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

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

#251

Post by harryh » Wed, Aug 17, 2016, 9:11 PM UTC

Broken_Hippo wrote: post #248

harryh wrote: post #166

Earlier quoted context omitted.

(My own story: I had my gallbladder out in 2004, and from that time on was denied personal health insurance for BS "pre-existing condition" reasons...until Obamacare.) Probably you were denied personal health insurance not for BS reasons, but because the insurance companies knew they would (probabilistically) lose money insuring you. But now under Obamacare, if they participate on the exchanges, they are obligated to…

Well, not really. I had my gall bladder out about '08. I couldn't eat properly before it got out. It wasn't emergency, but the pain put me in the emergency room more than once. I didn't have gallstones, it quit working. It has been years since I got it out. I still have a few problems eating greasy foods (especially meat), but now generally avoid those and am mostly vegetarian. No other complications, and I have not…

See #2 here: https://news.ycombinator.com/item?id=12308243

I'm actually quite curious about this.

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

#252

Post by ruste » Wed, Aug 17, 2016, 9:13 PM UTC

maxerickson wrote: post #232

ruste wrote: post #169

Earlier quoted context omitted.

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…

(successful) Suit against Medicare: https://www.cms.gov/medicare/medicare-fee-for-service-paymen...

That case was against Medicare contractors. Not Medicare.

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

#253

Post by maxerickson » Wed, Aug 17, 2016, 9:15 PM UTC

ruste wrote: post #252

maxerickson wrote: post #232

Earlier quoted context omitted.

(successful) Suit against Medicare: https://www.cms.gov/medicare/medicare-fee-for-service-paymen...

That case was against Medicare contractors. Not Medicare.

Jimmo v. Sebelius

The named defendant was the Secretary of Health and Human Services. The suit was over practices followed by Medicare contractors, but it's not like they were operating outside the knowledge of Medicare, they were acting as Medicare had directed them to act. The settlement agreement has Medicare changing the procedures the contractors will follow.

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

#254

Post by ashark » Wed, Aug 17, 2016, 9:15 PM UTC

Randgalt wrote: post #221

Randgalt wrote: post #191

Earlier quoted context omitted.

"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.

> Japan after the war.

arches eyebrow

Is that not the poster child for extensive government intervention in markets and public/private partnership done right?

https://en.wikipedia.org/wiki/Japanese_economic_miracle

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

#255

Post by lutorm » Wed, Aug 17, 2016, 9:16 PM UTC

Randgalt wrote: post #82

loteck wrote: post #75

Earlier quoted context omitted.

For example, in Canada (until recently) Until recently. This means that all people can obtain health care regardless of their ability to pay, and that the system is flexible enough to continue to experiment with the ideal implementation. Are public schools better than private schools? Public schools are exactly 100% better than private schools for students who can't afford to attend private schools. Is the US postal…

1. Try getting an MRI in Canada. Canada rations care via wait lists. 2. Your argument implies that there wouldn't be low cost schools in the absence of public schools. The evidence is overwhelming that the opposite is true. 3. I live in Panama. When I need something mailed here I use FedEx or DHL. The USPS is unreliable and takes far too long. If there weren't laws against private first class mail in the US they'd be…

I live in Hawaii. When I need something mailed to or from here, I use USPS. FedEx or UPS are an order of magnitude more expensive and, in my experience, not faster or more reliable.

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

#256

Post by lutorm » Wed, Aug 17, 2016, 9:20 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.

A fair number of people would consider the right to health care a fundamental human right.

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

#257

Post by Broken_Hippo » Wed, Aug 17, 2016, 9:22 PM UTC

Mister_Snuggles wrote: post #24

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

It's hard to tell if there are inefficiencies and waste or if health care is just simply really expensive. Health care is done by the Provinces in Canada, with transfers from the Federal Government to help out. The most recent Alberta budget[0] puts the cost of health care at about $20B. This represents approximately 40% of Alberta government spending. Is that due to waste or inefficiencies? I honestly have no idea.…

1. Health care is, indeed, really expensive. Most places with government-provided health care try to make sure the most expensive items aren't over-bought, reducing waste. For example, MRI machines. Some folks have to travel quite far to get a non-emergency MRI in Canada and wait some time, yet in the states, there might be 3-4 places in a city with 50k people. Neither extreme is ideal.

2. There are always going to be a few inefficiencies in health care, just like every other business. Some of these can't be helped as much. We want well-stocked emergency rooms and pharmacies to visit after the 2am visit said emergency rooms, for example. Drugs expire: Pharmacies take manpower even in slow times.

3. The other thing with health care is that it does somewhat cost what it costs. There are ways to reduce some of the costs by public education, generic drugs, not providing antibiotics when they aren't needed, and other such things. But folks get sick and hurt regardless.

Side note: The bit about the prescriptions is interesting. I'm in Norway. Private health care is available, but everyone is covered by the state health care. You pay a certain amount per year, then the government covers most things. Prescription coverage vary once the government starts paying. Things you need for life - such as heart medicines - will wind up covered, but some things like allergy meds you might have to pay a portion of the cost regardless. Most hospital expenses are free.

Dental is free for children under 18: 18 and 19 year olds get 75% covered and adults have to pay out of pocket.

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

#258

Post by gnaritas » Wed, Aug 17, 2016, 9:23 PM UTC

warfighting wrote: post #77

How long would a government run tech company survive in the valley? Now tell me again why you want them centrally planning your healthcare?

Government isn't a company, isn't competing with them, and shouldn't be measured in the way companies are measured; that you're even making this comparison speaks to the fact that you don't understand the purpose of government.

Why do I want centrally planning in my healthcare, because it can accomplish something companies can't: full coverage for all citizens rich and poor alike. No market solution can or will ever provide that, government CAN.

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

#259

Post by gnaritas » Wed, Aug 17, 2016, 9:29 PM UTC

Randgalt wrote: post #152

gnaritas wrote: post #127

Earlier quoted context omitted.

Wrong, it's exactly the world I want to live in and the Constitution happens to agree, which is why we've amended it many a time, because the governed decided it was outdated. The notion that we should still be living by the dictates of men long dead is simply absurd, every generation has a right to decide for itself how its government works as it should, and as we have done.

So, if the majority votes to take away the rights of, oh I don't know, Japanese citizens -- that's a world you want to live in? You're not thinking clearly about the issue.

No, you're not thinking clearly; the constitution requires a super majority, and yes, if a super majority of people want to be governed a particular way, then they deserve that right, even if it's stupid; but you'd never get a super majority to agree to such a stupid bigoted rule and it conflicts with other parts of the constitution and would be ruled unconstitutional by the courts. Without the notion that the rules can and do change for each generation, we'd still have slaves, thankfully, we don't live under a set of rules that can never be changed.

The will of the majority, and especially the super majority, is far better a thing to live under than the will of a handful of people from 238 years ago and any suggestion to the contrary is the definition of not thinking clearly.

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

#260

Post by mhurron » Wed, Aug 17, 2016, 9:32 PM UTC

jasonlotito wrote: post #109

mhurron wrote: post #84

Earlier quoted context omitted.

You must be pretty healthy or never actually had to pay for care in the US. You also probably shouldn't assume you're the only one in the room who moved to the US from another country. I moved to the US from Canada, thankfully I am pretty healthy and don't need the healthcare system beyond my yearly checkups. The first place I lived had someone who lived down the street who will be paying off a $100k bill until they…

> You must be pretty healthy or never actually had to pay for care in the US. Wrong. You probably shouldn't assume you know anything about me, or the situation I'm in. > You also probably shouldn't assume you're the only one in the room who moved to the US from another country. You probably shouldn't assume that it matters. > The first place I lived had someone who lived I was referring to problems with the system as…

> I was referring to problems with the system as a whole for entire groups of people, not just individual stories.

This person is not an isolated incident. Major medical care in the US is far more expensive than any other nation on the planet and for a large number of people in the US life saving care means financial ruin.

> My children being one of those where the Canadian system fails them horribly.

You can't be serious. Need your child to see their primary care physician in the US because it has a fever? That appointment is probably a week or more out, in Canada, they will see that child that day. And that visit will not cost money.

Simply posting as an American on HN I can make a good guess you are paid far better than the majority of the nation. Do you not know people that are not? When a child gets sick, it is a question on whether or not to call the doctor or go to urgent care because that visit costs money. If it's not the visit that is too expensive, its a question of if whatever treatment can be afforded.

The US system is entirely around how well you can afford to be. There are no benefits to the US healthcare system unless you are rich, a doctor or an insurance company.