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Insurance companies refusing valid, evidence-based treatments != denying unproven demands. Likewise, framing healthcare as either for-profit or purely charitabl
by jonathanlb 2y ago
Insurance companies refusing valid, evidence-based treatments != denying unproven demands. Likewise, framing healthcare as either for-profit or purely charitable ignores successful state-driven models worldwide that operate without prioritizing shareholder returns. Such false dichotomies and misdirection don’t justify profit-driven rationing of essential medical services.
> Everyone is going to die eventually
So why provide healthcare at all?
- nradov 2y agoMedicine is still more art than science. We only have clear evidence-based treatment guidelines for a limited set of conditions, and even with those there are a lot of exceptions. While health insurers do occasionally make egregious errors in denying claims or prior authorization requests, most of those fall into gray areas. Like if a patient is immobilized by severe hip pain should they go straight to joint replacement surgery or try physical therapy for a few months first? Ask 10 different physicians and you'll get 10 different treatment plans. And health insurers don't increase shareholder returns by denying claims. Due to the minimum medical loss ratio it's rather the opposite. Most of the pressure to tighten coverage rules actually comes from large self-funded employers who use those insurers not to provide insurance but rather to administer their health plans. https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio https://www.cms.gov/marketplace/private-health-insurance/med...