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this post was submitted on 20 Aug 2023
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Asklemmy
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Private health insurance is the biggest fucking scam ever. The private insurance companies benefit by getting the aggregate healthiest population into their plans (working adults). The most likely to be expensive people, i.e. old people (on medicare) or poor people (on medicaid, or not even on an insurance plan) are on government, tax payer insurance plans. There is literally no reason except for corporate profiteering that Medicare should not be expanded to cover all people.
Also all those conversations, especially in the 2020 election period, were totally bullshit. You say something like M4A will cost 44 trillion dollars or whatever, which sounds like an insane amount of money. What is often left out of the discussion is that estimated cost was 1) over 10 years and 2) has to be weighed against the current costs we already pay for insurance. So the deal was very simple: the overall costs would go down because the overall spending would be less, and at the same time millions of people without coverage would be covered, and at the same time you don't have to contemplate stupid bullshit like in network, out of network providers. Or ever again talk to your insurance about why something is or isn't covered. Boils my blood when I think too much about this.
Not even gonna weigh in on things like how medicare can't negotiate prescription drug prices (https://www.nytimes.com/2023/07/23/us/politics/medicare-drug-price-negotiations-lawsuits.html), or how dental, vision, and hearing are treated separately from general healthcare, or how med school is prohibitively expensive, or how the residents after med school are overworked because the guy who institutionalize that practice was literally a cokehead. Those are all just bonus topics. The point is we are getting fleeced.
The only instances where privatized offerings may work IMO is if the government themselves are the competition, acting as a "control".
Without a stable control that has the sole purpose of serving the people, fully privatized offerings will just squeeze more money out of already stretched households for profit as you've said... which is the case for practically everything RN
NoYeah no. Get out of US bubble.
Private and public are both viable models of operations with some applicability overlap. Private doesn’t necessarily pursue profit first, despite US literally enforcing it.
Basic needs that are either unchanging or change very slowly are the purview of public policy. Healthcare, infrastructure, etc. Privatize it and you’ll have a catastrophe.
Basic needs that benefit from variation and supply elasticity with a necessary baseline is where hybrid model works well. Public entrepreneurship provides variation, regulations or public enterprises cover baseline. Agriculture is a great example of such overlap. Private-only agriculture leads to profiteering on basic human need. Public-only agriculture leads to famines due to incompetence, malice, or lack of elasticity.
Desires that people can live without and can change on a whim is where private innovation thrives. Be it a product to sell or a charity project to pursue. Some of the results of said innovation can and will become matters of public interest. Forbid private enterprise here, and you’ll end up in a bleak reality of North Korea.
We literally had a case of “public everything” half a century ago and it didn’t fucking work. It needed serfdom and insane amounts of natural resources to prop itself up. It also left a mafia-led capitalism in its wake.
We also have a live case of blind trust in markets, as if information was immediately available everywhere. It leads to a very similar looking outcome.
Sadly one of the main exports of the US is its ideology, so many other countries want to implement the same heartless, profit-oriented privatizations of every state organism.
Welcome to the US
Private insurance (for the average person) in general is dumb. We have a collective need to insure various things against disaster, and realistically the federal government shells out huge amounts for most disasters anyways (after the so called insurance companies go bankrupt).
So why the heck are we paying a premium for all of the overhead of the insurance companies?! It's this massive inefficient system that doesn't work, while the "government as insurance" system works great, and doesn't require nearly as much overhead. There's no room for private sector insurance to inovate, because there's nothing to inovate on; IMO, the private insurance industry contributes nothing of value to society except jobs that it pays for by forcing everyone to engage with it.
The insurance industry in general is betting you'll be fine, and you're betting "maybe I won't." It's extra bad for medicine because they stick their head even into the small stuff, not just "I need a 10,000 unexpected hospital bill covered."
Probably gonna anger both sides here, but I see both private insurance and single-payer healthcare as equally-evil scams. Why not focus on driving down costs of healthcare (i.e. EVERYTHING) so that you throw a couple bucks at the receptionist to cover your surgery then check to see if you have enough for a post-surgery soda?
One of the objectives of single-payer is to drive down the costs of healthcare by eliminating the overhead of an insurance bureaucracy. There are other aspects that can be considered like nationalizing hospitals to eliminate private run, for-profit hospitals. People like this https://en.wikipedia.org/wiki/HCA_Healthcare are just as responsible for the high per-capita costs of healthcare we pay as are the insurance companies. And I agree with you, they shouldn't be getting a guaranteed government handout.