7 ms·

What a dystopian world we live in where oligarchs controlling anti-trust companies deny medical coverage [0]. Am I surprised this happened... [0] https://www.p

What a dystopian world we live in where oligarchs controlling anti-trust companies deny medical coverage [0]. Am I surprised this happened... [0] https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis https://www.propublica.org/article/unitedhealth-healthcare-i...

criddell 2y ago
What do you mean by anti-trust company?
- 93po 2y ago
  presumably a company that is violating the intentions of anti-trust laws
HDThoreaun 2y ago
[flagged]
- schmidtleonard 2y ago
  It's wild that we let insurance companies label government triage as "death panels" while for-profit denial innovation got a free pass.
  - HDThoreaun 2y ago
    Indeed, the insurance companies deserve a ton of blame too. They rightly have death panels but use scare tactics to keep people away from gov health insurance that does the same. Still, theyre playing by the rules the gov came up with. Fee for service is a horrible healthcare strategy and insurance is forced into it.
    - maxerickson 2y ago
      Do HMOs charge themselves fees?
  - lotsofpulp 2y ago
    Source?
    - criddell 2y ago
      https://www.npr.org/2017/01/10/509164679/from-the-start-obama-struggled-with-fallout-from-a-kind-of-fake-news https://www.npr.org/2017/01/10/509164679/from-the-start-obam...
      - lotsofpulp 2y ago
        > Sarah Palin coined the phrase "death panel" in a widely shared Facebook post. Does not support the claim > we let insurance companies label government triage as "death panels"
        nameless912 2y ago
        I would be fascinated to see to who was donating to Sarah Palin's campaigns at the time. In the US, all political speech is bought and sold on the open market. Especially statements made by (most) politicians.
        Arainach 2y ago
        Insurance companies funded the vast majority of advertising using that term to attack the ACA, and their lobbyists meet with politicians often enough that it's entirely plausible they coined the initial term as well (though harder to prove)
        lotsofpulp 2y ago
        So there is no evidence. The simpler explanation is that political Party A proposed legislation, and political Party B attacks it because a win for Party A is a loss for Party B. And digging into just slightly further makes the claim make even less sense: https://en.wikipedia.org/wiki/Death_panel https://en.wikipedia.org/wiki/Death_panel > Palin's spokesperson pointed to Section 1233 of bill HR 3200 which would have paid physicians for providing voluntary counseling to Medicare patients about living wills, advance directives, and end-of-life care options. Palin's claim was reported as false and criticized by the press, fact-checkers, academics, physicians, Democrats, and some Republicans. Why would managed care organizations (aka health insurance companies) oppose the government paying for more healthcare services? MCOs earn 2% to 3% of the premiums that flow through them. The higher the healthcare spend, the higher the premiums, the higher the profit for MCOs.
  - baggy_trough 2y ago
    [flagged]
    - SteveNuts 2y ago
      By switching jobs? That's not always feasible for many reasons.
      - baggy_trough 2y ago
        That in no way contradicts my point.
        behringer 2y ago
        Why do we need a government program. Continue with the medicare/medicaid and child healthcare programs as always. Outlaw regular health insurance. The problem will solve itself. "Free market".
- criddell 2y ago
  And insurance companies want us to need more or pay more for health care, not less. Insurance is regulated and the companies can only hold on to a certain percentage of the premiums. They would rather hold on to 20% of a huge number than 20% of a big number.
  - HDThoreaun 2y ago
    Agreed, the incentives are horribly misaligned throughout the entire healthcare market. We desperately need legislative overhaul but again congress is completely broken.
- deleted 2y ago
  [deleted]
- snakeyjake 2y ago
  The primary reason for the cost difference is the massive network of middlemen injected into the system, and rampant profiteering by for-profit healthcare companies. Average cost of 1 vial of insulin in France: $9.08 Average cost of 1 vial of insulin in the US: $98.70 HDThoreaun: huffing some libertarian shit "The people are using too much insulin." https://www.rand.org/pubs/articles/2021/the-astronomical-price-of-insulin-hurts-american-families.html https://www.rand.org/pubs/articles/2021/the-astronomical-pri... https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://aspe.hhs.gov/reports/comparing-insulin-prices-us-other-countries https://aspe.hhs.gov/reports/comparing-insulin-prices-us-oth...
  - lotsofpulp 2y ago
    It’s not middlemen. The middlemen (managed care organizations, aka health insurance companies) earn low single digit profit margins. In the US healthcare chain, the ranking of profit margins goes (and this is public info from public financials): Pharmaceutical companies Healthcare software companies (based on other software company margins) Healthcare providers (doctor groups) Hospitals (HCA, tenet, etc) Managed care organizations and retail pharmacies at the very bottom. The big one I don’t know is legal, which I assume slots between hospitals and healthcare providers, but could be higher. Those millions and tens of millions of dollar judgments don’t come from thin air. Go ahead and get rid of MCOs, and at best you will reduce costs by 5%. That’s an objective fact. They are just allocating the very limited resources among more and more demand.
    - psadauskas 2y ago
      I think you left out several layers. At least one of which in the news lately is the PBM, which sit between hospitals/providers and pharmaceutical companies, and are able to exert monopoly power on that market. They have agreements with hospitals that hospitals are only allowed to purchase through them, and then their suppliers are permitted to purchase exclusive access. This results in things like the saline shortage last year, and pushing small local pharmacies out of business. The PBMs also have incredible profit margins, upwards of 80%. https://www.youtube.com/watch?v=d_2yTvHoGs4 https://www.youtube.com/watch?v=d_2yTvHoGs4
- mossTechnician 2y ago
  "Americans consume too much healthcare"? I'm afraid to guess the logical conclusion to this, but I will counter with "Americans are offered two little preventative healthcare", because in more advanced countries where that is an option, the costs are lower.
  - behringer 2y ago
    Also americans are fed horrifying food products that are outlawed in civilized countries.
  - HDThoreaun 2y ago
    The conclusion is that we need to get rid of fee for service so that doctors stop prescribing things that dont work. Getting rid of fee for service also increases the amount of preventative healthcare people receive as providers realize its cheaper to do preventative than massive surgery down the line.
    - mossTechnician 2y ago
      Thank you for clarifying; I had a very different read on your previous comment that was probably the opposite of your intent.
- wing-_-nuts 2y ago
  >The main reason for that is because Americans consume too much health care. No, come on man, this is easily googleable. Americans go to the doctor less than other countries, they stay in the hospital less than other countries, they have lower life expectancy, infant and mother mortality than other countries. If you want to know why we spend so damned much, it's because we're billed 2-3x as much for the same care as other countries.
  - LargeWu 2y ago
    A more apt statement might be that we spend more, even if our quality of care is not better. And the reason we spend more is because of profit-maximizing companies in the middle.
- benterix 2y ago
  > The US spends over 17% of GDP on healthcare It doesn't have to be 17%, it can be an arbitrary number because the ones who decide on the nominal pricing are the ones who make money on them being extremely high. These same procedures can in some cases cost even 2-3 orders of magnitude less - and not in another country but in the same hospital but with a patient willing to pay in cash.
  - slt2021 2y ago
    list prices are high to scare Americans into buying [more expensive] insurance plan. they want Americans be scared of going bankrupt from medical bills. on the backend, between insurance and hospital, these giant list prices are automatically lowered by factor of 10 to the actual cost of procedure the business model is: 1. insurance scares people with huge prices 2. healthy americans buy a lot of expensive insurance 3. money is injected into healthcare system from healthy patients 4. money is split among insurance/pbm/providers/pharma
- S_Bear 2y ago
  My insurance denied me a MRI and physical therapy because having 2 working arms was a luxury. Had to pay out of pocket to be able to lift my arm above my head. Private insurance can go shove it.

criddell 2y ago

What do you mean by anti-trust company?

93po 2y ago
presumably a company that is violating the intentions of anti-trust laws

HDThoreaun 2y ago

[flagged]

schmidtleonard 2y ago
It's wild that we let insurance companies label government triage as "death panels" while for-profit denial innovation got a free pass.
- HDThoreaun 2y ago
  Indeed, the insurance companies deserve a ton of blame too. They rightly have death panels but use scare tactics to keep people away from gov health insurance that does the same. Still, theyre playing by the rules the gov came up with. Fee for service is a horrible healthcare strategy and insurance is forced into it.
  - maxerickson 2y ago
    Do HMOs charge themselves fees?
- lotsofpulp 2y ago
  Source?
  - criddell 2y ago
    https://www.npr.org/2017/01/10/509164679/from-the-start-obama-struggled-with-fallout-from-a-kind-of-fake-news https://www.npr.org/2017/01/10/509164679/from-the-start-obam...
    - lotsofpulp 2y ago
      > Sarah Palin coined the phrase "death panel" in a widely shared Facebook post. Does not support the claim > we let insurance companies label government triage as "death panels"
      - nameless912 2y ago
        I would be fascinated to see to who was donating to Sarah Palin's campaigns at the time. In the US, all political speech is bought and sold on the open market. Especially statements made by (most) politicians.
      - Arainach 2y ago
        Insurance companies funded the vast majority of advertising using that term to attack the ACA, and their lobbyists meet with politicians often enough that it's entirely plausible they coined the initial term as well (though harder to prove)
        lotsofpulp 2y ago
        So there is no evidence. The simpler explanation is that political Party A proposed legislation, and political Party B attacks it because a win for Party A is a loss for Party B. And digging into just slightly further makes the claim make even less sense: https://en.wikipedia.org/wiki/Death_panel https://en.wikipedia.org/wiki/Death_panel > Palin's spokesperson pointed to Section 1233 of bill HR 3200 which would have paid physicians for providing voluntary counseling to Medicare patients about living wills, advance directives, and end-of-life care options. Palin's claim was reported as false and criticized by the press, fact-checkers, academics, physicians, Democrats, and some Republicans. Why would managed care organizations (aka health insurance companies) oppose the government paying for more healthcare services? MCOs earn 2% to 3% of the premiums that flow through them. The higher the healthcare spend, the higher the premiums, the higher the profit for MCOs.
- baggy_trough 2y ago
  [flagged]
  - SteveNuts 2y ago
    By switching jobs? That's not always feasible for many reasons.
    - baggy_trough 2y ago
      That in no way contradicts my point.
      - behringer 2y ago
        Why do we need a government program. Continue with the medicare/medicaid and child healthcare programs as always. Outlaw regular health insurance. The problem will solve itself. "Free market".
criddell 2y ago
And insurance companies want us to need more or pay more for health care, not less. Insurance is regulated and the companies can only hold on to a certain percentage of the premiums. They would rather hold on to 20% of a huge number than 20% of a big number.
- HDThoreaun 2y ago
  Agreed, the incentives are horribly misaligned throughout the entire healthcare market. We desperately need legislative overhaul but again congress is completely broken.
deleted 2y ago
[deleted]
snakeyjake 2y ago
The primary reason for the cost difference is the massive network of middlemen injected into the system, and rampant profiteering by for-profit healthcare companies. Average cost of 1 vial of insulin in France: $9.08 Average cost of 1 vial of insulin in the US: $98.70 HDThoreaun: huffing some libertarian shit "The people are using too much insulin." https://www.rand.org/pubs/articles/2021/the-astronomical-price-of-insulin-hurts-american-families.html https://www.rand.org/pubs/articles/2021/the-astronomical-pri... https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://aspe.hhs.gov/reports/comparing-insulin-prices-us-other-countries https://aspe.hhs.gov/reports/comparing-insulin-prices-us-oth...
- lotsofpulp 2y ago
  It’s not middlemen. The middlemen (managed care organizations, aka health insurance companies) earn low single digit profit margins. In the US healthcare chain, the ranking of profit margins goes (and this is public info from public financials): Pharmaceutical companies Healthcare software companies (based on other software company margins) Healthcare providers (doctor groups) Hospitals (HCA, tenet, etc) Managed care organizations and retail pharmacies at the very bottom. The big one I don’t know is legal, which I assume slots between hospitals and healthcare providers, but could be higher. Those millions and tens of millions of dollar judgments don’t come from thin air. Go ahead and get rid of MCOs, and at best you will reduce costs by 5%. That’s an objective fact. They are just allocating the very limited resources among more and more demand.
  - psadauskas 2y ago
    I think you left out several layers. At least one of which in the news lately is the PBM, which sit between hospitals/providers and pharmaceutical companies, and are able to exert monopoly power on that market. They have agreements with hospitals that hospitals are only allowed to purchase through them, and then their suppliers are permitted to purchase exclusive access. This results in things like the saline shortage last year, and pushing small local pharmacies out of business. The PBMs also have incredible profit margins, upwards of 80%. https://www.youtube.com/watch?v=d_2yTvHoGs4 https://www.youtube.com/watch?v=d_2yTvHoGs4
mossTechnician 2y ago
"Americans consume too much healthcare"? I'm afraid to guess the logical conclusion to this, but I will counter with "Americans are offered two little preventative healthcare", because in more advanced countries where that is an option, the costs are lower.
- behringer 2y ago
  Also americans are fed horrifying food products that are outlawed in civilized countries.
- HDThoreaun 2y ago
  The conclusion is that we need to get rid of fee for service so that doctors stop prescribing things that dont work. Getting rid of fee for service also increases the amount of preventative healthcare people receive as providers realize its cheaper to do preventative than massive surgery down the line.
  - mossTechnician 2y ago
    Thank you for clarifying; I had a very different read on your previous comment that was probably the opposite of your intent.
wing-_-nuts 2y ago
>The main reason for that is because Americans consume too much health care. No, come on man, this is easily googleable. Americans go to the doctor less than other countries, they stay in the hospital less than other countries, they have lower life expectancy, infant and mother mortality than other countries. If you want to know why we spend so damned much, it's because we're billed 2-3x as much for the same care as other countries.
- LargeWu 2y ago
  A more apt statement might be that we spend more, even if our quality of care is not better. And the reason we spend more is because of profit-maximizing companies in the middle.
benterix 2y ago
> The US spends over 17% of GDP on healthcare It doesn't have to be 17%, it can be an arbitrary number because the ones who decide on the nominal pricing are the ones who make money on them being extremely high. These same procedures can in some cases cost even 2-3 orders of magnitude less - and not in another country but in the same hospital but with a patient willing to pay in cash.
- slt2021 2y ago
  list prices are high to scare Americans into buying [more expensive] insurance plan. they want Americans be scared of going bankrupt from medical bills. on the backend, between insurance and hospital, these giant list prices are automatically lowered by factor of 10 to the actual cost of procedure the business model is: 1. insurance scares people with huge prices 2. healthy americans buy a lot of expensive insurance 3. money is injected into healthcare system from healthy patients 4. money is split among insurance/pbm/providers/pharma
S_Bear 2y ago
My insurance denied me a MRI and physical therapy because having 2 working arms was a luxury. Had to pay out of pocket to be able to lift my arm above my head. Private insurance can go shove it.