5 ms·

Having to spend thousands for insurance every year (even if you’re totally healthy) and not having it even be remotely effective, is not my definition of “prosp

by bbqfog 2y ago

Having to spend thousands for insurance every year (even if you’re totally healthy) and not having it even be remotely effective, is not my definition of “prosperous”.

whimsicalism 2y ago
Individual insurers pay out tens of billions of dollars in claims every year, frequently have non-profitable years, and are the counterparty on pretty risky contracts. There are lots of problems with our current approach to healthcare, but insurers aren’t charging you way more than the cost to counterparty on that contract should be.
- bbqfog 2y ago
  None of this suggests a prosperous society. More like a corrupt and bureaucratic society.
- lenerdenator 2y ago
  "Frequently have non-profitable years" A graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years. If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much. Most of the rest of the industrialized world seems to grasp this concept, and their people live longer.
  - JumpCrisscross 2y ago
    > graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years Stock price ! profitability, but you're still correct. UnitedHealth's operations have churned out cash each of the last four years [1], as have Cigna [2] and Elevance [3]. Underwriting gains across the industry have been strong for years [4]. The only story I can think of where American health insurers lost money was Aetna with its underpriced ACA plans [5]. That said, whimsicalism is also partly right in that insurers aren't the cause of the unaffordability of American healthcare. They by and large pay out most of their premiums. (With some variance.) [1] https://finance.yahoo.com/quote/UNH/cash-flow/ https://finance.yahoo.com/quote/UNH/cash-flow/ [2] https://finance.yahoo.com/quote/CI/cash-flow/ https://finance.yahoo.com/quote/CI/cash-flow/ [3] https://finance.yahoo.com/quote/ELV/cash-flow/ https://finance.yahoo.com/quote/ELV/cash-flow/ [4] https://content.naic.org/sites/default/files/2021-Annual-Health-Insurance-Industry-Analysis-Report.pdf https://content.naic.org/sites/default/files/2021-Annual-Hea... [5] https://spia.princeton.edu/news/why-private-health-insurers-are-losing-money-affordable-care-act https://spia.princeton.edu/news/why-private-health-insurers-...
    - whimsicalism 2y ago
      Yes, if we subset to health insurance over recent years, they are profitable (not massive margins) - agreed. I was overstating the case.
  - whimsicalism 2y ago
    I was referring to insurance writ large, but yes it's true recently health insurers have been profitable - but not massively, more like 3-4% average margins. [0] > If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much. If it is only legal to lose money on providing insurance, nobody would do it. > Most of the rest of the industrialized world seems to grasp this concept, and their people live longer. I agree that there are problems with cost/performance in our healthcare market. I think it is largely due to overutilization & misallocation, combined with some poor genetic/cultural luck around opioids and obesity. 0: https://content.naic.org/sites/default/files/industry-analysis-report-2023-health-mid-year.pdf https://content.naic.org/sites/default/files/industry-analys...
- deleted 2y ago
  [deleted]
- willcipriano 2y ago
  The United States spends more per capita on socialized medicine than any other nation on earth[0]. US socialized medicine spending per capita is more than any other nation spends total between both public and private in fact, it just fails to provide it to anyone but the very poor, very sick and elderly. You'd think the healthy working population wouldn't be that much of a burden to care for as well, but they have to go out of pocket and get insurance to provide for themselves after providing for everyone else. There is a lot of graft going on for this to be the case. It may not be the fault of insurance companies but someone is stealing a great deal of money from the American people. Now here's the million dollar question; are you aware of this obvious fact? Have you ever heard someone frame the socialized medicine debate in this way: "If we could be as efficient as the UK we could give you free healthcare AND cut your taxes!". If not, why not? [0]https://www.statista.com/statistics/283221/per-capita-health-expenditure-by-country/ https://www.statista.com/statistics/283221/per-capita-health...
  - whimsicalism 2y ago
    graft but also overutilization/misallocation, ie. we will publicly spend massive portions of our GDP treating old people who are slowly dying but little on younger people who have some crippling illness, mostly because older people vote and triage is an uncomfortable concept to people
    - willcipriano 2y ago
      Every other nation on earth somehow finds a way to deal with that. Given the US is 48th in life expectancy[0] behind all these other nations that spend much less, that explanation doesn't seem to hold much water. [0]https://www.worldometers.info/demographics/life-expectancy/ https://www.worldometers.info/demographics/life-expectancy/
      - whimsicalism 2y ago
        > Every other nation on earth somehow finds a way to deal with that. well not every other nation, but i know what you mean. other nations are much better at managing overutilization by denying care where it is not needed. the US insurance system shields people from cost and encourages overutilization due to a number of stupid policy choices (aka refusal to have 'death panels' like in Canada/UK but also refusal to do away with massive publicly subsidy for health expenditure). for a personal story, my parents basically get free MRIs from the state for little reason whereas people I know have to pay an arm and a leg for MRIs because their insurance is worse. at minimum, we could at least also make my parents have to pay an arm and leg for useless MRIs and doctors would stop encouraging them or lose patients.

by bbqfog 2y ago

Having to spend thousands for insurance every year (even if you’re totally healthy) and not having it even be remotely effective, is not my definition of “prosperous”.

whimsicalism 2y ago

Individual insurers pay out tens of billions of dollars in claims every year, frequently have non-profitable years, and are the counterparty on pretty risky contracts. There are lots of problems with our current approach to healthcare, but insurers aren’t charging you way more than the cost to counterparty on that contract should be.

bbqfog 2y ago
None of this suggests a prosperous society. More like a corrupt and bureaucratic society.
lenerdenator 2y ago
"Frequently have non-profitable years" A graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years. If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much. Most of the rest of the industrialized world seems to grasp this concept, and their people live longer.
- JumpCrisscross 2y ago
  > graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years Stock price ! profitability, but you're still correct. UnitedHealth's operations have churned out cash each of the last four years [1], as have Cigna [2] and Elevance [3]. Underwriting gains across the industry have been strong for years [4]. The only story I can think of where American health insurers lost money was Aetna with its underpriced ACA plans [5]. That said, whimsicalism is also partly right in that insurers aren't the cause of the unaffordability of American healthcare. They by and large pay out most of their premiums. (With some variance.) [1] https://finance.yahoo.com/quote/UNH/cash-flow/ https://finance.yahoo.com/quote/UNH/cash-flow/ [2] https://finance.yahoo.com/quote/CI/cash-flow/ https://finance.yahoo.com/quote/CI/cash-flow/ [3] https://finance.yahoo.com/quote/ELV/cash-flow/ https://finance.yahoo.com/quote/ELV/cash-flow/ [4] https://content.naic.org/sites/default/files/2021-Annual-Health-Insurance-Industry-Analysis-Report.pdf https://content.naic.org/sites/default/files/2021-Annual-Hea... [5] https://spia.princeton.edu/news/why-private-health-insurers-are-losing-money-affordable-care-act https://spia.princeton.edu/news/why-private-health-insurers-...
  - whimsicalism 2y ago
    Yes, if we subset to health insurance over recent years, they are profitable (not massive margins) - agreed. I was overstating the case.
- whimsicalism 2y ago
  I was referring to insurance writ large, but yes it's true recently health insurers have been profitable - but not massively, more like 3-4% average margins. [0] > If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much. If it is only legal to lose money on providing insurance, nobody would do it. > Most of the rest of the industrialized world seems to grasp this concept, and their people live longer. I agree that there are problems with cost/performance in our healthcare market. I think it is largely due to overutilization & misallocation, combined with some poor genetic/cultural luck around opioids and obesity. 0: https://content.naic.org/sites/default/files/industry-analysis-report-2023-health-mid-year.pdf https://content.naic.org/sites/default/files/industry-analys...
deleted 2y ago
[deleted]
willcipriano 2y ago
The United States spends more per capita on socialized medicine than any other nation on earth[0]. US socialized medicine spending per capita is more than any other nation spends total between both public and private in fact, it just fails to provide it to anyone but the very poor, very sick and elderly. You'd think the healthy working population wouldn't be that much of a burden to care for as well, but they have to go out of pocket and get insurance to provide for themselves after providing for everyone else. There is a lot of graft going on for this to be the case. It may not be the fault of insurance companies but someone is stealing a great deal of money from the American people. Now here's the million dollar question; are you aware of this obvious fact? Have you ever heard someone frame the socialized medicine debate in this way: "If we could be as efficient as the UK we could give you free healthcare AND cut your taxes!". If not, why not? [0]https://www.statista.com/statistics/283221/per-capita-health-expenditure-by-country/ https://www.statista.com/statistics/283221/per-capita-health...
- whimsicalism 2y ago
  graft but also overutilization/misallocation, ie. we will publicly spend massive portions of our GDP treating old people who are slowly dying but little on younger people who have some crippling illness, mostly because older people vote and triage is an uncomfortable concept to people
  - willcipriano 2y ago
    Every other nation on earth somehow finds a way to deal with that. Given the US is 48th in life expectancy[0] behind all these other nations that spend much less, that explanation doesn't seem to hold much water. [0]https://www.worldometers.info/demographics/life-expectancy/ https://www.worldometers.info/demographics/life-expectancy/
    - whimsicalism 2y ago
      > Every other nation on earth somehow finds a way to deal with that. well not every other nation, but i know what you mean. other nations are much better at managing overutilization by denying care where it is not needed. the US insurance system shields people from cost and encourages overutilization due to a number of stupid policy choices (aka refusal to have 'death panels' like in Canada/UK but also refusal to do away with massive publicly subsidy for health expenditure). for a personal story, my parents basically get free MRIs from the state for little reason whereas people I know have to pay an arm and a leg for MRIs because their insurance is worse. at minimum, we could at least also make my parents have to pay an arm and leg for useless MRIs and doctors would stop encouraging them or lose patients.