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Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

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Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#201

Post by zeveb »

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")?

Government provision of health insurance means that every procedure covered is a political issue (e.g. abortion for the left, sexual-orientation counselling for the right). This means that there will be nationwide winners and losers, and no-one but the rich will be able to simply change providers, as with a private market. As an example, look at how public schools are run: only the rich are able to opt out of government schooling.

American governments are not capable of running efficient programmes, because to a first approximation American government employment is a make-work program for people who can't get hired at anywhere that cares about competence. That means that a government insurance provider will be incompetent and inefficient.

To make things worse, the employees of said provider will be unionised, and that union will do its best to make it even more inefficient (e.g. take a look at the prison guards' unions).

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#202

Post by harryh »

maxerickson wrote: post #189
Apocryphon wrote: post #43

Earlier quoted context omitted.

Then at least Aetna will twist in the wind for their avarice.

By walking away from the exchanges they are just walking away from a money losing business. That isn't twisting in the wind. The ACA established programs to make payments to insurance companies that got unusually expensive customers but the funding for those payments has been blocked. http://www.modernhealthcare.com/article/20160517/NEWS/160519...

The issue with those blocked payments is that the program was established to deal with an uneven distribution of unusually expensive customers. Insurance Company A makes more than expected so it pays into the pool. Company B loses more than expected so it draws from the pool. Thinks were expected to even out overall.

But what has happened is that all (or most) companies are losing money on the exchanges so there is no one to pay into the pool. Congressional Republicans have blocked funding the pool with government money because the pool wasn't supposed to cost money in the first place.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#203

Post by ruste »

vidarh wrote: post #178
ruste wrote: post #169

Earlier quoted context omitted.

Except you can sue your insurance provider if they deny you coverage for something that they're obligated to cover. You wouldn't be able to sue the government. Edit: Let me also add this; when you sign up for health insurance you're entering into a contract with the insurer. They have to be up front about what they're providing and it's your obligation to understand what you're buying. With the government you don't g…

Yes you can. In the UK people sue the government, or specially the NHS, over treatment decisions all the time. Including over things like denied coverage of specific drugs etc. (usually when there's no proven benefit from a given drug). And as I pointed out: If you think they are too strict, then you can pay for a private insurer to cover things the NHS doesn't cover or won't do fast enough for you.

>In the UK

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#204

Post by monocasa »

Randgalt wrote: post #92
blocktuw wrote: post #81

Earlier quoted context omitted.

I believe your examples of public services being worse than their private counterparts is a specious argument. Most private schools are paid for by rich people. The cost to attend is higher than public school so it would reason that the quality is better. Same for USPS vs FedEx. The shipping rates for USPS are much cheaper. Some people are price sensitive. Cheaper is all they can manage to afford and are willing to a…

Where's your evidence that most private school is paid for by rich people? Anecdotally, the people that I know that use private schools are middle class. Also, if there weren't public schools there would be more varieties of private schools. "As a healthy person I'd rather take a two percent annual increase in insurance premiums for lower quality of care since I do not have much need for services." -- And I wouldn't.…

Define "middle class".

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#205

Post by harryh »

eecc wrote: post #198
harryh wrote: post #166

Earlier quoted context omitted.

(My own story: I had my gallbladder out in 2004, and from that time on was denied personal health insurance for BS "pre-existing condition" reasons...until Obamacare.) Probably you were denied personal health insurance not for BS reasons, but because the insurance companies knew they would (probabilistically) lose money insuring you. But now under Obamacare, if they participate on the exchanges, they are obligated to…

you're suggesting the guy should throw himself off a cliff?

I'm not suggesting he do anything. In fact, I think his story is a great example of what makes the economics of health care so challenging.

I was merely pointing out a connection from his personal story to the general topic of conversation that a lot of people don't seem to realize.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#206

Post by jessaustin »

VonGuard wrote: post #172
nappy-doo wrote: post #137

Earlier quoted context omitted.

> If she does get us single payer, she's the greatest trojan horse ever in American politics. Arguably, that'd be Trump instead of Clinton.

I think Trump is more of an infected pot of filth catapulted over the walls... Not sure he's hiding much.

I'm torn. Sometimes I think Trump would be the most average President ever, and sometimes I think we have no idea at all what he would do. I'm quite sure it's unlikely he'll do anything that he's campaigned on. Wall-building is work.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#207

Post by [deleted] »

onewaystreet wrote: post #180
Apocryphon wrote: post #133

Earlier quoted context omitted.

It's more about opposing their attempts to thwart antitrust law. After AT&T's merger failed, T-Mobile used the money and the public fallout as an opportunity to reinvent themselves as a company that caters to the public. I'm wondering if this could be a similar opportunity for Aetna's competitors. If the government is unable to prevent monopolies, then consumers should step in by punishing companies that seek to mono…

The headline is misleading. Aetna didn't threaten to pullout if their merger wasn't approved, they said that they would be forced to do so because they would be losing too much money. That isn't "attempting to thwart antitrust law," it's simply stating the facts.

[deleted]

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#208

Post by tptacek »

harryh wrote: post #168
tptacek wrote: post #158

Earlier quoted context omitted.

You're a supporter of single payer? Health care is something like a fifth of the whole US economy. You're comfortable with the USG setting prices for it?

I don't know about single payer, but health care is tricky. What do we do (as a society) about this guy: https://news.ycombinator.com/item?id=12307526 He has his gallbladder out and all of a sudden he's a super risky person to insure. How do we get him in a risk pool where his premiums won't be unaffordable?

By shifting more of the group insurance market onto the individual market, perhaps mostly by eliminating current incentives for employer group coverage, to minimize the adverse selection problem.

Incidentally: two members of my immediate family have the same problem he does. No history of serious illness, no current health problems, probably healthier than the median in both cases for their age cohort, but uninsurable outside the exchanges due to bogus pre-existing condition rules.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#209

Post by davidf18 »

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

Switzerland, Germany and other countries lack single player plans. Israel has 4 different integrated health providers that compete to provide care. I am sure there are many other examples of health care systems that choose not to use a single payer.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#210

Post by DashRattlesnake »

Spooky23 wrote: post #153
derekp7 wrote: post #118

Earlier quoted context omitted.

I would really like to see a breakdown of the actual costs to provide a given service. Take something simple like removing an appendix or gall bladder. You have one surgeon, one or two surgical assistants (typically med students / interns), plus a couple nursing staff, and the anesthesiologist, for about an hour. 6 people, assume 200K per year, that's $100 per hour, so $600 in people salaries. (Throw in another coupl…

The anesthesiologist alone will be $5k. They are the person most able to kill you when they screw up, so a significant portion of that bill is insurance. They also make $300-500k. Also recovery room or ICU time is very expensive -- something like $1000/hr in some cases. That type of procedure (gall bladder) will cost something like $15-20k. When I had a spinal fusion, it was a 4-5 hour procedure involving a neurosurg…

Aren't healthcare list prices in the US really really distorted and nonsensical, due to decades of messed up incentives between hospitals and insurers?
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