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

fortune.com

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

#161

Post by NickC25 »

whatwhaaaaat wrote: post #81
lenerdenator wrote: post #52

Earlier quoted context omitted.

They're not going to for at least the next four years. "What is good for the shareholders is good for society" will be the order of the day.

Don’t you think it’s possible if drug advertising is banned then perhaps some of our media organizations may be at least slightly more inclined to investigate some of these hostile practices?

Sadly, no.

Our media organizations are still dependent on politicians, who themselves take billions in "donations" from healthcare corporations. Those same media organizations also have workers who are probably partially invested into pensions or other long-term safety nets who themselves are invested into healthcare companies.

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

#162

Post by criddell »

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…

But when UnitedHealth requires medications to be purchased from Optum health (with whom they share a parent company), they can jack up the price of a drug and keep some of that 85% too.

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

#163

Post by bitwize »

gruez wrote: post #107
baq wrote: post #53

Earlier quoted context omitted.

It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security. The US’s primary concern is mark to market in pension funds.

>It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security. Sounds like https://xkcd.com/1122/ For instance, Canada, which also arguably "never had a world war on the continent" has public healthcare. What gives? What about all the central/south american countries that don't have public healthcare?

"No nomimee whose first name contains a 'K' has lost."

...Until Kamala Harris in 2024. Took twelve years, but...

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

#164

Post by brightball »

lotsofpulp wrote: post #142
cibyr wrote: post #111

Earlier quoted context omitted.

Most people don't even get the ability to select among all the terrible insurance companies - their employer chooses for them!

Technically, they have the ability to choose whoever they want, they just have to pay full price with post tax income. If people accept their employer's choice, then they get to pay for a lower, employer subsidized premium with pre tax income.

That is one thing that would fix this problem fast. Let individuals tax deduct the price of their health insurance directly. There’s no reason it should only be up to your employer.

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

#165

Post by adamc »

gwbas1c wrote: post #122
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 /…

It's easy to just blame the insurance providers, but keep in mind: Everybody expects a higher standard of care, because now we treat things that we didn't even know about in the past. For example, I have a CPAP and went through surgery for sleep apnea. 50 years ago, who knows what would have happened to me? Medical providers are incentivized to "find" things to bill for. For example, I went to a podiatrist for foot p…

I have a CPAP too, and the insurance paid for part of the cost, but most was still paid for by me. I investigated the price of buying it directly, for cash, and it was only a few hundred dollars more.

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

#166

Post by tptacek »

craigmccaskill wrote: post #102
tptacek wrote: post #85

Earlier quoted context omitted.

I think this is a statistical artifact. Medicare preferentially selects the cohort of customers most likely to demand services from providers (that's the premise of the program). Fixed fees in, floating costs out. If you extended Medicare to 30 year olds, that 2% would, mechanically, soar; the same inputs from customers, but drastically lower service delivery.

The same statistics are similar for Medicaid too but also missing the forest for the trees in that for profit seems to be the main differentiator with the US vs. other parts of the world. There are plenty of models around the world that show this works and it works well. First it's the government can't do this, then it's the government wouldn't do this because of this reason while ignoring that the US healthcare syst…

This is my issue with M4A: it seems clear from the numbers that the problems in our system --- and I think they're grave --- are almost entirely on the provider-side, and Medicare has, if anything, locked us into those cost structures. If anyone's curious why there's a scarcity in physician care hours in the US: Medicare rate limits the number of new doctors allowed into the system every year, through the residency funding system.

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

#167

Post by BugsJustFindMe »

antisthenes wrote: post #135
BugsJustFindMe wrote: post #13

Earlier quoted context omitted.

I don't want you to give them the benefit of the doubt. I certainly don't think they deserve it. I do think, however, that a conversation about "overcharging" goes nowhere until people talk about exactly where charging ends and overcharging begins.

Anything above what Medicaid pays for drugs/procedures (and maybe a few % over to account for health insurance salaries) is overcharging. Is that clear enough for you?

The trouble with this cascades as follows:

1) I don't know what Medicaid pays.

2) I don't know that what Medicaid pays is a just price until we define what a just price is on its own merits. Maybe Medicaid pays more than they should.

3) What Medicaid pays could change at any time for any reason unless what Medicaid pays is based itself on some metrics that define otherwise, in which case let's just look at those metrics directly, yes?

4) If Medicaid decides to pay more, is that the new line?

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

#168

Post by FpUser »

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…

>"Average health insurance profit margin in US is ~3%. That's not a greedy profit margin."

Could it be that good chunk of the profits is eaten by overinflated salaries of major execs?

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

#169

Post by jldugger »

tredre3 wrote: post #92
baq wrote: post #53

Earlier quoted context omitted.

It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security. The US’s primary concern is mark to market in pension funds.

> It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security. You seem to be making a weird connection here, but maybe I misunderstand you. Are you truly suggesting that countries who have socialized health care do so because they've been affected by war on their territory at some point?

I seem to recall John Cleese or some other british person suggesting that the NHS was a given after so many had been through ww2. Wikipedia[1] on the NHS suggests the same, through quotes by politicians.

[1]: https://en.wikipedia.org/wiki/National_Health_Service#Histor...

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

#170

Post by nozzlegear »

franktankbank wrote: post #130
nozzlegear wrote: post #88

Earlier quoted context omitted.

I'm not sure about UHC specifically, but insurance companies do innovate. Some insurers have invested pretty heavily in biotech and wearables, and they're also a big driver behind telehealth/remote health monitoring tech. We can cynically say that they're just in it because they want to reduce costs – and that's probably true – but it'd be simplistic to say investing to reduce costs is purely selfish.

> biotech and wearables Tracking and data harvesting, excellent!

Or encouraging healthier lifestyles by blending technology with behavioral health incentives.

Or both.

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