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Aetna's CEO pays workers up to $500 to sleep

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Re: Aetna's CEO pays workers up to $500 to sleep

#51

Earlier quoted context omitted.

I'm sorry. I think their are fixes, but the average American doesn't seem to want change. All these big corporations need to do is throw some money at advertisers, create a little scare--almost always just a scare tactic. Like there will be Death Squads, or we will have to wait six months for a MRI, and the people just cave in, and say no to any changes. Again, I'm sorry about your wife.

Oh yes, the "death panels" nonsense. I remember that bullshit. These insurance companies already are death panels, by design. They have a big pile of money and they get to keep every penny they don't spend on someone's healthcare. Of course they're a fucking death panel. Their business model is letting the most people die without it becoming so obvious that people stop giving them money.

There is now the 80/20 rule:

https://www.healthcare.gov/health-care-law-protections/rate-...

They have to spend 80% of premiums or give money back. This is supposedly a cost control, but it isn't clear to me that it provides the right incentives (the easiest way for an insurance company that hits the rule to increase their profits is to raise premiums...).

Re: Aetna's CEO pays workers up to $500 to sleep

#52
post #28
post #17

Earlier quoted context omitted.

Medical insurance in the US doesn't make any sense. Insurance is supposed to be a hedge against a large risk, but in the US we use our medical insurance to pay for common visits and prescriptions. Everyone is so used to this model that it doesn't seem weird. Imagine if you used your car insurance to pay for gas. That would be ludicrous. No other "insurance" is handled in this manner.

That's the thing: medical insurance in the US is a weird hybrid between actual insurance and a complicated web of collective purchasing agreements. They let large organizations, companies and even individuals to get together by proxy to get bulk discounts on health costs. You can see why this second function might be useful, although it also does weird things to the market. But it feels like it should be fundamentall…

It's not apparent to me that my insurance company is engaged in attempting to get bulk discounts.

I have some recent bills that are 4x or 5x the supposed national rate for the services, having that hospital in their network appears to be a choice to try to collect premiums from people that live near it rather than the result of any sort of negotiation on my behalf.

I have the idea that we should ban networks. Not that we should ban insurance companies from trying to negotiate, but that we should prevent providers from charging arbitrarily different rates to different people. Especially hospitals that benefit from exclusive licenses, they should suffer under price regulation in exchange for those licenses (never mind that those licenses are intended to allow them to charge more for those services and "cost shift").

Re: Aetna's CEO pays workers up to $500 to sleep

#54
post #39

Earlier quoted context omitted.

Should the legal minimum be close to the highest potential cost? You can cause massive damage if you hit a luxury car, or are involved in a multi-vehicle accident. Should you be forced to carry insurance that would cover these scenarios? That would drive up the premium of the legally required insurance, and likely increase the number of uninsured motorists. Considering most accidents result in rather small payouts, t…

I think a fair legal minimum is the average price of a new car.

The property is a trivial cost in comparison to personal injury liability.

Re: Aetna's CEO pays workers up to $500 to sleep

#55
post #34
post #17

Earlier quoted context omitted.

Medical insurance in the US doesn't make any sense. Insurance is supposed to be a hedge against a large risk, but in the US we use our medical insurance to pay for common visits and prescriptions. Everyone is so used to this model that it doesn't seem weird. Imagine if you used your car insurance to pay for gas. That would be ludicrous. No other "insurance" is handled in this manner.

I wish I could upvote this more than once. In my view, this is one of the fundamental problems with the healthcare system in the US. People may not love car insurance - but it's a far cry from the vitriol reserved for medical insurance. And I think this issue is the fundamental cause of that problem. I want to be insured against rare, ultra high cost events that would otherwise wipe me out financially. I don't want t…

Google for State Farm customers with personal injury claims. Plenty of vitriol out there.

Re: Aetna's CEO pays workers up to $500 to sleep

#56

Earlier quoted context omitted.

> Imagine if you used your car insurance to pay for gas. That would be ludicrous. That's not ludicrous enough for me. Can the insurance be provided through my employer so that I'll need different insurance to pay for my gas if I switch jobs?

Only if gas stations can charge ludicrously higher rates to your provider but lower it to something reasonable for uninsured drivers.

No, that's backwards. The gas stations charge ludicrously higher rates to the uninsured drivers, but charge less than the wholesale price of gas to the providers. I think. I can't be sure because the price of gas isn't posted, and the gas station attendants don't even know the price. All you can do is pump it, then see what number pops up afterward.

And everyone thinks this is "normal".

Re: Aetna's CEO pays workers up to $500 to sleep

#57
post #28

Earlier quoted context omitted.

That's the thing: medical insurance in the US is a weird hybrid between actual insurance and a complicated web of collective purchasing agreements. They let large organizations, companies and even individuals to get together by proxy to get bulk discounts on health costs. You can see why this second function might be useful, although it also does weird things to the market. But it feels like it should be fundamentall…

It's not apparent to me that my insurance company is engaged in attempting to get bulk discounts. I have some recent bills that are 4x or 5x the supposed national rate for the services, having that hospital in their network appears to be a choice to try to collect premiums from people that live near it rather than the result of any sort of negotiation on my behalf. I have the idea that we should ban networks. Not tha…

I don't think they actually write a check for the amount the hospital owes. I think my EOB for surgery looked something like:

Item: drugs Amount requested: $7000 Amount paid: $3 Amount owed by patient: $0

Re: Aetna's CEO pays workers up to $500 to sleep

#58
post #22
post #17

Earlier quoted context omitted.

Medical insurance in the US doesn't make any sense. Insurance is supposed to be a hedge against a large risk, but in the US we use our medical insurance to pay for common visits and prescriptions. Everyone is so used to this model that it doesn't seem weird. Imagine if you used your car insurance to pay for gas. That would be ludicrous. No other "insurance" is handled in this manner.

Car insurance is worse actually. In the US if you have an accident with bodily injury the settlement can go in the millions, but the legal limit for car insurance is as low as 20k. They do the opposite of what insurance should do, hedge against a small risk and leave you unprotected from big risks.

20k? That is madness.

It's up to 100 Mio € over here in some european countries.

Re: Aetna's CEO pays workers up to $500 to sleep

#60

Earlier quoted context omitted.

It's not apparent to me that my insurance company is engaged in attempting to get bulk discounts. I have some recent bills that are 4x or 5x the supposed national rate for the services, having that hospital in their network appears to be a choice to try to collect premiums from people that live near it rather than the result of any sort of negotiation on my behalf. I have the idea that we should ban networks. Not tha…

I don't think they actually write a check for the amount the hospital owes. I think my EOB for surgery looked something like: Item: drugs Amount requested: $7000 Amount paid: $3 Amount owed by patient: $0

Do you mean the amount the hospital bills?

I'm talking about a bill I have to pay to meet my deductible, so the 5x number is the number that appears in the EOB (the covered amount for the service) and unless I am mistaken, it is the amount they would pay if I had met my deductible.

My paranoid speculation is that they push back harder against the coding of bills that they are responsible for than they do for bills that are under the deductible. This doesn't really make sense (the insurance company should want to control costs all the time), but it feels good.

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