Had to look it up myself. I think it refers to Group Member Organizations, which would be the health insurance providers.
When you really think about it, health insurance companies are a bizarre sort of consumers’ union. Your insurance company negotiates prices with providers on your (and their own) behalf leveraging their buying power based on the size of the group. That was probably a good thing at one time, but now the system is so completely broken that if you try to get the same procedure done without insurance, it’ll cost you double or triple what it would cost the insurance company.
Insurance is a bit of a scam. It’s sold as this rosy little co-op, where everyone contributes to a pot of money, then if someone suffers hardship they can withdraw from the pot to cover the cost. This falls apart when you have a 3rd party who manages the pot, determines how much people pay in and if and how much can be paid out, and also derives their income from the pot, at a rate they set themselves. This is an inherent conflict of interest, and makes insurance much more like casino gambling than what they advertise. Just like casino gambling, the house always wins, at the customers’ expense.
100% agree. Insurance companies make money by denying claims. If that isn’t a conflict of interest, I don’t know what is. There is literally a company with financial incentive to deny you the care you need. But specifically with health care, it should be illegal for anyone other than a board certified doctor to deny a claim. People who aren’t doctors have no place deciding whether a physician prescribed therapy is “medically relevant or necessary”.
Big insurance companies have way too much power. They can put immense amounts of pressure on both sides. Hospitals, doctors, and other care providers have to play by the insurance companies’ rules, or they could risk losing their “preferred provider” or in-network status which means they lose a huge number of patients.
Meanwhile, plan participants also have to play by insurance companies’ rules. It isn’t economically feasible to go without health insurance. Hospitals raise prices so that when the insurance company negotiates, the huge cuts they take are less burdensome. But that makes the provider’s listed price for visits and procedures astronomical.
So if you can’t get insurance through an employer, what can you do? What if you’re self employed or an independent contractor? It is often not feasible to buy coverage on your own because it is so expensive. If you do buy solo coverage, your plan is often much worse than a group plan. All more barriers to people getting the care they need.
Had to look it up myself. I think it refers to Group Member Organizations, which would be the health insurance providers.
When you really think about it, health insurance companies are a bizarre sort of consumers’ union. Your insurance company negotiates prices with providers on your (and their own) behalf leveraging their buying power based on the size of the group. That was probably a good thing at one time, but now the system is so completely broken that if you try to get the same procedure done without insurance, it’ll cost you double or triple what it would cost the insurance company.
Insurance is a bit of a scam. It’s sold as this rosy little co-op, where everyone contributes to a pot of money, then if someone suffers hardship they can withdraw from the pot to cover the cost. This falls apart when you have a 3rd party who manages the pot, determines how much people pay in and if and how much can be paid out, and also derives their income from the pot, at a rate they set themselves. This is an inherent conflict of interest, and makes insurance much more like casino gambling than what they advertise. Just like casino gambling, the house always wins, at the customers’ expense.
100% agree. Insurance companies make money by denying claims. If that isn’t a conflict of interest, I don’t know what is. There is literally a company with financial incentive to deny you the care you need. But specifically with health care, it should be illegal for anyone other than a board certified doctor to deny a claim. People who aren’t doctors have no place deciding whether a physician prescribed therapy is “medically relevant or necessary”.
Big insurance companies have way too much power. They can put immense amounts of pressure on both sides. Hospitals, doctors, and other care providers have to play by the insurance companies’ rules, or they could risk losing their “preferred provider” or in-network status which means they lose a huge number of patients.
Meanwhile, plan participants also have to play by insurance companies’ rules. It isn’t economically feasible to go without health insurance. Hospitals raise prices so that when the insurance company negotiates, the huge cuts they take are less burdensome. But that makes the provider’s listed price for visits and procedures astronomical.
So if you can’t get insurance through an employer, what can you do? What if you’re self employed or an independent contractor? It is often not feasible to buy coverage on your own because it is so expensive. If you do buy solo coverage, your plan is often much worse than a group plan. All more barriers to people getting the care they need.
The system is broken.