It seems like there are other mechanisms in play that are forcing costs to increase such as poor diet and exercise causing diabetes and heart disease, drug usage, and too few people coming into the system to pay for the aging population.
I stopped in at an urgent care center Thursday to get antibiotic. Less than five minutes at the UCC and 14 generic tablets cost me $87 out of pocket. I ended up in the ER in 2005 after a spider bite and the bill was over $10k a day. That was almost twenty years ago so it would probably cost twice that now. That level of price gouging when you have no alternatives should be illegal.
What I don't understand is why people stay in America. I left the country immediately after my experience having seen through the system for the scam it is.
@@themartinanderssonBecause they're constantly being told all other solutions: *A)* Lead to Communism *B)* Are impossibly expensive and *C)* Will leave the streets littered with the dead bodies of people who had to wait for government mandated treatments. Complete and total bullocks, of course. But the average American has no reference point to recognize how much they are being exploited.
@@sacul139 How much "health insurance" do you need in Sweden which has true universal healthcare (i.e. perfectly adequate care, no more no less)? Zero.
Unfortunately it’s a necessary for any valuable service to be profitable else you can’t attract enough talented people to run it. Just like for profit hospitals
Some people kill with bullets. Other people kill from behind a desk on the 98th floor of a skyscraper or a yacht in the Maldives. Friedrich Engels called this “social murder.”
@@ziliflax4689 You built a society that decided life is only valuable if it is profitable. Can't be surprised when everyone else decides life isn't valuable either honestly. Its just the natural conclusion to a psychopathic society.
Most Americans have no idea how cheap healthcare is in other developed countries. I’m a Korean-American and here in Korea X-rays cost 5-6 bucks, MRIs cost like 100-150 and most drugs between 5-20
There are other problems with single payer system namely long wait line and overworked medical staff. There are no perfect solution here, only trade offs
@@cokechang yeah but those same problems are happening in the US as well. So we have worse outcomes, twice the price and still have long lead times and burned out medical staff.
@@Metal_Fingers. Don't count on it. People have been well trained. The rich and powerful and act like savages for sport, but us normies are told the entire species would collapse if we stopped being civil and demanded justice for once. Millions of dollars have been spent to make sure our fellow Americans sit in that jury box and unironically think "I hate what happened to my family, it the law is the law. Thems the breaks!" Maybe I'm just cynically. I wish with every fiber of my being for a jury Nullification, but realistically they're going to find the most boring, bootlicking boomers on the planet to judge them.
Sometimes I feel truly sorry for Americans. Our free healthcare is far from perfect, but NOBODY worries about being able to afford treatment for serious illness or injury. (UK).
First, don't feel sorry for us. We are doing to ourselves. Second, one of the arguments against getting nationalized healthcare has always been to point out the imperfections in other nations systems (specifically the UK) and say "See!? Nationalized healthcare sucks!". The 'don't change what you know for what you don't know' crowd is easily swayed by these kinds of arguments.
@@ldkellandshaw Having British American dual citizenship is such an amazing cheat code for maximizing earnings and minimizing risk. Too bad most of y'all aren't thinking in terms of risk.
@@ldkellandshaw Inarguably true. If you've got the money, America's healthcare system is the *best* in the world. And it is _exactly_ why so many people are positively giddy at the death of the CEO.
A dentist charged me cash price of $110 with saying that my insurance doesn’t cover their consultation because I got a maxed out of the consultation coverage. So I paid in cash at the visit and found out later that that dentist claim another $1,100 on my insurance company for 10 minutes consultation and 3 x-rays eventually denied by the insurance company. The scam artists exist out there in an insurance sector as wall as practitioner’s. Be very aware with what the doctor’s office charges you on your insurance. What they charge is ridiculously high. That is how they drive healthcare cost higher and higher for American people.
I've seen plenty of cases where service providers are defrauding Medicare and insurance companies for millions of dollars and they get like 3 years jail if they get jail at all. Why wouldn't you be a white collar criminal when the rewards far outweigh the risks?
@stevechoe6729 In 2007, a private dentist told me that my tooth needed a crown. The cost would’ve been $1895 USD. I went to a dental school to get a second opinion and the crown specialist professor there told me that I didn’t need a crown, just a white filling. That filling is still there as of today. My cost was zero dollars.
I don't think controversial describes a criminal operation designed to fleece the vulnerable. "Medical Bankruptcy" is the major type of bankruptcy in the US, it is virtually unheard of elsewhere.
You'll still be complaining when you get a bill for 20% of the charges - which is what Medicare dosent cover. Oh and the Medicare Part B premium of $185 a month.
VA healthcare isn't remotely what you want. However that is what you're asking for at this point. You will wait weeks and months to be seen by a doctor.
They tried 'AI' for sorting CVs for job candidates and it was found to be rejecting appropriate applicants. And that's for a job...this is for a life. AI - most oversaturated term of the year, they'd of called queues in Rollercoaster Tycoon AI if they had the foresight.
@ I think the point is that insurance shouldn’t deny legitimate claims that could save lives. I’m not saying killing is justified. Maybe 🤔 your reading comprehension is lacking.
@ldkellandshaw I am not against private health care. But this greed and appeasement of shareholders is killing people. If the USA had public health care for everybody. Private corporations would need to compete with that. Now, it is race to the bottom. Who can charge more for less. I live in Europe and it is difficult for me to understand how Luigi didn't heppend sunner.
@@dduntOn point why don't nationalize it like im canada where provincal government's agencies get billed and take it private. It will increase transparency and lower admin costs.
@@ddunt I am British by birth and lived in the UK until I was 30. I have now been in the US 10 years and am naturalized. The US system is FAR superior for those that have the means to pay for the care. I have access to treatments and drugs that I would have had to wait years on a waiting list for on the NHS. The problem is the gap for people that do not have the means.
I didn't get a raise last year, so I dropped to the cheapest tier of my workplace's healthcare plan. Turns out this plan refuses to cover more than one month of maintenance medications at a time, even if your doctor wrote you a preacription for more than one month at a time, unless you agree to get your prescription filled by the insurance company's private mail order pharmacy. Which means if the mail is late for any reason you're *screwed*.
I bet if we paid pennies on the dollar on extra taxes, the government could lower the administrative costs to be more fair, subsequently lowering health insurance costs. I get it, businesses love the idea of having profit margins in the mid teens, ideally around 15%. But health insurance deals with people’s lives. You can’t screw customers over just to keep your shareholders happy. You shouldn’t have to worry about putting your shareholders first. They should have focused on cutting administrative costs such as overpaying themselves with bonuses/salaries or having too many middleman, there is absolutely no reason denial of claims should be so high when premiums are so high and only getting higher.
@@johanalejandrocazadordepin7225insurance companies do not create medicines , pharmaceutical companies do. The American per capita healthcare spending is 2x European spending with worse outcomes American public spending is the same as Europe yet Americans pay out of pocket. Either nationalise healthcare or remove government intervention
Unfortunately that is not how businesses operate. Very few businesses have a 15% profit margin, in most industries a 7-8% margin is already very good. In case of United Healthcare, they had a 6% margin in the last 2 years, but their average margin is around 4-5% for the last 10 years.
@ the profit margin number is just a number and can hide excessive/unnecessary spending. Quite frankly, even if a person looks at their balance sheet/income statement, I’m sure there’s ways to hide excessive expensive in account descriptions that no one understands. So while a 6% margin makes them look humble, no one believes they are
Dear Americans, it's your choice. If you have health insurance with for profit company, It will always be in their best interest to reject your claims. Any CEO doing something else, will be fired. If you've voted for Bernie Sunders, maybe something would change. Insted you choose billionaires and millionaires to run your government.
In a large part of Europe, under the Bismarck system, health insurance is/can be private, as are the hospital. They are for-profit organisations. But still, they operate quite different from the US. But as a latest case in the NL, it should never the insurance orgs that determine whether a claim is denied, it is a medical decision. Whether it is worth doing a procedure should be regulated, where, yes, also the cost factor is weighted in. In the NL, this is based for life lengthening procedures based of a maximum cost per year won. Cold but fair in principle, rather than on a CEO greed. Left to right in the EU, basic medical care should be afforable. You don't have to vote Bernie, just don't let big companies decide things.
No pencil pusher is deciding what care old dying patients get in Canada. Total BS statement. Dr’s decide and if anything they offer more care and resources than are necessary. They are often hesitant to give up on a patient at any age. Americans will find any way to excuse their heartless healthcare system. In Canada when you get Cancer you don’t have to fill in forms for your insurance company to decide if your chemo is covered. I love the American system when I am travelling because cost isn’t an issue for me. But I am also glad to come home to a place where I know my neighbours are cared for.
You neglected to mention the outcome that the ratio has had: rather than increasing coverage, it increased prices. Health insurance providers have an incentive to jack up the price of care to force the uninsured to seek health insurance. Every treatment needs to break the bank on the ticket price, but be negotiated behind the scenes to what its actually supposed to cost and the amount the insurer ultimately pays. They deny everything they can so they can keep the costs of treatments high without dipping into profits.
Another reason for those ludicrous base prices is to price gouge other health insurance companies for out-of-network services. Of course, in return affordable health insurance plans have shit out of network coverage. They don't want to donate money to other companies. It also makes it way harder for any upstart insurance companies to get a foot in the door.
Trump made it possible to be uninsured with no penalty. It just drove up costs for everyone else but you don't have to. You will likely be fucked but you don't have to
In my country Australia, maternity care is 100% free. My wife suffered from preeclampsia (high blood pressure in pregnancy) needed to be hospitalised for 4 weeks before giving birth and 3 weeks afterwards, we have both her and our son healthy and at zero out of pocket expense. Had we not had this support we could have lost both our son and my wife, and in an expensive healthcare system we could also be bankrupt for whatever outcome occurred. Now for Americans this may sound like scary socialism - but let’s look at this from a productivity standpoint, a healthy population can continue to work hard, contributing the GPD and the tax base - so why not have a healthcare system like this?
Managed care insurers are not medically necessary. They are a cost in the system and create inefficiency such as administrative cost. They do not increase the quality of care, contrary to what they say they do. There should be no business in the healthcare field that seeks to create ever increasing value to their investors. The hospitals, physicians, nurses, etc are also affected by these middle men. Politicians should not be allowed to see or benefit from lobbyists, directly or indirectly. Hopefully, the Dept of Govt Efficiency will take action in 2025 to cut govt and taxpayer waste.
The origin of the US healthcare system is NOT Obamacare in 2010, the employer provided healthcare system originated from WW2 by pure accident as a result of strict government price controls. Essentially the government limited how much employers could pay employees and controlled the costs of everything in the economy, so labor unions couldn't ask for more money. Hence they asked for health insurance instead, and got it, and this became the standard, even though it's a horribly inefficient system. The Obamacare changes tried a more free market approach to fixing problems with the system (and it did fix some big problems), but obviously it still has a lot of issues, but it DID NOT create the horrendous healthcare system we have today. Prices were also sky rocketing for health insurance BEFORE Obamacare to.
After debating for over 50 years, For Profit Healthcare has failed. Time for the USA to move into Single Payer Healthcare, Medicare For All, Universal Heathcare. For Profit Healthcare needs to end, once and for all, in the USA.
Classic question: Who responsible for Ai's decision? My proposal, if it is a corporation, the responsibility is fall to its CEO. If it is individual, the responsibility falls under its user.
I disagree with the idea that the faceless company should be the one to determine that treatment is not needed and not the hospital and doctors. Hospitals and doctors are not charities either, but they do know what their patients need for treatment, whereas the company does not. I've heard many times dumb shit where insurance won't cover certain amounts or brands of the same drug, but if you ask for slightly different of the same stuff suddenly their system approves it. It's insane and I don't fault Luigi for feeling like he needed revenge.
The principal is since but the practise is different. Doctors over treat, over test, and over prescribe. Thats a fact. That fact exists because the litigious nature of the US. Something will need to change there in consort with healthcare reforms.
Defining 'excessive profit' is almost impossible. If that becomes a concern for an industry, then that industry should be removed from the for-profit arena.
@@who2u333 when you achieved those profits by breeching over 30% of your contacts, that's an excess. That was resource that should have been spend on services, not a excess.
Private services will ALWAYS cost more. The reason is simple: private services also need to show some profit to cover themselves, but it gets worse, because if that private service is on a stock market then they need to show growth, so have to make more profit every year. A public service NEVER needs to show these things. they just have to meet budget.
I have no evidence, but I suspect my previous employer received an under-the-table payment to switch from BCBS to United. Decade later they went back to BCBS.
I appreciate your data focused breakdown on this topic. Most takes are just too politically biased. Ultimately the facts just speak for themself - no pundit needed.
This guy is wrong. In a public system, the standard of care is determined by medical professionals who weigh desired outcomes with curent research. It is very uncommon to need to reinvent the wheel when assessing patient care needs so the path is well understood. If you do need a new expensive treatment, then there is a process for special authorization. If declined, then you are no worse off than if you had been in private care to begin with!
I’m a free market person like probably most viewers here but healthcare is something everyone needs at some point and should be universal, no questions. Im guilty of avoiding a doctors office several times in my life I should have absolutely gone, due to what cost I could incur and that’s just sad.
I believe the anger comes from the "bait and switch" tactics. The insurance companies take premiums every month, often for years. Then, when it comes time to utilize the service a person paid for, all too often the service is refused. The appeal process is so arduous, that many people just give up. All this is done with deliberate intent. The results are greater profits for NOT providing a service and the customer's health deteriorates or even dies. It is a scam that many Americans are starting to lash out upon.
This is kind of a side issue but I want to point something out about the obesity rate in the US- that 40% figure comes from a single source, the CDC and they base obesity EXCLUSIVELY on a person’s BMI value. Also, even by the CDC’s own standards, obesity has actually plateaued, yet nothing has changed about American dietary habits. There’s many reasons to take issues with a figure: 1) that’s outrageous (40% is almost 1 in 2 people, yet if you counted 1 in every 2 people at random it’s unlikely you’ll find an obese person that quickly) 2) that comes from a single source, even if that source is a reliable one like the CDC 3) from their methodology which is using one test, the BMI, that’s been widely criticized by many equally valid parties and experts.
And its only a matter of time before the next guy snaps. Salaries need caps so profit is not the main priority. Something, anything but whatever this mess is.
Thanks for the most comprehensive yet concise video I've seen on the topic. People act like this is such a hard issue solve but I think it's pretty obvious what should be done. Insurance companies shouldn't be the ones responsible for determining whether or not a claim is medically necessary. That's an obvious conflict of interest with potentially life or death consequences. The gov't needs to implement some kind of system of independent doctors (probably employed by the government) representing the interests of patients, working as consultants at the health insurance companies, to whom the task of determining the medical necessity of an operation/drug is given. There should probably be multiple layers of oversight and an internal appeals process worked into this system. Now, this might exacerbate the problem of bureaucracy in the health insurance system, but it seems necessary to counterbalance the corporations' imperative to maximize profits. It's the best I could come up with given 5 minutes to think about this. I'd like to hear others' thoughts on the matter and criticism of my plan. The point is, it doesn't seem so hard to come up with a realistic solution. I guess the problem, as usual, is the special interests involved and the lobbying of politicians. That's why nothing is ever done to improve the system.
And good, dispassionate analysis. We need more of this approach on the internet. What I'd like to know is how does a more profitable healthcare insurance provider benefit me? In theory, a more profitable corporation can turn that money around to innovate and make the customer experience better. So, as long as they're not just giving themselves bigger bonuses and not providing better services at the end, more profit is not necessarily a worse thing for us. But I'd like a deeper dive into that.
Great content. It is a philosphical problem: is healthcare something everybody should have or is a consumer product? The NHS and CHS should be studied so that something similar can be set up in the USA.
The underlying reason why America's health insurance system is broken is actually pretty simple. There are other OECD nations with universal healthcare built on private health providers like Germany. The problem that is unique to the US is that your health insurer is in the majority of cases chosen by your employer. Your employer doesn't care if your EKG is denied. Your employer doesn't care if your son's specialist that he needs to see fortnightly has to be the next town over because no one in your local area is in network. Your employer wants to fulfill their legal obligations, pay the minimum cost possible and at least pretend to new hires that the health insurance they offer will look after them and their family. Japan has a massive book of prices set by the government every year what hospitals and pharmacies can charge for pretty much every procedure and every drug. Doctors aren't actually all that well compensated compared to peers in other OECD nations and some hospitals doing lots of a particular procedure can get screwed over if they desperately need a larger increase to the capped cost of that procedure. Australia has universal healthcare provided by the state with a private health market as a top up effectively if you don't want to die waiting for your elective procedure (elective waiting lists is often the biggest problem with state operated universal healthcare in lots of countries). Every other country has their own struggles with healthcare but America's the only place in the world a health insurer has the incentive and legal power to hire a podiatrist to review your EKG claim and decide your cardiologist is wrong about it being necessary.
One of the most baffling thing about America from a foreigner's perspective is their strange medical systems. That you need to haggle medical costs is absurd.
Its funny for me to look at a claim and see a physical therapy procedure that literally takes no resources but the therapist's time costing hundreds of dollars but insurance's negotaited rate with company stomps it to less than $10. Like good for me in this instance but the hospitals and insurance companies are incentivezed to be predatory.
All health insurance companies do is add a layer of cost and inefficiency on top of the existing system. Private enterprises only make sense when theres choice, but for almost all diseases there's a standardized treatment where there's no competitive gain to be had and thus should be universal. Regardless it wouldn't be in the insurance company's realm but the pharmaceuticals and other medical tech
I looked at the health care system as objectively as possible: every time I see out of pocket expenses and my copay. Remember, number one for health care spending, 48 for life expectancy
If a doctor gives me “unnecessary” care then why do I (the patient) get fucked instead of the provider? Answer: it’s a scam to serve the insurance and providers - they love each other
People are really missing the point with America’s healthcare system. They’re pointing the blame at health insurance companies and the real culprits are there observing the fiasco. The real problem is why does care cost so much? The same care in the other advanced countries cost 2X in America. The hospitals and pharmaceuticals are to blame for this and not the insurance companies that have to deal with the crazy costs.
Agreed! That guy in the security cameras has a different forehead and totally different eyebrows! Unless Luigi’s eyebrows grew at 5cms a day ! Or he was wearing a mask or something….
There are no unrationed healthcare. In other countries with different systems a patient simply gets what he gets and never knows there is an alternative.
The state should do the inefficient stuff that is necessary for working of society like building bridges and provide health care to working class. Because they break their back on building a country.
He just completely ignores the inflated prices for doctors visits and medicaments when he talks about why the American health care system is more expensive. Would love to see a statistic on how many services/ treatments/visits we use in Europe vs the US per year. I am quite sure that it would show that we use more in Europe while paying less.
Universal healthcare isn't necessarily good either. In my country of Denmark, we have year-long waiting lists for surgeries, specialist consultations and treatments. No system is gonna work well when half the population is chronically ill from junk food and physical inactivity.
It will keep getting worse as long as the healthcare companies keep prioritizing revenue growth and profits over patient care and well being. We have a perverse system where the more claims the deny, the more money they make. This needs to change or we might start to see more CEOs in the crosshairs.
Healthcare system needs reform. When government pays but the company's manage everything then there is a problem as incentives differ. Unfortunately, with lobbying, I don't see an easy solution anytime soon. Always drink lot of water, exercise, sleep well, eat less junk food, and try to be as healthy as possible. Also, go abroad to get treatment. Lot of Korean Americans just pay full cost in Korea and it's still cheaper. Also, before we fix the healthcare insurance system, we need price transparency in healthcare (hospitals) first. We had a problem where each hospital call different cost for the same procedures 20 years ago and it still persists...praying for America. God bless us all! Numbers 6:24-26 The Lord bless you and keep you; the Lord make his face shine on you and be gracious to you; the Lord turn his face toward you and give you peace
I used to have an Optum HSA and it was such a PITA to use, so many prescriptions and medical expenses would get denied for purchase that I literally just stopped using it. Peak scam artists
It’s not a kink in the system. It was the way the system was designed.
We live in a society 😈🐺
Medicare Beneficiaries DO NOT PAY NOTHING. FAR FROM IT.
je ne comprend pas. what system, and designed by who? i would like to know what you mean.
@@matt.stevick hes talking about the matrix. You can listen to andrew tate and sneako they mention it alot
It seems like there are other mechanisms in play that are forcing costs to increase such as poor diet and exercise causing diabetes and heart disease, drug usage, and too few people coming into the system to pay for the aging population.
I stopped in at an urgent care center Thursday to get antibiotic. Less than five minutes at the UCC and 14 generic tablets cost me $87 out of pocket. I ended up in the ER in 2005 after a spider bite and the bill was over $10k a day. That was almost twenty years ago so it would probably cost twice that now. That level of price gouging when you have no alternatives should be illegal.
What I don't understand is why people stay in America. I left the country immediately after my experience having seen through the system for the scam it is.
damn really?
Neta wey no mames
Some people pretend theres nothing wrong with that system too. Until they get sick themselves.
@@themartinanderssonBecause they're constantly being told all other solutions:
*A)* Lead to Communism
*B)* Are impossibly expensive
and *C)* Will leave the streets littered with the dead bodies of people who had to wait for government mandated treatments.
Complete and total bullocks, of course. But the average American has no reference point to recognize how much they are being exploited.
Health Insurance is such as a scam.
For-profit health insurance is a complete scam, but as a concept itself, health insurance (not for profit) is actually a great idea.
@@sacul139 How much "health insurance" do you need in Sweden which has true universal healthcare (i.e. perfectly adequate care, no more no less)? Zero.
For-profit insurance in any form is a legal scam.
@@sacul139 If we dont do single payer health insurance providers should 100% be non profits
Unfortunately it’s a necessary for any valuable service to be profitable else you can’t attract enough talented people to run it. Just like for profit hospitals
It’s not broken it’s working as intended.
Some people kill with bullets. Other people kill from behind a desk on the 98th floor of a skyscraper or a yacht in the Maldives. Friedrich Engels called this “social murder.”
As Omar said, "I got the gun. You got the briefcase."
Controversial? You Should have called it corrupt or a cartel
Exactly! Controversial means causing public disagreement. No one except insurance companies agree with the practices of insurance companies.
seriously stop 🛑. call ur senator.
Doesn't justify the death of a life
@@ziliflax4689 You built a society that decided life is only valuable if it is profitable. Can't be surprised when everyone else decides life isn't valuable either honestly. Its just the natural conclusion to a psychopathic society.
@@ziliflax4689 America is a society where life is only valuable if its profitable. Its a natural conclusion to such a place
As much as I am against murder, I don't have much of a problem with this. And I live in a country with universal healthcare.
Most Americans have no idea how cheap healthcare is in other developed countries. I’m a Korean-American and here in Korea X-rays cost 5-6 bucks, MRIs cost like 100-150 and most drugs between 5-20
@@ldkellandshaw “No innovation”
Get real. 🙄
You don't pay the full price, just a fraction, the rest is payed with government/tax money.
There are other problems with single payer system namely long wait line and overworked medical staff. There are no perfect solution here, only trade offs
@@cokechang yeah but those same problems are happening in the US as well. So we have worse outcomes, twice the price and still have long lead times and burned out medical staff.
Its also a universal system, much cheaper to run compared to price gouging middle men who get rich from denying cover
If there is even one jury member has had a family go through health insurance, there is no way he is getting to be convicted.
@@Metal_Fingers. Don't count on it. People have been well trained. The rich and powerful and act like savages for sport, but us normies are told the entire species would collapse if we stopped being civil and demanded justice for once. Millions of dollars have been spent to make sure our fellow Americans sit in that jury box and unironically think "I hate what happened to my family, it the law is the law. Thems the breaks!"
Maybe I'm just cynically. I wish with every fiber of my being for a jury Nullification, but realistically they're going to find the most boring, bootlicking boomers on the planet to judge them.
The corrupt justice system is very good at picking jury members who will provide the results they want.
How about you do a video on companies like Blackstone and rich Realestate investors buying up homes and jacking up rents..
Sometimes I feel truly sorry for Americans. Our free healthcare is far from perfect, but NOBODY worries about being able to afford treatment for serious illness or injury. (UK).
First, don't feel sorry for us. We are doing to ourselves. Second, one of the arguments against getting nationalized healthcare has always been to point out the imperfections in other nations systems (specifically the UK) and say "See!? Nationalized healthcare sucks!". The 'don't change what you know for what you don't know' crowd is easily swayed by these kinds of arguments.
@@who2u333 I am British by birth and American by choice, The US system delivers far superior care if you have access to it. The problem is the access.
@@ldkellandshaw Having British American dual citizenship is such an amazing cheat code for maximizing earnings and minimizing risk. Too bad most of y'all aren't thinking in terms of risk.
@@ldkellandshawthen it doesn’t work
@@ldkellandshaw Inarguably true. If you've got the money, America's healthcare system is the *best* in the world. And it is _exactly_ why so many people are positively giddy at the death of the CEO.
A dentist charged me cash price of $110 with saying that my insurance doesn’t cover their consultation because I got a maxed out of the consultation coverage. So I paid in cash at the visit and found out later that that dentist claim another $1,100 on my insurance company for 10 minutes consultation and 3 x-rays eventually denied by the insurance company. The scam artists exist out there in an insurance sector as wall as practitioner’s. Be very aware with what the doctor’s office charges you on your insurance. What they charge is ridiculously high. That is how they drive healthcare cost higher and higher for American people.
I spoke to someone who use to work in insurance and this is extremely common. The whole healthcare system is one giant price gouging cartel.
I've seen plenty of cases where service providers are defrauding Medicare and insurance companies for millions of dollars and they get like 3 years jail if they get jail at all. Why wouldn't you be a white collar criminal when the rewards far outweigh the risks?
@stevechoe6729 In 2007, a private dentist told me that my tooth needed a crown. The cost would’ve been $1895 USD. I went to a dental school to get a second opinion and the crown specialist professor there told me that I didn’t need a crown, just a white filling. That filling is still there as of today. My cost was zero dollars.
Yeah this what happens when government interferes with markets
@@panzervalkyrie9299 this is what happens when the government focuses on corporate welfare instead of public welfare.
I don't think controversial describes a criminal operation designed to fleece the vulnerable. "Medical Bankruptcy" is the major type of bankruptcy in the US, it is virtually unheard of elsewhere.
It is number 1 for personal bankruptcy in the US.
Deny delay depose
deny delay depose
deny delay depose
We need Medicare for All, along with breaking up these insurance and hospital chains.
You'll still be complaining when you get a bill for 20% of the charges - which is what Medicare dosent cover.
Oh and the Medicare Part B premium of $185 a month.
VA healthcare isn't remotely what you want. However that is what you're asking for at this point. You will wait weeks and months to be seen by a doctor.
@@ldkellandshawI live in Australia where we have Medicare for all and we don't pay a thing so I don't think you understand how it works
@@armandolimon7465well the problem is that the government is losing to much money having the current system. We need single payer healthcare.
@@Shawnjohson1608
Single Payer, Medicare for All, Superman Funtime, whatever name you wanna call it we need it
If you are on the jury for Luigi, not guilty. He saved lives
In this house Luigi is a hero! End of story!
Good luck to the judge trying to pick an unbiased and impartial jury.
They tried 'AI' for sorting CVs for job candidates and it was found to be rejecting appropriate applicants. And that's for a job...this is for a life.
AI - most oversaturated term of the year, they'd of called queues in Rollercoaster Tycoon AI if they had the foresight.
AI for health decisions and for Resume selection are outrageously prone to errors. It's all caused by companies cutting costs excessively.
Corporations will naturally want all customers to die when claims exceed premiums& that’s not ok.
Yep. Cant pay out $100k for some Dad's cancer treatment but we can pay shareholders dividends and C-suite million dollar yearly bonuses.
It’s more of a scam than car and home insurance
So dont buy it? If I don't like home insurance I won't buy it, I'm not gonna kill the people selling it lmao
@ I think the point is that insurance shouldn’t deny legitimate claims that could save lives. I’m not saying killing is justified. Maybe 🤔 your reading comprehension is lacking.
health care is for the people not for the profit
Most of the new and innovative drugs are created in America. If the profit goes away. so does the innovation.
@ldkellandshaw I am not against private health care. But this greed and appeasement of shareholders is killing people. If the USA had public health care for everybody. Private corporations would need to compete with that. Now, it is race to the bottom. Who can charge more for less. I live in Europe and it is difficult for me to understand how Luigi didn't heppend sunner.
@@ldkellandshawpharmaceutical companies are different from insurance companies.
@@dduntOn point why don't nationalize it like im canada where provincal government's agencies get billed and take it private. It will increase transparency and lower admin costs.
@@ddunt I am British by birth and lived in the UK until I was 30. I have now been in the US 10 years and am naturalized.
The US system is FAR superior for those that have the means to pay for the care. I have access to treatments and drugs that I would have had to wait years on a waiting list for on the NHS. The problem is the gap for people that do not have the means.
The news on UHC is getting actually getting lots of coverage unlike the insurance claims
I didn't get a raise last year, so I dropped to the cheapest tier of my workplace's healthcare plan. Turns out this plan refuses to cover more than one month of maintenance medications at a time, even if your doctor wrote you a preacription for more than one month at a time, unless you agree to get your prescription filled by the insurance company's private mail order pharmacy. Which means if the mail is late for any reason you're *screwed*.
I bet if we paid pennies on the dollar on extra taxes, the government could lower the administrative costs to be more fair, subsequently lowering health insurance costs. I get it, businesses love the idea of having profit margins in the mid teens, ideally around 15%. But health insurance deals with people’s lives. You can’t screw customers over just to keep your shareholders happy. You shouldn’t have to worry about putting your shareholders first. They should have focused on cutting administrative costs such as overpaying themselves with bonuses/salaries or having too many middleman, there is absolutely no reason denial of claims should be so high when premiums are so high and only getting higher.
if you dont habe profit margins, then how do you invest in new treatments and new medication?
@@johanalejandrocazadordepin7225insurance companies do not create medicines , pharmaceutical companies do. The American per capita healthcare spending is 2x European spending with worse outcomes American public spending is the same as Europe yet Americans pay out of pocket. Either nationalise healthcare or remove government intervention
@@johanalejandrocazadordepin7225 Are you serious????? Insurance companies don't create new medicines or treatments. They just profit off the sick.
Unfortunately that is not how businesses operate. Very few businesses have a 15% profit margin, in most industries a 7-8% margin is already very good. In case of United Healthcare, they had a 6% margin in the last 2 years, but their average margin is around 4-5% for the last 10 years.
@ the profit margin number is just a number and can hide excessive/unnecessary spending. Quite frankly, even if a person looks at their balance sheet/income statement, I’m sure there’s ways to hide excessive expensive in account descriptions that no one understands. So while a 6% margin makes them look humble, no one believes they are
He is the start of a revolution, you are just living in it
Lol.
Dear Americans, it's your choice. If you have health insurance with for profit company, It will always be in their best interest to reject your claims. Any CEO doing something else, will be fired. If you've voted for Bernie Sunders, maybe something would change. Insted you choose billionaires and millionaires to run your government.
In a large part of Europe, under the Bismarck system, health insurance is/can be private, as are the hospital. They are for-profit organisations. But still, they operate quite different from the US. But as a latest case in the NL, it should never the insurance orgs that determine whether a claim is denied, it is a medical decision. Whether it is worth doing a procedure should be regulated, where, yes, also the cost factor is weighted in. In the NL, this is based for life lengthening procedures based of a maximum cost per year won. Cold but fair in principle, rather than on a CEO greed.
Left to right in the EU, basic medical care should be afforable. You don't have to vote Bernie, just don't let big companies decide things.
@@piotrp5668 you think Americans had a choice? 😂
No pencil pusher is deciding what care old dying patients get in Canada. Total BS statement. Dr’s decide and if anything they offer more care and resources than are necessary. They are often hesitant to give up on a patient at any age.
Americans will find any way to excuse their heartless healthcare system. In Canada when you get Cancer you don’t have to fill in forms for your insurance company to decide if your chemo is covered.
I love the American system when I am travelling because cost isn’t an issue for me. But I am also glad to come home to a place where I know my neighbours are cared for.
I live in Canada. Some of what you say is true, but you left out the crazy waiting lists for many treatments.
You neglected to mention the outcome that the ratio has had: rather than increasing coverage, it increased prices. Health insurance providers have an incentive to jack up the price of care to force the uninsured to seek health insurance. Every treatment needs to break the bank on the ticket price, but be negotiated behind the scenes to what its actually supposed to cost and the amount the insurer ultimately pays. They deny everything they can so they can keep the costs of treatments high without dipping into profits.
Another reason for those ludicrous base prices is to price gouge other health insurance companies for out-of-network services. Of course, in return affordable health insurance plans have shit out of network coverage. They don't want to donate money to other companies. It also makes it way harder for any upstart insurance companies to get a foot in the door.
This
$6k a year is "affordable" Healthcare in America and that is for the worst plan and I am legally required to have it.
Trump made it possible to be uninsured with no penalty. It just drove up costs for everyone else but you don't have to. You will likely be fucked but you don't have to
I have private healthcare in Australia. It's quite high end. It costs $250Aud a month, this is about 150US, or $1800/yr
$6k isn’t bad, mine is over $10k
In my country Australia, maternity care is 100% free. My wife suffered from preeclampsia (high blood pressure in pregnancy) needed to be hospitalised for 4 weeks before giving birth and 3 weeks afterwards, we have both her and our son healthy and at zero out of pocket expense. Had we not had this support we could have lost both our son and my wife, and in an expensive healthcare system we could also be bankrupt for whatever outcome occurred. Now for Americans this may sound like scary socialism - but let’s look at this from a productivity standpoint, a healthy population can continue to work hard, contributing the GPD and the tax base - so why not have a healthcare system like this?
Maybe government should use AI to reject insurance companies requests for money from those programs?
Managed care insurers are not medically necessary. They are a cost in the system and create inefficiency such as administrative cost. They do not increase the quality of care, contrary to what they say they do. There should be no business in the healthcare field that seeks to create ever increasing value to their investors. The hospitals, physicians, nurses, etc are also affected by these middle men. Politicians should not be allowed to see or benefit from lobbyists, directly or indirectly. Hopefully, the Dept of Govt Efficiency will take action in 2025 to cut govt and taxpayer waste.
Right. But that last part about DOGE is never gonna happen. Elon is a greedy nimrod.
The origin of the US healthcare system is NOT Obamacare in 2010, the employer provided healthcare system originated from WW2 by pure accident as a result of strict government price controls. Essentially the government limited how much employers could pay employees and controlled the costs of everything in the economy, so labor unions couldn't ask for more money. Hence they asked for health insurance instead, and got it, and this became the standard, even though it's a horribly inefficient system. The Obamacare changes tried a more free market approach to fixing problems with the system (and it did fix some big problems), but obviously it still has a lot of issues, but it DID NOT create the horrendous healthcare system we have today. Prices were also sky rocketing for health insurance BEFORE Obamacare to.
After debating for over 50 years, For Profit Healthcare has failed. Time for the USA to move into Single Payer Healthcare, Medicare For All, Universal Heathcare. For Profit Healthcare needs to end, once and for all, in the USA.
Never going to happen. Too much money is involved.
@@ldkellandshaw America is full of guns. Just a fun fact. 🤷🏻♂️
It's not "Controversial ". It's overly complicated and a mess.
Classic question: Who responsible for Ai's decision?
My proposal, if it is a corporation, the responsibility is fall to its CEO. If it is individual, the responsibility falls under its user.
I disagree with the idea that the faceless company should be the one to determine that treatment is not needed and not the hospital and doctors. Hospitals and doctors are not charities either, but they do know what their patients need for treatment, whereas the company does not. I've heard many times dumb shit where insurance won't cover certain amounts or brands of the same drug, but if you ask for slightly different of the same stuff suddenly their system approves it. It's insane and I don't fault Luigi for feeling like he needed revenge.
The principal is since but the practise is different. Doctors over treat, over test, and over prescribe. Thats a fact. That fact exists because the litigious nature of the US. Something will need to change there in consort with healthcare reforms.
Defining 'excessive profit' is almost impossible. If that becomes a concern for an industry, then that industry should be removed from the for-profit arena.
@@who2u333 when you achieved those profits by breeching over 30% of your contacts, that's an excess. That was resource that should have been spend on services, not a excess.
Private services will ALWAYS cost more. The reason is simple: private services also need to show some profit to cover themselves, but it gets worse, because if that private service is on a stock market then they need to show growth, so have to make more profit every year.
A public service NEVER needs to show these things. they just have to meet budget.
I have no evidence, but I suspect my previous employer received an under-the-table payment to switch from BCBS to United. Decade later they went back to BCBS.
LUIGI FOR PRESIDENT!!!! GET RID OF THE DIAPER DONALD !!!!
Health Insurance is such as a scam.
We rocking with Luigi.
Americans deserve better than this. Healthcare should be a given in such a rich country
The country is rich for sure, but that’s a very small group of people. And those people own the majority of the market share.
its complicated
Most Americans complain or cannot afford healthcare premiums and yet the country pays for welfare...go figure.
For profit companies managing health care is a clear conflict of interest shortchanging the patients.
I appreciate your data focused breakdown on this topic. Most takes are just too politically biased. Ultimately the facts just speak for themself - no pundit needed.
2 months after being forced to switch to UHC, I'm still waiting for approval on a medication I've taken for 5 years. Luigi is a hero.
This guy is wrong. In a public system, the standard of care is determined by medical professionals who weigh desired outcomes with curent research. It is very uncommon to need to reinvent the wheel when assessing patient care needs so the path is well understood. If you do need a new expensive treatment, then there is a process for special authorization. If declined, then you are no worse off than if you had been in private care to begin with!
Saudi has oil
America has healthcare and
Russia has vodka problems
"he's likely to spend the rest of his life in prison"
Really ? by Jury trial ?
🤔
I’m a free market person like probably most viewers here but healthcare is something everyone needs at some point and should
be universal, no questions. Im guilty of avoiding a doctors office several times in my life I should
have absolutely gone, due to what cost I could incur and that’s just sad.
I saw a guy say "we need to look at how we view killing others with a gun vs killing with a PDF. Far more are killed with a PDF every day."
Profits before people - It’s the American way
which stock screener do you use that looks like coinmarket cap?
I believe the anger comes from the "bait and switch" tactics. The insurance companies take premiums every month, often for years. Then, when it comes time to utilize the service a person paid for, all too often the service is refused. The appeal process is so arduous, that many people just give up. All this is done with deliberate intent. The results are greater profits for NOT providing a service and the customer's health deteriorates or even dies. It is a scam that many Americans are starting to lash out upon.
This is kind of a side issue but I want to point something out about the obesity rate in the US- that 40% figure comes from a single source, the CDC and they base obesity EXCLUSIVELY on a person’s BMI value. Also, even by the CDC’s own standards, obesity has actually plateaued, yet nothing has changed about American dietary habits.
There’s many reasons to take issues with a figure:
1) that’s outrageous (40% is almost 1 in 2 people, yet if you counted 1 in every 2 people at random it’s unlikely you’ll find an obese person that quickly)
2) that comes from a single source, even if that source is a reliable one like the CDC
3) from their methodology which is using one test, the BMI, that’s been widely criticized by many equally valid parties and experts.
And its only a matter of time before the next guy snaps. Salaries need caps so profit is not the main priority. Something, anything but whatever this mess is.
oof. touchy af topic i am sure this will be quite interesting. luv luv luv ur work w$m! 💚📈🇺🇸
Thanks for the most comprehensive yet concise video I've seen on the topic. People act like this is such a hard issue solve but I think it's pretty obvious what should be done. Insurance companies shouldn't be the ones responsible for determining whether or not a claim is medically necessary. That's an obvious conflict of interest with potentially life or death consequences. The gov't needs to implement some kind of system of independent doctors (probably employed by the government) representing the interests of patients, working as consultants at the health insurance companies, to whom the task of determining the medical necessity of an operation/drug is given. There should probably be multiple layers of oversight and an internal appeals process worked into this system. Now, this might exacerbate the problem of bureaucracy in the health insurance system, but it seems necessary to counterbalance the corporations' imperative to maximize profits. It's the best I could come up with given 5 minutes to think about this. I'd like to hear others' thoughts on the matter and criticism of my plan. The point is, it doesn't seem so hard to come up with a realistic solution. I guess the problem, as usual, is the special interests involved and the lobbying of politicians. That's why nothing is ever done to improve the system.
3:24 That is a very satisfied face from that burger 😂
How is it political. It is personal
The fact that Americans aren't demanding Universal Healthcare is beyond my understanding. So much suffering could be avoided.
Vast majority of Americans are happy with their insurance, what you see online is a radical echo chamber advocating murder. I'd suggest you go outside
Old folks do pay for Medicare. Deductibles, copayments, premiums, prescriptions 👎🏼👎🏼👎🏼
Tax the billionaires and corporations already!!!
And good, dispassionate analysis. We need more of this approach on the internet. What I'd like to know is how does a more profitable healthcare insurance provider benefit me? In theory, a more profitable corporation can turn that money around to innovate and make the customer experience better. So, as long as they're not just giving themselves bigger bonuses and not providing better services at the end, more profit is not necessarily a worse thing for us. But I'd like a deeper dive into that.
There actually exists a thing called "Explainable AI", there no need to allow blackbox AI to make decisions if policy-makers don't want it to. IF.
Great content. It is a philosphical problem: is healthcare something everybody should have or is a consumer product? The NHS and CHS should be studied so that something similar can be set up in the USA.
This video was so detailed and informative- thank you!!
The underlying reason why America's health insurance system is broken is actually pretty simple. There are other OECD nations with universal healthcare built on private health providers like Germany. The problem that is unique to the US is that your health insurer is in the majority of cases chosen by your employer. Your employer doesn't care if your EKG is denied. Your employer doesn't care if your son's specialist that he needs to see fortnightly has to be the next town over because no one in your local area is in network. Your employer wants to fulfill their legal obligations, pay the minimum cost possible and at least pretend to new hires that the health insurance they offer will look after them and their family.
Japan has a massive book of prices set by the government every year what hospitals and pharmacies can charge for pretty much every procedure and every drug. Doctors aren't actually all that well compensated compared to peers in other OECD nations and some hospitals doing lots of a particular procedure can get screwed over if they desperately need a larger increase to the capped cost of that procedure. Australia has universal healthcare provided by the state with a private health market as a top up effectively if you don't want to die waiting for your elective procedure (elective waiting lists is often the biggest problem with state operated universal healthcare in lots of countries). Every other country has their own struggles with healthcare but America's the only place in the world a health insurer has the incentive and legal power to hire a podiatrist to review your EKG claim and decide your cardiologist is wrong about it being necessary.
One of the most baffling thing about America from a foreigner's perspective is their strange medical systems. That you need to haggle medical costs is absurd.
Its funny for me to look at a claim and see a physical therapy procedure that literally takes no resources but the therapist's time costing hundreds of dollars but insurance's negotaited rate with company stomps it to less than $10.
Like good for me in this instance but the hospitals and insurance companies are incentivezed to be predatory.
Terminally ill patients should all take one health insurance management guy with them.
Brian Thompson was a CPA and knew how where to defraud the system. Guy was going to get charged with insider trading
All health insurance companies do is add a layer of cost and inefficiency on top of the existing system.
Private enterprises only make sense when theres choice, but for almost all diseases there's a standardized treatment where there's no competitive gain to be had and thus should be universal.
Regardless it wouldn't be in the insurance company's realm but the pharmaceuticals and other medical tech
I looked at the health care system as objectively as possible: every time I see out of pocket expenses and my copay. Remember, number one for health care spending, 48 for life expectancy
If a doctor gives me “unnecessary” care then why do I (the patient) get fucked instead of the provider? Answer: it’s a scam to serve the insurance and providers - they love each other
This market has to be as transparent as possible. Both government employees and private sector will suck at managing it.
People are really missing the point with America’s healthcare system. They’re pointing the blame at health insurance companies and the real culprits are there observing the fiasco. The real problem is why does care cost so much? The same care in the other advanced countries cost 2X in America. The hospitals and pharmaceuticals are to blame for this and not the insurance companies that have to deal with the crazy costs.
Imagine walking into a McDonald’s and the price changes drastically depending on how you pay.
It's not controversial, it's universally loathed.
This Luigi guy doesn’t look like the dude in the security camera pics though 😅😅
Agreed! That guy in the security cameras has a different forehead and totally different eyebrows! Unless Luigi’s eyebrows grew at 5cms a day ! Or he was wearing a mask or something….
@@Quantum-1157 Didn't want to be caught maybe? It's clearly him. Just saying.
There are no unrationed healthcare. In other countries with different systems a patient simply gets what he gets and never knows there is an alternative.
We gotta talk about the record salaries of doctors too…
The next Luigi should also talk about the greed of the doctors as well as health insurance.
10:05 this all makes great sense. efficiency not wasteful, etc. just like every other publicly owned american business. 📈🇺🇸
Can you cover the implications of the inclusion of MSTR in QQQ? is the bubble going to get worse and affect more people?
This is some quality analysis
Very good and informative video. Well done thanks.
The state should do the inefficient stuff that is necessary for working of society like building bridges and provide health care to working class. Because they break their back on building a country.
When the other party has the power to decide if you live or die, it's not a free market anymore.
He just completely ignores the inflated prices for doctors visits and medicaments when he talks about why the American health care system is more expensive. Would love to see a statistic on how many services/ treatments/visits we use in Europe vs the US per year. I am quite sure that it would show that we use more in Europe while paying less.
Universal healthcare isn't necessarily good either. In my country of Denmark, we have year-long waiting lists for surgeries, specialist consultations and treatments. No system is gonna work well when half the population is chronically ill from junk food and physical inactivity.
There should be absolutely NO profit motive in healthcare, just like in k-12 education.
It will keep getting worse as long as the healthcare companies keep prioritizing revenue growth and profits over patient care and well being. We have a perverse system where the more claims the deny, the more money they make. This needs to change or we might start to see more CEOs in the crosshairs.
All the self proclaimed sigma males have been real quiet since Luigi's mission.
Healthcare system needs reform. When government pays but the company's manage everything then there is a problem as incentives differ. Unfortunately, with lobbying, I don't see an easy solution anytime soon. Always drink lot of water, exercise, sleep well, eat less junk food, and try to be as healthy as possible. Also, go abroad to get treatment. Lot of Korean Americans just pay full cost in Korea and it's still cheaper. Also, before we fix the healthcare insurance system, we need price transparency in healthcare (hospitals) first. We had a problem where each hospital call different cost for the same procedures 20 years ago and it still persists...praying for America. God bless us all!
Numbers 6:24-26
The Lord bless you and keep you; the Lord make his face shine on you
and be gracious to you; the Lord turn his face toward you and give you peace
I have no idea why my Canadian friends volunteer to move to the U.S. and take on all the disadvantages thereof.
The united health group ceo talking about limiting unnecessary care us nuts. They are not doctors and should not be determining care
No one deserves to be murdered but no one should be playing god
Other CEO when?
I used to have an Optum HSA and it was such a PITA to use, so many prescriptions and medical expenses would get denied for purchase that I literally just stopped using it. Peak scam artists
Because they want to point to UHC instead of all the insurers who have shareholders and need to make a profit at whatever cost .