Submitted by Thegreatcornholio459 t3_1267104 in explainlikeimfive
blipsman t1_je7wy71 wrote
It means heath insurance that covers every citizen. No matter their employer or whether they even have a job. Everybody has health insurance coverage.
HarryHacker42 t1_je844j9 wrote
Having health insurance not tied to your job means you can quit your job if they screw you over and still have healthcare. In the USA, many people are stuck at their job for their healthcare. Also, the average country similar to the USA pays HALF of what the USA pays per person for healthcare. It would save us trillions of dollars per year to switch to Canada's system, or Australia, or UK, or Europe, or pretty much anything.
djamp42 t1_je86b33 wrote
It would be one thing if the current system actually worked well. But it's fucking horrible. I'm disputing a charge right now.
Insurance is saying the doctor needed prior authorization. My wife is actively having a heart attack in the ER on vacation at Disney world with my 2 kids. The insurance company couldn't even pronounce the name of the procedure that needed authorization. Like I'm not going to know that, I don't know if the Dr knows that, and it's against the law to deny me coverage for prior authorization in an emergency.. but they still did it.
HarryHacker42 t1_je86tqp wrote
The whole USA system is designed to make it hard and charge you more, that's why we need to discard it and start over with another country's model as the goal.
They've found numerous insurance companies that had the policy of "reject every [nth] claim" such as "toss every 5th claim" so you get a rejection and either pay it or go complain, and if you complain, they'll usually pay it, but it is just to hassle you. And hospitals *LOVE* to have an out-of-network doctor visit and charge everybody huge rates the insurance doesn't cover. Its so bad they're making it illegal. There is nothing to fix, it needs to be replaced.
And worse, Christian hospital chains are buying up as many hospitals as they can get so they can deny abortions and contraception and anything they feel like.
djamp42 t1_je877fn wrote
You might have something on that nth claim thing, because I had a bunch of other bills from that same event and they were all covered, even ones from the same doctor, but for whatever reason this one was denied.
HarryHacker42 t1_je887ow wrote
20% error rate on claim processing:
https://www.carecloud.com/continuum/health-insurance-claim-errors-waste-17-billion-annually/
Aetna admits they never looked at some patients medical records before marking the claims denied:
https://www.cnn.com/2019/04/26/health/aetna-settlement-california-investigation/index.html
Superspudmonkey t1_je93wd4 wrote
Was that not what Obamacare was before it had to compromise to pass?
roseumbra t1_je8xoan wrote
Sorry you have to deal with this. Honestly do what you can to tell the doctors office you Cannot pay them a dime before the claim is approved by insurance. They have staff designed to deal with this in ways you don’t have the years of training to. If you force them to tackle insurance with hard stops before they see a dime they will find a way…
It’s all about how the fucked up the coding when sending it. And this is why I hate the healthcare system.
djamp42 t1_je97acq wrote
Yeah that coding shit is a disaster. The entire thing is a disaster.
Unkindlake t1_je8olyp wrote
Why would anyone want the current system? Who could possibly have something to gain from tying healthcare to an employer?
markroth69 t1_je8uf4x wrote
Employers who don't want to provide anything more than the lowest possible pay and some level of health insurance.
People who make money because of the current system.
And both groups can afford to buy Congressmen.
Unkindlake t1_jebbn5l wrote
Of course they don't, but it is more sinister than that. They want healthcare to be tied to employment to limit your options in shopping for a better job and to leverage it to exploit their workers
BlackEyedSceva t1_je8gb82 wrote
Do you know any sources I can look up and show people? I'm not sure where to look.
HarryHacker42 t1_jeaa78s wrote
USA: 51st in life expectancy
https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
(Wikipedia has all the sources for the data at the bottom of the page)
​
Per capita healthcare spending by country from 2021:
1l536 t1_je98v0n wrote
The downside to that is I can see many hospitals closing because it would be regulated by the government and they would choose what hospitals could remain open.
You can not say it wouldn't happen because since when has the government ever walked away from an opportunity to screw the public over. I mean they are now trying to screw over veterans just like Canada.
They (elected officials) should have been forced to give up their healthcare when Obamacare passed, I think that they should be exempt from any laws they pass to us the citizens.
HarryHacker42 t1_jea9glc wrote
I strongly agree that Congress should be in the muck with the rest of us, and their pensions and healthcare should be based on what the upper 50% of government workers get, so they have to lift up at least a huge chunk of people to elevate themselves.
The government has created the EPA, which helps the average American pretty often. The CFPB fights for citizens against banks every day. FEMA responds to disasters and does a pretty decent job of improving people's lives in hard situations. NOAA is so good at weather forecasting that private companies want to block it from publishing the data that they give away freely so those companies can publish it. California is guaranteeing school kids will have food. There is a lot of good government does. They're currently taking care of everybody over 65 years old for medical care, so extending that down to 55 or 45 would be a good test pattern, but in the end, insurance companies need to go away because they are what inflates the numbers, and we need to buy our drugs from countries who don't allow shameless profiting on drugs like the USA does.
skawm t1_je8frf4 wrote
Don't forget about the lack of dealing with insurance networks, so you're covered regardless of where you go instead of having to utilize specific providers to utilize the coverage.
Thegreatcornholio459 OP t1_je7ym03 wrote
Ahh thank you and here in the US, it's different, usually there are requirements and is often separate depending on income and much expensive?
horrifyingthought t1_je80zip wrote
No. The healthcare isn't more expensive. The fact it is both for profit and has absurd administrative costs is what drives prices up.
YellsAtGoats t1_je8fsvt wrote
That, and outright bizarro hospital / private insurance markups. In your everyday life, you can go to any pharmacy and get basic cough lozenges at like $10 for a pack of 20 or more. But under hospital billing, those exact same lozenges can be $10 apiece.
SilverSageVII t1_je85jo5 wrote
Yep this^ if anyone is interested, look up sticky ceiling in the medical industry. It is an economic theory explaining part of why cost is so high.
Edit: as I was searching for a link it seems that “sticky ceiling” was a term coined by NPR to refer to “price stickiness” that was tending toward highest prices in the medical field.
darkmooink t1_je8w5qz wrote
You realise that you just said “healthcare isn’t more expensive. The prices are just higher.”
roseumbra t1_je8xzvt wrote
I think they mean the actual cost to provide the healthcare isn’t higher, rather they just inflate the price to the consumer.
horrifyingthought t1_jec3nnq wrote
... and? That would be correct. The cost to provide services isn't different when compared with comparable nations, but the structure and incentives of US healthcare are set up in a way that increases the price astronomically compared to other nations.
DeHackEd t1_je80ygv wrote
Health Insurance is something you have to get like any other type of insurance, paying a monthly fee (or getting someone like your employer to pay it for you) and all the fun of shopping around and discovering what is and isn't covered, and what other catches might exist.
By contrast, for example, I had my appendix removed. I'm a Canadian citizen. Was in and out of the hospital, never even discussed a bill or price. Procedure was basically paid for by my (and everyone else's) taxes. Everyone is covered for life-saving procedures for sure at any hospital.
YellsAtGoats t1_je8ffmx wrote
It gets interesting at the level of nonessential care and procedures.
I too am a Canadian citizen. If I suffer a serious trauma like a gunshot wound or severely broken bone or severed appendage, I'm well taken care of on taxpayers' money. But it's not so nice for illnesses like Cancer or for less-than-urgent needs like eye care and dental care. There, I could be on a waiting list for an MRI or CAT scan for months or years, or left to pay mostly out-of-pocket for things like eyeglasses and dental surgery.
Case in point, in the Canadian system, if you don't have private insurance to cover dental care and you have gum disease, you're left to pay tens of thousands of dollars to keep your teeth from falling out of your head. If you need vision correction for poor eyesight, too bad, if you don't have private insurance for that, you're paying out of pocket for glasses/contacts/LASIK just like any American schlub. I say case in point because that's all me.
Irbricksceo t1_je8lyxw wrote
Good news, here in America dental care is also tens of thousands. I’m looking at another 32k soon, and I’ve already spent double that. And I have what is considered good dental
concentrated-amazing t1_je8bk66 wrote
It's interesting to note that spending on healthcare is lower per capita in Canada, for example, vs. the US, with health outcomes such as infant mortality and life expectancy being better.
anentropic t1_je93vwa wrote
Or healthcare that's not even framed in terms of insurance. Just provided free to whoever needs it.
[deleted] t1_je8fc14 wrote
[removed]
Viewing a single comment thread. View all comments