It's not about the appearance of helping to improve things, which so many are focused on.
It's about actually helping to improve things. Better access. Price transparency. Affordable care. No medical bill bankruptcies (the #1 cause of bankruptcy in the US...weird, huh? Oh yah...most of those people are "fully insured").
I know lots of people, like you, doing real work to create real change. That's where we need to focus.
Absent something like universal healthcare (like all the other nations with large economies), do you think direct care is best? Would it be coupled with a traditional major medical plan?
Insurances work best when lots of people throw money into a pot that few take out of, like fire insurance. But if people without many needs opt out of regular plans, and only the sick people are left in traditional plans, insurance stops being feasible.
Also, insurance margins are crazy, and so any alternative insurance approaches would also need some ways to handle the rampant greediness that leads to pre-auth requirements and other things.
All that said, direct seems what we have, anyway, with insane deductibles — we never hit ours, so we might as well go direct except for major med.
Thanks for this comment Brandon and I know I still owe you one on the last article! Singapore is the only country that does single pay healthcare without producing horrible outcomes and long waits for everyone, but you hit the nail on the head with the idea that the only reason Insurance works at all is because there’s a bunch of healthy people that don’t need it paying into the system. I’d have no problem with this if the healthy people were rich, but the healthy people are young people who can’t afford 25K a year and that’s predatory. The issue with the way it’s set up now is that no one is incentivized to make sure that there aren’t rampant price escalations that have nothing to do with the cost of care + fraud waste and abuse out the wazoo. So patients are getting worse care at 10 X the price. If you look at the charts, health insurance companies have continued to make record profits every year and premiums have continued to escalate- the taxpayer is just subsidizing industry. The Republicans are right when they say that these were Covid subsidies that were meant to be temporary and this is bs. The Democrats are totally right when they say that if they aren’t renewed, everything falls apart. Neither party is showing up with a solution. I’m not sure what the answer is and I’m also not sure that bailing out the current status isn’t the right call but the idea that this is gonna provide care for Americans is a pipe dream. I opted out of health insurance altogether and have actually saved a ton of money paying for primary care and medications out-of-pocket. It’s not hard to do when you’re healthy because premiums of 25K annually buy a lot on the cash pay market. The problem is this totally screws people who are sick. A.k.a. kids with hemophilia or sickle cell disease. I’d rather the ACA subsidies go to Medicaid for those people who desperately need care instead of subsidizing the behemoth health insurance companies who have a fiduciary responsibility to their shareholders, not to patients or the American people. If you have a solution tho lmk. I’m absolutely obsessed with finding one and still come up short. 😋
There are countless leaders echoing how healthcare is broken. Who is actually doing anything about it? It’s not disruptive, innovative, nor world changing unless it’s affordable to the poor and they have the same access we all have. We spend more $ on healthcare than any other developed country, and are the only country where we force people into bankruptcy. And, now thanks to this Administration, any medical debt will once again affect your credit. High Deductible? Land in the ER for emergency surgery? Don’t have the $$? You’re screwed!!
This was beautiful, Tiffany!
It's not about the appearance of helping to improve things, which so many are focused on.
It's about actually helping to improve things. Better access. Price transparency. Affordable care. No medical bill bankruptcies (the #1 cause of bankruptcy in the US...weird, huh? Oh yah...most of those people are "fully insured").
I know lots of people, like you, doing real work to create real change. That's where we need to focus.
It's time to stop waiting for the calvary to come, they aren't gonna make it.
Absent something like universal healthcare (like all the other nations with large economies), do you think direct care is best? Would it be coupled with a traditional major medical plan?
Insurances work best when lots of people throw money into a pot that few take out of, like fire insurance. But if people without many needs opt out of regular plans, and only the sick people are left in traditional plans, insurance stops being feasible.
Also, insurance margins are crazy, and so any alternative insurance approaches would also need some ways to handle the rampant greediness that leads to pre-auth requirements and other things.
All that said, direct seems what we have, anyway, with insane deductibles — we never hit ours, so we might as well go direct except for major med.
Thanks for this comment Brandon and I know I still owe you one on the last article! Singapore is the only country that does single pay healthcare without producing horrible outcomes and long waits for everyone, but you hit the nail on the head with the idea that the only reason Insurance works at all is because there’s a bunch of healthy people that don’t need it paying into the system. I’d have no problem with this if the healthy people were rich, but the healthy people are young people who can’t afford 25K a year and that’s predatory. The issue with the way it’s set up now is that no one is incentivized to make sure that there aren’t rampant price escalations that have nothing to do with the cost of care + fraud waste and abuse out the wazoo. So patients are getting worse care at 10 X the price. If you look at the charts, health insurance companies have continued to make record profits every year and premiums have continued to escalate- the taxpayer is just subsidizing industry. The Republicans are right when they say that these were Covid subsidies that were meant to be temporary and this is bs. The Democrats are totally right when they say that if they aren’t renewed, everything falls apart. Neither party is showing up with a solution. I’m not sure what the answer is and I’m also not sure that bailing out the current status isn’t the right call but the idea that this is gonna provide care for Americans is a pipe dream. I opted out of health insurance altogether and have actually saved a ton of money paying for primary care and medications out-of-pocket. It’s not hard to do when you’re healthy because premiums of 25K annually buy a lot on the cash pay market. The problem is this totally screws people who are sick. A.k.a. kids with hemophilia or sickle cell disease. I’d rather the ACA subsidies go to Medicaid for those people who desperately need care instead of subsidizing the behemoth health insurance companies who have a fiduciary responsibility to their shareholders, not to patients or the American people. If you have a solution tho lmk. I’m absolutely obsessed with finding one and still come up short. 😋
There are countless leaders echoing how healthcare is broken. Who is actually doing anything about it? It’s not disruptive, innovative, nor world changing unless it’s affordable to the poor and they have the same access we all have. We spend more $ on healthcare than any other developed country, and are the only country where we force people into bankruptcy. And, now thanks to this Administration, any medical debt will once again affect your credit. High Deductible? Land in the ER for emergency surgery? Don’t have the $$? You’re screwed!!