Health insurance at its core is very simple. You put money in, you go to doctor, insurance pay doctor. But in the USA, the insurance denies everything they possibly can. Money put in doesn’t ever see a doctor or your health costs, it goes right to the stockholders…
So why doesn’t someone just make a non-profit health insurance company where there’s no stock, no executives, just public servants and aggressive price negotiation where your medical bills are actually paid with the money put in?
Healthcare co-ops exist. But a good number of people get health insurance through their jobs, and those jobs usually contract with one of the big corporations.
Yep, and it’s not like it’s just cheaper, benefits packages are tied into compensation.
Say you pay $400, insurance says the real price is $800, and your employer only pays another $200 as a “discount” but the real cost is actually $600. But turn down coverage, you don’t get that $200 in extra pay.
Without an employer, you have to pay the whole $800.
With a co-op you’d pay the actual real cost of $600.
It needs a critical mass of people.
And OP doesn’t understand a non profit still has a CEO that can be paid millions. The organization can’t make a profit, but lots of corrupt people make a lot of money running non profits.
It is over $1000 per moth for me that I’m turning away. there is just no way anyone can compete with that. much as I don’t like my insurance my costs must go up by a lot if I skip my companies insurance.
Yeah. I was just making up numbers for illustrative purposes.
As much as people shit on the VA, they’ve been my healthcare provider for over a decade and I just legitimately don’t know what numbers look like anymore.
It’s not perfect, but it’s a hell of a lot better than the majority have to deal with
And the more you dig into it, the worse it gets. That price discrepancy exists at the provider level too.
- You have a health issue and need treatment.
- The treatment cost the Dr $200 to perform.
- The list price for the treatment is $500.
- The big insurer uses the weight of their customer base to negotiate with the Dr and the agree to pay $300 for the treatment. If the doctor doesn’t accept, then they’re out of network and can’t get patients.
- The plucky startup co-op doesn’t have the same negotiating leverage, so they have to pay $400 for the treatment.
- The co-op is going to cost more to operate, and now the real monthly cost you have to pay with the co-op is $700 instead of $600.
And it gets worse.
This video is a nice little primer about how the insurer might not even pay that $300 they agreed to, how that let’s them profit further on the treatment while creating financial pressure on healthcare providers, and how your Dr may end up being owned by the insurer, further reducing the ability of a new co-op to compete.
Everything with “middle men” is like that.
Numbers get inflated then discounted.
It’s why it’s present at every step of capitalism, at every step someone takes a cut, so the price is inflated, then “discounted” to what consumers are willing to pay which is still an insane profit margin.
According to this, there are only three co-ops left —down from 23 when the ACA became law.
https://www.healthinsurance.org/obamacare/co-op-health-plans-put-patients-interests-first/
Blue Shield of California is a “big corporation” that employers here often contract with for health insurance, and it is a non-profit. Somehow this doesn’t really result in a dramatically different experience.
Obama tried and the entire Republican party started talking about gulags
No one gets rich from public healthcare.
That’s why.
Not exactly. In theory corporations need workers so they should benefit from a healthy public.
In reality, they don’t need everybody healthy - just enough to meet their needs. And their needs for workers are met. They’ve been exporting and automating jobs for decades. So even with the system leaving lots of folks behind, enough are left over to occupy the jobs that are needed. If anything, we have more healthy people than corporations need - what is lacking are skills.
And so in a very American sense of “business first,” the current system is operating just fine. People and their health have no intrinsic value here.
It’s technically possible but it would take a truly massive sum of money to get off the ground, and nobody is going to put up the capital knowing they’re not going to get a return on that investment. People don’t get the kind of money required to do this by making decisions like that.
It’s important to recognize that the system in the US is more convoluted than you believe. It’s not like we have totally separate drug manufacturers versus distributors versus hospitals versus insurers. There’s a fair amount of overlap, and a lot of it is relatively secretive, so you don’t know where the kickbacks are. You don’t know who’s jacking up prices in general knowing that they’re going to lower prices for the company that they are partners with. All of which is to say, this is not a fair market, this is not a market where you can reasonably compete if you play by the rules, but even if they actually bothered to follow the rules, you’re already screwed because they have market dominance.
The only path forward is through government run single payer healthcare. You can call it NHS, you can call it whatever you want, but it has to be run by the government. You need the government to set price ranges for drugs and treatments so that the drug companies and the hospitals don’t f*** over everyone.
But I don’t think Americans are ready for that yet. Obviously Trump winning the election makes it incredibly unlikely, but I think even large numbers of Democrat voters are still trapped in American exceptionalism. They know they’re getting fleeced, but they aren’t yet willing to say that they should probably copy what’s happening north of the border or across either ocean. They have good stories, things about super long wait times or lack of doctor choice, pretending that those things don’t happen in the US, and then pretending that those things do happen in every other country that has universal health care, which is laughable. But it’s hard, because so many people are desperate to believe that the US is the greatest country in the world, and they are desperate to avoid recognizing that they’ve been getting f***** right in the ear for the last few decades.
