3 ms·

Maybe healthcare shouldn’t be primarily for profit?

by apercu 3mo ago

bendergarcia 3mo ago
But what about competition!?!?
arjie 3mo ago
Well, I suppose you can rest easy on that count. Kaiser is principally a non-profit.
- ButlerianJihad 3mo ago
  > principally a non-profit. I hate to break it to you, but "non-profit" doesn't mean what you literally think it means. https://en.wikipedia.org/wiki/Kaiser_Permanente https://en.wikipedia.org/wiki/Kaiser_Permanente Also, KPMGs are indeed "for-profit" while Kaiser Permanente as a whole is constituted as a "consortium" of both types.
  - wilg 3mo ago
    Do you suppose thats why they wrote "principally"?
    - ButlerianJihad 3mo ago
      You're absolutely wrong! And here is why: I guarantee you that the nurses are working in the "for-profit" units, and also, that still betrays ignorance of what "non-profit" actually means, which is the load-bearing topic of this thread.
      - procflora 3mo ago
        Ok fine, but I bet you can't come up with a good gluten free banana bread recipe.
      - wilg 3mo ago
        Can you just say the point you're trying to make about nonprofits directly?
      - fatcatsbestcats 3mo ago
        Kaiser nurses by and large work for KFH, which is non-profit.
wilg 3mo ago
There's no law saying you can't start a non-profit healthcare provider or insurance company. Why not do it?
anubistheta 3mo ago
Every healthcare system optimize costs and rations care based on the price. It has nothing to do with profit or non-profit status.
caturopath 3mo ago
I'm not sure the for-profit approach is exactly what's to blame. HMOs like Kaiser are legally forced to spend a certain fraction (80% percent for the worst case, more for large group plans) of their premium revenue on medical services. They can't save and pocket the money like a traditional for-profit enterprise. This doesn't seem like a money-saving measure exactly. The main AIs the article talks about is making sure nurses on their nurses' lines aren't being assholes. I guess this used to be spot checked before so you save on that? Maybe? It seems like they are trying to solve the problem of some of their nurses staffing their nurses' line not treating their patients the way they're supposed to.
- sarchertech 3mo ago
  > spend a certain fraction (80% percent Increasingly health insurance companies and healthcare providers are intertwined. So they may spend 80% on healthcare, but then a big chunk of that could go to the urgent care clinics that they own. And even if they don’t own the provider, they don’t have much incentive to lower total cost because 20% of a larger number means more total profit.
  - caturopath 3mo ago
    > Increasingly health insurance companies and healthcare providers are intertwined. Kaiser is an HMO. They are the insurer and try to have their employees, such as these nursing lines, perform almost all of their care. Shifting from one line of business to another is purely internal and can't game Medical Loss Ratio like your scenario. > they don’t have much incentive to lower total cost because 20% of a larger number means more total profit There is some bad incentive here for sure. That being said, insurers do compete on price so they lose customers if they charge more than other insurers. Also, regulatory rate review can decide whether they can raise premiums a given amount.
    - sarchertech 3mo ago
      I’m not talking about Kaiser. I’m talking about companies like UnitedHealth Group Incorporated who own UnitedHealthcare the insurance company and Optum the healthcare provider. > That being said, insurers do compete on price so they lose customers if they charge more than other insurers. Yeah but that’s a second order effect. Most companies are incentivized to cut costs because they will directly realize the profit. Insurance companies are incentives to cut costs only to grow market share. I understand the point of the profit limits, but I don’t think it works very well in practice. I think it would probably be better to just have private companies without that profit cap and add a government insurer to compete with them.
insane_dreamer 3mo ago
agree 100%; but kaiser is already a non-profit organization, that's not the main issue in this case

Maybe healthcare shouldn’t be primarily for profit?

by apercu 3mo ago

Maybe healthcare shouldn’t be primarily for profit?

bendergarcia 3mo ago

But what about competition!?!?

arjie 3mo ago

Well, I suppose you can rest easy on that count. Kaiser is principally a non-profit.

ButlerianJihad 3mo ago
> principally a non-profit. I hate to break it to you, but "non-profit" doesn't mean what you literally think it means. https://en.wikipedia.org/wiki/Kaiser_Permanente https://en.wikipedia.org/wiki/Kaiser_Permanente Also, KPMGs are indeed "for-profit" while Kaiser Permanente as a whole is constituted as a "consortium" of both types.
- wilg 3mo ago
  Do you suppose thats why they wrote "principally"?
  - ButlerianJihad 3mo ago
    You're absolutely wrong! And here is why: I guarantee you that the nurses are working in the "for-profit" units, and also, that still betrays ignorance of what "non-profit" actually means, which is the load-bearing topic of this thread.
    - procflora 3mo ago
      Ok fine, but I bet you can't come up with a good gluten free banana bread recipe.
    - wilg 3mo ago
      Can you just say the point you're trying to make about nonprofits directly?
    - fatcatsbestcats 3mo ago
      Kaiser nurses by and large work for KFH, which is non-profit.

wilg 3mo ago

There's no law saying you can't start a non-profit healthcare provider or insurance company. Why not do it?

anubistheta 3mo ago

Every healthcare system optimize costs and rations care based on the price. It has nothing to do with profit or non-profit status.

caturopath 3mo ago

I'm not sure the for-profit approach is exactly what's to blame. HMOs like Kaiser are legally forced to spend a certain fraction (80% percent for the worst case, more for large group plans) of their premium revenue on medical services. They can't save and pocket the money like a traditional for-profit enterprise. This doesn't seem like a money-saving measure exactly. The main AIs the article talks about is making sure nurses on their nurses' lines aren't being assholes. I guess this used to be spot checked before so you save on that? Maybe? It seems like they are trying to solve the problem of some of their nurses staffing their nurses' line not treating their patients the way they're supposed to.

sarchertech 3mo ago
> spend a certain fraction (80% percent Increasingly health insurance companies and healthcare providers are intertwined. So they may spend 80% on healthcare, but then a big chunk of that could go to the urgent care clinics that they own. And even if they don’t own the provider, they don’t have much incentive to lower total cost because 20% of a larger number means more total profit.
- caturopath 3mo ago
  > Increasingly health insurance companies and healthcare providers are intertwined. Kaiser is an HMO. They are the insurer and try to have their employees, such as these nursing lines, perform almost all of their care. Shifting from one line of business to another is purely internal and can't game Medical Loss Ratio like your scenario. > they don’t have much incentive to lower total cost because 20% of a larger number means more total profit There is some bad incentive here for sure. That being said, insurers do compete on price so they lose customers if they charge more than other insurers. Also, regulatory rate review can decide whether they can raise premiums a given amount.
  - sarchertech 3mo ago
    I’m not talking about Kaiser. I’m talking about companies like UnitedHealth Group Incorporated who own UnitedHealthcare the insurance company and Optum the healthcare provider. > That being said, insurers do compete on price so they lose customers if they charge more than other insurers. Yeah but that’s a second order effect. Most companies are incentivized to cut costs because they will directly realize the profit. Insurance companies are incentives to cut costs only to grow market share. I understand the point of the profit limits, but I don’t think it works very well in practice. I think it would probably be better to just have private companies without that profit cap and add a government insurer to compete with them.

insane_dreamer 3mo ago

agree 100%; but kaiser is already a non-profit organization, that's not the main issue in this case