Hospital executives at for profit hospitals have had joined the business model of execs getting unsustainable reimbursement compared to the workers.

Bingo

The insurance companies are helping to drive away the doctors

Unfortunately the business side of our medical structure is super complicated and the doctors are bottom-tier and actually get paid poorly considering our loans and educational requirements. A lot of docs hate the idea of gov't involvement, but there's gotta be some checks & balances somewhere.

How much time do you spend doing prior authorizations and generally dealing with insurance companies?

Do people NOT understand how Canada gets such cheap meds? The Gov't forces them to negotiate. IKYK.

I can NOT imagine what it is like over there now. I haven't had to deal with US insurance since 2017.

Zero—I live abroad

None yet, but I really fear for my future with prior auths 😭 The thought of a peer-to-peer with someone in a completely different specialty keeps me up at night. Idk a solution, I just have heard way too many docs (typically older) hate on the idea of the gov't negotiating w/ insurances

As a retired doc, I can tell you the government rate was low but at least they paid, private insurers fought every charge, demanded prior auth for generic birth control and sometimes demanded $ back from surgery done 2yrs ago because they changed their mind, all for single payer here 🤠

I have never ever ever heard of a doctor complaining that the govt was pushing back on the insurance companies. I have quite a lot of experience with insurance. 🤷‍♀️

I guess it's been them bitching about the government trying to control healthcare and mistrust of their actions. Mostly in the context of ACA "making everything unaffordable" (per a doc I talked with a few mins ago). Another one said "do you really trust the govt to manage healthcare"

Medicare (govt plan) has been managed for decades and had high customer satisfaction rates and high efficiency. Yes, I would trust a reasonable govt (not Trump) to manage a health insurance plan. They already did it

Well, contrary to your anecdotal example, people LOVE getting cheaper meds.

Yes! Sign me up for cheaper meds!!!

AMEN!

I would love cheaper meds and some Canadian influence! I'm definitely NOT on the same page as those old private-insurance loving docs 😂

I had to deal with insurance, in various roles, for most of my work career and I even worked for an agent for awhile. I HATE the insurance industry with the power of 1000 blazing suns.

Dissolve private insurance companies and let taxes fund the care.

As a licensed counselor who deals with Medicaid and Medicare consistently. We typically don’t have difficulty getting patients what they need from insurance. They are our best paying insurance, too! You have more hoops to jump through with documentation up front, and annually, but I’ll take that.

People fail to understand that insurance is a business and remains in business based on making a profit. Maybe costs would go down if we didn’t file so many lawsuits and there was a cap on monetary awards. We all pay with higher insurance premiums and doctors leave because of the cost of insurance

Health insurance used to be non-profit. It’s should have remained non-profit.

I must not be old enough to remember that. Some hospitals are non profit. I remember when if you were picked up by an ambulance and they took you to the closest hospital, if you didn’t have insurance they sent you to the county hospital and some died in route.

It’s alarming to see a wife beg for money because they don’t have $150,000 for heart surgery and keeping him alive. Whether you live or die shouldn’t depend on how much money is in your bank account. Those days are largely gone. The wealthy pay for concierge doctors. No waiting for an appointment

Are they bottom tier or is it because they were educated in another country? During Covid most of the doctors in charge of the emergency section were at least 90% foreign born. Maybe US educated doctors feel they are better or just want more money and prestige.

"bottom-tier" as in the insurance companies don't care about docs... I'm not saying anything about individual docs or regions/quality of education. I'm only saying insurance companies just don't respect any doctors and see them as a business expense

Got it. Some of their denials are ridiculous. But in essence they are actuaries. What’s the success rate of certain drugs or surgeries? How old is the person and other mitigating factors. Then there’s the overwhelming amount of fraud and the lack of oversight and some are Senators

I used to develop insurance "products." Then came the ACA. It was a compromise with an industry lobby. When I read it, I couldn't help but think it was designed to fail. Medicare for all is the most accessible solution for now.

Why are we profiting on people’s health