All these Americans (now the majority of the country) who want a more socialist health care system in the USA actually have a point… but not in the way you probably think.
As I’ve written about before, the United States has the worst health care system in the entire civilized world. Technologically, the quality of care is good (though not the best, since countries like Singapore have now surpassed the US in terms of tech and quality of care).
I’m talking instead about the economic aspects of the health care system. That is, who pays for the care, how they pay for it, and how much they pay.
The US doesn’t have a socialist health care system. (At least not yet. It’s coming.) It also doesn’t have a capitalist or free market health care system. It used to, way back in the 50s and 60s, when it was not only the highest quality health care in the world, but also one of the least expensive, and doctors actually came to your house(!). That’s what free market capitalism does. It drives down costs while increasing quality. But the US isn’t a capitalist country, and its health care system isn’t capitalist at all.
No, today the US is unique in that it has a corporatist health care system. As I analyzed here, corporatism is the opposite of capitalism and is even worse than socialism. Socialism sucks, and is an unworkable model in the long-term, but at least under socialism you receive some level of service regardless of your income. Capitalism is complicated in terms of how you handle society’s poor, but at least it provides inexpensive services at high quality to everyone.
Corporatism doesn’t have any of the benefits of either capitalism or socialism. Instead, it screws everyone except for the ultra-wealthy, as I’ve examined on this blog many times. Health care is no different.
Under a socialist health care system, everyone receives a low quality of care from a bankrupt, government-run health care system.
Under a capitalist health care system (which again, the USA does not have), most people receive inexpensive, high quality health care from the free market.
Under a corporatist health care system, no one receives quality care. Instead, everyone receives various levels of care ranging from horrible to decent, all of which is exorbitantly expensive and can only be paid by either the super-rich, big government (i.e., the taxpayer), or gigantic insurance companies. All three of these entities rip everyone off, poor, middle class, and upper class alike, to the enrichment of the elites. It’s the worst of all worlds.
I’ll tell you my latest encounter with America’s utterly ridiculous, worst-in-the-world health care system. This is but one of scores of real-life occurrences I could share, and I’m sure most of my fellow Americans can also share their horror stories with our health care system too. (Feel free to do so in the comments.)
Last summer, Pink Firefly was in searing pain and needed to go to the emergency room. This wasn’t those “I have a sniffle” or “My arm hurts” bullshit reasons that plague America’s corporatist ERs in hospitals all over the land. No, this was a legitimate use of the ER; she was in real pain and nothing else could be done for her.
We wanted to use an urgent care center since those are usually cheaper and less insane than going to a hospital. But it was in the evening and all the urgent care places near our home were closed. So, we had no other option than to go to the hospital. She worked for a large insurance company and thus had health insurance through her employer. No big deal. Or so we thought.
Went to the hospital emergency room, checked in, waited a while, I did my best to console her while she rocked back and forth in pain, the doctor saw her, ran a test or two, prescribed some pills, and we left. We spend a grand total of about 30 minutes actually in the doctor’s exam room.
Then we forgot all about it because covering that kind of thing is what insurance is for. That’s literally the only good thing about being an employee instead of owning your own business; your employer usually covers your health insurance. I, as a self-employed dude, have to purchase and manage my own insurance.
Several months later PF receives a bill in the mail from the hospital for $4,200.
She calls the hospital to see what the hell is going on. She has health insurance. Why is she getting billed? And she only spent 30 minutes in the exam room; why did that cost $4,200?
Multiple calls, multiple transfers, waiting on hold forever, and so on. You know the drill.
Finally, we get the answer. The hospital sent the bill to her insurance company, but her insurance company denied the claim.
So then she has to call her insurance company.
Multiple calls, multiple transfers, waiting on hold forever, and so on. Again, you know the drill. Hours upon hours on the phone when you add all of it up.
Finally, she gets an answer. Emergency room visits “aren’t covered” on her insurance policy(!).
What? What good is fucking health insurance if it doesn’t cover emergency room visits? Isn’t that what it’s primarily for?
Arguing, arguing. Again, if you’re an American trapped in the worst health care system in the world, you know the drill.
The insurance company doesn’t budge. They won’t pay the $4,200 bill.
So now she has to call the hospital back to negotiate the bill. She was so exasperated at this point that I helped her out and called them myself. (I’m also more of an ass-kicker than she is and have more experience negotiating.)
I get on the phone. Multiple calls, multiple transfers, waiting on hold forever, and so on. You know the drill.
Finally, I get a human who can “help” me. I explain the situation, that PF will have to pay this bill since her insurance company won’t. As a self-employed guy who has been on “self-pay” most of my adult life, I know that most hospitals and doctor’s offices have a lower rate for when you, the patient, pay the bill directly instead of when they bill insurance companies.
That right there is part of the problem. Under America’s corporatist health care system, the more expensive everything is, the more it benefits each part of the system (doctors, hospitals, insurance companies, government, etc). Each part of the system does its best to rip off the other components. It’s actually designed to be expensive, much like America’s corporatist college system (but that’s a topic for another time).
So I go in expecting them to drop the price of the bill by 50% or more. Then, once they get the bill down to $2,000 instead of $4,200, I’ll pretend to be angry (since I never actually get angry) and loudly complain as to why a 30-minute doctor visit was $2,000 – $4,000 dollars. But one step at a time.
The summarized conversation went something like this:
Them: No, I’m sorry, we can’t change the billing on that since we billed the insurance company the insurance rate rather than the patient rate.
Me: I know. But the insurance company didn’t pay it.
Me: We’re paying it instead.
Me: So you can give us the patient rate instead of the insurance company rate.
Them: No, we can’t sir, because it’s in the system under the insurance rate.
Me: Okay, then press whatever buttons that are on your screen there and change it.
Them: We can’t, sir.
Me: Your system will clearly show that the payment will be coming from her personal HSA debit card with her name on it, not an insurance company. So it will be on record that it will not be paid by an insurance company.
Them: I understand that sir, but I still can’t change it.
Long story short, they wouldn’t budge no matter what. Pink Firefly had to come up with a whopping $4,200 to pay for a 30-minute doctor visit when she was covered by insurance.
This would never have happened under a truly capitalist health care system. This would also never have happened under a socialist health care system. But because we have the worst health care system in the world, a corporatist one, it’s the worst of all worlds, and we in the Collapsing USA continue to get raped on a regular basis in ways no other country in the civilized world does.
And yes, of course socialism isn’t the answer. As I described in detail here, almost all of the other countries in the Western world who use a socialistic health care system are operating under government health care entities that have already gone bankrupt.
But where the Bernie Sanders types are correct is when they say that converting to a socialist health care system would be less bad than what we have now. To be objective and factual, they’re right. Again, what we have now is the worst of all worlds, so horrible as it sounds, Scandinavian-style socialism would be less bad.
Is that what I want? Of course not. Instead, we need to go back to the free market health care system the US was using back in the 50s and 60s, where it was just you and your doctor involved in the transaction, and that’s about it. Insurance companies were barely involved and the government wasn’t involved at all. I lay out one example of how this would work here.
The problem, and one of the many reasons socialism will soon prevail in the United States, is that people aren’t this knowledgeable, nor want to be. All they know is that they’re getting raped by a horrible health care system (and they are!) and they want something less bad. So when a Santa Claus guy like Bernie Sanders comes along and offers to just “have the government pay for it all,” these people love it and gleefully support it, even if they’re Republicans.
Enjoy the decline!
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