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

fortune.com

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

#81

Post by whatwhaaaaat »

lenerdenator wrote: post #52
arrty88 wrote: post #14

Some day our regulators at the fda, ftc, doj, etc should clean house and get some folks who can actually go after these greedy companies. Today they don’t because of the revolving door system.

They're not going to for at least the next four years. "What is good for the shareholders is good for society" will be the order of the day.

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?

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

#82

Post by llamaimperative »

onlyrealcuzzo wrote: post #56
segfaltnh wrote: post #47

Earlier quoted context omitted.

Honest question as someone who prefers single payer but acknowledged it's not a silver bullet: how much of the costs are nurses and doctors vs. admin? It seems to me there's a lot of overhead in passing the bills around to get paid. I just had my appendix out last year and got billed 8 times by 8 different firms, each with payment portals, call centers, billing providers, etc. I assume there's a lot of inefficiency i…

~40-60% is direct healthcare - not including admin or insurance labor costs. Pharmaceuticals is ~9%. Health insurance profits are 1.2%. Other profits are x%. Medical equipment, devices, hospital rents, etc are y%. Most of the remainder is admin & insurance costs - only about ~2% of which is private health insurance operating costs (largely labor).

You're ignoring the fact that all of the large insurers are increasingly also the healthcare providers.

UnitedHealth Group is the owner of both United Healthcare (the largest insurer in the country) and Optum (the largest healthcare provider in the country).

Part of UHG's low profit margin is its liberal use of intra-company eliminations, where transactions between Optum and United Healthcare get zeroed out and don't count toward profit despite it ultimately generating more dollars in the parent company's coffers.

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

#83

Post by 1024core »

acchow wrote: post #19
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…

How do you respond to people that say the profit motive is what drives innovation, and in the long term we’d rather have better, novel treatments sooner

What "innovation" is UnitedHealth doing, pray tell me?

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

#84

Post by com2kid »

slibhb wrote: post #46
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…

Insurance isn't a good industry to "get insanely rich". It doesn't have high profit margins. For one thing, the ACA mandates that insurance companies can't keep profits past a certain point. My sense is that people expect too much from their health insurance. Subconsciously, we expect to experience no pain and live forever. When this inevitably doesn't happen, we blame insurance companies for not bankrolling infinite…

There is a max % take insurance companies can have.

The easy as hell solution to this is insurance companies collude with hospitals to charge patients more. 5% of 5000 is more than 5% of 2000.

In some cases insurance companies just buy up hospital chains and then bill themselves whatever the hell they want to.

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

#85

Post by tptacek »

craigmccaskill wrote: post #66
onlyrealcuzzo wrote: post #37

Earlier quoted context omitted.

I don't particularly care if health insurance is public or private. DIRECT health care labor costs (doctor's, nurses, etc) are ~40-60% of TOTAL healthcare spending. Smart people try to figure out ways to make our system better every day. If there was a silver bullet, we'd have already taken it. Health insurance profits are ~1.2% of total health care spending, the cost of running it is approximately ~4% more. It's alw…

Medicare administrative costs are around 2% of total program spending [1] compared to typically >10%. While what you're saying on the surface may be true from the numbers you are comparing, the fact of the matter is that healthcare costs are becoming more and more expensive during a time when many are experiencing a cost of living crisis. The US gets a bum deal on costs and outcomes and while we can argue on which sp…

I think this is a statistical artifact. Medicare preferentially selects the cohort of customers most likely to demand services from providers (that's the premise of the program). Fixed fees in, floating costs out. If you extended Medicare to 30 year olds, that 2% would, mechanically, soar; the same inputs from customers, but drastically lower service delivery.

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

#86

Post by wlesieutre »

segfaltnh wrote: post #41
brightball wrote: post #26

Earlier quoted context omitted.

Does anybody defend them? I’ve been on the selection side as an employer and several others will probably echo what I’m about to say. Virtually every insurance provider is going up 15-20% / year to the point that it’s completely unsustainable. United was quoted to me as almost 20% lower than current rate for our provider (before they are about to go up 20%). On premium alone they will save some people close to $500 /…

I feel people defend them by opposing any other approach to solving this. Politicians in particular say things like "preserving customer choice", which I think just means having the ability to select among all the terrible insurance companies who will treat you poorly.

And shouting about "death panels" in public healthcare systems, as if the private insurance companies don't have people whose whole job is denying as many claims as possible

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

#87

Post by xenophonf »

yalogin wrote: post #8

I don’t understand how an insurance company can overcharge consumers. Isn’t their job to pay what pharmacies and hospitals charge? Do insurance companies get money if they approve the overcharged prices? If so how? I thought their revenue was the premiums which are fixed. Is the extra money because people are forced to pay everything after the little the insurance company pays?

That's the magic of vertical integration!

https://youtu.be/5rw4kNHNZyk

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

#88

Post by nozzlegear »

jsheard wrote: post #21
acchow wrote: post #19

Earlier quoted context omitted.

How do you respond to people that say the profit motive is what drives innovation, and in the long term we’d rather have better, novel treatments sooner

Even if that's true for the actual pharmas, how are insurance companies like UHC innovating? They're just middlemen.

I'm not sure about UHC specifically, but insurance companies do innovate. Some insurers have invested pretty heavily in biotech and wearables, and they're also a big driver behind telehealth/remote health monitoring tech. We can cynically say that they're just in it because they want to reduce costs – and that's probably true – but it'd be simplistic to say investing to reduce costs is purely selfish.

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

#89

Post by onlyrealcuzzo »

dangus wrote: post #65
onlyrealcuzzo wrote: post #50

Earlier quoted context omitted.

You're describing the federal system being massively more efficient - which is theoretically possible - but rarely happens in practice.

It is already established fact that Medicare is more efficient than private insurance. https://www.healthaffairs.org/do/10.1377/forefront.20110920....

Assuming that your numbers are correct:

You eliminate ~1.2% of total healthcare spending on private insurance profits.

Then you eliminate ~37% of ~14% of ~27% total healthcare spending on insurance labor costs = ~1.5%.

* Article states medicare is ~37% more efficient.

* Insurance companies are required to spend AT LEAST 80% of premiums on actual patient care (~6% of the remaining ~20% are profits - already taken out in the previous ~1.2% of total health care spending).

* ~27% of total US healthcare spending is on private insurance premiums.

You end up with ~2.7% cheaper healthcare in the ABSOLUTE best case.

That's not moving the needle.

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

#90

Post by chinathrow »

throwway120385 wrote: post #10
BugsJustFindMe wrote: post #4

https://archive.ph/cg4we I do not like UnitedHealth, I do not like our existing crop of health insurance executives, and I might even be viscerally glad at some level that the UnitedHealth CEO was killed in a world where justice clearly takes a back seat to greed, but I wish the headline didn't say "overcharged", because there's no established amount of markup that is the correct amount of markup other than what peop…

All I'm going to say is that Optum Specialty Pharmacy is the sole source that UHC will accept for a lot of special drugs. For example UHC offers insurance for IVF including a separate cap for medications, but if you use their insurance you have to order through their subsidiary Optum Specialty Pharmacy and the prices triple or quadruple over MSRP if you buy from OSP using insurance versus if you pay cash. They also w…

> subsidiary Optum Specialty Pharmacy and the prices triple or quadruple over MSRP if you buy from OSP using insurance versus if you pay cash.

As an European, this is mind boggling.

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