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

Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

huffingtonpost.com

Post reply on HN
Print view View original

331–340 of 353 posts

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

#331

Post by ruste »

maxerickson wrote: post #253
ruste wrote: post #252

Earlier quoted context omitted.

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.

Except the very first paragraph states that the reason for the suit was that the contractors were not appropriately following Medicare guidelines.

"...in which the plaintiffs alleged that Medicare contractors were inappropriately applying an “Improvement Standard” in making claims determinations for Medicare coverage involving skilled care..."

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

#332

Post by 20yrs_no_equity »

philjohn wrote: post #268
20yrs_no_equity wrote: post #241

Earlier quoted context omitted.

> you end up controlling costs by compelling the providers This is the basic premise of socialism. But it never works out. What you end up getting is either very low quality at high prices or very low availability. Obamacare attempts to do exactly that, and as a result the providers are simply leaving the "market". Meanwhile, price has skyrocketed, and quality of coverage has dropped dramatically. My marketplace plan…

Except that's not the case in other single payer systems ... The NHS has its flaws (having to wait for non-urgent or non life-threatening issues to be treated, but they are in fact treated, just at a lower priority) but if you present at the hospital with chest pains you'll be sorted out straight away, without having to pay up front - free at the source of treatment, one of the founding tenets of the service. It also…

> We pay less of our GDP on healthcare, yet have comparable, if not better, outcomes.

That's a very commonly held perception. However it's not the case.

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

#333

Post by dagw »

ruste wrote: post #250
st3v3r wrote: post #227

Earlier quoted context omitted.

"Except you can sue your insurance provider if they deny you coverage for something that they're obligated to cover. " With what money? And furthermore, what good will that do if you die before the trial is over?

You can have the procedure done then sue them when they won't pay for what they're contractually obligated to. You don't generally get a hospital bill until the procedure is done.

Will a hospital even perform the procedure if the insurance company has said no and they know the patient will never be able to pay for it?

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

#334

Post by splintercell »

VonGuard wrote: post #114
Randgalt wrote: post #97

Earlier quoted context omitted.

That's an excellent point. Medicare and SSI are equally bad programs that should be phased out.

I often wonder if John Galt ever found himself living alone in a room with no one to take care of him in his old age.

> I often wonder if John Galt ever found himself living alone in a room with no one to take care of him in his old age.

I hope you understand that to Objectivists that sounds like saying "I often wonder if Frederick Douglass ever found himself suffer an accident at work with no master to take care of him because he isn't a slave".

I am sure there are better arguments possible against objectivist position, but the one you made is rather naive one.

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

#335

Post by maxerickson »

ruste wrote: post #331
maxerickson wrote: post #253

Earlier quoted context omitted.

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.

Except the very first paragraph states that the reason for the suit was that the contractors were not appropriately following Medicare guidelines. "...in which the plaintiffs alleged that Medicare contractors were inappropriately applying an “Improvement Standard” in making claims determinations for Medicare coverage involving skilled care..."

I read that as mealy-mouthed cover for future questions about Medicare expanding coverage unilaterally, but I would agree that is pretty subjective.

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

#336

Post by danielweber »

vidarh wrote: post #178
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…

Yes you can. In the UK people sue the government, or specially the NHS, over treatment decisions all the time. Including over things like denied coverage of specific drugs etc. (usually when there's no proven benefit from a given drug). And as I pointed out: If you think they are too strict, then you can pay for a private insurer to cover things the NHS doesn't cover or won't do fast enough for you.

In Hillary Clinton's proposed health care plan in 1993, no, you weren't allowed to sue. You could get an appeal from a Board, but that's it. The proposed legislation explicitly said there could be no other review.

Note that this is a very good cost containment strategy. Note also that this can probably not reduce patient outcomes at all. Note also that it is extremely unpopular.

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

#337

Post by danielweber »

VonGuard wrote: post #112
danielweber wrote: post #98

Earlier quoted context omitted.

The situation is not helped when proponents of single-payer say things like "there will be no denial of claims." I think there are things to support about single-payer, but it really, truly, I swear to fucking God, has trade-offs, and since it has been sold as not having any honest trade-offs, we can't actually implement the hard parts of single-player. http://www.vox.com/2016/1/17/10784528/bernie-sanders-single-...

Yes, there are trade-offs. In my opinion, they are worth the switch, and amount to a difference between "choosing which hand to reattach and letting the other go dead," and "No lap-band for you fatty." The latter being the single payer option. Anyway, in almost all world single payer systems, rich people can still pay for vanity doctors.

> and amount to a difference between "choosing which hand to reattach and letting the other go dead," and "No lap-band for you fatty."

No, it tends to be a lot of care that isn't worth the cost that gets denied. This is very different from what an American expects, which is that everything they "need" (or what their doctor says they should do) ought to be covered.

The lap-band often passes, because it can be a relatively low-cost way to add a bunch of QALYs to a patient's life.

NB: I think having care decided on a cost-basis is a pretty good approach, at least to start from, but it is immensely unpopular in the US. On both sides of the aisle.

> Anyway, in almost all world single payer systems, rich people can still pay for vanity doctors.

Often. Not always. In Canada only recently could a doctor offer the same services the government offered, and that was against the will of the legislature. Their supreme court had to rule on it. https://en.wikipedia.org/wiki/Chaoulli_v_Quebec_(AG)

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

#338

Post by danielweber »

twblalock wrote: post #245
danielweber wrote: post #20

Earlier quoted context omitted.

Anyone who thinks this is leading to single-payer is dreaming. Whether you think it's a good idea or not, the political will wasn't there for in 6 years ago, and there is much less political will for it now.

The most likely outcome is a public option in the exchanges. I don't expect that many private insurers will continue to participate in the exchanges if they have to compete with a public option, so the public option will end up being a de-facto single-payer system for poor people who have to use the exchanges.

The public option isn't supposed to be government supported. It's run by the government, but with a private budget, taking all their operating fees from users. A lot of people on the right are skeptical that it will become either de jure or de facto government supported, and comments like "I don't expect that many private insurers will continue to participate in the exchanges if they have to compete with a public option" are the reason.

I'm skeptical of that the public option will work as well as its proponents say it will. We already have non-profit health insurance companies, and they haven't completely eaten everyone else's lunch. But it's worth a shot, as long as it really truly sticks to that mandate of not being government supported. The argument would need to be really convincing given how many of its backers think it ought to be government supported any way.

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

#339

Post by danielweber »

Apocryphon wrote: post #43
danielweber wrote: post #20

Earlier quoted context omitted.

Anyone who thinks this is leading to single-payer is dreaming. Whether you think it's a good idea or not, the political will wasn't there for in 6 years ago, and there is much less political will for it now.

Then at least Aetna will twist in the wind for their avarice.

Walking away has to be a fundamental right.

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

#340

Post by danielweber »

ende wrote: post #163
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.

I wonder how many people would trade individual mandate for public option.

You can't get rid of the individual mandate without completely destroying the whole law.

It's the unpopular part of the law. But pretty much anything that works is going to have some unpopular component that needs to be swallowed in order for the whole thing to work.

When Republicans talk about getting rid of the individual mandate, it's because they are, in actuality, trying to kill the law. When Democrats talk about it, I really don't know what's going through their heads. Leftist wonks like Krugman or Klein keep on telling them exactly why it's needed.

Post reply on HN