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Torrent of Hate for Health Insurance Industry Follows CEO's Killing

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Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#251

Post by s1artibartfast »

vundercind wrote: post #240
s1artibartfast wrote: post #226

Earlier quoted context omitted.

There are laws enacted by our elected government (Democrats under Obama) that say exactly how much overhead is acceptable for a health insurance company, and all business expenses and CEO pay comes out of that portion. If they collect too much in premiums to and their profits exceed that percent, they have to refund the insurance members. Health insurance has a fixed profit margin on claims paid. Denying claims costs…

There’s some nuance to this. The ACA’s loss ratio rules don’t apply to self-funded plans (many large employers use these) even if they’re administered (and possibly re-insured) by a health insurance company, which is usually the case. Just doesn’t apply at all. Certain plans also allow much lower loss ratios, like 60/40 for expat plans. A provider that manages to have a lot of new plans in a given state in a given ye…

Most of that makes sense to me. there is a self funded plan, my understanding is that the employer is collecting (and usually subsidizing) the premiums.

At the end of the day, my experience is that my UHC healthcare is about 10% more than healthcare from non-profit Kaiser, and Kaiser is far more stingy with services.

I think there is a hell of a lot wrong with healthcare in the US, but I don't think that constitutes murder just because the stakes are life an death.

Ethics depend not just on the outcome, but the processes that leads to that outcome.

The incentives in healthcare are terrible, but it is the government which has structured the system and those incentives.

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#252

Post by antisthenes »

tptacek wrote: post #215
rrrrrrrrrrrryan wrote: post #214

Earlier quoted context omitted.

Most Americans support a public option, which is the transition step toward a healthcare system that more closely aligns with other first world nations.

Only in the abstract. When you work out a concrete proposal that involves people paying for programs, support evaporates.

People are already paying for the healthcare one way or another, whether they understand it or not.

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#253

Post by tptacek »

antisthenes wrote: post #252
tptacek wrote: post #215

Earlier quoted context omitted.

Only in the abstract. When you work out a concrete proposal that involves people paying for programs, support evaporates.

People are already paying for the healthcare one way or another, whether they understand it or not.

Oh, you can get a lot of stuff done if you just assume you know better than voters do and make the decisions for them.

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#254

Post by s1artibartfast »

kerkeslager wrote: post #250
s1artibartfast wrote: post #66

Earlier quoted context omitted.

No, I disagree. We have a system of laws and courts to decide what is criminal. People should not kill law abiding citizens they disagree with because everyone has a different opinion.

> People should not kill law abiding citizens they disagree with because everyone has a different opinion. That's not what happened. Brian Thompson isn't a "law abiding citizen I disagree with" he's a law abiding citizen who killed people. If you or your loved one died because of his actions, would you "have a disagreement with him"? Is that what you'd call that?

There is a massive difference between not helping and killing someone. If you attribute the deaths from healthcare denials to him, did he also save every life that wasnt denied?

How many millions of people did he save?

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#255

Post by vineyardmike »

mlrtime wrote: post #221
vineyardmike wrote: post #10

Earlier quoted context omitted.

I think this comment betrays the reality of Americans interaction with healthcare insurance. It’s not about regulatory awareness, but angst over the system - People die because of the decisions made by insurance companies. If you read or hear the things people are saying, they’re expressing frustration over the way they’re treated by insurance providers and their policies. The costs across the industry are insane, an…

>People die because of the decisions made by insurance companies. And if we had single pay, wouldn't people still die but now there is someone else to blame? Meaning there is still a budget for care, it is not infinite. There will still be a group to decide what to accept and what not.

Well sure, theoretically budgets are limited. But (1) the entire "profit" of insurance companies, and other middle-men, today becomes extra cash in the budget. Which if OP is to be believed, would be upwards of a 25% increase - just from insurance companies. (2) A single-payer would have more negotiation power to actually drive down costs, because if the single-payer doesn't buy your goods, there is no market for you to sell to. (3) There is no expectation of out-of-pocket expenses, so no one was to worry about a massive bill after losing a family member.

Also, a key difference with single-payer healthcare is (generally) the distribution and accountability of program. We'd dispense with "preexisting conditions" and "in/out of network" and provide this service to everyone. Every single person would be eligible, it'd truly be for the citizenry. Because of this, coverage becomes a legislative practice, and if coverage or care is not meeting expectations, it can be changed.

(also, UnitedHealth profit margin was consistently > 20% pre-2024)

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#256

Post by rich_sasha »

WorldWideWebb wrote: post #88
cs702 wrote: post #71

Health "insurance" companies in the US are not actually, primarily insurers. For the most part, they are not in the business of insuring rare events. Maybe they were primarily in the insurance business at some point in the past, but today they are mainly in the business of entrenching themselves in the middle of all interactions between patients, doctors, and hospitals, and extracting rents from all of them. Health "…

Accurate. They are literally middle men taking a cut without offering anything to the process. Switch to single payer, dump the middlemen, and have our taxes pay for essential services (keeping us alive and healthy). Seems simple enough but…

I suppose, careful what you wish for. The NHS (UK's single payer health provider), allegedly the envy of whole wide world, is failing under the burden of insufficient funding, aging society and years of mismanagement by politicians. We're talking, properly dysfunctional, like ambulances taking hours to be dispatched to life-threatening emergencies or people dying on emergency wards due to neglect.

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#257

Post by vineyardmike »

mgh95 wrote: post #51
vundercind wrote: post #12

Earlier quoted context omitted.

I spent quite a bit of time trying to figure out what drives such high costs in US healthcare, some years back. My conclusion is everything does. This conveniently makes it easy to dismiss criticism of any one part (all of which are responsible) because “well they’re just increasing it a little—go look at these other things, they’re bad too, and if you add up all of that, they’re worse!” Right, but if you keep not ad…

Realistically, the big cost differential in absolute terms in healthcare are borne in the elder group (65+). See this: https://pmc.ncbi.nlm.nih.gov/articles/PMC7411536/ . This is exactly where the "government social safety net" takes effect (medicare and medicaid) and, in my opinion, the real spending bazooka of US subsidies take effect. I say this as someone who wound up owning one business in this area (health insu…

You can't genuinely believe that the reason that the 65+yo group costs more is the social safety net?

As you get older, you start to experience more adverse health affects. You start to need medical attention more. Especially if you've been denied healthcare for the first 65 years.

> I really think people underestimate just how generous (high cost) the "social safety net" is, and have a grass-is-greener view towards other countries healthcare systems for people currently working.

Well I think you misrepresent that greener grass is greener. Other countries literally live longer and healthier when they have socialized healthcare. It's a pretty easy metric to track, and pretty straightforward. Do you want the general population to live longer? Do you want the general population to be healthier? Do you want the general population to be saddled with crippling medical debt? Sometimes the grass is greener. And we have the data to prove it.

In the link you shared, other social-safety-net countries had lower spend per capita. They have a better social safety net. So how can that be the issue?

At least you're honest that you own a health-insurance business and you're biased. A single-payer system would destroy your income, and I guess that's pretty scary, so it's in your best interest to fear-monger.

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#258

Post by justinclift »

s1artibartfast wrote: post #249
justinclift wrote: post #235

Earlier quoted context omitted.

> Because they arent murdering or killing people to make money. Ahhh. I guess you're not aware of stuff like this? https://www.newsweek.com/hospitals-are-reporting-more-insura...

Denied claims mean less profit for the insurer. They only get to keep a percent of what they pay to hospitals. Do you have a response to that? One of the primary jobs of insurance companies is to vet claims. If we didnt want that, you could just make a shared bank account and let doctors and hospitals bill anything they want to it. You might save 10% on overhead, but it would collapse instantly.

> Denied claims mean less profit for the insurer.

If that were true then United Healthcare wouldn't have rolled out an automated system that (reportedly) denies ~90% of people regardless of their actual need.

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#259

Post by justinclift »

s1artibartfast wrote: post #169
justinclift wrote: post #158

Earlier quoted context omitted.

> mob rule lead to mass murder which left everyone worse off. From your point of view was the "everyone left worse off" a short term thing, or did it eventually come good for most, or something else?

I think the french revolution left everyone worse off than if it didnt happen, The first republic didnt address any one the underlying economic issues. The failure of populist mob governance lead to first empire, and the Napoleonic wars which killed several percent of Europe's population (~6million) in France's attempt to loot its way back to economic prosperity.

Sounds like a reasonable way to look at it.

How far along the path do you reckon the US is to the same kind of thing?

Re: Torrent of Hate for Health Insurance Industry Follows CEO's Killing

#260

Post by mgh95 »

vineyardmike wrote: post #257
mgh95 wrote: post #51

Earlier quoted context omitted.

Realistically, the big cost differential in absolute terms in healthcare are borne in the elder group (65+). See this: https://pmc.ncbi.nlm.nih.gov/articles/PMC7411536/ . This is exactly where the "government social safety net" takes effect (medicare and medicaid) and, in my opinion, the real spending bazooka of US subsidies take effect. I say this as someone who wound up owning one business in this area (health insu…

You can't genuinely believe that the reason that the 65+yo group costs more is the social safety net? As you get older, you start to experience more adverse health affects. You start to need medical attention more. Especially if you've been denied healthcare for the first 65 years. > I really think people underestimate just how generous (high cost) the "social safety net" is, and have a grass-is-greener view towards…

> As you get older, you start to experience more adverse health affects. You start to need medical attention more. Especially if you've been denied healthcare for the first 65 years.

Sort of: as you get older, time catches up to you. In the USA for, heart disease kills 1015/100k for both genders (see: https://usafacts.org/articles/what-are-the-top-causes-of-dea... in Germany, it is just 673/100k for just men alone. We have an obesity problem, not a healthcare problem, when it comes to life expectancy.

> Well I think you misrepresent that greener grass is greener. Other countries literally live longer and healthier when they have socialized healthcare. It's a pretty easy metric to track, and pretty straightforward. Do you want the general population to live longer? Do you want the general population to be healthier? Do you want the general population to be saddled with crippling medical debt? Sometimes the grass is greener. And we have the data to prove it.

The question here is QALYS. We quite literally avoid this discussion in the US at all (see this: https://pubmed.ncbi.nlm.nih.gov/19738253/). The issue isn't that we disagree about the issues: it's that the issues are not addressed and Americans pretty much always say "spend more".

Europe has already begun rationing, by the way (see this: https://pmc.ncbi.nlm.nih.gov/articles/PMC1831659/#:~:text=Be....) It's not as though it doesn't already occur; we simply choose to blame insurance companies instead of a national system.

> In the link you shared, other social-safety-net countries had lower spend per capita. They have a better social safety net. So how can that be the issue?

Healthier populations. Americans make awful health choices.

> At least you're honest that you own a health-insurance business and you're biased. A single-payer system would destroy your income, and I guess that's pretty scary, so it's in your best interest to fear-monger.

Not really. Margin shifts along value chains; it's rarely destroyed. All that would happen is the profits would shift to another location. Then the game becomes how to get there.

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