4 ms·

What are the penalties for bad faith 'compliance' on something that kills people? Does the company risk being shut down? Do the company officers personally fa

by neilv 3y ago

What are the penalties for bad faith 'compliance' on something that kills people? Does the company risk being shut down? Do the company officers personally face criminal charges?

skhunted 3y ago
None, no, and no. The Clinton administration sought to overhaul the healthcare system and there was lots of testimony by employees of insurance companies whose job was to improperly deny claims. Americans have an irrational fear of socialism and if you can convince them that something is socialist they will be against it. What is interesting today is that Republicans campaigned for years on getting rid of Obamacare. When they finally got control of Congress and the Presidency they did not kill it. Eventually there will be another overhaul because these companies just can’t help but be shitty.
- lotsofpulp 3y ago
  Because the real role of managed care organizations (MCOs, health insurance companies) is to take the heat for government leaders for having a tiered healthcare system where individuals get access to healthcare based on their socioeconomic position. If you are a government leader and you offer healthcare to everyone, you are now clearly responsible for any failures. But with an MCO in the middle, fingers can be pointed all over the place. Different formularies and prior authorization rules can be set for different populations. For example, reimbursement can be lower for Medicaid patients (poorer/younger people), so they end up with less access to doctors, and higher for Medicare (older, likelier to vote), so more doctors are available there. Senators can get their own plan, and the military another, and the tech company employees yet another, and fast food employees, and so on and so forth. This system benefits all the leaders, so it is not going anywhere. In fact, I would bet UK and Canada move towards this.
  - skhunted 3y ago
    And yet many countries have successful universal healthcare.
    - lotsofpulp 3y ago
      I imagine those are dependent on population pyramids not turning upside down. But they seem to be at least flattening, if not turning upside down in all developed countries, hence my prediction of why there would be a change. I keep reading about NHS in the UK having issues holding it together.
      - silverquiet 3y ago
        There's a PA at my general practitioner's office who's got to be about 80; it seems like a lot of healthcare jobs can be done into old age. I think about going the PA route after my next layoff actually because it seems like a job that could be a better fit for me.
      - skhunted 3y ago
        The population pyramid is in better shape than many other countries with universal healthcare. Instead of imagining or searching for plausible sounding excuses study the issue a bit. A government run healthcare system can do much better than our current system and in a much more moral way.
      - halostatue 3y ago
        The NHS (and many other UK institutions) has been starved of cash for fifteen years by the Tories led by increasingly incompetent PMs (I mean, seriously, if the best PM in the last fifteen years is David Cameron; frankly, a head of lettuce would have done better than most of the Tory caucus).
      - gambiting 3y ago
        >>I keep reading about NHS in the UK having issues holding it together I'm in the UK and yep, the system is on the verge of collapse, but it feels like it's entirely by design so it can be finally privatised and killed off once and for all - it feels inevitable at this point. Basically right now it works for: - maternity - anything child related - emergency services(to an extent, unless you are literally dying you will still wait hours for an ambulance). Everything else is so massively underfunded it's a miracle it exists at all. A friend was referred to see a psychiatrist on the NHS recently - you know what the wait time is to see a psychiatrist on the NHS in our region? 210 weeks. About 4 years.
- ethagnawl 3y ago
  > What is interesting today is that Republicans campaigned for years on getting rid of Obamacare. What is perennially interesting is that Republicans (Baby Boomers specifically, in this case) claim to hate "socialized medicine" but every time cuts to Medicare are floated under the guise of "fiscal responsibility" or whatever they're DOA. It's a trite observation at this point they are truly the fuck-you-got-mine generation. Sadly, one of the only things that _has_ trickled down from their generation is the belief that "socialized medicine" is evil. A maddeningly large percentage of Gen-Xers, Millennials and beyond have fallen for this line of reasoning. The ironic part, in my direct experience, is that a lot of those folks are the ones getting health insurance from the federal/local governments through the military, emergency response positions, sanitation, etc. So, again, got-mine-fuck-yours. As a counterpoint, I know a number of people in Europe who have been able to take entrepreneurial risks that either aren't realistic or responsible for people in the U.S. who are tied to their jobs for the sake of healthcare, medical/maternity/paternity/etc. leave, etc. One of them recently had a major health crisis that would have devastated an upstart entrepreneur in the U.S. and was actually able to focus on recovering instead of hustling side gigs or taking out predatory loans to ensure he didn't lose his house or his ability to send his kids to daycare. It's been very enlightening to watch play out in real-time.
  - ryandrake 3y ago
    > What is perennially interesting is that Republicans (Baby Boomers specifically, in this case) claim to hate "socialized medicine" but every time cuts to Medicare are floated under the guise of "fiscal responsibility" or whatever they're DOA. Existing socialized medicine, that helps them, is OK. New socialized medicine, which might help other people, is not OK. The politics involved here are not complex.

by neilv 3y ago

What are the penalties for bad faith 'compliance' on something that kills people? Does the company risk being shut down? Do the company officers personally face criminal charges?

skhunted 3y ago

None, no, and no. The Clinton administration sought to overhaul the healthcare system and there was lots of testimony by employees of insurance companies whose job was to improperly deny claims. Americans have an irrational fear of socialism and if you can convince them that something is socialist they will be against it. What is interesting today is that Republicans campaigned for years on getting rid of Obamacare. When they finally got control of Congress and the Presidency they did not kill it. Eventually there will be another overhaul because these companies just can’t help but be shitty.

lotsofpulp 3y ago
Because the real role of managed care organizations (MCOs, health insurance companies) is to take the heat for government leaders for having a tiered healthcare system where individuals get access to healthcare based on their socioeconomic position. If you are a government leader and you offer healthcare to everyone, you are now clearly responsible for any failures. But with an MCO in the middle, fingers can be pointed all over the place. Different formularies and prior authorization rules can be set for different populations. For example, reimbursement can be lower for Medicaid patients (poorer/younger people), so they end up with less access to doctors, and higher for Medicare (older, likelier to vote), so more doctors are available there. Senators can get their own plan, and the military another, and the tech company employees yet another, and fast food employees, and so on and so forth. This system benefits all the leaders, so it is not going anywhere. In fact, I would bet UK and Canada move towards this.
- skhunted 3y ago
  And yet many countries have successful universal healthcare.
  - lotsofpulp 3y ago
    I imagine those are dependent on population pyramids not turning upside down. But they seem to be at least flattening, if not turning upside down in all developed countries, hence my prediction of why there would be a change. I keep reading about NHS in the UK having issues holding it together.
    - silverquiet 3y ago
      There's a PA at my general practitioner's office who's got to be about 80; it seems like a lot of healthcare jobs can be done into old age. I think about going the PA route after my next layoff actually because it seems like a job that could be a better fit for me.
    - skhunted 3y ago
      The population pyramid is in better shape than many other countries with universal healthcare. Instead of imagining or searching for plausible sounding excuses study the issue a bit. A government run healthcare system can do much better than our current system and in a much more moral way.
    - halostatue 3y ago
      The NHS (and many other UK institutions) has been starved of cash for fifteen years by the Tories led by increasingly incompetent PMs (I mean, seriously, if the best PM in the last fifteen years is David Cameron; frankly, a head of lettuce would have done better than most of the Tory caucus).
    - gambiting 3y ago
      >>I keep reading about NHS in the UK having issues holding it together I'm in the UK and yep, the system is on the verge of collapse, but it feels like it's entirely by design so it can be finally privatised and killed off once and for all - it feels inevitable at this point. Basically right now it works for: - maternity - anything child related - emergency services(to an extent, unless you are literally dying you will still wait hours for an ambulance). Everything else is so massively underfunded it's a miracle it exists at all. A friend was referred to see a psychiatrist on the NHS recently - you know what the wait time is to see a psychiatrist on the NHS in our region? 210 weeks. About 4 years.
ethagnawl 3y ago
> What is interesting today is that Republicans campaigned for years on getting rid of Obamacare. What is perennially interesting is that Republicans (Baby Boomers specifically, in this case) claim to hate "socialized medicine" but every time cuts to Medicare are floated under the guise of "fiscal responsibility" or whatever they're DOA. It's a trite observation at this point they are truly the fuck-you-got-mine generation. Sadly, one of the only things that _has_ trickled down from their generation is the belief that "socialized medicine" is evil. A maddeningly large percentage of Gen-Xers, Millennials and beyond have fallen for this line of reasoning. The ironic part, in my direct experience, is that a lot of those folks are the ones getting health insurance from the federal/local governments through the military, emergency response positions, sanitation, etc. So, again, got-mine-fuck-yours. As a counterpoint, I know a number of people in Europe who have been able to take entrepreneurial risks that either aren't realistic or responsible for people in the U.S. who are tied to their jobs for the sake of healthcare, medical/maternity/paternity/etc. leave, etc. One of them recently had a major health crisis that would have devastated an upstart entrepreneur in the U.S. and was actually able to focus on recovering instead of hustling side gigs or taking out predatory loans to ensure he didn't lose his house or his ability to send his kids to daycare. It's been very enlightening to watch play out in real-time.
- ryandrake 3y ago
  > What is perennially interesting is that Republicans (Baby Boomers specifically, in this case) claim to hate "socialized medicine" but every time cuts to Medicare are floated under the guise of "fiscal responsibility" or whatever they're DOA. Existing socialized medicine, that helps them, is OK. New socialized medicine, which might help other people, is not OK. The politics involved here are not complex.