127

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?

you are viewing a single comment's thread
view the rest of the comments
[-] otp@sh.itjust.works 2 points 2 weeks ago

A public system specifically would mean it's run by the government. So that would need to be created by the government. Which means you'd need all relevant voting systems to vote in favour of it, which isn't likely... especially given the last presidential election.

I imagine the biggest challenge of creating a non-profit health insurance thing is one of two things.

Firstly, anyone who has that much money would probably rather open a charity.

Secondly, people actually DO commit fraudulent claims, or try to claim things that they don't need or that the health insurance company decided that they won't cover. If the company doesn't try to filter these out, it'd be losing more money than it expected to...and it'd go out of business.

Another factor is that being in the insurance business is already a losing model if you want to do good in the world. Hospitals will charge jacked up rates because they don't have to worry about what a person can pay. They try to extract as much as they can out of the big insurance corporation, since the patient doesn't care what the insurance company has to pay. So this non-profit insurance company would be paying as much as any other insurance company, more than any patient would be paying, and so it'd be losing money even just paying out all of its valid and covered claims, let alone the fake and unnecessary ones.

So, maybe you want to partner with the hospitals because, why should you pay as much as the evil companies, right?

Well, that sounds great from a consumer sense. But from a business perspective, that'd be suicide for the hospital -- why would any other insurance company do business with that hospital if they're giving one company discounts unfairly?

Or...maybe they do give discounts. But then they make less money and can't pay the doctors as much (who can leave for work elsewhere), or buy the newest equipment, etc.

But if they do want to give discounts and just charge the company what things actually cost...at that point, you might as well be a charity.

And even then, you still need to budget for validating the claims that come in, because how do you choose who gets covered, and within that group, who gets priority?

this post was submitted on 11 Dec 2024
127 points (94.4% liked)

No Stupid Questions

36169 readers
967 users here now

No such thing. Ask away!

!nostupidquestions is a community dedicated to being helpful and answering each others' questions on various topics.

The rules for posting and commenting, besides the rules defined here for lemmy.world, are as follows:

Rules (interactive)


Rule 1- All posts must be legitimate questions. All post titles must include a question.

All posts must be legitimate questions, and all post titles must include a question. Questions that are joke or trolling questions, memes, song lyrics as title, etc. are not allowed here. See Rule 6 for all exceptions.



Rule 2- Your question subject cannot be illegal or NSFW material.

Your question subject cannot be illegal or NSFW material. You will be warned first, banned second.



Rule 3- Do not seek mental, medical and professional help here.

Do not seek mental, medical and professional help here. Breaking this rule will not get you or your post removed, but it will put you at risk, and possibly in danger.



Rule 4- No self promotion or upvote-farming of any kind.

That's it.



Rule 5- No baiting or sealioning or promoting an agenda.

Questions which, instead of being of an innocuous nature, are specifically intended (based on reports and in the opinion of our crack moderation team) to bait users into ideological wars on charged political topics will be removed and the authors warned - or banned - depending on severity.



Rule 6- Regarding META posts and joke questions.

Provided it is about the community itself, you may post non-question posts using the [META] tag on your post title.

On fridays, you are allowed to post meme and troll questions, on the condition that it's in text format only, and conforms with our other rules. These posts MUST include the [NSQ Friday] tag in their title.

If you post a serious question on friday and are looking only for legitimate answers, then please include the [Serious] tag on your post. Irrelevant replies will then be removed by moderators.



Rule 7- You can't intentionally annoy, mock, or harass other members.

If you intentionally annoy, mock, harass, or discriminate against any individual member, you will be removed.

Likewise, if you are a member, sympathiser or a resemblant of a movement that is known to largely hate, mock, discriminate against, and/or want to take lives of a group of people, and you were provably vocal about your hate, then you will be banned on sight.



Rule 8- All comments should try to stay relevant to their parent content.



Rule 9- Reposts from other platforms are not allowed.

Let everyone have their own content.



Rule 10- Majority of bots aren't allowed to participate here.



Credits

Our breathtaking icon was bestowed upon us by @Cevilia!

The greatest banner of all time: by @TheOneWithTheHair!

founded 2 years ago
MODERATORS