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So you have to pay like $30k out of pocket in a year before the insurance chips in a single dollar? And if you ever ask for a dollar, I can also reject your cov
by whatever1 1y ago
So you have to pay like $30k out of pocket in a year before the insurance chips in a single dollar? And if you ever ask for a dollar, I can also reject your coverage.
How can I start an insurance company?
- Brendinooo 1y agoBroadly speaking yes, though to be fair I should note that if your household size is a certain number and your income is a certain number, that can come down. They cap the amount you pay in premiums to a certain percent of your income. EDIT: https://www.healthreformbeyondthebasics.org/wp-content/uploads/2024/08/REFERENCE_YearlyGuidelines_CY2026-rev.pdf https://www.healthreformbeyondthebasics.org/wp-content/uploa...
- rayiner 1y agoYou don't pay the deductible for many typical services if you're in-network. We have a mid-tier United Healthcare plan, and we only ever pay a $25 copay per doctor visit. United Healthcare's net profit margin is about half that of Chipotle in a good year: https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-group/profit-margins https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-g...; https://www.macrotrends.net/stocks/charts/CMG/chipotle-mexican-grill/profit-margins https://www.macrotrends.net/stocks/charts/CMG/chipotle-mexic...
- garciasn 1y agoI pay around $1100 a month for me and my two children through my employer. Yes; I have a $25 copay for many services, but most are simply not covered under that $25 copay. They refused an age-appropriate colonoscopy last year. It's basically fucking useless and expensive. So; is it worth it anymore? No. Is it necessary? Yes; unfortunately.
- Brendinooo 1y agoYeah, I think that's a big part of the overall grievance. If we paid these high premiums and got great care, that'd be one thing. But I've almost never walked away from a sizeable medical expense in my family thinking I wasn't being ripped off somehow.
- thehoff 1y agoI just took a look at our annual medical contributions and employer's part. We pay just over 10k for health insurance through our (different) companies. Our different employers cover almost 28k. So around 38k for insurance. This doesn't even include dental or vision which is separate. It just seems so crazy how much we pay and still have deductibles. I understand we have small copays and get items covered like age-related screenings but this just feels excessive.
- rayiner 1y agoJust talk to people in the healthcare industry about what kind of patients they have. We cover a tremendous amount of treatments in the U.S., at an arguably unsustainable level of service. My aunt had a kidney infection in Canada and my cousin had to pull teeth to get her scheduled for an MRI. My five year old got a black eye from running into a table and they scheduled him for an X-ray and CAT scan (“just in case “) later that same morning. Had the results by lunch. My dad had a non-emergency scan scheduled the next day, and an outpatient procedure for a kidney stent (to treat high blood pressure) within two weeks. Once the surgeon was in there he realized my dad didn’t need a stent after all.
- JohnFen 1y agoHere in the US, I see wait times for medical care comparable from what I hear from my Canadian friends. I don't think we our system can really tout that as an advantage over theirs.
- BobaFloutist 1y agoIt's not about wait times, it's about excessive scanning and endless, marginal-benefit end of life care
- _DeadFred_ 1y agoThe people who opposed socialized medicine by fear-mongering about “death panels” can’t now complain that their preferred system provides limitless, marginal benefit end of life care. That’s the trade off THEY argued for and said THEIR system could do.
- dh2022 1y agoWhat is a typical service that you only pay $25? This year I had two shoulder injuries. I paid for every single thing (doctor visits, X-Ray, MRI, Physical Therapy).
- antisthenes 1y agoProfit margins are irrelevant if you inflate your costs to reduce them.
- dh2022 1y agoNot really... If you want more $s by inflating costs and keeping the margin constant, then you will need more capital for paying these higher costs. This additional capital will either come from equity or from debt. Currently both equity and debt are expensive.... Profit margin is quite relevant...
- ceejayoz 1y agoThe capital comes from raising premiums. Mine went from $3k/month to $3.6k/month this year. Bonus points if you can steer the increased costs to providers you own. https://www.statnews.com/2024/11/25/unitedhealth-higher-payments-optum-providers-converts-expenses-to-profits/ https://www.statnews.com/2024/11/25/unitedhealth-higher-paym...
- lotsofpulp 1y ago>How can I start an insurance company? One requirement is to be willing to earn returns less than SP500. Look up profit margins and annual returns for UNH, Elevance, CVS, Cigna, Humana, Centene, and Molina. You have a billion laws to follow, you’re used as a punching bag by politicians and customers, have to get the price of your service approved by a government employee, and for all of that, you earn a 2% to 3% profit margin.
- whatever1 1y agoNo it will be a zero profit company. All of the revenues will go to my compensation and bonuses.
- Taikonerd 1y ago> for all of that, you earn a 2% to 3% profit margin. Yeah -- it seems like a paradox that the insurance companies charge so many people so much money, yet struggle to make a profit. I've heard that they spend a lot of money handling their "internal friction" -- reviewing claims, handling appeals, etc.
- lotsofpulp 1y agoHealth insurance premium revenue = medical loss ratio + operating costs + profit margin Medical loss ratio is the money paid to healthcare providers. Operating costs end up being ~10%, across multiple publicly listed companies. This fact, plus 2% to 3% profit margins means any more cost reductions have to come from legislation, reduction in healthcare prices, or advances in automation. https://www.oliverwyman.com/our-expertise/insights/2023/mar/health-insurer-financial-insights-volume-11-p1.html https://www.oliverwyman.com/our-expertise/insights/2023/mar/... https://www.kff.org/private-insurance/medical-loss-ratio-rebates/ https://www.kff.org/private-insurance/medical-loss-ratio-reb...
- nullocator 1y agoUh huh, and for them to have inserted themselves between me and my doctor, what exactly did they contribute to the transaction and how much should I want to pay for such a privilege since apparently $30k a year isn't enough? A measly 2-3% for adding no value and creating friction, egregious, we must get the profits higher!
- insane_dreamer 1y agoNo, $13.4K before the insurance company starts chipping in. Also that would be total deductible for the family; there's a lower deductible per individual. (I.e., the deductible might be $2.5K per individual, and $6K for the family.) So if one person needs more medical care, the insurance company kicks in once you've paid $2.5K (or whatever amount) for that person's care.