Why should I pay for somebody’s Viagra? Or IVF treatment? Because I am healthy? Diabetes is reversible with the healthy diet, no? Why not focus on reducing the costs.
Imagining things is fun, then reality and costs come crashing in. Go look at the state of VA healthcare for an example.
This is absolutely a problem we can fix.
Just compare access in the US to countries with regulated universal care.
Have cystic fibrosis? Good news! There are drugs that reverse the genetic defect! In the US even Medicaid patients got access back in 2014.
In Canada? Unless you live in one of 5 provinces that fund it, you don’t get it. Oh, and if you’re an adult? Nope, not a funding priority.
In the UK, they didn’t get access until 2020. Six years after the US.
Then you can look at some of the newest advances in cancer. You might need to wait 2-3 years after the US gets it.
Then look at physician salaries. Access to primary care doctors. Waiting lists for joint replacement.
/s
https://www.healthcare.gov/coverage/preventive-care-benefits...
Preventative is very narrowly defined to exclude anything considered a sickness in anyway.
Getting something done that will ensure you don't get more sick might be considered preventative naively but is considered fixing a problem and so not covered.
So basically this covers vaccines (make sure if you get multiple you don't see a doctor past the first or you are paying) tests unrelated to medical problems and a single non diagnostic visit to the doctor per year.
It is very much not to support health in any way whatsoever. In fact the industry loves ill-health, because it's far more profitable than wellness.
Public not-for-profit health systems change that motivation into something that actually makes sense from a healthcare pov instead of just being an exercise in piratical opportunism.
Profiting from suffering without the slightest hint of altruism or empathy is simply sociopathic.
ACA's medical loss ratio provisions basically makes this impossible: https://www.cms.gov/marketplace/private-health-insurance/med...
That's not to say they're not incentivized to deny claims. If you are loose with what you pay out, you could lose money by paying out more than you take in.
I feel frustrated when it seems that so much money somehow is going to preventive care… But when they quantify it, it’s just looks like screening. They ask if I feel safe at home they ask if I want to attend a group weight loss class, when I’m 95 pounds. They, the gatekeeping front desk clerks or nurses, just screen screen screen and check off items on a checklist earning them loads of credit. All that screening results in an approved amount of preventative treatment.
How I love socialized medicine!
That sounds great, compared to the status quo.
It's hard to see how regulated, single payor healthcare could be bigger or more expensive if the middle man is cut out.
https://www.healthsystemtracker.org/chart-collection/health-...
What? The government was forced to make insurers cap their profits at 20%.
Except now that means if they want to make more money, they just raise premiums and negotiated provider payments. Even easier when you're as vertically integrated as UHC.
https://www.cms.gov/marketplace/private-health-insurance/med...
For the past quarter, the UnitedHealthcare business unit of UnitedHealth Group had a profit margin of 6.6%.
https://www.sec.gov/ixviewer/ix.html?doc=/Archives/edgar/dat...
The business is still highly competitive, and payers have limited ability to raise premiums due to push back from employers.
The industry as a whole is insanely profitable. Revenue is $1.4 trillion. It posts profits of around $650bn. Which means on average it extracts around $2000 of profit from every single person in the US, with an average individual healthcare spend of more than $4000.
The profit is in the ballpark of the entire US defence budget, at around $750bn.
Healthcare is a huge boat anchor drag on the entire economy.
Source for these numbers? 0.65 billion in profits on 1.4 billion in revenue is an insane margin
https://www.healthsystemtracker.org/chart-collection/u-s-spe...
Health insurance profit would also disappear as much would their administration costs.
You would still need to determine price structures and deal with fraud but you wouldn't need to network anymore.
Look up the McKinsey study. The biggest driver is that Americans get way more healthcare.
The rate of self selection of healthcare is not that different in the US. While our old are more likely to seek care our young are way way less likely to.
A ton of that is unnecessary work to avoid getting sued, unnecessary work because of how our billing works (who would have thought that billing based on services rendered would result in escalating costs?), not to mention the complexity of the system helps make finding fraud more difficult.
- 944 billion on Medicare (federal) - 805 billion on Medicaid (federal + state) - 118 billion on VA health costs - 21 billion on CHIP
That's 1.5 trillion alone, and that doesn't count ACA subsidies, or other state and local government-owned or subsidized medical facilities. That's $5800/year per capita - ALL persons in the US, whether they have private or public or no insurance. US government per capita health care spending is already higher than many European countries and a little more than two-thirds the Swiss number you mention. While US private health insurance companies don't help the situation, neither are they a main cause of US health care costs.