Sounds like a failure of regulation to me. I can't imagine how it would be possible to just rely on the moral compass of whoever ends up setting policy at a huge insurance company. It's one thing to try to live a good life, but you can't fight incentives, and it's far more likely that each cog in the machine doesn't have a particularly hard time justifying their own contribution.
I'd ideally like to see decisions about medical necessity made by a third party who isn't financially tied to the outcome of a payout decision, but failing that the insurance companies should be held to a high standard which is obviously not happening.
(This may be because many consumers have their insurer chosen for them by their employer, and will change insurer only when changing job.)
Lobbying exists in many countries and in many forms does not constitute bribery. Lobbying is already regulated in countless ways. Without lobbying, elected officials would have a much harder time understanding the real impacts of policy. While, yes, Big Tobacco has lobbyists, so does the Cancer Society. Complicating the morality of the equation, a good lobbyist specializing in that industry might work (at different times) for both sides, just like many types of attorneys or other professionals.
In no other country in the world is money considered speech, and in no other country in the world is there remotely as much money in politics as the USA.
I understand you want to justify it's existence, but that doesn't mean it's good for society as a whole.
Lobbying, like for example every big tech now donating $1m to Trump’s inauguration. That’s just the start. What do you think is the motivation for that?
Donations are not the same as lobbying, especially within the context of a campaign or inaugural committee. Obviously the motivation is to curry favor / build influence.
It is a failure of regulation, but that regulation was promulgated by the regulated through lobbying. They come out and say "no, we want to fix healthcare too, we get your frustration and anger!" (only after a CEO was shot and killed) while they slip money and a wish list into the politicians' pockets. It's not a "can't" fight incentives situation; they won't fight them because they created them!
Then through their PR departments, they sow discord by trying to persuade everyone to think it's everyone else's fault. It's the pharmaceutical companies (it is). It's the providers (true, but they are also the providers). It's the politicians (yes, the one's they lobbied). What they don't want people to think is that they are all working together to fuck us over. So the pharmaceutical companies and the providers and the politicians likewise, through their PR departments, blame everyone else.
THEN, in this entirely unworkable system, the one they have control of, where they get to decide what is and isn't considered murder, the ruling class has the audacity to chastise the public for cheering on the death of an avatar that represents the system.
Interesting. I was curious what a single-payer healthcare system like the NHS has in comparison. The NHS is good for this because it has generally good data availability.
Based on this, I think the truth is that most societies are going to struggle to care for these people. We face a problem with a workforce expanding too slowly and increasing rates of these mental conditions. We’re going to have to either ration care or let something else go.
At this point, we have 1% of the federal budget dedicated to dialysis. Over time, I expect that we will allocate similar quantities of money to other chronic conditions that we have no means of escape from. Certainly some of the tools we use incentivize bad behavior (like the flat payment structure described in the article) but the fact that healthcare in another country is facing the squeeze indicates this isn’t the broad trend motivator.
If we do not accept the reality of rationing care, we must accept the reality of letting go of something else: pensions, our ability to patrol foreign waters, incentivize businesses or so on.
It’s an interesting thing. I would not have expected one of these things to have been a Precipice for our society.
Oh, insurance companies will collect data, the feds won't. Weather data shows climate changing. Employment data demonstrates discrimination, and wage theft. Crime data demonstrates civil rights violations, discrimination and police brutality. Insurance cares little for those, and neither does any megacorp.
Not collecting the data means every policy argument comes down to "well, common sense says...".
I'm all for capitalism, but still don't understand how people can work in that cost-cutting department.
If I was working there, Id quit the moment I realized what my job was about. Id honestly rather be homeless that get a paycheck from that kind of work.
> Id quit the moment I realized what my job was about
there's a scene in Arrested Development where Buster believes he's playing a airplane simulator video game, when in reality he was piloting drones for the Air Force the whole time
When dictators like the Assam regime opresess their people, everybody can see it. When corporations and laws like ObamaCare do the same it’s much harder to pinpoint it because the oppression is diffuse and everyone can see it when the CEO gets taken down.
The 'death panels' you're thinking aren't a result of the Affordable Care Act. Without the ACA, my kidney donation to my Dad would be a pre-existing condition and preclude me getting care for my remaining kidney. Fun fact: When I've mentioned this in social media online, Republicans love to tell me that it's my 'fault' for donating it so I have to suffer the consequences despite the fact that it saved the government money overall between Medicare and the VA.
This policy was recommended by Alice to her boss Bob, and it was then signed-off by Christine above him, Dave above her, Evelyn above him, and so on... until it reached the desk of Nathan Orville Percival III in the C-suite, who happily collected a fat yearly bonus for the savings. People made this decision, and in a large organization like UnitedHealth, likely a lot of people did so.
Unfortunately, the laws surrounding corporations make it largely impossible to hold such people accountable - piercing the corporate veil, so to speak, is rather difficult even in the few cases where it's allowed. The most you can do is fine the corporation a little and hope it shocks the business enough to make its own internal changes. In practice, it's usually just a small slap on the wrist that can be written off as a cost of doing business.
I would argue that for the long-term health of society, we ultimately need to start poking more holes in this corporate veil protection so individual people can no longer get away with the equivalent of "just following orders" which is the profit-above-all-else excuse.
I agree with your view, but to refine it: on the flip side, we could change our culture so that normative statements about "this company" refers to everyone in it, starting with the highest responsibility for top positions and trickling down. Corporations are indeed not individuals, but they are very much hierarchies of individuals. If a corporation is a body capable of agency, however diluted from individual human agency, we can hold it accountable. And that indeed starts with the upper brass.
I'd ideally like to see decisions about medical necessity made by a third party who isn't financially tied to the outcome of a payout decision, but failing that the insurance companies should be held to a high standard which is obviously not happening.
(This may be because many consumers have their insurer chosen for them by their employer, and will change insurer only when changing job.)