UnitedHealth overcharged cancer patients for drugs by over 1,000% • Hacker News Board

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#151

Post by adamc » Wed, Jan 15, 2025, 9:44 PM UTC

brightball wrote: post #26

porcoda wrote: post #7

Nothing is shocking about the insurance industry anymore since they’ve been pulling this kind of thing for years. To me the most shocking thing is the people who defend them. I understand the drive to make money and build huge businesses: what confuses me is that we treat human health the same as things that don’t directly impact the health of people. It seems to me that there are endless opportunities to get insanel…

Does anybody defend them? I’ve been on the selection side as an employer and several others will probably echo what I’m about to say. Virtually every insurance provider is going up 15-20% / year to the point that it’s completely unsustainable. United was quoted to me as almost 20% lower than current rate for our provider (before they are about to go up 20%). On premium alone they will save some people close to $500 /…

This is why we need to install National Health Care. Single payer systems get the best rate, and we can make a national decision over how much we can afford. The current system is insane and unsustainable.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#152

Post by fatbird » Wed, Jan 15, 2025, 9:44 PM UTC

yadaeno wrote: post #139

porcoda wrote: post #7

Nothing is shocking about the insurance industry anymore since they’ve been pulling this kind of thing for years. To me the most shocking thing is the people who defend them. I understand the drive to make money and build huge businesses: what confuses me is that we treat human health the same as things that don’t directly impact the health of people. It seems to me that there are endless opportunities to get insanel…

Medical Loss Ratio (MLR) is capped at 85% in the US which means 85% of revenue must go to patients. This is roughly inline with other countries with universal healthcare (MLR ranges from 85-95%). The fundamental problem is that we don’t have enough resources to take care of everyone. Insurance companies are faced with the impossible task of allocating resources and making care/nocare decisions. I don’t get the “endle…

The more revenue an insurer brings in, the larger that 15% slice of the pie. The fact that they have a capped MLR is beside the point.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#153

Post by lotsofpulp » Wed, Jan 15, 2025, 9:44 PM UTC

craigmccaskill wrote: post #124

onlyrealcuzzo wrote: post #105

Earlier quoted context omitted.

> But has everything to do with the need to take a closer look at the entire system and how we can do things better. People do that literally everyday. If there was a silver bullet, we'd take it.

If there is a silver bullet, the first step would be getting rid of the for profit mechanisms. Instead, because despite data linked in this thread that profit margins are only a few percentage points, Healthcare is an incredibly lucrative field that extracts a lot of money into the private market without delivering results commensurate with the cost to the public. Add to that lobbying making it incredibly simple and…

Kaiser Permanente, Providence Health, all the insurers in the BCBS franchise except Elevance, and many others are non profit.

Yet they are unable to provide lower premiums than UNH/Elevance/CVS/Cigna/Humana/Centene/Molina.

Kaiser is a full vertical, you buy insurance from them, you see their doctors and nurses in their outpatient clinics and hospitals, you get medicine from their pharmacies. So why is everyone not choosing Kaiser?

Edit to respond to below since posting limit hit:

UNH had $371B in revenue, not profit, therefore it is irrelevant. If the claim is UNH is excessively profiting, then profit margin is the only metric relevant to the discussion.

Kaiser's managed care organization IS non profit, so it is relevant here. It clearly shows that the managed care portion of the business is not sucking out outlier amounts of profit, because Kaiser's premiums are not different to UNH or any other MCO's premiums. Also, Kaiser's annual revenue is $100B or so, not $4B.

https://about.kaiserpermanente.org/news/press-release-archiv...

If a managed care organizations being for profit or non profit was the straw that was breaking the camel's back, then it would show up as non profit managed care organizations being able to offer much lower premiums.

>say that for profit is the way to go because if Kaiser can't do it then nobody can.

I am not claiming for profit is the way to go (or the opposite). I am saying, within the confines of the US healthcare system, for profit managed care organizations are not THE source of higher healthcare costs.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#154

Post by ktallett » Wed, Jan 15, 2025, 9:44 PM UTC

bloppe wrote: post #145

porcoda wrote: post #7

Nothing is shocking about the insurance industry anymore since they’ve been pulling this kind of thing for years. To me the most shocking thing is the people who defend them. I understand the drive to make money and build huge businesses: what confuses me is that we treat human health the same as things that don’t directly impact the health of people. It seems to me that there are endless opportunities to get insanel…

I'm going to go ahead and defend them because private insurance is actually far from the most broken thing about US healthcare, yet they seem to shoulder all the blame. Average health insurance profit margin in US is ~3%. That's not a greedy profit margin. It's the health care that's expensive, not the insurance. Health care is much more expensive in the US than in similar countries. I'm not an expert on why, but the…

I would be inclined to agree with you, the issues is related to the healthcare vastly overcharging for basic acts such as giving simple drugs such as ibuprofen or paracetemol.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#155

Post by tptacek » Wed, Jan 15, 2025, 9:44 PM UTC

ceejayoz wrote: post #134

tptacek wrote: post #97

Earlier quoted context omitted.

Sure, I'll defend them, conceptually at least. I think most actors in this system are in some sense corrupt, and I don't think insurers are the most corrupt. Pull up the 2022 National Health Expenditure table, "National Health Expenditures by Type of Expenditure and Program: Calendar Year 2022" and look at combined hospital and physician expenses compared to insurer expenses; it's pretty black-and-white.

> look at combined hospital and physician expenses compared to insurer expenses; it's pretty black-and-white I mean, yeah. They're doing all the work .

And billing us 4x more for it than Europeans, and, further: a lot of that work is wasteful and unnecessary (see: spinal fusion surgeries, back imaging). There were more MRI machines in Massachusetts in 2023 than there where in all of Canada.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#156

Post by monkeycantype » Wed, Jan 15, 2025, 9:44 PM UTC

bastardoperator wrote: post #43

porcoda wrote: post #7

Nothing is shocking about the insurance industry anymore since they’ve been pulling this kind of thing for years. To me the most shocking thing is the people who defend them. I understand the drive to make money and build huge businesses: what confuses me is that we treat human health the same as things that don’t directly impact the health of people. It seems to me that there are endless opportunities to get insanel…

The problem with greed is it has no limits. These people are happily dancing on graves all the way to the bank, and we allow it.

What I believe has broken in the US, UK and is well on the way to breaking in Australia, is the confidence that principles will win over greed. If you believe there is a critical mass of good principled people who will stand against selfishness, then being principled is a smart choice. If you do not have that belief, being principled feels like a foolish extravagance. As many have said before, it's got to the point people have more faith in a zombie apocalypse than in citizens cooperating for their own common good.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#157

Post by sssilver » Wed, Jan 15, 2025, 9:45 PM UTC

bloppe wrote: post #145

porcoda wrote: post #7

Nothing is shocking about the insurance industry anymore since they’ve been pulling this kind of thing for years. To me the most shocking thing is the people who defend them. I understand the drive to make money and build huge businesses: what confuses me is that we treat human health the same as things that don’t directly impact the health of people. It seems to me that there are endless opportunities to get insanel…

I'm going to go ahead and defend them because private insurance is actually far from the most broken thing about US healthcare, yet they seem to shoulder all the blame. Average health insurance profit margin in US is ~3%. That's not a greedy profit margin. It's the health care that's expensive, not the insurance. Health care is much more expensive in the US than in similar countries. I'm not an expert on why, but the…

The profit margin is just the shareholders' cut though.

What about the CEO salary? What about his secretary? The rent they pay for the buildings they occupy? Going down that path, how much of the operational expenses of private insurance meaningfully improve patients' health?

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#158

Post by mikeweiss » Wed, Jan 15, 2025, 9:45 PM UTC

There are only three things that keep companies from doing bad things. criminal liability, civil liability and brand risk(PR). companies will do what our society has designed them to do, which is to generate profit while navigating those three risks. Negative PR is not enough to dissuade health insurance companies from doing bad things because it's generally not consumers who choose their insurance, it's their employers. Clearly we cannot rely on brand risk to keep these companies in check..we need more laws and regulation.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#159

Post by mattgreenrocks » Wed, Jan 15, 2025, 9:45 PM UTC

hn_throwaway_99 wrote: post #100

I think one of the things that deserves discussion here is the whole concept of pharmacy benefit managers in the first place. To start, can anyone give some good resources that really explain clearly what the role is that PBMs actually serve, and how the whole system even functions? I've tried to understand in the past but have always thought "Why do you exist???". Like the whole way companies like GoodRX can have a…

Or the fact that you can mail order some name brand prescription drugs from Canada for a fraction of what you'd pay here.

Grift all the way down.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#160

Post by [deleted] » Wed, Jan 15, 2025, 9:45 PM UTC

tptacek wrote: post #97

brightball wrote: post #26

Earlier quoted context omitted.

Does anybody defend them? I’ve been on the selection side as an employer and several others will probably echo what I’m about to say. Virtually every insurance provider is going up 15-20% / year to the point that it’s completely unsustainable. United was quoted to me as almost 20% lower than current rate for our provider (before they are about to go up 20%). On premium alone they will save some people close to $500 /…

Sure, I'll defend them, conceptually at least. I think most actors in this system are in some sense corrupt, and I don't think insurers are the most corrupt. Pull up the 2022 National Health Expenditure table, "National Health Expenditures by Type of Expenditure and Program: Calendar Year 2022" and look at combined hospital and physician expenses compared to insurer expenses; it's pretty black-and-white.

[deleted]