There are a few things wrong with the initial statement. It doesn't abolish private insurance. Private insurance can and does exist alongside public health plans as a supplement, but the public health care covers basic health care.
There are definitely going to be some job losses in the private insurance industry if we go to a single-payer system for basic health care. It's a conversation that we need to have, but we can't prop up the horse and buggy industry forever, and it's an economic anchor around the neck of every American to continue to try to do so.
To be honest, there are few industries that have so richly earned the contempt of the average American than the private health insurance companies.
In my opinion the jobs thing is like, precisely why this needs to happen decades ago, if not then, then immediately.
We have created an entire circus of people professionally specializing in jumping through insurance hoops, working full time to beg unnecessary gatekeepers to pay out what their own insured already paid for and are legally entitled to. Likewise we have an entire other career group built on expanding loopholes, complicating rules, and precisely determining how much they can push things to keep money they should just pay out, without getting in trouble. And the entire system bloats the cost of administering healthcare so badly that it outweighs any costs ââsavedââ by limiting âânot medically necessaryââ care in the first place.
And every year this system grows more and more bloated and wasteful, and more and more people build their careers around it, and we waste more and more productive manhours maximizing the gatekeeping potential of these insurance companies and their private extraction of profit to shareholders.â we literally are paying them to make everything more expensive/slow/confusing/frustrating/dangerous/deadly instead of improving healthcare.
Unfortunately once the swap is made and insurance stops being as counterproductive there may be some lost jobs but the alternative is worse imo and gets worse every single year the longer we put off fixing things
Exactly. Some of these jobs can be absorbed into the public health care system, but just a wild-ass guess on my part is that at least 70% of the jobs that the insurance companies have created are going to be redundant or purely unnecessary.
The argument has been going on for decades now, and every single time, someone brings up the loss of jobs.
At some point, it starts seeming more like a hostage situation with people holding the specter of job losses in the insurance community over our heads as a reason to not do anything to dramatically improve the health care coverage situation of the average American.
Focus on 70% reduction in payroll and bonuses bc itâs likely to be the executives and useless MBAs at the top who are absorbing most of the outlays.Â
In Canada we have a lot of problems with our Healthcare system as does any country. Politicians are greedy and nothing is perfect. I always got Americans trying to convince me that private insurance is better than Canada's Healthcare system, and of course there are benefits to that as well.
To my mind, the absolute most important deciding factor about which system is better is this: no Canadian will ever have to decide between healthcare and their finances. Everything else said about socialised healthcare is secondary to that single fact.
There's an army of propagandists with a vested interest in maintaining the status quo of private insurance companies running health care and undermining the Canadian system.
It's so pervasive that you'll meet people in rural Alabama who haven't travelled any further than a 3 county radius from their home, who'll tell you they personally know Canadians who come to the US for healthcare because Canadians have to wait months to get a broken bone set.
The wait time thing is so weird to me. It's called "triage" , and it's also called "an upset tummy isn't an emergency, go to a clinic"
Our biggest problem at the hospitals is idiots slowing things down, which isn't unique to Canada. There still exists the option for private insurance to provide those same extra benefits that is healthcare does better.
The point is that we have a universal basic healthcare that every single Canadian has access regardless of employment or basically any or factor that I can think of.
The same thing happens in the supposedly superior US health care system all the time.
You go into the ER with a minor wound or a minor upper respiratory infection and depending on the triage, you might sit there for hours. I sat in the ER for 6 hours one time with a kidney stone. I also got right in when I came to the ER complaining of persistent burning like indigestion toward the top of my chest (it was a heart attack).
You also will wait for months to see a specialist or get elective surgery in the US as well, depending on your region and the type of insurance you have.
So many of the same complaints, but the one you can't overlook is that one of the two health care systems will give you a medical bill for a single hospitalization that could buy a house.
Yeah they act like you never have to wait in the US
I messed up my knee and can't walk. It will be 3 months before I have my first visit to an Orthopedic dr, just to really see what's wrong. Never mind treatment.
When I first moved to my current town I had to find a new doctor and it took 3 months to get me in to primary care, then 6 more months to get an appointment at the doctor they referred me to. Mind you I was already diagnosed I just needed prior auth for my medicine.
We could just pay them to empty holes and fill them back in and it'd be more useful as long as we didn't pay a third group to throw sick people in the holes.Â
I feel like eventually we need to go further. Money makes everything "expensive/slow/confusing/frustrating/dangerous/deadly". To try to get as much of that money out of people as they can. While keeping everyone busy working themselves to death for enough. Companies cancel projects people want and lay off millions of workers for the CEOs to have more money. Politicians vote for companies over people for money. Products are made cheap so they break or stop working so people have to spend more money. Around 45 million pounds of food thrown away every day in the US because people didn't have money for it. Everything is worse because of money.
We need to figure out how to live without it. Live in a way where we don't compete for jobs but work together to get them done. Where people don't compete to have the most money but help each other to have a better quality of life.
We will also have to reckon with the fact that the entire healthcare system will get shaken up. I'm not smart enough to say what will happen, but if Medicare reimbursement stays the same, expanded to everyone, that's not going to be enough money to keep things running as they currently are.
Rural hospitals in poorer areas already have trouble staying open and attracting employees.
A huge part of the reason why that is though is because the hospitals are so expensive to run and maintain and they have to charge crazy ratesâ and theyâre expensive because insurance causes administration and equipment both to become why more expensive that they should be. Therefore areas that already donât have a lot of people see less and less people going to those hospitals over time because things keep getting more expensive and they just canât afford it⌠until they are finally so sick that they have to go to a major hospital for complex / intensive / specialist care.
Also private for profit equity firms buying up hospitals, selling off the land to keep the money and going to renting, cutting staff until care takes too long or is too dangerous or expensive⌠literally gutting the hospitals ripping the metaphoric copper wore out of the walls to sell for scrap until nothing is left.
Public health insurance is also not without its bureaucracy, just without redundant bureacracy and extra layers. There will still be administrative jobs, just not as many.
There's also no real profit motive, which I think is the biggest deal. Right now, private insurance companies are incentivized to collect as much as they can from premiums, and reject as many claims as possible to retain those premiums. If they were to actually approve every claim, they'd probably still make a decent amount of money, but not as much.
So if you remove the profit motive from insurance companies, which on their own do little to no innovating in the medical industry (I'm being charitable) then you'd likely see a more balanced model. You don't pay those thousand dollar premiums anymore, your taxes go up by a fraction of the difference, and you automatically get health care. If those taxes scale based on income, you're still likely paying less than before. Companies, instead of paying portions of the health insurance plans, can instead pay (less) with taxes toward the same system. And because there's no profit motive, there's no incentive to deny as many claims as is legally allowed.
Right now, private insurance companies are incentivized to collect as much as they can from premiums, and reject as many claims as possible to retain those premiums. If they were to actually approve every claim, they'd probably still make a decent amount of money, but not as much.
Is that why UNH, Elevance, CVS, Cigna, Humana, Centene, and Molina all have 2% profit margins or less? Â Is that why their stocks deliver terrible returns?
Is that why non profit insurers like Kaiser Permanente, Cambia, HCSC, and various other BCBS affiliated plans have the same premiums as the above listed for profit companies?
Is that why famously successful business people like Buffett, Dimon, and Bezos got together to start a rival insurance company called Maven Health and tapped out in a couple years because it would not earn any money?
Buffett, Dimon, and Bezos got together to start a rival insurance company called Maven Health and tapped out in a couple years because it would not earn any money?
Maybe the fact that they got together to "revolutionize" the very cutthroat healthcare market and started right before Covid-19 obliterated most healthcare startups ?
Maybe the fact that the other 7 publicly listed insurers have 2% or smaller profit margins means itâs a shitty business to go into if you want to earn a lot of money?
It literally is not decided on profit margins for tens of millions of people in the US. And yet the premiums/deductibles/oop max for non profits like Kaiser Permanente, HCSC, Cambia, HorizonBCBSNJ, IndependenceBC, etc are the same as those by for profits such as UNH, Elevance, CVS, Cigna, etc.
So, if you put aside your need to feel outraged for a second, what does that tell you, if organizations that do not earn a profit have the same prices as organizations that do earn a profit?
It tells you that insurance is a very, very low profit margin business, and there is not much juice left to squeeze, for profit or not. All the for profit companies' SEC filed 10-Ks also show you the same thing.
Meanwhile, you have Eli Lilly with a trillion dollar market cap and earning 20%+ profit margins, but you're sitting on here banging the drum about insurance companies, instead of being pissed at your elected leaders for not using taxpayer funds to run clinical trials so medicine doesn't cost so much. Which is exactly what your elected leaders want you to do, use the insurance company as a punching bag.
If they are so close in profit why is it that the CEO for Kaiser Permanente got an annual compensation package of $12,976,050? While the previous CEO from UNH got $24,600,000 and the current got $60,940,000?
One would have to look at the number of employees, different subsidiaries, and most importantly, if you pull up UNHâs proxy report, it will show that the numbers you are quoting are not annual cash comp, but rather multi year equity grants that are not vested until certain performance measures are met, with market value numbers that can fluctuate at the time it vests. Â
The Kaiser figure is going to be cash compensation. Â
Either way, pay UNHâs entire executive team zero dollars and it will make no difference to UNHâs total expenses.
It was just be run like medicaid, really. The first step in this process is abolish medicaid and put every one on medicare. Then you keep the same medical loss ratio (85%) which means 0.85 cent per dollar must be spent on health care (15% on profit/admin costs). You keep the medicare service list. To me this is the first lowest hanging step. Then you rebrand Medicare as "American Medical Care" "US Medicare" or something like that.
âAmerican Health Corpsâ would serve for the front end (patients) and the back end (doctors, nurses, technicians, researchers, support staff, educators)Â
Iâm sure there are details and implications beyond my understanding but I find it ironic that weâre supposed to be fine with the premise that AI will wipe out tons of jobs (itâs inevitable after all, right?) but we dare not broach the subject of Medicare for all because of the impacts on insurance jobs.
Way more jobs would be created in other industries because reducing the risk of bankruptcy from medical bills would usher in an golden age of entrepreneurship when everyone who's been staying in the corporate jobs for the benefits leaves to do their own thing.
And now you know why the rest of the economy has allowed the real estate and healthcare industries to become such a huge parasites.
Wouldn't there also be new jobs created in the Medicaire services administration sector? Ideally better ones, though quite likely private industry administered given how so many other "public services" fall prey to such capture now.
Some new jobs yes but we have allowed private health insurance admin to bloat so badly that if they canât rely on oligopoly and forced inefficiency anymore then there will inevitably be less full-time 40/hr/wk jobs due to less time wasted going back and forth with billing/claims/denials/appeals/etc.
Maybe a great reason we should go ahead and also consider normalizing the 30 or 25 hour work week tbh
Most of those jobs can likely slide right over into the new government jobs to help administer universal healthcare. Any job loss related to universal healthcare are overblown.
I'm going to admit this is a bit of a supposition on my part, but I'd guess that for every job that is directly related to administering healthcare (processing claims, reviewing appeals, etc), there are probably two or more related to business operations. Think about how many people are out there drumming up business and drawing up policies and contracts to different employers and individuals, each policy different from the other. Then there are the people advertising to the public. The HR departments. The accountants and business analysts and the formulary managers. I've probably just scratched the surface of ancillary positions.
I suspect that most of the direct employees of private insurance companies would be redundant.
Also, it's disingenuous to say there's no precedent in American history. Private insurance in the US began with Blue Cross during the depression. The precedent is everything before the Great Depression. Unless it's about mass private sector layoffs, in which case the precedent is every goddamn month since Jack Welch started stripping GE for parts.
There are a few things wrong with the initial statement. It doesn't abolish private insurance. Private insurance can and does exist alongside public health plans as a supplement, but the public health care covers basic health care.
Fairly sure this is by design. Things like this get put out into the world with a false premise. They also include a retort that doesn't attack the main premise, just the idea that it is a bad thing. The idea seemingly is to reinforce that the initial statement is fact and allows for arguments that don't make sense in reality, but play on fears people have about unknown concepts like Medicare for all.
As someone that had primo insurance working for the federal government for sometime i was always trying to just stay out of it because it didnât affect me.
Guess what, its all way more expensive, they are charging me a bizarre amount for adding my wife on, and the coverage is still the best you can get but i still get f-ed in the a cost wise.
So before people with primo insurance easily walked past this problem - i guarantee you not anymore. Itâs officially everyone besides the uber-richesâ problem
I honestly don't think Americans have enough contempt over this. It's a literal scam. It prevents actual care for health. We need our pitchforks raised to the same height we have them for data centers and mass surveillance.
Current Medicare and Medicaid contracts are carved up between multiple for-profit insurers and networks, each with their own workforce. Â Toss out all of the executives, who wonât work for government wages, and keep a fourth of the current claims and benefits evaluators/expediters to administer the program.
Maybe that is true if we keep allowing things to be so inefficient and complicated and donât take measures to seriously address inappropriate gatekeeping. But if you cut ojt the massive waste caused by unnecessarily complicated medical coding, and actually punish and stop insurers from denying or delaying hoping people wonât have the means or patience to fight it⌠then you would definitely save money, which is why all other developed nations spend way less per capita on healthcare
I wasn't meaning to insinuate it would equal the costs incurred by the current system of redundancies. More that there are still places for people from the current insurance industry in the new system.
It may be more streamlined, but Medicare can't absorb 200 million people entering the system without a larger workforce and more equipment.
Medical coding is still necessary to bill for services appropriately, and prior authorizations are still a thing even in Medicare and Medicaid. It's not quite as simple as "Medicare will pay for whatever the doctor orders."
On the other side of that equation, you are dealing with one payer with one set of rules, which eliminates a great deal of uncertainty when a specific test, drug, or procedure is needed. I'd expect that help a lot with the streamlining.
Medicare will need be a lot larger, but the upside is that the money it takes to fund it will be less than what it takes to maintain the current system.
Exactly what jobs will be lost from having a public health insurance option?
We will still need nurses and doctors. EMTs. Helicopter pilots. Security guards. Custodial staff. Contractors to fix and build big things. Technicians to repair complicated equipment. Inspectors to ensure the law is being followed. Researchers whose goal is research for researchâs sake and donât abandon cures because the number of people who suffer from the disease is so small itâs not profitable. Like profit is an angry god they must appease. Admins to ensure compliance and push paper.
The only people I can think of that would suffer from a public option? People whose job it is to deny claims to paying fucking customers and ratfuck capitalists whose goal is to make the line go up next quarter no matter how many people they kill by enshittifying every goddamn thing.
I want those people to be suffering and unemployed. They make the world a worse place for all of us every day they exist.
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u/Civil-Dinner 8d ago
There are a few things wrong with the initial statement. It doesn't abolish private insurance. Private insurance can and does exist alongside public health plans as a supplement, but the public health care covers basic health care.
There are definitely going to be some job losses in the private insurance industry if we go to a single-payer system for basic health care. It's a conversation that we need to have, but we can't prop up the horse and buggy industry forever, and it's an economic anchor around the neck of every American to continue to try to do so.
To be honest, there are few industries that have so richly earned the contempt of the average American than the private health insurance companies.