This is the best summary I could come up with:
“In an ideal world, that might not be the best way to organize the health care system,” Eric Toder, institute fellow at the Urban-Brookings Tax Policy Center, told me.
Insuring people through their work offered two advantages that were obvious to employers, hospitals, and policymakers, Paul Starr, who wrote the seminal history The Social Transformation of American Medicine, told me.
During the Great Depression, FDR considered making national health insurance part of his signature New Deal legislation — which would have made the US a pioneer — but those provisions were nixed to prioritize the Social Security retirement and disability programs, among others.
After the war, Harry Truman made another attempt at national health insurance, but it was scuttled over opposition to new taxes and dogged by association with left-leaning economic ideas during the Red Scare.
When Vox conducted focus groups on single-payer in 2018, led by opinion researcher Michael Perry, one concern we heard was from people who mostly like the insurance they have and were worried about losing it under Medicare-for-all.
But the state legislature kept cutting taxes, and, in turn, copays for teachers kept going up — eventually costing Salfia and her family $100 just to show up at the emergency room or urgent care.
The original article contains 1,873 words, the summary contains 208 words. Saved 89%. I’m a bot and I’m open source!
That’s in the same category as “who would consider health care an appropriate industry for profit?”.
Who would consider it? The same people who are coming for public education.
The cruelty is the point.
Their end goal is a population of moronic wage-slaves who are living a barely subsistence lifestyle that will believe anything told of them rather than challenging the wealth, power, and right to rule of the ruling class.
They aren’t just conservative, they’re regressive. They long for the days of Feudal lordship with themselves cast as the lords.
“The cruelty is the point.”
I see this phrase often, and I disagree with it and I’m not sure why people keep repeating it.
Cruelty: inflicting pain on others. This is not the point at all. They don’t wake up every morning and say “how can I cause more pain” on individuals or the general populace.
They are almost completely indifferent to the suffering of others that they cause. They are simply greedy and selfish, they want all the money and power, so they can have it all to themselves. Fucking over everyone else is just the process to get and keep what they want. This is my opinion at least.
“Cruelty is the point” is just silly, and absolutely wrong. I also feel like it misdirects talking about the true motive, which I think is mostly greed and selfishness. Cruelty is just a side affect they don’t care about.
I think that there are spaces in healthcare where you could safely apply a free market. “Hey, yeah, I see you have a cane, but have you tried my super luxury high speed low drag jet-powered hover cane? Guaranteed to be 1000% more like a Nerf commercial than any standard cane!”
“Woah, check it out, we built an MRI that’s way cheaper and doesn’t scare the shit out of people!”
“Hey, I found a medicine that cures baldness!” Etc.
Right? I can see the intersection of luxury (in the sense that not buying it incurs no cost, not even an opportunity cost), convenience, and healthcare being a place where there’s room for the free market. The problem is that we’ve gone and applied it to everything, including all kinds of things that shouldn’t be free market. Then you end up with all kinds of goofy fucking bullshit like corporates parenting stuff that the DOD paid to develop (Epi Pens, vaccine adjuvants, etc), GSK opting to develop a singles vaccine instead of a tuberculosis vaccine, etc, etc, etc. Oh, that last one is real. Here: https://www.propublica.org/article/how-big-pharma-company-stalled-tuberculosis-vaccine-to-pursue-bigger-profits
This is probably an unpopular take on Lemmy, but I believe that free markets generally work well where they exist. But there’s a lot of things that have no business being free markets, like healthcare, and aren’t free markets (and won’t behave like them) even if you try super hard to pretend that they are. You see, a truly free market requires the ability to say no and suffer no cost. You can buy Bob’s Widget, Jan’s Widget, or no Widget and be perfectly fine. This is not the case in healthcare. If you’re having a heart attack, your choices are:
-Agree to pay for this widget but we can’t/won’t tell you how much it costs until we’re done.
-Die
That’s not a free market, that’s not how free markets work.
A free market cannot have oversights or constraints. If it does it’s not free. Free markets have never worked. Will never work. And simply can’t exist. Either powerful entities will seek to control the market for themselves. Or if you’re lucky benevolent people in government will do their best to control the markets against said group. Someone is always controlling it.
The best we could ever hope to have is a fair market. And the only way to have a fair market is to have a market that is completely optional. Markets that deal and necessities can never be optional. Because Necessities are not optional.
I don’t care what they charge for luxury housing or fru fru fancy food. But we can and should provide desirable public housing and basic nutritious food for everyone. And if they want a luxury house. Or fancy food. Any of us are free to work to get it should we choose to. But the point is choose to. Not be forced to under coercion for basic survival.
See… you kid, buuuuuut…
This is super personal to me because it almost killed me. I’ve told this story on reddit, but it bears repeating:
tl;dr lost my doctors due to an insurance change 4 weeks in to a 6 week open heart surgery recovery…
In 2018, my company was in the process of being sold. No big deal, above my paygrade, nothing for me to worry about.
Then I got sick right after Thanksgiving. Really bad heartburn that lasted 5 days. It wasn’t heartburn. I had a heart attack. 12/3 I had open heart surgery, single bypass, and that started a 6 week recovery clock.
On 1/1, the sale of my company closed and we officially had new owners. I also officially lost all of my doctors because the new employers don’t do Kaiser in Oregon. They do it in WA and CA, but each state has to be negotiated and they never had presence here.
1/2 I start working with Aetna to find doctors, hospitals, etc. Beyond the cardiologist I need a new pharmacist, podiatrist, diabetes care and a general “doctor” doctor.
Fortunately, my new employer is a big enough fish, they have their own concierge at Aetna and she gets me into the Legacy system.
On 1/3 I start developing complications, but I don’t know it at the time. It starts with a cough. All the time. Then, when I try to lay down, like to sleep, I’m drowning, literally choking and gagging.
The concierge and I try to get an appointment, we’re told 2-3 months. For a dude still recovering from open heart surgery? Best they could do is 2 weeks. 1/14.
I can’t lay down to sleep so I buy a travel neck pillow and sleep sitting up.
I get to see the new doctor at the “official” end of the 6 week recovery. He doesn’t know me or my history so he wants to run tests.
I’m sitting at home playing video games and waiting on test results when the call comes… Congestive heart failure. Report to the ER immediately.
My heart developed an irregular heart beat, which caused fluid build up in my chest. They admitted me and were getting ready to pull fluid off me.
“What happened to your foot?”
“I dunno, what happened to my foot? I can’t feel my feet.”
Remember when I said I was sitting around playing video games, waiting for test results? Yeah, my foot was touching a radiator and I didn’t know it. 3rd degree burns, first four toes. Pinkie was spared.
So I’m in the hospital a week. I lose 4 liters of water per day. 50 lbs. of water. No wonder I was drowning. Regular bandage changes.
So now I’m facing two procedures. Electrocardio version to fix my heart, skin grafts to fix my toes.
This whole time the new insurance covers 80% until I reach the out of pocket maximum of $6,500. Then it will cover 100%.
The old insurance? ER visit for heart attack, hospital admission, 8 days in the hospital, open heart bypass… $250.
So we hit the out of pocket maximum almost immediately. My wife had a problem with her foot running through the Seattle airport. The doctor who did her toe amputation was decided to be out of network so that was another $1,100.
I was never unemployed through all this. I had enough vacation and sick time banked to cover it. Cobra didn’t apply. Buying my old insurance wasn’t an option, it was far too expensive without employer backing. Income is too high for assistance (thank god) and I took steps to max out my HSA account, which is good because we drained it twice.
Three 1 week hospital stays (2 for me, 1 for my wife), multiple ER visits, two more major medical procedures… That would be enough to break most people even with good insurance.
So if you read any of that, let me ask you something… Why does the quality of my health care and my quality of life have to depend on who I work for and what insurance companies they choose to work with?
This is always what I think of when I hear arguments that our health care is “free market”. If it were, you could fire AETNA and go back to Kaiser. But that’s not the case, so insurers aren’t really beholden to satisfying their users, because their users aren’t their customers.
it is free market. It actually is the definition of free market, accompanied with lobbying which is direct consequence of lack of regulations.
Yes exactly, anyone is free to set up a competing business, and incumbant players are free to make that as hard as possible while also being free to provide poor service because there is no viable competition.
Registered to vote, told this story to the Bernie Sanders campaign, told it again for 4 days at the HLTH 2023 conference in Vegas. And I’ll keep telling it until something changes…
I hate to say this, but you are asking for meaningful change in a trillion dollar industry. It’s not going to happen through stories, public awareness, or by any other peaceful means.
Yeah and Sanders dropped out and we got fucking Biden. And people defend Biden because he’s not Trump. Nothing’s going to change now that Trump took over the Republican party, because why the fuck should Democrats try to do better? All that matters to voters is that Democrats are not Trump.
Someone at some point should have told you this, but it rarely gets communicated until its too late. If you have peripheral neuropathy, even if you are not a diabetic, you should be doing nightly foot inspections with the aid of a mirror.
It drops the likelihood of acquiring an amputation by around 70%. Pretty much all my patients who have had amputations acquired them because they didn’t know about a foot wound before it became infected and spread to the bone.
Simply flashing your feet at a mirror kept propped next to a nightstand can significantly improve your overall health outcomes.
It’s really for any peripheral neuropathy that includes the loss of protective sensation (pain).
I got a question!
How did forcing the doctors who knew you were in the midst of a sensitive medical situation not get forced into violating their hypocratic oath?
So, a couple of things… Kaiser is a membership hospital, if you aren’t a member, you don’t get in and as of 1/1/2019, I wasn’t a member anymore. :(
There is this thing called “Continuity of Care” but that only applies for services I had under the old hospital that aren’t available under the new one.
Because the new hospital DOES have a cardiac department, continuity of care didn’t apply.
Lastly, the Hippocratic Oath is largely a myth. ;)
https://www.health.harvard.edu/blog/the-myth-of-the-hippocratic-oath-201511258447
“According to a 1989 survey, barely half of U.S. medical schools used any form of the Hippocratic Oath and only 2% used the original. In a 2011 study published in the Archives of Internal Medicine, about 80% of practicing physicians reported participating in an oath ceremony, but only a quarter felt that the oath significantly affected how they practiced.”
She has had multiple problems with ill fitting shoes and infections. She was running through the Seattle airport to make a transfer for a flight, got rubbed the wrong way, by the time he trip had ended the damage was done, the infection went to the bone and the toe couldn’t be saved.
She just had too much going on, her mother had died so it was a super fast emergency trip from Portland to Kansas and back.
I couldn’t go because I was still on my back from the heart surgery, so it was just her and our adult son.
Indentured Servitude is the point. Business want to make it difficult for you to find another job.
I don’t think that’s actually true in this particular case. Just about every single full time job has to offer a health insurance plan because all of their competitors are doing it. You simply can’t attract good labor without it. So the motivation of the company providing you with health insurance isn’t necessarily to keep you there, but rather to get people in the door to begin with. If the motivation was to keep you there, they’d offer a health insurance plan so amazing that you realistically couldn’t go anywhere else without taking a cut.
On a larger scale though, there are lots of reasons that people want to keep this system intact. In particular, the societal “benefit” of extracting the maximum amount of work possible out of its populace.
So we don’t fuck off work to mass protest and dine in the flesh of the wealthy.
Saved you a click.
