this post was submitted on 10 Sep 2024
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Pooling everybody's money so that the ones who are unfortunate get money to help with their situation definitely is a product. Just because you don't understand something doesn't mean it doesn't exist.
It's called taxes
Yes, exactly. Healthcare via taxation can be viewed as a some sort of public insurance. The problem there is that the level of resources needed has to be decided manually instead of letting the markets handle it "magically".
But, why would any sane person view it that way? Do you think of the fire department as "some sort of public insurance"? Or is it just the people who come put out fires?
Yes, it can be viewed as such! Things can be viewed from many angles. Another one that're not called insurance but kinda are, are flat prices for things whose price actually varies. Like electricity prices: they're often based on a spot price in an power exchange, so if you as a consumer choose to get a flat price, you're essentially paying a premium.
Insurance is a pretty great industry and good fit for markets if only there's healthy competition. If there's no fertile ground for competition, it's one signal that perhaps the public sector should handle that one.
Insurance is generally for contingencies that are very rare but ruinously expensive. The average cost per person is low, but the cost to the one it happens to is extreme, like a reverse lottery. So it makes sense for a large group of people to pay a little bit of money each month, to pay for the cost to the one. This is how both health and fire insurance work. (Health care is about more than that but that's a different and less straight-forward story.) So, anyway, that's why sane people view it that way.
Historically, the problem with private firefighters was that you had a business that made money when there were major fires. That's a bad incentive. You get similar bad incentives in health care, too, which is one reason why coverage for some interventions may be denied. Another thing about fires is that they are contagious. They threaten the entire neighborhood. That's why you have, for example, the CDC in the US. Controlling contagious diseases is not left to private providers.
But, by the nature of the US, it still has to involve them. Because of the system, you can't get shots into people's arms without involving private hospitals, private insurance companies, etc. Which, during the pandemic resulted in some insurance companies still trying to charge co-pays for vaccinations, or billing people who received them. Maybe it was just paperwork mix-ups but it happened. And, since many people are used to the private system, they assumed that they would get charged or couldn't get vaccinated because they lacked insurance, so they didn't get vaccinated.
Imagine if a city had all kinds of private fire departments but it had a Center for Major Fires that could issue orders if a fire was declared to be "major". Until that point, firefighters could refuse to put out a fire at a business that hadn't subscribed to their firefighting services. So, they could sit there and watch a building burn down, only using their hoses on the stray embers that flew into houses nearby which had subscribed. Then, one day, there's a fire at an abandoned warehouse (no fire coverage, naturally) and it starts spreading to nearby buildings, some of which are also abandoned. The Center for Major Fires examines the situation and declares that this is a Major Fire, and that all the fire companies need to help put it out, regardless of whether it affects their pre-paid customers. But, unfortunately communicating that with the various fire companies is hard because the fire has already started to spread. Some companies are willing to do what's required, but first they want to ensure that their paid-up customers are safe, then they'll get to the abandoned warehouses... Other fire companies are hard to contact because they're already too busy fighting part of this Major Fire, so any hope of a coordinated response is slim.
There are just some jobs that should be done by government. Firefighting and healthcare are both in that category.
Its a service.
If only there was some kind of entity representing you the people, pooling your money to help the unfortunate..
Except when said healthcare is gated off for the protected class by cost or being and to work a certain type of job, that pool only helps those swimming in it. Here in the US ACA has done some to narrow that gap but it's still not enough. The proper model is everyone has a mandatory contribution % of their income above a poverty line. Then we see the pool truly helping those who cannot afford it and even those who can because care is standardized.
State-run Mandatory Health Insurance, that provides healthcare free of additional charges. *old Russian anthem intensifies*
Weird, I hear the anthems of nearly every other developed country in the world.
Well, true. It's not because russian healthcare so good, but because america is so... "special".
And nazis rolled out the highway system, but that's not a reason to dislike it.
Not true. Though the nazis certainly built a lot of additional Autobahnen to prepare for the war, they knew they would start. Fun fact: Wehrmacht logistics largely relied on horse-drawn carriages. The soviets got Studebaker trucks.
I don't follow.
Healthcare isn't something that only the unfortunate need. Healthcare is something every person needs. If you live long enough, it will be costly. This is why insurance as a concept is fundamentally unable to handle healthcare. It is antithetical to the concept of insurance.
This is why if you start paying for a healthcare insurance at an older age, your premiums will be higher. They are pretty good with the math there, and it's not even very advanced math.
Is there a nonprofit insurance company?
There are. They are also state-run. But they are mostly in former soviet republics.
Healthcare provided publically can be thought of as nonprofit insurance.
Yes, but they're fake.
This is my favorite answer so far
Kaiser Permanente to an extent, same with BCBS- though they also have a lot of for-profit affiliates. There are also a fair number of local non-profit insurers
Idk Chief
Like Mozilla, the parent company is not-for-profit with for-profit subsidiaries
How do they make money? Honestly I don't even know how Mozilla works with out Google paying them.
Sounds like something everyone should have
Yeah I have a partner that has it and she has MS took her 6 years to approved her for a life time injection.
Where do you find Insurance like this? Because all of American Health insurance is just about pooling everybody's money into the pockets of shareholders will denying as much coverage as possible
Literally all the insurances are like this. If yours isn't, why are you paying for it?
Maybe because the choices are pay for insurance or live in agony/die? Maybe both, if you're lucky.
Is it so that there is usually no competition for health insurance providers in the US? I don't know that system too well.
A little late on this, but this is essentially true. Technically you can buy a plan on the marketplace, but they... kinda suck. The cheapest plan I could get from my state marketplace as a single person household is about $315 a month with a $9000 deductible, and God only knows how many places actually accept it. The available plans and reductions are also very dependent on where you live. The ones available through office jobs are generally cheaper with better coverage and lower deductibles, but anything other than a white collar job will give you absolutely bare bones options if anything at all.
Most places I've worked have two plans based on how much you want to pay, but they are offered by the same company so no competition there. The last big contender is Medicaid, which can give pretty good coverage without having to pay a deductible or copay (most of the time). However, there's monthly income requirements based on which state you live in. Some go as high as $3000/month, some as low as $235 a month.
So that's pretty much it as far a options go. There's a whole mess of other vouchers and programs and individual practice discounts that you may or may not have available, but that's even more dependent on what's available in your area.
Having worked in Healthcare insurance, I can tell you it's an absolute mess and no one really knows what's going on. The whole thing is a rats nest of ever changing policies and algorithms arguing with each other while the humans try to keep up. It's basically impossible to "call around" as some suggest to figure out how much any given procedure will cost at any given practice with any given insurance, because there's a high chance that nobody knows until you actually run it.
Also, while looking stuff up for this, I found out that anyone living in a Medicaid funded nursing home is required to give almost all their income to the state to pay for it. Of the roughly $3000 limit, you are allowed to keep at most $200 a month, with most states limiting it to something under $100. So that's fun.
Yes - if they weren't one of the main causes for debt and inflated prices.
That's what the concept of insurance is, but health insurance very much does not match the concept.
U.S. healthcare on average is around 2-3x as expensive as countries with socialized healthcare, so if we didn’t have insurance jacking up our prices but also didn’t have insurance for a safety net we can pretend it’s 1/2 to 1/3 the cost of what our procedures cost. A broken bone would still be around $10,000 and if 1/3 of Americans would have to take out a loan for $1000 I’m willing to wager a $10,000 bill would wreck the average person. Other not fun fact is the average American is expected to break 2 bones in their life. The way health insurance works in the U.S. is atrocious but it’s not like if we just got rid of it overnight everyone’s life would be better
I seriously doubt it's only that much, but even if it is, it's the cost of production, not the cost to the end user.
With socialised medicine, you don't pay yourself, that's the fucking point. You pay taxes and the system is payed from everyone's taxes.
I broke my arm last year here in Finland. I think the whole bill for an overnight stay and surgery and all the medications was... around 50 euros. Now ofc that doesn't cover even the cost of a single worker for a few hours, let alone anesthesiologists, surgeons, nurses, physiotherapists, etc. It's just the part I have to pay straight up.
You want to say shareholders give up their yachts?
Australia has a mixed system.
Theres some nuance to this but essentially the government covers most things but you might wait a long time, especially for anything that isnt actively killing you. You don't get to pick your doctor, you get the treatments that are govt approved and you get shuffled out the door just as fast as humanly possible.
Private health insurance means you can choose your specialist, you have more of a say in your treatments and if your specialist says "If you want to go home tomorrow you can, but I'd like you to stay in for 3 days ideally" and you can if you want.
Please fix. Even in Russia of all places I can choose specialist. Well, if there is specialist at all. Regional healthcare is kinda fucked.
That reminds me of an old joke. Life in Soviet Union is not different from USA. For Dollars, you get everything.
Finland is famously having major problems with public healthcare currently because the costs versus clients relation is too low.