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Top health care agencies in nyc?
Enthusiast
Rising Star
Community Builder
Any PWC 🐠 open to a referral?
Hi fish! Anyone from Slalom willing to chat?
And I still sometimes have trouble understanding the enormous complexity. So when I hear someone say “insurance companies are greedy” or “I can’t believe that hospital charged $10,000 for 4 screws—they’re all about making money,” or “big pharma is evil,” I get really frustrated because I know there are so many factors driving the industry. Further, I have worked with countless clients over the years who I know are just regular, good people. Yes, some just want to get their paycheck and go home and the job is just a job, but many really believe in the work they’re doing and want to help others. I don’t blame people for making these generalizations because I think it’s good to try and be informed and it’s natural to form opinions, but it does scare me a little bit when I’m on social media or reading the news or seeing a protest or talking with friends and very few seem to actually know what they’re talking about and yet have extremely strong, vocal opinions one way or another.
I get really frustrated. Just had an experience the other day with someone complaining about greedy healthcare people because they had trouble getting an auth when I have worked endless hours at various firms, with other dedicated folks, trying to improve the processes and their impact on patients. But people only see what’s broken not what goes right.
I've worked in healthcare for several years and I still have some of these thoughts. I'm in a position where the worst of the healthcare system issues don't impact me usually but I've seen full-time people pay nearly $1000 a month in premiums to a company-sponsored health insurance plan that barely covers anything. Ive seen people making $40-$50k a year having to fight with their insurance company over $5-$10k+ bills after a medical emergency. I know how much money Pharma companies pay their employees and their consultants. So I really don't see how any of the quotes you listed seem untrue. The only ones that annoy me is when people say Pharma is Bad, end sentence. But then you have companies jacking up prices (ie: EpiPen) which supports this view. Or when they say that there isn't a way to come up with a better healthcare system. That I don't believe.
I don’t disagree at all that there are major issues. Wasn’t trying to suggest that the status quo is at all acceptable. But whether it’s the ACA or Medicare for All or increased privatization or whatever, most people can’t really back up why they feel so strongly about what the best solution is—and how could they be expected to? It’s so complex. Everything in this industry is interconnected, there are a million competing interests and misaligned incentives, and it’s obviously a very personal issue because it’s something that impacts every person at some point in their life. I firmly believe there is a solution (not all at once), but how will we ever align on something when people are diametrically opposes based on bad/incomplete information?
Honestly - the healthcare statement is fucked up precisely because of the reasons these people are bringing up - pharmacy, hospitals, insurance companies, etc. all need to quit being greedy assholes.
I agree that unraveling this mess is extremely complicated - but I 100% agree with the sentiment that hospitals are greedy and insurance companies and drug manufacturers too
Very little nuance or research behind some of the opinions I hear. Just anecdotal evidence and talking points heard on CNN or Fox News or random Facebook posts from uncited sources.
As someone in the clinical side I agree with your comments and sentiment. It’s a highly complex and fragmented field that is not easily distillable into a few sentences.
Takes, time and effort to develop informed opinions. Opinions are like assholes... The smarter people you engage with will recognize the opportunity to ask questions and develop a more nuanced understanding. Everyone else just wants to hear themselves talk.
It bothers me that these very extreme, vocal opinions are able to exert significant influence over others and contributes to polarization, lack of discourse, etc.
yes i agree. i also don’t like how people are like “i just paid $1500 out of pocket, this is why we can’t have medicare for all,” as if getting fucked by the healthcare system makes you know anything about it beyond the amount that you once paid out of pocket (fwiw i’m in favor of a public option, not that it matters for the example).
or when people say “the insurance companies make all the money,” or “the doctors make all the money,” or “the drug companies make all the money,” or “the hospitals make all the money,” as if the person has any insight beyond their own anecdotal experience.
but i think your view is actually more a dislike of people who exhibit dunning-kruger and you happen to know more than the average person about healthcare, so that’s where you’re fighting the battle.
i don’t think i’m old enough to share a comprehensive anecdotal perspective on that question, or qualified enough to give a really good answer.
i think one factor, as it relates to politics and public policy, is the abolition of the FCC fairness doctrine. i think another is that marketing has become more sophisticated and has taught people that exploiting emotion = increased engagement.
i also think one of the more underlooked causes is decline in community engagement. over the past half-century, participation in community organizations has decreased precipitously. this contributes to a lack of understanding of others, because of the decreased likelihood of association with people who are different from you. i think that, in turn, leads to decreased empathy and increased selfishness. that, then, leads to greater skepticism of other viewpoints, because they are potentially threatening, partially due to a lack of familiarity.
Agree with D1. I agree with this statement. Yes, most people don’t understand the intricacies of the healthcare system, but why does it need to be so intricate in the first place? Hell, even we don’t know everything about it since I’m sure we’re all learning something new/unknown about some aspect of it constantly in our day-to-day — we cant expect everyone else to see it. It’s not an ignorance issue, it’s a system issue. Everyone’s greedy, everyone plays games, and unfortunately it’s all out of necessity since they’re all trying to survive each other. It’s literally the Game of Thrones: Healthcare Edition. We need to break the wheel.
I've worked with various bits of health systems around the world for over a decade, ranging from the most nascent clinical and public health systems in rural Ethiopia to pharma/commercial strategy in the US. I'm also doing a health economics and medical statistics PhD on the English NHS.
OP, correct me if you are not talking about the US, but from context it certainly seems you are.
You are correct that any given health system is incredibly complex and reforms are hard because coordination is difficult. And indeed, nearly all the people I met in private US healthcare have been nice and reasonably well-intentioned. You are also right that people often opine that easy solutions are available.
But you must also understand that the US healthcare system achieves some of the poorest value-for-money in the world, and that fact is obvious to anyone who finds themselves financially unprotected and sick in America. Productivity in health isn't properly measured by number of procedures - that just enables profiteering and horrible unintended consequences. For example, enormous amounts of hard, serious work led by business managers and clinical leaders at American pharma, payers, and providers alike went into driving opioid sales. As you know, those opioid sales under the guise of a pain management revolution have resulted in a crisis, which is historically unprecedented - US life expectancy last fell during peacetime during the Great Depression.
The fragmentation isn't a bug but a feature - it's part of the design from the top, as the mutual industry lack of accountability for cost-effectiveness allows hospital managers, pharma marketing departments (much bigger line item spend than R&D), doctors, and management consultants to acquire and maintain unusual wealth.
It's not stupid at all for patients and people to be furious about that. I agree that solutions will require patient deliberation and hard work, but I don't think 'our side' does itself any favors by looking down on normal people (who are the ultimate point of the health system, not our jobs) or by minimising the seriousness of the problems they face.