Please view Stephanie Kelton's substack (The Lens) for awareness.
Old Age Survivors Disability Insurance, Disability Insurance, Hospital Insurance
(OASDI, DI, HI).
Politicians and pundits should stop playing games with a confused public, and focus on total spending and total taxes, how they affect the economy, who gains and who loses.
I would like to tweak your assessment of the core issue, if I may. The core issue isn't who should pay doctors and how much, and who should profit.
I suggest we go more fundamentally to a deeper core: why is it ethical to make the so-called beneficiaries be the product and the labor that provides the so-called benefits?
Insurers make their money off of using our data, which we provide and doctors collect for them, to then restrict access to the care we need. But we have paid them premiums, which they then pool and prevent us from using. We should charge interest or get a certain amount back every year if we don't use it.
But that would bust the real model, which is to use our health and data about us as crops, if you will, that they harvest and trade but do everything they can to avoid having to actually tend to.
As for the doctors wanting to both be fairly paid and exercise clinical judgement and practice at the top of their license instead of acting as the middleman for insurance company shareholders' greed: no problem! The solution is to control the doctor.
The vertical mergers of CVS and Aetna, CIGNA and ExRx are all about owning the doctors' prescription pen. If CVS/Caremark/Aetna/Ceasar controls what drugs the docs can prescribe (which they now do with their formularies, and step treatment, etc.), but the doctors push back and demand that rxs be dispensed as written, then the doctors increasingly face exile from the plans, which CVS et al also own.
So, the core issue is when will we stop asking how to achieve these two aims of paying docs and finding the right line to draw for profit, and instead admit that we are not interested in providing healthcare at all. Full stop. It is a shell game where we are the product. Once we admit that we do not have better healthcare because our legislators, all of whom have THE BEST healthcare plans, don't want us to.
The Biden admin, the Trump admin, any other admin. It doesn't matter who is in control because the paradigm is what never changes and yet must if we actually want the system to change.
I work in healthcare and continue to see doctors complain about pre-authorization, poor reimbursement and the list goes on. But do I see them taking to the streets en masse to demand universal healthcare, nope.
I read a freakishly slavish article in MedpageToday last week where the author, a 4th year med student, asked if it was healthy disruption that CVS was bringing to healthcare. NO!!! They are now the system, and they are not accountable to anyone but shareholders. And shareholders are not Main Street at all anymore. Meanwhile, our legislators are going on about how we don't want a nationalized system but this is no different. It's slyly not called socialism, but it's corporatism, and either way, it's still authoritarian and without any accountability to the so-called beneficiaries.
While costs continue to rise for all businesses and individuals, reimbursements to doctors have decreased for the past 30 years. It's become so bad that doctors are having to do a mix of self-pay for some plans (like United Healthcare, who refuses to pay their claims on a regular basis) just to stay afloat. Patients typically are fine with it once they see how little the doctors are asking for just to remain in business. I think patients are for the most part clueless about how very low the reimbursements are to begin with, so when they see out of pocket cost for self pay they don't mind. How much profit for these insurance companies is enough? It seems they can't stop shaking everyone down for those last few dollars- even if it means hiring a $15/hr employee to spit out letter after letter disputing a $35 reimbursement. It's organized crime with zero oversight at this point.
Please view Stephanie Kelton's substack (The Lens) for awareness.
Old Age Survivors Disability Insurance, Disability Insurance, Hospital Insurance
(OASDI, DI, HI).
Politicians and pundits should stop playing games with a confused public, and focus on total spending and total taxes, how they affect the economy, who gains and who loses.
I would like to tweak your assessment of the core issue, if I may. The core issue isn't who should pay doctors and how much, and who should profit.
I suggest we go more fundamentally to a deeper core: why is it ethical to make the so-called beneficiaries be the product and the labor that provides the so-called benefits?
Insurers make their money off of using our data, which we provide and doctors collect for them, to then restrict access to the care we need. But we have paid them premiums, which they then pool and prevent us from using. We should charge interest or get a certain amount back every year if we don't use it.
But that would bust the real model, which is to use our health and data about us as crops, if you will, that they harvest and trade but do everything they can to avoid having to actually tend to.
As for the doctors wanting to both be fairly paid and exercise clinical judgement and practice at the top of their license instead of acting as the middleman for insurance company shareholders' greed: no problem! The solution is to control the doctor.
The vertical mergers of CVS and Aetna, CIGNA and ExRx are all about owning the doctors' prescription pen. If CVS/Caremark/Aetna/Ceasar controls what drugs the docs can prescribe (which they now do with their formularies, and step treatment, etc.), but the doctors push back and demand that rxs be dispensed as written, then the doctors increasingly face exile from the plans, which CVS et al also own.
So, the core issue is when will we stop asking how to achieve these two aims of paying docs and finding the right line to draw for profit, and instead admit that we are not interested in providing healthcare at all. Full stop. It is a shell game where we are the product. Once we admit that we do not have better healthcare because our legislators, all of whom have THE BEST healthcare plans, don't want us to.
The Biden admin, the Trump admin, any other admin. It doesn't matter who is in control because the paradigm is what never changes and yet must if we actually want the system to change.
I work in healthcare and continue to see doctors complain about pre-authorization, poor reimbursement and the list goes on. But do I see them taking to the streets en masse to demand universal healthcare, nope.
I read a freakishly slavish article in MedpageToday last week where the author, a 4th year med student, asked if it was healthy disruption that CVS was bringing to healthcare. NO!!! They are now the system, and they are not accountable to anyone but shareholders. And shareholders are not Main Street at all anymore. Meanwhile, our legislators are going on about how we don't want a nationalized system but this is no different. It's slyly not called socialism, but it's corporatism, and either way, it's still authoritarian and without any accountability to the so-called beneficiaries.
Here's the link:
https://www.medpagetoday.com/opinion/second-opinions/99374
FYI. We don't specifically write about this but this book can put this privatization scheme in a larger context. https://thenewpress.com/books/privatization-of-everything
While costs continue to rise for all businesses and individuals, reimbursements to doctors have decreased for the past 30 years. It's become so bad that doctors are having to do a mix of self-pay for some plans (like United Healthcare, who refuses to pay their claims on a regular basis) just to stay afloat. Patients typically are fine with it once they see how little the doctors are asking for just to remain in business. I think patients are for the most part clueless about how very low the reimbursements are to begin with, so when they see out of pocket cost for self pay they don't mind. How much profit for these insurance companies is enough? It seems they can't stop shaking everyone down for those last few dollars- even if it means hiring a $15/hr employee to spit out letter after letter disputing a $35 reimbursement. It's organized crime with zero oversight at this point.