this post was submitted on 11 Jan 2024
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People with health insurance may now represent the majority of debtors American hospitals struggle to collect from, according to medical billing analysts.

This marks a sea change from just a few years ago, when people with health insurance represented only about one in 10 bills hospitals considered “bad debt”, analysts said.

“We always used to consider bad debt, especially bad debt write-offs from a hospital perspective, those [patients] that have the ability to pay but don’t,” said Colleen Hall, senior vice-president for Kodiak Solutions, a billing, accounting and consulting firm that works closely with hospitals and performed the analysis.

“Now, it’s not as if these patients across the board are even able to pay, because [out-of-pocket costs are] such an astronomical amount related to what their general income might be.”

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[–] [email protected] 0 points 10 months ago (1 children)

Republican obstruction and wanton destruction is responsible for the lack of progress. Refusing Medicaid expansions and then overturning the individual mandate is what gutted the plan.

And sure you could jump right into single payer without any incremental change. But you're going to put the 400,000 Americans currently working in the health insurance industry out of work, if you do that. Which is not a small consideration. (That's per a CBO analysis of the feasibility of single payer, which does conclude it would save money, but it will require a massive work transition.)

https://www.healthaffairs.org/content/forefront/congressional-budget-office-scores-medicare-for-all-universal-coverage-less-spending

[–] [email protected] 4 points 10 months ago* (last edited 10 months ago)

The broader point that I'm making is that incrementalism as a philosophy has resulted in us going backwards. The acceptance of it as a viable strategy when it consistently fails to yield results is a serious problem.

A majority of successful social programs in the US did so in broad sweeping reforms that dramatically changed the way people interacted with systems.

Arguing that 400k jobs in an industry that is basically parasitic to the process seems Stockholm syndrome ludicrous, and yet unsurprising, because this is about the best that branded, 'Democrat with a capital D' , Democrats seem to be able to come up with.

Incrementalism sounds great on paper, it fails for two primary reasons. The first is the opponents to a program have to do far less to dismantle it, so its easy to work against. The second is that it fails to create its own proof points for why something was necessary in the first place. Obamacare is a great example of this second kind of failure. We're still utterly fucked in terms of healthcare. Most people are more fucked than they've ever been in terms of healthcare. We're worse off than we were because at least in 2008, although I didn't have healthcare, I wasn't paying several hundred dollars a month to basically not have healthcare. Incrementalism fails to make enough of a difference in peoples lives to show them that a given project is worth investing in.