One thing to keep in mind in the United States is that the tax code is structured such that most working people are effectively forced to get their health insurance through their employer. This creates all kinds of problems such as distortions in the labor market and a greater likelihood of insurance companies to deny claims to save money. After all, even if a health insurance company gets a bad reputation for wrongly denying claims, it’s not as if people with their policies can easily drop them for another company the way they could with say auto insurance. Other countries that do have private health insurance such as the Netherlands and Switzerland don’t link it to employment. That is a unique and very negative feature of the American system.
I strongly agree, and part II discusses the origins of that toxic connection between insurance and employment. In addition to the distorted incentives for consumer satisfaction you mentioned, it also creates the problem that if you lose your job, you lose your insurance too, at exactly the moment you are most financially vulnerable and least able to afford out of pocket health expenses. It's a truly awful system that nobody would design from scratch and that ought to be completely overhauled.
I agree entirely! It is hard to imagine anyone designing a new health insurance system from the ground up choosing our terrible ramshackle system! I look forward to reading your part II!
I will follow along here. Looking forward to part 2, which incorporates the providers of the care. For a later discussion, I’ve had discussions with a forensic accountant who works for our government to investigate Medicare fraud. According to her, the fraud is actually coming from Russia hacking into those funds and stealing them to the tune of BILLIONS. Only a very small fraction of that fraud is coming from within the US. I can’t corroborate this information with publications…
I was relieved when you "liked" this haha - thanks for following and please don't hesitate to correct my mistakes. I'll give you a preview of Part II since you have more personal background than most on this stuff. There's a section on Americans living less healthy lifestyles. Another section on the incentives for providers to overtreat and overcharge, with some alarming stats on waste and fraud. A section on the FDA and AMA restricting competition. And another on why ultimately, the responsibility for creating and fixing this mess lies with policymakers, rather than expecting companies to be less greedy from the goodness of their hearts. So all in all, probably some stuff you'll like and other stuff you won't - but you're not allowed to get mad at me until after I defend doctors towards the end!! :)
Obviously I can't comment on Russia's involvement, but it does check out that Medicare fraud is easy enough that organized crime is in on it. Some criminals reportedly switched from drug trafficking to health care fraud, having discovered that defrauding Medicare is safer and more lucrative and carries a lower risk of detection and prosecution. https://www.cbsnews.com/news/mafia-violent-criminals-turn-to-medicare-fraud/
One thing to keep in mind in the United States is that the tax code is structured such that most working people are effectively forced to get their health insurance through their employer. This creates all kinds of problems such as distortions in the labor market and a greater likelihood of insurance companies to deny claims to save money. After all, even if a health insurance company gets a bad reputation for wrongly denying claims, it’s not as if people with their policies can easily drop them for another company the way they could with say auto insurance. Other countries that do have private health insurance such as the Netherlands and Switzerland don’t link it to employment. That is a unique and very negative feature of the American system.
I strongly agree, and part II discusses the origins of that toxic connection between insurance and employment. In addition to the distorted incentives for consumer satisfaction you mentioned, it also creates the problem that if you lose your job, you lose your insurance too, at exactly the moment you are most financially vulnerable and least able to afford out of pocket health expenses. It's a truly awful system that nobody would design from scratch and that ought to be completely overhauled.
I agree entirely! It is hard to imagine anyone designing a new health insurance system from the ground up choosing our terrible ramshackle system! I look forward to reading your part II!
You can read part II here: https://exasperatedalien.substack.com/p/a-more-plausible-story-for-how-us
I will follow along here. Looking forward to part 2, which incorporates the providers of the care. For a later discussion, I’ve had discussions with a forensic accountant who works for our government to investigate Medicare fraud. According to her, the fraud is actually coming from Russia hacking into those funds and stealing them to the tune of BILLIONS. Only a very small fraction of that fraud is coming from within the US. I can’t corroborate this information with publications…
I was relieved when you "liked" this haha - thanks for following and please don't hesitate to correct my mistakes. I'll give you a preview of Part II since you have more personal background than most on this stuff. There's a section on Americans living less healthy lifestyles. Another section on the incentives for providers to overtreat and overcharge, with some alarming stats on waste and fraud. A section on the FDA and AMA restricting competition. And another on why ultimately, the responsibility for creating and fixing this mess lies with policymakers, rather than expecting companies to be less greedy from the goodness of their hearts. So all in all, probably some stuff you'll like and other stuff you won't - but you're not allowed to get mad at me until after I defend doctors towards the end!! :)
Obviously I can't comment on Russia's involvement, but it does check out that Medicare fraud is easy enough that organized crime is in on it. Some criminals reportedly switched from drug trafficking to health care fraud, having discovered that defrauding Medicare is safer and more lucrative and carries a lower risk of detection and prosecution. https://www.cbsnews.com/news/mafia-violent-criminals-turn-to-medicare-fraud/