This sort of garbage will not be fixed until there's a real penalty for denied claims. Not merely pay the claim, but enough to deter misbehavior.
Every year I had to fill out the forms saying that I didn’t have any other insurance before they paid.
It felt like a straight up scam to get people to pay some bills that show up without realizing what was going on / receiving and returning the forms.
[0] eg one of the bullet points of widely celebrated health care reform was making it mandatory to pay the cartel!
In a scenario where the anti-abortion party takes control of the executive that is running Canada-style single-payer healthcare on the federal level, I could see them 1) defining abortion as "core service" rather than supplemental so that private providers can't offer it outside the system, and then 2) setting harsh term limits and other barriers like doctor approval to make it effectively banned in practice.
(Fetal personhood is another backdoor that can take this even further.)
But I do see your point that if the regressives take the presidency but not congress, then the more the government is involved in the more damage they will do. I'm not a huge fan of single payer healthcare, but I guess I accept it as a compromise as it's the only plan that's been put forth to reform the deeply corrupt healthcare system. I personally want less government involvement in individuals' lives in general (and it's necessary to include de facto corporate government in that scope as well). But I've also paused focusing on this line of argument because the regressive movement has used up so much of the air for it, in bad faith.
But really regardless, we're kind of screwed if the regressives take the executive any time before their social-media-fueled nonsense is run out of the mainstream by actual conservatives - that is people who believe in questioning change, not trying to drag us back in time 70 years to some imagined idyllic past.
State level feels much more doable. Not only that, but Canada did it that way - IIRC Saskatchewan did it first, it worked well for them, and those results entered political discourse in other provinces causing a domino effect of sorts. Then finally the feds jumped in to regulate the baseline and assist with money to help the poorer provinces keep up. But to this day, it's actually a voluntary arrangement that any province could leave at any point; it's just that even in Alberta ditching public healthcare is such a fringe extreme right position that no politician hoping to have a successful career would seriously contemplate it.
And ofc if you do it state by state, then it doesn't have to be single-payer everywhere, either. We could try that in states with a more socialized political culture, and e.g. the Swiss model in more conservative states, and maybe something like Germany's private non-profit healthcare coops elsewhere. I would probably prefer the latter for myself for the sake of decentralization.
There isn't one. I'm not saying healthcare in America is perfect or arguing that insurance companies aren't rent seeking or that this can't be changed. I'm just stating that the US is the most unhealthy country there has ever been.
More unhealthy than England during the Black Death?
Also, Mexico has already passed the US in obesity, and tons of countries have more smoking that the US.
But that rant wasn't supposed to be fact-based, was it?
If you're a government bureaucrat tasked with reducing healthcare expenditures, in a society that's made the determination that suicide is an acceptable medical treatment, you are incentivized to increase the practice.
I agree that Canada's pushing for classifying suicide as medical treatment is worrying. Suicide is a human right, but making it part of the medical system's all-encompassing paternalism is regressive.
In general we need less intermediation between individuals and medical care, not more. And the "insurance" cartel is one hell of an intermediary. The concept of the HMO is a complete failure, and they should be made illegal for their basic anti-competitiveness.
Do not do not resuscitate and forgoing treatment can make people’s lives better, reduce suffering.
Better if those bonuses go into reducing deaths.
They know I have their insurance… I have it so they pay… do the thing…
The only trick here is tricking yourself into thinking you've won until proven otherwise.
5 years ago a woman didn't look adequately and totaled my car. No problem with her insurance (she had a stop sign, I didn't, she was cited at the scene) until it came time to pay up--and they went silent until I contacted the insurance regulators.
Improper denials or nonpayment should carry substantial penalties.
Of course, it's also the insurance companies who are adjudicating the claims.
https://twitter.com/generalorthomd/status/163034936649709568...
https://twitter.com/generalorthomd/status/163207481760743833...
Perfect candidate for an insurance company; he's got no other prospects, so he'll do what he's expected to. Which is deny, deny, deny.
I'm imagining a non-profit organization that solicits any denial by "insurance" companies, determines if it is based on medical reasons, determines if it is medically imprudent (including harm caused by delaying care), and files a mostly pre-prepared complaint to the appropriate medical board. Make it extremely uncomfortable to work for a death panel.
Then if the state boards start really brushing the complaints under the table to protect the death panels, turn it into a direct political issue. Right now there's too much plausible deniability to hide behind.
Besides, I look much more favorably on a startup that is automating the filing of confusing paperwork designed to prevent middle-class folks from holding on to their money, than I am insurance companies that use boiler rooms of hack doctors to deny those same folks medical care.
Our regulatory system has totally failed, which is why it is rife with these perverse incentives.
Our so-called “regulatory system” works precisely as Karl Marx expected it to 150 years ago. The so-called "perverse incentives" are fundamental characteristics of capitalism.
The delusion that haunts us originated with the idea that capitalism is not a system but a set of isolated features that we can opt into and out of as we please. Karl Marx showed us 150 years ago that capitalism is in fact a complex system with many contradictions.
And no, your so-called "free market healthcare" fantasy was not considered an option because it was in fact the problem to solve.
You haven't come out and said so, so I apologize if I'm putting words in your mouth. But it seems like you're arguing toward a position: because we can see that government control of the market has resulted in the mess that we call Medicare, we should therefore stomp out any further vestiges of the market and put the government in control of that as well. This doesn't seem like a sane position.