A White House plan could help end decades of whack-a-mole between regulators and insurance companies over covering mental health and addiction treatment.
It might if y’all get your asses up and create some mutuals.
Historically speaking the German public insurance system started out with union-associated mutual funds, Bismarck didn’t so much create the system but brought it under state control and made having insurance mandatory because it was macroeconomically sound and otherwise beneficial for his conservative (as in Monarchist) ass: Result was less votes for the Socdems which Bismarck liked, more state control which he also liked, and less people emigrating to the US where you had more chances, but also no safety net whatsoever, which he also liked.
To this day German insurers are practically mutuals – as they’re public-law corporations we don’t own them (noone does) but we’re not customers but members, vote for their boards, and noone is siphoning off profit. They’re essentially like municipalities in a sense: Providing service and you’re a “citizen” of at least one (all German territory is covered by municipalities so you don’t get around that if you want to live somewhere), you get to vote in how they’re run. One thing you’ll want to also copy is to have a mutual for those mutuals so to speak, to transfer funds from insurers who insure lots of rich healthy people to insurers who insure lots of poor ill people.
But on the legal side more importantly you have to severely limit co-pays. One thing that absolutely must happen is that all kinds of preventive checkup and care that avoids worse is covered by the policy no questions asked. That’s literally saving the insurers money.
Over here co-pays are very limited and more of the “yeah we don’t want you to go to a doctor to get a prescription to get 1.50 over the counter drugs for free” kind, as well as some modest contributions to hospital stays, on the order of 5 Euro a day “you’d otherwise have spent it on food which you’re getting here”. All that has yearly caps, affordable ones. Generally speaking if people are paying for stuff out of pocket then it’s to get services that insurance doesn’t cover, like single rooms, or fancy treatments, where you’ll only pay the price difference to what’s medically necessary. In a nutshell if you want gold teeth you’ll have to buy the gold, but the insurer is still going to cover the work.
Am I the only person who keeps meeting medical professionals and support staff who don’t realize that insurance is unhelpful in some situations? The only insurance with premiums my family can afford has deductibles and co-pays/etc so high that we only ever paid premiums when we had it, we literally never once were able to also afford to go get care. Once the mandate dropped and we didn’t have to pay premiums anymore, we could use that money to self-pay our appointments.
Sure, yes, if I get cancer or my husband is hit by a truck, we are fucked. But also, if we go bankrupt paying for insurance we can’t afford to use, I’m gonna be pretty fucked for that cancer anyway because I can’t afford the co-pays etc. Idk what part of “I can’t afford to pay premiums and co-pays until I potentially reach a $1.5k out of pocket maximum,” is so hard to understand.
I helped host a local protest to raise awareness about Single-Payer (anybody else remember SPAN, the Single-Payer Action Network?) back in 2004, and holy fucking shit that was almost 20 years ago.
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It might if y’all get your asses up and create some mutuals.
Historically speaking the German public insurance system started out with union-associated mutual funds, Bismarck didn’t so much create the system but brought it under state control and made having insurance mandatory because it was macroeconomically sound and otherwise beneficial for his conservative (as in Monarchist) ass: Result was less votes for the Socdems which Bismarck liked, more state control which he also liked, and less people emigrating to the US where you had more chances, but also no safety net whatsoever, which he also liked.
To this day German insurers are practically mutuals – as they’re public-law corporations we don’t own them (noone does) but we’re not customers but members, vote for their boards, and noone is siphoning off profit. They’re essentially like municipalities in a sense: Providing service and you’re a “citizen” of at least one (all German territory is covered by municipalities so you don’t get around that if you want to live somewhere), you get to vote in how they’re run. One thing you’ll want to also copy is to have a mutual for those mutuals so to speak, to transfer funds from insurers who insure lots of rich healthy people to insurers who insure lots of poor ill people.
But on the legal side more importantly you have to severely limit co-pays. One thing that absolutely must happen is that all kinds of preventive checkup and care that avoids worse is covered by the policy no questions asked. That’s literally saving the insurers money.
Over here co-pays are very limited and more of the “yeah we don’t want you to go to a doctor to get a prescription to get 1.50 over the counter drugs for free” kind, as well as some modest contributions to hospital stays, on the order of 5 Euro a day “you’d otherwise have spent it on food which you’re getting here”. All that has yearly caps, affordable ones. Generally speaking if people are paying for stuff out of pocket then it’s to get services that insurance doesn’t cover, like single rooms, or fancy treatments, where you’ll only pay the price difference to what’s medically necessary. In a nutshell if you want gold teeth you’ll have to buy the gold, but the insurer is still going to cover the work.
Am I the only person who keeps meeting medical professionals and support staff who don’t realize that insurance is unhelpful in some situations? The only insurance with premiums my family can afford has deductibles and co-pays/etc so high that we only ever paid premiums when we had it, we literally never once were able to also afford to go get care. Once the mandate dropped and we didn’t have to pay premiums anymore, we could use that money to self-pay our appointments.
Sure, yes, if I get cancer or my husband is hit by a truck, we are fucked. But also, if we go bankrupt paying for insurance we can’t afford to use, I’m gonna be pretty fucked for that cancer anyway because I can’t afford the co-pays etc. Idk what part of “I can’t afford to pay premiums and co-pays until I potentially reach a $1.5k out of pocket maximum,” is so hard to understand.
I helped host a local protest to raise awareness about Single-Payer (anybody else remember SPAN, the Single-Payer Action Network?) back in 2004, and holy fucking shit that was almost 20 years ago.