Antiwork

[MichVandal]

I wish companies didn’t have to provide benefits like healthcare.

we’ll continue to cut off our noses to spite our faces for a good while when it comes to healthcare

At one time, I did the math, and if you extrapolate all of the private insurance to public- using the overhead/profits- the sum of all of the private insurance will cover the whole population.

Which is to say, there is a lot of money to be made being the middleman who adds nothing to actual healthcare outcomes other than telling people they can’t have it. How we all think that is a valid way to make money is beyond me.

 

[Swansong]

What's insanely frustrating is that insurance companies are so aggressively taking the short term outlook with regards to long term healthcare. I know this isn't the thread for this, but I've spent a lot of time working with internal regulatory folks on various health maintenance initiatives. Mostly Medicare - who seems to have a much longer view (imagine that), but not exclusively. In fact, one of the more recent things I've personally worked on was to develop a better clinical workflow for hypertensive patients, and this was part of a BCBS program. It was good! It helped better equip primary care providers on hypertension treatment and gave an easy referral to whichever specialist they felt appropriate, should they choose that.

But other than that, pretty much everything out of private insurers has been denials and resulted in us scrambling to fix whatever totally-not-actually-broken thing they're complaining about. Meanwhile, Medicare has for years had all kinds of guidelines on health maintenance - certain percentages of your patients with X diagnosis need specific criteria "checked" yearly, or payments are cut (and if they're consistently high, payments are increased). Example: xxx percent of diabetic patients over yyy age must have yearly foot and eye exams, and regular a1c checking, and some other stuff.

Meanwhile, BCBS will deny covering that very same a1c test if you put the diagnosis as "annual physical". It's absolutely absurd.

 

[FadeToBlack&Gold]

Or dies because the back of the truck is at 130 degrees and they passed out.

Sadly, most of them won’t be driving a brown truck. Most will be a PVD or Personal Vehicle Driver, basically an Uber driver but for your boxes. You deliver and UPS pays you a wage but doesn’t pay for your fuel or insurance. It’s an idea our new CEO implemented last year during the holidays. It’s another step on the “corporate America tries to turn everything into gig work” ladder.

That's a new low. And I thought meal prep services and local furniture retailers contracting delivery out to third party trucking companies was a cheap move.

 

[Jimjamesak]

That's a new low. And I thought meal prep services and local furniture retailers contracting delivery out to third party trucking companies was a cheap move.

They were heavily recruiting union employees last year during the holidays to make PVD deliveries and most of rejected them because a) they weren’t going to pay for insurance or mileage and b) weren’t going to pay more than our regular wage to compensate.

 

[dxmnkd316]

At one time, I did the math, and if you extrapolate all of the private insurance to public- using the overhead/profits- the sum of all of the private insurance will cover the whole population.

Which is to say, there is a lot of money to be made being the middleman who adds nothing to actual healthcare outcomes other than telling people they can’t have it. How we all think that is a valid way to make money is beyond me.

Isn't the overhead in Medicare like 3%?

 

[Kepler]

Government programs are efficient and effective. That's why the Right has to go out of their way to wreck them.

 

[Swansong]

Isn't the overhead in Medicare like 3%?

I've read approximately that too. To be fair, this doesn't include the World's Largest Accounts Payable/Receiveable department, AKA the IRS. Not that your point isn't valid.

 

[dxmnkd316]

I've read approximately that too. To be fair, this doesn't include the World's Largest Accounts Payable/Receiveable department, AKA the IRS. Not that your point isn't valid.

I mean, that's a fair point and I'd rather get the real number rather than play the stupid "AHA THIS MINISCULE DETAIL IS WRONG THEREFORE LYIN DEMS"

 

[dxmnkd316]

As it turns out, if you assume 100% of the IRS budget is Medicare accounts payable, that's a measly 1.58% increase to about 4.58%. If you scale that, Medicare is 14% of the budget so really it's 0.22% = 3.22%.

 

[Stauber1]

That's a new low. And I thought meal prep services and local furniture retailers contracting delivery out to third party trucking companies was a cheap move.

FedEx end-point is entirely contracted out to trucking companies, but the volume is such that 100% of these contractors' business is operating for FedEx. Meaning if they are being treated unfairly they can't just walk. To no one's surprise, FedEx routinely treats them horribly and then threatens to terminate their contracts if they start complaining

 

[MichVandal]

As it turns out, if you assume 100% of the IRS budget is Medicare accounts payable, that's a measly 1.58% increase to about 4.58%. If you scale that, Medicare is 14% of the budget so really it's 0.22% = 3.22%.

When I did the calculation, I used 5%. And there was still money left over. The profits gotten from healthcare is nuts. Especially considering that they add exactly nothing to outcomes other than denial of service.

 

[Deutsche Gopher Fan]

When I did the calculation, I used 5%. And there was still money left over. The profits gotten from healthcare is nuts. Especially considering that they add exactly nothing to outcomes other than denial of service.

Can confirm

 

[Kepler]

When I did the calculation, I used 5%. And there was still money left over. The profits gotten from healthcare is nuts. Especially considering that they add exactly nothing to outcomes other than denial of service.

It's capitalism in its purest form.

 

[Swansong]

Please keep in mind that working where I do has converted me from "leaning towards preferring private payers" to "FUCK NO, WE NEED SINGLE PAYER HOLY SHIT". Anything I say that seems like an argument against moving towards single payer is more of a "problem to be solved" kind of thing than a show-stopper.


One additional issue is with investments into the private insurers. There is an enormous amount of investment - and much of that in the form of retirement (401k, 403b, IRA, pensions, etc.) - in these companies. We would need to find a way to move us off them without mangling state pension plans and whatnot.

 

[MichVandal]

Please keep in mind that working where I do has converted me from "leaning towards preferring private payers" to "**** NO, WE NEED SINGLE PAYER HOLY ****". Anything I say that seems like an argument against moving towards single payer is more of a "problem to be solved" kind of thing than a show-stopper.


One additional issue is with investments into the private insurers. There is an enormous amount of investment - and much of that in the form of retirement (401k, 403b, IRA, pensions, etc.) - in these companies. We would need to find a way to move us off them without mangling state pension plans and whatnot.

True, but maybe we can slowly get them off of this pyramid scheme.

As for the actual workers, many of them can be converted to the same position in single payer.

 

[Swansong]

Again, no argument at all that we should not do this. My biggest concern is that we'll have Republicans violently and staunchly against any change, and then Democrats just throwing their hands up and either continuing to do nothing or, worse, simply outlawing private insurance (directly or indirectly) and causing an enormous economic disruption that leads to years of fascist Republican electoral victories.


The problem here, to me, is that we have one of our two main political parties currently standing as a brick wall against any change.

 

[Deutsche Gopher Fan]

Again, no argument at all that we should not do this. My biggest concern is that we'll have Republicans violently and staunchly against any change, and then Democrats just throwing their hands up and either continuing to do nothing or, worse, simply outlawing private insurance (directly or indirectly) and causing an enormous economic disruption that leads to years of fascist Republican electoral victories.


The problem here, to me, is that we have one of our two main political parties currently standing as a brick wall against any change.

This is why I don’t care if I’m laid off. I’ve been in this work for nearly two decades and have had enough.

conservatives would rather die or go bankrupt than paying less for care. And you get tired of people- like the absolute buffoons from this board- who scream about how single payer won’t work and yet haven’t spent a day working in a single payer system or willing to acknowledge that the things that we used to be better at are slipping or failing

 

[psych]

Again, no argument at all that we should not do this. My biggest concern is that we'll have Republicans violently and staunchly against any change, and then Democrats just throwing their hands up and either continuing to do nothing or, worse, simply outlawing private insurance (directly or indirectly) and causing an enormous economic disruption that leads to years of fascist Republican electoral victories.


The problem here, to me, is that we have one of our two main political parties currently standing as a brick wall against any change.

I’m confused on one thing. You said we need single payer, yet you also say your biggest concern is Democrats outlawing, either indirectly or directly, private insurance, resulting in GOP wave elections. Are you insinuating Democrats’ messaging on outlawing private insurance, aka single-payer, will be much worse than the GOP’s messaging against it, but that single-payer needs to happen anyways?

Edit: Or, maybe you mean Democrats will bungle the transition, which is a distinct possibility, considering the, I presume, difficulty of the task?

 

[Swansong]

Sorry, that isn't clear at all is it.

I have a few concerns here:

• Democrats bungling the messaging in general.
• Potential for a "fine, f it, we're going to outlaw private insurance effective tomorrow because we think its our least bad option" and the resulting economic chaos that would bring... that would likely lead to many years of GQP electoral victories.

I think there's likely a place for private insurance, even in a single-payer system, but I absolutely haven't thought that through so don't come at me on it.

 

[Deutsche Gopher Fan]

Sorry, that isn't clear at all is it.

I have a few concerns here:

• Democrats bungling the messaging in general.
• Potential for a "fine, f it, we're going to outlaw private insurance effective tomorrow because we think its our least bad option" and the resulting economic chaos that would bring... that would likely lead to many years of GQP electoral victories.

I think there's likely a place for private insurance, even in a single-payer system, but I absolutely haven't thought that through so don't come at me on it.

I teach classes on this. There are many, many ways of funding in all the socialist nations, and private insurance exists in basically all of them.