You must log in or register to comment.
Buddy, bro, my pal, finance friend.
Nvidia went up 350% over the past year. You should have written a fake story about videogames.
My mom around 8 months back went to Micro Center, Denver.
She needed a new graphics card. The salespeople there urged her to buy the brand new Nvidia 4090 for $1500.
She used to get free AAA games with purchase, now that was withdrawn
"capitalism is a horrible system that tried to bankrupt my family though medical expenses.
But don’t fight it, support it by giving them your money anyway, and then any that you earn after that.
You are a fool of you don’t buckle to the whims of big business"
“support it via ✨️ g a m b l i n g ✨️”
What’s extra annoying about this is that in his story, his mom gets screwed over by the hospital so rather than thinking to complain or go elsewhere he thinks ‘yah im gonna invest in that’. Investing in bad actors like that just reinforces their shitty behavior.
Don’t forget to short the stock prior to the malpractice lawsuit when mom dies
Are you fucking joking that a hospital is on the stock market? I know, its the company that owns the hospital, but its still fucked up. Should not be allowed.
Why not? Companies that make pharmaceuticals, prosthetics, imaging devices, etc are all on the stock market too, so if hospitals weren’t on there, you could build a portfolio to approximate it by buying producers of medical equipment.
The real issue isn’t whether something is publicly traded, but collusion between groups to keep prices high. For example, it’s mutually beneficial for insurance, hospitals, and medical equipment providers to increase costs. Higher equipment costs means care providers can charge more (what’s another few hundred when the bill is in the thousands?), and higher total bills means insurance companies can charge higher premiums (they’re usually limited to a certain percent of cost as profit). Hospitals generally don’t have direct competitors since it’s prohibitively expensive to build one and there’s lots of bureaucracy based on “need,” so you can’t just go next door to an org that’s not involved in the collusion.
Here’s some YouTube videos about it:
There are lots of viable solutions here, but banning them from the stock market isn’t going to solve anything. The first order of business imo is making everything more transparent.
Because demand and supply don’t self-regulate healthcare. How much do you value your health? How about your own life? Oh, you’re willing to pay ANYTHING to live? Even if it’s not life threatening as long as it leaves you crippled, unable to work, you may as well be dead.
As a customer the only way to be an informed buyer is to be a physician yourself. Even if a treatment doesn’t work you still get charged, no refunds!
For-profit healthcare is fundamentally inhumane and is incompatible with capitalism. The forces that would usually regulate the market are non-existant. Demand is infinite, undercutting is pointless, customers have no way to be informed.
There’s a huge difference between emergency, life threatening care and relatively routine care. For example, if I need to get a tooth extracted, I can certainly wait to shop around a bit, and living with some pain for a few days could be worth finding a cheaper solution. I can also choose between hospitalization and self-care in many circumstances as well (e.g. normal baby delivery can happen at home or in the hospital).
For those cases where informed decisions are possible, supply and demand can work efficiently. It doesn’t work as well when there’s a monopoly on care, like in an ER, ambulances, etc.
And no, you don’t need to be a physician to be informed, you just need to consult one. I may not know the practical difference between operations, but I do understand chances of success and costs, and I know how to get multiple opinions and decide from there. That works for any field, I can convert a problem from needing an expertise to evaluating experts. Tell me what expected outcomes, the chances of various outcomes, and the costs, and I’ll get a second or third opinion if I’m not satisfied.
This gets even better the more transparent things are, because other experts can do independent reviews. A newspaper, for example, can hire a physician to review posted prices for routine operations and give an idea of how realistic those costs are. Insurance companies so exactly that, so I don’t see why a private organization couldn’t. News organizations routinely consult experts on stories.
But there are areas where there’s a monopoly, and those mess up the market’s ability to regulate prices. That’s why I’m in favor of universal coverage for emergency care, but against universal coverage for other forms of care.
The real issue is the belief that essential services should make profit. Socialized, regulated Healthcare FTW.
I disagree.
I know it’s an anecdote, but I have a coworker that shared an experience moving from Canada to the US, and they said they much prefer the American healthcare system to the Canadian system. This is from the perspective of a relatively well off individual (not rich, just middle to upper middle class), so obviously someone at the bottom end of the income spectrum would have a different opinion.
So my question for people who promote socialized medicine is this: if you could easily afford both, would you prefer socialized or privatized medicine? And why?
I think we have a cost problem, not a structural problem, so we should look at ways of reducing cost before completely changing the structure of our healthcare system. My primary concern is getting insurance away from employers, publicly funding emergency services, and making hospital costs more transparent (e.g. publicly posted price ranges for common procedures). As in, reform the current system, not replace it.
know it’s an anecdote, but I have a coworker that shared an experience moving from Canada to the US, and they said they much prefer the American healthcare system to the Canadian system. This is from the perspective of a relatively well off individual (not rich, just middle to upper middle class), so obviously someone at the bottom end of the income spectrum would have a different opinion.
The problem is that healthcare systems are meant to take care of the entire population, not just the middle class or higher. If you are a moderately healthy and wealthy person, yes the American healthcare system is fine, but that’s not exactly the what your entire system should be geared for.
The only reason they like the system is because they are the bread and butter of private insurance. Healthy working adults whom don’t require lots of expensive care. However, if they were to developed a chronic illness, or get injured or I’ll to the point where they can’t maintain their employment… That’s when you get to experience the worst healthcare experience America has to offer.
if you could easily afford both, would you prefer socialized or privatized medicine? And why?
As someone who’s had socialized medicine (Tricare) and now currently has “good” private insurance (BCBS ppo), I definitely prefer socialized.
There’s no worry that your going to catch an unexpected co-pays, you aren’t nickle and dimed for every script or visit. No worrying about out of pocket maximums, yearly deductibles, or lack of specific coverage. You don’t have to get specialized insurance for just your eyes and teeth, the benefits go on and on.
I think we have a cost problem, not a structural problem, so we should look at ways of reducing cost before completely changing the structure of our healthcare system.
The cost problem stems from the structural problem. Private insurance steals the ability to effectively collectively bargain for lower prices. It also diverts funding away from the socialized insurance pool of Medicare, which lacks the young healthy subscribers that help stabilize and fund the care for elderly and sick.
Imagine if all the money that private insurance pockets went towards actually caring for people. Imagine if hospitals didn’t have to employ a small army of managers and billing agents, just to get paid for services already rendered. Imagine the collective bargaining power that we’d all have if pharmaceutical companies knew there was only one customer in the entire nation.
You give that all away for what? A policy that goes away the moment your employer decides they don’t want to pay that much this year? A policy that ties your physical well being to your employment? A policy that terminates your coverage the very moment you need it the most?
unexpected co-pays, you aren’t nickle and dimed for every script or visit
Again, you’re talking about cost, not which you’d prefer from a service perspective.
I think there are lots of opportunities to make costs lower, such as reducing patent lengths (reduces medication costs) and simplify insurance (reduces admin costs). We should also make changes to liability law so doctors can focus on providing care. Some specific proposals:
- patents - reduce to 5-7 years; should cut costs of pharmaceuticals
- insurance - simplify and standardize coverage; coverage details and bill processing should be automated
- publicly post costs of common procedures, and give expected, average, and maximum costs before any procedure
And so on. And on top of that, expand Medicare/Medicaid a bit with costs phasing in the higher your income goes. I think we should also cap access to Medicare for retirees at a certain income level as well, and remove FICA tax caps.
We should absolutely be discouraging employer sponsored insurance and encouraging longer term insurance plans (e.g. like life insurance, you lock in at a lower rate if you sign up while healthy). Dropping someone from insurance shouldn’t be a thing at all, and the payout for doing so should be much higher than any costs the insurance company would incur by keeping them.
Again, you’re talking about cost, not which you’d prefer from a service perspective.
If you went to a restaurant and they ran separate charges every time you ordered something… You wouldn’t consider that bad service?
Also, I went to the same physician when on Tricare, so it’s the same exact service, minus all the billing hassle.
I think there are lots of opportunities to make costs lower, such as reducing patent lengths (reduces medication costs) and simplify insurance (reduces admin costs).
And I think you could do the same things and still lower the cost even more by banning privatized insurance?
Also, what is the profit motive for insurance companies to simplify their process? Their systems were purpose built to be as complicated and time consuming as possible, if they make the process easier, their subscribers would utilize it more, making insurance pay more often.
patents - reduce to 5-7 years; should cut costs of pharmaceuticals
- insurance - simplify and standardize coverage; coverage details and bill processing should be automated
And again, why would corporations do this? And how would we enforce this?
The Medicare billing is automated, and pretty simple. It’s what every insurance company has the option of doing, but only Medicare and Medicaid have automated the process. This is because private insurance companies have no profit motive to pay for their prescribers healthcare.
publicly post costs of common procedures, and give expected, average, and maximum costs before any procedure
Most hospitals have this information available, especially if you call their financial services office. In fact if you are a Medicare patient this information is publicly available on the CMS website, and they list exactly how they came to that figure.
The whole hidden ledger thing is primarily only a problem at privatized hospitals that were bought or built by private hospital networks operating for profit.
I think we should also cap access to Medicare for retirees at a certain income level as well, and remove FICA tax caps.
The inherent problem with this is that the elderly are fundamentally uninsurable. You can’t make a profit from an elderly subscriber, the cost of their end of life care will always cost more than any subscription fee they may pay in.
This is why the vast majority of private insurance do not offer primary insurance to people older than 65. The whole point of private insurance is to extract money from healthy patients and then dump them onto Medicaid if they become disabled, or onto Medicare when they begin to age and decline in health.
We should absolutely be discouraging employer sponsored insurance and encouraging longer term insurance plans (e.g. like life insurance, you lock in at a lower rate if you sign up while healthy).
Who would offer those plans, and why? The only reason most people can afford private insurance is because their employer collectively bartered for the price. A lot of people have no idea how much of their employee compensation package is taken up by their insurance, but the burden of cost is redistributed by the entire employer pool.
Dropping someone from insurance shouldn’t be a thing at all, and the payout for doing so should be much higher than any costs the insurance company would incur by keeping them.
This would bankrupt private insurance companies… I don’t think you fully understand how hard it is to make money on health insurance. The only way to do so is by withholding healthcare to your subscribers, or to offer plans with obscene co-pays or deductible.
The cost on average for full coverage is around 8.5k dollars a year for an individual, or 24k for a family. Meaning that the cost of a single operation, illness, or inpatient procedure will wipe away the potential profits from an individual subscriber for years. The only way to recover from having one I’ll subscriber is to balance them with a dozen healthy subscribers.
Without managing this equation of large healthy profitable pool vs small costly pool, the entire charade of private insurance would collapse upon itself.
One of the largest drivers in the increase in healthcare cost is these types of people. People whom don’t have any insurance, but still have healthcare needs. For these people the emergency room is typically their only option. This is one of the reasons emergency medicine is such a drain on hospital resources. For every person they treat without insurance, they have to raise the cost on people with insurance, simply so they don’t go out of business.
restaurant and they ran separate charges
It’s funny you mention restaurants, in that case I don’t particularly care when they bill me because the menu says precisely what I’ll pay (counter order vs table service doesn’t matter as much as cost and quality). If it’s market rate (steak or seafood), they’ll tell me what the day’s rate is and what cuts they have.
I don’t get that with health care, even getting a range in a quote is like pulling teeth. I pushed back a ton when my daughter needed a surgery, and after several calls I still didn’t get a clear answer, and this was for a routine surgery. The quality and speed of service was great, billing was not.
One of the benefits of socialized medicine is not having to worry about billing, but you also often get delays in care. I don’t think we need to go to socialized medicine to solve the unexpected costs issue, we can expect care providers to absorb some of the variability.
what is the profit motive for insurance companies to simplify their process?
I agree, the current profit motives are misaligned, and pushes like the ACA to further expand the number of people with insurance further entrench these practices.
The profit motive should be attracting customers who otherwise would go without. But since pricing isn’t transparent, cash payers don’t have the same leverage to get a fair price. Many care providers have an informal “cash discount,” but that’s just not the same.
If the system works well for cash customers, insurance would need to earn customers’ business, but when most people have insurance, the patient is no longer the customer, the employer is, so they’ll charge individual customers more than employers with group plans. If we separate the insurance from the employer, they would need to cater to patients.
Removing private insurance is one option, but that’s also quite disruptive and has potential for other issues (e.g. why would Medicare bother with good customer service if it’s the only option?).
Most hospitals have this information available
That wasn’t my experience. We had two options for a surgery with different risks and costs, and after several calls, we couldn’t get any numbers, just A costs more than B. That’s why I’m so interested and “it depends on your insurance” blah blah blah. That’s why I’m so interested in this. And this wasn’t some podunk hospital, it was the premier children’s hospital in the state, run by the premier public university in the state, and services kids outside the state.
I should be able to get quotes on a procedure from multiple care givers for a non-urgent procedure (like the one we had).
how would we enforce this?
Patients should be able to switch insurance if they don’t like the one they have. Right now, you either use the insurance you have or pay out the nose by giving up company cost share and ACA subsidies.
If my company offers a crappy plan, I should be able to take what they would’ve contributed and pick my own plan. If that was the case, insurance companies would try harder to make their service more convenient, just like auto insurance does (not a gold standard, but much better), and HR orgs would probably try harder to pick better plans.
You can’t make a profit from an elderly subscriber, the cost of their end of life care will always cost more than any subscription fee they may pay in.
If you’re wealthy, you don’t need much from your insurance. End of life care could be self funded, and insurance is there for the other surprises that could ruin your retirement. It would be totally acceptable for an insurance company to require some kind of down payment to cover EOL care, or a minimum number of years for coverage (if you die before the end of the contract, it counts as debt the estate needs to pay back).
their employer collectively bartered for the price
I’ve run the numbers and can get a similar price (within 10% or so) for similar coverage without ACA subsidies, but I need to factor in how much they’d contribute to their own plan. Add to that couples who both work, your options are: have separate plans (less efficient) or give up the employer subsidy.
This would bankrupt private insurance companies
No, they’d just adjust rates to compensate. If there’s something insurance companies are good at, it’s averaging costs and holding a surplus. So a company that’s better able to estimate this should get more customers and stay in business longer.
If they offer a 10-year or longer plan, they just need to average costs across their target demographic over those years to come up with a premium. Term life insurance companies do this, so why not health insurance?
For these people the emergency room is typically their only option.
Especially for homeless people. Which is a huge part of why I’m a fan of government funded ER. That’s a huge risk factor for insurance companies and hospitals, and it’s also a huge complexity for visitors and whatnot, so it should just be provided. If the paramedic thinks you need emergency care, it should be 100% free. However, hospitals should be empowered to deny care (and charge for wasting ER capacity) for non-emergencies.
But any extended care once you’re stabilized should be covered by insurance instead, because you have actual choices in your care (and could theoretically walk out if you choose not to accept further care).
All shareholders are liable for the actions of the company they own and control. When a company commits a crime, the shareholders should be held personally accountable. No fines. Jail time.
Major shareholders only. People just trying to retire aren’t the problem.
I disagree. Shareholders don’t have a say in how the company is run, and buying shares in a company doesn’t really change anything about how the company is run.
I do think execs and board members should be jailed for committing crimes though. If you have a part in the decision making, you’re culpable.
