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

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

#231

Post by landryraccoon » Wed, Jan 15, 2025, 10:26 PM UTC

theteapot wrote: post #201

landryraccoon wrote: post #28

Earlier quoted context omitted.

I take issue with the claim that in order to say something is too expensive that you must be able to precisely propose an alternative price. I have no idea what the correct margin for essential cancer drugs is. I don’t think it should be a 10x markup. Intuitively, it seems that there’s something wrong with price gouging dying cancer patients. If you have an argument why my intuition is wrong, please share it.

> I take issue with the claim that in order to say something is too expensive that you must be able to precisely propose an alternative price. If you want to be quantitative of course you do. How hard is it? Margin of error is allowed. If you want to be qualitative, vague and wishy washy, that has its place too, but at some point someone is going to ask for a quantitative assertion, otherwise you get nowhere.

To use a software development analogy, the average person is a user of health care, not a health care project manager or designer.

Just as the user of an App doesn't need to provide an alternative design when they say "this App sucks", the average user of healthcare likewise has no obligation to redesign the healthcare system when they say "this healthcare system sucks."

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

#232

Post by theGnuMe » Wed, Jan 15, 2025, 10:26 PM UTC

adamredwoods wrote: post #222

We have UnitedHealth, and my wife died of cancer. They denied a lot of things, but ultimately, they covered a lot when we rapidly soared past our deductible. We kept a running list of EVERY bill paid. It's a shame they put so much onus onto the family dealing with tragedy. So while it was a pain to fight them on every bill, they did shell out for us. Some of the biggest battles were with the hospital bill collectors.

So sorry for your loss. It is crazy that cancer treatments are so criminally expensive.

The analysis in the comments suggests that UHC pricing is high due to cartel like price fixing. So while they “shell out” it seems like they are playing a shell game to loophole the 85% rule.

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

#233

Post by ceejayoz » Wed, Jan 15, 2025, 10:27 PM UTC

gruez wrote: post #203

cluckindan wrote: post #140

Earlier quoted context omitted.

”Survey of 1,000 registered voters conducted Dec. 11-13, 2024”

Again, not sure what you're trying to say but given how it's overwhelmingly against "killing was acceptable or somewhat acceptable", it's unlikely that polling error would significantly change the conclusion.

> Young voters were far more split: 41% found the killer's actions acceptable, while 40% found them unacceptable, per the poll. About 24% found them "somewhat acceptable" and 17% "completely acceptable."

That's a big number of people.

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

#234

Post by ceejayoz » Wed, Jan 15, 2025, 10:29 PM UTC

criddell wrote: post #162

yadaeno wrote: post #139

Earlier quoted context omitted.

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.

They own the physicians, too.

https://www.statnews.com/2024/07/25/united-health-group-medi...

To whom they pay higher "medical loss":

https://www.statnews.com/2024/11/25/unitedhealth-higher-paym...

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

#235

Post by llamaimperative » Wed, Jan 15, 2025, 10:29 PM UTC

gruez wrote: post #119

llamaimperative wrote: post #77

Earlier quoted context omitted.

There should be a method + requirement to pay royalties back to public funding for basic research, but pharmaceutical companies really bear 99% of the risk and complexity of bringing a drug to market. It's not all that expensive to find molecules that might do something useful, it's obscenely expensive and risky to prove one does something useful.

>There should be a method + requirement to pay royalties back to public funding for basic research, You mean the patent system? The university of california holds patents on CRISPR, for instance.

CRISPR was obviously commercializable, most academic research is quite a bit further from commercialization and some tiny portion ends up being extremely valuable way downstream nonetheless.

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

#236

Post by MandieD » Wed, Jan 15, 2025, 10:32 PM UTC

gruez wrote: post #126

jmyeet wrote: post #64

Just look at the per-capita spending on healthcare by OECD countries, basically all of which have universal healthcare except for the US [1]. So the US pays almost twice as much as #2 (Switzerland) for significantly worse outcomes and less coverage. The US healthcare system is an unmitigated disaster that is a cautionary tale in how capitalism only promotes rent-seeking and regulatory capture. It's done with a servic…

"cautionary tale in how capitalism only promotes rent-seeking and regulatory capture" is a weird takeaway from this when the same applies to government-run healthcare. medicare, medicaid, veteran's affairs combined almost approaches OECD levels, but only covers a fraction of the population.

Medicare chooses the oldest (over 65), Medicaid chooses the poorest (who are more likely to have issues that went untreated and got worse) and most severely disabled, and Veterans' affairs chooses the ones who gave their bodies to Uncle Sam to be pushed out of planes, deafened in tanks, and have their backs wrecked with giant packs marched for several hours a day.

In other words, all patients that private insurers are likely delighted not to have on their books.

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

#237

Post by gedpeck » Wed, Jan 15, 2025, 10:33 PM UTC

tptacek wrote: post #229

gedpeck wrote: post #209

Earlier quoted context omitted.

I take it then that we agree that for profit health insurance companies profiting from denying care is immoral. That there are other immoral actors is not germane to the discussion.

No, we don't agree. I think there are different values implicated in our system, in a system like the UK NHS, and a system like Australia's (for the record: I'd take Australia's over ours). The UK does a good job of hiding economic concerns from its users, at a cost in availability of services, especially high-end and experimental interventions. The UK makes these rationing decisions knowing that some people are goin…

Then your reply above to me was a red herring and as such a bad faith reply.

The American system does a good job of getting services delivered to customers;

Therein lies one of the reasons the U.S. system is immoral. There are lots of people who can’t afford to be customers.

It is immoral to profit from denying someone healthcare.

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

#238

Post by nradov » Wed, Jan 15, 2025, 10:34 PM UTC

swatcoder wrote: post #61

BugsJustFindMe wrote: post #4

https://archive.ph/cg4we I do not like UnitedHealth, I do not like our existing crop of health insurance executives, and I might even be viscerally glad at some level that the UnitedHealth CEO was killed in a world where justice clearly takes a back seat to greed, but I wish the headline didn't say "overcharged", because there's no established amount of markup that is the correct amount of markup other than what peop…

The article is about UnitedHealth's PBM, which negotiates rates and then earns revenue from drug manufacturers through rebates. Remember that insurance is part of Big Finance and involves a lot of clever instruments to shuffle around money, risk, and accountability. PBM's are one of those instruments. Our intuitive Econ 101 models of the industry don't always go far enough into the weeds when we're just reacting to h…

For those who want to really understand the impact that PMBs play on the overall US healthcare system I highly recommend reading the "The Price We Pay: What Broke American Health Care--and How to Fix It" by Marty Makary, MD. The system of legalized kickbacks that they use isn't widely recognized but it will have to be reformed if we ever want to bring down prescription drug spending.

https://www.bloomsbury.com/us/price-we-pay-9781635575910/

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

#239

Post by ruthmarx » Wed, Jan 15, 2025, 10:36 PM UTC

henry_bone wrote: post #210

I wonder a lot about this argument of private health care vs state funded health care. I have libertarian leanings and so would prefer a truly free market, because I would like to believe it would lead to affordable levels of health care for everyone. But I don't know that it's true. My questions regarding the US system and health insurance: Is it a truly free market or does the state regulate in ways that make it di…

> I have libertarian leanings and so would prefer a truly free market, because I would like to believe it would lead to affordable levels of health care for everyone.

Without regulation it just leads to predation.

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

#240

Post by jjk166 » Wed, Jan 15, 2025, 10:37 PM UTC

BugsJustFindMe wrote: post #6

itishappy wrote: post #5

Earlier quoted context omitted.

They've chosen 90% margin (cost + 1000%). Semicon tool builders (my industry) have margins around 50% (cost + 100%). This is considered high margin manufacturing work. To match United Health's margins we'd need to raise prices by 5x.

I agree, but we can't talk about "over" without talking about where the line is.

You can talk about jetliners cruising over towns without discussing the height of a town's buildings. No one here seems to be in disagreement that the line is lower, which is all we need to know to describe the markup as over.