[continued from previous message]   
      
   >>>>>>> and it shows the public wanting public health   
   >>>>>>> care. Not more layers of insurance profiteers,   
   >>>>>>> not HSA's.   
   >>>>>>>   
   >>>>>>   
   >>>>>> 64% said they did not want government a single payer program   
   >>>>>   
   >>>>> I would wager that 64% or more don't even understand what a single   
   >>>>> payer system is.   
   >>>>> The same people don't realize that the subsidies in danger of being   
   >>>>> cut from ACA were started due to COVID.   
   >>>>   
   >>>> The only thing they understand about it is that someone else pays   
   >>>> their bill.   
   >>>   
   >>>   
   >>>       How is that different from insurance companies?   
   >>   
   >> How's it not? It's different in several key ways that promote choice,   
   >> efficiency, and better care—things a government monopoly can't match.   
   >   
   >   
   >      "Efficiency" as in an anonymous   
   > insurance actuary telling your doctor   
   > that your operation won't be funded   
   > because SHE thinks it is unnecessary.   
      
   Here's how it's different in a competitive market vs. a government   
   monopoly like Medicare for All -   
      
   Choice and Competition: With private insurance, if one company's actuary   
   denies your claim unfairly, you can switch to a competitor that might   
   handle it better. Insurers have to compete for your business, which   
   incentivizes them to approve legitimate care to keep customers happy and   
   reduce churn. In a single-payer system, you're stuck—no alternatives, no   
   market pressure to improve.   
      
   Appeals Work: Data shows that when people appeal denials, they're often   
   overturned. For ACA marketplace plans, about 40-50% of appealed denials   
   get reversed on internal review. For Medicare Advantage (which is run by   
   private insurers), it's even higher at around 82% overturned when appealed.   
      
   The key? In private systems, denials are often for cost control, but   
   competition drives efficiency through innovation (like telehealth or   
   preventive programs). Government systems decide via "anonymous"   
   bureaucrats or committees, often based on rigid rules rather than market   
   incentives.   
      
   Real-World Efficiency: Look at single-payer systems like Canada's or the   
   UK's NHS—wait times for specialists are way longer (over 50% wait >4   
   weeks in Canada vs. <25% in the US), and elective surgeries can take   
   months or years.   
      
   That's the "efficiency" of a monopoly: rationing by queue, not by need   
   or innovation.   
      
   Both systems have gatekeepers, but private insurance gives you options,   
   accountability through competition, and faster access overall. A   
   government takeover would just replace one set of deniers with   
   another—without the escape hatch.   
      
      
   >   
   >   
   >   
   >   
   >> Competition and innovation: Private insurers compete for customers,   
   >> which drives them to innovate, negotiate better rates with providers,   
   >> and offer tailored plans (e.g., low-deductible for families or HSAs for   
   >> healthy individuals). A government single-payer system eliminates   
   >> competition, leading to stagnation—like how the VA system has faced   
   >> scandals over inefficiency and poor quality.   
   >   
   >   
   >      Who do you think your insurance company   
   > works for, you or it's stockholders?   
      
   Profit motive actually aligns with serving customers better than a   
   government monopoly would. A few things about this-   
      
   Profits come from keeping customers happy and healthy: Insurers only   
   make money if they attract and retain policyholders in a competitive   
   market. Dead customers aren't good for business.   
      
   That means negotiating hard with providers for lower rates, offering   
   wellness programs to reduce claims (e.g., gym discounts, telehealth,   
   preventive screenings), and innovating with things like apps for virtual   
   visits or personalized plans. Companies like Oscar Health or   
   UnitedHealthcare have rolled out tech-driven tools for easier claims,   
   real-time health tracking, and lower-cost options—driven by the need to   
   compete. A government single-payer has no such pressure; there's no   
   incentive to innovate when you're the only game in town.   
      
   Profit margins are actually quite low. Health insurers' net profit   
   margins hover around 1-3%. The ACA's medical loss ratio rule requires   
   them to spend at least 80-85% of premiums directly on medical care,   
   limiting how much goes to "profits" vs. patient benefits. Compare that   
   to government programs: While Medicare's overhead looks low (~2%),   
   private plans handle more complex tasks like network management, fraud   
   detection in competitive environments, and rapid adoption of innovations   
   (e.g., widespread telehealth expansion during COVID came largely from   
   private insurers).   
      
   The alternative is bureaucrats, not "no one": In a single-payer system,   
   the government works for... politicians and voters, but with no direct   
   accountability to you as an individual customer. Decisions get made by   
   committees setting rigid rules, often leading to rationing (long wait   
   times in Canada/UK) or political interference. Profits in private   
   insurance create accountability through competition—if one insurer   
   prioritizes shareholders too much (e.g., excessive denials), customers   
   switch, and they lose market share.   
      
   Bottom line - the profit motive isn't perfect, but it drives efficiency,   
   choice, and innovation that a monopoly can't. Without it, we'd trade one   
   set of incentives (shareholder returns via satisfied customers) for   
   another (political/bureaucratic priorities) that historically delivers   
   slower access and less tailoring. Competition keeps insurers working for   
   you to earn those modest profits.   
      
      
      
   >   
   >>   
   >> Choice and personalization: You pick your plan based on your needs,   
   >   
   >   
   >     LOL!   
   >   
   >     Your needs, or the stockholders wants?   
      
   Stockholders do want profits, but in a competitive market, the only   
   sustainable way to get them is by offering plans that actually meet your   
   needs better than the next guy's.   
      
   Here's why that drives real personalization and choice - you literally   
   shop and pick based on your life: On the ACA marketplaces or through   
   employers, Americans choose from dozens (often hundreds in larger areas)   
   of plans. High-deductible with HSA if you're healthy and want lower   
   premiums? Low-deductible comprehensive if you have kids or ongoing   
   conditions? Narrow network for cheaper rates, or broad network for more   
   doctors? Plans tailored for maternity, chronic conditions, wellness   
   perks (gym rebates, telehealth)—all competing to match different needs.   
   In a single-payer "Medicare for All," there's one plan: take it or leave   
   it (and private supplements are often banned). No tailoring.   
      
   Profits are thin, and most money goes to care: Health insurers' net   
   profit margins are consistently low—around 1-3% in recent years (e.g.,   
   1.3% industry-wide as of late 2025). The ACA mandates they spend 80-85%   
   of premiums directly on medical care. That modest profit incentive   
   pushes them to innovate (apps, virtual care, preventive programs) and   
   negotiate rates to keep premiums competitive—so they attract you, the   
   customer.   
      
   If they ignore your needs, you switch: Unlike a government monopoly   
   where you're stuck, competition means if one insurer's plans suck for   
   you (too stockholder-focused, bad coverage), millions switch during open   
   enrollment. That pressure keeps them accountable to customers first.   
      
   At the end of the day stockholders get returns because insurers have to   
   earn your business by giving you options that fit your needs. A   
   single-payer system replaces that with one-size-fits-all bureaucracy—no   
   choice, no competition to personalize. I'd rather have plans competing   
      
   [continued in next message]   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)