2w ago

Why can't someone create a public alternative to health insurance in the USA?

Health insurance at its core is very simple. You put money in, you go to doctor, insurance pay doctor. But in the USA, the insurance denies everything they possibly can. Money put in doesn't ever see a doctor or your health costs, it goes right to the stockholders....

So why doesn't someone just make a non-profit health insurance company where there's no stock, no executives, just public servants and aggressive price negotiation where your medical bills are actually paid with the money put in?

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39 comments

Healthcare co-ops exist. But a good number of people get health insurance through their jobs, and those jobs usually contract with one of the big corporations.
- Yep, and it's not like it's just cheaper, benefits packages are tied into compensation.
  Say you pay $400, insurance says the real price is $800, and your employer only pays another $200 as a "discount" but the real cost is actually $600. But turn down coverage, you don't get that $200 in extra pay.
  Without an employer, you have to pay the whole $800.
  With a co-op you'd pay the actual real cost of $600.
  It needs a critical mass of people.
  And OP doesn't understand a non profit still has a CEO that can be paid millions. The organization can't make a profit, but lots of corrupt people make a lot of money running non profits.
  
  It is over $1000 per moth for me that I'm turning away. there is just no way anyone can compete with that. much as I don't like my insurance my costs must go up by a lot if I skip my companies insurance.
  
  Yeah. I was just making up numbers for illustrative purposes.
  As much as people shit on the VA, they've been my healthcare provider for over a decade and I just legitimately don't know what numbers look like anymore.
  It's not perfect, but it's a hell of a lot better than the majority have to deal with
  
  And the more you dig into it, the worse it gets. That price discrepancy exists at the provider level too.
  You have a health issue and need treatment.
  The treatment cost the Dr $200 to perform.
  The list price for the treatment is $500.
  The big insurer uses the weight of their customer base to negotiate with the Dr and the agree to pay $300 for the treatment. If the doctor doesn't accept, then they're out of network and can't get patients.
  The plucky startup co-op doesn't have the same negotiating leverage, so they have to pay $400 for the treatment.
  The co-op is going to cost more to operate, and now the real monthly cost you have to pay with the co-op is $700 instead of $600.
  And it gets worse.
  This video is a nice little primer about how the insurer might not even pay that $300 they agreed to, how that let's them profit further on the treatment while creating financial pressure on healthcare providers, and how your Dr may end up being owned by the insurer, further reducing the ability of a new co-op to compete.
  
  Everything with "middle men" is like that.
  Numbers get inflated then discounted.
  It's why it's present at every step of capitalism, at every step someone takes a cut, so the price is inflated, then "discounted" to what consumers are willing to pay which is still an insane profit margin.
- According to this, there are only three co-ops left —down from 23 when the ACA became law.
  https://www.healthinsurance.org/obamacare/co-op-health-plans-put-patients-interests-first/
- Blue Shield of California is a “big corporation” that employers here often contract with for health insurance, and it is a non-profit. Somehow this doesn’t really result in a dramatically different experience.

39 comments