That would be illegal though, the goal is do this legally after all.
We also have to remember all claims aren't equal. i.e. some claims end up being way costlier than others. You can achieve similar % margin outcomes by putting a ton of friction like, preconditions, multiple appeals processes and prior authorization for prior authorization, reviews by administrative doctors who have no expertise in the field being reviewed don't have to disclose their identity and so and on.
While U.S. system is most extreme or evolved, it is not unique, it is what you get when you end up privatize insurance any country with private insurance has some lighter version of this and is on the same journey .
Not that public health system or insurance a la NHS in UK or like Germany work, they are underfunded, mismanaged with long times in months to see a specialist and so on.
We have to choose our poison - unless you are rich of course, then the U.S. system is by far the best, people travel to the U.S. to get the kind of care that is not possible anywhere else.
> While U.S. system is most extreme or evolved, it is not unique, it is what you get when you end up privatize insurance any country with private insurance has some lighter version of this and is on the same journey .
I disagree with the statement that healthcare insurance is predominantly privatized in the US: Medicare and Medicaid, at least in 2023, outspent private plans for healthcare spending by about ~10% [1]; this is before accounting for government subsidies for private plans. And boy, does America have a very unique relationship with these programs.
https://www.healthsystemtracker.org/chart-collection/u-s-spe...
That's a great and thorough analysis!
My take away is that as public health costs are overtaking private insurance and at the same time doing a better job controlling costs per enrollee, it makes more and more sense just to have the government insure everyone.
I can't see what argument the private insurers have in their favor.
It is more nuanced, for example Medicare Advantage(Part C) is paid by Medicare money but it is profitable private operators who provide the plans and service it a fast growing part of Medicare .
John Oliver had an excellent segment coincidentally yesterday on this topic.
While the government pays for it, it is not managed or run by them so how to classify the program as public or private ?
Why does saying "AI did it" make it legal, if the outcome is the same?