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UHC has a profit margin of 6%. If the company was PERFECTLY run, you're still going to have tons of people getting denied claims. That's what happens with the

UHC has a profit margin of 6%. If the company was PERFECTLY run, you're still going to have tons of people getting denied claims. That's what happens with the law of big numbers. And guess what. You're never going to have a perfectly run company. If you take the CEOs salary and distribute it to healthcare patients, $50M worth of healthcare is not going to even minutely move the needle. UHC revenue is $100B PER QUARTER. The CEO's pay is not even a rounding error on a rounding error. Was the CEO a perfect, honorable guy? No. Is taking his salary and spending it on patients going to do anything? In the large picture, also, no.

avn2109 2y ago
FWIW, 6% is clearly "Hollywood accounting," just look at the stock chart. No business with six percent margins has stock performance like UNH.
- onlyrealcuzzo 2y ago
  Have you seen Carvana's stock?
- brodouevencode 2y ago
  It just means that their costs have correlated with revenues, which is to be expected in certain industries. The better comparison would be with other insurance carriers.
- gruez 2y ago
  "Hollywood accounting" only works because you're transferring the profits of one enterprise (ie. the movie itself) to something else (ie. the production/distribution company). Unitedhealth Group is a publicly traded company. Where are they funneling the profits to?
  - ceejayoz 2y ago
    Subsidiaries and affiliates. For example: https://www.ftc.gov/news-events/news/press-releases/2024/09/ftc-sues-prescription-drug-middlemen-artificially-inflating-insulin-drug-prices https://www.ftc.gov/news-events/news/press-releases/2024/09/... > The FTC’s administrative complaint alleges that CVS Health’s Caremark, Cigna’s ESI, and United Health Group’s Optum, and their respective GPOs—Zinc Health Services, Ascent Health Services, and Emisar Pharma Services—have abused their economic power by rigging pharmaceutical supply chain competition in their favor, forcing patients to pay more for life-saving medication. According to the complaint, these PBMs, known as the Big Three, together administer about 80% of all prescriptions in the United States.
    - gruez 2y ago
      Wouldn't that still end up on the parent company's financial statements? What are PBMs' margins compared to insurance companies?
ceejayoz 2y ago
> If you take the CEOs salary and distribute it to healthcare patients, $50M worth of healthcare is not going to even minutely move the needle. They make $15-20B profit annually. They aren't just funding a single well-paid role off denials.
Teever 2y ago
What if this entire sector just didn't exist and the money paid out to health insurance secretaries and janitors who clean their offices and the people in the accounting department who handle their salaries just went into paying for actual healthcare instead? Like isn't the entire sector just inefficient bloat? What value does it provide that can't be provided much more efficiently?
- onlyrealcuzzo 2y ago
  > What if this entire sector just didn't exist and the money paid out to health insurance secretaries and janitors who clean their offices and the people in the accounting department who handle their salaries just went into paying for actual healthcare instead? Then healthcare fraud would be 80% of GDP.
  - Teever 2y ago
    Is healthcare fraud 80% of the Canadian GDP?
    - onlyrealcuzzo 2y ago
      No. You're still paying the same people the same wages to work for the government. Or is your solution that we should pay health insurance workers less money? You originally proposed eliminating all the jobs. Now you've moved all the jobs to the public sector. So unless you're paying them dirt, all that money is still going to people working to make sure healthcare fraud isn't 80% of GDP. In a perfect world, you have 6% more money to spend on healthcare instead of corporate profits. That's not going to change the picture that much. And you're unlikely to arrive in a perfect world. You'll probably get a 10% more expensive system that's 9% more inefficient and has 0 profits.
      - Teever 2y ago
        Are you sure about this? I've proposed eliminating those jobs because they're bullshit jobs that have a net negative contribution to society because the American medical system is hopelessly inefficient and corrupt.[0] It is a curious thing watching people defend the undefendable. What makes you so confident in this system that so many Americans loathe and feel betrayed by? [0] https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_healthcare_spending.jpg https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_heal...
lenerdenator 2y ago
> If you take the CEOs salary and distribute it to healthcare patients, $50M worth of healthcare is not going to even minutely move the needle. I have a hard time buying this. Really? You can't cover a few more cents of a few more claims if you reduce c-suite pay? I don't pay my premium to just see it go directly to the c-suite and some retirement fund's coffers. I pay it to cover healthcare costs and to keep from being financially ruined by a chance illness or injury. If the CEO is making a half-million a year and his company is coming to me telling me that there just isn't any money to cover my back injury surgery, they're negotiating in far better faith than if they're paying him ~5x the median lifetime earnings of the American male each year, every year. Good faith matters.
- onlyrealcuzzo 2y ago
  > I have a hard time buying this. Really? You can't cover a few more cents of a few more claims if you reduce c-suite pay? A single Tylenol in a hospital costs $15. If you think a few cents is going to do anything, you are completely bamboozled. A few cents is nothing in healthcare.
  - lenerdenator 2y ago
    I work in healthcare technology. I'm well aware of what things cost. Maybe instead of paying for the c-suite's bonuses, they need to be paying someone to air the dirty laundry of the health system that's charging $15 for an acetaminophen. When someone's f*cking both you and your customer like that, you go after them. But it's not about that, is it? It's about transferring value to shareholders, not reducing the costs of care. Hell, doing actual work to reduce the cost of care is expensive, and we can't possibly expect the retirement funds and major shareholders of America to pay for that.
    - onlyrealcuzzo 2y ago
      > When someone's f*cking both you and your customer like that, you go after them. But it's not about that, is it? It's about transferring value to shareholders, not reducing the costs of care. It's almost as if it's not an easy problem to solve, or some other health insurance company would do it and put all the other ones out of business.
itchyouch 2y ago
What's the best way to solve the engineering issue of high load on any given system? Reduce or eliminate the load. Of course insurance will reduce their load with tactics such as deny, deny. But systemically, there's a better, good-faith way. IMHO, without getting into all the nitty gritty details, the good-faith way to improve a ton of healthcare is to extend the efforts of fortification in common foods, expand people's consumption of healthier foods (more plants that provider fiber + minerals), improve people's abilities and motivation around healthier lifestyle choices (exercise, sleep), and significantly reduce or re-engineer illness-causing agents (plastics, VOCs) in our daily lives. The challenge is how to implement these things in a balanced and sustainable manner, while keeping most industries relatively happy. Of course this would take a decade or more, but the knowledge is out there from some very competent healthspan PHds/MDs and a variety of scientists. In my personal opinion, if all we did was increase consumption of sulfur, protein (especially collagenic sources), we would improve a tremendous amount of health outcomes drastically. Asian countries are a great example where the food actually has sulfur and collagenic sources built into their culture. Koreans consume cabbage 3x/day (cruciferous veggies with sulfur) and traditionally consume a bone-broth (collagenic) type of soup with 1-3 meals on the daily. I could outline the science here, but a huge amount of chronic illness, such as the shooter's mother may have seen some relief with some of my aforementioned efforts. The way we can take for granted iodine deficiency because they added it to salt, we really need to do that for others. Omega 3s within milk these days is also a good path forward.

avn2109 2y ago

FWIW, 6% is clearly "Hollywood accounting," just look at the stock chart. No business with six percent margins has stock performance like UNH.

onlyrealcuzzo 2y ago
Have you seen Carvana's stock?
brodouevencode 2y ago
It just means that their costs have correlated with revenues, which is to be expected in certain industries. The better comparison would be with other insurance carriers.
gruez 2y ago
"Hollywood accounting" only works because you're transferring the profits of one enterprise (ie. the movie itself) to something else (ie. the production/distribution company). Unitedhealth Group is a publicly traded company. Where are they funneling the profits to?
- ceejayoz 2y ago
  Subsidiaries and affiliates. For example: https://www.ftc.gov/news-events/news/press-releases/2024/09/ftc-sues-prescription-drug-middlemen-artificially-inflating-insulin-drug-prices https://www.ftc.gov/news-events/news/press-releases/2024/09/... > The FTC’s administrative complaint alleges that CVS Health’s Caremark, Cigna’s ESI, and United Health Group’s Optum, and their respective GPOs—Zinc Health Services, Ascent Health Services, and Emisar Pharma Services—have abused their economic power by rigging pharmaceutical supply chain competition in their favor, forcing patients to pay more for life-saving medication. According to the complaint, these PBMs, known as the Big Three, together administer about 80% of all prescriptions in the United States.
  - gruez 2y ago
    Wouldn't that still end up on the parent company's financial statements? What are PBMs' margins compared to insurance companies?

ceejayoz 2y ago

> If you take the CEOs salary and distribute it to healthcare patients, $50M worth of healthcare is not going to even minutely move the needle. They make $15-20B profit annually. They aren't just funding a single well-paid role off denials.

Teever 2y ago

What if this entire sector just didn't exist and the money paid out to health insurance secretaries and janitors who clean their offices and the people in the accounting department who handle their salaries just went into paying for actual healthcare instead? Like isn't the entire sector just inefficient bloat? What value does it provide that can't be provided much more efficiently?

onlyrealcuzzo 2y ago
> What if this entire sector just didn't exist and the money paid out to health insurance secretaries and janitors who clean their offices and the people in the accounting department who handle their salaries just went into paying for actual healthcare instead? Then healthcare fraud would be 80% of GDP.
- Teever 2y ago
  Is healthcare fraud 80% of the Canadian GDP?
  - onlyrealcuzzo 2y ago
    No. You're still paying the same people the same wages to work for the government. Or is your solution that we should pay health insurance workers less money? You originally proposed eliminating all the jobs. Now you've moved all the jobs to the public sector. So unless you're paying them dirt, all that money is still going to people working to make sure healthcare fraud isn't 80% of GDP. In a perfect world, you have 6% more money to spend on healthcare instead of corporate profits. That's not going to change the picture that much. And you're unlikely to arrive in a perfect world. You'll probably get a 10% more expensive system that's 9% more inefficient and has 0 profits.
    - Teever 2y ago
      Are you sure about this? I've proposed eliminating those jobs because they're bullshit jobs that have a net negative contribution to society because the American medical system is hopelessly inefficient and corrupt.[0] It is a curious thing watching people defend the undefendable. What makes you so confident in this system that so many Americans loathe and feel betrayed by? [0] https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_healthcare_spending.jpg https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_heal...

lenerdenator 2y ago

> If you take the CEOs salary and distribute it to healthcare patients, $50M worth of healthcare is not going to even minutely move the needle. I have a hard time buying this. Really? You can't cover a few more cents of a few more claims if you reduce c-suite pay? I don't pay my premium to just see it go directly to the c-suite and some retirement fund's coffers. I pay it to cover healthcare costs and to keep from being financially ruined by a chance illness or injury. If the CEO is making a half-million a year and his company is coming to me telling me that there just isn't any money to cover my back injury surgery, they're negotiating in far better faith than if they're paying him ~5x the median lifetime earnings of the American male each year, every year. Good faith matters.

onlyrealcuzzo 2y ago
> I have a hard time buying this. Really? You can't cover a few more cents of a few more claims if you reduce c-suite pay? A single Tylenol in a hospital costs $15. If you think a few cents is going to do anything, you are completely bamboozled. A few cents is nothing in healthcare.
- lenerdenator 2y ago
  I work in healthcare technology. I'm well aware of what things cost. Maybe instead of paying for the c-suite's bonuses, they need to be paying someone to air the dirty laundry of the health system that's charging $15 for an acetaminophen. When someone's f*cking both you and your customer like that, you go after them. But it's not about that, is it? It's about transferring value to shareholders, not reducing the costs of care. Hell, doing actual work to reduce the cost of care is expensive, and we can't possibly expect the retirement funds and major shareholders of America to pay for that.
  - onlyrealcuzzo 2y ago
    > When someone's f*cking both you and your customer like that, you go after them. But it's not about that, is it? It's about transferring value to shareholders, not reducing the costs of care. It's almost as if it's not an easy problem to solve, or some other health insurance company would do it and put all the other ones out of business.

itchyouch 2y ago

What's the best way to solve the engineering issue of high load on any given system? Reduce or eliminate the load. Of course insurance will reduce their load with tactics such as deny, deny. But systemically, there's a better, good-faith way. IMHO, without getting into all the nitty gritty details, the good-faith way to improve a ton of healthcare is to extend the efforts of fortification in common foods, expand people's consumption of healthier foods (more plants that provider fiber + minerals), improve people's abilities and motivation around healthier lifestyle choices (exercise, sleep), and significantly reduce or re-engineer illness-causing agents (plastics, VOCs) in our daily lives. The challenge is how to implement these things in a balanced and sustainable manner, while keeping most industries relatively happy. Of course this would take a decade or more, but the knowledge is out there from some very competent healthspan PHds/MDs and a variety of scientists. In my personal opinion, if all we did was increase consumption of sulfur, protein (especially collagenic sources), we would improve a tremendous amount of health outcomes drastically. Asian countries are a great example where the food actually has sulfur and collagenic sources built into their culture. Koreans consume cabbage 3x/day (cruciferous veggies with sulfur) and traditionally consume a bone-broth (collagenic) type of soup with 1-3 meals on the daily. I could outline the science here, but a huge amount of chronic illness, such as the shooter's mother may have seen some relief with some of my aforementioned efforts. The way we can take for granted iodine deficiency because they added it to salt, we really need to do that for others. Omega 3s within milk these days is also a good path forward.