Will the Lottery Get Better?

 

I'm having a moment of serious irritation that my main function in this civilization's healthcare system is to produce profit for those who really don't give a shit what happens to me.

The delay in the MRI didn't save the insurance company any money, and in fact, it let things fester to the point where I may never have proper biomechanics in my foot again. I'll be extra expensive on the back end dealing with that fall out.

Here we are again, proving what I keep saying...we need to get to imaging faster. Yes, I hate the contrast and that's not ideal, but we've also got to stop letting things fester into the worst outcome for patients.

We've got to stop delaying it because of costs. By my rough estimation, the insurance company will end up paying the equivalent of at least one more MRI in extra costs that could have been avoided by the time this is over, if not more.

Of course, apparently the math holds that most people don't need any imaging at all and they've decided all the extra they pay delaying imaging is still cheaper (in my experience, corporate finance sucks at capturing all the cost impacts of poor management so...I have some reservations on that...they make the numbers say what they want and there's a bonus incentive for it*). So I guess I win society's Shirley Jackson style lottery here. Again. Unfortunately, I'm not inclined to be gracious about it. This is bullshit.

I wonder what happens as our demographics make people more valuable and less expendable? We see this new term 'labor hoarding' being bandied about in financial analysis. Companies are giving raises to retain staff now because they know they can't replace people easily anymore. If they can't afford to lose people, they also can't afford for them to be medically fucked by insurance companies and inefficient standards of care. You don't want people out on disability for longer than necessary. And competitive employers will poach your best people with better insurance.

Will we see things shift toward more proactive healthcare to preserve the output of the population? Or will large corporations suddenly discover a newfound love for immigrants who will bolster the demographics and maintain the status quo? (Or will AI just take over? But then who's earning enough money to buy what AI produces?)

Low wages and lots of people have allowed corporations to make healthcare costs a high deductible personal responsibility complete with a heavy dose of moralizing gaslighting when people can't afford it. What does it matter if people die or end up disabled when there are 50-100 in the labor pool who can replace them at any given time? 

What happens when you don't have those people anymore? Even if we increase immigration there'll be a gap period while people get up to speed in a new country...perhaps there'll be a short lived, but golden era of improved care and access for people. Maybe we can win a better lottery for a while. Or somehow AI will fill all the gaps and it'll be same ol', same ol'.

*Oh man. Now I'm really wondering how AI is going to hit corporate taxes. Maybe I just worked with particularly stupid C-suite execs in my corporate days, but to my mind, you just know they're going to eliminate the Accounting Dept, turn it all over to AI, not realizing it doesn't know the loopholes and tricks, that it'll follow tax law as written, and then they're going to be so surprised when the shit hits the fan. At some point somewhere somehow AI is going to get the C-suite crew fired lol.