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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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Yeah, but then anesthesiologists could then just say they can only work a certain amount of time because it costs them too much money in billing and appeals. Thus rushing a surgeon that then has a set time limit. Any time an insurance company makes a decision about what care a patient needs over the advice of doctors, it will result in problems. Sure there are going to be abuses, but instead of a blanket policy, it should be the responsibility of the insurance company to investigate fraud and waste.
I mean what other job do they have to spend money on but reducing fraud and waste? Oh wait, they spend money on software that is designed to deny claims, so they can blame the software for being overzealous and not the policies.
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.
Clearly havent seen the german system
We don’t have “one” health insurance, we have like 90 of them.
https://www.krankenkassen.de/gesetzliche-krankenkassen/krankenkassen-liste/
While a few of them are the same with the same administration, it’s still like 50 individual ones. A few of those are also “special” and only accept certain people. But each has their own administration, “CEO” of sorts and people that have to be paid.
The german healthcare system is mismanaged beyond belief and complete and utter dogshit. Don’t get me wrong, still better than the american system, but considering I’m paying 421,76€ a month in health insurance (and my employer pays the same amount aswell), I should be able to expect a certain level of service, but most of the money is lost in these administrations as it seems.
Many stuff isn’t paid for either. Early checkups, for example, aren’t covered. My girlfriend had to have her blood levels checked and it wasn’t covered by the insurance which cost her like 500€.
It’s just a fucking disgrace how bad the healthcare system in this country is.
When insurance insidious corporations claim they’re protecting the common people from greedy doctors, I’ll believe the doctors’ point of view.
I hate the argument that it’s not the insurance companies fault for high prices. If they are struggling so much, how come they are so fucking profitable.
Lets fix both, and not complain about the order if we make incremental progress one-at-a-time.
how come they are so fucking profitable.
UHC has a profit margin around 6%, whereas Anthem’s is around 3%. Those are not particularly high. For comparison, Toyota (8%) and Home Depot (10%) are both more profitable.
It’s not useful to compare health insurance profit margins to other industries because the Federal Government requires that they spend 80% of all premium revenue on care. This is effectively a cap on profits and also creates an incentive for insurance companies to pay higher costs for care so they can make more profit.
they spend 80% of all premium revenue on care
True. Actually, large insurance companies need to spend 85%.
an incentive for insurance companies to pay higher costs for care so they can make more profit
That doesn’t make sense. Insurance companies have to pay health care providers for care. The more care costs, the less money is left for insurance companies. In fact, if health care costs are too high then the insurance company can go bankrupt.
That said, the converse is not true: insurance companies don’t directly profit by cutting health care spending. That’s because they need to use 80% or 85% of their revenue on care. However, cutting health care spending (by delay, denial, etc) allows insurance companies to lower their premiums.
And since people often want the cheapest possible insurance, lower premiums means more customers, which means more total revenue, which ultimately does mean higher profits.
Of course, the key assumption here is that customers will accept worse care if it means lower premiums. This is one of the few industries where you literally get what you pay for.
See how it’s “a big insurer” so we don’t kill them?
