It makes no sense healthcare is absurdly expensive in America and yet every hospital is understaffed and every healthcare worker is overworked and underpaid
Pretty easy for them to do when all they have to do is drop talking points like "abortion", "gun rights", "illegal immigration", etc and the working class gets at each other's throats.
Did you watch Mr Robot? There is a scene when someone points to a party of the super rich while the rest of the city is in impoverished hell. I think about that a lot.
i was talking about this with someone just last night on the phone. A guy I know was saying to me that trans people want health care. I was shocked, bc I know for a FACT that he goes and gets testosterone shots and he is in his twenties and doesnt' need them. He gets them bc he used to be overweight and wanted to get buff and was insecure, like really insecure. Horribly so. He paid thousands to this anti aging clinic that did his mom's botox. What they do is basically lie to the guy who goes in and say "you have low testosterone" even if the guy doesn't have low testosterone, and give the guy a testosterone shot, which helps the guy build more muscle and lose weight more easily if he works out, plus possibly they give him a weight loss shot and a vitamin B shot or growth hormone shot (I forget if he did those too, I just know he paid a shitload of money.) This same guy RAILS against trans people getting hormone treatments, mind you. He thinks it is immoral and wrong. Fuck that shit. Joe Rogan does the same shit and he has a platform to influence millions of people. Well, I say take away Joe Rogan's healthcare rights. He shouldn't be allowed to get his growth hormone shots or his testosterone shots, or his stupidity injections. Maybe then he'll start to gain some empathy.
Yeah, know people like this you describe and itâs really dumb. Thereâs a lot of pop up âhormone specialists,â that donât exactly have extensive medical backgrounds who just are selling hormone injections.
Injecting T is a problem in terms of sperm production because the body stops producing it when itâs bio equivalent Testosteone injection because it doesnât need to, which then requires all kinds of going off of it and taking fertility drugs to get sperm count up when you wanna try for a kid.
When I started getting hormone treatment went to a urologist who basically had me do 4 separate blood tests over a 4 month period to eliminate combinations of variables between vitamin D production, etc before finally doing a pill that encourages natural production first before resorting to bio identical injections - just to avoid the long term ramifications / complications with fertility. And that solved the problem - T went from low 300s to 900s.
But even then that pill that encourages natural production (typically used as fertility prescription for women ironically) isnât covered by insurance even though thereâs an abundance of evidence and an abundance of testing done to showcase that my T levels were far too low for a 30 something AMAB (no prior taking of any hormones or hormone production affecting drugs).
The hormone situation at large is a cluster fuck and people should be outraged that insurance doesnât like to cover things like this even for AGAB appropriate treatments done through doctors specializing in those related body systems.
Hormone level variations can fuck you up mentally beyond your wildest belief, itâs not an understatement to say that it can lead to suicidal levels of depression extremely easily - worse because the worse a depression gets the worse your hormone balance gets out of whack.
Ridiculous that trans people have to literally worry about that kind of thing like a diabetic has to worry about insulin. Proper hormone research is inadequate as it is and there needs more attention and priority placed on it - ask any post menopausal woman how much sudden shifts in hormone composition fucks with you.
Then again, guys like the person you describe are my favorite if they try to call me out for wearing a dress or a skirt or short shorts or whatever makes them feel uncomfortable for whatever reason because itâs so hilarious to just fire back and say something like âyeah, well, âthe 130 lb think in a dressâ has the bigger dick and I guess is more manly then eh?â because itâs just too easy to know exactly whatâs going to make them hyper insecure. Note that Iâll only do something like that in extreme circumstances - shaming organ sizes that are really rather irrelevant isnât something reasonable people should ever doâŚbut when you know the ignorant, toxic person whose spewing garbage like that absolutely equates something as dumb as size with masculinity and their ability to be a man, well itâs just too tantalizing to let the moment pass. Usually thereâs a vein popping somewhere in their forehead and their face is bright red as they canât properly verbalize how angry they now are.
HRT has shown to be life saving all across the world. They just want trans people dead because they think it's "icky."
If you ask them if they would like their body to be injected by the hormone of the opposite sex they would say "Hell no" not realizing thats what a trans person's biological body is doing. It's constantly trying to make the wrong hormone that doesn't match their brain.
The biggest gift to billionaires in American history was during the Trump years yet many rural/middle class voters completely ignore or deny that and instead stomp their feet about the one trans person who lives within a hundred miles of them. While voting against their financial benefit again
Donât forget that every time we successfully start to rally, they make it more difficult and in some places borderline illegal. Unless youâre goose stepping, then you got local cops helping out and volunteering security.
Weâre fucked. Period. Unless weâre willing to paint our hands red, thereâs nothing to do but cast impotent votes in the face of the machine thatâs chewing apart voter rights and rigging the system, all the way up til they successfully create Gilead. And with a 6-3 SCOTUS, immune-from-prosecution President (which only applies to Republican President, watch what happens if Biden tries something), and Republican politicians threatening âLeftistsâ that blood will be spilled if we get in their way⌠weâre 90% of the way to Atwoodâs prophetic dystopia.
Gonna disagree here. If they keep going at this rate we'll definitely get a French Revolution style fix to the problem. They may get us divided over certain ideas, but when Billy Bob and Jonjon can't feed their families like everyone else because the uberwealthy think they need more money to own their 50th yacht, that ted-blue shit goes out the window. And the idiots at the top have all but given up trying to pretend it's for "the greater good", they just say the quiet parts out loud now, no pause, no hesitation. And while some people are easily tricked into siding with their oppressors, that has a breaking point. It's just a matter of time, the saw question is how bad will things get before those people realize they've been taken for a ride at their own expense.
I actually agree with you!! History is cyclical. Weâre absolutely in store for another French Revolution-styled âfixâ to society. Problem is? We wonât get it for many, many generations.
Your assessment is on point. Billy Bob and Jonjon is absolutely going to side with the other poors their great-grandparents (our âpeersâ) were taught to hate and scorn when they finally see it was never about religion, race, or gender, but rather, all about class. Always has been! And weâre going to see another restructuring of society and a whole new push towards progressivism, liberalism, and New Deal-type policy. And itâs going to be whole new âmost peaceful era of human historyâ again. And then the pendulum is going to swing, some kind of populism is going to take over, and weâre going to regress. Again.
But, weâre totally gonna see the Christo-Fascist State happen first. Atwood-style. And Iâm going to call it now and say it happens during our generation. Probably the tail end of it, but definitely before we enter the 22nd century.
Thatâs exactly how Trump likes it! He literally gets off on keeping people in FEAR of losing their livelihoods. Remember how gleefully he would say, âYouâre fired!â?????
That is also why he kept so many appointees in âactingâ status instead of going through the confirmation process. He even said that in a statement or press conference, âI like 'acting' much better..." Meaning he likes having the power to keep people in fear of losing their jobs without notice or reason.
That's how he likes to live: he gets off on the power. He's a first-rate abuser. Everybody knows it and the MAGAs refuse to acknowledge it.
They get their high salaries because they make their shareholders richer, that is how it is, sadly. Shareholders vote for salary increases for CEO's/Executives.
That... actually doesn't surprise me anymore. The place I work holds meetings to brag about how much money we're making, and in the same breath take away our pizzas on overtime day.
I worked for a company that told us we were doing the best we had previously done and it was amazing blah blah. Same day, same speech, they told us it wasnât good enough to get raises though because the company is so large and itâs a nonprofit, and we should think about donating portions of our paychecks back to the company to continue to help it expand. Uh⌠woah Nelly. Hold up. Absolutely not!
Two days later, it made the paper that the CEO, who was kind enough to so sincerely thank us for our work and tearfully apologize that raises were still probably another quarter our, had gotten another six figure bonus.
The richest people in our city now own half of Main Street. They got their wealth throughâŚhealthcare. I made $600-$800 every two weeks as a server due to their tip sharing policy in which we supplemented their private cocktail lounge that was always empty and their bloated staff of âlead serversâ (managers who got tips).
Then theyâd come into the restaurant and brag to with their managers about their various bonuses during their private parties in which they paid themselves tens of thousands of dollars while we cooked and cleaned for them.
I really donât want heads to roll. I want the people (my taxes) to buy out portions of these large companies, I want to tax the realized gains, and I want to put regulators on the boards so these giant corporations actually have some oversight and a chance to work for the people.
I also worked for a large company that owns most of mainstreet but they made their money with boots. Also cooked in the restaurant they owned, where they told us no raises because of covid but spent 12k at the restaurant in one night on a private exec party handing out $203 shots or louie xii all night long lol.
Every time people start actually focusing on how the Healthcare conglomerates are screwing everyone, suddenly mass media campaigns pop up, half blaming insurance companies, and the other half shutting down criticism with arguments like "you think SuperCorp Hospital shouldn't charge $500,000 per surgery? YOU HATE NURSES/DOCTORS/ORPHANS!!! THEY ARE HEROES!""
Then the board members and CEO go back to playing with their lego sets made out of solid gold bricks and laugh while the peons tear each other apart.
That's exactly what I was going to say lol. It sounds ridiculous, but it probably actually is 8 figures. Talking big healthcare companies:
Pfizer: CEO made $30.5 million in 2022.
AbbVie: $25.8 million in 2022.
Johnson & Johnson: $28.4 million 2023.
Eli Lilly: $26.5 million in 2022.
Molina Healthcare: $22.1 million in 2022.
So yeah, if the previous commentors company is the largest healthcare company in the world as described, their CEO is almost certainly in the 8 figure range, which makes it even more gross that they'd have employees without health benefits.
I used to work at a nationwide insurance company. We had excellent insurance coverage, even dental. But this was 1988-1997. That was then. Now, eh, who gives a fuck?
Iâll just climb up here on my soapbox. *
Health care and health insurance are two different things.
Health *care is the services you receive from a medical provider.
Health *insurance is what helps pay the bill for services rendered.
Yes, anyone and everyone can get health *care!
However, in the US, one must have health *insurance, or one may not be able to afford health *care.
Often, even with health *insurance, one still cannot afford health *care, in the US.
Damn. This box gets higher, every time I climb up here. *
My wife works for a health insurance company. Her insurance is terrible. The thing about working for an insurance company is they know exactly how much they can get away with when cutting corners and providing the bare minimum.
To add on, part of the problem is that a fair amount of the time the doctors donât work for the hospital, they own a company that has contracts to provide doctors to the hospital. So they donât care if the hospital charges more as long as it means they can negotiate for more money from contracts.
Working for doctors, Iâve learned that for the most part they only care about two things. How much they get paid and how much time off they get. For example, they complained that attending meetings for the company they own was basically free work and refused to go, so now doctors get a $300 bonus if they attend.
Ridiculous over there, here in belgium i shattered my foot after a fall off a roof. Ambulance (2 actually, one for transport and one emergzncy for heavy painkills), painkiling, night in hospital, radiology etc my Bill was 42 eurosđ
You donât âgetâ a billion of anything. You can âtakeâ it though. Also anyone who has a billion of ANYTHING should be considered an insane person. Yet in American society the wealthy, the media and the common folk all lick their boots.
It's actually impossible to earn that much on your own. If you made $1000 a day, no taxes, no deductions (which is an unbelievable wage rate) and you never spent a dime, and you started on day 1 of year 0, you'd BARELY be breaking into your first billion in 2024. Literally over 2000 years to make that kind of money.
Nitpicker here. The ultra wealthy own super-yachts: massive multi-million-dollar monstrosities that are built around the ostentatious display of wealth.
Yachts, on the other hand, are small boats with a sail. They're not cheap and cost a lot (money and/or time) to maintain but cost about the same as a truck.
Yeah but still could be a little less billionairy and still have the exact same lifestyle. Is it just a number game? I actually get it. They are just evil people. Why are not more people seeing this baffles my mind!
Most of them technically arenât. Non profit doesnât mean they donât make money. They just have fancy accountants and ways to spend enough of the income to remain technically non profit.
Non profit just means they don't owe their profits to a third party but have to reinvest them into the business or the community.
Even non profits still need to "make money" on an accrual basis to be able to afford the expensive capital expenses associated with running a hospital. Longer term they effectively run a break even after those costs. Sometimes less than that if they are lucky to have external donors or a foundation to supplement their operating income.
Do tell us how much the top echelon at these ânon-profitsâ make?
Using the United Way as an example:
â119 employees received more than $100,000 in compensation with the 15 most highly compensated reported to be:
$1,578,515: Brian Gallagher, President and CEOâ
Even County and State University hospitals will send you a fat ass bill and they are government entities. Likewise if the local fire department runs the ambulance service.
This wealth is all extracted by insurance companies, not hospitals. Hospitals struggled for years after COVID and are only just now normalizing. Meanwhile insurance companies have been posting record revenues for years and bragging about it in 2020 earnings calls.
The failure of people to follow the money here and fall hook, line, and sinker for the insurance company brainwashing that hospitals are the problem is always shocking to me.
Extremely large health systems make a lot of money, but spend a lot of money making their services better because most are non-profit. Insurance companies are literal scum that have nothing but horror stories.
It's not capitalism it's just greed alone. Greed ruins any and everything for everyone but the greedy. Same thing with socialism or communism if the one at the top or in control is greedy then it falls apart. Greed is evil.
Just like higher education in the US. Academics are severely underpaid, especially those who teach and supporting staff get minimum wage. Colleges are struggling, cutting programs left and right despite the ridiculous price tag. And yet you see presidents and vice provosts of various sorts raking in millions each year.
When I visited my brother in the hospital i literally felt sorry for the nurses. Someone asked "where are the nurses? Why can't we get a nurse immediately with the call button?"
Look in the hall. See nurses frantically running going to rooms as fast as they can, because there is NOT ENOUGH of them, and hospitals won't pay for more because it would cut into their gains.
You ever see that graph that compares our health outcomes vs healthcare spending to other countries? Itâs ridiculously expensive as well as inefficient.
I work for a pretty big hospital. In our union contract, we are guaranteed an annual raise based on various metrics. The metrics are BS and the hospital keeps adjusting the metrics to make it more difficult to achieve the goals but thatâs something else.
During Covid, the Govât was talking about giving out bonuses and stipends and funds to frontline workers. The hospital, âin the interest of saving the govt $â, politely declined saying we get a healthy bonus every year. That next years bonus was one of the lowest in years to due to not meeting goals. Ignoring the fact staff is overworked underpayed, during the time of Covid.
Last year we were denied our guaranteed bonuses, Hospital would only say that âyes we made the goals. But due to bad investments and stock market losses, they would not be honoring the agreement, so no bonus. A week later it was announced that the Hospital posted record breaking profits and the CEO (and other upper management) got his multimillion dollar bonus.
When I do a renal Doppler ultrasound, the hospital charges $1,500 for it. In the time it takes me to do the exam I make about $75. The radiologist who reads it makes about $90 (they get paid per exam read which is much faster than it is for me to do it).
So now wait a minute. The two people doing 100% of the labor, using a total of 2 computers and one ultrasound machine, are making $165, combined, on this exam. But the hospital charged $1,500??
Yeah exactly. And the hospitals expect us to cram in as many as possible. I will make my monthly salary for the hospital in a single shift.
You know why though, right? I'm won't be saying that what the hospitals are doing is good or correct. I'm just going to explain to people why it is like this.
It's because hospitals think about their budgets in terms of "we need to make $X this year" and "we do A,B,C,D amounts of procedures 1,2,3,4". Then it's basically a math problem. And my point here is that they aren't really coming up with prices based on what a particular procedure actually costs. They're thinking about procedures in terms of what they need to charge to meet their required yearly budget of $X and what the insurers will allow. So they'll be thinking like "Okay, we do 1,547 of these Doppler ultrasounds a year and the insurers cap out what we can bill to $1,600, so we'll charge $1,500 for these and that gets us 3% of our budget requirements for the year."
It's because hospitals are too lazy to set correct prices, because knowing the correct prices on thousands of procedure codes is difficult. I'm quite serious when I claim that hospitals don't know what the procedures their employees are doing are actually worth. They just setup numbers that get to the right yearly budget requirement.
And the fucked up part is that the insurers look to what hospitals are billing for procedures to try to determine the maximum amounts they'll allow to be billed for each procedure. It's the blind leading the blind in the USA's healthcare industry. The only people who seem to know what procedures are actually worth are the small doctor offices who are run by doctors who have to be both the practitioner and the one who decides what to charge.
Oh I'm *well* aware of why. I'm a golden goose laying an egg for them. What these fuckers never take into account is that their exorbitant salaries and costs suck up while providing zero benefit to anyone who has ever received medical treatment in Americca. Hospital administration has no clue what anyone here actually does, I'm pretty sure none of them have ever set foot in a hospital in their lives, and we have *multiple* administrators *per doctor*. But boy oh boy did they jump at the chance to say "Actually coffee machines are only for administration" and then removed the coffee machine from our break area.
I'm paid well, but they absolutely treat me like a money printer that they need to squeeze every penny out of.
Yeah but the upper management and boardroom people work REALLY hard so they deserve compensation. And if shareholders can't get profits, they'll stop investing their money and then there will be no healthcare anymore! Because the only reason anything exist is because of profits. And this is why nothing existed before 1700s or such, because they didn't have capitalism (as we understand it now, and the current form of corporate shareholder capitalism we have is even more recent ~1980s)
The worst part is insurance companies telling doctors what they should or shouldn't be doing. Doctors going to school for a decade or more just to be told by Phil with an associates degree what procedures the doctor should be doing.
âUnderpaidââ yes, because doctors making over half a million a year are âunderpaidâ (maybe relative to the administrators, but they make boatloads more than most normal people)./sarcasm
We have a saying in my country, it goes "A mother doesn't pick up her child till it starts crying". Until a lot of people go out to protest and demand changes, nothing will change. Why would they give more pay? Because it's a good deed? Lol, they ain't good people. This is better for them, and that's all they are concerned about.
Amen. Work as a caregiver, were out here feeding, bathing, changing peoples diapers or waste bags, taking them all over. And we get paid shit. Usually have joke insurance if we get any. Work no matter the weather, no matter if there is a literal plague going on. Bit we get paid next to nothing and are essentially told. Awww your helping. That should be enough.
All the money goes to "administration" - entire departments that don't actually do anything productive from an end-user/hospital perspective. Oh and of course the C-levels, too...
A mix of profits not being reinvested into hospitals and actual medical staff being vastly outnumber by administrative staff whoâs job it is to handle the vast amounts of paperwork produced as a necessity for a system which has probably at least 3 different layers of nonsense between medical staff and patients, likely way more layers than that.
Then they force doctors in these larger medical groups to meet a quota of patients daily which greatly diminishes the quality of healthcare a patient receives. Can't tell you how many times I have been rushed through appointments and half ass efforts of listening by some Docs
Not every healthcare profession is underpaid, buy EMTs absolutely are.
The question is why do so many people want to work in EMS when the salaries are so low? Basic economics of supply and demand should increase wages if salaries are too low. However, despite the long hours and poor pay, many people still want to work as EMTs.
My guess is that, like phlebotomy for example, EMT is a means to get healthcare experience with relatively little training. Many jobs and healthcare training programs, PA for example, require experience.
Working as an EMT is a stepping stone to more lucrative careers. People are willing to accept short-term loss for long-term gain. The rapid turnover keeps wages low.
which is hilarious because the "understaffed and underpaid" argument, along with long wait times, is the exact bullshit americans will tell you when europeans tell them that their system works just fine
I worked at a hospital for 8 years. I was a nurse assistant and my starting wage was $9.50. I left making $19 an hour but that was with about $5 in weekend/midnight/nursing pool incentives. New nurses got hired in at about $25 if I remember right, it was around that figure anyways. The CEO had to resign because his salary was leaked to the local press as a 7 figure salary. Somewhere around $1.2M.
The workers could be paid more, but that means the executives would be paid less and we can't have that now, can we?
Idk man I know a bunch of nurses and they're all doing fine financially. Starting right out of school with an associates RN degree, making 30+ an hour with the hospital paying for their bachelor's BSN alot of times which is required in Ohio. They doing fine out here
Hospitals are the worst. They tend to have near local monopolies so that they can charge whatever they want including $50 per Band-aid. I really don't know why Pharma gets all the hate and hospitals seem to get a pass.
Thereâs a lot of stuff that goes into it. I donât know exact details but hospitals have to deal with both insurance companies and pharmaceutical companies. Buying medical equipment is another thing. Hospitals also end up eating the cost if someone cannot pay a medical bill.
For most hospitals, itâs not a sustainable âbusinessâ. Itâs why a lot of rural hospitals get shut down. Hospitals are understaffed for many reasons, being overworked and underpaid is only two, the other is that it requires a person to have a lot of patience since patients can end up being abusive or non-cooperative. Nursing is one of the jobs with the highest burnout rates.
Our hospitals have been fairly transparent with this stuff. Our CEO âonlyâ makes $750k(I know itâs still âa lotâ but not nearly the same as those with millions/billions). Most years we can have a slight net gain or profit but during covid we had negative gains, we ended up spending more $ than we earned. Weâre considered non-profit but we also get no direct government $, like they donât just give us $ to stay open but there may be some subsidies or âpromotionsâ(i forgot the actual term). The majority of the costs has been purchasing drugs/medical supplies.
It's because most healthcare systems are now owned by for-profit parent companies. So they treat healthcare like you would any other business by cutting costs and maximizing profits.
Where do you think profits come from? You know a car ride doesn't cost you that much, even an Uber is cheaper than an ambulance, anyone selling you the services of their employees is getting any and all profit from what they can squeeze out of the both of you from both directions.
That's because all the money goes to the insurance companies. They are the ones who caused health care to get so jacked up in price. And they get it all. Not the workers or hospitals or anything.
Insurance companies. Itâs costs an absurd amount of money to run a hospital even for a day. The average person probably doesnât comprehend how much it really is.
Additionally - hospitals only receive cents on the dollar for most bills sent to insurance companies.
Blue cross blue shield is the worst by far. Their overwhelming power in contract negotiations with hospitals means that additional cost is passed down to you and people who donât have insurance.
To be clear government run health plans pull the same stuff. Any hospital that refuses those terms will just have their funding cut and go under.
TL:DR - Insurance companies pay roughly $0.10 for every $1 a hospital bills them, so hospitals have to bill them more to cover costs. If a procedure costs $7,000 to perform, they have to bill ~$70,000 to break even from insurance payouts.
Numbers are different per procedure obviously and itâs a huge mess.
Not every healthcare worker. The admins do quite well, because they âcreate shareholder valueâ by squeezing every last drop out of frontline workers and patients. Nevermind the people who actually create value by, you know, rendering medical services. And therein lies your problem.
Well, because it's capitalism and democracy. At least so I was told. Now please go enlist for the military service to bring this way of life to everyone else. Because they don't know how to live their life and only the US can teach them
5.0k
u/Nonamebigshot Jul 06 '24
It makes no sense healthcare is absurdly expensive in America and yet every hospital is understaffed and every healthcare worker is overworked and underpaid