My husbands suicide shows theres something very wrong with US insurance industry
A personal essay about a man’s suicide after his insurer abruptly cut off inpatient psychiatric care prompts a broader critique of how U.S. health insurance rations treatment, especially for mental health. Commenters argue that perverse incentives across insurers, hospitals, drug companies, and lawyers create opaque, adversarial systems where patients and families must fight for coverage even in crises. Many contrast this with public or mixed systems abroad, share their own billing and denial nightmares, and float reforms ranging from non‑profit public insurers to stricter limits on insurers’ power to overrule doctors.
Scope of the Problem: Insurers vs Entire Healthcare System
- Many argue the insurance company is primarily at fault in the story: overruling psychiatrists, cutting off necessary inpatient care, and making life‑and‑death decisions via non-treating bureaucrats.
- Others stress the whole US system is broken: hospitals overbill, some doctors overtreat (especially when financially incentivized), drug prices are inflated, and litigation risk drives unnecessary testing.
- One view: all players have adapted to a bad regulatory niche; corporate interests shape policy while the public is distracted by culture‑war rhetoric.
Economics, Goals, and Tradeoffs
- Debate over whether the goal should be “best care for every individual” vs “best population outcomes at sustainable cost.”
- Some say economics is just the language of real resource constraints; others argue we have enough resources and are choosing to ration by money.
- Comparisons to other developed countries: same or better outcomes at roughly half the cost, universal coverage vs US undercoverage.
Mental Health Care Specific Issues
- Multiple anecdotes: delays, denials, and token access to therapy or psychiatry, particularly under large integrated systems.
- Concern that mental health is treated as “less real” than physical illness, with infrequent follow‑ups and fragile continuity of care.
- Some emphasize partial hospitalization / intensive outpatient programs as more therapeutic and cheaper than many US inpatient psych units, though availability is uneven.
Insurance Denials, Bureaucracy, and Financial Risk
- Stories of imaging, cancer care, NICU stays, and specialist tests initially denied or mis-coded; patients forced to appeal, game diagnoses, or front large sums.
- Conflicting personal experiences: some say catastrophic events with insurance still wreck finances; others report hundreds of thousands to millions covered with manageable out‑of‑pocket costs.
- Several consider dropping insurance and self-insuring, countered by warnings about ruinous rare events and opaque cash pricing.
Alternative Models and Radical Proposals
- Suggestions range from:
- Fully socialized care, no opting out.
- Public, non-profit insurer to compete with private plans.
- Abolishing health insurance entirely so prices must become affordable.
- Reliance on charity for those unable to pay (criticized as unrealistic for modern high-cost care).
- Broad agreement that the current US hybrid model mixes the worst of capitalism and socialization, with huge administrative waste and poor mental health outcomes.