kmundy

3 ms·

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by kmundy 9mo ago
The inequality gap, the root of our divisive and fractious politics, continues to widen. The “Great Decoupling” of 1973 was just the first leak. The AI revolution is now poised to burst the entire pipe. I’ve been working on a system called
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Show HN: Modeling the US Debt as a Healthcare Pricing Failure ($26T Gap)(taprootlogic.substack.com)
4 points by kmundy 10mo ago|2 comments
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by kmundy 10mo ago
You’re right—Congress is the bottleneck for the important stuff (Residency Cap, MLR). And the lobby is massive. I'm a tad more hopeful than you though. I'm hoping that if we all have a shared understanding of how these well inten
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by kmundy 10mo ago
Well, the subsidy just buys us some time to stabilize the risk pool. Meanwhile, the ACO+Factory model is emerging, which flips the incentives; changes the way the product is consumed, so we stop overpaying in the first place.
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by kmundy 10mo ago
Right! Sort of the reason the MLR cap ran into this issue in the first place. The insurers are forced into the only remaining avenues to grow profits: 1. Grow the pie, by letting prices rise. 2. Acquire the entities benefitting from this pr
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by kmundy 10mo ago
OP here. I’m a retired engineer researching US healthcare pricing mechanics. I analyzed the 10-K filings for the 'Big 3' insurers (United, CVS/Aetna, Cigna) to test the common claim that their profit margins are razor-thin (~
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Data: Big Three Health Insurer revenues spiked after 2018 PBM mergers(taprootlogic.substack.com)
3 points by kmundy 10mo ago|3 comments
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by kmundy 10mo ago
You are right about the math of the 'Death Spiral.' If we simply deregulated AHPs without a safety net, healthy people would flee, leaving the sick in a collapsing ACA pool. That is exactly what happened in the pre-ACA 'bad o
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Vertical Integration Allows US Insurers to Bypass the 85% Profit Cap(taprootlogic.substack.com)
5 points by kmundy 10mo ago|7 comments
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by kmundy 10mo ago
OP here. This is Part 3 of my series on US Healthcare structural flaws. The core argument is that the ACA’s 'Medical Loss Ratio' (which caps insurer profits at 15%) inadvertently created a 'Cost-Plus' incentive for infla
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Why the 1997 Residency Cap is bankrupting US Healthcare(taprootlogic.substack.com)
4 points by kmundy 11mo ago|0 comments