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Hit men aren't what you think

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Re: Hit men aren't what you think

#131

Post by kelseyfrog »

kube-system wrote: post #127
kelseyfrog wrote: post #122

Earlier quoted context omitted.

I omitted it because it doesn't change the calculus. If the child were brought up into the sunlight out of that vile place, if it were cleaned and fed and comforted, that would be a good thing, indeed; but if it were done, in that day and hour all the prosperity and beauty and delight of Omelas would wither and be destroyed.

According to who? It changes the calculus for me. I pay my health insurance because it covers the services I need. I could absolutely opt out if I wanted to, but I don't.

Except we're not talking about the choice of being a customer or not. We're talking about the design choices of the system.

Re: Hit men aren't what you think

#132

Post by kelseyfrog »

kube-system wrote: post #128
kelseyfrog wrote: post #121

Earlier quoted context omitted.

But we aren't talking colloquially, we're talking about within the maxim. I'm trying to give you the benefit of the doubt, but it feels like you're doubling down in order to prove a point.

The maxim, applied here, is an obtuse oversimplification of the problems with the health insurance system, and the barriers to changing it. Yes, if we could wave a wand and delete the fact that it ever happened, that would be ideal. But the problem is more difficult to solve now, because we have the problem of the health insurance system, and the problem of drastic systematic and economic change.

In my experience, choices to label opposition as either reductive or overly complex are largely rhetorical. They don't pass the validity test.

Perhaps we should ask borrow the "magic wand" that seems to exist for every other country. Maybe they can lend us theirs since that's apparently how realistic a system that does not bankrupt people is.

Sadly, it doesn't seem equally possible or realistic to build a system where CEO's aren't revenge murdered.

Re: Hit men aren't what you think

#133

Post by kelseyfrog »

kube-system wrote: post #126
kelseyfrog wrote: post #123

Earlier quoted context omitted.

Except every other country is able to function without the black box :/

Most countries do have private health insurance, even if they also have more robust public options.

But we're talking about our inability to avoid the box. The existence of public options in other countries has no bearing on that.

Re: Hit men aren't what you think

#134

Post by avalys »

michaeljx wrote: post #129
avalys wrote: post #115

Earlier quoted context omitted.

How do you avoid losing money due to fraudulent claims, claims for services outside the scope of what you're insuring against, claims for ineffective resolutions to the claimed damages, etc.? Am I supposed to know what a "scale-up insurance company" is?

Scale-up means youngish (10-12years old), mid-size in the countries we are operating, think 3 countries 600-800m revenue. Fraudulent claims are a tiny percentage of claims, and are rejected after human review, usually involving detectives. In the countries we operate, fraudulent claims are about 6-8% of all claims, and that's usually the level we aim to detect. Being able to absorb some false negatives is usually che…

Is this a health insurance company or are you providing property insurance?

Re: Hit men aren't what you think

#135

Post by michaeljx »

avalys wrote: post #134
michaeljx wrote: post #129

Earlier quoted context omitted.

Scale-up means youngish (10-12years old), mid-size in the countries we are operating, think 3 countries 600-800m revenue. Fraudulent claims are a tiny percentage of claims, and are rejected after human review, usually involving detectives. In the countries we operate, fraudulent claims are about 6-8% of all claims, and that's usually the level we aim to detect. Being able to absorb some false negatives is usually che…

Is this a health insurance company or are you providing property insurance?

No this is general insurance (motor, property, travel etc). It is also founder-led, which is an important factor, as the reason they started it was their personal frustration with the motor insurances.

Re: Hit men aren't what you think

#136

Post by [deleted] »

nickff wrote: post #93
itsanaccount wrote: post #53

Earlier quoted context omitted.

I think in philosophy there's something to be said for the difference between action and lack of action when it comes to culpability. Is a surgeon responsible for not being good enough to save a persons life? No, I don't think so. Is a surgeon responsible for not being sober for a planned surgery? In our society, yes. I think a lot of responsibility is determined by mens rea, and when you run a health insurance compa…

You think this CEO had more 'mens rea' than a city police chief (or the other examples I listed)? The police chief is literally responsible for purchasing guns, distributing them to officers, and telling the latter to use the former to coerce people!

[deleted]

Re: Hit men aren't what you think

#137

Post by aleph_minus_one »

nickff wrote: post #34
itsanaccount wrote: post #30

Earlier quoted context omitted.

You know why I don't work for a trapping and pest control company? Because structurally they kill animals. They go around with tools of destruction and end the lives of animals. Its the function of their existence. Do you know why I don't work for a _for profit_ health insurance company, who's stated goals are explicitly to make profit by slicing out some amount of premiums that are not spent to provide healthcare in…

If your definition of responsibility is so broad, wouldn't every Head of Government for every country be deserving of assassination? Even more broadly, every police chief in every large city, along with all military officers, most mayors, governors, and premiers would also be 'natural targets'. This seems a bit drastic to me, is it your view?

> If your definition of responsibility is so broad, wouldn't every Head of Government for every country be deserving of assassination?

I don't agree to the radical formulation "every Head of Government for every country is deserving of assassination", but I do believe that the weaker statement "for most Heads of Government of most country, there exist quite some people (even among the citizens) who would like them them to be dead" is very plausible.

Re: Hit men aren't what you think

#138

Post by Eddy_Viscosity2 »

avalys wrote: post #60
aijdosaijd wrote: post #52

Earlier quoted context omitted.

Personal income, that which sustains someones family, is vastly different then the billions made by United off the backs of those suffering. What, are you some healthcare exec or something? This is not the own you think it is.

United Healthcare is a publicly-traded company which makes a 6% profit margin and pays a dividend, which means that those profits ultimately benefit people's retirement accounts, pensions and middle-class investments. The person who was killed made $10M last year, while UHC provided care to 52 million patients. So, the CEO was paid approximately $0.20 per patient treated last year. What part of all this do you believ…

The immoral part is the care not provided to paying customers. Care denied, people made to hop through needless hoops at a time when they are already in distress. Delays and denials that cause suffering, they cause deaths. This is the immoral part.

Re: Hit men aren't what you think

#139

Post by nradov »

jonathanlb wrote: post #125
avalys wrote: post #110

Earlier quoted context omitted.

1. Who decides what care is "needed"? Everyone is going to die eventually. I have a relative who believes they "need" ivermectin to prophylactically safeguard against contracting covid. Are insurance companies obligated to provide ivermectin to everyone who demands it, or should they apply some standard of efficacy and cost/benefit analysis? 2. Profits to shareholders and other people contributing their time and reso…

Insurance companies refusing valid, evidence-based treatments != denying unproven demands. Likewise, framing healthcare as either for-profit or purely charitable ignores successful state-driven models worldwide that operate without prioritizing shareholder returns. Such false dichotomies and misdirection don’t justify profit-driven rationing of essential medical services. > Everyone is going to die eventually So why…

Medicine is still more art than science. We only have clear evidence-based treatment guidelines for a limited set of conditions, and even with those there are a lot of exceptions. While health insurers do occasionally make egregious errors in denying claims or prior authorization requests, most of those fall into gray areas. Like if a patient is immobilized by severe hip pain should they go straight to joint replacement surgery or try physical therapy for a few months first? Ask 10 different physicians and you'll get 10 different treatment plans.

And health insurers don't increase shareholder returns by denying claims. Due to the minimum medical loss ratio it's rather the opposite. Most of the pressure to tighten coverage rules actually comes from large self-funded employers who use those insurers not to provide insurance but rather to administer their health plans.

https://www.cms.gov/marketplace/private-health-insurance/med...

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