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(NPR)   The exact amount that your health insurers are ripping you off is about to be made public   (npr.org) divider line
    More: Murica, Health care, Health insurance, Health economics, Insurance, Hospital, health care prices, health insurers, data release  
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4401 clicks; posted to Main » and Politics » on 01 Jul 2022 at 10:50 AM (6 weeks ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook



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2022-07-01 9:56:44 AM  
Sure they will, just like the hospitals were supposed to do a while back.
 
2022-07-01 9:59:19 AM  
It's on their website, there are just no links to it. And each one is in its own filepath. But you can access the physical folder where the URLs are stored in their basement. The lights are broken and the stairs are out, but the cabinet is right there in the broken lavatory behind the sign "beware of the leopard."

Can't miss it.
 
2022-07-01 10:02:23 AM  
Transparency is good. Naturally, though, this information will be available after jumping through 26 hoops on the insurance website, then returned as a 58,000 page PDF sorted by procedure codes, followed by 36 columns of gibberish, one of which shows a price. Maybe. Unless the check digits fail to return a prime number when added together and a square root is taken. Then you proceed to the next entry with the desired procedure code and run the check digit column calculation, divide by the first digit in column A6 of the immediately preceding entry, then seek the highest prime number square from the following eleven procedure code entries (but only for odd numbered dates associated with the request date for the data set). For even numbered dates for the data set, multiply the lower of the highest prime squares of columns B55 through C73 in 43 lines proceeding the second instance of the desired procedure code, then apply that product to the formula noted on line 108673, columns AB19 through AB91, reduced by the square root of column L in the fourth instance of the procedure code. This number will reveal the appropriate column to find the price factor, based on 10/6/1983 USD value, to be adjusted for inflation according to schedule 4a of the CPI reference guide published by the University of Michigan in 2013 (second edition ONLY), which may be requested by mailing a self-addressed, stamped 11x14 envelope to Marafat Associates, Inc., 117000 241st Avenue, Suite 907-N, Mailstop 486BřDæ, Caligula-Wässersteinhoffbrau, Jelog District, Banterbang, East Timor, 999077z111000. Allow 37-62 weeks for delivery.

Piece of cake.
 
2022-07-01 10:51:10 AM  
Words of advice:
1. HAVE EVERY BILL PHYSICALLY MAILED TO YOU AND KEEP THEM IN A FOLDER, THEN COMPARE YOUR PAYMENTS FROM THE INSURANCE COMPANY AND YOUR CO-PAYS TO WHAT THE MEDICAL PROVIDER SAYS YOU PAID AND WHAT YOU OWE.

Medical billing people suck donkey dong, they're always screwing up the bills against you, and will try to say you didn't make payments, etc. Also, health insurance companies will make a payment, then they'll reverse it and the provider will try to get you to pay it, even though you're covered. Currently dealing with an orthopedic place that keeps farking up the bills -- and it's not fun. If you don't have a record of what you paid and what you owe, it's hard to keep track.

2. ALWAYS PAY BY CHECK/NEVER GIVE A DEBIT CARD

Paying by check is perfectly acceptable at most places. However, in many doctor's offices they may require you to provide a card, and there's fine print that says "You permit us to charge the card on file for your balance". If you have like a Visa gift card or an HSA card or something, use that. NEVER a debit card.

3. REVIEW YOUR EOB, AND CALL IF SOMETHING IS NOT RIGHT

Instead of throwing it away, review and make sure that they covered the amount on the bill. If something is off, give them a call.

4. IF ON A PAYMENT PLAN, PAY A DIFFERENT AMOUNT EVERY SINGLE TIME

I'm on a payment plan with my dentist, and a minimum of $50 a month. So, I pay him $50.01, then $50.02, etc. Medical billing dopes will try to say that you made only 3 payments of $50 each when you made 4. So, if they say, "Well, we have a payment for $50.01, $50.02 and $50.04", you can tell them they're missing the one for $50.03 which they cashed 60 days ago without having to go searching through your checking account.

Hope this helps!
 
2022-07-01 10:52:43 AM  
10 years late, but cool.
 
2022-07-01 10:52:55 AM  
How much are those fines? How many of these companies will just pay them instead?
 
2022-07-01 10:52:59 AM  
Unless they can think of something clever very fast....

/ I was going to pretend to be mad...but, who would notice another madman around here...
 
2022-07-01 10:54:44 AM  
Is there any other industry where you show up for service without any idea of what it's going to cost you? I mean besides sex.
 
2022-07-01 10:55:14 AM  
Good. 

And I don't blame the health insurance companies alone.....a lot of these doctors are absolute scammers when it comes to over charging for bullshiat and opaque fee structures.
 
2022-07-01 10:55:23 AM  
Now we need a watchdog not associated with these companies to go over them ,publish issues and prosecute bad behavior.
 
2022-07-01 10:55:45 AM  
All of it. It's make-work at your expense. For-profit healthcare is an abomination.
 
2022-07-01 10:56:47 AM  

fat_free: Words of advice:
1. HAVE EVERY BILL PHYSICALLY MAILED TO YOU AND KEEP THEM IN A FOLDER, THEN COMPARE YOUR PAYMENTS FROM THE INSURANCE COMPANY AND YOUR CO-PAYS TO WHAT THE MEDICAL PROVIDER SAYS YOU PAID AND WHAT YOU OWE.

Medical billing people suck donkey dong, they're always screwing up the bills against you, and will try to say you didn't make payments, etc. Also, health insurance companies will make a payment, then they'll reverse it and the provider will try to get you to pay it, even though you're covered. Currently dealing with an orthopedic place that keeps farking up the bills -- and it's not fun. If you don't have a record of what you paid and what you owe, it's hard to keep track.

2. ALWAYS PAY BY CHECK/NEVER GIVE A DEBIT CARD

Paying by check is perfectly acceptable at most places. However, in many doctor's offices they may require you to provide a card, and there's fine print that says "You permit us to charge the card on file for your balance". If you have like a Visa gift card or an HSA card or something, use that. NEVER a debit card.

3. REVIEW YOUR EOB, AND CALL IF SOMETHING IS NOT RIGHT

Instead of throwing it away, review and make sure that they covered the amount on the bill. If something is off, give them a call.

4. IF ON A PAYMENT PLAN, PAY A DIFFERENT AMOUNT EVERY SINGLE TIME

I'm on a payment plan with my dentist, and a minimum of $50 a month. So, I pay him $50.01, then $50.02, etc. Medical billing dopes will try to say that you made only 3 payments of $50 each when you made 4. So, if they say, "Well, we have a payment for $50.01, $50.02 and $50.04", you can tell them they're missing the one for $50.03 which they cashed 60 days ago without having to go searching through your checking account.

Hope this helps!


Re: number 2

Always use a credit card for recurring payments or pre authorized payments, regardless of whether they are health related or not.  Do not allow any ACH debits against your checking account.  Either you write a check, run a single transaction on a card, have the payment sent by YOUR bank through electronic bill bay, or charge it on a credit or charge card,

You should never have random debits appear on your debit card or drawing against your primary draft account.  Credit cards allow an extra buffer.
 
2022-07-01 10:57:17 AM  
I got news for everyone. It's hard to write down infinity as a number.
 
2022-07-01 10:57:34 AM  

nmrsnr: It's on their website, there are just no links to it. And each one is in its own filepath. But you can access the physical folder where the URLs are stored in their basement. The lights are broken and the stairs are out, but the cabinet is right there in the broken lavatory behind the sign "beware of the leopard."

Can't miss it.


There are links to it. I know because I put the process together for my company. What most people don't realize is that it's a machine-readable file, not a human-readable report. Because of the requirement to list cost on a per-plan, per-network, per-service basis, the text-based files will reach gigabytes in size. We are a relatively small insurer, and we have thousands of plans and hundreds of networks with tens-of-thousands of providers. A x B x C = a big-ass file. Good luck searching with Notepad.
 
2022-07-01 10:57:39 AM  

White_Scarf_Syndrome: Is there any other industry where you show up for service without any idea of what it's going to cost you? I mean besides sex.


Car maintenance? The plumber? The electrician? Granted...all three will give you quotes and you can negotiate with them if repairs are more expensive than they originally quoted you.
 
2022-07-01 10:59:34 AM  
Yeah, my insurer definitely doesn't rip me off.

Cancer, chemo, all of the related tests, twice weekly check ins with the doctor, all of that, and we paid roughly $500 out of pocket for the entire adventure. Oh, and that includes a trip to the ER and a week in the hospital, with half of that being in the ICU.

I'm cool with how my insurer spends their money. But it highlights the big problem with our helathcare insurance system. You only get good rates if you have a large enough company to have some clout, or if they have a really, REALLY good HR person negotiating the insurance contract. Otherwise, you're farked.
 
2022-07-01 11:00:14 AM  
¯\_(ツ)_/¯

I like my insurance company, but then again, o actually work for a company that gives a fark about their employees and chooses their insurer.

I also live in NYC which requires insurance companies to start from a pretty high baseline.
 
2022-07-01 11:00:24 AM  
encrypted-tbn0.gstatic.comView Full Size
 
2022-07-01 11:01:14 AM  

austerity101: How much are those fines? How many of these companies will just pay them instead?


$100 per day per patient: Insurers or self-insured employers could be fined as much as $100 a day for each violation and each affected enrollee if they fail to provide the data.

So if you have the minimum number of employees to be covered by the ACA (50), and you fail to provide them with records for a week, the fine is 50 x 7 x $100, or $35,000. After 30 days, it's (50 x 30 x $100 =) $150,000.

If you have 100 employees, it's $10 grand per day.
 
2022-07-01 11:01:20 AM  
I work in the industry.  Been doing it for 20 years.  This data is almost certainly going to be unusable for the average person.

To do it right, you'll need to find out what codes and modifiers your doctor's office will bill.  Will there be a multiple procedures in the same surgery mod?  Better knock 50% off that second procedure.  Will there be a cosurgeon?  Welcome to getting billed twice for the same surgery.  Etc., etc.
 
2022-07-01 11:01:21 AM  
writing a googolplex in full decimal form (i.e., "10,000,000,000...") would be physically impossible, since doing so would require more space than is available in the known universe
 
2022-07-01 11:01:25 AM  
I full expect numbers to be at least 4000% upcharges.
 
2022-07-01 11:01:49 AM  
It'll be great to do hours of research when I'm 15 minutes from death.
 
2022-07-01 11:02:09 AM  

iheartscotch: White_Scarf_Syndrome: Is there any other industry where you show up for service without any idea of what it's going to cost you? I mean besides sex.

Car maintenance? The plumber? The electrician? Granted...all three will give you quotes and you can negotiate with them if repairs are more expensive than they originally quoted you.


"We've confirmed that it was a heart attack and have quoted you a price on our heart bypass product. Unrelated we'd like to speak to you wife for a moment about something else in our second husband line of products. Specials on through Valentine's Day."
 
2022-07-01 11:02:33 AM  

fat_free: Words of advice:
1. HAVE EVERY BILL PHYSICALLY MAILED TO YOU AND KEEP THEM IN A FOLDER, THEN COMPARE YOUR PAYMENTS FROM THE INSURANCE COMPANY AND YOUR CO-PAYS TO WHAT THE MEDICAL PROVIDER SAYS YOU PAID AND WHAT YOU OWE.

Medical billing people suck donkey dong, they're always screwing up the bills against you, and will try to say you didn't make payments, etc. Also, health insurance companies will make a payment, then they'll reverse it and the provider will try to get you to pay it, even though you're covered. Currently dealing with an orthopedic place that keeps farking up the bills -- and it's not fun. If you don't have a record of what you paid and what you owe, it's hard to keep track.

2. ALWAYS PAY BY CHECK/NEVER GIVE A DEBIT CARD

Paying by check is perfectly acceptable at most places. However, in many doctor's offices they may require you to provide a card, and there's fine print that says "You permit us to charge the card on file for your balance". If you have like a Visa gift card or an HSA card or something, use that. NEVER a debit card.

3. REVIEW YOUR EOB, AND CALL IF SOMETHING IS NOT RIGHT

Instead of throwing it away, review and make sure that they covered the amount on the bill. If something is off, give them a call.

4. IF ON A PAYMENT PLAN, PAY A DIFFERENT AMOUNT EVERY SINGLE TIME

I'm on a payment plan with my dentist, and a minimum of $50 a month. So, I pay him $50.01, then $50.02, etc. Medical billing dopes will try to say that you made only 3 payments of $50 each when you made 4. So, if they say, "Well, we have a payment for $50.01, $50.02 and $50.04", you can tell them they're missing the one for $50.03 which they cashed 60 days ago without having to go searching through your checking account.

Hope this helps!


You're hired!
 
2022-07-01 11:03:19 AM  

White_Scarf_Syndrome: Is there any other industry where you show up for service without any idea of what it's going to cost you? I mean besides sex.


Defense contracting?
 
2022-07-01 11:04:37 AM  
Mrs Gerbil had an Rx filled the other day.  Cash price - $1600 for 90 days.   Medicare price - $1100 but we only pay the co-pay.   Sams Club member price - $47.  WTF is this BS?
 
2022-07-01 11:04:40 AM  

Dr Dreidel: $100 per day per patient


Wait, no, I'm dumb.

"Enrollees" are not "patients" - and insurers generally cover FAR more than one business' worth of people. So if an insurer fails to provide ANYONE with that data, it's likely a thousand, or several thousand, people.

So for every 1,000 enrollees @ $100/day, you're looking at a fine of $100,000. Per day.
 
2022-07-01 11:04:42 AM  

fat_free: Words of advice:
1. HAVE EVERY BILL PHYSICALLY MAILED TO YOU AND KEEP THEM IN A FOLDER, THEN COMPARE YOUR PAYMENTS FROM THE INSURANCE COMPANY AND YOUR CO-PAYS TO WHAT THE MEDICAL PROVIDER SAYS YOU PAID AND WHAT YOU OWE.

Medical billing people suck donkey dong, they're always screwing up the bills against you, and will try to say you didn't make payments, etc. Also, health insurance companies will make a payment, then they'll reverse it and the provider will try to get you to pay it, even though you're covered. Currently dealing with an orthopedic place that keeps farking up the bills -- and it's not fun. If you don't have a record of what you paid and what you owe, it's hard to keep track.

2. ALWAYS PAY BY CHECK/NEVER GIVE A DEBIT CARD

Paying by check is perfectly acceptable at most places. However, in many doctor's offices they may require you to provide a card, and there's fine print that says "You permit us to charge the card on file for your balance". If you have like a Visa gift card or an HSA card or something, use that. NEVER a debit card.

3. REVIEW YOUR EOB, AND CALL IF SOMETHING IS NOT RIGHT

Instead of throwing it away, review and make sure that they covered the amount on the bill. If something is off, give them a call.

4. IF ON A PAYMENT PLAN, PAY A DIFFERENT AMOUNT EVERY SINGLE TIME

I'm on a payment plan with my dentist, and a minimum of $50 a month. So, I pay him $50.01, then $50.02, etc. Medical billing dopes will try to say that you made only 3 payments of $50 each when you made 4. So, if they say, "Well, we have a payment for $50.01, $50.02 and $50.04", you can tell them they're missing the one for $50.03 which they cashed 60 days ago without having to go searching through your checking account.

Hope this helps!



The fact that these instructions are considered helpful and, in some sense, normal is really sad.

I feel for my American friends and can't imagine the kind of stress the US medical system must generate. Even the thought of needing medical assistance must be exhausting, let alone actually using the system.
 
2022-07-01 11:04:53 AM  
In 2021, I hit my $3000 out of pocket limit on January 5 and the insurance company pickup up the other $496,000 so I've got no complaints.  So far for this year, $3000 from me, only $42,000 from them.
 
2022-07-01 11:05:14 AM  

Rent Party: White_Scarf_Syndrome: Is there any other industry where you show up for service without any idea of what it's going to cost you? I mean besides sex.

Defense contracting?


Nah, Congress says every year how much it's going to cost.

If any cash is left on the table that's entirely the fault of the contractors.
 
2022-07-01 11:05:38 AM  
I checked costplusdrugs.com yesterday. One of the meds I take is around $310 for a supply of 30 5 mg tablets through my Medicare provider. At Mark Cuban's site, it's $12.90 for 90 20 mg pills (S&H $8). The med has a long clearance time, so I buy 20 mg, break them in half and take 10 mg every other day. so, my 5 mg/day cost drops to just under six cents.  I've been buying through a Canadian company, but I'll be switching.
 
2022-07-01 11:06:13 AM  
They make a ton off me that's for sure. I pay them like 10K a year and cost them on avg $200. Hopefully my luck keeps up. Because everything costs a fark ton when you actually need to use it. I miss the old days when everything was almost totally covered. Oh that xray was $10. Now: oh that xray is $300. What the fark happened in like 20 years? I mean other than shiat getting really farked up.
 
2022-07-01 11:07:53 AM  
It's not that difficult.  Doctors contract with insurance to take a percentage over Medicare allowed.  So.... In order for the physician to maximize profit they charge 20-50% more than what they think they will get from insurance.  This was hardly a problem till the government, in the late 90's, made it illegal for doctors to charge uninsured a lower rate for paying cash.  Insurance companies didn't like that loophole and pushed to make it illegal to charge uninsured people less than what an insurance company paid.  This made it impossible for uninsured to be seen for minor illnesses cause they now had to pay 3-4 times more than they were before this law.  It had the added benefit of making the doctor look like a greedy SoB.   Which is not true in most cases.
 
2022-07-01 11:07:54 AM  

iheartscotch: Unless they can think of something clever very fast....

/ I was going to pretend to be mad...but, who would notice another madman around here...


I would notice...
 
2022-07-01 11:08:55 AM  
iheartscotch:

You go and get the car looked at for a known price. He lets you know what's wrong, how long it will take and how much the rate is, and how much any parts will cost. shiat happens, sure and it can take longer. But they call you, and get the ok before continuing work. It's definitely not my experience with healthcare.
 
2022-07-01 11:09:01 AM  

12349876: It'll be great to do hours of research when I'm 15 minutes from death.


You can still choose to go to the nearest clinic or hospital - nothing in this plan changes that.

// you can also do that research beforehand (like, look up "what 'treating a heart attack' costs at the nearest X clinics")
// might not end up being what you need in an emergency (I dunno, a bad norovirus or something), but it can likely still inform your thinking
 
2022-07-01 11:09:23 AM  

beezeltown: Transparency is good. Naturally, though, this information will be available after jumping through 26 hoops on the insurance website, then returned as a 58,000 page PDF sorted by procedure codes, followed by 36 columns of gibberish, one of which shows a price. Maybe. Unless the check digits fail to return a prime number when added together and a square root is taken. Then you proceed to the next entry with the desired procedure code and run the check digit column calculation, divide by the first digit in column A6 of the immediately preceding entry, then seek the highest prime number square from the following eleven procedure code entries (but only for odd numbered dates associated with the request date for the data set). For even numbered dates for the data set, multiply the lower of the highest prime squares of columns B55 through C73 in 43 lines proceeding the second instance of the desired procedure code, then apply that product to the formula noted on line 108673, columns AB19 through AB91, reduced by the square root of column L in the fourth instance of the procedure code. This number will reveal the appropriate column to find the price factor, based on 10/6/1983 USD value, to be adjusted for inflation according to schedule 4a of the CPI reference guide published by the University of Michigan in 2013 (second edition ONLY), which may be requested by mailing a self-addressed, stamped 11x14 envelope to Marafat Associates, Inc., 117000 241st Avenue, Suite 907-N, Mailstop 486BřDæ, Caligula-Wässersteinhoffbrau, Jelog District, Banterbang, East Timor, 999077z111000. Allow 37-62 weeks for delivery.

Piece of cake.


But at least the government isn't involved. That would be terribly inefficient.
 
2022-07-01 11:10:51 AM  
My understanding is since insurers are capped at 15% profit on the premium the only way they can make more money is to go into agreements with hospitals to pay more.  They then go back and say "well health care costs are going up we have no choice but to raise your premium."
 
2022-07-01 11:11:47 AM  
I had a heart attack in 2006. Thankfully all I needed was 5 stents in a few arteries.

One day while laying in the hospital bed, in the heart-attack ward, one of the nurses came by and I just happened to ask her.

"Hey would you know how much all of this is going to cost me?"

She said she didn't know and that when I was discharged, I would be set up with a full itemized bill/invoice.

So a week later I'm getting discharged. I'm in the head nurses' office going through instructions, paperwork and finally she tells me the final bill.

Nurse: So we have to wait to hear back from your insurance company but right now, as of this moment, we're billing you and them, $120,000.00

Me: I just had my first heart attack are you trying to give me another one?

In the end, my wife took care of my finances and I'm not sure what the insurance paid and what we paid but I know for the longest while, she was cutting checks to the hospital.

Wife: You know Stek we don't have to pay what they suggest on the bill here, they'll be happy to get a few bucks so I've been sending less than what they've listed. They won't put us in collections, because we're sending in "some" money.
 
2022-07-01 11:11:56 AM  
If we're talking hospitals, go to the non-profit hospital.  Their care is more patient based than money based most of the time.
 
2022-07-01 11:14:59 AM  
Fark user imageView Full Size
 
2022-07-01 11:15:34 AM  

Dr Dreidel: 12349876: It'll be great to do hours of research when I'm 15 minutes from death.

You can still choose to go to the nearest clinic or hospital - nothing in this plan changes that.

// you can also do that research beforehand (like, look up "what 'treating a heart attack' costs at the nearest X clinics")
// might not end up being what you need in an emergency (I dunno, a bad norovirus or something), but it can likely still inform your thinking


Except ambulance drivers take you to the closest facility, not the closest one in your network.
 
2022-07-01 11:19:20 AM  
WHAT ARE YOU GONNA DO ABOUT IT?
 
2022-07-01 11:20:04 AM  
You know...  The economists of the world have run the numbers.  The amount that we currently pay for healthcare in this country FAR outweighs what we would be paying if we had the government pay for it all, and just paid a little more in taxes.

Like, the amount that we would have to pay in taxes is a small percentage of what we actually pay now, both for insurance, and THEN for the stuff that insurance doesn't cover.

The math is done.  The data is in.  The proof on concept is already out there, in that every other civilized country in the world has universal health care.

But this government will NOT budge.  Partly because the Republicans refuse to budge.  But also because the Conservatives that that "socialism" is a bad thing.

I know I'm preaching to the choir here.  But it just sucks.
 
2022-07-01 11:21:08 AM  

gyruss: Dr Dreidel: 12349876: It'll be great to do hours of research when I'm 15 minutes from death.

You can still choose to go to the nearest clinic or hospital - nothing in this plan changes that.

// you can also do that research beforehand (like, look up "what 'treating a heart attack' costs at the nearest X clinics")
// might not end up being what you need in an emergency (I dunno, a bad norovirus or something), but it can likely still inform your thinking

Except ambulance drivers take you to the closest facility, not the closest one in your network.


So you're saying nothing changes in an emergency situation? Welcome to my point.

// I guess "choose" was the wrong word - "you can still go to the nearest hospital"
// but OP implied they were going to the ED/ER under their own power and not in an ambulance
 
2022-07-01 11:21:20 AM  

bthom37: I work in the industry.  Been doing it for 20 years.  This data is almost certainly going to be unusable for the average person.

To do it right, you'll need to find out what codes and modifiers your doctor's office will bill.  Will there be a multiple procedures in the same surgery mod?  Better knock 50% off that second procedure.  Will there be a cosurgeon?  Welcome to getting billed twice for the same surgery.  Etc., etc.


You should know better. It's not going to be nearly as easy as you've suggested.

Happy to no longer work in the industry.
 
2022-07-01 11:23:23 AM  

Nirbo: Rent Party: White_Scarf_Syndrome: Is there any other industry where you show up for service without any idea of what it's going to cost you? I mean besides sex.

Defense contracting?

Nah, Congress says every year how much it's going to cost.

If any cash is left on the table that's entirely the fault of the contractors.


I can find no flaw in your reasoning.
 
2022-07-01 11:25:43 AM  
who cares, nothing will change from this.

my biggest and most successful American investments are, and will continue to be:

-Medical debt collection
-Student loan debt collection
-General Debt collection

Land of the "Free", home of the indebted.
 
2022-07-01 11:28:17 AM  

durbnpoisn: You know...  The economists of the world have run the numbers.  The amount that we currently pay for healthcare in this country FAR outweighs what we would be paying if we had the government pay for it all, and just paid a little more in taxes.

Like, the amount that we would have to pay in taxes is a small percentage of what we actually pay now, both for insurance, and THEN for the stuff that insurance doesn't cover.

The math is done.  The data is in.  The proof on concept is already out there, in that every other civilized country in the world has universal health care.

But this government will NOT budge.  Partly because the Republicans refuse to budge.  But also because the Conservatives that that "socialism" is a bad thing.

I know I'm preaching to the choir here.  But it just sucks.


A good chunk of those savings come from people being able to get treatment for things when they are minor and inexpensive to treat, instead of a major emergency that is expensive to treat. There was a study, probably 15 years ago, in, I think, Texas, that assigned nurses to frequent users of the local emergency department (mostly poor/homeless/etc.) and actively went out to proactively check on them on a regular basis. I forget what the exact numbers were, but it cost less than waiting for them to turn up with a medical emergency. But, if we did that, some "undeserving" people might get something they didn't pay for and that would be "unfair". At least that's the best summary I've been able to come up with for the current conservative mindset.
 
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