Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger • Hacker News Board

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#221

Post by Randgalt » Wed, Aug 17, 2016, 8:36 PM UTC

Randgalt wrote: post #191

ashark wrote: post #185

Earlier quoted context omitted.

> "'Rights' are basically just freedoms we've decided we like a whole lot and want the government to guarantee" - as I said below, the logical conclusion of that argument is not a world you'd want to live in. How is that not the world we live in? What is the alternative? At some point someone's deciding what's a right and what isn't. Other people may disagree. Rights aren't a law of nature, they're a fuzzy category,…

"What is the alternative?" - a system of rights based on the nature of human beings. Human beings survive by producing the things we need to survive. We need governments to protect others from initiating force against us in opposition to our primary needs of living. Will we ever see this in reality? No. But, the closer humans have gotten in history the better off they've been.

"Do you have an example in mind of when and where we've come especially close to this ideal?" The USA of course - though it's quickly moving away. Hong Kong (though China is ruining it). England before the Fabians took over. Japan after the war. There are many others.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#222

Post by seanp2k2 » Wed, Aug 17, 2016, 8:37 PM UTC

harryh wrote: post #205

eecc wrote: post #198

Earlier quoted context omitted.

you're suggesting the guy should throw himself off a cliff?

I'm not suggesting he do anything. In fact, I think his story is a great example of what makes the economics of health care so challenging. I was merely pointing out a connection from his personal story to the general topic of conversation that a lot of people don't seem to realize.

When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. Why does all this stuff cost so much in the first place? Medical equipment prices seem so far separated from reality that it's seriously laughable, and it'd be funny if it wasn't everyone who had to find a way to afford this junk. Go look at some prices for medical equipment (where you can even find prices) and see if those prices seem reasonable to you for the equipment.

Let's find a way to fix that? This doesn't even touch how some hospitals / networks must buy from a specific vendor, or how vendors sell packages which include things the buyer doesn't need (at the same exorbitant prices).

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#223

Post by tptacek » Wed, Aug 17, 2016, 8:39 PM UTC

harryh wrote: post #220

tptacek wrote: post #208

Earlier quoted context omitted.

By shifting more of the group insurance market onto the individual market, perhaps mostly by eliminating current incentives for employer group coverage, to minimize the adverse selection problem. Incidentally: two members of my immediate family have the same problem he does. No history of serious illness, no current health problems, probably healthier than the median in both cases for their age cohort, but uninsurabl…

1) Can we make the individual mandate in the individual market strong enough to really eliminate (or at least minimize) the adverse selection problem? I am unconvinced that we can. Perhaps though. 2) Are you really convinced that the pre-existing rules you encountered were bogus? Are insurance companies just dumb when it comes to this sort of thing? I tend to assume, absent other evidence, that insurance companies wi…

I think penalties need to be sharply increased, but the problem isn't so much free riders as it is that statistically the most attractive segment of the market is overwhelmingly likely to be employed at a firm that offers group coverage.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#224

Post by harryh » Wed, Aug 17, 2016, 8:41 PM UTC

tptacek wrote: post #223

harryh wrote: post #220

Earlier quoted context omitted.

1) Can we make the individual mandate in the individual market strong enough to really eliminate (or at least minimize) the adverse selection problem? I am unconvinced that we can. Perhaps though. 2) Are you really convinced that the pre-existing rules you encountered were bogus? Are insurance companies just dumb when it comes to this sort of thing? I tend to assume, absent other evidence, that insurance companies wi…

I think penalties need to be sharply increased, but the problem isn't so much free riders as it is that statistically the most attractive segment of the market is overwhelmingly likely to be employed at a firm that offers group coverage.

I certainly agree that employer provided health care coverage should be taxable income (I assume that's the mechanism by which you would shift people).

It's interesting to note that McCain proposed this as part of his campaign in 2004 and Obama pilloried him for it.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#225

Post by georgemcbay » Wed, Aug 17, 2016, 8:41 PM UTC

harryh wrote: post #159

snsr wrote: post #10

Kind of ironic given that Aetna is largely responsible for the elimination of the public option from the Affordable Care Act. Thanks again Joe Lieberman https://en.wikipedia.org/wiki/Aetna#Lobbying_and_campaign_co...

If you think a ~$100,000 a year to a politician (plus another couple million to some other politicians) is largely responsible for the rules that govern how 20% of our economy functions you are quite mistaken. There are huge economic and political forces at work that render Aetna's tiny expenditure irrelevant in the grand scheme of things.

I'm no expert in this at all, but I do know a number of people who work in government and across the board they are all of the opinion that most people would be shocked if they knew just how cheap it was to buy major influence, even at the national level.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#226

Post by random28345 » Wed, Aug 17, 2016, 8:42 PM UTC

harryh wrote: post #159

snsr wrote: post #10

Kind of ironic given that Aetna is largely responsible for the elimination of the public option from the Affordable Care Act. Thanks again Joe Lieberman https://en.wikipedia.org/wiki/Aetna#Lobbying_and_campaign_co...

If you think a ~$100,000 a year to a politician (plus another couple million to some other politicians) is largely responsible for the rules that govern how 20% of our economy functions you are quite mistaken. There are huge economic and political forces at work that render Aetna's tiny expenditure irrelevant in the grand scheme of things.

> If you think a ~$100,000 a year to a politician (plus another couple million to some other politicians) is largely responsible for the rules that govern how 20% of our economy functions you are quite mistaken.

cough https://en.wikipedia.org/wiki/Copyright_Term_Extension_Act cough

That was purchased pretty cheaply, and industries affected by copyright(books, movies, music, software, software) are a decent chunk of the economy.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#227

Post by st3v3r » Wed, Aug 17, 2016, 8:43 PM UTC

ruste wrote: post #169

vidarh wrote: post #161

Earlier quoted context omitted.

Reality, of course, being that the US has death panels: Insurance providers, so the argument was idiotic to begin with. The difference is that with most socialised systems there are two system in parallel: A public system whose priorities set based on measured impact, rather than by . E.g. in the UK, a separate agency develops guidance independently that measures how treatments affect "quality adjusted life years". A…

Except you can sue your insurance provider if they deny you coverage for something that they're obligated to cover. You wouldn't be able to sue the government. Edit: Let me also add this; when you sign up for health insurance you're entering into a contract with the insurer. They have to be up front about what they're providing and it's your obligation to understand what you're buying. With the government you don't g…

"Except you can sue your insurance provider if they deny you coverage for something that they're obligated to cover. "

With what money? And furthermore, what good will that do if you die before the trial is over?

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#228

Post by ecommerceguy » Wed, Aug 17, 2016, 8:43 PM UTC

eridius wrote: post #34

VonGuard wrote: post #9

Earlier quoted context omitted.

There is no benefit. The benefit is for the legislatures who passed the law. There was no way that we'd get single payer here in the US because our Congress is very much in the pocket of the health care industry. As such, the markets were a compromise measure enacted by congress to make it easier for people to choose health care. Before Obamacare, it was sort of a black box where only HR people could figure out prici…

There's no way that we'd get single payer here because the Republican party has convinced their base that single-payer health care is socialism and that socialism is evil, which leads to the situation where poor people who desperately need health care and can't afford it still oppose single-payer even though they stand to gain the most from it.

I think you'll be remiss to find that the majority of insurance company donations go to the Democratic party. Of course poor people have been voting Democrat for over 50 years and they are, for the most part, still poor. Que Einstein quote.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#229

Post by zaroth » Wed, Aug 17, 2016, 8:45 PM UTC

rrggrr wrote: post #11

You can either have a system where everyone is covered at great relative expense to the healthy, or one where everyone is covered at great expenses to taxpayers. Either way, quality of care, breadth of services and speed of access are going to suffer. Demographic reality is inescapable.

Only 5-10% pay the majority of taxes, but almost everyone is, eventually, not healthy.

Another way to put it is that average lifetime healthcare cost is about $250k for men, $350k for women.

So yes, definitely people should be paying for health insurance while they are healthy, so that they can also have it when they are sick.

In a sense, health insurance should be priced just like a $250k/$350k term-life policy that you take out at birth.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#230

Post by harryh » Wed, Aug 17, 2016, 8:45 PM UTC

georgemcbay wrote: post #225

harryh wrote: post #159

Earlier quoted context omitted.

If you think a ~$100,000 a year to a politician (plus another couple million to some other politicians) is largely responsible for the rules that govern how 20% of our economy functions you are quite mistaken. There are huge economic and political forces at work that render Aetna's tiny expenditure irrelevant in the grand scheme of things.

I'm no expert in this at all, but I do know a number of people who work in government and across the board they are all of the opinion that most people would be shocked if they knew just how cheap it was to buy major influence, even at the national level.

There are people that are experts and they generally agree that the effects of political contributions are much smaller than is generally believed by the public.