Universal healthcare is so hard that only 32 of the 33 highly developed countries in the world do it.
Probably be 32/32 in the near future at the rate they’re going.
True that.
I hear you. How does one pirate health insurance?
Sail the seven seas to medical tourism
Given how highly adaptable Americans are I am very surprised to not seeing more of you trying to make a life for yourself in Europe. A plane ticket to any eu country is far cheaper than an ambulance ride to er…
I’ve seen a lot of Americans in my life.
Most of them are not adaptable.
There was a movie about this called John Q.
Last time I had a surgery, I wrote “by participating in this surgery, all participants confirm they are covered under bcbs, and agree to waiver payment if not” right below the surgery site.
The doctor got a kick out of it, says apparently I ‘got’ one of his aides, who saw it, said his coverage was lapsed, and ask if a patient could do that. The doctor said he made him stand in the corner for 30 mins while they did my shoulder repair.
What amazes me is Americans doing this to themselves. Literally acting against their own best interests, putting their lives and wellbeing in the hands of companies only concerned about profit.
So this sucks but you can avoid this with a simple trick. Call your insurance company first with the CPT codes for what you need done and where you plan to get it done. Your doctors office can give you the codes. They aren’t a trade secret or anything. Get diagnoses codes too if you can. Have the insurance company run the codes for you before you go. This does a couple things:
- You verify everyone involved is in network (be wary of anesthesiologists)
- You are getting a quote on a recorded line. The end price won’t be exact (especially is if the claim involves a hospital, fuck them, go to smaller providers whenever you can)
- if you get sticker shock anyway, you can call the insurance company back on that same recorded line and say the word “misquote”. This triggers an investigation that can strengthen your appeal.
- You now have evidence you can file internally with a quality of care/quality of service complaint if the provider did something shady with the billing, or with your state’s department of insurance if your insurance company is being bitchy.
Ideally, we would have single payer insurance, but we instead have a government that pays itself to make private enterprise do its job, then the shareholders in that private enterprise make sure nothing ever gets changed. -sigh-
In the mean time, if you really want to fuck them over, consider switching to health insurance company that does not have shareholders. In many states, they are legally mandated to refund any profit they make over a certain percentage at the end of the year and without shareholders, it’s harder to hide the money, which puts much more pressure on them to spend it on patient care.
United Health Care want you to believe their way is the only way to do this. They are wrong. A shareholder-free insurer still isn’t perfect but the pressures are different without the parasites.
is this seriously what you americans have to do?
Most of us bend over and die.
jfk. I had to take someone to the hospital yesterday for an acute problem (which turned out ok). When leaving, after 7 hours at the hospital, I started to reach for my wallet and the lady looked at me and said wtf are you doing put it away. And the two presriptions- free instead of the usual $5 each. I laugh when those repubs call my country a “social hellscape”
Yes. Everything is a fight against the rich.
Freedom isn’t free
The fact you have to jump through these hoops at all IS FUCKING STUPID AND ISNT HOW IT SHOULD WORK.
Agreed. But the fact is there is a lot of money in paying for medical expenses that keep going higher and not a lot of money going to the pot that pays it out. Single payer would address all of that instantly but the rich would be unhappy so we basically have to pay a survival tax to insurance companies every month.
I hate it here.
It’s like they’ve made the system so convoluted that you have to be an underwriter to receive services.
There are those of us in n this industry that want that changed but we don’t have as much power as the bigger companies do so the best we can do is play by their rules. :(
Any tips on finding an insurance company in your state that doesn’t have shareholders? A big part of the insurance issue is that you have to practically be an industry insider to navigate… Anything in insurance, really.
A shareholder-free insurer still isn’t perfect but the pressures are different without the parasites.
This is the first time I see this solution mentioned. It doesn’t seem to be known much. Why would a single payer insurance lower costs further?
Single payer means more people are in the group, diluting risk further. There’s no way to compete with that. The costs are impossible to beat.
There must be a limit to the necessary size. Small countries can offer affordable health care. So an insurer of that size should be able to handle the risk as efficiently.
Well in a small country there’s not an incentive to raise prices endlessly for medical care. In America there is. So now you have the providers which always want more (don’t misunderstand this, it’s not always the doctor you are seeing that’s commanding a higher price. In fact, it rarely is. It’s the others down the line that want their cut for his work.) and insurers that need to pay for things but can’t just constantly demand more money themselves.
Enter the business majors.
They have decided the insurance companies just need to play chicken with the providers and deny paying for things they deem unreasonable. It does stop some scams, but it also backfires sometimes. So for things like insulin, we don’t have direct control over the price. So we will say “fuck them, if we start paying for insulin X, everyone’s prices go up, not just yours, and we won’t be able to covers everything. Get something more reasonably priced.” It doesn’t matter that insulin X would be perfect for you. Lots of other people need it too, and if we cover it, that money has to come from somewhere and people are financially strapped as is.
Drug companies don’t want to do us any favors. They price insulin like it’s a new fucking iPhone. Luxury insulin. It’s not a new thing. It’s been around forever. It’s settled. But they have the patent and the money to bribe congress critters to prevent regulating prices so here we are.
In other cases, like HIV medication, those drugs are incredibly expensive because they are ridiculously expensive to develop for. The drug company does have to recoup their costs. However they do offer patient assistance programs for a lot of those drugs where THEY will cover your copays. Plus in many countries they aren’t allowed to sell the drug there unless they agree on a reasonable price. And in India, their government said “fuck you” and just outright copied an HIV drug.
Then we get things like GLP-1 inhibitors. Those can be a blessing for diabetics that need them. But as many people as there are that legitimately need it, there are even more that can be sold to for insecurities in appearance and given it as a way to slim down. So guess who the drug companies market to? Demand surges and the price is high because they intentionally created a scarcity like they are selling the next PlayStation. And many insurance companies won’t cover it anymore. And the reason is surprising. Everybody wants this damn thing until they actually get it. Very few actually want to stay on it. They usually vomit constantly on it and they stop taking it. So that’s all that money getting spent on what’s basically TikTok marketing instead of patient care. And then for those that do stay on it, they have to stay on it forever. The longer they take it, the worse they are when they stop. All the weight lost comes back PLUS more. So they end up worse than they started and we paid for that instead of someone’s MRI.
It’s the scarcity that drives up the prices. More money coming in from single payer systems kills the scarcity, and the prices are forced to come down because they have to compete with eachother. But rich people are just business majors with hoarding issues. They always need more. They will never be happy. And they will make us all suffer over their endless persist to bleed the country dry.
We do what we can. This really is the responsibility of a larger entity with more resources than we have, like a fucking government, but they figured out all they have to do keep resources scare to keep us fighting amongst eachother. Add shareholders and you get cartoon villain evil shit like United Health Care. All the while tax dollars go in and do nothing but blame us for trying to make this losing game work.
Imagine your heath insurance just being part of your taxes. You pay them that way. Now imagine that that health insurance tax is less than a third of what you are paying for health insurance now to get better coverage. Thats the absurdity of it. We have a government that doesn’t want to do its job, so business majors swoop in and screw us all.
I hate it here.
It kinda scales. What’s the likelihood of 10 million people at once being sick in a country of 10 million? And what’s the likelihood in a country of 300 million?
The number of sick people also scales. The likelihood for 100 thousand sick out of 10 million is the same as 3 million sick out of 300 million.
What changes is the variation. If you have 10 people, it’s possible that all are sick at the same time. All being sick is much less likely for 10 million and even less for 300 million.
An insurance company must have a certain size to handle variation but after that point a bigger size is not needed for that but can help with other properties.
Single payer moves the bargaining power out of the hands of the service provider party using the government’s power to set prices. It doesn’t give all of the power to the user side, since if the government tries to set a too low price, the providers can just choose to not offer that service, so it is still a negotiation, it’s just no longer based on “how badly do you want to live/get better?”
It’s much worse because you can choose not to watch Netflix but you don’t have much choice if you are sick.
It’s more like receiving a bill for songs you hear on the radio in the grocery store, on the bus, in other people’s cars passing by. You didn’t ask for the benefit, could not really negotiate it, but it was useful to you when you got it. You could maybe avoid it by not leaving your house.
you can choose what hospital you go to
But u can’t choose whether u need to go there in the first place so that doesn’t matter at all
you can, it’s just not advisable
U can choose whether u do actually go there but u CANNOT choose whether u NEED to
Edit: why do u want to die on this hill so bad ur very clearly wrong
just as I can die on this hill people can choose to die instead of going to hospitals
But they still can’t choose whether they needed to go there, they js chose to not go. I’m assuming ur trolling, in which case, I feel bad for you. Although on the off chance ur not, it’s not my responsiblity to educate u and I won’t engage in this discussion further.
Not when you have a stroke and are found unconscious by the side of the road. You can ask my father about it, when he learns to talk again.
Not always
In Taiwan, I pay for Universal Healthcare because I own a business. 5800nt(185usd) every 2 months for a familyof 4. It would be 3000nt(100usd)for 2 months if it’s just myself.
The copay is 10usd for everything. Fever? Food poisoning? Chemotherapy? All the same cost. This includes all the medications and all incidental costs.
If you worked for a Taiwan company, you don’t have to pay the 5800nt. But the copay is the same.
in Spain , if only one out of x people in their family works, all the rest of the family members are insured for universal healthcare, as long as they are legal residents or citizens of course.
In Canada, you pay nothing for anything that isn’t elective as long as you’re a resident. You just need to register for a healthcare number which can be done at admittance.
I am Canadian too. If I remember correctly, you had to get your family doctor to refer you to a specialist for anything major. During this time, your condition can get worse.
I haven’t heard much better about Americans waiting until they die for their insurance company to deny care, or wait for months to find a spot in network, and pay hundreds to thousands of dollars a month for the privilege. I think we do pretty good up here, as life expectancy and outcome comparisons would show.
American have it the worse. No competition. At this point I wouldn’t move back to the US anymore. I might move back to Ontario somewhere.
Taiwan sounds amazing!
My entire mindset of Healthcare had to change when I moved here. Previously in America, when I got a fever or a rash or a major allergy, I would see if its worth it to go to a clinic and sit for a few hours with other sick people and pay 75USD for them to tell me to go to a drug store and eat some Tylenol.
Now, I go into the clinic downstairs even if I have a cold. 10USD and they gave me a week’s worth of meds. It’s normal to go back to the doctor 2 days after if your condition worsens or if you just had a question.
I have yearly check ups and my doctor told me I needed to do a colonoscopy. If I opted for staying awake during it, its 10USD. But I elected to be put to sleep. It was 310usd.
Come visit us on your next vacation! The people here are very polite and pretty happy.
I guess I need to look into tiwanese citizenship
Sadly enough for you, the whole nation just died by syntax error.
I don’t follow.
They could be referencing your username
And then having to send emails back and forth for months talking to several people, taking days off work and spending hours on the phone for clearance to watch stranger things and having it be denied because of some obscure reason that is going to take you several more days off work to try to get clearance to watch the show again
And if you don’t watch Stranger Things, you die.
Yep because you got fired for missing too much work and lost your Netflix. This was Netflix’s plan the entire time
All this while being sick like a dog.
After recently apartment hunting, I have a (slightly tangential) gripe to add on here.
When I was getting my income verification (to prove I could afford the proposed rent), it went off gross income - what you make before taxes and so-called “benefits” are taken out. The hundreds I pay each month for the “benefit” of being insured make a significant difference between what I make and what I take home. Do I make 3x a given rent? Well technically, by gross income, I do. But my net income is where that rent payment comes from, so the chunk of my take-home going toward rent is absolutely higher than 1/3 of the net income I can actually use.
I have no choice but to pay for this “benefit.” Notice I keep using quotation marks. That’s because I think the term is bullshit. I think a work-sponsored benefit should be something work provides. Yeah, maybe they got a “deal” to offer insurance to employees for lower than it’d cost to buy for ourselves, but come on. If work really wanted to call it a “benefit,” they should pay us more so the numbers even out on our take-home. We’re forced into these situations, yet employers have the nerve to use a term that implies they’re offering some special bonus to us.
Okay, enough ranting for now. No, wait - prescriptions! That’s another health-related cost that isn’t deducted, that I still have to pay for, despite having insurance.
The screws keep tightening around us workers and there’s no escape. I really hope Mamdani sparks inspiration across the country, because this shit is untenable.
https://www.yesigiveafig.com/p/part-1-my-life-is-a-lie
Basically, stuff that used to be cheap has been turned into “markets” and now the entire middle class is teetering on the brink of bankruptcy.
Fantastic article! I’m bookmarking it to share.
The guy has a wonderfully idiosyncratic writing style. None of what he says is in any way new (there are videos on YouTube of Sen Warren saying the exact same things from 2008-2010 or so), but it’s certainly an interesting read.
It’s not stupid, it’s nefarious. Free Luigi!
American health insurance? That’s not how it works in other countries
Virtually all of our politicians love it.
But hey, my doctor gets to brag about the multiple properties he owns while he barely pays attention to what I’m talking to him about. It’s a great system for doctors.
I don’t know if that’s the doctor, but definitely the CEO of the insurance company
Little bit of column a, lot of column B
Maybe we should try voting harder for representatives that are owned by the corrupt insurance companies and their shareholders
Maybe we should vote against them in the kabuki primaries.
Fuck the American healthcare system and fuck Netflix
