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Private insurance companies have earned the public’s distrust. They routinely put profitability above their policyholders’ well-being. And a system of private health insurance provision also has higher administrative costs than a single-payer system, in which the government is the sole insurer.
But the avarice and inefficiencies of private insurers are not the sole — or even primary — reasons why vital medical services are often unaffordable and inaccessible in the United States. The bigger issue is that America’s health care providers — hospitals, physicians, and drug companies — charge much higher rates than their peers in other wealthy nations.
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They’ll take the savings and issue a stock buyback.
They can’t do that.
The ACA requires large health insurers to spend 85% of their income on health care providers. If they don’t (eg because they start paying less to anesthesiologists) then the savings must be used to reduce premiums or give rebates to customers.
Hmm I didn’t know this. But is there anything stopping health insurers from spending the money on businesses they own (i.e. their own clinics, pharmacies etc)? If not I still fear they’ll run off with the savings.
United Health actually bought a bunch of health care providers, so they basically own a good chunk of the entire ‘vertical’ and somehow still ended up denying record amounts of claims.
What I don’t understand is why Americans are still looking to the federal government to solve the issue, instead of getting together and building a non profit co-op to deal with health care. Do the insurance part, gain market share by being the ones that actually don’t deny valid claims, start/take over hospitals, start making your own generic medicine, etc. If you don’t have to make a profit and appease shareholders you can take over the entire market. Local/state governments could provide some of the seed capital for this and make it the ‘public option’ in that state.
What I don’t understand is why Americans are still looking to the federal government to solve the issue, instead of getting together and building a non profit co-op to deal with health care.
You’re surprised that normal people don’t just start up their own multi-billion dollar corporation with assloads of liability and assloads of government oversight?
instead of getting together and building a non profit co-op
The Blue Cross Blue Shield insurers are either nonprofits or mutuals (the shareholders are the policyholders). So are many smaller insurers.
But nonprofit insurers are subject to many of the same pressures as other insurers. They need to keep premiums low, and they would go bankrupt if they paid every claim.
Likewise, the vast majority of hospitals are nonprofits. But nonprofit hospitals have to pay for medicines, doctor salaries, etc too. Most are barely scraping by and can’t fund clinical trials into novel genetic medicines.
Well, when you deny a claim from a clinic you own then it’s very likely your “savings” are losses for your clinic.
I was thinking more along the lines of deny claims for clinics you don’t own but approving claims for clinics you do own. Effectively shifting premiums away from outside clinics and into your own pockets all while staying under the 80/20 rule.
