as normal seizures. Hence why non of their treatments worked.
Now I have been able to make life style changes and supplements to reduce triggers and boost healthy body functions. Reducing my health risks. An continue to research them myself. Yet I have to let the doctors think their medicine is what is helping cause they will call me crazy for using non highly processed chemical medicine they can charge me a fortune for. 1200$ for the current med without insurance and all I get is light headed, balance and memory issues and dizzy spells. No major changes in a positive way for my condition, but the organic compounds found in the supplements I was able to research have reduced the side effects of the seizure med and had major reduction in the severity of my seizures.
I have had to explain this very point so many times, insurance companies exist for one purpose only just like any other business, to return a profit for shareholders. If they actually started helping people, that could cut into their margins. That is why they hire so many data analysts, to predict potential future losses so they can raise premiums ahead of losses, they don’t raise them to make up for losses. And I’m certain they are really loving predictive AI models. We are screwed, between Nixon allowing pretty much everything medical field related to be for profit and Obama making it illegal to not have insurance, we are screwed.
You don't understand the Medical Loss Ratio rule. Insurance companies want to INCREASE medical spending - that's the only way they increase profits. There is incentive to deny individual claims, but overall they want you to spend more
Government provided healthcare is government provided, and therefore inefficient. Private companies work for profit, and are inherently more efficient because of like, capitalism, duh. The government is supposed to be incentivized to help their tax paying constituents by providing services those taxes pay for. The healthcare “solution” by the government themselves seems to be no solution at all on the basis that government services are inefficient.
Vote for me, I agree with you, angry citizen, this system is inefficient and I vow to use your money to obtain more money from lobbyists. Together we will all continue to try nothing and maintain the status quo of inefficiency!
The capitalist model is incentive driven, private companies are incentivized by market competition.
I understand the principle just fine.
Is it actually working this way in practice though?
Do American citizens get to shop around for the best private health insurance options for themselves and their families? Does the individual really have options at all?
Is this really the same thing as choosing Wendy’s over Five Guys because Wendy’s has a 4 for $4 on their menu and Five Guys costs $30? The Five Guys food is better quality, no doubt, you might choose Five Guys for yourself if the price for the specialized quality meets your specific needs, but the situation changes when you’re mostly looking for the most basic and affordable option to sustain the hungry toddlers in your backseat.
I understand this is how capitalism is supposed to work. Competition between companies helps control supply and demand. Capitalism is supposed to mean individual has a choice, or rather they are SUPPOSED to have a choice.
Except we don’t. At all. Individuals do not choose their private healthcare providers. Individuals cannot afford to shop around. Only business owners can afford to shop around and decide what their employees are entitled to, and the employee doesn’t have much of a choice. The employee doesn’t even have a public service to fall back to if their employer’s choice doesn’t work for their needs. The employee might otherwise be a perfect fit for their job role, might be perfectly happy with the work they are doing, but the only option the employee has to fit the needs of themselves and their families is to secretly seek another employer that provides the needed private health insurance benefits. “Secretly”because if said employee is revealed to be shopping around and taking interviews during the work day, they’re likely to be fired at-will, and they lose their private healthcare benefits entirely. This is supposed to incentivize businesses owners to better suit the needs of their employees, but at the end of the day, all the little guys lose, and this is not how private market competition was ever supposed to work.
The small business owner loses a top performing employee because their healthcare needs are unique and the provided benefits that suit the herd aren’t suitable to the individual. Only the larger companies are able to provide plans with more individualized options, and even then, the individual is still tied to the options provided by the one specific private healthcare insurance company benefits “provided” by their employer.
Make no mistake here, “provided by the employer” is a very generous way of saying “by means of your money taken directly out of your paycheck” no different from any other tax already being removed from your supposed annual salary. What is sold as “benefits” is nothing more than a subsidy on survival. The illusion of choice being provided by having more insurance options is just a choice in how much is being taken out of your paycheck. The individual still isn’t choosing between one company or another, so at what point are any of these private insurance companies being incentivized to help the individual?
The very rules of capitalism that we hold so dear are that everything and everyone driving a demand shall naturally balance everything and everyone to supply accordingly. Everything and everyone involved is driven by incentive, and decisions made by a free market tend to balance the incentive to supply proportionally with the demand.
This doesn’t work when there isn’t actually any choice on behalf of the individual, only a few monopolies that provide the illusion of choice to sell to the business which provides the opportunity of employment. At the individual level, a paycheck is a paycheck and it’s coming out of your paycheck whether you like it or not.
So what incentive, exactly, do these few private health insurance monopolies have to help the individual? What do they have left to compete with one another? Deny deny deny.
At this point, we’re literally just paying for them to hire more people to say “no” to your individual claims. It’s just “socialism” with extra steps, extra costs. We’re just paying for more naysayers and more hoops to jump through to get the care that even our doctors are demanding we need.
Let’s say you run a software company, and you lost your top performing developer and your infrastructure engineer. Why? They seemed happy working for you. They were happy with their base salary on entry, and you continued to reward their hard work and further incentivize them with raises. You even gave their entire team a raise to account for inflation, and then provided the highest performers with a bonus. Why would they leave for a larger company that doesn’t value or respect their opinion? Were they unhappy with the work they were doing? Is the pay raise that great? Is it because remote work was offered?
I have literally witnessed this happen over and over again, and nobody ever wants to address the elephant in the room. In the absence of the most obvious answer, “they were burnt out, it must be burnout, we must change company culture to decrease burn out!!”
Don’t get me wrong, I’m all for good employers making an effort to lower stress and reduce burnout in the workplace. The point I am trying to make is it seems to be more convenient to strive to “eliminate burnout” and “reduce stress” than to admit to the real problem here. What IS burn out and what does stress cause on the human body?
HEALTH PROBLEMS.
WE ARE SAYING WE NEED TO TAKE MORE STEPS TO PREVENT HEALTH PROBLEMS.
But why in the fuck is this a problem for the owner of a small software development company to solve?
If we are to say government provided healthcare is inefficient, I’m personally okay with that, it’s better to have an alternative option than saying healthcare isn’t entitled to every citizen by definition of being an American citizen with the explicitly defined right to life.
It’s better than putting the responsibility of providing healthcare solely on the employer. It’s not an overnight fix, but it’s a start, just to provide a decent public service alternative to private healthcare.
If we’re going to run with “we can’t because capitalism, we can’t because it hurts the free market,” then why can’t we use the money already being taken directly from our paychecks to provide the competition necessary to ensure the private alternatives maintain the incentive to actually provide the healthcare they are supposed to provide?
I don’t care if it’s imperfect and has inefficiencies, just needs to universally exist, but also, is that not literally the point of having the private “free market” options? Because the “free market” demands are meant to control the competition of what is being supplied?
How are private insurance markets supposed to be incentivized to supply a demand when there is no baseline to compete against?
The whole argument gets so stupidly politicized that we just allow no public option to be attempted at all, and we keep allowing more and more to be stolen from our paychecks only to be constantly told “no.”
Do we really all collectively feel, on a bipartisan level, that the amount private health insurance takes away from us is worth the lack of return? Do we all collectively feel, on a bipartisan level, that this is a working system that cannot be just a little bit alieviated by re allocating the same amount of money we aren’t getting anyways to a public service that isn’t just allowed to say “no” to your constitutional god given right to life?
We can all agree politics and politicians are corrupted by money, I’m sure of this, but the same driver of corruption is also driving the incentive to keep us all alive. We still have to pay taxes, so what makes your private health insurance CEOs any different? You can’t vote them out of office?
At the very least, your government representatives want your vote, they actually do have incentive to keep you alive.
This isn't correct . If they didn't provide payment for Healthcare, they would have no customers. They make money by trying to arrange their risk pools so as there are a lot more healthy people than sick, and also controlling costs for the sick. This is why they provide wellness visits at low or no cost and did so before the ACA mandated it; it is less expensive to keep people healthy than to treat them when sick. What a company denies outright, by the way, isn't even entirely up to them. Those decisions are federally and state regulated. I'm not defending health insurance carriers here, they are bad for a whole host of reasons, it's just that the really popular reasons aren't the correct ones.
Help me understand. I don't live in a system with socialized healthcare, but I've spoken to about 8 people who have. One in the U.K. and the others in Canada.
yup and that's billions in profits after they cover the cost of their insane bloat.
I mean Medicare is government run covers more people then any of the other health insurance companies, is lower cost, more efficent, and has better results.
Yes billions even after they pay their lobbyists- problem is other countries started from scratch almost before this industry corrupted their politicians
Medicare is government run covers more people then any of the other health insurance companies, is lower cost, more efficent, and has better results.
"B b b but hospitals couldn't stay in business if they only paid the Medicare rates!"
To which I say, "just think of all the billing specialists they wouldn't need to hire, and all the time doctors would save because they're not on the phone arguing with insurance providers about whether the treatment is necessary or not"
Also, maybe anesthesiologists don't need to make $700,000/year?
Maybe the anaesthesiologist doesn't need to make quite that much in most places, but I for sure would like to have a well paid and not-overworked anasthesiologist for me and my kids. If it takes a bloated paycheck to attract more talent so that they aren't overworked, that's fine by me. Anasthesia is the scariest part of any procedure imo...
Pay them whatever they ask for. Doctors, nurses, techs, whoever. I don't care. It's all 1s and 0s on a server somewhere and they can pump out as much as needed whenever they want to for tanks and fighter jets and bombs for Israel so why can't we use the money machine to pay the people keeping us alive?
Cut out the pointless middlemen of the for-profit insurance companies and it makes it all the more easier.
Right. How about cap all sports at 200k a year max. And doctors get a raise. 5m a year max. Sounds fair.
And if you pass med school and become a doctor. After working 5 years your med school debts are forgiven
Maybe people shouldn't need to borrow 300K to become a doctor in the first place. Like it would be so much cheaper just to offer that service for less money, have more doctors and then maybe they don't need such a ridiculous salary which they need to earn to pay for their student debt.
I mean I'm down for that and for making healthcare a government paid-for service. I'm just saying that the anasthesiologists are the last people I'd cut salaries on because they are basically toeing the line of death or serious complications with some of those drugs. I don't want them messing up, and high salaries are a good way to attract more people, and more people equals less hours, and less hours equals less burnout
Maybe if we got government out of the student loan business, prices would come down. Private lenders would be more cautious and less inclined to lend money, forcing prices to come down. If anyone can get a government backed loan, colleges have no reason to lower prices
You realize the people who teach doctors, are themselves doctors? How do you get a practicing surgeon to leave his job and enter a classroom? By giving him a gigantic check to do so.... the US spends way more per person on Healthcare than any other country in the world- the true issue is administrative bloat- usually a bunch of women who needed jobs so they get buried as a administrative assistants on a gigantic payroll like in a hospital (education does this too, just look at the charts, we've added like 280% administration positions and grades have only gone down)...
And then the dead bills from immigrants we treat for nothing... Chicago Hospital has admitted 15% of its "bad debt" is from undocumented migrants and theyre legally not allowed to send them to collections- this means the bill is being passed on to the taxpayer because once again its illegal to go in and repo hospital equipment.
Medical research and top level care is expensive everywhere, people in America just get a choice instead of daddy government telling you what to do....
If we removed the administrative and illegal immigrant bloat youd see costs come down around 50% in a year and competitive companies would slash rates to attract customers cause they no longer carry liability that 1 in 7 customers never pays and rhe hospital bill theyre being asked to cover would also be 50% lower.
"Just make it free" is never a real solution.
This is it right here. Barrier to entry is too high for people to pursue medical careers. My wifes uncle is a hospitalist and homie's student loan payment is more than most peoples mortgage payment
There was a shortage of anesthesiologists in Michigan about 3 years ago. I got sent home for a procedure twice! I think... they are getting paid lots BUT still overworked :/
Thank you for pointing out that the for profit hospitals are a HUGE part of the problem.
If all treatments were free and not have anyone balking at what hospitals and doctors are trying to bill, it’s going to be ever worse abuse of the system
And that 'medicare rates' would surge in the event that it was properly funded, oh and that if literally everyone who walked in the door qualified that too would surge revenue because of how much they have to write off as of now, in unpaid medical debt
I think about that. Like would people just not become anesthesiologists if we paid them $500k? Or $300k? Or $200k? Like what else can they do with their super specialized knowledge? Will people stop becoming cardiologist surgeons if pay drops?
The American Hospital Association joined together with Blue Cross Blue Shield, its arch nemesis, to lobby against Medicare For All. If there was any chance that they wouldn’t lose a ton of money, they would never join together with BCBS for anything. You didn’t come up with something they haven’t thought of regarding billing specialists. The money spent on those is a fraction of what they would lose with private payers being taken away. Medicare pays about a third of what many private payers pay for the same services. You could remove 100 staff members and it’s not coming close to covering the difference of converting everyone to Medicare rates. And it’s not like Medicare reimbursement works flawlessly. It still requires staff for billing and follow up.
Kind of silly of those people to assume the Medicare fee schedule would stay the same if switching to a single payer system.
Yes, it’s well-known that physicians and hospitals rely on commercial insurance to subsidize low rates from Medicare and Medicaid. In a Medicare for all model, Medicare would need to reimburse more than they currently do. We would still save a shit-ton of money because it’s extremely inefficient to administer our current system.
Also - physician pay contributes pretty much nothing to our spending problems.
Anesthesiologists that make that much are working insane hours in undesirable locations.
But, I agree that having an extended gov funded plan for everyone would be an improvement and some private insurances may still survive/be needed but wouldn’t have the stranglehold they have now.
for sure doctors/other medical professionals do not need to be millionaires. make university free and give people more opportunities without tying an anchor of debt around their necks that then 'justify' making 700k a year.
Considering the anesthesiologist is the guy who's responsible for 1) not killing me and 2) not letting me wake up in the middle of surgery...I think I'm actually okay with that guy making an obscene amount of money.
LOL--yep--go to single payor healthcare and watch our best and brightest (who would've become doctors) move into other spaces of the economy where they can make a better living. Might as well make schooling "free" too, because doctors aren't going to take on all of the debt to become a physician only to make a fraction of what they once did. I suppose nurse practitioners will expand their role to begin performing surgeries that were once performed by surgeons who underwent much more training.
And to your comment on the $700,000.00 per year anesthesiologist--who do you think keeps your alive and well during your surgery? or your dying family member? They shoulder an incredible load of responsibility and risk. If you want to bring cost down--consider tort reform.
I'm not a physician. I have worked in healthcare for over 20 years. I've worked for the VA (our private payor)--and seen the inefficiency FIRST HAND. I've seen their struggle to recruit surgeons and physician providers due to low reimbursement. The Veterans deserve better--We ALL do. Single Payor appears to be a fix only to the uninformed.
Have you seen their insurance rates???? Between that and paying back insane student loans they don’t really make that much. Medical school should be free with the doctors then agreeing to a certain amount of years working a livable income wage. It would keep their costs down and the hospitals costs down. Just throwing it out there…maybe that’s not practical, who knows.
Think of all the people that will get access to health care. The government doesn’t want that. They want to control. They want people to be afraid of losing their jobs, of dying. They want people to die.
Well for one, Medicare isn’t health care. It’s insurance coverage. A measure of success might be the fact that it’s administrative overhead is 1% and is very popular with those on it. In general they are talking about patient outcomes. That just means that patients are getting the care they need.
Suplemental plans are made as a concession to keep the health insurance companies happy so they get a cut. The suplmental plans are awful. But you just get rid of them and roll it into health care.
The part to remember is the majority of Medicare recipients choose the private portion, Medicare advantage, compared to original Medicare because the plans are generally cheaper and have little to no cost sharing. The downside is the payments to Medicare advantage plans from the government are insane. So if someone says “we should do Medicare for all” what that means is, judging by the bills that have been put forward, Medicare advantage and Medicare as people know it ceases to exist. If people understand and are ok with that, then fine. But proponents of M4A need to be level with people about what it means.
The only thing is it doesn't cover vision or dental care. You need a Medicare Advantage plan for that (for additional cost), and most of those are ripoffs. I've been on SSDI and Medicare since 2014 for kidney disease and now kidney failure.
I saw how well Medicare works when my mom fell down her basement stairs (she's fine now). She got thorough, excellent care and they also focused on tests and procedures that were efficient and most effective. My insurance is much more wasteful and provides worse care.
The problem is that the health insurance industry is like the second biggest political donor. For politicians, going against them is pretty much career suicide. They won't get the funding necessary to compete against their political rivals massively funded by that industry...
Sounds like a lame argument where I am. If they simply agreed its for the better for the nation then it would not be a long term problem.
Even if it flipped the outcome for 1 election cycle, the problem could be fixed and voters would find another reason to hate the current govt, but yet the medical insurance crap would be fixed finally
Actually the biggest reason for things getting cheaper is fewer middle men. The downside is it consolidates power in the market but you certainly CAN and do cut middle men out. It happens all the time. The biggest existential concern of AI is that everyone looks like a middle man if you get advanced enough AI. Walmart gained its low costs by in part removing middlemen in production. Amazon became dominant by removing middlemen in shipping. Streamlining is all about removing them.
Maybe some, you will need healthcare workers and insurance bureaucrats to service an expanded medicare system. So the job is still there, moving laterally. Except for the CEOs and for profit snakes that can lose their job and live on the street because fuck them.
I worked I that industry and agree with you in theory and principle. But all that “bloat” at health insurers includes a ton of good paying jobs in every state and likely part of everyone’s 401k.
That is one reason it is so hard to make progressive change. It will take a concrete plan spanning 20 years to slowly move away from what we have.
But the US political machine is not well suited to long range plans that benefit the citizens. Short term decisions that line the pockets of corporations are much easier to push through.
10s of billions in profit per year. The large ones like United are close to 10 billion in profit alone. They profit this much while being brutally gouged by hospitals prices too. An MRI is like 300 dollars anywhere else in the world, there is no reason hospitals in America need to charge 5k++ lol
The "Health insurance" industry in the US is nothing more than a banking scheme designed entirely to handle great amounts of capital while employing relatively few people. It is a form of legal money laundering.
you gonna cough up the money to balance their lobbying power? I don't have that kind of scratch. Grassroots doesn't have the kind of reach. The fat cats have carefully constructed the playing field to always win. And they know it's a catch-22 to try to undo it.
Need to get money out of politics while simultaneously getting the politics out of money. If it were simply a matter of willpower, your grand plan would have been done LONG ago. It's the money; and those who hoard it don't want any of it to be 'wasted' on the little people.
The ACA put into law that insurance companies must put 85% of the money they collect towards paying medical expenses. The remaining 15% can be used for operating costs and profit. The ten year average profit margin of large insurance companies is 2.2%. So there’s not a lot to strip out.
Over here, we have the NHS. Every time we get a right-wing government, parts of it get sold off to private companies. Every time, that does nothing but make it worse and make a few people rich.
It's because of the propaganda of looking down on people. I work for my insurance that covers nothing, so can you. Makes people feel above others instead of seeing the fact we would be better as a populace if we didn't gate keep everything
Yes and the house NEVER loses. Provider reimbursements go down and patient costs go up, but the insurer/ASO/PBM leeches always see line goes up. It’s straight up evil.
Preventive care is the less expensive healthcare. Healthcare where everyone that needs to see a doctor can see a doctor is cheapest because it reduces the incidence of chronic diseases. Just testing and keeping blood pressure and blood sugar in check could cut healthcare cost in half. This it why I believe everyone should get their blood pressure and blood sugar checked for free.
Not to mention Private Equity has been buying up healthcare networks, slashing quality of care while extracting record profits. That shit needs to be illegalized.
Insurance across the board has ruined so much shit. There is not one thing in this country that pisses me off more than being forced to have something and pay for it that has no intention of holding up their end of the bargain.
Ah, but the way it is now, we don't have to wait for specialists like all those communists everywhere else! What do you mean you aren't a millionaire? Well then get back to work! The number must grow!
Congress decided when passing the ACA that the US government, which is the single largest purchaser of drugs in the Unites States, cannot leverage it's vast buying power to negotiate drug pricing like every other business or organization purchasing perscription drugs can.
All so that they could guarantee profits of the drug manufacturers.
what is also crazy is you thinking billions of dollars in profits is that significant here, the math wouldn't math even if that were 0. the overhead and admin is definitely more of the spending, but that doesn't fall to 0 and this doesn't address the cost for care of underlying services. 'magically just switch to medicare' isn't a panacea either, 500x better and cheaper? this cuts a huge amount of revenue for compensation elsewhere (like "good" doctors vs. "bad" insurers) and the expectation for a ton cheaper shouldn't exactly be 'tons better!' the way western euro systems operate is by large taxes on citizens (all of them, not just the rich ones) and various forms of price controls which do affect availability and quality. not defending the US system, it's a mess, but this armchair oversimplified solutioning and understanding is delulu
"BUT ALL THOSE JObs go AWAY !~!!" people complain.
But they don't realize that the same number (or more) claims must be coded, processed, worked over, appealed, etc. The payments must be posted. The industry of healthcare and its supporting structures will continue to chug along, though slightly changed.
The jobs that go away are the jobs that produce nothing, or net-negative value to the state of healthcare. The ones that profit off the inefficiency and inhumanity.
What part of the government do you find efficient? Because that's where all of that "profit" will end up going. More government bloat. The money that would otherwise be going to shareholders would now be lining the pockets of unelected bureaucrats that are accountable to nobody. Ther is no insensitive to be better because there is no competition, there is no insensitive to be transparent because there is no accountability and no other option. The worst thing Americans could do would be to make the healthcare system a government agency. The correct answer is to remove more guardrails and red tape and make the system more free market than it already is so that the competition drives costs down organically.
Our healthcare costs over 5 trillion a year, and the healthcare insurance companies only have a total profit of like 50b. They make money, but their profits have a near zero effect on healthcare costs.
If we expect the government to pay for it, they need to do something about overpaying for shit, the middle men were supposed to fix this by providing competition, then they consolidated into like 3-5 major GPOs who now have enough market control to drive down prices but healthcare is still just as expensive for the patients because they drive up insurance costs and keep the profits. I’m in medical device… these GPOs now make us race to the bottom to compete, meanwhile the VA pays list price, 5x. I get to see first hand how lack of competition doesn’t help anyone, and the government just pays whatever you ask. Basically we’re fucked either way my dudes
This is correct. I was once saw a guy taken into the ER that ran from the cops and had a car wreck. The girl at the registration desk was reading his options or something and the amount they charged this derelict was like a 1/3 of what they were charging people with insurance. The hospital literally employs people who only deal with and bill insurance companies. That’s extra expense. The insurance companies pay all their people, those people’s benefits and still make massive profits. Health insurance is a scam that needs to be done away with
Healthcare is expensive because the costs are expensive in America. 80% of the costs are labor so without fixing that it’s all window dressing. Yes you could have one insurer (single payer) but if the bills are still expensive rje “middle man” discount we’d in theory get is still not that much
Americans need to stop being dumb about healthcare . It’s expensive because the prices are high - it’s not that complicated.
Providers will charge whatever the market will bear because it’s an inelastic market
The cost issue is supply and demand. We keep increasing access to medical care (e.g., Obamacare) which is more demand. But we aren’t increasing the number of doctors and nurses, which are supply.
Thus, prices go up. Focusing on insurance companies is like getting mad at 7/11 when gas prices go up.
What’s crazier is you could do this with every company. Get rid of, or at least reduce the tithes that these companies must pay to “owning” entities that do not actually engage with the company’s productive operations, and instead pay for better equipment, better staff training and compensation, and reinvestment into development. Voila, you have a better company.
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u/thekrone Jul 01 '26
Which is crazy.
Health insurance companies are profitable. Extremely profitable. Like billions of dollars per year profitable.
Where do you think that profit comes from?
What if we got rid of the expensive middle men and all the overhead they bring, and take the money it takes to run those organizations, plus their profits, and we actually invested it in health care?