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re: article detailing the lengths health insurance companies will go to deny coverage
Posted on 2/3/23 at 2:36 pm to frogtown
Posted on 2/3/23 at 2:36 pm to frogtown
It's true the government is extremely inefficient, but health insurance is the only industry where increased efficiency leads to greater losses (claims paid).
The whole health insurance industry is designed to be as frustrating and slow as possible. In this way, the insurance company doesn't have to pay claims, which increases their profits.
The only efficient department in a health insurance company is the one that cashes the premium checks. Can you imagine if customers started asking for prior auths before the insurance companies were able to process their premium payments?
The whole health insurance industry is designed to be as frustrating and slow as possible. In this way, the insurance company doesn't have to pay claims, which increases their profits.
The only efficient department in a health insurance company is the one that cashes the premium checks. Can you imagine if customers started asking for prior auths before the insurance companies were able to process their premium payments?
1
Posted on 2/3/23 at 2:47 pm to frogtown
quote:
extremely inefficient government.
And there it is, the belief based on nothing but what they’ve been told all their lives by people paid off by lobbyists with connections to the insurance and pharma companies. Weird how plenty of other first world western nations can run universal healthcare but we can’t.
Posted on 2/3/23 at 2:48 pm to Metrybaw
Since United Healthcare is the favorite whipping boy in this thread, I'll use their publicly available numbers from google finance.
Last quarter, their profit margin was 4.17%.
If this company decided to convert itself to a purely non-profit model, costs for insurance only go down 4.17%.
Are corporations "greedy"? Sure. Are they the reason healthcare is so expensive? Hell no.
Something for yall to think about.
Last quarter, their profit margin was 4.17%.
If this company decided to convert itself to a purely non-profit model, costs for insurance only go down 4.17%.
Are corporations "greedy"? Sure. Are they the reason healthcare is so expensive? Hell no.
Something for yall to think about.
This post was edited on 2/3/23 at 2:53 pm
Posted on 2/3/23 at 2:51 pm to dawgfan24348
quote:
Weird how plenty of other first world western nations can run universal healthcare but we can’t.
Those other countries spend less than 1% of the GDP on military because they know the US will provide their global security. If we could cut our military budget to just 1% and let all those countries quintuple their military budgets and provide our global security, then we can talk about having nice things. Trump tried to do this when he poked NATO. He was villified.
This post was edited on 2/3/23 at 2:52 pm
Posted on 2/3/23 at 2:51 pm to dawgfan24348
Doesn’t the government contract out to private companies the vast majority of their Medicare system, including claims processing?
Posted on 2/3/23 at 2:54 pm to deeprig9
quote:
Those other countries spend less than 1% of the GDP on military because they know the US will provide their global security. I
The US also has far more wealth than those nations and could actually cut into their military budget while still maintaining the most powerful and expensive military on the planet by far. But sure let’s act like that’s an actual reason why we have to let insurance companies frick over people
Posted on 2/3/23 at 2:55 pm to dawgfan24348
OK, now respond to my post right above that.
Posted on 2/3/23 at 2:58 pm to deeprig9
quote:
convert itself to a purely non-profit model,
Never asked them to, I know they can’t. However when dealing with something like healthcare profit margin should not be a concern hence why having healthcare privatized is inherently flawed and will not put the patient first
Posted on 2/3/23 at 3:11 pm to dawgfan24348
quote:
Never asked them to, I know they can’t. However when dealing with something like healthcare profit margin should not be a concern hence why having healthcare privatized is inherently flawed and will not put the patient first
You are missing the point. Their profit is 4%. If the profit motivation is magic-wanded away, cost only goes down 4%. So how can you continue to blame greed and evilness, when all the greed and evilness only adds up to 4% of the money changing hands?
Posted on 2/3/23 at 3:27 pm to dawgfan24348
quote:
Actually they are, at least partly to blame. Here’s a pretty unbiased article that tries to break down the reasons for healthcare being so expensive
If you want unbiased you need to crack open an economics book and learn some things for yourself. Only then will you get 'unbiased".
This post was edited on 2/3/23 at 3:28 pm
Posted on 2/3/23 at 3:33 pm to deeprig9
quote:
If this company decided to convert itself to a purely non-profit model, costs for insurance only go down 4.17%.
That is never the whole story...
quote:
UnitedHealth Group CEO Andrew Witty took home $18.4 million in total compensation last year, according to the company's latest proxy filing.
quote:
The CEOs of America’s seven largest publicly traded health insurance and services companies cumulatively earned more than $283 million in 2021 — by far the most of any year in the past decade.
quote:
Total CEO compensation in the last 10 years
Sum of all compensation by company since 2012
Cigna $365,959,592
UnitedHealth Group $349,470,281
Centene $322,619,510
CVS-Aetna $265,741,187
Humana $187,880,631
Anthem-WellPoint $166,515,815
Molina Healthcare $112,148,401
Chart: J. Emory Parker/STAT Source: SEC Filings
Add to that a fleet of private jets, lavish company expenses, oftentimes little incentive to pressure better reimbursement rates due to corrupted relationships and asymmetries, and suddenly a negative-innovative industry is handing out take-home compensation and benefits rivaling top fortune 500 companies.
However it is true that insurance alone does not explain America's uniquely enormous healthcare morass, it is a combination of a ton of factors all coming together to feed this monster....and America has time and time again shown they will not fix it due to a combo of fear, propaganda, and inertia.
This post was edited on 2/3/23 at 3:49 pm
Posted on 2/3/23 at 3:35 pm to frogtown
quote:
If you want unbiased you need to crack open an economics book and learn some things for yourself. Only then will you get 'unbiased".
Let me know when you get to the part about market failures....
Posted on 2/3/23 at 3:44 pm to frogtown
quote:
If you want unbiased you need to crack open an economics book and learn some things for yourself. Only then will you get 'unbiased".
Nice way of telling me you didn’t read the article
Posted on 2/3/23 at 3:44 pm to Bronc
quote:
UnitedHealth Group CEO Andrew Witty took home $18.4 million in total compensation last year, according to the company's latest proxy filing.
Add to that a fleet of private jets, lavish company expenses, oftentimes little incentive to pressure better reimbursement rates due to corrupted relationships and asymmetries, and suddenly a negative-innovative industry is handing out take-home compensation and benefits rivaling top fortune 500 companies.
Are you implying that the operational costs of government would be cheaper than the operational costs of a corporation that has investors to answer to?
Posted on 2/3/23 at 3:56 pm to deeprig9
quote:
Are you implying that the operational costs of government would be cheaper than the operational costs of a corporation that has investors to answer to?
Factually, Medicare does have lower overhead costs, yes. part of that is they arent paying exorbitant salaries and can benefit from economies of scale, part of that is that they can piggyback off the administration of SS, as there is a lot of crossover. Medicare overhead is in the single digits, and private insurance can reach upwards of the 20% ceiling but tends to hover around 12-14%.
But that was not the point, the point is looking simply at profit margins doesn't tell the whole story. Its a lot more complex than that. As your assumption is that these companies are operating perfectly efficient, and therefore the only savings would come from profit, but that's not really accurate.
This post was edited on 2/3/23 at 4:00 pm
Posted on 2/3/23 at 3:58 pm to dawgfan24348
quote:
Nice way of telling me you didn’t read the article
I skimmed it. It's an op-ed. It doesn't cite any sources or post any numbers. It's pure opinion. The single citation is that the author is a Harvard professor, and thus, must be true and credible.
I did agree with a couple points he makes. Regarding blood pressure and hypertension, I have had it all my adult life, and no doctor every prescribed me anything for it, until the last doctor I saw, I had to say something to him, shouldn't I be on meds for this? He says oh sure sure, I'll write you a prescription for that, of course. I wonder if I didn't say anything if I would still be unmedicated for that. Don't get me wrong, I'm not a staunch defender of our healthcare system in the US, but I am a staunch opponent to socialized medicine, even though I know it's probably coming anyway.
Posted on 2/3/23 at 4:00 pm to Bronc
quote:
But that was not the point, the point is looking simply at profit margins doesn't tell the whole story.
You are right, it doesn't tell the whole story. But it takes a huge whack at the trope "insurance company greed!"
Posted on 2/3/23 at 4:02 pm to deeprig9
quote:
but I am a staunch opponent to socialized medicine, even though I know it's probably coming anyway.
I mean if you are on Medicare you already have it...or at least what conservatives label as socialized medicine even though only one or two countries truly have government controlling all aspects of the system.
Posted on 2/3/23 at 4:06 pm to deeprig9
quote:
But it takes a huge whack at the trope "insurance company greed!"
It doesn't really though.
They are greedy, and not very efficient, and often lacking in actually fighting for better reimbursement rates for consumers, instead relying on constant rate hikes. And they do whatever they can to deny claims under the law.
I mean it was only a decade or so ago that there was a near crisis of pre-existing condition denials and insurance companies were caught paying bonuses to teams that could deny the most claims.
Again, they arent the only problem, but they are A problem
This post was edited on 2/3/23 at 4:07 pm
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