Posted by ceejayoz 4/12/2025
We’ve legalized bribery. Politicians are genuinely very cheap to buy.
It doesn’t matter who you vote for. Everyone has a price.
https://www.skadden.com/insights/publications/2024/07/us-sup...
It is an untenable situation that would require radical restructuring at this point. I don't see it getting any better.
What would be the point, honestly?
Calling for his assassination would, rightly in my opinion, be prosecutable.
I'm too demoralized at the moment to hope for what I'd consider an appropriate response by state or federal governments / courts.
The third most likely solution, revolution / civil war, would probably cause far more suffering than any fixes it might enable.
I'm curious if America will soon reach a tipping point where a sizeable portion of its population actually makes an effort to emigrate, rather than just talking about it.
Whether this will usher in a free market utopia remains to be seen, but I think the health insurance industry is going to collapse under the weight of its own greed.
If Medicare goes away, much of the healthcare system will simply implode rather than getting more expensive. Looking it up, the system my hospital is part of gets 36% of revenues from Medicare. I expect my hospital is slightly higher than that.
Emigrate where? The parts of the world where quality of life is equal or better don't just have open door policies letting Americans in freely, last I checked. I imagine it's going to get even harder.
Now, it might violate Hacker News's policies and get deleted, but that's different from it being against the law.
Maybe we need more of plausible deniability.
Changing insurer's incentive landscape.
The moment a company capitulates as the result of murder, they’ve now incentivized more murder.
Such attacks on the people running these companies can only impede change I think by forcing companies to become more entrenched in their existing practices.
ooor they're incentivized to force some legal resolution to make crowd "believe in system working" instead of "despair in neither system nor murder working"
The world is filled with complexity and systems that are broken. They require thoughtful solutions, not chaos. Setting aside the moral and ethical dilemmas that arise, advocating for the murder of company leaders is essentially a roll of the chaos dice attached to a wish that somehow the resulting situation will sort itself out.
If you remove all moral/ethical considerations (not the least of which is that blame is shared by many people), it’s far from obvious that the result would resemble the thing people want. Pragmatically, it’s a poorly considered idea that introduces potential for equivalent or greater harms.
I think this misses the 'fuck it, I'm going out like a grenade' aspect. Someone facing death or long-term painful chronic illness due to lack of access to medical care, and who has the perception that this is in part or wholly due to health insurance problems, might not care that they're as you said, rolling the chaos dice. They won't be around for long to deal with those consequences. They might want to roll those dice as a desperate attempt to exert some control, to make some kind of statement, to a world they feel has trodden on them.
There's a kind of logic to it, one borne from pain and desperation. But there's a reason the cliche about a cornered rat exists.
I think this is very separate from the disturbingly popular trend to advocate for violence as a solution.
I do agree that the trend for the more average person to be okay with or even advocate for violence as a solution is disturbing. But a massive part of why it's disturbing is that it's a symptom. There are always fringe groups who resort to it as their primary approach, but when your regular person starts looking at violence as the way to solve things, there's some kind of broader sickness happening - a large scale societal malaise.
My great grandmother used to compare war, revolution, mass civil unrest and other such breakouts of violence as a fever for the body that is humanity; She'd lived through far too many of these fevers. They're rarely idiopathic, and while they might help fight off the current sickness, they also often killed. And even if you survive a fever, it's never a particularly pleasant experience.
To constrain violence to physicality is to ignore and minimize the myriad creative ways we've concocted as a society to inflict harm. Maybe to you it seems to dilute meaning, but to me that's more of an indication of a dependence on the narrowed definition on your part, than a problem with the increased scope per se.
But we disagree about the use of language. Many people reduce complexities to the most extreme word they can think of. It’s very popular these days to call many things “violent”.
The issue is that this kind of reductionism makes people stop taking the word seriously, and by proxy the people using it. In my opinion, this ultimately hurts the underlying message.
> To constrain violence to physicality is to ignore and minimize the myriad creative ways we've concocted as a society to inflict harm
This is fallacious and untrue. There is no reason to believe that using precise/accurate (and no less expressive) language is synonymous with ignoring harms. To reiterate the point above, overloading language is far more likely to cause this problem because at some point people have no idea what the word means to the person using it.
I consider myself “woke” by the original definition and spirit of the word. But you’d get 10 different answers about what that actually means these days.
The looser these definitions become, the less able we are to communicate effectively and this is one of the many ingredients driving increased polarization and the feeling that we exist in separate realities.
I’m with the poster who suggested emigration. If this chaos continues, I’ll be tempted to renew my UK passport and/or apply for an Irish passport.
When I reach those, I’d expect them to pay the remainder. As agreed. As implied by a prior authorization.
They won't. "Out of pocket maximum" means something completely different to the insurance company than it does to any normal person.
Out of every dollar you pay out of pocket, the insurance company will decide how much they feel like counting it. Might be the full dollar, or some pennies, or nothing.
You might have paid $20K out of pocket in a year, but the insurance company will say you've only paid $1000 because just because. Good luck reaching that "out of pocket maximum".
Source: I've been there.
That's via Aetna.
That's because they negotiated and paid for such a plan.
My sister works for a similar large employer. They hired Cigna as the insurer/benefits administrator, and every interaction is a problem. Your two kids have an ear infection? Cool, we've determined that the second one is due to an auto accident. It's so bad that the company hired another company to argue with Cigna for you.
End of the day, the employer controls the purse, and the insurer is doing what the employer paid for. It's cheaper to hire another company to argue for the folks who have noticed problems than to pay for a level of service.
Stop having employer provided insurance / benefits; just tax and then provide services. No more billing department. Just single payer (we the people) get what a patient needs healthcare.
My doctor wanted to give me an MRI for a pain near the heart, and insurance told them they wouldn't cover it until they did various other forms of cheaper treatment, including taking antacids for one month, and 5 months of physical therapy. Which of course didn't work. The waiting time for the first appointment was 3 months.
It took over 9 months for my doctor, the only person to actually properly know the details of my case, to be able to give an MRI that he thought was necessary because someone at the insurance company, who I never met, who had less medical expertise than my doctor, wanted to save the insurance company money.
Anecdotally, all the people I know who live in countries with socialized medicine haven't ever had a wait time as long as that, and haven't ever had a simple MRI be delayed by their socialized insurance.
Australia has a combination of public and private health insurance, and they both work well together. The public health options provide the safety net, while the private health insurance is optional.
Where the private option makes sense is if you want to go to specific private hospitals, or if you have elective surgery (the classic example being a knee reconstruction for sports injury) and you don't want to be in a queue behind people waiting for public hospital beds for more serious conditions like heart surgery and so on.
My dad in Australia had open heart surgery 2 years ago, and is doing very well. His cost for the entire procedure? $0 and this was done by one of the very best heart surgeons in the country. He has private health insurance, but elects to go to public hospitals, which have excellent surgeons committed to the best care, because he's a patriotic sort and he's paid into the public health system through taxes for his entire life.
Meanwhile I pay > $3k per-month for not even top tier care in Upstate New York for myself, my wife and my 10 year old daughter, with no serious pre-existing conditions, and I have absolutely no guarantee that any surgery or anything that any of us need in the future will be even covered, even if my primary physician says it's medically necessary.
The rest of the world would do well to study how the combination of public and private health insurance is done in Australia.
Far better to instead wait for 11 months, spend a couple hundred hours bouncing around phone trees for my health insurance provider, and pay a few thousand dollars per month for having the privilege to do so. So much less stress for me and my doctors to get jerked around by barely medically competent insurance company employees, makes it much easier to sleep at night. Especially fun to have PA withdrawn because due to how long it's taken to get the MRI has allowed the issue to progress to the point where the kind of MRI needed is now different and requires a new PA.
There are already large swaths of people who can't get a MRI period because they are excluded from healthcare in this country. And if your belief is that a single payer system will be hampered by measures such as austerity, then say that. Because then your issue isn't with single payer healthcare but instead with politicians who believe institutions need to be run as a business instead of what they actually are, which are public services.
This option doesn't work because healthcare can't be a free market. Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible.
(b) if we had a reasonable market then some people could have an alternative like paying out of pocket
US healthcare has to compete against cheap healthcare in mexico or whatever
A good first step would be banning price discrimination for medical procedures. Right now you get three different prices for "I pay", "insurance pays", and "insurance denies and I pay". People can't tell you what those prices will be. The whole point of insurance is supposed to be to derisk these kinds of decisions, not increase uncertainty and risk. Attempting to use insurance and getting denied can 10x your cost, so what is the purpose of the insurance?
Otherwise we end up paying more anyway. Someone needs to bail out hospitals.