All your post required.
Why do we allow private insurance companies to decide how health care is accessible?
- Thread starter Hume
- Start date
SmarterthanYou
rebel
don't make excuses for your lack of brain cells. the only thing you had was to make a trump reference, which was moronic considering who you were talking to
bye jerkoff
T. A. Gardner
Serial Thread Killer
Everybody thinks you are stupid.
Public or Private? The Battle Over America's Essential Services
Every day, Americans interact with services that could be run by either government or private companies. The water from your tap, your child’s school, mail delivery to your door, the electricity powering your home—all represent fundamental choices about who should control these essential...
govfacts.org
Do Government Programs Outperform Their Private Sector Counterparts in Terms of Efficiency? in 2025
In 2025, a question is often raised about the efficiency of government programs compared to their private sector counterparts: Do government programs outperform their private sector counterparts in terms of efficiency? While the answer may vary depending on the context and specific programs in quest
www.linkedin.com
Privatization vs. Government Bureaucracy: Weighing the Pros and Cons of Public Service Management
Explore the benefits and drawbacks of privatization vs. government bureaucracy, focusing on efficiency, innovation, and public service management. Discover which model suits your needs best.
socialstudieshelp.com
Governments Should Be Effective, Not Efficient
President-elect Donald Trump’s recently announced Department of Government Efficiency (DOGE), led by business leaders Elon Musk and Vivek Ramaswamy, is creating ripples in Washington. While the idea that the sprawling federal government bureaucracy is in need of a shake-up may be appealing to...
hbr.org
And, they're correct. You are stupid. The private sector beats the hell out of government in efficiency. Where government is needed is to do something the private sector cannot or will not do and it is accepted that inefficiency is to be tolerated to get whatever that is done.
After all, countries where the government owns and runs everything, like say, N. Korea, Cuba, or Venezuela, are so efficient that the whole country is impoverished and a creaking economic and governmental disaster.
T. A. Gardner
Serial Thread Killer
If government gets to do it, it'll get ten times worse.
I never read your posts when you just post links. Or post pictures.Everybody thinks you are stupid.
Public or Private? The Battle Over America's Essential Services
Every day, Americans interact with services that could be run by either government or private companies. The water from your tap, your child’s school, mail delivery to your door, the electricity powering your home—all represent fundamental choices about who should control these essential...
Do Government Programs Outperform Their Private Sector Counterparts in Terms of Efficiency? in 2025
In 2025, a question is often raised about the efficiency of government programs compared to their private sector counterparts: Do government programs outperform their private sector counterparts in terms of efficiency? While the answer may vary depending on the context and specific programs in quest
Privatization vs. Government Bureaucracy: Weighing the Pros and Cons of Public Service Management
Explore the benefits and drawbacks of privatization vs. government bureaucracy, focusing on efficiency, innovation, and public service management. Discover which model suits your needs best.
Governments Should Be Effective, Not Efficient
President-elect Donald Trump’s recently announced Department of Government Efficiency (DOGE), led by business leaders Elon Musk and Vivek Ramaswamy, is creating ripples in Washington. While the idea that the sprawling federal government bureaucracy is in need of a shake-up may be appealing to...
And, they're correct. You are stupid. The private sector beats the hell out of government in efficiency. Where government is needed is to do something the private sector cannot or will not do and it is accepted that inefficiency is to be tolerated to get whatever that is done.
After all, countries where the government owns and runs everything, like say, N. Korea, Cuba, or Venezuela, are so efficient that the whole country is impoverished and a creaking economic and governmental disaster.
No where in the world is that true.
T. A. Gardner
Serial Thread Killer
Well, it'd help if you were literate.
bye jerkoff
Not the ones who make more profit by denying care that you have already paid for. Also, they have no product. They stand between the health care you pay for and somehow have the power to meter it out as they decide. They force doctors and hospitals to invest in a staff of workers to handle the deliberately confusing paperwork.
They have doctors on staff whose function is to find a way to deny care. They make more money that way. The CEOs of health insurance companies make huge bucks for fighting peopl trying to get the care they pay for. https://ceoworld.biz/2023/05/10/hig...ceos-raked-in-a-record-123-million-last-year/
Thank you, good post.
T. A. Gardner
Serial Thread Killer
Look at this report. Ignore everything except where they discuss "Care process." That's the ONLY category in this report that deals with the quality of care. The entirety of the rest of it measures how socialized the medical administration and pay system is.
Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System
Mirror, Mirror 2024 compares the health systems of 10 countries on five domains: access to care, care process, administrative efficiency, equity, and outcomes.
They rank the US at #2 behind New Zealand. The US has some of the world's best medical care and treatment. What the US doesn't have is socialized medicine and that's what drags other nations down in terms of care.
Crepitus
Verified User
Coverage for all, not just those rich enough to afford it.
Crepitus
Verified User
Medicare for all
T. A. Gardner
Serial Thread Killer
Terrible idea. That amounts to doing the same thing over and over again expecting different results. Of course, Medicare For All might simply not allow that procedure to begin with as it is too expensive to cover.
Funded by the same method Medicare is currently? How would that work?
Medicare for All (MFA) — a single-payer system that eliminates private insurance and puts every American on a government plan — faces near-insurmountable barriers in the United States. Here’s why it’s extremely unlikely to become law anytime soon:
- Sheer cost and the tax problem
The most rigorous estimates (Mercatus Center at George Mason, Urban Institute, RAND, Charles Blahous for Medicare Trustees) put the additional federal cost at $32–$38 trillion over the first 10 years. That’s roughly double current federal revenue. Even if you eliminate all private insurance spending ($1.4 T/year), the government still has to come up with an extra ~$3 T a year.
To raise that kind of money you’d need one of the largest tax increases in world history:- A 25–30 % national VAT (Europe’s highest is ~27 % and they have private options)
- Payroll tax jumping from 15.3 % to ~35–40 %
- Doubling or tripling income-tax rates across the board
Every politician knows middle-class voters will revolt the moment their paychecks shrink by 30–40 %. That’s why even Bernie Sanders refused to show how he’d actually pay for it.
- 219 Republican House seats + 53 Republican senators (as of Jan 2025)
The GOP uniformly opposes MFA; zero Republicans voted for the 2019 Jayapal bill. You would need:- 60 votes in the Senate (impossible without 7–10 Republicans flipping)
- OR eliminating the filibuster, which requires 50 Democrats + VP who are all willing to nuke it for this one issue
Even moderate Democrats (Manchin’s gone, but Sinema-style senators remain) won’t touch filibuster abolition for a $35 T program.
- Half the Democratic caucus doesn’t actually support it
In 2025, only ~100 House Democrats co-sponsor the Jayapal MFA bill (down from 120 in 2020). In the Senate, only 14 Democrats co-sponsored Sanders’ bill in 2023, and several (Bennet, Carper, Coons, Warner) have explicitly said they’re against single-payer.
Polls of Democrat voters show support collapses when you mention “eliminating private insurance” or “higher taxes.” - 400,000+ healthcare jobs disappear overnight
Private insurers (UnitedHealth, Anthem, CVS/Aetna, Cigna, Humana) employ ~550,000 people directly. MFA wipes most of them out. Those jobs are spread across every state — red and blue. No member of Congress wants to explain to their district why 5,000 high-paying white-collar jobs just vanished. - Hospitals lose 15–20 % revenue instantly
Current Medicare pays hospitals ~20 % less than private insurance. Shifting 180 million privately insured Americans onto Medicare rates triggers:- Mass hospital closures, especially rural (already 140+ closed since 2010)
- Credit downgrades for every major system (Moody’s and S&P have modeled this)
Hospital associations (AHA, FAH) spend nine figures lobbying against it every cycle.
- The “you lose your current plan” backlash is lethal
181 million Americans under 65 have employer or private coverage. Kaiser Family Foundation polling:- 68 % say they like their current plan
- Support for MFA drops from ~55 % to ~37 % when people hear “you can no longer keep your private insurance”
That phrase killed the public option in 2009; it kills MFA every time.
- Provider opposition is wall-to-wall
- American Medical Association
- American Hospital Association
- American Nurses Association
- Pharma (PhRMA)
- Every specialty society
All oppose single-payer. Doctors don’t want Medicare’s 30-day payment delays and 30–40 % fee cuts.
- State governments revolt
States currently spend ~$250 B/year on Medicaid. MFA federalizes that cost, but governors lose control and the ability to fund their universities, roads, and prisons with the savings. Red-state governors will sue (they already sued over ACA Medicaid expansion). - No developed country has ever switched from private-dominant to single-payer as adults
Every rich nation that has universal coverage either:- Started with it post-WWII when private insurance barely existed (UK, Canada), or
- Kept multi-payer private systems (Germany, Netherlands, Switzerland)
None abolished a $1.4 T private insurance industry after it was entrenched.
Even during peak progressive power (2009–2010 with 60 Senate Democrats), they couldn’t pass a public option, let alone single-payer. Nothing fundamental has changed since then except the price tag got bigger and Republican opposition got stronger.That’s why Medicare for All remains a messaging slogan, not a viable 10-year policy.
Which adds to the cost.
Government regulation drives up the cost of private health insurance—and thus what you pay in premiums, deductibles, and out-of-pocket expenses—in several direct, measurable ways.
Here’s how:
- Mandated benefits force you to buy coverage you don’t want or need
Every state plus the ACA requires insurers to cover dozens of services: acupuncture, fertility treatment, maternity even for single men or post-menopausal women, unlimited mental-health days, autism therapy up to age 25 in some states, hair prostheses (wigs), pastoral counseling, etc. Each mandate adds roughly 1–5% to premiums according to actuarial studies. The Council for Affordable Health Insurance counted 2,271 separate benefit mandates across 50 states as of 2023; that’s ~45 extra things you’re forced to pay for whether you use them or not. - Guaranteed issue + community rating = massive adverse-selection premium spiral
ACA rules say insurers must accept everyone (guaranteed issue) and can only vary premiums 3:1 for age and 1.5:1 for smoking—nothing for health status. A healthy 30-year-old in New York now subsidizes a 63-year-old with diabetes by about 400%. Result: young healthy people drop out → risk pool gets sicker → premiums jump 20–40% a year until the next bailout. CBO estimated community rating alone added 20–30% to individual-market premiums permanently. - Price controls on hospitals create hidden taxes passed straight to private plans
Medicare and Medicaid pay hospitals ~74¢ and ~67¢ respectively for every dollar of cost (MGMA 2024 data). Hospitals offset this shortfall by charging private plans 275–479% of Medicare rates (RAND 2024). That’s literally a tax on privately insured patients to subsidize government programs. A hospital that gets $10,000 from Medicare for a procedure will bill a private plan $35,000 for the exact same thing. You pay that overcharge in higher premiums. - Medical Loss Ratio (MLR) rules turn insurers into claims-processing utilities
ACA forces carriers to spend 80–85% of your premium dollar on claims or rebates. Sounds consumer-friendly until you realize it kills competition on administration and forces insurers to raise premiums to hit the ratio when claims spike (COVID, new weight-loss drugs, etc.). UnitedHealth’s 2024 10-K explicitly says GLP-1 drugs added $2,000–$3,000 to per-member annual costs because they can’t cut admin to absorb it. - Certificate-of-need (CON) laws block new hospitals and surgery centers
35 states still require government permission to build a new MRI scanner or cardiac cath lab. This protects incumbent hospitals from competition, letting them keep prices 30–50% above competitive markets (FTC data). North Carolina’s CON board just blocked a new physician-owned hospital in October 2025—meaning higher prices for everyone with private insurance in the Triangle. - Risk-adjustment and reinsurance games transfer billions from efficient plans to sick pools
ACA risk-adjustment takes money from insurers with healthier members (think young-tech-company plans) and gives it to insurers with sicker members. In 2023 this transferred $11.6 billion. Your premium pays for someone else’s liver transplant even if your plan never sees that claim. - Endless compliance paperwork
HIPAA, MACRA, No Surprises Act, transparency rules, 2715 summary-of-benefits templates, etc.—the American Action Forum estimates regulatory compliance costs the health system $61 billion annually, with most of that landing on private plans. UnitedHealthcare alone employs ~18,000 people just for “regulatory and compliance.”
Strip away the mandates, rating bands, CON laws, and cross-subsidies, and private plans would cost 30–50% less overnight. Every dollar of that savings would go straight back into your pocket.
T. A. Gardner
Serial Thread Killer
We need a better system that relies more heavily on market forces and individual responsibility.
How would you suggest caregivers be paid for their services?
How would facilities be paid for? Who'd pay for the maintenance, administrative costs, and utilities?
How would medical products, drugs, and devices be funded?