How much health insurers pay for almost everything is about to go public • Hacker News Board

Re: How much health insurers pay for almost everything is about to go public

#91

Post by jjeaff » Fri, Jul 01, 2022, 7:44 PM UTC

wccrawford wrote: post #24

ch4s3 wrote: post #17

Earlier quoted context omitted.

Health insurers in the US have a cap on how much of premiums can go to profits.

Doesn't that just mean that they have an interest in keeping these costs high ? The higher the costs, the larger that % is for the in absolute dollars. If all the costs come down, they are allowed to make less money.

In a vacuum, that would make sense, but most of these insurers still have to compete with at least one or two other big players.

So while you could increase your costs so that you can increase your premiums thus getting 5% of a larger pie, that assumes that you can increase your premiums without losing customers to competitors.

For the most part, on the ACA marketplace, all the plans are pretty similar, so price is really your main differentiator.

Perhaps the obstacles of switching providers makes this competition less of an issue.

Re: How much health insurers pay for almost everything is about to go public

#92

Post by CogitoCogito » Fri, Jul 01, 2022, 7:45 PM UTC

lotsofpulp wrote: post #81

CogitoCogito wrote: post #79

Earlier quoted context omitted.

So? They're insurance companies. Why should they have high profit margins?

I never wrote they should. I am disputing the notion that they earn huge profits (“enormous scoop”). Which is trivially disproven by looking at their financials.

How is it disproven exactly? Are you saying 5% is not a lot because it's the number 5 or something?

Re: How much health insurers pay for almost everything is about to go public

#93

Post by pastor_bob » Fri, Jul 01, 2022, 7:45 PM UTC

daenz wrote: post #8

This is regulation everybody should be able to get behind. How are these markets supposed to function efficiently with healthy competition if critical information like this is hidden away?

The free market produces the most efficient outcome

Re: How much health insurers pay for almost everything is about to go public

#94

Post by elromulous » Fri, Jul 01, 2022, 7:46 PM UTC

ageitgey wrote: post #2

I'm one of the co-founders of Turquoise Health, mentioned in the article here. We've been downloading and parsing this data all day. It's a really big deal in the industry that the prices that insurance companies pay doctors are now being shared publicly. It will have all sorts of positive impacts over time, hopefully making rate negotiations more consistent and fair between different insurance plans. Right now, 10x…

Could this backfire - similarly to how publicly traded companies' CEOs disclosing their pay caused their pay to skyrocket?

Re: How much health insurers pay for almost everything is about to go public

#95

Post by lotsofpulp » Fri, Jul 01, 2022, 7:47 PM UTC

uoaei wrote: post #84

lotsofpulp wrote: post #21

Earlier quoted context omitted.

The fact that there are at least 5 large insurers competing nationwide and all have 5% or less profit margins means there is lots of competition, and if they are not providing the best prices, their customers will go elsewhere. See pharmacy forums as an example for all the pharmacists complaining about how independent pharmacies are so tough to operate due to ever smaller payments from insurance companies for the pas…

I would like to understand better your definition of "competing" because accidental cartels happen all the time in highly regulated and captured markets such as healthcare.

Nobody chooses to earns a 5% profit margin if they can earn 6%. Low single digits is objectively a low profit margin, for any business, and so must indicate that competitors exist Who prevent charging higher prices to increase the profit margins.

Re: How much health insurers pay for almost everything is about to go public

#96

Post by quarantaseih » Fri, Jul 01, 2022, 7:48 PM UTC

uoaei wrote: post #85

pkaye wrote: post #30

Next step is pharmacies. Find out which step in the chain is overpricing. The manufacturers, PBMs or local pharmacies, etc.

I think we all already know it's all of them.

Agreed, but admin is probably the greediest and while adding the least value.

Re: How much health insurers pay for almost everything is about to go public

#97

Post by jjeaff » Fri, Jul 01, 2022, 7:48 PM UTC

pishpash wrote: post #45

logicalmonster wrote: post #19

Question to somebody who might know as this seems like a relevant thread to ask in. If a person wants to pay directly in cash/credit-card for services rendered by a doctor, do doctors' agreements with insurance companies generally prevent them from offering a cash discount to cash-paying patiences lower than the insurance company negotiated price?

Sometimes they aren't allowed to offer a cash option at all, if you've told them you have insurance.

I have come across quite a few doctors that will not treat you at all if you don't have insurance.

Re: How much health insurers pay for almost everything is about to go public

#98

Post by quarantaseih » Fri, Jul 01, 2022, 7:49 PM UTC

uoaei wrote: post #86

karaterobot wrote: post #62

Earlier quoted context omitted.

> It's not just the insurers themselves, but the whole system. Burn it all down. Painstakingly, methodically, improve it, taking care at each step that you're making it better. :)

This is exactly how to corner yourself into a local optimum that balances how much people are pissed off, rather than how much people see benefits.

The chaos of "nothing" is very destructive. That realization is at core of why Im a conservative.

Re: How much health insurers pay for almost everything is about to go public

#99

Post by lotsofpulp » Fri, Jul 01, 2022, 7:49 PM UTC

CogitoCogito wrote: post #92

lotsofpulp wrote: post #81

Earlier quoted context omitted.

I never wrote they should. I am disputing the notion that they earn huge profits (“enormous scoop”). Which is trivially disproven by looking at their financials.

How is it disproven exactly? Are you saying 5% is not a lot because it's the number 5 or something?

From experience operating businesses and reading financials of various companies, 5% profit margin is on the low end. Walmart and other retail play in the 2% to 5% range.

Re: How much health insurers pay for almost everything is about to go public

#100

Post by karaterobot » Fri, Jul 01, 2022, 7:49 PM UTC

uoaei wrote: post #86

karaterobot wrote: post #62

Earlier quoted context omitted.

> It's not just the insurers themselves, but the whole system. Burn it all down. Painstakingly, methodically, improve it, taking care at each step that you're making it better. :)

This is exactly how to corner yourself into a local optimum that balances how much people are pissed off, rather than how much people see benefits.

I'm not sure I agree. If it did happen, that's another problem to be fixed.

I do know that the way to design complicated, successful systems is to start with simple, successful systems and build on them: starting to design a complicated system from scratch seems like a recipe for much bigger problems, and that's what you'd have to do after "burning it all down". That's even assuming that "build something new" was the second step implied after "burn it all down", though you'll note that was not stated in the original comment.

I think we can agree that "burn it all down, and that's it" is the worst possible solution.