this post was submitted on 07 Oct 2024

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How medical insurance works (lemmy.world)

submitted 1 month ago by [email protected] to c/[email protected]

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[–] [email protected] 12 points 1 month ago* (last edited 1 month ago)

My $7000/mo medication has a bunch of "cost relief" programs so they can pretend that they give a shit about affordability, then when you actually try to use them they make you do like 20 phone calls over the span of several months until they finally let you enroll and when you do it only lasts for a short amount of time before they kick you off and you have to start the process all over again. I've had to miss multiple doses of the medication which is dangerous for my physical health because I don't have the money to pay for it and this process takes so fucking long.

Recently, they signed me up for some super shady thing where I pay for the medication upfront and then they pay me back after showing me the receipt. What they didn't tell me is that it has a limit for how much it will pay for, so I pay for the medication, and what a surprise, they rejected my claim and now I lost $5000 to the medication, which could have paid for a car or a semester of community college. Our healthcare system does a great job at making dying sound like a decent alternative to healthcare.

[–] [email protected] 5 points 1 month ago* (last edited 1 month ago)

Sure we could save lives by listening to doctors! But who will save our dollars, huh? The REAL value!

[–] [email protected] 27 points 1 month ago (2 children)

And when the patient turned out to be fine after the scan, the insurance company will try to blame that the doctors are lying so that the insurance company has to pay the hospital more It's like they thought that the doctors must be able to see through the patients' body as if they forgot that the reason for these equipments to exist in the first place is that because the doctors can't really be 100% sure about what's actual situation inside human body

[–] [email protected] 7 points 1 month ago* (last edited 1 month ago) (4 children)

There's two sides to this coin. On the one end, you have insurance companies refusing to pay for anything because the modern industry is just six scams in a trench coat.

But on the other, you have doctor's offices where the physician literally leases an MRI machine to the tune of several million dollars and then has to run a certain number of patients through the scanner every year or lose money. That's because the MRI patent is held by GE and they can charge 10-100x markups on hardware that is fundamental to modern medicine.

Its the same with diabetes treatments. Insurance companies will try and refuse service or kick people off their policies if they are at risk. But then pharmacy companies will sell $3 of insulin for $75, then kickback a chunk of the balance to judicial/congressional bribes in order to guarantee the cash flow.

At some level, the only insurance companies that can survive in such a market are the ones that say "No!" to everything. The even-remotely-ethical firms just get fleeced by the for-profit industry until they get bought out or go bankrupt. That, or you're Medicare/Medicaid and you have an infinite wallet backstopped by the US Treasury. You don't care if you're paying multiples of whatever any other clinic anywhere else in the world would charge on an enormous population of poor and elderly patients, because you have an unlimited money cannon to mow it all down with.

[–] [email protected] 11 points 1 month ago (1 children)

Very uninformed take, its almost laughable.

GE isn't the only one who makes MRIs. The other big players are Siemens, Philips, United, and to some extent Canon, Fujifoto, and Hitachi.

No, that's really how much it costs. The margin on MRI machines is terrible. I'd like to see you do it cheaper... "Just" build then supercool magnet for superconduction for 3T of homogenius magnetic field, build coils that handle KW of RF/gradients that can fit a human comfortably without artifacts, build the high power and precision circuitry to transmit and receive said RF, then control that equipment accurately and safely.

Super easy, off-the-shelf stuff.

Oh, and you can't use any ferrous parts, nor can your power supplies generate any noise.

That's like, senior design level stuff amirite

[–] [email protected] 5 points 1 month ago

The other big factor in cost is supply chain. Everything has to be tracable. So the supply chains have to do a lot of paperwork, inspection audits, since a defective part can kill someone.

[–] [email protected] 5 points 1 month ago

Six scams in a trench coat

Fucking poetry lol. I'm gonna use this.

[–] [email protected] 1 points 1 month ago (1 children)

Shouldn’t that patent have expired by now?

This kind of thing is why it bothers me when people complain about “free market medicine”.

A market where only one entity is allowed to build MRI machines, or license the tech to others to build, is not a free market. That’s a government-enforced monopoly.

Even the fact that a patient can’t just go get their own MRI at Scans-R-Us, but needs to get a doctor’s referral first, is a huge departure from what an actually free market for medicine would look like.

[–] [email protected] 1 points 1 month ago (1 children)

Shouldn’t that patent have expired by now?

It's an evolving technology. We get new patents with every iteration.

A market where only one entity is allowed to build MRI machines, or license the tech to others to build, is not a free market.

If you spend a few years in Business School getting your MBA, you get an earful about how and why patent law exists. The core argument is that private investment is predicated on returns and we can't have nice things unless we have men with guns come for the property and freedom of anyone who "steals an idea".

But more practically, this shit is just a racket. Lots of lobbyist money changes hands to make sure the decks at the casino are properly stacked. Medical treatment is just another opportunity to apply leverage through debt to control other people.

[–] [email protected] 2 points 1 month ago (1 children)

I understand the value of a patent system, but patents should expire.

Is there some reason why previous-generation technology, like the tech being used for MRIs in the 90s, can’t be used to manufacture more competitively-priced machines?

Like, is there a law specifying that the new technology must be used for an MRI to be usable as a diagnostic tool?

[–] [email protected] 2 points 1 month ago (1 children)

patents should expire

They do. It's just that they can be renewed under various circumstances, typically as an incentive to increase production.

Is there some reason why previous-generation technology, like the tech being used for MRIs in the 90s, can’t be used to manufacture more competitively-priced machines?

You need a certain amount of industrial capital geared towards making these machines and GE is the only one that really does (excepting manufacturers overseas). A big part of the problem is that we don't have a good mechanism for introducing new small businesses to the market. You really need to know someone that needs a steady number of MRI machines on a regular basis to make a new MRI factory worth it, and unless you have that business connection you have no buyers.

[–] [email protected] 0 points 1 month ago

So you’d need to have a single integrated business, just to get all that information in-house.

The same company could build the machines, and sell the MRI scanning service.

Then you’d need a lot of conversations with various doctor’s offices.

But there are probably lots of places who’d rather be able to provide patients with a lower-cost, lower-quality MRI, so it should be possible to collect a number of providers saying “if such a service exists, I’ll use it”.

My guess is there’s gonna be a lot of government money available soon for people who want to build new manufacturing capability in the US

[–] [email protected] 3 points 1 month ago* (last edited 1 month ago) (1 children)

*cough* single payer fixes all this *cough*

Sorry, cough has been acting up. I should go see a doctor with a MRI about that...

[–] [email protected] 6 points 1 month ago

cough single payer fixes all this cough

I'd go one further and say a National Health System fixes all this. Rather than paying a guy to pay a guy, you just have publicly financed clinics and hospitals. This is the traditional way of building up medical infrastructure, btw. City hospitals used to be the norm. We only entered the era of corporate consolidation when we sold off our public infrastructure for a song during the neoliberal turn of the 70s and 80s.

[–] [email protected] 7 points 1 month ago* (last edited 1 month ago) (1 children)

IThey can't even be sure after the MRI. Which again, proves your point. It took one MRI battery and one alert and skilled MRI tech to catch my brain cyst, THEN another whole set, I straight up spend a whole 8hr shift in an MRI machine, Then a TEAM of neurologists studied my custom hand made brain for MONTHS. THEN they had a really good set of educated guesses. Then they did the surgery, and only after they opened up my brain case did the actually see what in the hell was going on. Even after all that, my neurologists was like ''This is what we think is happening'', I asked what it would take to really know factually, he said an autopsy. He didn't recommend it. The point is, Doctors save lives with these scans, and nothing is certain. That's not a barrier to treatment, but no scans Is a barrier to treatment.

[–] [email protected] -1 points 1 month ago

This is why we need transporter tech from star trek.

Beam yourself into the copy buffer, kill the copy, and do an autopsy.

[–] [email protected] 5 points 1 month ago (1 children)

Fuckingcapitalists

[–] [email protected] 15 points 1 month ago

tl;dr: It doesn't.

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