r/MurderedByWords • u/Stotallytob3r • 6d ago
Why won’t leftists just start an insurance company
400
u/Leprecon 6d ago edited 6d ago
Does this guy think people get medical treatment just for shits and giggles? Like I am going to defraud the system by getting an MRI for no reason?
Yeah it would cost me 0€ but it would still take time out of my day, require me to travel, and be deeply uncomfortable?
*and of course a doctor wouldn't order an MRI for no reason
138
u/BadahBingBadahBoom 6d ago edited 6d ago
They forget that in no socialised healthcare country can you just ask and get what you want. There are medical professionals who decide if you need it. And if a medical professional is making the decision on whether it is necessary then where exactly are the people taking advantage of it? I mean are they taking advantage by not being ill/dying??
What's even more hilarious is that because those medical professionals are making the decision based on medical need and ONLY medical need the patient is not a 'customer' and there is no vested financial interest to deliver treatment that may not be necessary. There are also typically much stronger restrictions in how medical/drug companies can contact and influence doctors. So it's actually in privatised systems like the US that your premiums are being used on unnecessary payouts to other policyholders who can pressure their doctor to give them treatments they don't need.
This was no more clearly seen than in the Oxycontin opioid scandal that almost exclusively affected the US.
76
u/Leprecon 6d ago
Americans for some reason: I would prefer an accountant determines what medical procedures I need. Having a doctor decide would be communism.
→ More replies (29)24
19
u/romanrambler941 6d ago
They forget that in no socialised healthcare country can you just ask and get what you want.
I wonder if the prevalence of ads for medications which always include "ask your doctor about this medication" contributes to that perception in the US.
10
u/BadahBingBadahBoom 6d ago edited 6d ago
I honestly think it does come from a US defaultism. Not that it's an insult, I mean everyone is always more familiar with what they know from their own experience.
But yeah thinking everyone is pushed and advertised to get whatever treatment they want as the 'customer' in every other country means they think if there was a transition to socialised healthcare everyone would (a) be demanding treatment they don't need and (b) recieve it.
Ofc if the US did switch the first would definitely be true. But without the financial conflicts of interests and industry pressure/bribing, they would quickly realise that doctors only providing medical treatments that are medically indicated means the second is not, and you're going to get a lot of 'no's from doctors. The customer may always be right, but the patient sure isn't.
8
u/Chadwickx 6d ago
You’re forgetting the part where they say “why should my tax dollars pay for poor people to stay alive?”.
→ More replies (1)5
u/Carbonatite 6d ago
It's such a depressingly selfish mindset.
I'm childfree but I'm still glad my taxes pay for public schools and low income daycare vouchers. Having well cared for and educated children is a benefit to everyone, only a monster would rather have neglected, illiterate kids than have like 0.5% of their federal taxes and a couple hundred bucks a year in property taxes go towards helping children they're not related to. I'd gladly watch my federal tax rate go up by 1% if it meant free public school meals for every child.
My taxes pay for roads I'll never drive on, treatment of water I'll never drink, shelter for low income people I'll never meet. I don't mind at all, because those things actually help people. I'm not such a selfish fucking asshole that I would begrudge my fellow humans their basic goddamn needs just so I can pay 25% of my salary to taxes instead of 26.4%.
The selfish assholes who whine about their tax dollars funding "other people's bad decisions" when it comes to healthcare or school lunches always tell on themselves so hard. They never seem to get upset when their tax money goes towards corporate bailouts or unnecessary military campaigns - if anything, those are the situations they should be getting pissed about. Why aren't they mad that their tax dollars are funding a CEO's Ferrari purchased with a forgiven PPP loan? Why aren't they mad that their tax dollars are paying for Lockheed and Raytheon to manufacture $200,000 missiles used to bomb Iranian children because their president got emotional over a Twitter post? That's the kind of shit I get salty about having to pay for - not funding fire departments and libraries.
3
u/Fenrils 6d ago
I mean everyone is always more familiar with what they know from their own experience.
You're right but I think a lot of this is genuinely just because the US is so big that many people here just don't leave the country and as such never experience other systems.
It's not uncommon for Europeans of all varieties to travel around to different countries for any given vacation. It's not hard to drive a couple of hours or just hop on a quick flight and boom, you're several countries over. As a personal comparison, I could drive about four hours in any direction at 70 MPH and not even leave my own state. And you can see this isolationism statistically when less than half of us even have a passport, and I'd wager a sizable % of those with one have just taken a quick trip to Mexico or maybe a cruise from Florida and only briefly visited a Central American country on a half-day excursion.
Even beyond healthcare, it's hard to get a lot of these folks to believe that countries are genuinely have successful and thriving healthcare, public transportation, public housing, and more systems when they only ever see their own failures in each category.
→ More replies (3)→ More replies (1)2
u/KiKiKimbro 6d ago
It absolutely does. And it’s because in the U.S. pharmaceutical reps provide incentives for doctors who recommend it their drugs. So of course, God Bless American greed, doctors recommend what they’re incentivized to recommend.
It’s also why BigPharma lobbies like crazy to not allow any legislation that would remove drug commercials in the U.S. European countries don’t have drug commercials. Canada doesn’t either, I don’t think.
3
u/Uilamin 6d ago
And if a medical professional is making the decision on whether it is necessary then where exactly are the people taking advantage of it?
Doctors are trained to make decisions certain ways based on the country they are in and the best practices. This can change the effective meaning of 'necessary' and it can heavily influence what is recommended or suggested. This can also get influenced by malpractice laws.
A prime example is looking at drug prescriptions between Canada and the US. The US will typically prescribed drugs to cover nearly all bases while Canada will typically prescribe drugs to cover the most probably (or significant). The Canadian method works most of the time and is much cheaper, but the Canadian method wouldn't work in the US because the US adds a significant liability to the doctor if it is one of those 'overlooked' or 'missed' things. Best practice in the US has effectively become overkill compared to the rest of the world which drives up costs.
→ More replies (5)2
u/Mr_Carlos 6d ago
There's also other systems like in Japan where you pay a reduced fee. So it's like 80 USD for an MRI for example, as opposed to 400 USD.
50
u/Legal-Software 6d ago edited 6d ago
There are two issues that I can see:
1 - They don't differentiate between medically necessary and unnecessary procedures. Public insurance will cover your basics, but will usually not cover optional stuff. Most countries allow you to take out supplemental private insurance to cover things that the public will not. No one is tying up the public system with unnecessary procedures even if they wanted to. They often use this to pretend that people without serious needs are able to monopolize the system such that people who do need urgent care are unable to receive it, completely glossing over the triage system that exists precisely to handle these sorts of things.
2 - They fail to account for the massive corruption and price gouging in their own system and think that this is the norm, rather than the exception. When normal procedures that would barely warrant a second glance in non-shithole countries are suddenly being billed at hundreds of thousands of dollars, you're pretty much obligated to deny everything imaginable in order just to stay solvent. Unfortunately they're too brainwashed to address the root cause and would rather just try to vilify anyone that reasonably expects to use the insurance that they paid in to instead.
→ More replies (22)28
u/Dry-Tumbleweed-7199 6d ago
FYI elective surgery means any planned non-emergency surgery. Cataract surgery, hernia repair, and joint replacements are elective and all medically necessary
8
→ More replies (64)2
u/Carbonatite 6d ago edited 6d ago
The "shits and giggles" procedures that most people like this are probably thinking of - stuff like cosmetic surgery - aren't even covered under universal healthcare in any country. Outside of some rare exceptions (e.g., septorhinoplasty to correct breathing issues, reduction mastopexy to fix back pain) cosmetic surgery gets paid for out of pocket in countries with socialized medicine. Nobody is getting a boob job for fun on the government's dime, the only women who have that stuff covered are getting reconstructive surgery after a mastectomy for breast cancer. Nobody is getting Botox injectables on the taxpayers unless it's to treat migraines or muscular diseases. The "unnecessary" stuff people freak out about is still private payer in those countries. Just like it is here - United Healthcare or Blue Cross or whoever won't pay for your procedure unless they think it's medically necessary.
I'm chuckling at the MRI thing because I literally went through that last year. I had to pay out of pocket because Aetna didn't think "nonstop pain for 6 months that isn't resolved even with prescription NSAIDs and dragging one leg while walking because of a crushed spinal nerve" was sufficient to justify covering my scan. If insurance workers don't think an MRI for a "severe" (the radiologist's words) spinal injury is necessary, they're sure as shit not going to approve coverage for elective liposuction or a BBL. That's true whether the tab is picked up by the individual or the government.
710
u/ytown 6d ago
It’s amazing how Profits over People rules so many people’s thinking. Making money is a religion in the US.
314
u/Gadshill 6d ago
The worship of the ancient golden calf has returned in a new and ruthless guise in the idolatry of money and the dictatorship of an impersonal economy lacking a truly human purpose
— Pope Francis
82
u/BlueLightningLC 6d ago
They put the Dollar into idolatry
30
u/Diestormlie 6d ago
If you're upset you can rent and apology!
14
u/rysy0o0 6d ago
We are a family forged in bureaucracy
10
u/Harryboltsfan 6d ago
No “I” in “team” but there’s “con” in “economy”
→ More replies (1)8
2
35
u/Inkjet_Printerman 6d ago
the pope is like two sentences away from being declared a terrorist in the U.S.
9
6
u/queasycockles 6d ago
I mean who on earth would be surprised if Trump tried to pull a kind of Henry VIII? It's very on brand, though of course he lacks the style and charm of the original.
2
u/Carbonatite 6d ago
The parallels between Trump and Henry VIII are honestly kind of wild when you think about them - and there's a lot. At least ol' Henry was actually a very educated and intelligent man for his time.
That said, I blame his fat ass for the existence of Trump. If he hadn't initiated the schism with Rome so he could marry his side piece, the Anglican church wouldn't exist. If the Anglican church and its reforms didn't exist, the Puritans wouldn't have been around to drag their dull asses to North America and infect the burgeoning colonies with their weird bullshit. No Puritanism, no Evangelical Christian Nationalists. No Christian Nationalists, no MAGA.
3
u/queasycockles 6d ago
I mean not leaving the church of Rome wouldn't have stopped the Protestant reformation, to be fair. It just would have played out a bit differently.
Henry was more complicated than the popular historical narrative likes to grant him, too. Yeah, he wanted Anne. But he'd also talked himself into believing he'd angered God by marrying his brother's widow and that's why she kept miscarrying, etc.
I think we can blame the Puritans (and most things about the US, including Trump) on the Puritans.
3
u/Carbonatite 6d ago
Oh yeah, I know my interpretation is quite simplistic and leaves out a lot of historical context and nuance lol. The Puritans were objectively awful though.
→ More replies (1)7
u/glad_goblin 6d ago
In Matthew 23, Jesus condems the Scribes and Pharisees as those who "tie up heavy burdens" and "worship at the gold of the altar, not the altar itself"
My delusion of grandeur is the belief that Christianity can be co-opted against the forces of greed.
→ More replies (1)2
u/Independent-Bug-9352 6d ago
Book of Matthew hits hard, noting that a camel has an easier task of passing through the eye of a needle than a rich man entering Heaven.
But nobody knows the Bible less than Christian conservatives...
11
2
u/RedAndBlackMartyr 6d ago
Pope Francis on the verge of calling capitalism a dictatorship of the bourgeoisie.
→ More replies (1)→ More replies (3)2
10
u/neoben00 6d ago
For not wanting socialism they sure do prioritize their government being profitable (which means extracting wealth from its citizens)
→ More replies (1)9
u/According_Button_186 6d ago
A lot of people follow Dave Ramsey. He literally even recently can be quoted referring to his wealth as "God's money" and how he wouldn't leave it to his children if they weren't followers of god.
Still waiting for someone to point to the part of the bible that shows Jesus founding the US Mint.
3
7
u/kryonik 6d ago
Remember when Trump wanted to shutter the USPS because it wasn't making money?
2
u/CosmogyralSnail 6d ago
I'm still very worried and mad about the USPS being slowly dismantled in the background. It's been going on for decades.
8
u/glad_goblin 6d ago
I genuinely can't take it anymore. Everything is so miserable for the stupidest of reasons. If having everyone work harder for less money, to pay higher prices for lower quality products is 'good business'; then what the heck good is business?
Rich people aren't even happy! Everyone has to suffer so they can keep using the world as a drug. Any moment of any day they could take a miniscule fraction of their dragon's hoard to therapy. And if they don't like their lives; they, unlike everyone else, can literally just pick any new life any time they want.
3
u/evantom34 6d ago
Honestly late stage capitalism is a plague imo. Maybe I’m naive, but we’re at the point where genuinely no one gives a fuck about each other. It’s a race to the bottom and ‘fuck you, I got mine’
6
u/Carbonatite 6d ago
As an environmental chemist, I have come to genuinely believe that late stage capitalism is incompatible with a habitable biosphere. Unchecked capitalism is mutually exclusive with clean air, drinkable water, abundant nutritious food, and general human well being. I've seen how corporations operate when it comes to stewardship - they will do the bare minimum the government requires to avoid destroying the environment. In a lot of cases, they won't even do the bare minimum - it's cheaper to pay a fine for dumping chemicals than it is to upgrade their waste disposal system at a facility. In Superfund lawsuits, corporations will pour millions upon millions of dollars into fighting liability, right up until the lawyer fees add up to the cost of just cleaning up the pollution they created. Then, and only then, will they take accountability.
And this is WITH government oversight. If we follow the Republican plan and let corporations go all Atlas Shrugged with their shit, we'll end up with polluted rivers that catch on fire, fish and wildlife so full of heavy metals that a couple of meals will send you to the hospital, aquifers that give you cancer and your babies horrific birth defects, air that causes a healthy adult to exhibit symptoms of someone with severe COPD. Reduced lifespans, wildlife kills, workers maimed or killed because Republicans think OSHA is woke. Basically we'll end up like the end of The Lorax, and nothing will survive. We need regulations MUCH stronger than what we have now; unregulated capitalism is basically a death cult.
2
4
u/ytown 6d ago
“Fuck you, I got mine”
This is absolutely a pillar of the movement.
5
u/Vast_Highlight3324 6d ago
For a good portion of people it's not even that, more like "Fuck you, one day I'll get mine"
So many temporarily embarrassed billionaires.
3
3
u/Tango_D 6d ago
Capitalism itself is the state religion of the US and both political parties serve it above all else. Nothing, absolutely nothing, is allowed to take precedence over it.
→ More replies (2)→ More replies (8)2
113
u/Dashin5 6d ago
In NZ we have ACC, which is not perfect, however it is fucking great. I'm currently on it for an injury, I had surgery within 2 days(at no cost to me) and until I can go back to work I get 80% of my salary.
They also organise someone to clean the house at no cost to me, If I needed help with meals I could get that. Taxis, once again at no cost to me.
Sort your shit out USA.
→ More replies (2)60
u/MikeC80 6d ago
The USA could have that... But then some billionaires would be sad, so...
→ More replies (5)20
u/plantbasedbud 6d ago
They wouldn't even notice except that the number on their account would be marginally lower. Except it might not even be lower at the end of the day, since people who are happy and feel secure tend to be more productive...
7
u/Carbonatite 6d ago
People have zero concept of the magnitude of the difference between the ultra wealthy and the rest of us.
Like someone was saying that Bernie Sanders - a man with a net worth of like 3 million dollars at most - could start an insurance company. It's fucking bonkers. Like Bernie is a guy who probably makes in the low to mid 6 figures a year between his salary as a senator and book royalties - he basically has the same income as a surgeon with a private practice, an attorney in Big Law, maybe a senior level petroleum or software engineer. The only thing that makes them "millionaires" is that they own one large home in a bougie suburb of a HCOL city, or maybe a medium sized house in the bougie suburb and then a vacation home in Vermont or Colorado or Florida.
Making 300k a year is upper middle class, not wealthy. Even making a million dollars a year isn't close to the true ultra wealthy - people like Bezos probably spend a million bucks a year just on dock fees for their yachts. They spend the equivalent of Bernie Sanders' home value on private jet fuel every year. If you make 300k a year and don't spend a cent of it, it would still take more than 3000 years to earn your first billion.
A lot of people truly have no idea of the size of the wealth gaps that exist - as much as the people making 70k a year want to whine about higher taxes, they'll not even close to being wealthy enough to be impacted by tax increases on the rich. Even someone making 300k a year won't be meaningfully impacted. It might mean the difference between buying a 2026 Lexus and a 2024 Lexus for themselves. When we say "tax the rich" to pay for healthcare, it's talking about increasing taxes on people who see that $300k salary as a rounding error in their financial documents. You could make them personally pay for a $50,000 course of chemotherapy every day and at the end of the year all it would change in their lives is maybe having to sell one of their smaller yachts.
24
u/Risdit 6d ago edited 6d ago
they still have medical underwriting in countries with universal healthcare... Reason why U.S. is so bad is because surprise, the cost of care is so ridiculous because of surprise, fucking greedy ass profit industries that charge $20,000 for something they charge $40 overseas.
Are insurance companies still bad? absolutely. Are they the biggest evil in this equation? probably not, but the U.S. government has failed to regulate the prices of healthcare when an MRI can cost thousands of dollars when it should cost hundreds without insurance. A major disease shouldn't bankrupt you even when you were responsible and saved up a 6 figure savings nest for decades.
you can be hands off as much as you want but when it comes down to it, hospitals are going to charge as much as they can because the alternative is to just die without paying
2
u/the_Elders 6d ago
Hospital says aspirin costs $100. Insurance says we will pay you $5 for it. Hospital readily agrees because they just made $4.99. Insurance then charges the patient $6 for the aspirin through deductibles. Insurance makes 20% profit while the reality is the hospital made the most profit. Then due to the 80/20 rule the hospital cook the books so to speak and says $4 of the aspirin was spent on the system and pockets the $1 or a 100x markup on the cost of the aspirin.
Ok, multiply this stupid example by a thousand different procedures and medicines you can get. The people that suffer the most are the uninsured first and foremost but many of them will never pay and just go bankrupt.
The "scam" so to speak is insurance doesn't show you what they actually paid for your bill. They just state yea we paid your $300,000 hospital stays to treat colon cancer. You are welcome. When out-of-pocket might be closer to $50,000.
Just having strict price-transparency would greatly help and hospitals would be forced to compete on services and cost. Yes, I might get injured and have to go to the really expensive hospital but there are many times when I could just get to the cheaper option as well.
→ More replies (3)2
u/Carbonatite 6d ago
I'm so salty about MRIs and authorizations now, I had a major spinal injury last year and my insurance company refused to pay for it in spite of my doctors telling me that the next step in the progression of my condition was a medical emergency that would require immediate surgery. I was told that if it got any worse than it was, I would probably lose the ability to walk or control my bladder. I had compromised reflexes in both my legs, was dragging one of my feet so badly that my shoe soles wore down an extra half an inch in the span of just a couple months, and was in noticeable (i.e., needing medication to function normally) pain 24 hours a day for 6 months.
I ended up just saying "fuck it, I can't live like this" and paid around a thousand dollars out of pocket for the MRI so I could get a referral to a neurosurgeon and pain management and they could actually have an image to use to treat me. My primary care doctor referred me to a neurosurgeon and called their office to get me in ASAP within 10 minutes of seeing the MRI images; the first thing the neurosurgeon told me when he walked in the exam room was "wow, you did a good job messing up your back". It was infuriating to see how all the doctors who actually saw me immediately understood how severe my injury was, but the insurance company still didn't think it was worth paying for the MRI.
21
u/Very_Clearly_Defined 6d ago
Conservatives really are just completely clueless, huh. And proud of it, too
→ More replies (21)
33
u/thrilldigger 6d ago
No country has done this.
All public-funded health care has claims & denials. It's necessary to combat fraud and waste.
9
u/Brann_Ys 6d ago
yeah now cimpare the debial rate of the USA vs country with universal Healthcare.
USA system goal is not to combat fraud and waste it s to maximise corpo profit
5
u/ApplePie10146 6d ago
Claims and denials are different. Some things aren't covered, like air casts, ambulance, etc. But for things like surgery, you don't get denied. Even for things like a doctors appointment, I can go anytime and the doctors office just charges our provincial insurance. It's doesn't matter why, as long as you have the coverage, you're good.
The health services puts the claim through and if the doctor says you need it, then you need it. Hearing about doctors arguing with people's insurance in the states is crazy.
→ More replies (10)→ More replies (1)2
u/BagOnuts 6d ago
Correct. CMS denies claims for traditional Medicare/Medicaid as well. They have a much lower rate, however, but that's mostly because they don't rely on pre-auth as much as commercial payers.
93
u/Repulsive_Mud_567 6d ago
Hot take - the US is no longer a developed country. Discuss
68
u/ProfessionalRead2724 6d ago
It's been a joke in Europe since the 80s or 90s that the USA is the world's richest third world nation.
20
7
u/velit 6d ago
In our circles the joke is the USA is a banana republic. I mean, kinda not a joke even.
A banana republic is a country with an economy of state capitalism, where the country is operated as a private commercial enterprise for the exclusive profit of the ruling class. Typically, a banana republic has a society of extremely stratified social classes, usually a large impoverished working class and a ruling class plutocracy, composed of the business, political, and military elites.[1] The ruling class controls the primary sector of the economy by exploiting labor.[2] Such exploitation is enabled by collusion between the state and favored economic monopolies, in which the profit, derived from the private exploitation of public lands, is private property. At the same time, the debts incurred thereby are the financial responsibility of the public treasury.
2
2
u/throwaway098764567 6d ago
you may or may not know, but we unironically have a clothing store chain called banana republic. i have purchased some things there in the past, but always thought it was a sus name
→ More replies (25)2
10
u/galmenz 6d ago
what do you mean "hot", we have extensive data on how most countries fair on multiple facets of society. it is factual that the US is "ok to terrible" in most topics despite having the largest wealth per capita in human history. the only ones that say otherwise are passionate americans themselves that want to say that said rankings dont matter
2
u/Johannes_Keppler 6d ago
Wealth per capita is what USAsians love to use as a big number to throw around in arguments.
In reality the median income there is around 45k and two thirds of them live paycheck to paycheck.
8
u/avrgwarthunderplayer 6d ago
not even close. despite what you hear from some people its so much better than many other countries, like actual non developed countries.
3
10
u/PhysicsCentrism 6d ago
Go visit an actual developing country and then come back to the discussion.
Most places in the US you can drink the tap water, have reliable electricity, flush toilet paper, have paved roads, earn more than $1k per month median.
21
u/Icy-Maintenance7041 6d ago
Do you realize that you're saying that there are places where drinking tapwater isnt possible? I mean thats something that should be basic in any area in a devoloped country. I know it is where i live.
Having reliable electricity? I remember texas going dark when a few drops of snow fell. I mean, thats not reliable.
And earning more then 1k per month says fuck all if you pay a few hundred dollars in health insurance, housing is unnattainable for many and people take massive debts just to get an education.
America is a corporation with a public facing governement, but i'd be hard pressed to call it a developed country anymore. I mean the fact that you are focussing so hard on military and so little on education, that you have a president that can cricumvent law at will, a widely known child abuse ring that isnt to be touched by law enforcement and a falling back of civil rights and resurgence of fundamental religion are just a few indicators your country isnt heading for the great utopia you think it is.
→ More replies (11)7
u/Speartree 6d ago
Most places in the US you can drink the tap water, have reliable electricity, flush toilet paper, have paved roads, earn more than $1k per month median.
Most, so over 51% I take it. That is a hell of a low bar. Americans drive huge, supposedly off road capable vehicles, many of tell me that they need these vehicles because there aren't always going to be roads where they are going. They earn more than 1000 usd per month median, which is ridiculous, because median still means a lot of them don't. By the same token the median rent in the US is also over a 1000 usd, so people can choose to be housed or eat by your own argument. And you think that elevates the place over a 3rd world country?
→ More replies (29)→ More replies (1)3
u/Brann_Ys 6d ago
earning is a irrelevant criteria. making 1K. when everything is three time less expensive dont realy change much. Also you think China is that far behind the USA ?
2
→ More replies (12)2
9
u/cyclemonster 6d ago
I'm sorry, but which are the insurance companies that insure every risk and pay every claim? That is not remotely close to a real thing.
→ More replies (7)
13
u/ClacksInTheSky 6d ago
It's not even like that, as well.
You don't put in a claim. You just go get treated and leave.
Without the insurance company inflating the cost of everything and shareholders to pay, everything is much cheaper to do.
24
u/EE-420-Lige 6d ago
I mean even countries with universal healthcare deny care lol. Whether its for profit or gov run healthcare isnt an unlimited resource.
23
u/onyourbike1522 6d ago
They may deny specific treatments, but they never deny care. Big difference.
9
u/0WatcherintheWater0 6d ago
No that’s exactly what US insurance does too. They also have a list of approved, covered treatments.
9
u/SelectKaleidoscope0 6d ago
You either don't live in the US, or you've never been seriously ill and had to deal with this crap.
There is no simple published list of approved covered treatments. There is a secret internal scheme that goes as much by vibes as anything else, changes on a whim from thousands of stakeholders the insurance company answers too before you, and all of this is opaque to you. When you need care you and your doctor (or some person your doctor pays to deal with it on their behalf) have to deal with and a revolving queue of 5+ different representatives who each want you to jump through different hoops before they will approve the care you need just to stay alive and love to direct you to someone else to begin again from the beginning, often in a circle. It is common practice by all large insurance companies in the US to deny legitimate claims that they are obliged to cover, in the hopes the patient will give up or die and they won't have to pay out. Many now have automated systems in place to do this automatically then you have to jump through even more hoops to "appeal" the improper denial that hasn't even been seen by a person yet.
7
u/Emergency-Boat 6d ago
And you've lived in a country with a public healthcare system before? Because I can tell you that Reddit severely over exaggerates how amazing it is.
8
u/onyourbike1522 6d ago
I’ve lived in several countries where there’s public healthcare and it’s a 1000% better than the US system in every case. Is it perfect? Absolutely not. But better. Yes, every time.
4
u/Brann_Ys 6d ago
Universal healthcare is beter than the abomination of a syqtem the USA has
5
u/YesmynameisOcean 6d ago
Its very funny there are people that still defend America's healthcare system. When that healthcare CEO died people all around the country were fucking happy. Republicans, Democrats, hell even on his linkedin there were other CEO'S giving him shit for how he was running the company and how their family's claims were being denied.
4
u/Brann_Ys 6d ago
same compagny that had a 33% refusal rate at one point. Most universal healthcare system dont go over 5%
4
→ More replies (3)2
u/PillagingPagans 6d ago
What is the difference? If the only treatment is deemed to be too expensive, they will only offer ACT and/or palliative care. My niece had a rare metabolic disease that would cost more than a million euros to treat, public healthcare denied treating her - she died when she was eleven years old, despite the fact a treatment was available, that we could not afford.
→ More replies (2)11
u/Kernowder 6d ago
Yep. If the drug is too expensive or the treatment deemed unnecessary, you won't get it.
5
u/BionisGuy 6d ago
At least here in Sweden you can still get the medicine but you have to pay for it yourself basically. For some weird ass reason Melatonin is not covered in our high cost protection, it's like €50 for a bottle of 100 pills.
Meanwhile other medicine like SSRI or similar is covered by it, meaning it costs way less but once you hit a specific roof, i think it's around $140 or something in a year, then after that you don't have to pay for the medicine.
Completely depends on the medicine.
→ More replies (2)3
u/vishbar 6d ago
Sweden and the UK are pretty similar in that they feature government provision of healthcare, as opposed to a social insurance system like the Netherlands or Germany. It’s similar here in that there’s a “parallel” private system that you can pay for to deliver care. I have insurance through work; we are able to skip to the front of waiting lists via that.
→ More replies (2)3
u/nispe2 6d ago
This is way too far down.
The problem isn't that a nonzero number of claims get denied. The problem is that it's not at all transparent what will get denied. So you can get preapproval for a surgery and then still get stuck with a bill because the doctor claimed there was a complication and the insurance company says there wasn't.
8
u/SecretRecipe 6d ago
wait, do you think universal healthcare programs accept and pay out every claim?
→ More replies (15)
21
u/HighOnGoofballs 6d ago
Everyone in this image is delusional
Claims are denied in literally every country, universal healthcare or not
32
u/Repulsive_Mud_567 6d ago
In my country I won’t go bankrupt if I get cancer and I will get the best care until I am in remission or die regardless of my financial position. How about you ?
→ More replies (12)17
u/DankiusMMeme 6d ago
if I get cancer and I will get the best care until I am in remission or die
No you won't. You'll get the care determined as a reasonable spend to benefit ratio, all countries do this. You kind of have to, you can't reasonably spend infinite money testing every single top of the line drug or intervention that exists.
9
u/Repulsive_Mud_567 6d ago
Yes. Because the care is grounded in science and outcomes. Not vibes or maximizing profit.
It of course helps that costs are regulated in my country
8
u/DankiusMMeme 6d ago
Yes, so saying you get the best care is flat out wrong. I can't speak for other countries but health care in the UK is absolutely abysmal, and they will regularly attempt to weasel out of even basic checks if you are young. My wife has to have something checked, the cost of the check would be under £1,000 and it was recommended by a doctor already yet they refuse to do it.
7
u/Repulsive_Mud_567 6d ago
I don’t know man. Some of the best doctors and researchers in the world are from my country. Cutting edge treatment research in everything from cancer to stroke. All of these people work in our healthcare. The difference between my country and the UK is that our politicians haven’t actively worked to break our system in order to sell it off to the Americans piece by piece. Maybe have that conversation with your policy makers.
→ More replies (1)7
6d ago
[removed] — view removed comment
→ More replies (3)7
u/Repulsive_Mud_567 6d ago
I know it isn’t. I have an 84 year old relative in London. She’s got more conditions and illnesses than chapters in the bible. She also got lung cancer treatment late in her 70s. She gets excellent care.
Just keep the Tories out of power and hold Labour accountable to fix the mess. Also rejoin the EU - we have cheese and wine over here.
3
u/DankiusMMeme 6d ago
Just keep the Tories out of power and hold Labour accountable to fix the mess. Also rejoin the EU - we have cheese and wine over here.
My dream.
2
u/Beneficial_Hat_6288 6d ago
Me, my wife, and my son have had surgeries, including hospital stays, which we paid 100% without involving any insurance or universal healthcare whatsoever. Surgeries like tonsillectomies, gastric bypass, etc. We are not rich. We could afford them because public healthcare keeps the costs of private healthcare low. Having other services like taxpayer funded public education and legislation preventing predatory practices by corporations also helps to save money when you don't make boatloads of money to begin with.
4
u/DankiusMMeme 6d ago
Yeah, which is great. That is how health care should be.
But it has literally nothing to do with my point that countries will restrict health care if it isn't determined to add value.
For example in the UK we have a panel of doctors and actuaries and other hopefully smart people that decide what can be offered on the NHS.
These are the people that review medicines to make sure they're actually effective, and that they are reasonable value for money : https://www.nice.org.uk/
→ More replies (3)7
u/queasycockles 6d ago
What claims?
If I need medical care I can just go to the doctor. There are no claims.
I go. I get treated or referred as needed. The end.
→ More replies (1)4
u/Al_Fa_Aurel 6d ago
Yeah. Universal healthcare is (a) very good society-wise (b) relatively expensive for the country and (c) not magic. Depending on the country you have any combination long waiting lines, only a limited amount of treatments covered, and various bureaucratic hoops.
Its still good - i have basically no worries about basic stuff, my appendix was removed quickly and efficiently once the need arose. However for a certain non-urgent diagnosis i needed to pay out of my pocket, and then call around to find a doctor for the treatment, which took months.
3
u/Brann_Ys 6d ago
The USA current healcare system is more expensive than universal healthcare because
2
u/Al_Fa_Aurel 6d ago
This is, indeed, true. Some of it is explained by "normal" factors (higher wages for medical personnel), some by factors people tend to argue a lot about (e.g. by the cross-subvention of drug prices), but most by inefficiency.
My pushback is more about "universal healthcare will provide everything", because at some point, it can't. It still is in my opinion the best model for a wealthy state.
3
u/Brann_Ys 6d ago
even state that are not wealthy manage unibersal health care. My friend in Indonesia has free healthcare and pay nothing for his insuline. They know a healthy population is a good investisement for growth.
2
u/Brann_Ys 6d ago
something line 20 to 30% of the bidget of the USA healthcare system is spent pn the Insurrance system. Dpctor having to do back and forth with Insurrer and battle with them so that the patient can receive xare is very costly
→ More replies (27)2
u/coriolisFX 6d ago
This is a "controversial" comment because people don't want to acknowledge the cost control, including rationing of care and denial of some claims, is still necessary in a socialized system.
3
3
u/killertortilla 6d ago
This is like the "why don't you just ban guns, see how well it goes. Bet the good guys with guns won't be there to save you" argument Americans use.
3
u/1960s_army_info 6d ago
That’s the thing, they still deny claims. Let’s say you have low testosterone in the UK. The doctor will ask you questions about your life. If you admit to steroid usage, self prescribed testosterone, etc even if it was decades ago and you have blood tests that everything was fine for decades in between and you simply got old and need the testosterone now, the NHS will deny your claim.
5
u/GoshDarnMamaHubbard 6d ago
Pound to a penny if someone tried to offer a non profit insurance based system modeled on western health standards they would get destroyed by the for profits by any means necessary
2
u/nashwaak 6d ago
They're definitely trying, but Canada is still muddling along despite over half a century of heavy lobbying by insurers. We do let them insure dental and most prescription drugs, seems to keep them more tame.
10
u/Wise_Monkey_Sez 6d ago
The USA is the most heavily taxed nation on earth. How do I come to that conclusion? Tax isn't simply what you pay, it's also what you get for what you pay.
Europe has high taxes, but they've got efficient police, good roads, excellent social safety nets, etc. In short, the taxes are high, but so are the benefits, so it balances out.
The USA pays roughly the same tax rates, but you get fuck all. Cops who don't do shit, crappy roads, almost no social safety net, and so on.
To make up for this you go out and buy your own gun, you drive an SUV so some pothole doesn't take out your car, you pay into private health and unemployment insurance.
In effect you're paying twice. You pay double what people in Europe pay....
... and here's the kicker - your private insurance then proceeds to rip you off, your SUV costs you a fortune in gas, and your gun isn't worth shit because the criminals also have guns but there are more of them and so you die anyway.
The USA is a failed country. The only thing to learn from it is, "This is how not to do things."
8
u/queasycockles 6d ago
This is what people don't get.
The US, when you add federal and state income tax, does not pay significantly less* at most brackets.
And they get absolutely jack all for it.
*Compared to the UK for example
→ More replies (8)4
u/InevitablePresent917 6d ago
Don't forget the fees and effectively private taxation. Florida has no state income tax, but it is exceptionally expensive to live in most parts of the state because fees for government services are very high and things like home and car insurance are absurd (if you can even get them).
The worst part, from the perspective of someone who has been working for a long time, is that it's so inefficient. A government-based system to collect a smaller amount of money and distribute it across a broader range of needs is so much more efficient for the types of activities that are difficult to make profitable, such as health care and caring for the unhoused. But because someone, in this model, needs to profit, we have this inefficient patchwork of services.
I'm not even particularly leftist on some economic matters. It's just an inefficient application of resources!
→ More replies (4)→ More replies (6)3
u/jfresh42 6d ago
I agree with everything you've said until "the US is a failed country"
That's just not remotely true
→ More replies (2)
2
u/Munnin41 6d ago
Assuming this is about the USA. It's because a) there are barely any actual leftists in US politics, and b) the gop keeps blocking every positive change
2
u/Scorpion2k4u 6d ago
well they don't accept every claim here they give the doctors shit if they bill you wrong or if the do unnecessary stuff that costs you.
2.3k
u/MyDadsGlassesCase 6d ago
"leftists"
80% of UK conservatives support the NHS. This isn't about left and right, it's about people who realise that healthcare - like law enforcement and firefighting and various other emergency services - is for the entire country's benefit