A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims • Hacker News Board

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#181

Post by dragonwriter » Mon, Mar 26, 2018, 1:18 PM UTC

whatshisface wrote: post #152

AFNobody wrote: post #148

Earlier quoted context omitted.

I'm not sure its fair to argue that universal healthcare is a human right despite the fact it makes economic sense. Humanity survived just fine without real healthcare and healthcare is not essential to a fair balance of power b/t the government and its citizenry. Universal healthcare needs to be argued on the economics of the issue because that is the only practical way to make it sustainable. The "feel good" stuff…

You also have to watch out that asserting positive rights that are sometimes impossible to provide (like healthcare) will confuse people when governments attempt to claim that other, deeper rights are "impossible to give." (For example, they might try to argue that they can't afford to not torture, comparing it to how their impoverished country can't give everyone free internet.)

As anyone who lived through the more recent Bush Administration witnessed nearly daily, people claim “not torturing” is an impossible right to give while denying all positive rights—and acted on that argument—so I fail to see the relationship.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#182

Post by kup0 » Mon, Mar 26, 2018, 1:23 PM UTC

lotsofpulp wrote: post #177

zaroth wrote: post #118

Earlier quoted context omitted.

Years ago I purchased private insurance for my family in CA. As I recall I was able to get a plan for my wife with no maternity benefits since we were done having children at that point which was significantly cheaper than the alternative. We were paying something like $400/mo total for a family of 4 with an HSA and $4k deductibles. Later, after some health issues first child diagnosed with T1D we were grandfathered…

Yes, ACA is bad if you don’t care about your others in your country getting healthcare. If you do, then you need to figure out how to spread the costs, and ACA is the best we could get with the legislature we had.

The ACA is bad for people that even do care and even initially supported the ACA, like myself. It has plenty of good parts, but I have to be honest, my choices of insurance options went to almost nothing, and the prices skyrocketed. Part of this may have to do with certain parties in Congress purposely underfunding the ACA to make it fail, so I don't know how much blame goes to the ACA and how much goes to those trying to sabotage it.

However, the fact remains that my health insurance options have generally been worse and more expensive since ACA passed. This year, thankfully, I am on employer healthcare plan instead. Because in my area, with the ACA, there is one provider only, and none of the plans are good, and they're all more expensive than before, and at least 2x what I was paying pre-ACA and with MUCH MUCH higher deductables.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#183

Post by lotsofpulp » Mon, Mar 26, 2018, 2:00 PM UTC

kup0 wrote: post #182

lotsofpulp wrote: post #177

Earlier quoted context omitted.

Yes, ACA is bad if you don’t care about your others in your country getting healthcare. If you do, then you need to figure out how to spread the costs, and ACA is the best we could get with the legislature we had.

The ACA is bad for people that even do care and even initially supported the ACA, like myself. It has plenty of good parts, but I have to be honest, my choices of insurance options went to almost nothing, and the prices skyrocketed. Part of this may have to do with certain parties in Congress purposely underfunding the ACA to make it fail, so I don't know how much blame goes to the ACA and how much goes to those tryi…

ACA allowed more people to get access to healthcare. This means increased demand. ACA did not increase supply of healthcare. This means higher prices, implying higher premiums and deductibles.

Your options are fewer now because you have to be bigger to able to absorb the costs of the extremely high cost individuals such as those with anemia and premature babies and cancer patients.

Everything you’re experiencing is because more people are getting access to healthcare, and instead of everyone paying for it via higher taxes, we’re paying for it via higher premiums and deductibles.

Only way to bring relief is through more supply of healthcare, which means more doctors (they lobby against that) and more medicine (they lobby against that too).

One solution is to marry a doctor so you can take advantage of the situation.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#184

Post by whatshisface » Mon, Mar 26, 2018, 2:12 PM UTC

dragonwriter wrote: post #181

whatshisface wrote: post #152

Earlier quoted context omitted.

You also have to watch out that asserting positive rights that are sometimes impossible to provide (like healthcare) will confuse people when governments attempt to claim that other, deeper rights are "impossible to give." (For example, they might try to argue that they can't afford to not torture, comparing it to how their impoverished country can't give everyone free internet.)

As anyone who lived through the more recent Bush Administration witnessed nearly daily, people claim “not torturing” is an impossible right to give while denying all positive rights—and acted on that argument—so I fail to see the relationship.

Denying every right is the last step of the manuver I'm describing, the first step is to re-define right to mean comfort. Bush-era politics just went straight to step 2 and it didn't work on us.

I suspect that the current UN rights council may be an example of this in action. See: the track record of the members on negative rights, the number of positive rights on their list of rights.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#185

Post by wyager » Mon, Mar 26, 2018, 2:18 PM UTC

ModernMech wrote: post #50

wyager wrote: post #21

Earlier quoted context omitted.

> This is the whole point of health insurance! This is a serious misunderstanding of what insurance is. Insurance is a net benefit for society because it linearizes individual risk curves even if you have to pay in proportionally to your expected costs, not because it makes less risky people subsidize more risky people. Perhaps you should avoid calling people “stupid” for misunderstanding insurance.

And by what mechanism does insurance linearize individual risk? The fact that if I get cancer, it's less likely to bankrupt me. But if it's not bankrupting me, someone else is paying for it. Who's paying for it? Someone who didn't get caner. So how is this not "less risky people subsidizing more risky people"?

It’s not healthy people paying for your treatment - it’s the underwriter. There don’t need to be any other people with different health outcomes involved. The only thing happening here is you’re outsourcing some risk to someone who has a lot more capital and therefore a more linear risk curve.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#186

Post by theluketaylor » Mon, Mar 26, 2018, 2:22 PM UTC

tptacek wrote: post #14

If you're a tech entrepreneur, it's the first story in here that should alarm you the most. It's about denying coverage altogether, not about denying individual claims. Outside of the "guaranteed issue" ACA market, there is virtually no due process for coverage denial. You can be denied on a whim, with little recourse. The list of conditions for which insurance outside the ACA will be denied is long and opaque. The s…

As a Canadian observer I don't understand why Democrats don't go after the small business angle of single payer much, much harder. Don't get me wrong; the lack of health care for poor and at risk populations in the US is a complete disaster, but that argument hasn't swayed the debate for decades now, so it's time for a new approach.

Health care being tied to employment is anti-startup and anti-small business, full stop. In countries with single payer (or similar) systems you can change jobs without any impact to your coverage, you can start a business knowing your family's health and financial future won't be affected.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#187

Post by wyager » Mon, Mar 26, 2018, 2:25 PM UTC

b1daly wrote: post #175

curun1r wrote: post #119

Earlier quoted context omitted.

Let's say your odds of getting that cancer are 5% and you know that ahead of time. So, knowing that it would bankrupt you, you gather 20 other people who are also at a 5% risk of getting cancer to form a group where you all chip in no matter who gets sick. You've now spread the risk out across a pool of people and, yet, everyone is still paying their fair share because no one knows who will be the unfortunate cancer…

I’m repeating myself, but you are wrong in at least two ways. Health insurance in the US is not conducted in any way like the over simplified, text book example you provide. There exists no real world example of health insurance that functions as you describe. There is the obvious problem that there is nowhere near that level of precision in anticipating the given level of risk for any individual getting a certain di…

> There is the obvious problem that there is nowhere near that level of precision in anticipating the given level of risk for any individual getting a certain disease

This doesn’t matter at all, on account of the way variances from independent RVs add up. Look up the Bates distribution as an example. Variance over mean goes down as the square root of the number of independent RVs (insurees). That’s like half the point of insurance.

> was through the patchwork system of employee health plans,

These were the result of highly nonlinear tax policy during WWII, not the reasons you’re claiming.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#188

Post by crzwdjk » Mon, Mar 26, 2018, 2:51 PM UTC

whatshisface wrote: post #128

tptacek wrote: post #123

Earlier quoted context omitted.

You have a young family of four, and can barely afford insurance premiums. Basically, without insurance, every single year you're hitting on a blackjack 17 against bankruptcy. You see the ACA penalty, and you see the insurance premium cost, but you're not factoring in the 5-digit cost of virtually any significant medical expense. Rising insurance premiums aren't good for anyone. The ACA set out to fix the problem of…

If enough people didn't have access to insurance, then there would be pressure on hospitals to find ways to reduce prices (so that their volume could go up). As it stands the medical industry is allowed to hold the poor for ransom ("accept our increased costs or they won't get treated") against the US's deep but finite pockets. Before, we had the (very poor) demand elasticity of people paying everything they had and…

> pressure on hospitals to find ways to reduce prices

This might be the case if hospitals had to actually show their prices rather than sending bills after the fact for a price you aren't allowed to know when you consent to treatment. It might also help if competition were allowed, but for hospitals it is pretty much not in a lot of states. To open a new hospital in many states, you need a "certificate of need", which is basically a document demonstrating that you won't be competing with the existing hospitals. So much for "free market health care".

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#189

Post by curun1r » Mon, Mar 26, 2018, 3:58 PM UTC

b1daly wrote: post #174

curun1r wrote: post #115

Earlier quoted context omitted.

I'm sick of people making this comment because it's flat out wrong. Insurance is about lowering variance, not about subsidizing high risk. The ACA tries to make insurance affordable for everyone, and in the process, some people pay less than their actuarial cost and others pay more. That is not just insurance, it's forcing people with a lower actuarial risk to subsidize those with a higher risk. Insurance is about ta…

You seem to be making an argument based on “semantics” here? The idea of extending an insurance program into a mechanism for subsidizing those who can’t pay the premium does not mean it magically transforms the program into a totally different thing. In the limited definition, it is still the case that the healthy pay the cost of sick. The extension of the concept of insurance fits semantically, because it is based o…

Yes, it's semantics...no quotes needed, that's what it is. But it's also people trying to make other people look stupid by being wrong, and they deserve to be called out for their improper semantics.

It's not "just insurance." That's not "what insurance is." We're talking about a form of socialized medicine, not insurance. That's the correct terminology. Anyone arguing for anything between Obamacare and Medicare For All (which includes me, BTW) needs to own up to that terminology or something to that effect and stop selling the notion that what they're arguing for is just insurance.

Insurance, as a concept, doesn't shift the burden for risk from people who can't afford to pay to people who can. It's something different and you don't get to alter definition of insurance just because the correct terminology has a stigma. So when the comment I replied to says,

> This is the whole point of health insurance!

No, it's not. That's the whole point of socialized medicine. Words have meaning and we should be using the correct ones.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#190

Post by bitwize » Mon, Mar 26, 2018, 3:59 PM UTC

curun1r wrote: post #102

lsc wrote: post #69

Earlier quoted context omitted.

>ACA is horrendous, unless you're receiving a government subsidy. I'm curious as to why you say "the ACA is horrendous" rather than "The income cutoffs for the ACA subsidies are way too low" - I mean, it seems obvious to me that if you make a median salary and have a family of four that you need some sort of health insurance subsidy, but I don't know where the ACA subsidy lines are, or even if they vary per state or…

My own personal "why I hate the ACA"... In 2016, I decided to take off from work and travel outside the US. I did what I thought was the responsible thing and purchased a travel insurance plan. In total, I was gone for a year...I had an amazing trip. When I got home, I wanted to sign up for insurance again. But since it wasn't a life event, I wasn't eligible to enroll until the open enrollment period. And when that t…

Should've not stopped travelling outside the US and settled in a civilized country.