5 ms·
As someone who worked for CareFirst, I had a privilege to accidentally overhear the panel of doctors who work for C.F. deciding if C.F. will cover procedure for
by newprint 9y ago
As someone who worked for CareFirst, I had a privilege to accidentally overhear the panel of doctors who work for C.F. deciding if C.F. will cover procedure for the patient....fuck those guys. Next to the building, there was a helicopter landing platform for CEO.
US insurance system anti-humane.
- vkou 9y agoWhen Obamacare was being drafted, house Republicans were busy condemning the 'death panels' of single-payer systems.
- jstewartmobile 9y agoDo you expect them to fly commercial, like animals?
- prostoalex 9y agoHow much of that egregiousness has been fixed by ACA’s cap on insurance company’s profits, in your opinion?
- ggg9990 9y agoWouldn't a profit cap encourage profligate spending on things like corporate helicopters?
- te_chris 9y agoOnly if that's deductible.
- jacobush 9y agoI assume you mean in a sarcastic way. If not: Of course it is. That’s what our man in congress is for.
- ceejayoz 9y agoNo. The ACA's profit cap (the "80/20 rule") requires that at least 80% of premiums taken in must be spent on actual medical care costs.
- rbehrends 9y agoThe ACA requires the somewhat perversely called Medical Loss Ratio (MLR) to be at least 80% (and 85% for large group plans). The MLR is the percentage of revenues from insurance premiums that are being used on actual healthcare benefits (and thus can't go towards profits, hence the name). Corporate helicopters don't increase the MLR and reduce profits.
- Zak 9y agoThis is a perverse incentive. If I'm running an insurance company and my goal is to maximize absolute profit, how do I do that when my profit margin is capped by law in this manner? Well, I certainly don't have an incentive to reduce healthcare costs; quite the opposite. 20% of a larger cost leaves me with more profit, and most of my customers won't drop my service. It's required by law and subsidized in a lot of cases.
- rbehrends 9y agoThis is why there are marketplaces where you have to compete against other insurers. And companies in particular will evaluate their group plans critically.
- tomohawk 9y agoFunny. The biggest input for the law was from large companies like the insurance companies, large hospital systems, and other cronies. And it shows.
- pas 9y agoHow does it show?
- Eridrus 9y agoThe cap on profits encourages higher spending on medical procedures, since the more you spend the more you can make, so it works to keep prices high.