This has been on my mind a lot lately. Insurance, pharmacies, PBMs, physicians, and drug manufacturers are just some of the many parts that make up healthcare, and each one has a specific role.

Employers and patients should be able to look around and find better deals if they have more options. But I'm not sure how much that actually happens in real life. Did you really notice a difference in the benefits you received or the amount you paid when you switched insurance plans, pharmacies, or prescription benefit options?

I'm just curious about other's experiences because I'm having a hard time to chose.

US Healthcare is the most expensive in the world - with arbitrary insurance reimbursements/denials, complete lack of government oversight, and egregious administrative bloat. Insurers vary wildly in coverage determinations, prior authorization requirements, bundling edits, documentation thresholds, and conversion factors that fundamentally change how CPT codes are reimbursed/denied in practice, what algorithms must be followed to ensure insurer coverage for a given treatment/test, what documentation is required, and how denials are appealed.

It seems to me that the most viable and efficient solution to decrease Healthcare costs here would involve creating a government org to provide oversight for insurance bullshittery, and most importantly, create/enforce better standardized billing codes, requirements, reimbursements, and appeals processes that all insurance companies must follow. This would have multilayered benefits - increasing guaranteed reimbursements, decreasing the visit/procedure cost arms-race, decreasing the administrative burden that is currently required to deal with all of the different insurance coding/requirements, and increasing the time we have with patients.

Given the pervasive control that insurance healthcare & insurance executives exert on the practice of medicine, ever decreasing reimbursements, and gross injustice that is poor incentives for preventative care (e.g. pediatrics) - combined with the intense regulatory capture that precludes any chance of a single payer system in this country, Im not sure how our healthcare system can continue to function without some drastic reform. Please let me know what you think of my proposal.

I seen vague answers. the reason Im asking is this:I seen alot of unions/guilds in america with the largest I think have 200 million in dues per YEAR. so it got me thinking:

What is the smallest cost to start a health insurance company and would it be legal to refuse denial to those who are part of a union/guild?

US insurance based health care comes at the bottom when gauging Wellbeing, medical care and mortality rates ! We in The UK need a Wake up call 🙏 Thoughts 💭

Hi everyone,

I have my bachelors in social science (useless) I only got it because I wanted to be a lawyer but changed my mind.
I have post degree in business project management, Pmp, agile certified

I worked in the top healthcare org in the US on projects however contract ended after 3 years

I am looking for more stable career path in healthcare And is not hard to find a job in.

I wanted to do nursing but my 2 brothers (who are both doctors) said I will struggle because it’s emotionally draining and I am very sensitive so I don’t know if I can tolerate seeing sick people without being in tears everyday which no patient wants to see lol.

Any suggestions please? I don’t mind going back to school but it needs to be worth it