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  • Yeah.. Because there's no place for downward pressure on health expenses. Hospitals are incentivized to raise prices as much as possible, because they know insurance companies will negotiate downwards. Insurance companies pass all costs back down to the pool while working as hard as possible to deny everything. Drug companies know they have a captive market, nobody else is making that medicine you need for survival so "Cha-Ching!". Employers are looking for the cheapest health plans possible which means the shittiest plans for their employees. And any company that sells medical equipment is looking at selling it for as much money as possible (or in a "package" that gets hospitals to overcharge on individually wrapped tylenol). Hospital Admins spend more time and money to make sure patients are charged $20 for a $0.10 pill than they trying to keep enough doctors and nurses on staff.

    Medicare for all, that's the only way to start righting the ship here. Nationalizing the entire healthcare system would be the next step. It's beyond stupid that we run healthcare for profit.

    • So it’s actually more complicated than that (at least to your first point, the points about drug companies is accurate). First, I support M4A, especially plans like Bernie’s that improved reimbursement. One major issue is that the government (Medicaid in particular, Medicare also) pays below costs in some cases. So hospitals charge a shit ton to commercial insurance to make up for their loss on other patients.

      In terms of employers saving money, most large employers have moved to self-insurance (70-80%, depending on how you define “large”).

      • In a single payer system, why would how much the payer pays for service matter, on a per service basis? The payer may as well just run the entire system. Essentially, an integrated delivery network (like Kaiser Permanente) on a national scale.

        • I don’t mean this in a condescending way, but that’s a great question. Lmk if my answer isn’t clear and I can elaborate more.

          Single payer is not nationalized healthcare. Those are two different models with very different implications for funding.

          Any business could buy up their downstream suppliers, just like the government could nationalize hospitals. But most governments (and most businesses) don’t do that.

          In a single payer system, hospitals would get paid from one source, plus supplemental services that people buy out of pocket. What a hospital gets paid impacts what they can pay their employees. Ever heard someone say “why would they be an EMT for $15 an hour when they could make that flipping burgers?” It’s the same logic. Private companies lobby single payer govts so that they can attract employees, among other things they can do with money. More money makes running anything in a capitalist society easier.

          If you’re nationalized, then the healthcare workers are government employees.

261 comments