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Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

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

#271

Post by Randgalt »

lutorm wrote: post #256
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.

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

How can you logically have a right to the services of someone else? Health care is a product - doctors, hospitals, medicine, etc. These must all be produced by people.

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

#272

Post by Frondo »

harryh wrote: post #251
Broken_Hippo wrote: post #248

Earlier quoted context omitted.

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.

About being rejected from buying my own health insurance, based on a surgery I'd had, I think that the question of whether it's "smart" or "dumb" for insurers to do so is irrelevant.

Especially in a modern society, that decision-making process is no more relevant than asking whether it's OK to dump toxic waste into the river, because the fines could be cheaper than processing such waste safely.

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

#273

Post by harryh »

Frondo wrote: post #272
harryh wrote: post #251

Earlier quoted context omitted.

See #2 here: https://news.ycombinator.com/item?id=12308243 I'm actually quite curious about this.

About being rejected from buying my own health insurance, based on a surgery I'd had, I think that the question of whether it's "smart" or "dumb" for insurers to do so is irrelevant. Especially in a modern society, that decision-making process is no more relevant than asking whether it's OK to dump toxic waste into the river, because the fines could be cheaper than processing such waste safely.

Private companies refusing to sell insurance to someone where they will lose money on the transaction is not at all like dumping toxic waste into a river.

If insurance companies can't make money (or at least break even) for a certain population then they are't a viable means of making sure care is payed for, and we need to develop alternate policies to make things work.

So it's actually very very relevant to understand the decision-making process of insurance companies in these situations.

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

#274

Post by philjohn »

harryh wrote: post #156
nfriedly wrote: post #4

Good riddance. Heath insurance in the US seems to benefit the insurance companies more than anyone else.

That's silly. Insurance is a great method of hedging risk. If my apartment burns down it would cost me A LOT of money to replace my stuff. But the chances of it burning down are really small. So I can purchase renters insurance for just a couple hundred bucks a year, an expense I can easily afford. That benefits me a great deal! Maybe when you said insurance you meant to say "health insurance" but the same principle…

Except a building isn't almost certain to burn down during its lifespan. Humans, metaphorically, burn down at a much higher rate. Cancer, heart disease, systemic infection ...

"Spreading the risk" doesn't work when the likelihood of something bad happening approaches a percentage in the high double digits, especially with an ageing population and falling birth rates to keep paying into the ponzi scheme.

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

#275

Post by harryh »

philjohn wrote: post #274
harryh wrote: post #156

Earlier quoted context omitted.

That's silly. Insurance is a great method of hedging risk. If my apartment burns down it would cost me A LOT of money to replace my stuff. But the chances of it burning down are really small. So I can purchase renters insurance for just a couple hundred bucks a year, an expense I can easily afford. That benefits me a great deal! Maybe when you said insurance you meant to say "health insurance" but the same principle…

Except a building isn't almost certain to burn down during its lifespan. Humans, metaphorically, burn down at a much higher rate. Cancer, heart disease, systemic infection ... "Spreading the risk" doesn't work when the likelihood of something bad happening approaches a percentage in the high double digits, especially with an ageing population and falling birth rates to keep paying into the ponzi scheme.

Sure, we're all gonna die. But the amount of money we spend on medical expenses between now and then varies by at least an order of magnitude between different people.

If there weren't risk differences then we wouldn't need insurance at all.

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

#276

Post by AnimalMuppet »

harryh wrote: post #273
Frondo wrote: post #272

Earlier quoted context omitted.

About being rejected from buying my own health insurance, based on a surgery I'd had, I think that the question of whether it's "smart" or "dumb" for insurers to do so is irrelevant. Especially in a modern society, that decision-making process is no more relevant than asking whether it's OK to dump toxic waste into the river, because the fines could be cheaper than processing such waste safely.

Private companies refusing to sell insurance to someone where they will lose money on the transaction is not at all like dumping toxic waste into a river. If insurance companies can't make money (or at least break even) for a certain population then they are't a viable means of making sure care is payed for, and we need to develop alternate policies to make things work. So it's actually very very relevant to understa…

True, but Frondo also has a point. If insurance companies can cherry-pick individuals and refuse to sell to specific individuals where the insurance company is more likely to lose money, that's... not good. It kind of defeats the point of insurance, in fact.

If Obamacare-as-a-block is business they don't want, they shouldn't have to take it. If it's a subset of individuals, I'm less sympathetic.

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

#277

Post by tn13 »

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?

Competition is very important. Government provides free education. Is there a case for private educational institutes ? Surely yes there is. Catholic schools, schools focused on gifted children, schools focused on differently-able children etc. that diversity is important in all spheres of life.

Also, please note that when you use words like "government provided insurance" the word insurance can mean something totally different under government just the way we have learned that government's definitions of "traitor", "whistleblower", "sex offender" are different from what common sense might tell us.

If only government provides insurance government also ends up deciding what health services we can use or not use. For example Liberals might say "sex change surgery" is essential procedure and force tax-payers pay for it. Conservatives on other hand might say any health issues occurring because of anal sex will not be covered.

I think one big problem is that American's who support single payer system fail to see that "healthcare" is a lose term and under the "single payer" that definition might change to suite the payer instead of consumers.

I really like this news item : https://www.youtube.com/watch?v=K0e3-EvpDwM

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

#278

Post by harryh »

AnimalMuppet wrote: post #276
harryh wrote: post #273

Earlier quoted context omitted.

Private companies refusing to sell insurance to someone where they will lose money on the transaction is not at all like dumping toxic waste into a river. If insurance companies can't make money (or at least break even) for a certain population then they are't a viable means of making sure care is payed for, and we need to develop alternate policies to make things work. So it's actually very very relevant to understa…

True, but Frondo also has a point. If insurance companies can cherry-pick individuals and refuse to sell to specific individuals where the insurance company is more likely to lose money, that's... not good. It kind of defeats the point of insurance, in fact. If Obamacare-as-a-block is business they don't want, they shouldn't have to take it. If it's a subset of individuals, I'm less sympathetic.

Indeed. Obamacare-as-a-block was specifically designed to try to eliminate this cherry picking of individuals. But it's turning out that the solution might not be adequate because insurance companies are choosing to just abandon the whole block. That's what I meant with my "closely related" comment above.

And if the Obamacare exchanges don't work, that's no good either!

As I said elsewhere, the economics of health care are very challenging.

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

#279

Post by lettergram »

snsr wrote: post #31
lettergram wrote: post #19

Earlier quoted context omitted.

The main issue with healthcare in the u.s. actually has to do with Medicare, Medicaid, and social security. All of the state options pay only ~10% of what they are billed no matter how large the bill (there is also usually a cap). This forces hospitals to charge exorbitant prices. Private insurance options pay larger percentages: 12 - 50%. People without insurance usually will pay either 100% or 0%, with some people…

> Honestly, the easiest way to fix it is to get rid of Medicare, Medicaid, and social security or force everyone to pay 100% as opposed to negotiating lower rates. Bullshit. This isn't an easy problem, and you're casually dismissing systems that support millions of people.

Supports millions of people in what way? I "casually" wrote off millions a dollars a day in the billing office for people who didn't have insurance. I "casually" wrote off 90% of people's bills who were state funded.

The only people we actually were forced to try and collect on were private companies and people making over $X per year.

I have no idea how much experience you have with this stuff, but the unfairness comes from the fact doctors/hospitals can effectively charge outrageous prices, knowing they will only make a percentage. On the state payments, they lose money and on the private insurance companies, wealthy and naive honest people they will make more. They have to charge that much to make up for the difference caused by the state options, and people who never pay.

Just like any system with a (semi)guaranteed payment (college tuition, healthcare, government contracts, minimum wage, etc.) Prices will inflate capturing the free market rate + the guaranteed amount. If you want to fix that, you have to force deflation by forcing everyone to pay equally. You can do that by removing the guaranteed payment and create competition.

Seriously, this is econ 101...

Also, antibiotics, insulin, and many of the other standard drugs doctors prescribe could essentially be free for everyone for half the cost of Medicare. Insurance companies only pay like 10% on the dollar for that stuff. So I would much rather "support" everyone by providing the basics, and having the rest be a free market. It would solve probably 80% of the issues with the current healthcare system.

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

#280

Post by im_down_w_otp »

SteveLAnderson wrote: post #269
im_down_w_otp wrote: post #120

Earlier quoted context omitted.

It wasn't Republicans that removed the "Public Option" or the Drug re-importation initiatives from the ACA. FWIW.

Well ... you're strictly right, but just like the idiotic provision that forced Congress to give up their employer sponsored insurance and use the exchange instead was forced by the GOP, so to were these provisions dropped due to GOP pressure. You see, the GOP continually promised, on one hand, to tie the ACA up in legislative hurdles so it couldn't pass, or, on the other hand, vote for it if it met their requirement…

Um, no. Those provisions were the Democrats negotiating with themselves. At the time the Democrats had the votes to force the issue regardless of the Republican opposition.

It was people like Ben Nelson, Joe Lieberman, and Max Baucus that played a rotating merry-go-round of scapegoats that the Democratic Party used to trump up reasons why they couldn't support more progressive reforms in the healthcare legislation.

Also, it wasn't Republicans that put a WellPoint Executive Lobbyist (Elizabeth Fowler) in charge of writing large portions of the actual legislation and acting as the liaison between the White House and the Senate.

In the end we got a big pageant and self-aggrandizing back-patting session from the Democrats who called it the greatest Democratic legislative accomplishment since the Civil Rights Act... which is ironic considering that the ACA is almost the spitting image of Republican Bob Dole's Heritage Foundation sourced (and AHIP sponsored) reform plan from just a few election cycles prior.

So... the greatest Democratic policy achievement in at least a generation was to pass a Republican policy proposal. Well played Democrats. Well played.

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