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of United Healthcare CEO Brian Thompson shot dead Many people felt a sick sense of inevitability online. The often indifferent nature of the U.S. health care system has long been widely debated, and evidence is mounting that the way the country delivers health services comes at significant costs in both money and lives. Executives in the healthcare industry, from insurance companies to pharmaceutical companies and even hospitals, have become popular villains.
Killing humans is a morally abhorrent act, please stop it. However, many people still I found myself asking: If that happens, Maybe sois it any surprise that the shooter’s primary motive was the injustices of the American health care system?
On the day of shooting, News about different insurance companies Restrictions on the application of anesthesia during surgery spread quickly and served as a kind of cosmic support for this idea. In New York City, a health insurance executive was (supposedly) shot and killed for the industry’s greedy practices, while another insurance company suffered the worst stereotypes with seemingly arbitrary limits on anesthesia benefits during surgery. affirm.
However, the reality is more complex. As Vox’s Eric Levitz covered, this policy doesn’t actually result in higher bills for patients. Rather, it is a type of cost control often guaranteed by policymakers when the public’s interests are elsewhere, aimed at reining in high payments to health care providers. However, with the public political riot Because we didn’t stop to build that relationship, the insurance company quickly withdrew the policy.
All aspects of this tragic episode taken together reveal the rotten core of American health care. The ongoing blame game between the brutality of the U.S. health care system and the private industry that profits from it has left patients angry and confused, with no one to blame, fair or not. trying to inflict
No one person, or even one industry, is to blame for America’s health care failures. Finger pointing is a distraction. All parties are responsible. The only way forward is to consider that collective failure. If we have any hope of creating a world that the Thompson shooting truly couldn’t imagine, we need to start working towards a more rational and just system.
Distracting Medical Liability Game
In the early days of the modern American health care system, the private industry that made up the bulk of the health care sector was a collaborator.
In the mid-20th century, physicians in particular were passionate defenders of private insurance. American Medical Association and its brethren very favorable The state decided to cover most people with employer-sponsored private insurance rather than government programs and lobbied heavily to crib the latter. They allowed the creation of Medicare and Medicaid in 1965 to cover the uninsured population, but they will come together again to buy insurance. Stop Clinton’s health care reform efforts in the 1990s.
All involved were invested in preserving the free market system. Hospitals and drug companies can raise prices, insurance plans can pass those increases on to employers, and thanks to Congress, health benefits are now tax-free, making price hikes easier to tolerate. Medicare and Medicaid limited spending, but created opportunities for the private portion of the market to increase profits, working together whenever the status quo was threatened. At least for a while.
but prices continue to risehas been accelerated by the aging of the baby boomer generation and important but costly medical advances. Today, as everyone knows, healthcare in the United States could be: prohibitively expensive Even if you have insurance. Almost 4 out of 10 Americans say They skip necessary medical care because of cost; millions of I have medical debt from a past incident.
The passage of Obamacare over industry opposition was the first sign that the political stranglehold on the private sector was loosening, President Obama said. successfully divided the industry against itselfis aiming for cuts by targeting insurance companies and hospitals, effectively buying into the opposition of pharmaceutical companies. Recent anti-inflation legislation includes provisions that allow Medicare to negotiate prices with drug companies, reducing costs and allowing the program to cap out-of-pocket costs for seniors. . This would have been unthinkable a generation ago in the era of major pharmaceutical companies. carried out lobbying activities Congress prohibits such policies. Lawmakers from both parties continue to look hard at ways to overhaul the health care system and cut costs.
This political realignment pitted insurance companies, pharmaceutical companies, and the hospital industry against each other. I have been covering health care for over 10 years, starting shortly after the ACA was passed. During this time, the battle lines became sharper, with each sector blaming the other for patients’ dissatisfaction with the health care system.
- hospital condemnation pharmaceutical companies (because they charge higher prices that must be passed on to payers) and insurance company (to limit benefits and expose patients to non-covered claims)
- Pharmaceutical companies’ fault insurance company (to charge patients high co-payments for medicines) and hospital (To exploit technical programs like 340B to artificially increase profits). They also blame pharmacy benefit managers (PBMs), which coordinate between drug companies, pharmaceutical companies, and pharmacies.
- Insurance company’s responsibility hospital and pharmaceutical company (because they charge higher prices for services and products and patients pay higher insurance premiums and co-pays)
- Patients blame everyone (because of the high costs they face and the hassle of navigating this complex system).
This leads to misplaced anger towards Anthem’s anesthesia policies. Doctors portray this as insurance companies trying to police patients, but it’s actually a plan to lower overall costs and save patients money. It will be difficult to do anything to reduce costs, and dissatisfaction with the system will metastasize until we see what happens after the murder of UnitedHealthcare CEO Brian Thompson.
Collective failure of US healthcare
Let’s be clear: health insurance companies have received a lot of scorn. Before the ACA was enacted, they simply denied coverage to people with high medical costs. Now that the ACA is law, insurance plans are more constrained, but new reports continue to emerge of new tactics by insurance plans to deny coverage to patients. they are equal Make it happen with AI. United Healthcare is The subject of recent ProPublica revelations Among other things, the company uses algorithms to deny claims for mental health services.
Similarly, pharmaceutical companies are sitting on the sidelines for now. Their critique of how health insurance companies, PBMs, hospitals, and their entities steal money in the drug reimbursement process has some merit. But drug companies also exaggerate how much the high prices they charge are necessary to fund research and development for new treatments. How do they swerve when pressed? exploiting loopholes in patent law To maintain a monopoly on the prices of popular drugs like diabetes drugs Humalog.
It’s no surprise that the insurance and pharmaceutical industries list hospitals and doctors as their biggest companies. Drivers of U.S. health care costs. Most doctors are very generously compensated, and entry into the field is restricted, leading to fewer doctors, less access to care, and higher costs per patient. Masu.
But health insurance companies have legitimate complaints about the way they roll out their networks to limit coverage. For example, health insurance companies must overcome prior approvals and other bureaucratic hurdles to receive compensation for patient care. U.S. doctors may earn more, but they also spend more Administrative tasks cost more time and money than its peers in other countries.
And round and round it goes.
People are fed up. The healthcare industry briefly gained popularity during the pandemic, but its approval ratings remain As measured by Gallup The approval rating has returned to 31%, with 51% disapproving. Percentage of Americans approve of the quality of health care they receive fell to an all-time low. Only 18% of Americans view Favorable to the pharmaceutical industry. 60% have a negative opinion. According to I am. KFF.
providers enjoy highest approval ratingthat may be why many people instinctively opposed the Anthem policy. However, while the majority of Americans still prefer nurses, their ratings of doctors and hospitals have declined, from 81% in 2003 to 69% in 2023, and over the same period for hospitals. It has increased from 70% to 58%. The passage of the No Surprise Act targeting hospital billing was a sign that their political influence was weakening.
America’s health care failures are collective, the result of a system that was haphazardly put together over decades rather than thoughtfully planned from the beginning. Even ordinary people often have conflicting desires for both more choice and guaranteed coverage. conflict between two impulses Helps explain the uphill battle for health care reform in the United States and history of voters punish politicians People trying to change the system.
Some progress has been made. Uninsured rates remain too high, but as low as ever 10 years after ACA. Medicare can negotiate drug prices, and seniors now have to pay out-of-pocket for their medications. with cap first time.
More work needs to be done, and to do so we need to overcome the industry’s tough calls. Some kind of reform is required in every field.
We can only save the system by looking at it as a whole and finding ways to make it economically viable while providing the necessary care to everyone who needs it. lagging behind other rich countries. There are many ways to achieve a version of universal health care. The United States, like other developed countries in Europe and Asia, still needs to decide that this is actually what it wants. Many Americans have no concept of a world where people go bankrupt over medical bills, which is a daily reality in the United States.
No one, not even the CEO, is responsible for all of the nation’s health care problems. These problems have been festering long before most of us were born. No one has all the answers either. But it has long been clear that the entire system is deeply flawed. Fixing this requires better policies across all industries that make up the so-called American health care system.
