Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I’m amazed at the number of people who think health insurance is the main problem, as if the hospitals just honest businessmen submitting bills for their services and the docs as well. The whole system is a sh&t show. Cardiologist in the US make like a half a million, in the Uk it’s like £150K.
People should be mad at their legislators for allowing it to get this way. This is not to say that insurers don’t have their problems but they are but one cog in the wheel of grift and dysfunction.
Cardiologists actually provide an extremely valuable service. Insurance companies suck money out of the system. Do you really not see the difference?
In many cases they keep the system from ripping people off and in many cases make sure that people don’t get the wrong med or unnecessary procedures. I know you think your doctor is the bees knees and would never do anything unethical or wrong but you would be wrong. Consider the fact that so many physician groups have sold out to PE who are managing care by the way in which they manage the practice. The docs didn’t sell because they are concerned about the good of the patients - they wanted a paycheck. There are no innocents in this game.
Yep. Private equity is all over specialized surgical and medical groups …. these doctors are money machines. Cha Ching! $$ Smart doctors know how to game the system. Spend 15 minutes with a patient, quick exam, order scans. Done. Next!
Even large hospital groups order needless scans, ultrasounds, blood work, procedures, unnecessary surgeries…it’s insane.
Yes—I’m generally pro doctor but anyone who thinks that doctors don’t need checks on spending is naive. The nursing homes are notorious for ordering useless tests and therapies to pad their profits. And lots of doctors will just write whatever test or script their patient wants because it’s easier than arguing or because they are making a profit (remember the opioid epidemic?). Everyone would like to have great doctors who only prescribe medically necessary stuff and only do so in their best interest, and have affordable health care that covers all medically necessary treatments, even if those treatments cost millions of dollars a year for a single condition. But it’s not reality. Yes, let’s crack down on the bad actors, but this generalized hate for health insurance providers is just so naive and dangerous. Does anyone remember the world before health insurance? Working class people just died if they got anything that needed more than a doctors visit. Pooling of risk is a good thing—that’s what insurance is. But insurance companies have to follow their written policies.
Some of what you say sounds like nonsense to me, such as your claim that nursing homes are notorious for ordering unnecessary tests to pad profits. Maybe in Florida, and I saw an episode of Blue Bloods that has something like that (as if the DA's office would be the front line for investigating a nursing home), but in general that's not how things are set up. The opioid epidemic resulted from a combination of factors ranging from a blitzkrieg of deceptive marketing and pushing certain narratives about pain management that shaped standards of care, a very corrupt drug company, criminal doctors and pharmacies, the resulting addictions, and the continuing lack of truly effective methods of managing chronic pain.
Physician income in the US is highest in the world (except for Luxemburg) yet for primary medicine, including pediatrics, compensation has been dropping for several years, training takes more years in the US than in many countries, and costs a huge amount more (German medical school tuition is free, in the UK it's about $20k USD a year and taught as an undergrad degree). The percentage of doctors in private practice has been dropping--the majority are now employees of "non-profit" corporations (many of which make a ton of money but convert it into assets and function much like a for-profit company) and private equity (Read the grim stories about Steward Healthcare, St. Elizabeth's, and the woman who died shortly after childbirth from a liver bleed because the equipment needed to save her life had been repossessed).
Plus, UHC is not just insurance. It is:
Medicare Advantage, which incentivizes the insurers to falsify patient medical information to qualify for higher payments from CMS and to deny needed care
a system of vertical and horizontal integration which captures physician, hospital, clinic, and pharmacy services and provides a way to sidestep federal limits of profit after claims
It just so happens that a number of insurance companies have been in the bulls-eye for anti-trust reasons as well as for fraud. In UHC's home state some major healthcare providers have decided to drop UHC MA because of its claims denials, which forces patients to change doctors or change insurance. Formularies change by the year--a woman was denied the safer version B of a drug while she was pregnant because she had to "fail" version A first, and the next plan year A was dropped from the formulary and she was only allowed to take B. Doctors end up spending hours of unpaid time dealing with insurance issues (and every insurer having its own procedures and paperwork) while being expected by their employers to pack in 40 pati9ents a day.
If health insurance was only risk management, everyone would just have catastrophic policies. It's not the same as homeowners or car insurance at all. It's also a maintenance plan for a mechanism (the human body) that often has design flaws or is poorly maintained or is forced to operate in harmful environments (environmental pollution, for example) or to the limits of its tolerance (people in low-wage, physically onerous jobs) besides occasionally encountering a catastrophe and is also almost guaranteed to need a LOT of maintenance in the final years before it is discarded.