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Do you think medical insurance is a money-making scheme?

US medical insurance, the ultimate magic show! It's like they play hide and seek with coverage, offer deductibles taller than NBA players, and speak in insurance jargon that's harder to crack than secret codes.

But here's the real kicker: Prior authorization denials are their favorite disappearing act! "Poof! Denied!" Then, "Abracadabra! Approved!" Just when you thought you needed a PhD in insuranceology, they surprise you. It's a wild ride, folks!
twiigss · M
The entire US health system is for profit. That is the number one problem with this world. Greed. Money is the world's worst invention. It does nothing but hold us back from being our best selves.

But because of money, everyone who works as a nurse, a doctor, a surgeon, a secretary, lab technicians, all want their share fair of this huge pile of money.

And that's why healthcare in this world sucks. At the end of the day, they only care about money, not you. Oh sure, they'll do what they have to do, to take care of you, but you better pay that $2137.44 bill.
samueltyler2 · 80-89, M
@twiigss that works for minor care, but not fir big price services.
twiigss · M
@samueltyler2 well money is the world's number one problem. So we are concerned with future proofing the human race. So why can't that be done if it's so important? Why does money have to be an issue?

I'm sorry but if I wanted to get something done that benefitted the human race, I would say to hell with money. What good is money if you're dead?? Exactly.
samueltyler2 · 80-89, M
@twiigss I we t onto academic medicine so I wouldn't have to worry about seeing a set number of patients a day to pay for my office expenses. Unfortunately even academic medicine changed a lot. I was lucky enough to have my research grants pay my complete salary, so I could spend whatever time I wanted saving lives.
I have read from those in the industry, and for that matter at the social security disability office, it is most common to deny any claim three times. Most will give up. Problem solved.
That we have some of the best medical technology in the world, and yet we have some of the worst healthcare in the world, is a sad statement about how money trumps everything. If you can’t get rich doing it, it shouldn’t exist
WiFiWitch · 41-45, F
@SatyrService Ah, the American healthcare system: where 'cheaper to die' sometimes feels like the unofficial slogan
martyjay · 46-50, M
Any kind of insurance is a money making scheme.
whowasthatmaskedman · 70-79, M
@martyjay Insurance of any kind is betting against the house. Literally. They exatcly what actuaries do. Calculate the odds and add the edge for the house..If you think you can beat the odds, dont take the bet and you will be in front...😷
plungesponge · 41-45, M
From what I can see, the entire insurance scheme in the US is a scam. They offer you medical coverage while working, but if you get too sick to work it goes away? That's like selling umbrellas when it's dry and confiscating them when the rain starts. It's modern day slavery
Richard65 · M
Each year federal agencies receive funding from Congress, known as budgetary resources . In FY 2023, the Department of Defense (DOD) had $2.04 Trillion distributed among its 6 sub-components.

So in the USA it is acceptable for the DOD to be financed to the tune of trillions from the public purse, and nobody thinks of this as socialism or communism. But if the idea of a Universal Healthcare system is proposed, financed by the public purse, then that somehow becomes unacceptable as it smacks of socialism or communism?
Sure. By design, US medical insurance sets prices such that the company can return a profit to stockholders. That's capitalism!!
WiFiWitch · 41-45, F
@ElwoodBlues but ....because of insurance companies...health care is expensive
deadteddy · 26-30, F
Sure. It’s not philanthropic , they just wanna make profits.
WiFiWitch · 41-45, F
@deadteddy but shouldnt health care be about helping people?
deadteddy · 26-30, F
@WiFiWitch It should. But it’s not. Not if it’s not a universal healthcare system. And even in that system there are doctors who don’t give a damn about people, zero empathy. Some doctors do study medicine for money and status rather than for assisting people.
Diotrephes · 70-79, M
@deadteddy Why do you expect them to work for free?

If you want free medical care then use the biblical health care plan =

James 5:13-16 (CEV) = "13 If you are having trouble, you should pray. And if you are feeling good, you should sing praises. 14 If you are sick, ask the church leaders[a] to come and pray for you. Ask them to put olive oil[b] on you in the name of the Lord. 15 If you have faith when you pray for sick people, they will get well. The Lord will heal them, and if they have sinned, he will forgive them.

16 If you have sinned, you should tell each other what you have done. Then you can pray for one another and be healed. The prayer of an innocent person is powerful, and it can help a lot."
BarbossasHusband · 36-40, M
What isn't a money making scheme? Especially these days?
WiFiWitch · 41-45, F
@BarbossasHusband ill get back to you on that one....
Picklebobble2 · 56-60, M
I doubt any other country on Earth would put up with it and call it healthcare
ArishMell · 70-79, M
I don't know about American medical insurance specifically, but all insurance companies are in it for the money and are far keener at taking premiums than settling claims - even allowing for their rightly having to ensure claims are fair and legitimate.

By telephone call, I've just had my home insurance renewal reduced from the wanted a near-£100 increase from last year with no intervening changes or claims - to a more sensible figure.

(I don't pay medical insurance as such because I am an NHS not private-care patient; but when working my National Insurance contributions from my Gross Pay helped pay for everyone's health and welfare, including the State Pensions of those already retired)

"Insuranceology"... I like that term!
dancingtongue · 80-89, M
For-profit insurance companies with stockholders to appease certainly contribute to the problems. But there is a fundamental flaw in how doctors and hospitals are paid as well, whether they are for-profit or non-profit: the traditional fee-for-service piece rate approach, which leads to unnecessary services being added on and $15 band-aids from mark-ups. Part of Obamacare, if it wee allowed to fully roll out, was to gradually shift to payment based on type of medical procedures required with quantified serv ice and quality standards factored in.

Layer on top of this the lack of universal coverage but mandated treatment of everyone regardless of their ability to pay. This is a triple whammy in that (1) hospitals in particular, but medical personnel as well, factor in the need to cover the expenses for these people who show up in the ER, (2) the ER is one of the most expensive venues to provide care, and (3) many of these ER visits, or treatments at all, could have been avoided with cheap preventive health care services . But the uninsured put off such visits until they are so sick they need the ER.
ninalanyon · 61-69, T
@dancingtongue Perhaps we should pay doctors in the way that a story I read once said that doctors were paid in ancient China. There you paid your doctor while you were healthy. If you fell ill you stopped paying until the doctor cured you.
dancingtongue · 80-89, M
@ninalanyon Exactly what Dr. Sidney Garfield used as his inspiration for founding what is now known as the non-profit Kaiser Permanente medical care program, where the medical groups are paid a monthly per member flat rate and individual doctors are salaried. The model for the HMO concept, which unfortunately got twisted by for profit insurers into "mother may I" operations forgetting the original concept.
All insurance is money-making.
Like gambling, the odds always favour the house.
Except the insurance accountants have the advantage of mass statistics to weight the chances in their favour. The game is rigged; the majority of punters are more likely to lose than win.
Otherwise, the industry wouldn't survive and couldn't list its companies on stock exchanges.

The smarter bet is to live a healthy lifestyle,
and if possible invest savings in something that beats inflation,
to save for a rainy day.
JSul3 · 70-79
@hartfire True. The ultra wealthy don't have health insurance. They pay $$$.
Richard65 · M
Universal healthcare is communism. Apparently.
WiFiWitch · 41-45, F
@Richard65 pfft, most people who accuses of something of being communist or socialist doesnt understand what communism is...
Richard65 · M
@WiFiWitch agreed. The UK has a National Health Service, free to everyone at the point of use, and we're renowned for being a hotbed of hardline communist ideology.
JimboSaturn · 51-55, M
Insurance is a business intended to make money. All business try to maximize profit.
iamBen · M
My experience is that USA insurance is mostly a scam. Things improved a lot when they ACA got rid of the pre existing condition rip off. Huge deductables, denied care, balance billing, it seems to me that, basically, insurance is in the business of not paying to the greatest extent they can get away with and providing nothing that benefits actual medical care.
whowasthatmaskedman · 70-79, M
Of course it is. At all levels. Pharma production. Just look at that stunt with the price of insulin a few years ago). To price gouging medical equipment and hospital stays.. Then malpractice insurance to raise costs, and finally health insurance itself. The US system feeds directly off the ill and infirm.. Bl**dy Vultures..😷
It is, it’s about making money. Not preserving life or even health.
@WiFiWitch I much prefer the idea of it. It blows my mind that something which would save lives is dismissed even by people in the U.S. whom it would [b]help[/b] because they see it as "socialism" ! 🤦🏻
WiFiWitch · 41-45, F
@bijouxbroussard i mean the fire dept and police dept kinda operates the same way...why cant health care??
@WiFiWitch And public schools. You could explain this to them indefinitely. I’ve tried. They don’t hear.
JSul3 · 70-79
The USA is Corporate America. It is about profits. It will always be about profits.
The US has the highest costs for healthcare than any industrialized nation.
Highest drug costs.

Big Pharma, just like Big Oil, own the politicians.
Until we have non-profit healthcare, nothing will change.
beaglehunter · 70-79, M
ya be late on a payment they are ready to drop you.put in a claim and get ready for a fight.they are as bad as the mob
Diotrephes · 70-79, M
@twiigss You have my best wishes for good health. Things can get depressing when you, and loved ones, become sick. I think we are all better off, regardless of our conditions, intoday's world than we would have been in the past. Lots of health care plans have maximun out-of-pocket limits, which can vary quiet a bit among them. We should be glad that we don't have to pay the total bill.
twiigss · M
@Diotrephes Thank you, that means a lot. I wish you good health too 🙂
Diotrephes · 70-79, M
@twiigss Thanks for the kind words. I expect that my health will take a turn for the worse within a couple of years. I am working on getting my affairs in order. It's a lot of work and I want to get it done while I'm still healthy. When I do get sick, I don't plan on hanging out at the hospital. I hope I will go into a coma at home and fade away.
OldBrit · 61-69, M
Yes. It's how capitalism works. You sell goods or services for more than they cost you to provide. That's the system we all openly accept and support.
plungesponge · 41-45, M
@OldBrit I feel like the kids are just about ready for a revolution
OldBrit · 61-69, M
@plungesponge they said that when I was a kid 🤷🏼‍♂️
Ontheroad · M
Yep, a huge money-making racket. Something like $31 billion net profit in 2020, but it declined during Covid, then regained almost all of that in late 2022/early 2023.
beaglehunter · 70-79, M
how the hell do you think they get the money to build all those high rise office buildings.they are the worst crooks in the world
WiFiWitch · 41-45, F
Dont forget the stadiums named after them
samueltyler2 · 80-89, M
Unfortunately the big insurance companies, and pharmaceutical companies have all the power.
supersnipe · 61-69, M
From what i hear, they're careful to keep the politicians on side. So i wouldn't expect much change.
pentacorn · F
of course it is... we're paying out enough to make doctors, hospitals, and ins co.s rich as hell, but getting less and less care for our dollar. there are big time lobbyist making sure health care stays a scheme in the U.S.
pentacorn · F
@OldBrit that's a shame, and i do mean a real shame, how they use manipulation to reach their end goal. you will see people lose everything over major illnesses. i've just been watching [i]Call The Midwife[/i] and how the NHS changed the lives of the suffering poor and improved conditions for the entire nation. the greed of the U.S. is like a cancer metastasizing across the ocean.
OldBrit · 61-69, M
@pentacorn that's filmed in my home town in the old dockyard where many of my family worked
pentacorn · F
@OldBrit ah, cool. now i won't be able to watch without thinking of you. it's a really great show, although i miss Jessica Raine since she left.
SunshineGirl · 36-40, F
It is a poorly regulated and inefficient means of providing healthcare. If companies seek the privilege of profitting from peoples' ill health, they should be compelled to offer universal coverage. Any idiot can turn a profit our of insuring essentially fit and healthy people.
It absolutely is.
WhateverWorks · 36-40
I do.. but then I think about my family member in Canada waiting weeks for their MRI then more weeks for his results to see if the cancer treatments are working or if it’s getting worse. 🙁
Puppybog123 · 13-15
Buy your own insurance that way you don't get scammed by the government
Of course it is. That's why they are in business.
CheshireAzur · 36-40, F
Obviously when it's for profit.
Yes, and Obamacare made it worse.
WiFiWitch · 41-45, F
@NativePortlander1970 it wasnt really a closed ended question
@NativePortlander1970 Gosh, somebody said something about a "secret agreement" on youtube, therefore you believe it's true?? How naive are you???
Kwek00 · 41-45, M
@NativePortlander1970 I hope Bigone5555J is right about this video. Because the rest of his material seems extremely dubious.

[b]SOURCE:[/b] https://www.youtube.com/@Bigone5555J/featured

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