4 ms·

Insurance companies aren't the main villain of the U.S. health system

16 points by throw0101b 2y ago

gnabgib 2y ago
Previous discussion (6 points, 6 days ago, 13 comments) https://news.ycombinator.com/item?id=42380377 https://news.ycombinator.com/item?id=42380377
FireBeyond 2y ago
This article completely seems to miss the point. If your profits are capped by regulation, how can you increase them? Increase costs. I don't know how you can write so many words about health insurance and not mention this even once, even concluding your post with "Why don't they have the same profit levels as the S&P?"
- throw0101b 2y ago
  > If your profits are capped by regulation, how can you increase them? Increase costs. Mentioned in the article: > [Matt Bruening] also alleges that some of this “inefficiency” is actually intentional on the part of the insurers — a disguised way to pay themselves out.
saltlyfe 2y ago
I'll break this down simply: - the Affordable Care Act subsidizes American health insurance with tax payer funds by covering much of the cost of insurance - Health insurance companies are required by law to spend 85% of that revenue on healthcare - Health insurance companies, logically, acquire providers. Thus, the 85% of their spending on healthcare is just funneled into the other companies that they own The system is currently the worst of both worlds. We have tax payer funds going straight to for-profit entities which have become vertically integrated throughout every aspect of the American healthcare system.
- pazimzadeh 2y ago
  Within the context of the current system it’s still better than being denied insurance due to pre-existing conditions. What the author ignores re: the shooting is that United Healthcare is particularly bad compared to other insurance companies. I’ve had multiple instances of them denying a first choice drug without explanation despite doctor’s write ups. Doctors are always on the edge and saying things like “if the insurance approves.” What is the point of going to medical school/residency/fellowship/etc if at the end of the day the insurance is making medical decisions? From the blog: > If insurers were so good at extracting money from the system, why are they so unprofitable? Maybe their unprofitability is driving them to find new ways to extract money? For healthcare I don’t understand the need for profit except for the researchers and companies who directly had a role in discovering and manufacturing the product (and funding trials). Why do we even need insurance companies if we actually trusted doctors to make the right decisions?
karmakaze 2y ago
> It's mostly the providers overcharging you, not the middlemen. What kind of post is this. Kettle, pot, whatever. The numbers are good to see, but don't make it paint it better by pointing elsewhere. I once did consulting work for a US student loan company. The best thing they could say was that they weren't as bad as the worst student loan company.
- AtlasBarfed 2y ago
  I call them the four pigs at the trough: -insurance companies -doctors and hospitals -drug and device and medical supplies companies -trial lawyers Each of these four pigs has any major component to the exorbitant cost in US healthcare. And just like this particular article, one of them would just point at one of the other three or all the other three to blame when questioned. Insurance companies have gigantic management structures, because insurance companies can't show high profits. So the sociopath MBAs flooded into their management structure to suck up the excess revenue as bonuses.
  - nozzlegear 2y ago
    I understand the other three, but can you explain trial lawyers? What's their role?
    - BizarroLand 2y ago
      I am not a lawyer, but my opinion is the people who hate on trial lawyers do so because they sue for astronomical amounts of money when the doctors fuck up and accidentally ruin peoples lives. People who hate on "trial lawyers" driving up the cost of medical services in America should shut their traps because Doctors are not saints. For instance, Dr. Paduch: https://nypost.com/2024/11/20/us-news/disgraced-nyc-urologist-darius-paduch-sentenced-to-life-in-prison-for-perverse-and-pervasive-sexual-abuse-of-male-patients-including-minors/ https://nypost.com/2024/11/20/us-news/disgraced-nyc-urologis... Do you think that the hospital who employed the Doctor who used his medical practice to enable him to molest young boys so horrifically that they gave him life in prison should not be at least somewhat responsible for the crimes he committed? Should they not provide oversight? I'm sure those victims are going to get a lot of money, and it's going to come from the insurance that the hospital paid for to protect itself from these kinds of insane scenarios. If it weren't for trial lawyers, victims would go on being victims, and it's not like the hospitals would charge less just because they didn't have high insurance premiums, they would just get to pocket more of the money themselves.

16 points by throw0101b 2y ago

Previous discussion (6 points, 6 days ago, 13 comments) https://news.ycombinator.com/item?id=42380377 https://news.ycombinator.com/item?id=42380377

FireBeyond 2y ago

This article completely seems to miss the point. If your profits are capped by regulation, how can you increase them? Increase costs. I don't know how you can write so many words about health insurance and not mention this even once, even concluding your post with "Why don't they have the same profit levels as the S&P?"

throw0101b 2y ago
> If your profits are capped by regulation, how can you increase them? Increase costs. Mentioned in the article: > [Matt Bruening] also alleges that some of this “inefficiency” is actually intentional on the part of the insurers — a disguised way to pay themselves out.

saltlyfe 2y ago

I'll break this down simply: - the Affordable Care Act subsidizes American health insurance with tax payer funds by covering much of the cost of insurance - Health insurance companies are required by law to spend 85% of that revenue on healthcare - Health insurance companies, logically, acquire providers. Thus, the 85% of their spending on healthcare is just funneled into the other companies that they own The system is currently the worst of both worlds. We have tax payer funds going straight to for-profit entities which have become vertically integrated throughout every aspect of the American healthcare system.

pazimzadeh 2y ago
Within the context of the current system it’s still better than being denied insurance due to pre-existing conditions. What the author ignores re: the shooting is that United Healthcare is particularly bad compared to other insurance companies. I’ve had multiple instances of them denying a first choice drug without explanation despite doctor’s write ups. Doctors are always on the edge and saying things like “if the insurance approves.” What is the point of going to medical school/residency/fellowship/etc if at the end of the day the insurance is making medical decisions? From the blog: > If insurers were so good at extracting money from the system, why are they so unprofitable? Maybe their unprofitability is driving them to find new ways to extract money? For healthcare I don’t understand the need for profit except for the researchers and companies who directly had a role in discovering and manufacturing the product (and funding trials). Why do we even need insurance companies if we actually trusted doctors to make the right decisions?

karmakaze 2y ago

> It's mostly the providers overcharging you, not the middlemen. What kind of post is this. Kettle, pot, whatever. The numbers are good to see, but don't make it paint it better by pointing elsewhere. I once did consulting work for a US student loan company. The best thing they could say was that they weren't as bad as the worst student loan company.

AtlasBarfed 2y ago
I call them the four pigs at the trough: -insurance companies -doctors and hospitals -drug and device and medical supplies companies -trial lawyers Each of these four pigs has any major component to the exorbitant cost in US healthcare. And just like this particular article, one of them would just point at one of the other three or all the other three to blame when questioned. Insurance companies have gigantic management structures, because insurance companies can't show high profits. So the sociopath MBAs flooded into their management structure to suck up the excess revenue as bonuses.
- nozzlegear 2y ago
  I understand the other three, but can you explain trial lawyers? What's their role?
  - BizarroLand 2y ago
    I am not a lawyer, but my opinion is the people who hate on trial lawyers do so because they sue for astronomical amounts of money when the doctors fuck up and accidentally ruin peoples lives. People who hate on "trial lawyers" driving up the cost of medical services in America should shut their traps because Doctors are not saints. For instance, Dr. Paduch: https://nypost.com/2024/11/20/us-news/disgraced-nyc-urologist-darius-paduch-sentenced-to-life-in-prison-for-perverse-and-pervasive-sexual-abuse-of-male-patients-including-minors/ https://nypost.com/2024/11/20/us-news/disgraced-nyc-urologis... Do you think that the hospital who employed the Doctor who used his medical practice to enable him to molest young boys so horrifically that they gave him life in prison should not be at least somewhat responsible for the crimes he committed? Should they not provide oversight? I'm sure those victims are going to get a lot of money, and it's going to come from the insurance that the hospital paid for to protect itself from these kinds of insane scenarios. If it weren't for trial lawyers, victims would go on being victims, and it's not like the hospitals would charge less just because they didn't have high insurance premiums, they would just get to pocket more of the money themselves.