this post was submitted on 11 Dec 2024
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No Stupid Questions

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Health insurance at its core is very simple. You put money in, you go to doctor, insurance pay doctor. But in the USA, the insurance denies everything they possibly can. Money put in doesn't ever see a doctor or your health costs, it goes right to the stockholders....

So why doesn't someone just make a non-profit health insurance company where there's no stock, no executives, just public servants and aggressive price negotiation where your medical bills are actually paid with the money put in?

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[–] the_toast_is_gone@lemmy.world 21 points 1 week ago (2 children)

Insurance companies make money by indirectly extorting customers, be they individuals or businesses, through pricing schemes with healthcare providers. The American healthcare system is designed and priced around people having insurance, as you've noticed. This leads to insanely high bills for what should be simple things. An ambulance ride often costs over $1,000 without insurance, for example. In a nutshell, they've created a system where they are both the problem and the solution. Why don't they start behaving more ethically? Well, from a money standpoint, why would you become less corrupt when you can collect more money by being corrupt?

Changing insurance providers, or even just certain coverage choices, isn't easy. We have what are called "enrollment periods" in the US when you can do this, and the only other times are under major life changes such as marriage or having a child. As another user noted, most people get insurance through their employer. The company (usually) pays the lion's share of the premiums; otherwise, the plans would be completely out of reach to employees. My plan would be four times as expensive to me if I was paying for it out of pocket.

As a result, starting something like what you want on a national level would be extraordinarily expensive, hard to compete with established players, and likely legally troublesome. Don't get me wrong, we need reform pretty badly, but those reasons are why it hasn't really taken off.

[–] spankmonkey@lemmy.world 5 points 1 week ago* (last edited 1 week ago) (1 children)

The company (usually) pays the lion’s share of the premiums; otherwise, the plans would be completely out of reach to employees.

Which is just smoke and mirrors because the insurance the company pays is part of the cost to employ, aka they are paying with money that would have gone on the paycheck. The company insurance scheme limits choice.

[–] the_toast_is_gone@lemmy.world 4 points 1 week ago (1 children)

Very true. There's some benefit where the business can get a "package deal" of sorts which makes it cheaper than buying individual policies, but it's still a shell game.

[–] spankmonkey@lemmy.world 1 points 1 week ago

It is really about attracting and controlling employees. A 'good' package to draw them in and fear of being uninsured to keep them from leaving by choice.

[–] DuckWrangler9000@lemmy.world 2 points 1 week ago (1 children)

I feel like you in many others blame the insurance companies for basically everything which is fair, but what you are excluding conveniently is the fact that it's not just the insurance companies that are doing this extortion, it's also the leaders and people in charge. Hospital administration, pharmacy managers, and so many others. If everyone started saying no and stopped allowing this, it would never happen. If they cut out the insurance companies entirely and started making their own decisions on treatments and if the insurance doesn't cover it, so be it, we'll eat the cost, That's kind of the way the world worked before insurance became so big and massive. We take care of people in our hospitals and health care system and figure out the payment and insurance later. Would that be costly, probably. But it's not as bad as the fear mongers want people to think it would be, that's what I feel. They want us to think that healthcare is so expensive without insurance that no one would ever possibly be able to afford it in a thousand years so we have to have insurance, when that's not really the case, there were times when people simply did not have health insurance widely, and they still went to the doctor or went to the hospital. I mean hell look at other countries?

[–] the_toast_is_gone@lemmy.world 4 points 1 week ago

I'd love to see insurance companies get taken down a notch, but what you're saying isn't nearly as simple as you think. People regularly get tens of thousands of dollars into debt for lifesaving care, even with insurance. Those without it can go hundreds of thousands or even millions in the hole - I've personally known people in that situation. I certainly agree that hospitals are partly to blame, but the whole healthcare system is built around insurance paying most of the cost. This never would have happened if insurance didn't exist. It's a captive market. The only way doctors, hospitals, and pharmacists would unite in not accepting insurance was if all insurance companies disappeared. There's just too much money on the table otherwise.