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Re:How a Customer Got Trapped in Ambetter's Ghost Network by akira2501 on Sunday September 08, 2024 @05:31PM (#41483399)
Government health care subsidies and purchasing programs have completely destroyed the market for services. It's an incomprehensible mess of products with a bloated middle layer that only exists to extract value out of the actual Consumer + Expert Care Provider equation to the extreme detriment of both of them.

How anyone stays alive and wealthy in such a system is beyond me. Very few, apparently, are fortunate enough to enjoy this. We need to completely rethink this entire model.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by Terr_ on Sunday September 08, 2024 @06:22PM (#41483735)
Hold up, how does this type of fraud require any government action at all? (Except for prosecuting the fraud after-the-fact, of course.)

The core situation isn't specific to healthcare either: Someone's offering you a long-term contract service based on the strength of a menu of available services and options, but their offering is effectively fake.

It's a similar concept to subscribing to a mostly-fake library of repair manuals or something, only the popular/cheap ones are there, and the others are permanently temporarily unavailable.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by akira2501 on Sunday September 08, 2024 @06:41PM (#41483855)
> Hold up, how this type of fraud require any government involvement at all?

Hold up (seriously hold up and stop serially editing your comments), where did I say it did?

> It's a similar concept

The government has decided, without much input from actual citizens, that copyright should exist for life plus 70 years. Government interference in copyright has created the fraudulent market conditions you've just related.

We can do this all day if you like.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by immibis on Sunday September 08, 2024 @07:08PM (#41484028)
I can still give you a fake repair manual subscription with or without copyright.
Re:How a Customer Got Trapped in Ambetter's Ghost Network by Terr_ on Sunday September 08, 2024 @08:15PM (#41484382)
Yeah, or even a (fake) catalog of flavors from the subscription-based Ice Cream of The Month club, where X months of continuous membership entitles you to something that didn't actually exist.

I wouldn't consider dairy-product safety/labeling laws a root-cause of that.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by akira2501 on Tuesday September 10, 2024 @03:15AM (#41498041)
Technically.. sure.. you can also sell buggy whips. If there's no market for what you are selling then why would anyone buy it?
Re:How a Customer Got Trapped in Ambetter's Ghost Network by mindslight on Sunday September 08, 2024 @07:18PM (#41484080)
Why are you putting the word "government" in there? The main perpetrator of this particular problem is the health "insurance" cartel with their closed "networks". This regime was directly created and nurtured by government-based regulatory capture, but that does not mean that removing government from the equation will cause the "insurers" to spontaneously dismantle their lucrative arrangements.

So directing the ire at "government" seems like it's directly detracting from focusing on the problem, which is a complete lack of sensible regulation of these "private" corporate extraction machines. At a minimum this "network" nonsense needs to be outright banned for the restraint of trade scheme that it is, and "providers" need to be taken to task for shaking down patients with fraudulent bills not based on any sort of contract (the latter being the main thing driving people into the arms of these "insurers" to begin with).

Re:How a Customer Got Trapped in Ambetter's Ghost Network by jonhohle on Sunday September 08, 2024 @06:03PM (#41483628)
It’s almost as if people warned about this very thing. It’s almost as of anything the government touches turns to crap for most while a few, especially those in Congress, ride off with a huge pay day. I’m not sure why people continue to fall for it.
Re:How a Customer Got Trapped in Ambetter's Ghost Network by Hnrobert42 on Sunday September 08, 2024 @06:52PM (#41483925)
I assume this is a criticism of the ACA. How, specifically, did it lead to this outcome?

And why is your criticism reserved for the government and not the perpetrator of the fraud, namely Ambetter?

Re:How a Customer Got Trapped in Ambetter's Ghost Network by GendingMachine on Sunday September 08, 2024 @07:38PM (#41484208)
Christ, reading Americans declare that the issue with American healthcare is "too much government" always completely floors me. The system did not work well before the ACA, the system does not work now. The only countries in the world with strong, consistent and equitable healthcare systems have government health systems.

Here in the UK our NHS is a goddamn mess, it's cracking and creaking and bureaucratic, but every American expat i have ever known who now lives in the UK has horror stories about how much worse it is over there. In our monthly social classes (PSHCE) we watched documentaries of poor Americans unable to afford healthcare, and it horrified us all.

You can't run healthcare as a profit seeking enterprise, it just doesn't work, the financial incentives of healthcare providers just fundamentally do not align with their customers. Government run institutions can often fall into a state of bureaucratic atrophy but if this and countless other stories make clear - that's an issue with institutions in general, whether they be government run or not.

This problem will not improve until you get over your ideological commitment to trying to solve every problem with markets. Healthcare must be socialised, anything less is barbarism.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by jonhohle on Sunday September 08, 2024 @10:25PM (#41484964)
Health insurance is the problem and always has been the problem. Having the government mandate insurance is far worse than a public health system. Currently we have the worst of all of the options (and if an insurance company has bought all of the smaller providers in your area, it’s even worse)!

Healthcare hasn’t been a “market” in decades. It’s completely captured by monopolies which have captured regulation to prevent any alternatives. I do know that the mashup of government mandates for for-profit entities is about as corrupt a system as could be conceived.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by akira2501 on Tuesday September 10, 2024 @03:19AM (#41498060)
> The system did not work well before the ACA

It wasn't nearly as corrupt.

> we watched documentaries of poor Americans unable to afford healthcare, and it horrified us all.

A system so good shouldn't need such propaganda to justify it's existence.

> you get over your ideological commitment

The ideological commitment that are the underpinnings of our system of government and the core of our very constitution? Why don't you just "get over" your ideological commitment to entertaining that absurd royal family?

Re:How a Customer Got Trapped in Ambetter's Ghost Network by GendingMachine on Tuesday September 10, 2024 @08:10PM (#41506959)
By what metric are you evaluating corruption here, other than selected news anecdotes that support your ideological intuition.

We watched videos of the horrors of the American healthcare system for the same reason as we watched videos and were otherwise taught about oppressive regimes, international poverty, bigotry and racism both local and international - to learn about global issues, to gain a wider perspective on the world, to be knowledgeable about the many ways in which a society can fail it's most vulnerable. Such as, for instance, letting your poor die and suffer from preventable, curable illnesses.

Oh, and I have no such ideological commitment to the monarchy, I and most people I know would choose to abolish it in a heartbeat. It is here, as it is everywhere, the conservative right clinging onto traditions, ideologies and policies that have long since proven unproductive, disfunctional or outright harmful.

The monarchy may well underpin much of how British law and government works, and that is something we should work to change - just as you in the US should work to change those parts of your founding constitution written almost 300 years ago that no are no longer to the benefit of yourselves and your country.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by karmajunkie on Sunday September 08, 2024 @07:31PM (#41484158)
yes, things tend to turn to crap when you have half the government composed of a party dedicated to ensuring that everything government touches turns to crap or benefits the wealthy. not sure how this is a valid point or makes the case that allowing industry to police itself will work.
Re:How a Customer Got Trapped in Ambetter's Ghost Network by jonhohle on Sunday September 08, 2024 @10:00PM (#41484871)
When that’s the game, don’t let them play. The party you’re referring to is ambiguous. Democrats seem to make an awful lot representing their constituents[0].

Health insurance shouldn’t exist. When the government mandates it, now there are two problems. If this wasn’t obvious prior to the ACA, I have a bridge to sell you.

0 - https://ballotpedia.org/Changes_in_Net_Worth_of_U.S._Senator...

Re:How a Customer Got Trapped in Ambetter's Ghost Network by monero-xmr on Sunday September 08, 2024 @06:07PM (#41483656)
We just need to create more agencies, throw more money at the existing programs, establish new programs, and add more regulations. This time for sure
Re:How a Customer Got Trapped in Ambetter's Ghost Network by jonhohle on Sunday September 08, 2024 @10:04PM (#41484889)
Probably a few commissions as well. And adjust for inflation.
Re:How a Customer Got Trapped in Ambetter's Ghost Network by ok_dad on Sunday September 08, 2024 @08:35PM (#41484490)
If I didn’t have healthcare on the Obamacare market today, my special needs son would be without care because I can’t afford his care myself. Furthermore, his healthcare would have been impossible to even get privately because of all that preexisting conditions BS. People like you probably don’t care about anyone else, but ACA is a life saver for so many people.
Re:How a Customer Got Trapped in Ambetter's Ghost Network by jonhohle on Sunday September 08, 2024 @10:03PM (#41484881)
You pay for insurance, which pays for Dr’s insurance, which pays other people absurd amounts for malpractice. If you weren’t having to pay two insurance companies with awfully large buildings, naming rights to stadiums, etc., maybe you could pay for that without government assistance. Somehow people did it successfully for millennia.
Re:How a Customer Got Trapped in Ambetter's Ghost Network by dragonwriter on Sunday September 08, 2024 @10:21PM (#41484949)
> Somehow people did it successfully for millennia.

No, they didn't. People with unusual medical needs just died. Heck, people with what we now view as pretty routine medical needs just died.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by FireBeyond on Monday September 09, 2024 @12:02PM (#41489887)
> which pays other people absurd amounts for malpractice

Many states now cap malpractice insurance. Also, malpractice insurance is not as crippling to physicians as some would have you believe.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by AtlasBarfed on Sunday September 08, 2024 @10:04PM (#41484891)
OMG it was truly paradise before the ACA.

That is sarcasm if you can't tell.

As someone that used the open market plans before the ACA, it basically changed nothing, added subsidies, and removed the lifetime limits, at least from my perspective.

But this is all pointless accounting bullshit, we simply need a medicare-for-all plan.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by jonhohle on Sunday September 08, 2024 @10:31PM (#41484983)
I was on employee plans until recently. I knew I would eventually need private health insurance and watched it for 5-10 years, during which ACA took over. For most, premiums rose and coverage fell. Maybe that would have happened regardless, but that wasn’t the ACA promise. Prior to ACA, growth of per capita health care costs were slowing.[0]

0 - https://www.healthsystemtracker.org/chart-collection/u-s-spe...

Re:How a Customer Got Trapped in Ambetter's Ghost Network by AtlasBarfed on Monday September 09, 2024 @12:36AM (#41485489)
The ACA was a disappointment, don't get me wrong. It should have been medicare for all but...

Fucking Joe Lieberman.

Granted, whenever democrats are in power, they rotate the "bad guy" to give in to the corporate demands and side with the Republicans, but Joe Lieberman was the reason we got a washed out reformed healthcare. Sure it could have been some other democrat senator turncoat, but he wasn't being the surreptitious underminer while the Republicans did the public PR, that a-hole was front and center hollowing out the ACA.

Joe Lieberman probably killed hundreds of thousands of Americans as a result. Maybe a million. Maybe more.

Re:How a Customer Got Trapped in Ambetter's Ghost Network by nitwit005 on Monday September 09, 2024 @12:43AM (#41485523)
> Government health care subsidies and purchasing programs have completely destroyed the market for services.

No it hasn't. People will happily take cash. Some of the offices called in this article suggested they only took patients who pay cash.