7 ms·

Luigi Mangione-inspired ballot initiative targets health insurance denials

75 points by howard941 2y ago

JumpCrisscross 2y ago
This is a very Californian solution to the problem. Prediction: we’re going to see a lot more MRIs.
- polski-g 2y ago
  No you're not. You are going to see health insurance companies leave the state, just like the property insurance carriers did.
  - JumpCrisscross 2y ago
    > You are going to see health insurance companies leave the state They’ll first raise rates. If those get rejected, they’ll leave. In the meantime, private equity will extract a payday [1]. [1] https://www.chcf.org/publication/private-equity-in-health-care-prevalence-impact-and-policy-options-for-california-and-the-u-s/#related-links-and-downloads https://www.chcf.org/publication/private-equity-in-health-ca...
lolinder 2y ago
I know this is an unpopular opinion here, but Luigi Mangione as martyr figure makes me extremely uncomfortable. This is a very different situation than the Aaron Swartz or any of the other victims of abuse by powerful people and corporations. What precedent are we setting by explicitly making "murder someone" a viable path to making progress on your personal political agenda? It's one thing when you agree with the motive, but are we ready to accept the inevitable outcome that someone decides to engineer a high-profile murder to push a different agenda? In a lot of ways this is like all the media attention on school shootings: we will see copycats, and the next one may not be targeting an unsympathetic healthcare CEO.
- voidfunc 2y ago
  It's becoming acceptable to people because many people increasingly feel their means for change are being suppressed or their voices ignored. This kind of violence is just the beginning. It's what happens when societies start to collapse.
  - JumpCrisscross 2y ago
    > This kind of violence is just the beginning. It's what happens when societies start to collapse Well, no. It’s what forms popular pretext for expanding police powers. If we get a second or third Mangione, search and arrest powers will have to be expanded.
    - ok_dad 2y ago
      Why? We have a few thousand murders in the USA each year, why would a few more deaths cause a need for expanded police power when several thousand other deaths didn’t require it?
      - JumpCrisscross 2y ago
        > why would a few more deaths cause a need for expanded police power when several thousand other deaths didn’t require it? Visibility.
        ok_dad 2y ago
        Sorry, I meant to say, "other than the fact that the additional deaths are rich people." I know that the real reason is "because they are rich and powerful and the cops serve them as masters" but I was curious if you had another reason.
    - AngryData 2y ago
      You act like police powers haven't been continuously expanded for decades despite crime rates dropping regardless of local police presence.
Manuel_D 2y ago
Associating a political initiative with an unrepentant murderer is a pretty bad idea. Imagine anti-abortion activists decided to make James Kopp the centerpiece of the movement.
- hobs 2y ago
  [flagged]
  - Manuel_D 2y ago
    > Having been around the planned parenthood lines with screaming terrifying threatening christian folks Did that expose improve your opinions of them?
- JKCalhoun 2y ago
  Ballot initiative, informally named.... I think the article might be trying to be a little too edgy with its title.
- areyouliving 2y ago
  The insurers are genocidal torturers who exploit everyone who's forced to interact with them. They're backed by all law enforcement.
deleted 2y ago
[deleted]
Spivak 2y ago
Good, your insurance company should get no say on this matter. If your doctor prescribes it, insurance pays. If you think the doctor is committing fraud then you can take that up with the doctor, not the patient. The mistreatment by insurance companies is so normal now that people are just defeated. My MIL has been trying different treatments for over a decade and finally found a drug that can manage her chronic spinal pain. She's finally mobile enough to play with my nephews. And because her work switched insurance she now going through years of needless bullshit to prove to this insurance company that no really, this is the only thing that works. And now she has to pay for it out of pocket and it's over $1000/mo. I know, I know, you would really rather pay for the cheaper thing that doesn't.
- Aloisius 2y ago
  No developed country gives doctors absolute power to authorize treatments. There isn't an infinite bucket of money to draw from. At some point, spending priorities have to be made and elsewhere, it's usually based on cost vs. years of quality of life improvement, so giving antibiotics to dozens of children wins out against a third MRI for acute back pain for an 80 year old. The US is abnormal in how much discretion it gives doctors and we are incredibly inefficient with our spending because of it.
  - Spivak 2y ago
    The world you've envisioned sounds nice except: 1. That's not the trade that's happening. Every person in the US is paying for their own health insurance. Having Aetna tell you your claim is denied because someone else needed a heart transplant makes no sense. Also this is unrelated but the whole "years of quality of life" is such a made up bullshit thing it's laughable. It's reasonable on the physician end especially when treatments have hard recoveries but for the insurance end it's ridiculous. Can you imagine your car insurance not paying out after an accident because they decided you don't have enough years driving left? That's just patently not your job to evaluate. 2. For most treatments the fight with insurance happens after the services are rendered and even when you do get prior auths they're not binding so that's always fun for people. The money is already being paid, the only question is who. 3. Doctors aren't given absolute power under this system, they're still limited by all the same restrictions they had before—medical board, government regulations, standards of care—except there isn't a private 3rd party with a direct financial incentive to deny care inserting themselves in the middle.
missedthecue 2y ago
It's very interesting that insurance companies take so much of the blame for healthcare costs in the US, given that they are essentially the only player in the entire system, (alongside the patient), that is against price increases and overbilling by providers. I recently had an endoscopy done. Simple 15 minute operation where they look at your insides with a camera. They put you under for it. I got the itemized bill in the mail and the anesthesiologist alone charged $738 for the 15 minutes. Of course they probably also did some work pre/post op, but the fact that there were 4 people in the room and one charged $738 for 15 minutes makes it very hard to imagine healthcare costs going down without pinching providers. AKA doctors. My insurer isn't even for-profit.
- mancerayder 2y ago
  It's a great point. But then the other side of the equation is, when the providers charge too much and the insurance won't approve, or later (months later) decided they weren't paying and now there's a bill, then guess who gets the surprise in the mail. It's the customer, the patient, who has to mediate between these kafkaesque entities. If insurance fought behind the scenes with each provider instead of blaming the patient, maybe they wouldn't be viewed as the bad guys so much. The health care system - insurance and provider - needs a centralized perspective rather than attacking this or that piece of it. That's also how reform should happen - no one wants to hear it, but it has to be planned centrally or at least a central authority should expand the legal guard rails. It already exists with Medicare, why not expand on that idea and cover more ages?
waltercool 2y ago
[dead]

75 points by howard941 2y ago

JumpCrisscross 2y ago

This is a very Californian solution to the problem. Prediction: we’re going to see a lot more MRIs.

polski-g 2y ago
No you're not. You are going to see health insurance companies leave the state, just like the property insurance carriers did.
- JumpCrisscross 2y ago
  > You are going to see health insurance companies leave the state They’ll first raise rates. If those get rejected, they’ll leave. In the meantime, private equity will extract a payday [1]. [1] https://www.chcf.org/publication/private-equity-in-health-care-prevalence-impact-and-policy-options-for-california-and-the-u-s/#related-links-and-downloads https://www.chcf.org/publication/private-equity-in-health-ca...

lolinder 2y ago

I know this is an unpopular opinion here, but Luigi Mangione as martyr figure makes me extremely uncomfortable. This is a very different situation than the Aaron Swartz or any of the other victims of abuse by powerful people and corporations. What precedent are we setting by explicitly making "murder someone" a viable path to making progress on your personal political agenda? It's one thing when you agree with the motive, but are we ready to accept the inevitable outcome that someone decides to engineer a high-profile murder to push a different agenda? In a lot of ways this is like all the media attention on school shootings: we will see copycats, and the next one may not be targeting an unsympathetic healthcare CEO.

voidfunc 2y ago
It's becoming acceptable to people because many people increasingly feel their means for change are being suppressed or their voices ignored. This kind of violence is just the beginning. It's what happens when societies start to collapse.
- JumpCrisscross 2y ago
  > This kind of violence is just the beginning. It's what happens when societies start to collapse Well, no. It’s what forms popular pretext for expanding police powers. If we get a second or third Mangione, search and arrest powers will have to be expanded.
  - ok_dad 2y ago
    Why? We have a few thousand murders in the USA each year, why would a few more deaths cause a need for expanded police power when several thousand other deaths didn’t require it?
    - JumpCrisscross 2y ago
      > why would a few more deaths cause a need for expanded police power when several thousand other deaths didn’t require it? Visibility.
      - ok_dad 2y ago
        Sorry, I meant to say, "other than the fact that the additional deaths are rich people." I know that the real reason is "because they are rich and powerful and the cops serve them as masters" but I was curious if you had another reason.
  - AngryData 2y ago
    You act like police powers haven't been continuously expanded for decades despite crime rates dropping regardless of local police presence.

Manuel_D 2y ago

Associating a political initiative with an unrepentant murderer is a pretty bad idea. Imagine anti-abortion activists decided to make James Kopp the centerpiece of the movement.

hobs 2y ago
[flagged]
- Manuel_D 2y ago
  > Having been around the planned parenthood lines with screaming terrifying threatening christian folks Did that expose improve your opinions of them?
JKCalhoun 2y ago
Ballot initiative, informally named.... I think the article might be trying to be a little too edgy with its title.
areyouliving 2y ago
The insurers are genocidal torturers who exploit everyone who's forced to interact with them. They're backed by all law enforcement.

deleted 2y ago

[deleted]

Spivak 2y ago

Good, your insurance company should get no say on this matter. If your doctor prescribes it, insurance pays. If you think the doctor is committing fraud then you can take that up with the doctor, not the patient. The mistreatment by insurance companies is so normal now that people are just defeated. My MIL has been trying different treatments for over a decade and finally found a drug that can manage her chronic spinal pain. She's finally mobile enough to play with my nephews. And because her work switched insurance she now going through years of needless bullshit to prove to this insurance company that no really, this is the only thing that works. And now she has to pay for it out of pocket and it's over $1000/mo. I know, I know, you would really rather pay for the cheaper thing that doesn't.

Aloisius 2y ago
No developed country gives doctors absolute power to authorize treatments. There isn't an infinite bucket of money to draw from. At some point, spending priorities have to be made and elsewhere, it's usually based on cost vs. years of quality of life improvement, so giving antibiotics to dozens of children wins out against a third MRI for acute back pain for an 80 year old. The US is abnormal in how much discretion it gives doctors and we are incredibly inefficient with our spending because of it.
- Spivak 2y ago
  The world you've envisioned sounds nice except: 1. That's not the trade that's happening. Every person in the US is paying for their own health insurance. Having Aetna tell you your claim is denied because someone else needed a heart transplant makes no sense. Also this is unrelated but the whole "years of quality of life" is such a made up bullshit thing it's laughable. It's reasonable on the physician end especially when treatments have hard recoveries but for the insurance end it's ridiculous. Can you imagine your car insurance not paying out after an accident because they decided you don't have enough years driving left? That's just patently not your job to evaluate. 2. For most treatments the fight with insurance happens after the services are rendered and even when you do get prior auths they're not binding so that's always fun for people. The money is already being paid, the only question is who. 3. Doctors aren't given absolute power under this system, they're still limited by all the same restrictions they had before—medical board, government regulations, standards of care—except there isn't a private 3rd party with a direct financial incentive to deny care inserting themselves in the middle.

missedthecue 2y ago

It's very interesting that insurance companies take so much of the blame for healthcare costs in the US, given that they are essentially the only player in the entire system, (alongside the patient), that is against price increases and overbilling by providers. I recently had an endoscopy done. Simple 15 minute operation where they look at your insides with a camera. They put you under for it. I got the itemized bill in the mail and the anesthesiologist alone charged $738 for the 15 minutes. Of course they probably also did some work pre/post op, but the fact that there were 4 people in the room and one charged $738 for 15 minutes makes it very hard to imagine healthcare costs going down without pinching providers. AKA doctors. My insurer isn't even for-profit.

mancerayder 2y ago
It's a great point. But then the other side of the equation is, when the providers charge too much and the insurance won't approve, or later (months later) decided they weren't paying and now there's a bill, then guess who gets the surprise in the mail. It's the customer, the patient, who has to mediate between these kafkaesque entities. If insurance fought behind the scenes with each provider instead of blaming the patient, maybe they wouldn't be viewed as the bad guys so much. The health care system - insurance and provider - needs a centralized perspective rather than attacking this or that piece of it. That's also how reform should happen - no one wants to hear it, but it has to be planned centrally or at least a central authority should expand the legal guard rails. It already exists with Medicare, why not expand on that idea and cover more ages?

waltercool 2y ago

[dead]