Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

fortune.com

Post reply on HN
Print view View original

241–250 of 323 posts

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

#241

Post by ceejayoz »

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.

Sure we can.

Some loaves of bread are worth a dollar. Some are worth ten dollars. The exact line is hard to pin down... but a $1,000 loaf of bread is probably excessive.

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

#242

Post by wat10000 »

mindslight wrote: post #103
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…

In many ways, the problem is that we do treat health care different . What other industry will actively reject attempts to ask about prices? What other industry just sends out bills with no contractual basis and exaggerated fraudulent amounts made up after the fact? What other industry do you need to buy "insurance" to even be able to financially communicate with service providers? What other industry does the govern…

The problem is that it is different. What other industry sells a product that you might need in order to survive or to not be disabled which requires the dedicated efforts of multiple professionals with a decade of post-secondary education? What other industry sells a product that you might suddenly need at a moment’s notice that is the only way you’ll survive the day, that requires sophisticated equipment, dedicated facilities, and a team of the aforementioned highly educated professionals?

Most industries are either optional things you want to have but can live without, or necessities you need on an ongoing basis that need more than a few minutes of individual attention.

There’s a lot more to medicine than emergencies and lifesaving treatments. But I think those are the original sin from which the rest flows.

The basic question is this: should people be left to die if they have a sudden life-threatening event (heart attack, hit by a bus, shot) and they can’t demonstrate an ability to pay for treatment? (Note, not the same as not being able to pay for treatment. This would potentially apply to a rich person who got mugged and left for dead, for example.)

Few will answer “yes.” And everything else flows from the “no.” The US’s universal health care system is built around it. We pretend we don’t have universal health care, but we do. It’s just tremendously shoddy and weird. The one place with universal care is the hospital emergency room. Those have been required to treat everyone regardless of ability to pay since 1986. Once you start doing that, the rest flows from there. People start saying, what if it’s not critical to survival but they’ll be crippled without it? What if it’s life critical but there’s time to verify payment?

Can we do better without removing that? No doubt. But we’ll have a hard time getting to a proper competitive market.

Other industries with these characteristics (police, firefighting, rescue, ambulance if you count that separately from medicine) are usually handled by the government or at least contracted by them.

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

#243

Post by ceejayoz »

bloppe wrote: post #173
jandrese wrote: post #148

Earlier quoted context omitted.

The army of middlemen the doctors and hospitals need to hire to deal with the insurance companies adds a lot to healthcare costs in the US. Not to mention the armies of middlemen hired by the insurance companies themselves. While every healthcare system has administrators, the US system with its thousands of different systems interacting with thousands of other individuals makes for a nightmarishly complex problem. D…

That may be true. I can only assure you that the army of government bureaucrats who do that work in countries with universal healthcare tend to be less efficient.

You can't assure us of that; the facts say otherwise.

https://www.epatientdave.com/2017/06/16/the-effectiveness-of...

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

#244

Post by gruez »

ceejayoz wrote: post #233
gruez wrote: post #203

Earlier quoted context omitted.

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.

"greater public" =/= "Young voters"

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

#245

Post by jmyeet »

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.

Welcome to the concept of "selection bias".

As another commenter put it, the government covers those with the highest cost of healthcare: veterans with varying degrees of disability, the elderly and the poor.

Another way to look at that is that insurance companies offload the highest cost people to the government so they can profit from the younger and healthier. How does that make sense?

You see this everywhere too, like with the push for privatization of education through charter schools and/or school vouchers. Some will point to the lower cost per student and completely ignore that the government education system doesn't get to be selective about students. State education caters to those with high-needs who are, just like with Medicare and the elderly, those that cost the most.

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

#246

Post by SpicyLemonZest »

regularization wrote: post #194
SpicyLemonZest wrote: post #101

Earlier quoted context omitted.

It's hard to imagine anything more toxic to the cause of healthcare reform than tying it to support for vigilante murder.

People have wanted health care reform in the US for over a century and it is farther away from ever. This carrot you are waving does not exist, which is why CEO Brian Thompson has filed his last claim denial.

Of course it exists! Most other countries in the world have it. I don't know exactly what the path towards a good healthcare system looks like in the US, but I do know and regret heavily that my uncompromising anti-murder stance will prevent me from endorsing any reform proposal that's associated with Luigi memes.

I'm sorry that your frustrations with the healthcare system have driven you to embrace evil and I really hope the day will come when you reconsider.

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

#247

Post by [deleted] »

monkeycantype wrote: post #156
bastardoperator wrote: post #43

Earlier quoted context omitted.

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 p…

[deleted]

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

#248

Post by SilasX »

ceejayoz wrote: post #213
tptacek wrote: post #204

Earlier quoted context omitted.

Doctors don't make 4x more here than in Germany because of insurance costs.

Healthcare here isn't 4x the price because of doctor costs, either. https://www.washingtonpost.com/business/2023/08/04/doctor-pa... / https://archive.is/ZBRMx > Polyakova and her collaborators find doctor pay consumes only 8.6 percent of overall health spending. It grew a bit faster than inflation over the time period studied, but much slower than overall health-care costs. > “People have a narrative that physician e…

Exactly. Even if you forced doctor compensation down to the level of other countries, that's, what, a 6% overall reduction, at best? Wow, so now when you get a surprise bill for $5000, it'll instead be $4700 instead! Hooray! We did it, Reddit/HN!

Does anyone think American healthcare was thereby fixed? I don't!

Now, FWIW, I'm happy to accept that US doctors are overpaid, and that there are feasible ways to make progress on that front. It's an important conversation to have. But it has virtually nothing to do with what makes US healthcare so brutal and kafkaesque.

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

#249

Post by whatwhaaaaat »

NickC25 wrote: post #161
whatwhaaaaat wrote: post #81

Earlier quoted context omitted.

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.

Well we will get to find out. Interesting red5 gets the ban after 30 years - days before RFK is on the menu.

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

#250

Post by mindslight »

wat10000 wrote: post #242
mindslight wrote: post #103

Earlier quoted context omitted.

In many ways, the problem is that we do treat health care different . What other industry will actively reject attempts to ask about prices? What other industry just sends out bills with no contractual basis and exaggerated fraudulent amounts made up after the fact? What other industry do you need to buy "insurance" to even be able to financially communicate with service providers? What other industry does the govern…

The problem is that it is different. What other industry sells a product that you might need in order to survive or to not be disabled which requires the dedicated efforts of multiple professionals with a decade of post-secondary education? What other industry sells a product that you might suddenly need at a moment’s notice that is the only way you’ll survive the day, that requires sophisticated equipment, dedicated…

> Few will answer “yes.” And everything else flows from the "no."

Everything else has flowed from the "no", but I do not think it needs to have. Imagine the government being a definitive payer of last resort, instead of this unfunded mandate where hospitals have to provide emergency service for free but then receive a bunch of regulatory capture to make up for it.

That still leaves an avenue for hospitals to defraud the government about how much providing that care cost, and emergency care has that dynamic intrinsically regardless of who is paying. But that's still leaps ahead of basing the entire industry on a foundation of billing fraud shakedowns. And it would be a lot harder for emergency departments to claim exaggerated fraudulent costs when the rest of the hospital is charging much less.

The vast majority of care is not life saving emergency treatment, and this is where the brokenness of the current system gets really galling. For example I just had a specialist declare that the proper course of treatment is to follow up in 12 months. I nudged them that 12 months seemed like an awful long time, but they held fast. I would happily pay for another check in 6 months if the system would let me. But instead, the concept of patient agency has been completely scrapped in favor of top down "necessary" and "not necessary".

Post reply on HN