• theneverfox@pawb.social
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    9 months ago

    The worst part is Obamacare wasn’t even good - it was a huge compromise with insurance companies… Before it was further compromised and sabotaged. It came out of the heritage foundation after all - everything they come up with is some way to cause mass suffering to make a few people a lot of money

    On the pro column, they gave up preexisting condition rejections - definitely good - and increased child coverage to 25 - which is nice to have I guess. It also made it easier to get health care not coupled to your job. Which would be great, except insurance gives you so much less protection at this point that people aren’t much better off than they were uninsured before

    On the minus side, they came up with standards of care, which creates so much documentation it drove most of private practice out of business, forcing them to join healthcare systems. It’s as much as 2-4x as much time doing paperwork as seeing patients, and then the doctor has to negotiate with the insurance company back and forth on a case by case basis.

    And healthcare systems are basically regional monopolies, which is why costs ballooned so ridiculously. It was always bad in this country, but nowhere near this bad.

    They also overwork doctors, which is probably a big part of why outcomes are getting worse - they’re running healthcare as a business. People who have zero healthcare training are min-maxing health system policies to make line go up

    Not to mention, the one big win was supposed to be a public option on the healthcare marketplaces - the idea is you get something like a government run, at-cost insurance company. That was going to be the base line - private competition with “government inefficiency”

    It’s all just such a shit show - the solution is so simple too. Insurance does three things - it collects a little money from a lot of people to cover big costs from the minority who suddenly needs a lot of it. It uses economies of scale/collective bargaining to keep costs down on the provider side. And it has to have enough bureaucracy/oversight to keep embezzlement/fraud/kickbacks at sustainable levels (you don’t even have to stop it, you could just keep good records and watch for large scale offenders, and come down on them hard)

    All of those things are better done without a profit incentive, and they work better the more people are in this kind of union… It’s mind boggling that people don’t understand how straightforward it is.

    Hell, know what happens when a homeless man comes into the ER and racks up a 6 figure bill because they couldn’t afford treatment until they’re at deaths door? The hospital doesn’t just eat the cost, we all pay for it collectively anyways