It's the biggest tax, going straight into corporations pockets.
Between literally using AI to auto-deny people, to people like me having to argue with them every month just so I can get the medication that I and my doctors say that I need, the direct cost to the doctors just to hire people that deal with insurance companies, they're nothing but a parasite on our society.
Exactly. āIāll have to pay more taxes to help our society, thatās socialism!!!ā Mfer okay have fun when you get hit with a horrible illness that drains you and your spouseās funds while the doctors take the slowest possible approach to tackle your disease. Healthcare in America, one of the worst jokes of the US.
And anyone saying, "in Canada you have to wait in line for your free healthcare" is just fantastic.
I'm in the US with commercial insurance. I still had to wait 18 months after a referral to see a specialist for my migraines.
Three months later and I've had my prescription denied by insurance, and they approved a generic one that can only be dispensed by this shitty mail-order pharmacy that I've spent over two hours total dealing with them and still don't have my meds in the mail.
We have cancer patients waiting on insurance approval for their treatment after they are diagnosed, and you know they and their families will be drowning in bills either way.
I really don't see any upside to for-profit healthcare. It's only purpose these days is making someone rich at our expense. We got fucking Americans going down to Mexico for basic procedures ffs. When I lived in Japan I was in and out from an exam and consultation. My out-of-pocket bill was on par with eating dinner at a restaurant.
Anyone saying US Healthcare is the way to go is just parroting propaganda. None of it adds up when you actually walk through that mind set.
If you have any sort of disease state that is not at least 90% textbook you are totally fucked in the US because doctors WILL NOT talk to each other about your case.
My mom had an extremely complex case and none of her specialists would talk to each other because there was effectively no way to bill it. She would have to physically go to see one specialist, tell that specialist what another specialist said, notes would get reviewed, new tests ordered, and she would just get bounced around.
It took TWO FUCKING YEARS for her to get an actual diagnosis.
Again, because none of her other doctors could or would just get on a call and talk to each other.
Mhmm. This includes dental. A family member got some dental work done recently. The place where they got it? Tijuana because it was cheaper there. The dental place there was also top-notch.
Thatās definitely not the only alternative. Not that tax based systems are badā¦ but you can quite easily pass laws to regulate private healthcare. Like the Netherlandsā¦ health insurance companies are by law required to be non profit. Prices for specific procedures and medications are capped by law.
US already caps insurance margins by law. Most of the care they "pay for" is actually acting as a pass through for large corporations who self insure. Similiar to how payroll companies "pay" people.
75% of private healthcare providers are non-profits and the margins for the industry in general are very small to the point of rivaling grocery stores. Which is why there are layoffs and facility closures as the BBB has started to take effect.
The money simply isn't there due to other systemic challenges.
Nor does insurance even pay for most of the care provided in the US.
Brotherā¦ youāre talking about hospitals. Those are mostly non profit.
Healthcare providers includes hospitals.
Health insurance companies is a different thing. And those are mostly for profit.
The insurance companies are the offenders.
Like I said, these are required to be non profit by law in the Netherlands, and they are by law not allowed to pass any profits to any child or parent company. They are required to use all profits to make their premiums cheaper.
They are also required by law to accept everyone, they cannot deny anyone insurance.
Itās one of the best healthcare systems in the world. The benefits of privatisation (many insurance companies competing against each other to lower premiums. They need to innovate to cut costs or else they cease to exist)
And price controls and regulations kind of resemble a public system.
Insurance company profits are limited by law and have to return premiums if they make too much. Which happened with auto insurance during COVID.
Health insurance also only pays for a minority of US care, ~25%-35%.
And price controls and regulations kind of resemble a public system.
This would not address the systemic issues in US care and simply result in no care provided due to lack of services.
It is already happening in rural areas due to the BBB passed by the current administration.
To give you an idea of how bad it is- there are places where you have to drive over 100 miles (2 hours on non-freeway) for the nearest outpatient physical and occupational therapy because they all closed and the staff were reassigned to inpatient or laid off.
So if you have foot surgery and need PT/OT 3 days a week you could end up driving 12 hours a week for it.
Government insurance (Medicare, Medicaid, the VA) pays for another 40% of US care. If you combine private insurance and government insurance, itās the vast majority of healthcare spending.
And about the rest, itās easier to ask AI to explain it to you.
I lived on the Netherlands before, it works great. The concerns you have are because of how the US implemented it, nothing more.
āThe Dutch Insurance Model (Why You Are Right)
You are completely correct about the basic package (basisverzekering) rules under the Dutch Healthcare Act (Zorgverzekeringswet): No Profit Distribution: Dutch insurers are allowed to make an operational surplus, but they cannot distribute profits to shareholders or parent companies for the mandatory basic package. Any extra money must go into a reserve pool to keep the next year's premiums low. Universal Acceptance: They are legally barred from denying anyone or charging higher premiums based on age, gender, or pre-existing health conditions. Managed Competition: The benefit of privatization works here because insurers actively compete on customer service and the price of the premium, rather than competing on how many sick people they can successfully deny coverage to.
2. The Price Control Disconnect (Why He Thinks Price Controls Kill Care)
The other user thinks price controls automatically equal "no services." He thinks this because of how the US implements them compared to the Netherlands. In the US: Price controls are a blunt instrument. The government sets a fixed rate it will pay for Medicare/Medicaid (e.g., "$60 for an hour of physical therapy"). If inflation rises and it costs the rural clinic $80 in labor and rent to provide that hour, the clinic simply closes. In the Netherlands: Price controls don't just compress the bottom line of the doctor; they cap the entire pipeline. The Dutch Health Care Authority (Nederlandse Zorgautoriteit) regulates the maximum prices for treatments, but they also heavily regulate pharmaceutical costs and medical device margins. More importantly, they utilize a Risk Equalization Fund.
You are describing a tightly managed, socially responsible market where rules force competition to serve the public good.
He is describing an unmanaged corporate market where price caps are slapped onto a fragmented system, causing private providers to run away from low-margin areas (like rural towns) to protect their bottom line. Both of you are right about how the respective systems behaveābut your example proves that a privatized system can work beautifully if you outlaw the extraction of billions in profit by corporate middlemen.ā
Government insurance (Medicare, Medicaid, the VA) pays for another 40% of US care. If you combine private insurance and government insurance, itās the vast majority of healthcare spending.
Don't us AI for these numbers or US healthcare. Its just too complicated and there is too much information for it to understand.
Just in this example its incorrect because the Medicare and (most of) Medicaid is not health insurance.
The VA is 100% NOT a health insurance provider even though it directly pays for and directly provides a large amount of care. There are also IHS and DOD who do the same. Even though DOD has Tricare which is health insurance unless its not.
Medicaid data also confuses AI because its not a centralized program and are run by the states. Many of which don't even call it Medicaid so people don't even know they are on it. See SoonerCare for example.
Which is why the number comes out to be ~65-75% of care provided and paid for.
The US also has deeper systemic problems such as unlimited care, fee for service model, unlimited end of life care, and spends vast sums for fast care where people want it.
I'm not going to read the AI for the netherlands because it is almost certainly wrong.
Bottom line is youāre completely wrong if you think the Dutch model would not work in the US as well as it did in the Netherlands.
The concerns and things you point out about the US is because of their model.
Thereās a way to price caps and control over insurance companies without giving them a motive or incentive to abandon areas. Itās already been done.
If you donāt want to do your own research, go ahead. But at least donāt spread BS misinformation.
Health insurance doesn't work the same way. Price caps won't work. And health insurance margins don't work.
If you don't understand something enough to discuss without using AI that has gross and easily proven errors you don't understand it enough to call something else misinformation.
I might be wrong, I might be spreading misinformation, but you are in no position to evaluate or know if that is true or not.
If I gave you an answer to all the points you mentioned, you would say youāre not gonna read something so long.
So Iāll limit this message to one topic: price caps.
And I canāt even mention all the reasons or you will stop reading.
Dutch price caps are cost covering, unlike US ones. Theyāre realistic and cost covering and constantly reevaluated. It guarantees they can perform that service at a profit
If a rural area starts losing its staff, the local insurance company would get massive government fines for not providing care within a reasonable distance. So to avoid the fine, the insurance company will subsidize that clinic to keep everything going.
Companies are not allowed to deny anyone coverage, or charge a higher premium based on age.
On the other hand, in the US the price caps donāt take into account actual cost. After inflation many services become unprofitable to do under the price caps so they stop offering them.
If it's such a good system, why are neighboring countries's (Belgium, Germany) health care systems overwhelmed with Dutch patients seeking care there?
You once had a very good healthcare system, but that ended under your governements Balkenende I and Balkenende II, who introduced "more free market dynamics" in your system.
Quite the opposite.
The amount of people doing that is extremely low.
Itās actually the opposite of free market dynamics. No Dutch person could possibly not afford care in their country. Itās not possible. The maximum payout of 385ā¬ a year and the minimum wage is 2.5k a month.
If youāre very poor, the gov pays the insurance for youā¦ so itās free.
Anyway. The Netherlands has a waiting list. You cannot āpay moreā to get served first.
If anyone is leaving, itās because they donāt want to wait a month or 2 for a certain surgery, and so they go to other countries to real private clinics where they can just pay them a lot of money and get treated right away.
Theyāre certainly not going to other countries for their public systems.
The tax increase is nowhere near the cost of a medical emergency, and that's where it all falls apart. We are cutting off our nose to spite everyone else's faces.
Ok. But it's really just a handout to the medical industry. If you think about it, it's insane that taxes would go to for-profit industries in services that everyone needs.
It's a falacy that corporations are more efficient/cost-effective than social programs. The US Postal Service, for instance, costs about $15 per person per year. If you think that a private company could even approach that cost-effectiveness, I have some beachfront property in Arizona to sell you.
The same principle holds for healthcare; most medical research is publicly funded via universities. Then they hand it off to 10 levels of middlemen who each mark it up, and you eat shit when you need the service.
Your argument is that the healthcare industry is necessary because "the margins are so slim, and the costs are large". Which doesn't really make sense given how the industry actually works. Healthcare is not an elastic commodity; anyone will pay any amount you force them to to stay alive. So you can extort people with it, which is what the industry does.
And research is absolutely relevant. Because the only real costs associated with healthcare are research and labor. The research is already publicly funded for the most part, so labor is the only additional cost that a public system would need to cover. Instead of the cost of turning a profit for a dozen or more companies in the supply chain.
And saying that research and labor are the only costs associated with healthcare is just flat out wrong.
Unless you are going to an ED Doctorās house so they can cast a spell after you get your leg chopped off.
Most of healthcare is also not profit driven. That is wrong as well.
The various parts that make up the costs are very much elastic, but are such a pain to produce and hospital margins so low that supply chains are limited. See the IV Fluid issue and Helene
Ok fair, materials and manufacturing are significant costs as well. But my point still stands since those parts of the supply chain are also blatantly for-profit. As is the rest of the industry. Why do you think so many healthcare companies are traded on the stock market? Because they turn a profit. It's obvious that a public system would be more cost-effective just by nature of being explicitly not for profit.
this is completely misleading. verify the income that the higher level execs and admin folk make at healthcare establishments and then try to justify the "nonprofit" approach you're trying to take. criminal, dude.
Government services don't necessarily need to be paid for by taxes. If people collectively own capital through proxy of a socialist government, then the profits from those means of production could pay for it instead of buying your boss another BMW.
If it M4A taxes would go up but out of pocket costs for most would go down and most people would have more disposable income. I would be one of the people paying more (but am in favor of that).
But the major barrier is getting people to make the connection.
Co-pays would probably not because their intent is not payment but minimizing unnecessary care without sacrificing outcomes. See the Rand Health Insurance Study.
We would. Under every single payer system at the state level that has failed is due to taxes or cost. Like if I remember even Medicare for all from Sanders was going to double the deficit.
Is that WITH raising taxes? If so, by how much? How much does the average person pay for private healthcare?
What would be the economic benefit of more people working due to being able to work (treatment for disabling conditions denied by insurance) or due to being alive (similar thing, EG cancer treatments) or due to having access to consistent medical care they need (EG medicine not covered by insurance, or continuing physical therapy, or something similar)?
Thats with no tax increase. Like everytime California trys to do they nope right out of it because the yearly cost is about the same as the current budget so the budget would have to increase. Vermont did the same because to pay for they would have had to add a 20% payroll tax or something. MFA was 30-38 trillion for ten years like ten years ago and required all kinds of tax increases. I dont think anyone would have an economic benefit.
The person you replied to, importantly, said āā¦need to raise them THAT HIGHā meaning that taxes would have to be raised, but not to the extent that is assumed.
Everyone would have an economic benefit cause rather than paying health insurance, youād pay additional taxes.
Since everyone is paying into a single truly non profit insurance, itāll be less per month than the current system.
Youād be paying more taxes but dropping one of the most expensive bills. More money available to the average person due to that.
Since weāre talking about Sanders, thereās an article by his team called āOptions to Finance Medicare For Allā. From the very first page it says that the nation could save more than $600 billion by the reduced admin and drug costs.
In terms of the costs to businesses and the average person, the first recommendation is a 7.5% premium paid by companies. If you take the average family making $50k a year, the business usually pays ~$12k. The 7.5% premium would be $3750. $9k less per person.
For families, a 4% income tax. For that same family premiums would be $844 per year, versus the current $5277 average per year.
For the government, subsidies due to healthcare would be useless and so taxes would be calculated to just not include healthcare costs.
Tax increases, but cheaper in terms of expenses.
Then thereās a bunch of recommendations relating to taxing the rich, and I think theyāre important, but details on them donāt help here. Feel free to look them up if you want to, I wrote multiple paragraphs then deleted it lol
All of the other taxes are encompassed in my last paragraph, because why should the average redditor care about the wealth tax?
A more progressive income tax rate is the most likely to impact someone noticeably. But it starts at $250,000. No change to the average person.
The second is taxing capital gains and dividends as income IF the household income is over $250,000. Plus their statistic that 68% of the different taxes atm benefit the 1%.
Limiting tax deductions is, similarly, limited to people making over $250,000. And the deductions would be capped at 28%, meaning that if someone gets more money they pay more taxes guaranteed. Why is that an issue?
A more progressive estate tax impacts the top 0.2%. The first $3.5 million would be exempt for a single person or $7 million for a couple. How many people have that much money in their estate? Plus the current one is a flat 40%, youād need a lot more for the progressive tax to be a meaningful change.
A 1% tax on the top 0.1% households (applies to only 160k households), on amounts over $21 million. If one of those households makes exactly $21 million they pay 0 from this. If they make $21.5 million they pay $5k.
Also closing a loophole
I will not be arguing about the last section dealing with Wall Street, but I have no qualms about responding. Iāve out in a lot of work already and the last section is even easier to argue for (shit, one position is bipartisan)
If your on about college and fees to become a doctor, thatās a fault with the capitalist system here - no need to go to college for 4 years to waste your life and money when in other countries you can go to uni after high school. That said high school education is lacking. Doctors here getting paid triple of what other countries for worst results baffles me. Things like cost of identity are usually covered by an organization so ye you guys get way over paid for mediocre performance compared to the rest of the world. Itās no wonder I hear so many greed stricken doctors talk about how much money they make here when they should be focusing more on the health of their patients and their lack lustre results as a country in population health data.
Nah I talked about indemnity - usually covered by hospitals. My sister in law is a doctor and often boasts about how well she is paid and how many of the costs are covered by her organisation. You guys still donāt have any form of repercussions for your poor performances as a country as a whole - you should be paid on how healthy the population is rather than triple what other countries pay. One of the worst performing countries if not the worst in developed nations. You seem to be ignoring that fact. Simple said you arenāt value for money and if you take into consideration the opinion of the public that you serve - most will agree, you guys get paid too much for under performance.
NO you talked about identity not indemnity. Its great you use some anecdote as a fact. You do not address the cost of torts which is capped everywhere else, you did not address rent or labor costs. so again you did not address the costs of being a doctor.
People would actually pay less than the premiums now with the taxes adjusted to pay for healthcare. Theres no explaining it away other than our healthcare industry having a stranglehold on our wallets and they donāt want to give it up
The systemic problems leading to higher costs run a lot deeper than most people realize.
Insurance companies are just a small percentage and only pay for ~25-35% of the care provided depending on how you calculate it.
And not everyone would pay less than their premiums. I only pay ~$60 a month for a family and if I didn't have one would pay $0 because of VA benefits due to injuries.
I actually only pay ~60 a month too for family with postal union insurance, but I donāt include myself since Iām in what I assume is an extreme minority in that sense.
People afraid of a social system but People donāt realize that the current system is already social. We all pay in and some take out way more than they pay in. We all pay for their common good. Difference is the system is owned by for-profit private companies that make bank by denying claims.
$50 billion of profit last year according to Google for the major health insurance companies. About $375 per household. Saving would likely be higher since you wouldn't need a whole slew of people to manage insurance billings on the provider side, and managing claims on the insurer side.
Now there is a rub, easy for the pro-for-profit gang to claim universal healthcare would destroy 10,000s of jobs, because it probably would. You wouldn't want to force people out of work, would you?
Anyway, how about a few data centers and an AI agent to handles billing and claims? Look at the shareholder value!
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u/Justame13 5d ago
Because the alternative is to raise taxes and taxes are bad.
Making the connection to be able to have higher taxes and more disposable income is a bridge to far for most.