This is what markets do. They amplify political and financial inequality.
Anyone who thinks that competition will somehow magically fix this isn't paying attention to how markets actually work.
If you allowed foreign doctors to come and practice in USA the problem would get fixed extremely quickly. Competition is the solution. The problem isn't the free market here, but that the incumbents gets to control legalization and hence stifle competition. I'm not sure why private money has so much more influence in USA than other western countries, but it is the main source of this problem.
https://www.kff.org/medicare/issue-brief/10-faqs-on-prescrip...
The market has been intentionally manipulated to set up little choice for individuals and even worse, little transparency on cost and benefits.
Markets DO work, but you have to set them up to succeed. Customers need to be able to choose between providers, customers need to know what the full cost of healthcare is prior to committing, and customers need to be able to walk away or find an alternative if a price is unattractive.
But more complex is that when people argued for a nationalized health plan a lot of people agreed with it until opponents argued that white people would be paying for minorities’ health insurance with their tax increases. These days it’s difficult to outwardly tell whom opposes public welfare policies requiring some solidarity based upon fiscal principles or social ones first.
Separating the consumer of a insurance (the employee) from the decision of which insurance to use (the employer) is where this all went sideways.
Otherwise, in a competitive market, people would be free to jump to any provider with a better offer, forcing other providers to respond and preventing the disaster that we have now.
But now it’s a national mess to unravel and we have union demands to thank for it.
Providers, trial lawyers, drug/device companies, and insurance companies are absolved of blame!
I used to tell people that when the subject of "why is healthcare so expensive" comes up, these four pigs feasting at the trough point to whomever is to their right.
Now they have someone to point to that's not even eating, and arguably died a long time ago.
Some big companies, like the car companies, ran (and I believe may still run) their own medical systems. Most of course outsourced.
Nowadays a company would be insane to drop this because it’s a very sticky incentive. We’d probably have more innovative startups if we had ACA which is a reason the big companies lobbied against it and why having a company to simply pay your ACA premium was made more expensive than the company running a health plan the old way.
They eventually decided to take the job, but having to even consider healthcare access in that calculus is ridiculous.
Not everyone has the skills and experience to be in demand. A lot of people feel their current job is the only thing standing between them and the food stamp line. These people should not have to worry about getting sick and losing everything after losing their job.
https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co...
If you let coverage lapse, plans were allowed to impose a waiting period before coverage for the existing condition would start.
Since 2014, the “fix” is that now it’s just required to always have insurance, or else you pay a penalty.
Then for the last couple years the penalty was repealed but the coverage for pre-existing conditions is still guaranteed, which does open up a hazard that people will only buy insurance after they get sick... but really the risk of a sudden health issue is still high enough that most healthy people will still want coverage.
This is even more pronounced with lower-wage employees. I didn't switch jobs for years because of benefits: At best, I'd have to pay for COBRA for 60-90 days, which would basically take all of my money and then some. But mine was also fairly cheap and I had good coverage, something that similar jobs usually didn't match.
It's a huge chilling effect on employee turnover. Until ACA pre-existing conditions was a huge aspect of that. Even now IIRC when I changed jobs once I recall any existing conditions would not be covered for 1 month.
And it's the biggest cost increase over the past 2 decades and has soaked up almost all the profits that could have gone to employee salaries.
https://www.pewresearch.org/fact-tank/2018/08/07/for-most-us...
https://www.healthsystemtracker.org/chart-collection/u-s-spe...
I'm my own employer, and the exchange choices are shitty beyond belief. I pay $15K/yr for a family of 3 (that's excluding the considerable deductibles), and I'm not even sure to what extent I will be covered if I e.g. break a leg. The premiums go up every year like clockwork, and will likely go _way_ up this year, due to C19.
I'm thinking of just finding a clinic somewhere abroad if shit really hits the fan, and going without insurance in the US at all, covering my yearly physical out of pocket. It boggles the mind that politicians are proposing to sink trillions more into the bottomless money pit that is the US "healthcare" system.
Thing is, your boss may know way more about your health than you’d expect.
The entire system is broken.
Well, a bit less effective, but sometimes works, you can also complain to HR about the insurance.
I think from that alone you can safely conclude that HR departments don’t or can’t deliver things that employees need.
Employees are not the customers of HR departments and they won’t or can’t fix your health insurance.