My wife is looking to change jobs in the midwest of the US. When we search, however, the majority of openings are less than full time and have no health insurance benefits.
And she is a public employee and looking to stay in the public sector.
And she is a public employee and looking to stay in the public sector.
The underlying harsh truths of health care in the United States is that it became bloated by design (incentives for high base prices), and also that the US population is incredibly unhealthy. And that a few million of health care workers (mostly in insurance companies) will have to lose their jobs to make it fair for the rest of us.
But because unhealthy people are lumped together with healthier ones, it tends to lower the costs to a tolerable (still very high) level. Also, many workers don't pay their full premiums, which again helps mask the true costs of health care.
Eventually it will all come crashing down and there will be far more suffering than there had to be, had we addressed the problem earlier and in full (Gut the insurance companies, Single-Payer, Cost ceilings on critical medication).
Net income: 2.9B USD
HOWEVER:
1. They paid 3.6B USD in dividends in 2021
2. They paid 10B in operating costs and receieve ~70B in premiums on top of other streams
3. They increased their interest expense for the KAH acquisition
4. They hold $44B in assets and $28B in liabilities
The story they are clearly telling investors is they are seeking to consolidate Payers with Providers to improve efficiencies, which ignores that they they could improve operational efficiencies today.
A move to Medicare for all at current reimbursement rates would require drastic budget cuts at every healthcare provider in the country. That may be what's necessary to fix the broken system, but it would involve a lot of pain.
Worst case: we go back to what things were before the ACA where if you had a preexisting condition you were screwed.
I think we might save some money right away, but more likely we'll lose a bit, gain the ability for our citizens to not have to worry as much about their jobs being their literal lifeline, and over time we'll save more and more versus the current system due to an increased quality of living due to better health outcomes and longer lives.
In the book he offers some numbers on the healthcare system in the US, where in administration and insurance there are indeed many such bullshit jobs. What is worse, they often bring a bureaucratic burden on people like nurses, who do have real work to do. (All by the assessment of the people doing the bullshit job)
He offers quotes to show this was even the point of view of Obama
> Everybody who supports single-payer health care says, ‘Look at all this money we would be saving from insurance and paperwork,’ ” the former President noted. “That represents one million, two million, three million jobs.” Graeber describes this comment as a “smoking gun” of bullshittization. “Here is the most powerful man in the world at the time publicly reflecting on his signature legislative achievement—and he is insisting that a major factor in the form that legislature took is the preservation of bullshit jobs,” he writes. Politicians are so fixated on job creation, he thinks, that no one wonders which jobs are created, and whether they are necessary. Unnecessary employment may be one of the great legacies of recent public-private collaboration.
In healthcare, I imagine there is a lot of bullshit that would still have momentum in a post-single-payer world that we couldn't eliminate right away, but I still want that. See my other recent comment, I went into more detail on why I think single-payer would be great, but isn't a panacea for healthcare costs and efficiency.