i take it you don’t have a lot of experience with the healthcare system prior to 2008 or so when parity for mental health benefits became a requirement. let me tell you what a hellscape it was. it was pretty well accepted practice to never use insurance for mental health, because if you tried, not only would your claim be denied but it would be a preexisting condition forever after that. if you had your GP prescribed an antidepressant —preexisting condition. if you did manage to find someone who took your insurance it was a six month wait for an appointment. and then (because it was pre obamacare) you were highly likely not to be able to get coverage again if you ever had to change insurance providers on the private market. people stayed at jobs years longer than they wanted to solely because of healthcare benefits like mental health.

basically, only those who could afford to pay out of pocket got access to mental health benefits.

i often hear people think out loud, we’re should just let the market dictate X, and it boils my blood because they clearly weren’t paying attention the LAST time we just let the market decide something like this, and it killed a lot of people.

> nearly impossible to objectively compare provider quality using any publicly available data set.

That's true for all medical specialties I know of in the US, except there are some useful published measures for hospitals and surgical centers.

> the behavioral health product is terrible

So it is, so are most specialties. But plenty of patients do get actually useful help with basolutely recognizable improvement. Often night and day.

So. Is it useful and needed? Yes.

I would think the highly variable costs make it a great fit. The whole point of insurance is to spread outlier risk across a large group of people.

(To be clear, I have no love for the health insurance industry in general, but it's for reasons other than this.)

Yes. the answer is yes we want mental health to be covered.

"We"? Who are "we" here? Isn't this decision completely in the hands of the insurers themselves?

Insurance generally does cover chronic conditions where the patient only stays “better” as long as treatment continues.

> Hold up, how this type of fraud require any government involvement at all?

Hold up (seriously hold up and stop serially editing your comments), where did I say it did?

> It's a similar concept

The government has decided, without much input from actual citizens, that copyright should exist for life plus 70 years. Government interference in copyright has created the fraudulent market conditions you've just related.

We can do this all day if you like.

I assume this is a criticism of the ACA. How, specifically, did it lead to this outcome?

And why is your criticism reserved for the government and not the perpetrator of the fraud, namely Ambetter?

Christ, reading Americans declare that the issue with American healthcare is "too much government" always completely floors me. The system did not work well before the ACA, the system does not work now. The only countries in the world with strong, consistent and equitable healthcare systems have government health systems.

Here in the UK our NHS is a goddamn mess, it's cracking and creaking and bureaucratic, but every American expat i have ever known who now lives in the UK has horror stories about how much worse it is over there. In our monthly social classes (PSHCE) we watched documentaries of poor Americans unable to afford healthcare, and it horrified us all.

You can't run healthcare as a profit seeking enterprise, it just doesn't work, the financial incentives of healthcare providers just fundamentally do not align with their customers. Government run institutions can often fall into a state of bureaucratic atrophy but if this and countless other stories make clear - that's an issue with institutions in general, whether they be government run or not.

This problem will not improve until you get over your ideological commitment to trying to solve every problem with markets. Healthcare must be socialised, anything less is barbarism.

yes, things tend to turn to crap when you have half the government composed of a party dedicated to ensuring that everything government touches turns to crap or benefits the wealthy. not sure how this is a valid point or makes the case that allowing industry to police itself will work.

OMG it was truly paradise before the ACA.

That is sarcasm if you can't tell.

As someone that used the open market plans before the ACA, it basically changed nothing, added subsidies, and removed the lifetime limits, at least from my perspective.

But this is all pointless accounting bullshit, we simply need a medicare-for-all plan.

If I didn’t have healthcare on the Obamacare market today, my special needs son would be without care because I can’t afford his care myself. Furthermore, his healthcare would have been impossible to even get privately because of all that preexisting conditions BS. People like you probably don’t care about anyone else, but ACA is a life saver for so many people.

We just need to create more agencies, throw more money at the existing programs, establish new programs, and add more regulations. This time for sure