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The system was created at their behest specifically not to reduce their profitability. If you didn’t follow the debate 15 years ago, the ACA was the compromise

by acdha 2y ago

The system was created at their behest specifically not to reduce their profitability. If you didn’t follow the debate 15 years ago, the ACA was the compromise adopted after the healthcare industry plowed money into advertisements, lobbying, and astroturf to kill the idea of a public option. The concept traces back to the Heritage Foundation’s proposal offered after the healthcare industry killed the Clinton healthcare plan in 1993, but the Republicans immediately switched to opposing that as soon as it had any chance of passing because literal billions were on the line as soon as insurers couldn’t drop the most expensive customers from their pools.

avalys 2y ago
What role did the CEO who was killed play in that debate 15 years ago? Why are you still shifting blame from the politicians who created this system? They didn’t have to listen to the healthcare industry. They are accountable to the public. They got voted into office and they put this system in place. Of course the healthcare CEOs are going to argue in their own interest - but they don’t call the shots here! The politicians do.
- acdha 2y ago
  A better question would be why you’re trying so hard to exonerate some of the richest and most powerful people in the country. Trying to blame nebulous politicians without thinking about how they got elected or what they were asked to do legislatively, or how much public opinion is shaped by mass communications and the status quo, feels like a joke about a physicist trying to say another field shouldn’t exist because their “assume a perfectly spherical cow” thought exercise wasn’t too complicated.
  - avalys 2y ago
    The guy who was killed, with annual compensation of $10M, is one of the richest and most powerful people in the country? There are FAANG ICs making more than that.
    - astrange 2y ago
      The shooter is from one of the richest families in Maryland and is richer than the guy he shot. His cousin is a state congressman.
    - bigtex88 2y ago
      There may be a few IC's who make that amount but they do not wield nearly the same amount of power as the CEO of one of the largest healthcare companies in the country.
    - acdha 2y ago
      Do those FAANG ICs set policy for the largest healthcare company in the world? I don’t know why you’re so committed to trying to dismiss the idea that the policies his company sets have produced many angry customers but it’s not unreasonable for people to think that a CEO has some control over policy in a way that those ICs at adtech companies do not.
  - Wowfunhappy 2y ago
    I'm not the GP and in fact I don't agree with the GP, but I really don't think anyone should have to explain why they are defending someone who they think is innocent, regardless of how much money that person does or does not have.
    - acdha 2y ago
      This isn’t a criminal case. They’re trying to say this is just like any other unhappy customer, ignoring the life-altering outcomes healthcare problems have unlike most other industries or how much more Americans pay for lower-quality, high-stress service. Trying to understand why so many people were conflicted about a murder without understanding that context is like trying to explain what’s going on in Gaza while refusing to consider the role religion played.
- Epa095 2y ago
  If you are willing to shift the blame from the CEOs, why stop by shifting it one level? Why not shift it all the way to the top, to the voters who voted in the politicians? The health insurance industry is a modern example of the banality of evil, and there is enough blame to go around.
  - phkahler 2y ago
    Hey, why not blame the shareholders. If you own a mutual fund that may be you! ... or me. The irony of people funcking themselves over via this route is kinda funny.
astrange 2y ago
The ACA caps health insurers' profits. When you say "the healthcare industry", you're confusing insurers and providers, who are not allied. Doctors (the AMA) killed the public option because it would save money by lowering their salaries. American healthcare is expensive because of providers. (Another example is that we banned opening new hospitals unless nearby competing hospitals approve of it. This is called "certificate of need".)
- acdha 2y ago
  It’s wrong to state this as a binary. This isn’t mutually exclusive and all of the parties profiting from the status quo had a common interest in preventing reforms - those don’t overlap perfectly so the groups fissured on different lines but they lobbied independently and as part of joint groups like this one: https://en.wikipedia.org/wiki/Partnership_for_America%27s_Health_Care_Future https://en.wikipedia.org/wiki/Partnership_for_America%27s_He... There are significant generational issues, too. For example, older doctors who owned highly profitable private practices took a very different position from younger doctors who are employees of huge companies, and the pharmaceutical lobby wasn’t opposed to the ACA as long as it didn’t involve cutting their profit margin to what Medicare or the VA pay.
- llamaimperative 2y ago
  > The ACA caps health insurers' profits. When you say "the healthcare industry", you're confusing insurers and providers, who are not allied. I see you didn't look up the relationship between UnitedHealthcare (the single largest insurer in the country) and Optum (the single largest healthcare provider in the country), did you? Hint: They're both owned by UnitedHealth Group.
  - astrange 2y ago
    I'm aware, they run the prescription side of my employer health plan. But if they denied care for me, that would actually be my employer doing it. Most employers self-insure and set how much they want to pay. The insurance company is more like a fall guy for them. I of course have a nice tech employer plan, but they won't do early refills on medication which means I have to pay cash (well, GoodRX) for that anytime I travel for more than a week. Not a life changing expense but an annoying one. (Maybe my fault for choosing the HSA/HDHP plan?) Also, I was talking about hospitals and don't believe Optum controls those. Here the plan that runs everything including hospitals would be Kaiser, and as far as I know people are happier with them, but I haven't tried it. Haven't tried ACA marketplace plans either.

by acdha 2y ago

avalys 2y ago

What role did the CEO who was killed play in that debate 15 years ago? Why are you still shifting blame from the politicians who created this system? They didn’t have to listen to the healthcare industry. They are accountable to the public. They got voted into office and they put this system in place. Of course the healthcare CEOs are going to argue in their own interest - but they don’t call the shots here! The politicians do.

acdha 2y ago
A better question would be why you’re trying so hard to exonerate some of the richest and most powerful people in the country. Trying to blame nebulous politicians without thinking about how they got elected or what they were asked to do legislatively, or how much public opinion is shaped by mass communications and the status quo, feels like a joke about a physicist trying to say another field shouldn’t exist because their “assume a perfectly spherical cow” thought exercise wasn’t too complicated.
- avalys 2y ago
  The guy who was killed, with annual compensation of $10M, is one of the richest and most powerful people in the country? There are FAANG ICs making more than that.
  - astrange 2y ago
    The shooter is from one of the richest families in Maryland and is richer than the guy he shot. His cousin is a state congressman.
  - bigtex88 2y ago
    There may be a few IC's who make that amount but they do not wield nearly the same amount of power as the CEO of one of the largest healthcare companies in the country.
  - acdha 2y ago
    Do those FAANG ICs set policy for the largest healthcare company in the world? I don’t know why you’re so committed to trying to dismiss the idea that the policies his company sets have produced many angry customers but it’s not unreasonable for people to think that a CEO has some control over policy in a way that those ICs at adtech companies do not.
- Wowfunhappy 2y ago
  I'm not the GP and in fact I don't agree with the GP, but I really don't think anyone should have to explain why they are defending someone who they think is innocent, regardless of how much money that person does or does not have.
  - acdha 2y ago
    This isn’t a criminal case. They’re trying to say this is just like any other unhappy customer, ignoring the life-altering outcomes healthcare problems have unlike most other industries or how much more Americans pay for lower-quality, high-stress service. Trying to understand why so many people were conflicted about a murder without understanding that context is like trying to explain what’s going on in Gaza while refusing to consider the role religion played.
Epa095 2y ago
If you are willing to shift the blame from the CEOs, why stop by shifting it one level? Why not shift it all the way to the top, to the voters who voted in the politicians? The health insurance industry is a modern example of the banality of evil, and there is enough blame to go around.
- phkahler 2y ago
  Hey, why not blame the shareholders. If you own a mutual fund that may be you! ... or me. The irony of people funcking themselves over via this route is kinda funny.

astrange 2y ago

The ACA caps health insurers' profits. When you say "the healthcare industry", you're confusing insurers and providers, who are not allied. Doctors (the AMA) killed the public option because it would save money by lowering their salaries. American healthcare is expensive because of providers. (Another example is that we banned opening new hospitals unless nearby competing hospitals approve of it. This is called "certificate of need".)

acdha 2y ago
It’s wrong to state this as a binary. This isn’t mutually exclusive and all of the parties profiting from the status quo had a common interest in preventing reforms - those don’t overlap perfectly so the groups fissured on different lines but they lobbied independently and as part of joint groups like this one: https://en.wikipedia.org/wiki/Partnership_for_America%27s_Health_Care_Future https://en.wikipedia.org/wiki/Partnership_for_America%27s_He... There are significant generational issues, too. For example, older doctors who owned highly profitable private practices took a very different position from younger doctors who are employees of huge companies, and the pharmaceutical lobby wasn’t opposed to the ACA as long as it didn’t involve cutting their profit margin to what Medicare or the VA pay.
llamaimperative 2y ago
> The ACA caps health insurers' profits. When you say "the healthcare industry", you're confusing insurers and providers, who are not allied. I see you didn't look up the relationship between UnitedHealthcare (the single largest insurer in the country) and Optum (the single largest healthcare provider in the country), did you? Hint: They're both owned by UnitedHealth Group.
- astrange 2y ago
  I'm aware, they run the prescription side of my employer health plan. But if they denied care for me, that would actually be my employer doing it. Most employers self-insure and set how much they want to pay. The insurance company is more like a fall guy for them. I of course have a nice tech employer plan, but they won't do early refills on medication which means I have to pay cash (well, GoodRX) for that anytime I travel for more than a week. Not a life changing expense but an annoying one. (Maybe my fault for choosing the HSA/HDHP plan?) Also, I was talking about hospitals and don't believe Optum controls those. Here the plan that runs everything including hospitals would be Kaiser, and as far as I know people are happier with them, but I haven't tried it. Haven't tried ACA marketplace plans either.