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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

#311

Post by wtbob »

seanp2k2 wrote: post #222
harryh wrote: post #205

Earlier quoted context omitted.

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.

When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. Why does all this stuff cost so much in the first place? Medical equipment prices seem so far separated from reality that it's seriously laughable, and it'd be funny if it wasn't everyone who had to find a way to af…

> When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money.

The insurance companies are the ones paying for that $50 dot. Well, after their discounts it's probably a $10 dot.

It was either Time or Newsweek a few years back which had an excellent long-form article on where health-care spending goes. As I recall, it's not the insurance companies: it's the hospitals, physicians, nurses, other staff and an army of hangers-on and middlemen.

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

#312

Post by dredmorbius »

philjohn wrote: post #274
harryh wrote: post #156

Earlier quoted context omitted.

That's silly. Insurance is a great method of hedging risk. If my apartment burns down it would cost me A LOT of money to replace my stuff. But the chances of it burning down are really small. So I can purchase renters insurance for just a couple hundred bucks a year, an expense I can easily afford. That benefits me a great deal! Maybe when you said insurance you meant to say "health insurance" but the same principle…

Except a building isn't almost certain to burn down during its lifespan. Humans, metaphorically, burn down at a much higher rate. Cancer, heart disease, systemic infection ... "Spreading the risk" doesn't work when the likelihood of something bad happening approaches a percentage in the high double digits, especially with an ageing population and falling birth rates to keep paying into the ponzi scheme.

That actually raises an interesting question: what have the changes in building fire risk been over the past 150 years or so?

Historically, instances of entire cities burning were commonplace enough to be noted: the Great Fire of London (1666), the Great Chicago Fire (1871), the Baltimore Fire of 1904, the Great Fire and Earthquake of 1906 in San Francisco.

The Oakland Hills Fire of 1991 was actually the biggest urban fire in the US since the 1906 San Francisco event.

There's a list of fire-related losses here, though it includes terrorist (9/11) and industrial accident events: http://www.nfpa.org/news-and-research/fire-statistics-and-re...

Among the changes I can think of:

1. Better alerting systems.

2. Standardisation. Baltimore and Oakland Hills both saw incompatible hose-hydrant couplings.

3. Building standards. Everything from fireblocks and exits, to sprinkler systems.

4. Replacement of candles, oil lanterns, and gas lighting by electricity. Electrical fires happen, but they're far rarer. The Great Chicago Fire was caused by a lantern.

5. Safety and certification ratings of equipment, appliances, and wiring. "Underwriters Laboratories", the source of the ubiquitous (in the US) "UL" logo, was created by insurance companies.

That is: appropriately collectivising risks can result in reduced overall risk.

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

#313

Post by im_down_w_otp »

SteveLAnderson wrote: post #301
im_down_w_otp wrote: post #280

Earlier quoted context omitted.

Um, no. Those provisions were the Democrats negotiating with themselves. At the time the Democrats had the votes to force the issue regardless of the Republican opposition. It was people like Ben Nelson, Joe Lieberman, and Max Baucus that played a rotating merry-go-round of scapegoats that the Democratic Party used to trump up reasons why they couldn't support more progressive reforms in the healthcare legislation. A…

I agree with your assessment of the legislation. It's true that Sen. Lieberman, in coordination with Sen. Snowe, threatened a filibuster. At the time, Sen. Lieberman was an independent, not a Democrat. So, it was an independent and a Republican. I know that's splitting hairs, but these are valid hairs to split.

He caucused with the Democrats and was only an Independent because he got primaried out of his seat by Ned Lamont, so to stay on the general ticket he switched to being an Independent.

While we're splitting hairs.

Anyway, HN is a place I relish usually being devoid of pointless political conversation, so I'm just going to drop it now and go back to reading about Zippers in Erlang.

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

#314

Post by infinite_beam »

wtbob wrote: post #311
seanp2k2 wrote: post #222

Earlier quoted context omitted.

When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. Why does all this stuff cost so much in the first place? Medical equipment prices seem so far separated from reality that it's seriously laughable, and it'd be funny if it wasn't everyone who had to find a way to af…

> When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. The insurance companies are the ones paying for that $50 dot. Well, after their discounts it's probably a $10 dot. It was either Time or Newsweek a few years back which had an excellent long-form article on where…

Bitter Pill: Why Medical Bills Are Killing Us By Steven Brill Time Magazine Feb. 20, 2013. http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,Medical...

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

#315

Post by lutorm »

Randgalt wrote: post #290
lutorm wrote: post #288

Earlier quoted context omitted.

Good luck with that.

https://www.amazon.com/Objectivism-Philosophy-Ayn-Rand-Libra...

Maybe I should have been clearer: Just because you say it's derivable "from logic" doesn't mean it is. No logic system can do anything without axioms, and the adoption of those axioms is an arbitrary choice.

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

#316

Post by tn13 »

VonGuard wrote: post #9
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?

There is no benefit. The benefit is for the legislatures who passed the law. There was no way that we'd get single payer here in the US because our Congress is very much in the pocket of the health care industry. As such, the markets were a compromise measure enacted by congress to make it easier for people to choose health care. Before Obamacare, it was sort of a black box where only HR people could figure out prici…

> Our Congress is very much in the pocket of the health care industry.

When you question some group's integrity please show restraint and back it up with solid evidence. Without that these statements are on part with racist statements like "all blacks are criminals".

It is absolutely true that government regulation is hurting healthcare in USA. It has drove the prices up and made understanding healthcare far more difficult. Hospitals do not benefit by these regulations, Insurance providers don't benefit either, Patients don't benefit either. The shi*load of these regulations has already crossed the mark where anything makes sense.

Government regulation is driven less by healthcare industries willingness to get hurt in the butt but by the voters who want government to do "something" everytime someone dies.

https://www.quora.com/What-are-the-profit-margins-in-the-hea...

Profit margins of insurance companies are nothing worth boasting about. If the congress is really in pocket of insurance companies let me say they are doing a lousy job for their masters.

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

#317

Post by astronautjones »

ruste wrote: post #252
maxerickson wrote: post #232

Earlier quoted context omitted.

(successful) Suit against Medicare: https://www.cms.gov/medicare/medicare-fee-for-service-paymen...

That case was against Medicare contractors. Not Medicare.

... because Medicare contracts out services

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

#318

Post by Spooky23 »

20yrs_no_equity wrote: post #241
Spooky23 wrote: post #160

Earlier quoted context omitted.

Remember that the existence of private players doesn't mean that you have a free market, which tends to drive efficiencies. In the US, it's more of a planned/command economy. A retail consumer gets the worst price. (Think the "rack rate that you never pay that's in the back of a hotel door) The government through Medicare/Medicaid/Tricare gets the best price. Everyone else is in the middle, on a spectrum of discount…

> you end up controlling costs by compelling the providers This is the basic premise of socialism. But it never works out. What you end up getting is either very low quality at high prices or very low availability. Obamacare attempts to do exactly that, and as a result the providers are simply leaving the "market". Meanwhile, price has skyrocketed, and quality of coverage has dropped dramatically. My marketplace plan…

That's republican health policy. It was essentially the Romney plan rolled out in Massachusetts, and the only thing that would pass.

Obamacare is actually working very well in compelling the providers to participate. In most regions, private practices are rolling up into regional health systems, often around anchor hospitals.

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

#319

Post by tn13 »

eridius wrote: post #34
VonGuard wrote: post #9

Earlier quoted context omitted.

There is no benefit. The benefit is for the legislatures who passed the law. There was no way that we'd get single payer here in the US because our Congress is very much in the pocket of the health care industry. As such, the markets were a compromise measure enacted by congress to make it easier for people to choose health care. Before Obamacare, it was sort of a black box where only HR people could figure out prici…

There's no way that we'd get single payer here because the Republican party has convinced their base that single-payer health care is socialism and that socialism is evil, which leads to the situation where poor people who desperately need health care and can't afford it still oppose single-payer even though they stand to gain the most from it.

Pardon my use of words but I think it is foolish not to accept that there are pretty serious trade-offs involved here and there are perfectly legitimate reasons why single payer is a very bad idea. I personally think a single payer system in USA would pretty much resemble Veterans Affairs. Corrupt, inefficient and something that makes consumers profoundly unhappy while taking away a good chunk of your hard earned wealth.

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

#320

Post by tn13 »

VonGuard wrote: post #114
Randgalt wrote: post #97

Earlier quoted context omitted.

That's an excellent point. Medicare and SSI are equally bad programs that should be phased out.

I often wonder if John Galt ever found himself living alone in a room with no one to take care of him in his old age.

I think John Galt would prefer to die than use someone else's money by force to take care of himself. I think that is very honorable.
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