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Friday, December 6, 2019

Republicans think U.S. Health Care is Normal and should be Profitable?

While my Trump cultist friend in Milwaukee is as happy to see Wall Street and black employment up "like never before," he's one of millions being told; be happy, this is normal and will be protected by Republicans only if we do nothing.

The U.S. Health Care Horror: The surreal idea Republicans have for our private health care system: It's good now but could be better if free market competition and profits were allowed to flourish. It's supposedly normal to have only one month to shop for insurance, pay higher monthly premiums, co-pays and deductibles, all the while trying to decide if you can afford to use your insurance when you finally need it. Does that make sense, seriously?

Here's a great summary from an actual doctor and medical journalist, Elisabeth Rosenthal, from Kaiser Health:
There’s one issue that nearly every American can agree on: Our health care system is a mess and in need of dramatic overhaul. That’s not just because it is absurdly expensive compared with the systems of other developed countries. It’s also because it is so dauntingly complex ... driven significantly by profit, rather than by measures of health. Countless providers, companies, consultants and intermediaries are trying to get their piece of the $3.5 trillion pie that is U.S. health care. That has led to a maze-like system — with twists and turns and barriers and blind alleys and incomprehensible signposts — that ordinary people are expected to navigate. We say ... our system gives consumers choices. We tell people that to benefit they just need to be smarter shoppers. What we are really telling them is to perform the impossible.
Any adult whose seen a doctor, whether for themselves or their kids, has experienced much or all of the following "choices:"
"Choose an insurance policy; endless permutations involving personal budget calculations and modeling that would defy a post-doc in economics; in-network deductible and an out-of-network deductible; copays and coinsurance (yes, they’re different); as well as an annual maximum personal out-of-pocket outlay; choose between a PPO and an HMO; a tax-advantaged flexible spending account or health savings account; rigged against patients thanks largely to its opacity and complexity; Insurance plans can refuse to pre-certify a prescribed treatment or decide it was not medically necessary and deny coverage after the fact; complexity grew out of financial considerations; All the players are effectively licensed to reach into our wallets when they can’t get the money they want from one another."
A few more important final thoughts: 
"We’ve turned somersaults not to do what almost every other developed country has done; restrain charges by setting prices or by large-scale national negotiations. “Innovation” in our profit-oriented system is not just about developing lifesaving treatments, but also about inventing new ways to bill and new charges that don’t exist elsewhere.

Americans trying to be smart shoppers are understandably confused about navigating the open enrollment season, as they are doing currently. And just when they have figured it out for one year, they have to do it all over again. The odds of success are small."

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