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Every healthcare system (even single-payer) denies some care to some people; they do this because of limited resources, fraud risk, etc. Do government healthca

by nickff 2y ago

Every healthcare system (even single-payer) denies some care to some people; they do this because of limited resources, fraud risk, etc. Do government healthcare ministers and other administrators responsible for single-payer systems deserve to die too? What about legislators who limit healthcare budgets to below 100% of GDP (which is to say all of them); should they be summarily executed?

cogman10 2y ago
> Do government healthcare ministers and other administrators responsible for single-payer systems deserve to die too? No, because as you point out there are legitimate reasons to deny coverage. However, when your competitors are denying at a rate of something like 10->15% and you are denying at 36%, that goes beyond just managing resources or fraud prevention. Your question is a false dichotomy. > What about legislators who limit healthcare budgets to below 100% of GDP (which is to say all of them); should they be summarily executed? Again, false dichotomy. Primarily because it's not even provable that 100% of GDP going to healthcare would actually save more lives than 99% or 50%. Further, unless you have a very expansive definition of what healthcare means (food? housing? etc?) then putting 100% of the budget towards it would ultimately starve out necessary industries for life thus causing death. The real question to ask is "Can an insurance company be moral if it denies legitimate claims" my answer to that is no. Pragmatically, I can excuse some of it to human error as that'll happen. People will die from accidents and that's just a part of life. However, let's not pretend that there isn't a massive incentive for these large companies to deny as many claims as possible with no market forces and few regulations to impede them. A government denying a liver transplant to a 90 year old is quiet different from a health insurance agency blanket denying cancer treatment because it costs them too much money.
- nickff 2y ago
  How can you simultaneously contend that United’s denials of coverage are responsible for killing people, and also contend that increasing healthcare spending wouldn’t save people?
  - cogman10 2y ago
    You are using binary thinking. It's not a binary. I can contend that United's denials are responsible for killing people because they are denying at 2x the industry average. To prove me wrong, you'd have to show that actually the rest of the industry isn't denying enough and that United has somehow stumbled upon the real rate of spurious insurance claims. And for the 100% of money to healthcare that makes the assumption that we have that much healthcare need to spend that much money on. There are limits to needs which is why the argument you make is flawed.
    - nickff 2y ago
      Why is the burden of proof on me? You’re the one justifying a murder! Also, I wouldn’t have to prove than increasing healthcare spending to 100% of GDP would be optimal, just proving that there is some incremental gain by spending a tiny bit more than is currently spent by a single-payer would justify the murder of one or more legislators (by your logic).
      - cogman10 2y ago
        > You’re the one justifying a murder! I'm not, nor have I ever. And with that I think this conversation is done. If you won't engage with any point I've made and instead are just here to insult me there's no point in continuing further.
      - antasvara 2y ago
        By my cursory Google search, the successful appeal rate for claims denials is somewhere between 30 and 60 percent. With the caveat that this isn't a representative sample (people appealing likely have the denials most likely to be overturned), 30% at the low end still feels too high. This rate is even higher for prior authorization denials. Those get overturned on appeal more than half the time. Probably safe to assume that if your denial rate is 2x competitors, those numbers would be even worse.

by nickff 2y ago

cogman10 2y ago

> Do government healthcare ministers and other administrators responsible for single-payer systems deserve to die too? No, because as you point out there are legitimate reasons to deny coverage. However, when your competitors are denying at a rate of something like 10->15% and you are denying at 36%, that goes beyond just managing resources or fraud prevention. Your question is a false dichotomy. > What about legislators who limit healthcare budgets to below 100% of GDP (which is to say all of them); should they be summarily executed? Again, false dichotomy. Primarily because it's not even provable that 100% of GDP going to healthcare would actually save more lives than 99% or 50%. Further, unless you have a very expansive definition of what healthcare means (food? housing? etc?) then putting 100% of the budget towards it would ultimately starve out necessary industries for life thus causing death. The real question to ask is "Can an insurance company be moral if it denies legitimate claims" my answer to that is no. Pragmatically, I can excuse some of it to human error as that'll happen. People will die from accidents and that's just a part of life. However, let's not pretend that there isn't a massive incentive for these large companies to deny as many claims as possible with no market forces and few regulations to impede them. A government denying a liver transplant to a 90 year old is quiet different from a health insurance agency blanket denying cancer treatment because it costs them too much money.

nickff 2y ago
How can you simultaneously contend that United’s denials of coverage are responsible for killing people, and also contend that increasing healthcare spending wouldn’t save people?
- cogman10 2y ago
  You are using binary thinking. It's not a binary. I can contend that United's denials are responsible for killing people because they are denying at 2x the industry average. To prove me wrong, you'd have to show that actually the rest of the industry isn't denying enough and that United has somehow stumbled upon the real rate of spurious insurance claims. And for the 100% of money to healthcare that makes the assumption that we have that much healthcare need to spend that much money on. There are limits to needs which is why the argument you make is flawed.
  - nickff 2y ago
    Why is the burden of proof on me? You’re the one justifying a murder! Also, I wouldn’t have to prove than increasing healthcare spending to 100% of GDP would be optimal, just proving that there is some incremental gain by spending a tiny bit more than is currently spent by a single-payer would justify the murder of one or more legislators (by your logic).
    - cogman10 2y ago
      > You’re the one justifying a murder! I'm not, nor have I ever. And with that I think this conversation is done. If you won't engage with any point I've made and instead are just here to insult me there's no point in continuing further.
    - antasvara 2y ago
      By my cursory Google search, the successful appeal rate for claims denials is somewhere between 30 and 60 percent. With the caveat that this isn't a representative sample (people appealing likely have the denials most likely to be overturned), 30% at the low end still feels too high. This rate is even higher for prior authorization denials. Those get overturned on appeal more than half the time. Probably safe to assume that if your denial rate is 2x competitors, those numbers would be even worse.