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Top-level
 @SearingTruth @QasimRashid Single Payer would solve almost none of the problems in the US health care system. Health insurance companies in the US operate on profit margins around 4%. That 4% is not the answer to the problems in the US health care system. While symbolicly fun to reason about, people making these claims just don't know what they're talking about. Most European countries don't thave single payer systems and none of them have these problems. The issue is corrupt politicians. 46 comments
@jenzi @Schouten_B do you know how billing works? Married to a doctor and figuring out how to get a patient covered by their insurance though the arcane billing codes is far more the norm than defrauding. Sure there are corrupt docs but Iād say mandated billing procedures by hospitals is more where you want to look.  @fistfulofdave oh relax, no one named you - yes I know how billing works, I've worked on both sides of the entire scam (including your sacred doctors) and know a lot of people who do fraud investigations too... there are a billion issues, I cited just one. I just wanted to know how a corrupt politician was to blame for bad doctors (who act defensive on social media). @fistfulofdave @jenzi I don't think doctors are the big ones here. There's a lot of care providers involved in processes where there is a lot more fraud if you look at the data (more in long-term care and nursing as well aiui). But yeah, almost everywhere in the western world doctors are complaining about the complexity of billing procedures. I know Dutch doctors feel that way at least :-). @Schouten_B @SearingTruth @QasimRashid You have no idea what you are talking about. Do you want someone to profit off denying you health care? @66gardeners @SearingTruth @QasimRashid The profits of US health insurance companies are a little on the high side. But also not crazy. Essential Health Benefits of course should always be covered (and that is mandated by the ACA). More complex and extensive treatment options, that's another story, and that's where insurance companies come in. A famous one that isn't covered in NL for example is lymph duct reconstruction after a lymphadenectomy. Lots of discussion about that. It's hard. @Schouten_B @SearingTruth @QasimRashid Again, do you want someone to profit off denying you life saving health care? In a single payer system, all people are treated the same. Your doctor decides what is indicated. In the for profit insurance industry, decisions are arbitrary on a case-by-case situation and are made by bureaucrats with profit in mind. This is after you've paid thousands in premiums for said health care. It is criminal. No one should profit off denying people health care @66gardeners @SearingTruth @QasimRashid Well, kind of, in reality of course in a single payer system you just need to be -more- wealthy to get better treatment than others. And then private clinics compete for the best doctors with public hospitals and stuff, it's a little bit more complicated than you are making it seem :-). @Schouten_B @SearingTruth @QasimRashid Again, profitting of denying health care that is indicated and recommended by your doctor is the worst. You do not live in the US, so you really do not have the experience to be so set in your opinions about it. @66gardeners @SearingTruth @QasimRashid There's private clinics everywhere that I know of (including in the UK, Norway and Australia). So you can just bypass the health insurance system altogether (be it single payer or privatized), and go pay a clinic to give you the 20 million dollar cancer treatment :-). Plenty of doctors who like money. @Schouten_B @SearingTruth @QasimRashid Do you believe some people are more worthy of health care? @66gardeners @SearingTruth @QasimRashid Not more worhy. But I accept that money can buy people privileges, and that includes superior care. A proper consistent baseline for everyone is very important though, and the US doesn't provide that well. @Schouten_B @SearingTruth @QasimRashid And the reason why is because of the complex billing in a for profit industry. I read somewhere that there is around 2-4% increase in costs just because of billing difficulties. @66gardeners @SearingTruth @QasimRashid I can believe that. Never seen concrete percentages like that but a lot of doctors in my Dutch family complain about this as well. @Schouten_B @SearingTruth @QasimRashid Insurance in the US didn't cover lymphedema tteatment until Medicare was forced to last year with the Inflation Reduction Act. Yet still, there are no protections for private health insurance to cover lymphatic issues @66gardeners @SearingTruth @QasimRashid Yeah, mostly the same here in the Netherlands (depending on the lymphatic issues, if it's a danger to your health it's covered, if it's just a quality of life issue it's not. Or at least it wasn't a couple of years ago). @Schouten_B @SearingTruth @QasimRashid Thank you for being respectful in this discussion. @Schouten_B @SearingTruth @QasimRashid How do you rationalize that profits by health insurance companies are reasonable? They are greedy, and nothing is ever enough. Your 4% number is wrong. @66gardeners @SearingTruth @QasimRashid It was between 3.5 and 7% for all the ones I've looked at for the last 5 years, where'd you find a much higher one (4% was kind of the average for some years, but it differs a bit, affected by inflation as well? And well.. You need profits so that people will put down capital for them right? @Schouten_B @SearingTruth @QasimRashid @66gardeners @SearingTruth @QasimRashid The quarterly reports are public though. I didn't see a huge snowballing in the ones I looked at (which admittedly was only UHC and 2 others). They mostly seemed to roughly correlate with interest rates which is what you'd expect. @Schouten_B @SearingTruth @QasimRashid What is your ulterior motive in defending for profit health insurance? Do you own stock? @66gardeners @SearingTruth @QasimRashid Some of the best health are systems in the world (like where I live), have for profit health insurance. They give people choice, like I can theoretically pay for a lower premium and then have a health insurance that doesn't cover expensive end of life care that I don't want. Those kind of things. Other than that I'm not really attached to it. Single payer systems can work well too if they're well run. But also have nothing against it in principle. @66gardeners @SearingTruth @QasimRashid I do not own any stocks, ETFs or anything like that has insurance companies in it. I do have some in companies that produce medical imaging equipment. Which I was just arguing the US uses way too much of ;-). @Schouten_B @SearingTruth @QasimRashid Health care and health insurance are not the same thing. Some of the best medical facilities are in the US. We pay the most for health care here and get some of the worst outcomes. This is not a recipe for success no matter how you slice it. @66gardeners @SearingTruth @QasimRashid Yeah. I was talking about health insurance. The Dutch health insurance system is even more for profit than the US one (no medicare here), and it works fine š. (Better regulations though) @Schouten_B @SearingTruth @QasimRashid Are you SURE they are for-profit. Private health insurance that is NOT for-profit works well. @Schouten_B @SearingTruth @QasimRashid A quick search tells me it is not for-profit. @66gardeners @SearingTruth @QasimRashid I live there and pay a lot of money to a company called Zilveren Kruis every month :p. https://en.m.wikipedia.org/wiki/Zilveren_Kruis it definitely makes money :) @66gardeners @SearingTruth @QasimRashid Looks like their profit margin was about 2% last year: https://www.zilverenkruis.nl/overons/feiten-en-cijfers/onze-jaarcijfers-2023 @Schouten_B @SearingTruth @QasimRashid They are nonprofit. Any profits are used to make improvements. In the US, CEO's get bigger yachts and people die. @66gardeners @SearingTruth @QasimRashid Their CEO makes a 2 million base salary, and then bonusses on top of that. Not the biggest yachts I'm sure, definitely not as big as some of the Americans. But 2 million plus bonuses and stock can make you a pretty penny :-). @Schouten_B @SearingTruth @QasimRashid He made 8 million in bonus. Bonus' are determined by how much you save (deny) in life saving care. @66gardeners @SearingTruth @QasimRashid I was talking about the CEO of my health insurance company. I believe only her base salary is public, not sure about the bonuses. @Schouten_B @SearingTruth @QasimRashid The bonus was info put out after Brian Thompson was killed. People are suffering from for profit health insurance, and you trivialize it at every turn. Search "is dutch Silver Cross for profit". @66gardeners @SearingTruth @QasimRashid You do realize stuff on the internet is wrong right? Why not use their own website and their own year reports :). Also, we might be affected by google targeted delivery here but that query just takes me to their website for me and that confirms they do pay dividend and are a for profit company. So not sure what it's linking you to sadly. @66gardeners @SearingTruth @QasimRashid (And again, wasn't talking about the US, I was talking about the CEO of Achmea, the insurance company that owns by health insurance company, they make 2 million a year base. And I don't think their bonuses are public, but I might be wrong.) @Schouten_B @SearingTruth @QasimRashid @66gardeners @SearingTruth @QasimRashid The stock pays dividend occasionally.. I'd argue that means some of the profit is not placed into making improvements š. But if we're only counting profits paid in dividends rather than reinvested we're using a definition of profit that is rather unusual. @Schouten_B @SearingTruth @QasimRashid due. I know what I read. They consider your system nonprofit. @66gardeners @SearingTruth @QasimRashid Who is they? I showed you their wiki page, I can show you the dividend payments as well if you want? It's all public. There are a couple of insurance companies here which are cooperative and that don't pay dividend. I'm not with one of those though. If memory serves me right the US has a couple of regional health insurance co-ops as well. @66gardeners @SearingTruth @QasimRashid Paywalled sadly but: https://news.achmea.nl/achmea-distributes-capital-to-shareholders/ Also their public financial numbers are here: Like this is from their own website, I don't know how much more reliable you want this, but I'll happily look at your sources. @Schouten_B @SearingTruth @QasimRashid This affirms for me you have no idea how much worse for profit is. I'm beginning to think you do not care. @66gardeners @SearingTruth @QasimRashid If CEOs make millions of dollars in salaries and bonusses, shareholders get hundreds of millions in dividend, a company is for-profit. It's that simple. You have continued to make this claim without sharing a single piece of evidence, which makes me feel like you don't take this conversation seriously. In any case, our system works great, the US system is garbage. This isn't because of 'profit', it's because of greed and corruption. |
Gregory's Server
@Schouten_B Onus is on you to draw the line between corrupt politicians and a doctor defrauding insurance companies by overbilling. You blame one thing with not a single feeling that you should make that make sense at all. They don't have corrupt politicians in other countries? They don't have single payer? Are you for real?