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Until you find yourself desperate for a malpractice suit, and Surprise! your insurer and care provider are on the same team and you already agreed to arbitratio

by pengaru 11mo ago

Until you find yourself desperate for a malpractice suit, and Surprise! your insurer and care provider are on the same team and you already agreed to arbitration when you got that insurance. A friend had his life wrecked by Kaiser, and none of the attorneys he consulted wanted to touch the case because according to the attorneys they had an army of lawyers and he'd already agreed to arbitration when getting the insurance. The max they claimed could be won wouldn't even cover the legal fees. You definitely don't want insurance from the same team you're getting the insured services from. It's the conflict of interests to end all conflict of interests, especially in the context of health care.

triceratops 11mo ago
From what you tell us, binding arbitration sounds like the actual problem. Not the insurer and provider being the same company. To me the latter is an alignment of interests. The insurer will happily pay for preventive screenings and care to save itself costs on treatment later.
- autoexec 11mo ago
  > From what you tell us, binding arbitration sounds like the actual problem. Not the insurer and provider being the same company. No, the actual problem is that the insurer and provider want to screw over the paying customer. Binding arbitration is just one convenient method they've taken advantage of to accomplish that. Getting rid of binding arbitration is still a good idea, but you can bet they'll find some other way to screw over their customers because they clearly care more about profit than people. The actual solution would be to reform the healthcare system so that its goal is focused more on healing people than stuffing pockets with cash and so companies that only care about money are forced out of it entirely. Since it's unlikely that anyone with the power to fix the deeply broken healthcare system will do it any time soon, the least people can do is avoid this insurer and healthcare provider since they've demonstrated themselves to be hostile to their own paying customers.
  - triceratops 11mo ago
    Kaiser's structure is complicated. Its health plan arm, which offers insurance, is non-profit. So is its hospital foundation, which owns and operates hospitals. Its medical offices are for-profit and owned by doctors. I don't see a big profit motive for Kaiser because it's a non-profit. And because the same company owns the insurance provider and hospitals, they're incentivized to keep overall costs down. As long as they can't arbitrarily throw people off their plans, this means investing in preventive care and doing it cheap. Traditional insurance providers don't care about that. They actually like it when hospitals raise prices because it allows them to charge higher premiums. Since they can only take up to 10% in premiums (or some other number, but it's a fixed %) as profits, higher costs and higher premiums are good for their bottom line. Kaiser is how single-payer healthcare would look if it wasn't run by the government. > reform the healthcare system so that its goal is focused more on healing people than stuffing pockets with cash and so companies that only care about money are forced out of it entirely. What does that actually mean? What concrete steps would you take to accomplish this? Without specifics this is wooly, idealistic nonsense. Again to take Kaiser's example: their doctors are salaried (at least the ones that work in hospitals). They have no incentive to overbill you or make you take unnecessary tests. The doctors make the same money no matter what procedures they do on you. And Kaiser owns the insurance company that's paying those bills. They also have no incentive to skip necessary tests. If they miss a problem it'll cost Kaiser more money later to treat you. Do you have a better way to "focus [only] on healing people" than that?

by pengaru 11mo ago

triceratops 11mo ago

From what you tell us, binding arbitration sounds like the actual problem. Not the insurer and provider being the same company. To me the latter is an alignment of interests. The insurer will happily pay for preventive screenings and care to save itself costs on treatment later.

autoexec 11mo ago
> From what you tell us, binding arbitration sounds like the actual problem. Not the insurer and provider being the same company. No, the actual problem is that the insurer and provider want to screw over the paying customer. Binding arbitration is just one convenient method they've taken advantage of to accomplish that. Getting rid of binding arbitration is still a good idea, but you can bet they'll find some other way to screw over their customers because they clearly care more about profit than people. The actual solution would be to reform the healthcare system so that its goal is focused more on healing people than stuffing pockets with cash and so companies that only care about money are forced out of it entirely. Since it's unlikely that anyone with the power to fix the deeply broken healthcare system will do it any time soon, the least people can do is avoid this insurer and healthcare provider since they've demonstrated themselves to be hostile to their own paying customers.
- triceratops 11mo ago
  Kaiser's structure is complicated. Its health plan arm, which offers insurance, is non-profit. So is its hospital foundation, which owns and operates hospitals. Its medical offices are for-profit and owned by doctors. I don't see a big profit motive for Kaiser because it's a non-profit. And because the same company owns the insurance provider and hospitals, they're incentivized to keep overall costs down. As long as they can't arbitrarily throw people off their plans, this means investing in preventive care and doing it cheap. Traditional insurance providers don't care about that. They actually like it when hospitals raise prices because it allows them to charge higher premiums. Since they can only take up to 10% in premiums (or some other number, but it's a fixed %) as profits, higher costs and higher premiums are good for their bottom line. Kaiser is how single-payer healthcare would look if it wasn't run by the government. > reform the healthcare system so that its goal is focused more on healing people than stuffing pockets with cash and so companies that only care about money are forced out of it entirely. What does that actually mean? What concrete steps would you take to accomplish this? Without specifics this is wooly, idealistic nonsense. Again to take Kaiser's example: their doctors are salaried (at least the ones that work in hospitals). They have no incentive to overbill you or make you take unnecessary tests. The doctors make the same money no matter what procedures they do on you. And Kaiser owns the insurance company that's paying those bills. They also have no incentive to skip necessary tests. If they miss a problem it'll cost Kaiser more money later to treat you. Do you have a better way to "focus [only] on healing people" than that?