Yea, my system likely does as well, particularly nurse practitioners.

Millions of Americans being able to just go to the damn doctor, get their insulin, etc., will be worth the *effort* it will take us to make M4A work.

Profit-driven healthcare is not working. Only reason these CEOs are "worth" millions is because of how well they are screwing us over.
We are paying far more than other countries for less desirable outcomes. We can do a lot better. We must do a lot better..

The health insurance fund I pay money to is not-for-profit. Weird huh?

This is the essence of the problem, and why it's insane to leave health insurance up to the for-profit private sector: companies maximize their profits by minimizing how much healthcare they provide.

It's that simple. The more a company spends on providing, you know, actual healthcare to a person, the less money they make. Because a company and its executives are legally bound (in the U.S.) to always maximize shareholder value they have to spend as little as possible (or they'll get sued and the executives replaced with amoral ones with no hesitation to do it).

Some insurance companies talk about 'investing' on 'prevention', 'wellness care', etc. Of course those are sound and needed approaches - preventing illness is usually more effective, less expensive, and better for you than treating disease once it's occurred.

Unfortunately, it's also mostly bu!!sh!t. Some worker-level employees believe in this necessary mission and try to carry it out. But the senior executives know it's just propaganda.

Company share prices are driven by short-term profits. Public companies literally live and die by their quarterly earnings. Their executives (and their hallowed bonuses) also live and die by that. 'Investing' might pay off years down the road. Or it might not. But cutting costs to the absolute bare minimum you can possibly get away with, investors LOVE that because it pays off TODAY. Investors don't care about what a company does that might improve the fundamentals of the business years down the road. They severely punish you if you try to do that. Shareholders want a company spend money on stock repurchases, not to invest for the future, and often sue if you don't. They only care about pumping the stock price in the shortest time possible. I worked with venture capitalists and Wall Streeters for over 35 years, and would be hard pressed to think of a single institutional investor I ever dealt with who actually cared about anything other than the short term (because that's how their performance is judged, and how their bonuses are determined).

Every other developed (and not-so-developed) country in the world has realized this. You don't want to put healthcare in the hands of people whose mission is to deliver as little healthcare as they possibly can.

Why do we put up with it? Money. The people in charge are making so much money with the current system, they are highly incentivized to keep it. The companies raking in the money certainly have no incentive to put themselves out of business, and their shareholders are also profiting from the ride. They spend unimaginable amounts of money lobbying members of Congress and lining their pockets to keep things just the way they are. So we end up with false messaging equating national healthcare with 'socialism' and ridiculous untruths and scare tactics about 'government death squads' deciding who lives and dies, and how awful 'socialized medicine' is in other countries. Enough people believe the lies, don't educate themselves on the realities, and the system continues.

Regardless of what a person believes, we all pay the price by spending a lot more than we should, and getting a lot less. In the case of the roughly 30 million uninsured people in this country, getting nothing at all.

Yea, if given the option. I’m choosing private. Until I’m told I don’t have a choice, that’s my right.

How many of you M4A supporters signed up for ACA? Or even (as a stretch) experienced public insurance whether it be in the military, VA, or Medicare? I’m interested to hear some real life, first hand, experiences instead of paper ideas.

I already posted this. There is a difference between VA insurance and VA hospitals, but this:

https://content.gallup.com/origin/ga...4jxswxqvjg.png

https://news.gallup.com/poll/186527/...satisfied.aspx

Even with non-profits we have this:

https://www.google.com/amp/s/www.ibt...863585%3famp=1

I don’t have first had experience of government insurance. I work for a hospital and am on private insurance that is an EPO (half way between a HMO and PPO). I have been under-insured and uninsured in my life. I’ve had bad experiences with private insurance and not being insured.

I obviously see the benefits from healthcare expansion through the ACA first hand from patients. I deal with the VA hospital and clinics, as well as, medical and medicare and medicaid insurance. I have family using different types of insurance from government, medicare and private. I know of bad experiences, but I don’t know their overall opinion.

I see waste from restrictions like VA patients need to be transferred to the VA for admition, so they get two bills now. I see the same for HMO/capitated patients that have to be transferred and double charged.

These types of anecdotal stories really aren’t guaranteed to be representative. I’d like to think my experiences aren’t bias and would reflect most experiences, but I can’t guarantee that, which is why we rely on other metrics. I probably have thousands of stories from patients, so there is a lot to share. In general, I see that coverage is an obstacle for receiving the best care, and insurance causes a lot of waste, while passing the buck to patients with higher premiums or refusing to pay for something.

Because I work for a Catholic hospital system, my insurance reflects their values, so even though most insurance companies would jump at the opportunity to pay for an abortion or pay for a vasectomy, they don’t allow it. In fact, if it wasn’t for the ACA mandating they pay for birth control, we would have to pay that out of pocket. That wouldn’t be the end of the world, but it highlights the issues. Per diem employees get 15% extra pay to offset the lack of healthcare and lack of other benefits, but full time employees either accept the healthcare plan, or they get nothing, so if I wanted to get on my wife’s insurance then I wouldn’t get 15% and the hospital gets to pocket the premiums they don’t have to pay for me. Odd because I would rather have the cash or have taxes taken than feel like I’m getting less contributions than my coworkers just because I chose her plan. Because of that, we have a problem maintaining full time staff and maintaining staffing levels. I’m regressing and ranting.

The system needs improvements.

This is skewed. The VA is relentless with their surveys, I get two letters and a follow call for a survey after every interaction. I spend on average ab 45 minutes on hold just to get simple questions answered. I don’t believe that number to be accurate at all. It’s quite laughable. For the record, I’ve never filled out a survey because the last thing I want to do is be on the phone with them longer.

I prefer BCBS over my VA insurance everyday of the week and twice on Tuesday. As a recipient of a VA insurance, I avoid it like the plague until they require me to be there.

Gallup did the survey. This information was in the article:

https://content.gallup.com/origin/ga...pg3y0ybdxq.png

Frankly I don't trust the surveys to mean much. I'm a good example. I've been on some form of health insurance for 40 years. During that time, my use of the system has been only for routine care as I've never had a major health event. So, for the most part I am satisfied with the insurance I have because it has always covered my needs.

The problem is, my opinion shouldn't matter because why would I have a bad opinion of the system?

Lol another thread gone off topic

I’m sure medicare, medical, medicaid and VA insurance patients use the system more than private insurance members, so the fact that they report back satisfied reflects that much better, as whatever they say is likely more accurate. I’m sure the biggest problem people have with private insurance is the premiums that continue to rise and employers jumping plans all the time. The other things are the limitations some plans have like the ones I mentioned in mine or network limitations. While problems can be found in all insurance providers, and there is some overlap, I see more people underinsured or limited with private insurance, even though it can offer the opposite. The reality is many don’t have premium private insurance.

The elephant in the room is that satisfaction is inversely correlated to outcomes *for hospitals*. Meaning, someone could be upset that they didn’t get that MRI for their hangnail, or didn’t get antibiotics or retrovirals for their cold, or didn't get a prescription for two bottles of oxytocin, but they are better without those things when they don’t need them. This could be the case for insurance too, but I don’t know if it applies the same. I only know it is true for hospitals, but it is worth mentioning. FYI, patients of female physicians have better outcomes like mortality is lower.

It’s not that I don’t trust Gallup it’s that I don’t believe it is an accurate representation of the truth. Go visit of a VA hospital and tell me that 78% of that lobby is happy with their service.