-
This was the top article on the WSJ. The comments were interesting. Many people opining that the CEO was killed by someone who had a family member die or him/herself was financially ruined due to a denial of health care coverage. Of course, we don't know yet.
My fear is that this is the latest episode of violence due to the increase of the wealth inequality problem in the US.
We'll see what the actual motivation is, but I do find it odd that people will give more sympathy to this man than the millions that were impacted and died due to his decisions to put profits over people.
-
This was the top article on the WSJ. The comments were interesting. Many people opining that the CEO was killed by someone who had a family member die or him/herself was financially ruined due to a denial of health care coverage. Of course, we don't know yet.
My fear is that this is the latest episode of violence due to the increase of the wealth inequality problem in the US.
We'll see what the actual motivation is, but I do find it odd that people will give more sympathy to this man than the millions that were impacted and died due to his decisions to put profits over people.
What ever the facts of this case healthcare system overall has become greedy and is broken. For 2 decades now it has become very clear, incentives in US healthcare are not aligned with health. Hospitals, doctors, insurers, Pharma, Pharma benefit managers every part of healthcare infrastructure have become too greedy. While people are aware of this for a while, Insurers will take most of the blame by all parties for the issues that are plaguing the system as they are the main interface for all parties. I am not surprised a bit about peoples reaction.
-
Yes, I would not be shocked if this turns out to be related to "late stage capitalism".
-
Yeah, I'm not actually surprised that the general event happened. The specifics (who, where, when, etc) are of course a surprise. But the fact that someone shot a big company CEO? That isn't a surprise. The current political, economic, and social conditions are ripe for violence. Its likely going to get worse before it gets better.
-
Shooter used a silencer. Could be a mob hit.
Corp CEOs will use this as an excuse to double their corporate security budgets at home, office and while traveling. More jobs for retired military and FBI types who don't mind wearing suits and earpieces while overhearing executive drivel.
-
Shooter used a silencer. Could be a mob hit.
Corp CEOs will use this as an excuse to double their corporate security budgets at home, office and while traveling. More jobs for retired military and FBI types who don't mind wearing suits and earpieces while overhearing executive drivel.
That doesn't make it fun for them.
My in-laws bought a house from an Exxon exec in the 90's. This was when the Exxon Valdez was still fresh. The security system on that house was insane. It's one thing to do it, but to feel you *need* to go to that level would not help me sleep at night.
-
This was the top article on the WSJ. The comments were interesting. Many people opining that the CEO was killed by someone who had a family member die or him/herself was financially ruined due to a denial of health care coverage. Of course, we don't know yet.
My fear is that this is the latest episode of violence due to the increase of the wealth inequality problem in the US.
We'll see what the actual motivation is, but I do find it odd that people will give more sympathy to this man than the millions that were impacted and died due to his decisions to put profits over people.
There aren't good records for the wealth of the aristocracy in France before the revolution and most of the wealth was held in assets that traded infrequently and are thus hard to properly value. But I started taking notice in 1998 during my Econ undergrad that the US was on an inescapable trajectory of mirroring the inequality of that time. Occupy Wall Street isn't so distant in time. I was expecting our Bastille Day moment at any time during OWS. I'm not sure how the new oligarchs managed to save their skins.
Side note: saw a meme on Facebook just last week that said something to the effect of "If were to EAT just one of these billionaire mutha fuckas, the rest would surely fall in line." I think the difference this time is the executions will be less humane than the guillotine.
-
UNH stock is up today. Maybe the market has discounted the value of one golden parachute, plus a few months of executive salary?
-
This was the top article on the WSJ. The comments were interesting. Many people opining that the CEO was killed by someone who had a family member die or him/herself was financially ruined due to a denial of health care coverage. Of course, we don't know yet.
My fear is that this is the latest episode of violence due to the increase of the wealth inequality problem in the US.
We'll see what the actual motivation is, but I do find it odd that people will give more sympathy to this man than the millions that were impacted and died due to his decisions to put profits over people.
There aren't good records for the wealth of the aristocracy in France before the revolution and most of the wealth was held in assets that traded infrequently and are thus hard to properly value. But I started taking notice in 1998 during my Econ undergrad that the US was on an inescapable trajectory of mirroring the inequality of that time. Occupy Wall Street isn't so distant in time. I was expecting our Bastille Day moment at any time during OWS. I'm not sure how the new oligarchs managed to save their skins.
Side note: saw a meme on Facebook just last week that said something to the effect of "If were to EAT just one of these billionaire mutha fuckas, the rest would surely fall in line." I think the difference this time is the executions will be less humane than the guillotine.
I think part of it is that they have done an outstanding job of creating scapegoats and directing the anger and frustration toward them and away from themselves. It's not the .1%; it's the immigrants and the trans people and the libtards who are responsible for all the suffering.
-
This was the top article on the WSJ. The comments were interesting. Many people opining that the CEO was killed by someone who had a family member die or him/herself was financially ruined due to a denial of health care coverage. Of course, we don't know yet.
My fear is that this is the latest episode of violence due to the increase of the wealth inequality problem in the US.
We'll see what the actual motivation is, but I do find it odd that people will give more sympathy to this man than the millions that were impacted and died due to his decisions to put profits over people.
There aren't good records for the wealth of the aristocracy in France before the revolution and most of the wealth was held in assets that traded infrequently and are thus hard to properly value. But I started taking notice in 1998 during my Econ undergrad that the US was on an inescapable trajectory of mirroring the inequality of that time. Occupy Wall Street isn't so distant in time. I was expecting our Bastille Day moment at any time during OWS. I'm not sure how the new oligarchs managed to save their skins.
Side note: saw a meme on Facebook just last week that said something to the effect of "If were to EAT just one of these billionaire mutha fuckas, the rest would surely fall in line." I think the difference this time is the executions will be less humane than the guillotine.
I think part of it is that they have done an outstanding job of creating scapegoats and directing the anger and frustration toward them and away from themselves. It's not the .1%; it's the immigrants and the trans people and the libtards who are responsible for all the suffering.
IDK, I think consumerism is different than feudalism. Yes, in either system regular people sacrifice their lives working until death. However, the key innovation of consumerism is bribing the workers with fun little things like cars, iphones, golf course houses, and fast fashion. Receiving these things - which the workers themselves produce - gives the workers a bunch of distracting things to play with and creates the illusion in the workers' minds that they are increasing their status relative to others. The workers will still work all their lives, and benefit the ownership class, but they think they're doing great, and so revolts are rarer.
That kind of system is inherently more stable than the famine conditions of 1800's France. However, there is reason to believe the economy is transitioning toward the worst aspects of feudalism.
-
People get shot every day here. It's only "news" because this time it's some rich dude and not a retail worker/random bystander. If the media covered all of them to this extent we'd have reasonable gun laws by now.
-
People get shot every day here. It's only "news" because this time it's some rich dude and not a retail worker/random bystander. If the media covered all of them to this extent we'd have reasonable gun laws by now.
People get shot all the time, people don't always get publicly executed by an expert with a silencer. This raises eyebrows for a ton of reasons, none of them just being that "he's rich" but how he got rich and the corrupt system that has pushed someone to this point.
-
It’s interesting how not shocking this is.
-
This was the top article on the WSJ. The comments were interesting. Many people opining that the CEO was killed by someone who had a family member die or him/herself was financially ruined due to a denial of health care coverage. Of course, we don't know yet.
My fear is that this is the latest episode of violence due to the increase of the wealth inequality problem in the US.
We'll see what the actual motivation is, but I do find it odd that people will give more sympathy to this man than the millions that were impacted and died due to his decisions to put profits over people.
There aren't good records for the wealth of the aristocracy in France before the revolution and most of the wealth was held in assets that traded infrequently and are thus hard to properly value. But I started taking notice in 1998 during my Econ undergrad that the US was on an inescapable trajectory of mirroring the inequality of that time. Occupy Wall Street isn't so distant in time. I was expecting our Bastille Day moment at any time during OWS. I'm not sure how the new oligarchs managed to save their skins.
Side note: saw a meme on Facebook just last week that said something to the effect of "If were to EAT just one of these billionaire mutha fuckas, the rest would surely fall in line." I think the difference this time is the executions will be less humane than the guillotine.
I don't think the underclass has the organising ability to do anything more than sporadic unfocussed violence. Time will tell I guess. But I'd be betting my money on the State, in this scenario.
It pays to not advertise your wealth too freely. No one needs to know how much money you have and how many rental properties you own. No one outside these forums, anyway :)
-
This was the top article on the WSJ. The comments were interesting. Many people opining that the CEO was killed by someone who had a family member die or him/herself was financially ruined due to a denial of health care coverage. Of course, we don't know yet.
My fear is that this is the latest episode of violence due to the increase of the wealth inequality problem in the US.
We'll see what the actual motivation is, but I do find it odd that people will give more sympathy to this man than the millions that were impacted and died due to his decisions to put profits over people.
Just watched the video of the assassination.
Definitely a professional job.
Location is Manhattan.
Victim is CEO of large corporation.
Said corporation has been suspected to have engaged in large scale Medicare fraud to the tune of 8+ billion $$ in addition to numerous other financial crimes that together have likely resulted in deaths and injuries of many policyholders.
These days one finds the more important mob players in boardrooms rather than running numbers or similar rackets.
United Health looks more like a racketeering operation at the highest level than anything and that, in turn, makes the assassination look like a gangland killing designed to send a message.
We'll see - or not.
-
One thing that struck me as interesting is that if you go to the subreddit r/antiwork (which is composed of a bunch of unemployed people/people who hate the system), the entire front page is taken up by discussions about the shooting.
-
I wonder how Trump's ear is doing?
-
United Healthcare is so bad about how they treat medical providers and the ridiculous rate that they decline claims that my very, very large local hospital spent a lot of time considering just booting them (and their insured) out of the system.
He was at the helm of a very corrupt ship, that's for sure. It seems like there are a huge number of possible reasons that someone might have wanted to shoot him in the back.
-
United Healthcare is so bad about how they treat medical providers and the ridiculous rate that they decline claims that my very, very large local hospital spent a lot of time considering just booting them (and their insured) out of the system.
He was at the helm of a very corrupt ship, that's for sure. It seems like there are a huge number of possible reasons that someone might have wanted to shoot him in the back.
Yep.
-
If it was a hit man, it’s surprising that it would be done in such a public place. It seems like there would be so many other options to get the guy alone.
-
I agree. Other than the stone cold nature of it, there was not a hit man vibe to me at all. Initially shot him from fairly far away, escaped into the park on a bicycle, getting filmed before at Starbucks, eyes uncovered, and more . . . just seems like a lot of rookie moves. Not that I'm an expert ;-)
-
Oh dear. How unfortunate. No one deserves that. Also, I do certainly hope he did not fail to obtain prior authorization before seeking care for the gunshot wound to his chest. Of course, they would acknowledge the emergent nature of the situation, however the policy requires that all non-preventative services, including "unexpected chest injuries," be pre-approved through the 24/7 Prior Authorization Hotline.
-
Oh dear. How unfortunate. No one deserves that. Also, I do certainly hope he did not fail to obtain prior authorization before seeking care for the gunshot wound to his chest. Of course, they would acknowledge the emergent nature of the situation, however the policy requires that all non-preventative services, including "unexpected chest injuries," be pre-approved through the 24/7 Prior Authorization Hotline.
!
There was some news that they found a water bottle and a phone - if true, it seems they could find this guy fairly quickly.
-
Shell casings suggest a kook with a grudge.
-
Shell casings suggest a kook with a grudge.
Well, he used a suppressor so he had to use a semi automatic; and as long as the weapon disappears, shell markings are not very helpful in the investigation unless shell casings from that gun have been linked to a previous crime.
The water bottle and the cell phone are a different story though.
-
Shell casings suggest a kook with a grudge.
Well, he used a suppressor so he had to use a semi automatic; and as long as the weapon disappears, shell markings are not very helpful in the investigation unless shell casings from that gun have been linked to a previous crime.
The water bottle and the cell phone are a different story though.
The three casings had the words "deny" "defend" and "depose" on them.
-
Shell casings suggest a kook with a grudge.
Well, he used a suppressor so he had to use a semi automatic; and as long as the weapon disappears, shell markings are not very helpful in the investigation unless shell casings from that gun have been linked to a previous crime.
The water bottle and the cell phone are a different story though.
The three casings had the words "deny" "defend" and "depose" on them.
Now those are kook vibes for sure.
-
Shell casings suggest a kook with a grudge.
Well, he used a suppressor so he had to use a semi automatic; and as long as the weapon disappears, shell markings are not very helpful in the investigation unless shell casings from that gun have been linked to a previous crime.
The water bottle and the cell phone are a different story though.
The three casings had the words "deny" "defend" and "depose" on them.
Welp
-
Ah. Makes sense. In other insurance news:
https://www.newsweek.com/doctors-rail-against-insurers-new-anesthesia-time-limits-1995875
-
Ah. Makes sense. In other insurance news:
https://www.newsweek.com/doctors-rail-against-insurers-new-anesthesia-time-limits-1995875
I was just about to post that another CEO seemed to be itching for some upgraded security.
-
Ah. Makes sense. In other insurance news:
https://www.newsweek.com/doctors-rail-against-insurers-new-anesthesia-time-limits-1995875
I was just about to post that another CEO seemed to be itching for some upgraded security.
Right? It's like they've stopped even pretending to care about their customers. I wonder whose genius idea this was...
-
Coldest-ass meme I’ve seen yet:
-
The S&P 500 hit a new record high yesterday!
-
Interesting what this federal district judge had to say about United Health:
Cancer-Survivor Judge Steps Down From Case Over Insurer's 'Barbaric' Denial of Treatment
Cole, Scott & Kissane managing partner Richard Cole is the named plaintiff in a putative class action lawsuit against United Healthcare Insurance Co., which denied him coverage for proton beam radiation therapy to treat cancer.
April 29, 2019 Zach Schlein
U.S. District Judge Robert Scola on Monday recused himself from Richard Cole v. United Healthcare Insurance Co. in the Southern District of Florida — a case in which prominent Miami litigator and Cole, Scott & Kissane managing partner Richard Cole is the named plaintiff.
The judge wrote that his own life-saving experience with the treatment at the heart of the lawsuit—proton radiation, which United Healthcare Co. does not cover—plus a friend's six-figure medical bills for cancer care prevented him “from deciding this case fairly and impartially.”
https://www.law.com/dailybusinessreview/2019/04/29/cancer-survivor-judge-steps-down-from-case-over-insurers-barbaric-denial-of-treatment/?slreturn=20241205122956
-
My dd says she met him at work a couple of years ago, and she isn’t even a little bit shocked.
-
I used to work in the health insurance industry. UnitedHealth is really awful. They deny more claims by far than all the other insurance companies.
And I've seen discussions about the shooting on multiple subreddits on Reddit. No one seems to be sad.
-
If it was a hit man, it’s surprising that it would be done in such a public place. It seems like there would be so many other options to get the guy alone.
I think the very public nature of the assassination is actually part of the message.
It does not distinguish lone wolf assassinations from gangland murders though.
The mob either disappears their victims and nobody is the wiser or, if a message is being sent, an assassination is staged as a high profile public event - and that isn't that uncommon.
Putting cryptic messages on shell casings, or taking public responsibility for such deeds is decidedly un-mob-like. Those for whom a message is intended do not need that - they understand.
PHOTOS: In Plain Sight: Mob brutality on the streets of New York
New York Daily News
By New York Daily News | NYDN@medianewsgroup.com
UPDATED: December 15, 2023
Brutal, final and so often carried out in the heart of the city's most public places, mob executions were all too frequent on the streets of New York, but still always shocking.
https://www.nydailynews.com/2020/12/16/in-plain-sight-mob-brutality-on-the-streets-of-new-york/
-
Ah. Makes sense. In other insurance news:
https://www.newsweek.com/doctors-rail-against-insurers-new-anesthesia-time-limits-1995875
BCBS is my hospital insurance and they have taken a noticeable nose dive since they got bought by Anthem a year or two ago. (They used to be Empire BCBS.) Routine prior authorizations that used to be no issue are now being denied even after appeal. They contract all of their admin out to some other company called Carelon and they're a nightmare. Unfortunately my workplace doesn't really offer a good alternative so we're stuck with it for now.
-
Ah. Makes sense. In other insurance news:
https://www.newsweek.com/doctors-rail-against-insurers-new-anesthesia-time-limits-1995875 (https://www.newsweek.com/doctors-rail-against-insurers-new-anesthesia-time-limits-1995875)
BCBS is my hospital insurance and they have taken a noticeable nose dive since they got bought by Anthem a year or two ago. (They used to be Empire BCBS.) Routine prior authorizations that used to be no issue are now being denied even after appeal. They contract all of their admin out to some other company called Carelon and they're a nightmare. Unfortunately my workplace doesn't really offer a good alternative so we're stuck with it for now.
Hopefully, they're paying attention to the public response to this recent shooting.
-
The estranged wife said he was getting death threats AND said something about it being over lack of coverage, according to news. She also seemed more focused on comforting her kids than grieving him.
He also did not have security, which is unusual in his position. An exec at my megacorp job always had secret service-type guys around them with earpieces, though I wonder if it was selective based on specific threats or if all of the execs had it.
I do think it's silly that people are saying this is late-stage capitalism or a new era of vigilantes is upon us since this seems highly personal. But it would be interesting to know if there's a rise in the number of lone-wolf vigilantes/wannabe mercenaries or if it's at "normal" levels. People like the 2 Trump attempted assassins, the guy who was killed storming an FBI building, American ex-military supposedly going to fight for Russia, etc.
I read somewhere years ago something about assassins in the US being useful crazies. And it is notable that most of them are. Would be interested in reading about that again (analysis of US political assassins) if anyone has a link.
-
So it looks like that the assassin almost certainly is an individual who is personally affected by the business practices of UnitedHealth, directly or indirectly, and/or got radicalized online and developed a fixation on the CEO.
In any case, it moves the motivation for the killing from a purely criminal to a more political/terrorist motivation.
A strictly personal grievance arising from personal relations seems unlikely given the circumstances.
Here is more from someone who seems to know what he's talking about:
CEO shooter labeled a 'doofus' by expert arguing against professional killing theory
Tom Boggioni
December 5
"The exercise to clear rounds are tap, rack, bang and that's drilled into you when you're an agent or officer," he elaborated. "Tap, rack, bang –– he doesn't do that. He racks the gun, the slide, and then he slaps the top of the gun, the top of the slide a couple of times. There's no trained shooter that would do that."
https://www.rawstory.com/brian-thompson-ceo/
Edit: Just want to clarify that I'm referring strictly to the way the author describes how the gunman cleared the jam and I take what he writes at face value.
He is completely wrong about the gunman not taking a shooter's stance - having lived in Manhattan for years, I can guarantee that taking up a shooter's stance is a great way to focus all attention on oneself on a Manhattan street, nonchalance is key and a suppressor helps.
-
...
I read somewhere years ago something about assassins in the US being useful crazies. And it is notable that most of them are. Would be interested in reading about that again (analysis of US political assassins) if anyone has a link.
This paper is not an analysis of US politucal assassins per se, but I think it is very much related to the question you are asking:
Stochastic terrorism: critical reflections on an emerging concept
James AngoveORCID Icon
Pages 21-43 | Received 23 May 2023, Accepted 20 Dec 2023, Published online: 03 Feb 2024
ABSTRACT
This paper critically discusses the recent concept, stochastic terrorism – broadly, the idea that influential individuals may demonise target groups or individuals, inspiring unknown actors to take up terroristic violence against them. I collect together different strains of thought on the emerging concept, reflecting critically on what a suitable definition of the phenomenon would look like (or whether it would be needed), what the social urge to coin the concept may reveal about authoritarian power and violence, and what makes this form of political violence possible. I argue that present commentary fails to emphasise sufficiently the role of mistruth and deceit in such rhetoric, as well as its historical and mainstream precedents. Moreover, I understand the phenomenon to be specifically authoritarian in nature, which not only demonises but dehumanises its targets. In light of this, I suggest that given both the mainstreaming of racist conspiracy theory and the historical and continuing presence of centrally constructed “folk devils”, the authoritarian problem which can manifest into stochastic violence is very much endemic to modern liberal democracies. With this framing of stochastic violence in mind, we ignore it simply as a buzzword at our peril: even if the theoretical issues I have highlighted continue to persist, even if we struggle to pin down the concept with desired clarity – it bears a phenomenological significance and reflects an ongoing political structure of violence.
https://www.tandfonline.com/doi/full/10.1080/17539153.2024.2305742#abstract
-
Ah. Makes sense. In other insurance news:
https://www.newsweek.com/doctors-rail-against-insurers-new-anesthesia-time-limits-1995875
If the only pay for 10 hours of anesthesia in a 14 hour surgery... should hospitals let the patient wake up and scream in pain for the last few hours? Maybe they can use restraints, or give someone a bottle of whisky and a bullet to bite on.
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
Does the board insist on a candidate that promises to reform the claim rejection mechanisms? If you are a top talent CEO, how much premium do you demand to work for a employer that might get you murdered? What do they have to pay in additional 24/7 security? Do key board members or key members of management start resigning out of self preservation?
It is kind of macabre but the assassin might prove to be effective in driving change.
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
Does the board insist on a candidate that promises to reform the claim rejection mechanisms? If you are a top talent CEO, how much premium do you demand to work for a employer that might get you murdered? What do they have to pay in additional 24/7 security? Do key board members or key members of management start resigning out of self preservation?
It is kind of macabre but the assassin might prove to be effective in driving change.
Ha. Haha. No one is reforming claim rejections because that would cut into profits. It seems to me as though they are already getting a premium. And any additional security costs will raise our own premiums or be covered by even more AI replacing workers/denying claims or all of the above. No one is going to be concerned about self preservation unless this is not an isolated incident.
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
If the board is doing their job they already have a written succession plan in place for which other senior executive would take over on an interim basis. Of course hiring the next permanent CEO might be slightly tougher given how the last one went out, but with the type of compensation these folks get I bet there's plenty of people who would happily take the job and just insist on a company-paid security detail.
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
Does the board insist on a candidate that promises to reform the claim rejection mechanisms? If you are a top talent CEO, how much premium do you demand to work for a employer that might get you murdered? What do they have to pay in additional 24/7 security? Do key board members or key members of management start resigning out of self preservation?
It is kind of macabre but the assassin might prove to be effective in driving change.
Ha. Haha. No one is reforming claim rejections because that would cut into profits. It seems to me as though they are already getting a premium. And any additional security costs will raise our own premiums or be covered by even more AI replacing workers/denying claims or all of the above. No one is going to be concerned about self preservation unless this is not an isolated incident.
Thompson pulled in a cool 10 million in 2023. I joined the Army out of school for 18 thousand. For 555 times the comp, I would willingly take the risk for a year or two, no way the danger is greater. I also see his estate gets about 21 million for his untimely demise. My family might encourage me to take the job…
-
[snip] unless this is not an isolated incident.
You folks are even darker than I am. I saw a meme a couple weeks ago that said something to the effect of "If were to eat just ONE of these billionaire mutha fuckas, the rest would fall in line." But @jrhampt has just convinced me we actually have to eat least TWO...
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
If the board is doing their job they already have a written succession plan in place for which other senior executive would take over on an interim basis. Of course hiring the next permanent CEO might be slightly tougher given how the last one went out, but with the type of compensation these folks get I bet there's plenty of people who would happily take the job and just insist on a company-paid security detail.
There are plenty of folks who willingly do life-threatening work for a heck of a lot less than insurance company CEOs make.
The company will just shrug, the replacement will probably gleefully step in, but yeah, might take the death threats a little more seriously than their predecessor.
I can't really see a pathway by which this changes much of anything. I could be wrong, but big, shocking things don't seem to change much anymore.
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
If the board is doing their job they already have a written succession plan in place for which other senior executive would take over on an interim basis. Of course hiring the next permanent CEO might be slightly tougher given how the last one went out, but with the type of compensation these folks get I bet there's plenty of people who would happily take the job and just insist on a company-paid security detail.
Can CEO identities be protected information?
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
If the board is doing their job they already have a written succession plan in place for which other senior executive would take over on an interim basis. Of course hiring the next permanent CEO might be slightly tougher given how the last one went out, but with the type of compensation these folks get I bet there's plenty of people who would happily take the job and just insist on a company-paid security detail.
Can CEO identities be protected information?
I believe officers have be named in SEC filings.
-
I read ... somewhere ... that UHC started using AI instead of people to deal with coverage claims, which led them to deny 90% of all claims. And they continued to use AI, even though it was grossly incorrect on coverage.
-
Who/how do you name an interim CEO in this case? How do you hire a permanent replacement?
If the board is doing their job they already have a written succession plan in place for which other senior executive would take over on an interim basis. Of course hiring the next permanent CEO might be slightly tougher given how the last one went out, but with the type of compensation these folks get I bet there's plenty of people who would happily take the job and just insist on a company-paid security detail.
Can CEO identities be protected information?
Actually, the opposite. They are one of the officers that has to sign the SarbOx docs.
I don't think they have to post a picture, though.
-
CEOs have to be listed by name. There's also requirements for compensation disclosure, and I believe they have to disclose security costs. I can confirm that the (different) big health insurance company I worked for previously did have private security for at least the CEO.
I can't confirm this, but someone on social media was saying that UnitedHealth did not provide security for any of its executives. I don't have time to dig into the filings, but if anyone wants to do so, please report back.
-
United Healthcare is pretty notorious for fucking folks over to make a buck. Seems like sometimes actions have consequences, even for the ultra rich.
-
CEOs have to be listed by name. There's also requirements for compensation disclosure, and I believe they have to disclose security costs. I can confirm that the (different) big health insurance company I worked for previously did have private security for at least the CEO.
I can't confirm this, but someone on social media was saying that UnitedHealth did not provide security for any of its executives. I don't have time to dig into the filings, but if anyone wants to do so, please report back.
I read one report that said he was travelling without his detail; that he was purposely traveling low key.
The Wall Street Journal has an article on the implications for corporate security. UnitedHealth disclosed no costs for executive security. But, separate disclosure is only required when it is is off-duty; essentially, it's a perk, like private air travel. So, at least you could say he had no personal security, or security at his home or for family.
-
Wouldn't it be ironic if his life insurance company denied his policy claim? "It appears your euthanasia was out of network."
-
Wouldn't it be ironic if his life insurance company denied his policy claim? "It appears your euthanasia was out of network."
Maybe he had a Bullworth-esque deal in the works, but life insurance company got wise . . .
-
As someone who's dealt with denial of claims, medical necessity arguments, ect, I'll say "I don't agree with murder, however I also understand how the system/process could drive someone to do it"
The rest of the developed world rations healthcare via provider shortages.
The United States rations healthcare through a third party payor system. At best an insurer should be a speed bump to escalating healthcare costs, battling the hospital systems / pharma companies over what they can charge. When they get into rationing care via pre-approvals, delays, and arbitrary determinations of medical necessity, the only thing surprising about this is it hasn't happened sooner.
My last arugment with Anthem/BCBS was over them determining a proedure was not medically necessary if you were a resident of South Carolina, however they would provide coverage in most surrounding states. They didn't care what one of the 60 or so experts in that field of medicine said, even though said expert had a subspecialty fellowship.
As for the Anesthesia headline, the unsurprising part is Medicare made this change a few months ago and it was accepted, but when Anthem does it they are bad.
My only comments are they need to battle prices, but get out of the business of rationing care and let doctors be doctors.
-
As someone who's dealt with denial of claims, medical necessity arguments, ect, I'll say "I don't agree with murder, however I also understand how the system/process could drive someone to do it"
The rest of the developed world rations healthcare via provider shortages.
The United States rations healthcare through a third party payor system. At best an insurer should be a speed bump to escalating healthcare costs, battling the hospital systems / pharma companies over what they can charge. When they get into rationing care via pre-approvals, delays, and arbitrary determinations of medical necessity, the only thing surprising about this is it hasn't happened sooner.
My last arugment with Anthem/BCBS was over them determining a proedure was not medically necessary if you were a resident of South Carolina, however they would provide coverage in most surrounding states. They didn't care what one of the 60 or so experts in that field of medicine said, even though said expert had a subspecialty fellowship.
As for the Anesthesia headline, the unsurprising part is Medicare made this change a few months ago and it was accepted, but when Anthem does it they are bad.
My only comments are they need to battle prices, but get out of the business of rationing care and let doctors be doctors.
I'd add that our rationing system also increases cost per unit healthcare by massively increasing the administrative friction and need for those administrators to get profits as a percentage of overall budget, including the admin costs. The system may attempt to ration costs for care, but also has absolutely zero incentive for the overally cost of care to go down... quite the opposite in fact.
My SO is a physician who works with a patient population that needs a lot of expensive medical equipment. She literally spends hours arguing with insurance-paid doctors without area specific knowledge about whether parapalegic patients need wheelchairs. Apparently, mobility is not needed for survival, so no medically necessary. Our system is insane and that it drives people out of their minds is understandable, even if not condonable in practice.
-
This is an attack on a rich corporate guy, so we can be sure that law enforcement will do everything they can to find the perpetrator.
If the death was that of, say, a child who was denied cancer treatment, law enforcement will shrug.
-
Shooter used a silencer. Could be a mob hit.
Corp CEOs will use this as an excuse to double their corporate security budgets at home, office and while traveling. More jobs for retired military and FBI types who don't mind wearing suits and earpieces while overhearing executive drivel.
That doesn't make it fun for them.
My in-laws bought a house from an Exxon exec in the 90's. This was when the Exxon Valdez was still fresh. The security system on that house was insane. It's one thing to do it, but to feel you *need* to go to that level would not help me sleep at night.
Our current home was owned by a defrocked Big Pharma CEO who was apparently fairly paranoid. I won't go much into details but it feels a bit like Fort Knox at times. An HVAC guy remarked yesterday remarked that our front doors were the thickest he has ever seen anywhere.
-
Shooter used a silencer. Could be a mob hit.
Corp CEOs will use this as an excuse to double their corporate security budgets at home, office and while traveling. More jobs for retired military and FBI types who don't mind wearing suits and earpieces while overhearing executive drivel.
That doesn't make it fun for them.
My in-laws bought a house from an Exxon exec in the 90's. This was when the Exxon Valdez was still fresh. The security system on that house was insane. It's one thing to do it, but to feel you *need* to go to that level would not help me sleep at night.
Our current home was owned by a defrocked Big Pharma CEO who was apparently fairly paranoid. I won't go much into details but it feels a bit like Fort Knox at times. An HVAC guy remarked yesterday remarked that our front doors were the thickest he has ever seen anywhere.
Why stretch to amass a $100m fortune as a CEO and deal with all the shit that comes with it when you can have everything you could ever want, and generational levels of wealth, by just working hard in a normal job, investing well and keeping your name out of the headlines.
-
Forgive the analogy, as I am in no way making these comparable ethically, morally, etc. etc.
The thing that comes to my mind in regard to this is Columbine. I wonder if we'll see this as a turning point where after this violence against CEOs or other representatives of parties/companies/groups with which people have grievances becomes more commonplace.
-
Why stretch to amass a $100m fortune as a CEO and deal with all the shit that comes with it when you can have everything you could ever want, and generational levels of wealth, by just working hard in a normal job, investing well and keeping your name out of the headlines.
I had a number of perfectly anonymous clients that owned businesses and were worth $50mil to $150mil. It was a sweet spot where they got to choose how public or anonymous they wanted their life to be and could earn that amount in one generation without some massive social / public footprint.
-
Forgive the analogy, as I am in no way making these comparable ethically, morally, etc. etc.
The thing that comes to my mind in regard to this is Columbine. I wonder if we'll see this as a turning point where after this violence against CEOs or other representatives of parties/companies/groups with which people have grievances becomes more commonplace.
It's already commonplace that people shoot each other over grievances. For example there are many instances of doctors and healthcare staff being murdered over perceived blame for a family member's death or even for refusing to prescribe opioids.
-
Forgive the analogy, as I am in no way making these comparable ethically, morally, etc. etc.
The thing that comes to my mind in regard to this is Columbine. I wonder if we'll see this as a turning point where after this violence against CEOs or other representatives of parties/companies/groups with which people have grievances becomes more commonplace.
It's already commonplace that people shoot each other over grievances. For example there are many instances of doctors and healthcare staff being murdered over perceived blame for a family member's death or even for refusing to prescribe opioids.
Oh certainly. I'm specifically referring to shooting a figure head/representative or someone in a position of authority in an organization. Someone that you haven't directly interacted with but who represents the organization to the shooter.
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
The assassination seems meticulously planned. Let's hope the shooter doesn't go on an Andrew Cunanan spree next.
-
I say it's the wife.
-
I say it's the wife.
Agreed.
-
Forgive the analogy, as I am in no way making these comparable ethically, morally, etc. etc.
The thing that comes to my mind in regard to this is Columbine. I wonder if we'll see this as a turning point where after this violence against CEOs or other representatives of parties/companies/groups with which people have grievances becomes more commonplace.
It's already commonplace that people shoot each other over grievances. For example there are many instances of doctors and healthcare staff being murdered over perceived blame for a family member's death or even for refusing to prescribe opioids.
Oh certainly. I'm specifically referring to shooting a figure head/representative or someone in a position of authority in an organization. Someone that you haven't directly interacted with but who represents the organization to the shooter.
Yes, the type of thing we've seen happen in other countries but not routinely in the U.S. Reminds me of stuff we hear about in Mexico or Central/South American countries.
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
It's an interesting moral question.
You have a person who committed a single murder (bad). The person who was murdered though, is responsible for running the company that has killed thousands through denial of care.
If the murderer manages to change the way that the next person running the company does things and that saves just two of those thousands of lives, there's a pretty clear argument that it is morally justified (legality aside).
But there's also the scenario where the system that has been created simply guaranteed that any rich guy running an insurance company will kill people who need health care in order to save money. In that case the murder of the CEO doesn't serve a purpose. He'll simply be replaced with another CEO who will continue to do the same thing. (And in that case, I'd argue that there's really no point in having a CEO as he just seems to function as an overpaid figurehead with no power or responsibility.)
-
I wonder if this changes Trump's "concept of a plan"?
-
I say it's the wife.
Agreed.
Interesting. This hadn't occurred to me, but I suppose it would make sense to make it look like a disgruntled patient or family member (especially when you know those are in no short supply) to divert attention. One thing that gives me pause though is that it seems like this was pretty amateurish, so this doesn't seem like an expert killer hired by the wife. It could be a non-professional (like a lover, perhaps?) but that makes it seem more likely, to me, that the shooter was the one with the issue, not some hired killer or puppet for the wife.
I guess time will tell (assuming they catch him).
-
Some positive change coming out of this already: This has caused Anthem Blue Cross Blue Shield to reverse their position on not covering anesthesia after a certain amount of time:
https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue-shield-anesthesia-anthem
-
If nothing else, this week's response from insurance customers, health providers, nurses, and family members of people who have died as a result of these policies should serve as a message to health insurance companies that they are almost universally disliked, resented, and even hated. Full disclosure - I have worked in the health insurance industry for a couple of decades now, including a short stint at United Health, and I can say that their employees are not treated much better than their customers at this point. There is lots of resentment to go around. I didn't always feel this way about the industry, and some companies are definitely better than others (UHG is probably the low point) but it seems to only get worse over time and people are very, very frustrated.
-
Some positive change coming out of this already: This has caused Anthem Blue Cross Blue Shield to reverse their position on not covering anesthesia after a certain amount of time:
https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue-shield-anesthesia-anthem
Call me cynical, but I can imagine that they will reintroduce this policy in a few months when the media circus moves on. In a few months, they can wait to sneak in a policy update late on a Friday while the medica is focused on how Donald Trump has tweeted a new plan to give the Michigan Peninsula to Wisconsin because Gretchen Whitmer said mean things about him.
-
If nothing else, this week's response from insurance customers, health providers, nurses, and family members of people who have died as a result of these policies should serve as a message to health insurance companies that they are almost universally disliked, resented, and even hated. Full disclosure - I have worked in the health insurance industry for a couple of decades now, including a short stint at United Health, and I can say that their employees are not treated much better than their customers at this point. There is lots of resentment to go around. I didn't always feel this way about the industry, and some companies are definitely better than others (UHG is probably the low point) but it seems to only get worse over time and people are very, very frustrated.
Is it at all a surprise to these companies that they're universally hated though??
-
Some positive change coming out of this already: This has caused Anthem Blue Cross Blue Shield to reverse their position on not covering anesthesia after a certain amount of time:
https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue-shield-anesthesia-anthem
Call me cynical, but I can imagine that they will reintroduce this policy in a few months when the media circus moves on. In a few months, they can wait to sneak in a policy update late on a Friday while the medica is focused on how Donald Trump has tweeted a new plan to give the Michigan Peninsula to Wisconsin because Gretchen Whitmer said mean things about him.
Haha, totally, but at least it’s a few months reprieve… get your surgeries in now, don’t wait until the policy gets reinstated!
-
Some positive change coming out of this already: This has caused Anthem Blue Cross Blue Shield to reverse their position on not covering anesthesia after a certain amount of time:
https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue-shield-anesthesia-anthem
FWIW, CMS hasn't changed the policy. This just delays it. The insurers will follow what medicare dictates.
There was no outrage when CMS did this earlier in the year.
-
If nothing else, this week's response from insurance customers, health providers, nurses, and family members of people who have died as a result of these policies should serve as a message to health insurance companies that they are almost universally disliked, resented, and even hated. Full disclosure - I have worked in the health insurance industry for a couple of decades now, including a short stint at United Health, and I can say that their employees are not treated much better than their customers at this point. There is lots of resentment to go around. I didn't always feel this way about the industry, and some companies are definitely better than others (UHG is probably the low point) but it seems to only get worse over time and people are very, very frustrated.
Is it at all a surprise to these companies that they're universally hated though??
Hmm. How to put this delicately...yes, I am active in some insurance forums and there were several people this week who expressed surprise/shock at the response to the UHG death. If you haven't personally yet had a bad health situation where you or a close family member had an unfavorable experience with an insurance company and if you don't work in customer service/pre-auths/denials areas of the company, I do think you might buy the positive mission statements/propaganda and the rah-rah town halls for a while, but experience breeds cynicism.
-
Some positive change coming out of this already: This has caused Anthem Blue Cross Blue Shield to reverse their position on not covering anesthesia after a certain amount of time:
https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue-shield-anesthesia-anthem
FWIW, CMS hasn't changed the policy. This just delays it. The insurers will follow what medicare dictates.
There was no outrage when CMS did this earlier in the year.
This was the first I'd heard of this. Is no one protesting the Medicare policy at all?
-
Some positive change coming out of this already: This has caused Anthem Blue Cross Blue Shield to reverse their position on not covering anesthesia after a certain amount of time:
https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue-shield-anesthesia-anthem
FWIW, CMS hasn't changed the policy. This just delays it. The insurers will follow what medicare dictates.
There was no outrage when CMS did this earlier in the year.
This was the first I'd heard of this. Is no one protesting the Medicare policy at all?
CMS established guidelines and published them but from what I read they are not (yet) doing what Anthem BCBS announced they would start doing (routinely paying up to the typical amount for that procedure but requiring additional documentation showing why more anesthetic services were necessary in order to be paid for that extra time).
This is how cost controls tend to work, whether it's by CMS or private health insurers. The announcement was unfortunately timed, though.
-
I say it's the wife.
Agreed.
Interesting. This hadn't occurred to me, but I suppose it would make sense to make it look like a disgruntled patient or family member (especially when you know those are in no short supply) to divert attention. One thing that gives me pause though is that it seems like this was pretty amateurish, so this doesn't seem like an expert killer hired by the wife. It could be a non-professional (like a lover, perhaps?) but that makes it seem more likely, to me, that the shooter was the one with the issue, not some hired killer or puppet for the wife.
I guess time will tell (assuming they catch him).
You must not have heard her first(?) public statements. She was already too helpful "he had death threats, more of them recently" or some such. And estranged or not, she did not sound like I would have expected.
-
If nothing else, this week's response from insurance customers, health providers, nurses, and family members of people who have died as a result of these policies should serve as a message to health insurance companies that they are almost universally disliked, resented, and even hated. Full disclosure - I have worked in the health insurance industry for a couple of decades now, including a short stint at United Health, and I can say that their employees are not treated much better than their customers at this point. There is lots of resentment to go around. I didn't always feel this way about the industry, and some companies are definitely better than others (UHG is probably the low point) but it seems to only get worse over time and people are very, very frustrated.
Is it at all a surprise to these companies that they're universally hated though??
Hmm. How to put this delicately...yes, I am active in some insurance forums and there were several people this week who expressed surprise/shock at the response to the UHG death. If you haven't personally yet had a bad health situation where you or a close family member had an unfavorable experience with an insurance company and if you don't work in customer service/pre-auths/denials areas of the company, I do think you might buy the positive mission statements/propaganda and the rah-rah town halls for a while, but experience breeds cynicism.
I suppose...but I'm not even American and it's so well established in the social discourse that US insurance companies make patients and doctors fucking miserable with their immoral cost-cutting bullshit.
You basically can't watch an American TV show without getting this very, very loud messaging that the entire system is a dystopian hellscape.
-
I say it's the wife.
Agreed.
Interesting. This hadn't occurred to me, but I suppose it would make sense to make it look like a disgruntled patient or family member (especially when you know those are in no short supply) to divert attention. One thing that gives me pause though is that it seems like this was pretty amateurish, so this doesn't seem like an expert killer hired by the wife. It could be a non-professional (like a lover, perhaps?) but that makes it seem more likely, to me, that the shooter was the one with the issue, not some hired killer or puppet for the wife.
I guess time will tell (assuming they catch him).
You must not have heard her first(?) public statements. She was already too helpful "he had death threats, more of them recently" or some such. And estranged or not, she did not sound like I would have expected.
I did see the statements and yeah, she didn't strick me as overly distraught. But grief is also weird and I try to give people a lot of grace in that department, especially when they are doing portions of it publicly. And it does seem possible that she could be not especially sad he's dead, while also not having murdered him. Unless she had a lover and got him to do it, or something like that, the details of the crime don't seem to fit. Sure, writing "deny" on a bullet to deflect could be part of a hired hit, but the (seemingly) relative amateurishness of the execution (in both senses of the word!) doesn't seem to fit a wife-procured hit. But I've been wrong before.
-
If it actually was the wife, that's some next level supervillain shit there.
Considering how close she lived to him, and (presumably) how well she knew his daily routines (they have kids together), it would have been much easier for her to kill him in a less attention getting way. For example, someone could have run him over while he's out walking a dog and it would have been caulked up to just a freak accident.
-
The rest of the developed world rations healthcare via provider shortages.
The United States rations healthcare through a third party payor system. At best an insurer should be a speed bump to escalating healthcare costs, battling the hospital systems / pharma companies over what they can charge. When they get into rationing care via pre-approvals, delays, and arbitrary determinations of medical necessity, the only thing surprising about this is it hasn't happened sooner.
It's not just that for-profit insurance companies directly block people from getting medical care. There's also the ridiculous amounts of paperwork and bureaucracy that they impose. It's effectively a hidden tax on consumers, because of the extra staff that hospitals and doctors' offices are forced to hire to deal with it.
Insurance company overhead is a major part of the reason why the U.S. spends so much more on healthcare than other developed countries. According to this article, it accounts for more than a third of total healthcare spending:
https://www.reuters.com/article/business/healthcare-pharmaceuticals/more-than-a-third-of-us-healthcare-costs-go-to-bureaucracy-idUSKBN1Z5260/
U.S. insurers and providers spent more than $800 billion in 2017 on administration, or nearly $2,500 per person - more than four times the per-capita administrative costs in Canada's single-payer system, a new study finds.
Over one third of all healthcare costs in the U.S. were due to insurance company overhead and provider time spent on billing, versus about 17% spent on administration in Canada, researchers reported in Annals of Internal Medicine.
-
I agree, and it's also an indirect drain on businesses.
Employees dealing with health care insurers and administrators mainly have to do so during typical office hours, Mon-Fri,
9am to 5pm. Meaning workers have to take time during the workday to try to appeal claims denials or fix snafus instead of doing their job.
I worked in cubicle-land for many years and overheard scores of conversations from co-workers who were forced to handle these things in a not so private workspace.
I always wondered why private corporations didn't insist on Medicare for all for this reason alone: it would eliminate the many hours their employees had to spend on this and let them spend that time focused on their jobs instead.
-
https://nymag.com/intelligencer/article/united-healthcare-ceo-shooting-corporate-america-panic.html
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
It's an interesting moral question.
You have a person who committed a single murder (bad). The person who was murdered though, is responsible for running the company that has killed thousands through denial of care.
If the murderer manages to change the way that the next person running the company does things and that saves just two of those thousands of lives, there's a pretty clear argument that it is morally justified (legality aside).
But there's also the scenario where the system that has been created simply guaranteed that any rich guy running an insurance company will kill people who need health care in order to save money. In that case the murder of the CEO doesn't serve a purpose. He'll simply be replaced with another CEO who will continue to do the same thing. (And in that case, I'd argue that there's really no point in having a CEO as he just seems to function as an overpaid figurehead with no power or responsibility.)
Your argument that a denial of resources which leads to someone's death can be equated with a wilful causing of a death can lead to many difficult moral questions being asked. I don't see the moral equivalence at all.
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
It's an interesting moral question.
You have a person who committed a single murder (bad). The person who was murdered though, is responsible for running the company that has killed thousands through denial of care.
If the murderer manages to change the way that the next person running the company does things and that saves just two of those thousands of lives, there's a pretty clear argument that it is morally justified (legality aside).
But there's also the scenario where the system that has been created simply guaranteed that any rich guy running an insurance company will kill people who need health care in order to save money. In that case the murder of the CEO doesn't serve a purpose. He'll simply be replaced with another CEO who will continue to do the same thing. (And in that case, I'd argue that there's really no point in having a CEO as he just seems to function as an overpaid figurehead with no power or responsibility.)
Your argument that a denial of resources which leads to someone's death can be equated with a wilful causing of a death can lead to many difficult moral questions being asked. I don't see the moral equivalence at all.
Technically, denying insurance coverage would not be homicide or manslaughter, even though it is morally reprehensible. This is because there is no assumed intent to do harm. In this case, it is an entity choosing to have money instead of paying for care. Apparently willingness to do harm in the name of greed is not intent to do harm.
I think that if we are going to have an insurance based medical system, that we should have a formal malpractice type liablity for the insurance decisions. Any person making claim decisions should have personal liability or some structure to make liabillity for health insurance companies actually have teeth. Perhaps there should be a licensure for decision making that affects medical care distribution. Malpractice type action can result in your loss of ability to work in the field. Automated claim review should have strick guardrails.
I personally think that it would be appropriate to not allow insurance providers to be for-profit. The incentive structures do not align for a public good. The market efficiencies are only leveraged to increase profit, which - as middlemen - can only come through increased gap between premiums and care paid for.
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
It's an interesting moral question.
You have a person who committed a single murder (bad). The person who was murdered though, is responsible for running the company that has killed thousands through denial of care.
If the murderer manages to change the way that the next person running the company does things and that saves just two of those thousands of lives, there's a pretty clear argument that it is morally justified (legality aside).
But there's also the scenario where the system that has been created simply guaranteed that any rich guy running an insurance company will kill people who need health care in order to save money. In that case the murder of the CEO doesn't serve a purpose. He'll simply be replaced with another CEO who will continue to do the same thing. (And in that case, I'd argue that there's really no point in having a CEO as he just seems to function as an overpaid figurehead with no power or responsibility.)
Your argument that a denial of resources which leads to someone's death can be equated with a wilful causing of a death can lead to many difficult moral questions being asked. I don't see the moral equivalence at all.
Come back after you Google "price famine".
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
It's an interesting moral question.
You have a person who committed a single murder (bad). The person who was murdered though, is responsible for running the company that has killed thousands through denial of care.
If the murderer manages to change the way that the next person running the company does things and that saves just two of those thousands of lives, there's a pretty clear argument that it is morally justified (legality aside).
But there's also the scenario where the system that has been created simply guaranteed that any rich guy running an insurance company will kill people who need health care in order to save money. In that case the murder of the CEO doesn't serve a purpose. He'll simply be replaced with another CEO who will continue to do the same thing. (And in that case, I'd argue that there's really no point in having a CEO as he just seems to function as an overpaid figurehead with no power or responsibility.)
Your argument that a denial of resources which leads to someone's death can be equated with a wilful causing of a death can lead to many difficult moral questions being asked. I don't see the moral equivalence at all.
Technically, denying insurance coverage would not be homicide or manslaughter, even though it is morally reprehensible. This is because there is no assumed intent to do harm. In this case, it is an entity choosing to have money instead of paying for care. Apparently willingness to do harm in the name of greed is not intent to do harm.
I think that if we are going to have an insurance based medical system, that we should have a formal malpractice type liablity for the insurance decisions. Any person making claim decisions should have personal liability or some structure to make liabillity for health insurance companies actually have teeth. Perhaps there should be a licensure for decision making that affects medical care distribution. Malpractice type action can result in your loss of ability to work in the field. Automated claim review should have strick guardrails.
I personally think that it would be appropriate to not allow insurance providers to be for-profit. The incentive structures do not align for a public good. The market efficiencies are only leveraged to increase profit, which - as middlemen - can only come through increased gap between premiums and care paid for.
A few things:
1. Not every case of denying insurance coverage is morally reprehensible. It depends if the insurance term was disclosed transparently and is interpreted reasonably. If a term of insurance is that pre-existing conditions are not covered and the insurer refuses a claim that relates to a pre-existing condition, then there's no moral difficulty there at all. I am sure that some insurers act immorally, but that doesn't mean that every insurer act is immoral.
2. I disagree that the greedy keeping of money (which then results in a bad outcome for someone else) is the same as a willingness to do harm. You could otherwise use the argument against anyone who hoards money instead of giving it to charity; anyone who puts up rent on her investment property when the rent increase is driven purely by greed or market economics; any lawyer who refuses to do legal aid work and does only high-paying private legal work (or the corresponding doctor); etc etc.
As for insurers forced to be not private, we have a National Disability Insurance Scheme in Australia where the government pays for medical and disability services for a small portion of the population which has a disability. Fewer than 2.5% of Australians are on the NDIS, but total spending on NDIS now exceeds total Medicare spending on everyone else combined. So I don't know that a public system is any more efficient.
-
A few things:
1. Not every case of denying insurance coverage is morally reprehensible. It depends if the insurance term was disclosed transparently and is interpreted reasonably. If a term of insurance is that pre-existing conditions are not covered and the insurer refuses a claim that relates to a pre-existing condition, then there's no moral difficulty there at all. I am sure that some insurers act immorally, but that doesn't mean that every insurer act is immoral.
In the U.S., one key piece of the ACA is that it prohibits the use of pre-existing conditions to deny coverage, increase premiums, or make people wait for care. So this example would not only be morally reprehensible, but also (thankfully) illegal.
2. I disagree that the greedy keeping of money (which then results in a bad outcome for someone else) is the same as a willingness to do harm. You could otherwise use the argument against anyone who hoards money instead of giving it to charity; anyone who puts up rent on her investment property when the rent increase is driven purely by greed or market economics; any lawyer who refuses to do legal aid work and does only high-paying private legal work (or the corresponding doctor); etc etc.
Yes, there are, of course, degrees to things. United Healthcare was particularly egregious in denying claims and making patients' lives difficult. They deny twice the national average (1 of every 3 claims). And they relied on Artificial Intelligence to process (and deny) claims, 90% of which were overturned when challenged. This is pretty damn inexcusable. We don't yet know the assassin's motives, but being on the other end of such an outrageous claim dispute, either for himself or a family member, puts him pretty close to "justifiable" territory, for me. The executives of these companies do not understand humanity—they understand dollar bills only.
As for insurers forced to be not private, we have a National Disability Insurance Scheme in Australia where the government pays for medical and disability services for a small portion of the population which has a disability. Fewer than 2.5% of Australians are on the NDIS, but total spending on NDIS now exceeds total Medicare spending on everyone else combined. So I don't know that a public system is any more efficient.
I won't claim to know anything about Australian healthcare. But I know the U.S. healthcare system. And we pay more than any other country on the planet. And have significantly worse results to show for it. The life expectancy in the U.S. is 77 years old. Australia, for example, has a life expectancy of 83 years old. The U.S. spends twice as much per capita as Australia does on healthcare.
-
...
A few things:
1. Not every case of denying insurance coverage is morally reprehensible. It depends if the insurance term was disclosed transparently and is interpreted reasonably. If a term of insurance is that pre-existing conditions are not covered and the insurer refuses a claim that relates to a pre-existing condition, then there's no moral difficulty there at all. I am sure that some insurers act immorally, but that doesn't mean that every insurer act is immoral.
2. I disagree that the greedy keeping of money (which then results in a bad outcome for someone else) is the same as a willingness to do harm. You could otherwise use the argument against anyone who hoards money instead of giving it to charity; anyone who puts up rent on her investment property when the rent increase is driven purely by greed or market economics; any lawyer who refuses to do legal aid work and does only high-paying private legal work (or the corresponding doctor); etc etc.
As for insurers forced to be not private, we have a National Disability Insurance Scheme in Australia where the government pays for medical and disability services for a small portion of the population which has a disability. Fewer than 2.5% of Australians are on the NDIS, but total spending on NDIS now exceeds total Medicare spending on everyone else combined. So I don't know that a public system is any more efficient.
For 1 and 2: insurance companies are not allowed to exclude pre existing conditions under the ACA. I also agree that it is reasonable that a fraction of insurance claims are not legitimate and should be denied. I think that the cases we are talking about here are ones where the procedure or medication is recommended by a doctor, is medically necessary, and shoudl be covered under the terms of their insurance. The absolute prevalence of this type of activity indicates that it is a structural goal of many of these companies. If the structural goal is to find reasons to deny claims (thus increasing profits), it is reasonable to infer that they are willing to do harm by denying payment for medical services.
For 3: in most insurance pools/populations, a small number of parties account for the majority of expenses. If a system is set up to cover a specific population with a reasonably expected higher medical cost (such as those with disabilities) the per capita cost should be expected to be much higher assuming constant system efficiency.
Insurance companies in the US profit more when there is more administrative load. Capitalism drives towards efficient profits, and will not drive towards competitive efficiency in delivering services.
An anecdotal aside/example is the difference between public utility districts and private utility districts. PUDs, in my experience, operate their systems better, are more responsive to the public, and are less expensive.
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
-
Technically, denying insurance coverage would not be homicide or manslaughter, even though it is morally reprehensible. This is because there is no assumed intent to do harm. In this case, it is an entity choosing to have money instead of paying for care. Apparently willingness to do harm in the name of greed is not intent to do harm.
Intent to do harm is not required for negligent homicide.
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
-
I agree, and it's also an indirect drain on businesses.
Employees dealing with health care insurers and administrators mainly have to do so during typical office hours, Mon-Fri,
9am to 5pm. Meaning workers have to take time during the workday to try to appeal claims denials or fix snafus instead of doing their job.
I worked in cubicle-land for many years and overheard scores of conversations from co-workers who were forced to handle these things in a not so private workspace.
Yes, that too. My wife has had several medical procedures in the past couple of years where her insurer tried to deny coverage for routine care, or billed us for things that should have been covered. She had to fight them each time, spending hours on the phone to resolve it.
I'm FIREd and she works mostly from home, so even though it was a burden on us, we had the time to spend on it. Someone with a less flexible job, like a teacher, would have a much harder time or wouldn't have been able to fight it at all.
I always wondered why private corporations didn't insist on Medicare for all for this reason alone: it would eliminate the many hours their employees had to spend on this and let them spend that time focused on their jobs instead.
I may be cynical, but I bet big companies prefer the burdensome system we have now because it's a moat that they can deal with, but smaller competitors can't. It holds down the competition from small businesses and startups.
-
I may be cynical, but I bet big companies prefer the burdensome system we have now because it's a moat that they can deal with, but smaller competitors can't. It holds down the competition from small businesses and startups.
Less so now with the ACA, but I think it also makes employees more beholden to their employers. Everyone knows that medical care can potentially bankrupt them without proper insurance. And where do most people of working age get medical insurance?
-
I'm frankly disgusted at the inequality of treatment. 100 policemen beating the bushes of Central Park!
-
I'm waiting to see when they catch this guy whether the jurors on his trial will go rogue, ala O.J. Simpson's jury.
Given the public reaction to date I can honestly seeing that scenario happening.
It's an interesting moral question.
You have a person who committed a single murder (bad). The person who was murdered though, is responsible for running the company that has killed thousands through denial of care.
If the murderer manages to change the way that the next person running the company does things and that saves just two of those thousands of lives, there's a pretty clear argument that it is morally justified (legality aside).
But there's also the scenario where the system that has been created simply guaranteed that any rich guy running an insurance company will kill people who need health care in order to save money. In that case the murder of the CEO doesn't serve a purpose. He'll simply be replaced with another CEO who will continue to do the same thing. (And in that case, I'd argue that there's really no point in having a CEO as he just seems to function as an overpaid figurehead with no power or responsibility.)
I thought about this after watching "Extreme Measures" (1996) where Gene Hackman made the following point:
"If you could cure cancer by killing one person, wouldn't you have to do that?"
https://www.imdb.com/title/tt0116259/
In my view, the flaw is the missing "with 100% certainty" in that quote. One person's death for cancer research contributes, but doesn't cure cancer. And going back to the healthcare example, there is no certainty the next CEO's actions will save lives, compared to the prior CEO.
-
And in the ongoing issue of for-profit vs. not-for-profit health care, get ready for more of your taxes going to the for-profit insurance companies:
Apparently the U.S. is at a tipping point where more citizens turning 65 are choosing the for-profit Medicare Advantage plans vs. original government not-for-profit Medicare. It's initially attractive because of low premiums and perks like limited dental and vision coverage, but people are finding out - surprise! - that it comes with excessive prior authorization denial rates, slow payments, and only emergency treatment while traveling, so now many doctors and health care systems are refusing Medicare Advantage patients.
When are we going to learn that profit should not be included in any health care scheme?
-
I'm frankly disgusted at the inequality of treatment. 100 policemen beating the bushes of Central Park!
+1
-
And in the ongoing issue of for-profit vs. not-for-profit health care, get ready for more of your taxes going to the for-profit insurance companies:
Apparently the U.S. is at a tipping point where more citizens turning 65 are choosing the for-profit Medicare Advantage plans vs. original government not-for-profit Medicare. It's initially attractive because of low premiums and perks like limited dental and vision coverage, but people are finding out - surprise! - that it comes with excessive prior authorization denial rates, slow payments, and only emergency treatment while traveling, so now many doctors and health care systems are refusing Medicare Advantage patients.
When are we going to learn that profit should not be included in any health care scheme?
It's not surprising when you see some of the advertisements that target seniors and people nearing/at 65. They are quite misleading/convincing. People who don't have the time or inclination or even the idea to do their own research into how Medicare actually works may not even understand that they're getting private insurance.
In my family's experience, traditional Medicare plus so-called Medigap (supplemental) insurance is the gold standard. I hope when I get to that age it's still a viable option.
-
And in the ongoing issue of for-profit vs. not-for-profit health care, get ready for more of your taxes going to the for-profit insurance companies:
Apparently the U.S. is at a tipping point where more citizens turning 65 are choosing the for-profit Medicare Advantage plans vs. original government not-for-profit Medicare. It's initially attractive because of low premiums and perks like limited dental and vision coverage, but people are finding out - surprise! - that it comes with excessive prior authorization denial rates, slow payments, and only emergency treatment while traveling, so now many doctors and health care systems are refusing Medicare Advantage patients.
When are we going to learn that profit should not be included in any health care scheme?
I'm lost. I thought that those were add ones not complete replacements for Medicare.
-
And in the ongoing issue of for-profit vs. not-for-profit health care, get ready for more of your taxes going to the for-profit insurance companies:
Apparently the U.S. is at a tipping point where more citizens turning 65 are choosing the for-profit Medicare Advantage plans vs. original government not-for-profit Medicare. It's initially attractive because of low premiums and perks like limited dental and vision coverage, but people are finding out - surprise! - that it comes with excessive prior authorization denial rates, slow payments, and only emergency treatment while traveling, so now many doctors and health care systems are refusing Medicare Advantage patients.
When are we going to learn that profit should not be included in any health care scheme?
I'm lost. I thought that those were add ones not complete replacements for Medicare.
No, Medicare Advantage plans are not Medicare at all but private health insurance in lieu of Medicare.
Medicare Advantage plans are some of the most predatorial health insurance products out there.
Insurance companies offering these products target one of the most vulnerable populations out there, namely the old and sick on fixed income. The victims are typically unable to deal with insurance company shenanigans and are bankrupted, go untreated or die.
Medicare Advantage Myth-Busting
March 14, 2024
Brandon Novick
This year, the majority of Americans eligible for Medicare coverage chose to enroll in private Medicare Advantage (MA) plans rather than Traditional Medicare. Insurance companies that run these MA plans spend significant sums of money to blanket seniors with marketing that highlights the supposed advantages of MA like low upfront costs, supplemental coverage, and other unique perks like subsidizing gym memberships. However, the ads leave seniors in the dark on the downsides of MA like heavily restricted networks that damage one’s choice of provider along with dangerous delays and denials of necessary care. At the same time, both the Biden Administration and many members of Congress from both parties have voiced support for the further privatization of Medicare through growing Medicare Advantage.
...
All in All, Medicare Advantage Is a Scam
Congress created Medicare Advantage with the 2003 Medicare Prescription Drug Improvement and Modernization Act (MMA). After signing the bill into law, President George W. Bush boasted how MA would lower costs, expand benefits, afford seniors more choices, and improve quality of care. However, this supposed modernization of Medicare was really a scheme to privatize, gifting billions of dollars to insurance companies while seeking to end Traditional Medicare.
In reality, MA has never saved taxpayer money. Through gaming the system of capitated payments, MA insurance companies have reaped billions in overpayments — which have also increased the amount all Medicare beneficiaries pay in Part B premiums.
Through restricting care and taxpayer subsidies, MA plans do offer a lower cost alternative to Traditional Medicare, especially for beneficiaries who cannot afford a supplemental Medigap plan. Additionally, it can offer supplemental benefit coverage unavailable under Traditional Medicare, even if the quality of such coverage is poor and provides limited financial support. However, this reality is not because of its inherent design; it is a result of the political sabotage of Traditional Medicare. Congress can cap OOP expenses and provide supplemental coverage for Traditional Medicare with the same money it overpays to MA insurance giants lining their profit margins.
The only choices MA afforded seniors has been which private plan they want to choose. The program destroys beneficiaries’ choice of doctor due to restricted networks. Additionally, there is not sufficient evidence that MA significantly improves health outcomes while health providers are increasingly dropping MA plans due to low reimbursements, further limiting the number of providers MA patients can see. At the same time, current comparisons between MA and Traditional Medicare are unfair as long as policy makers refuse to fix the cost gaps in the latter.
Within both the Medicare and entire American populations, healthcare costs are rising at the same time as health outcomes are worsening, especially in comparison to peer nations. While MA is a convenient solution for insurance companies, it neither addresses the causes of high prices nor poor health outcomes.
MA proponents consistently point to the increasing share of beneficiaries who choose MA over Traditional Medicare as evidence of success. Along with millions of dollars spent on deceptive advertising by insurance companies, this is the consequence of policymaker’s failure to update Traditional Medicare.
It’s past time Medicare beneficiaries are given a real choice. Instead of overpaying insurance giants to the tune of hundreds of billions of dollars, Congress can cap OOP expenses at $5,000 annually and provide supplemental benefits in Traditional Medicare.
https://www.cepr.net/medicare-advantage-mythbusting/
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
Also, this was paired in the ACA with a requirement for universal coverage. If you were young and fit (and invincible) and so skipped coverage, you were fined essentially the amount of premium. This was exactly to keep the insured pool from reducing to the most sick, and making premiums spiral. Republican efforts during the first Trump administration eventually led to that penalty being lowered to $0, in the hopes said death spiral would happen. Only, it hasn't. The ACA has continued to grow enrollment since then.
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
Also, this was paired in the ACA with a requirement for universal coverage. If you were young and fit (and invincible) and so skipped coverage, you were fined essentially the amount of premium. This was exactly to keep the insured pool from reducing to the most sick, and making premiums spiral. Republican efforts during the first Trump administration eventually led to that penalty being lowered to $0, in the hopes said death spiral would happen. Only, it hasn't. The ACA has continued to grow enrollment since then.
Universal coverage means the young and healthy subsidise the premiums of the old and chronically ill. It would be like all drivers being categorised as having the same driving history. Great for someone who's had a DUI conviction. Not so good for the person without a speeding fine in 20 years.
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
Also, this was paired in the ACA with a requirement for universal coverage. If you were young and fit (and invincible) and so skipped coverage, you were fined essentially the amount of premium. This was exactly to keep the insured pool from reducing to the most sick, and making premiums spiral. Republican efforts during the first Trump administration eventually led to that penalty being lowered to $0, in the hopes said death spiral would happen. Only, it hasn't. The ACA has continued to grow enrollment since then.
Universal coverage means the young and healthy subsidise the premiums of the old and chronically ill. It would be like all drivers being categorised as having the same driving history. Great for someone who's had a DUI conviction. Not so good for the person without a speeding fine in 20 years.
Not a fair comparison. You can choose not to drive drunk but you can't really choose not to become ill or disabled. The whole point in insurance is that you can't predict who it will happen to and when.
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
Also, this was paired in the ACA with a requirement for universal coverage. If you were young and fit (and invincible) and so skipped coverage, you were fined essentially the amount of premium. This was exactly to keep the insured pool from reducing to the most sick, and making premiums spiral. Republican efforts during the first Trump administration eventually led to that penalty being lowered to $0, in the hopes said death spiral would happen. Only, it hasn't. The ACA has continued to grow enrollment since then.
Universal coverage means the young and healthy subsidise the premiums of the old and chronically ill. It would be like all drivers being categorised as having the same driving history. Great for someone who's had a DUI conviction. Not so good for the person without a speeding fine in 20 years.
Not a fair comparison. You can choose not to drive drunk but you can't really choose not to become ill or disabled. The whole point in insurance is that you can't predict who it will happen to and when.
Yes, more like people who were driving cars with airbags that would project shrapnel, vs. those who weren't. It wasn't until long after the purchase that the fact was known. Same with cancer, alzheimer's etc. You can't "healthy life" your way past hereditary diseases, or environmental damage.
And, everyone gets old eventually. Over a lifetime, whatever subsidizing occurs gets reversed. Advocate for "young rights" at your peril.
-
There is a scene in "A Christmas Carol", where Scrooge is being show the town's reaction to his death. Basically, nobody is sad because he was a worthless piece of shit who valued profit over people. Why is that considered a heartwarming morality tale when it is considered tacky to throw shade at this CEO?
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
Also, this was paired in the ACA with a requirement for universal coverage. If you were young and fit (and invincible) and so skipped coverage, you were fined essentially the amount of premium. This was exactly to keep the insured pool from reducing to the most sick, and making premiums spiral. Republican efforts during the first Trump administration eventually led to that penalty being lowered to $0, in the hopes said death spiral would happen. Only, it hasn't. The ACA has continued to grow enrollment since then.
Universal coverage means the young and healthy subsidise the premiums of the old and chronically ill. It would be like all drivers being categorised as having the same driving history. Great for someone who's had a DUI conviction. Not so good for the person without a speeding fine in 20 years.
Kind of what the point of insurance is, isn't it?
The comparison of health insurance with car insurance risk pooling is fallacious as it rests on a false equivalency:
Car insurance is required to cover a risk that is imposed on others while exercising the privilege of operating a piece of dangerous equipment in shared public space.
Stratifying the pool of the insured into risk pools with premiums proportional to the risk brought to bear on the public makes perfect sense when it comes to car insurance.
Access to affordable health care is a nearly universal need that arises from unpredictable biologic events/injuries and is brought into being by merely existing as a human being. (And yes, there are risks imposed on others by simply living, such as infectious diseases etc., but that veers into public health, not individual health which is what concerns health insurance.)
In addition, the comparison fails on the grounds that the pool of the young and healthy is somehow comparable to people who forego driving a car and therefore do not require insurance.
It does not take much to realize that young and healthy people do carry a risk of becoming ill, whereas it is impossible for a person who does not operate a car to become involved in an at fault motor vehicle accident while driving a car.
The false equivalency fallacy might be the most common logical fallacy employed in bad faith arguments and is also rampant in meme level reasoning, but typically does not hold up on even cursory evaluation.
The false equivalency fallacy is an indicator of either malicious intent (typically a derailing effort) or weak thinking on the part of the writer/speaker.
We seem to get a lot of weak thinking and opinionating from relatively clueless Australian posters who for, some reason, are interested in American politics - is there something in the water over there or is it simply that life is so boring on the island that even discussions of US healthcare become a source of entertainment.
-
Not quoting to save space...
ACA premiums are age adjusted and can be up to 3 times higher for an elderly person than a young one. Rates can also be adjusted upwards for people who smoke tobacco. So, yes, to some extent the young and healthy subsidize old and sick, but it is not quite an outright plundering of the young to finance health care for the elderly.
The insurance is a risk pool with generic adjustments based on where you fit in those populations rather than pre-existing conditions (ie, for age or smoking as a behavior rather than presence of emphazema). The pre-existing conditions clause also prevents the reverse moral hazard case in which insurers simply drop (or make prohibitively expensive) for patients likely to be expensive while basing premiums on the full risk pool.
-
Not quoting to save space...
ACA premiums are age adjusted and can be up to 3 times higher for an elderly person than a young one. Rates can also be adjusted upwards for people who smoke tobacco. So, yes, to some extent the young and healthy subsidize old and sick, but it is not quite an outright plundering of the young to finance health care for the elderly.
...
True, when looked at solely from the perspective of the insured and what they have to pay (when paying full fare) - but there are also the premium subsidies which amount to around 50% (an accurate number is hard to find) and those subsidies are paid from tax $$ which, in turn, end up as higher subsidies for older people thus leveling individual cost to some degree.
I'd really like to see some numbers to get a better handle on this but I think it is safe to say that, for the insured, the actual difference in premiums paid might not be that great between the young and the old. Where it does show up is in the payments to insurance companies, who receive more for older and less for younger people.
-
Not quoting to save space...
ACA premiums are age adjusted and can be up to 3 times higher for an elderly person than a young one. Rates can also be adjusted upwards for people who smoke tobacco. So, yes, to some extent the young and healthy subsidize old and sick, but it is not quite an outright plundering of the young to finance health care for the elderly.
The insurance is a risk pool with generic adjustments based on where you fit in those populations rather than pre-existing conditions (ie, for age or smoking as a behavior rather than presence of emphazema). The pre-existing conditions clause also prevents the reverse moral hazard case in which insurers simply drop (or make prohibitively expensive) for patients likely to be expensive while basing premiums on the full risk pool.
I don’t know at what age you consider someone “elderly” but in my book elderly people are on Medicare.
-
There is a scene in "A Christmas Carol", where Scrooge is being show the town's reaction to his death. Basically, nobody is sad because he was a worthless piece of shit who valued profit over people. Why is that considered a heartwarming morality tale when it is considered tacky to throw shade at this CEO?
Because the idea of abusing wealth to hurt the lower class has been deified in our hypercapitalist society enough to distort many people's view of morality.
-
There is a scene in "A Christmas Carol", where Scrooge is being show the town's reaction to his death. Basically, nobody is sad because he was a worthless piece of shit who valued profit over people. Why is that considered a heartwarming morality tale when it is considered tacky to throw shade at this CEO?
Because the idea of abusing wealth to hurt the lower class has been deified in our hypercapitalist society enough to distort many people's view of morality.
And in reality, no one gives a fuck about Tiny Tim and the public would probably elect Scrooge to office.
-
There is a scene in "A Christmas Carol", where Scrooge is being show the town's reaction to his death. Basically, nobody is sad because he was a worthless piece of shit who valued profit over people. Why is that considered a heartwarming morality tale when it is considered tacky to throw shade at this CEO?
I mean... one is a fictional character and the other is a dead actual human being, father, and husband. Just spitballing, but that may have something to do with it.
-
I've spent time thinking about why I'm totally okay with this murder. It's not my normal reaction to such things. I'm a strong believer in the rule of law, due process, etc.
It comes down to two things. The first is personal.
My wife recently went through chemotherapy and I got to witness the necessity of anti-nausea medications first hand. It took the doctors a few chemo sessions to figure out the right anti-nausea dosage. These aren't pills. This was a one-hour IV drip of a fluid that blocked nerve receptors in her spinal cord right before the dose of chemotherapy. The chemo drugs are ones that will actually cause skin burns if it touches your skin, but are somehow safe to put in your veins. My wife was incapable of leaving bed for about 3 days after each chemo session. Dealing with this while raising two kids under 10 is the hardest thing I've done in my life. It was harder than going to war and watching people get blown up.
If I had an insurance company throw anti-nasuea denials at me in the middle of chemo (as UHC is known to do), the thought of murder would have crossed my mind. Not to the point of action, but it would have been considered. A company that behaves this way has gone further than amoral profit seeking. They have moved to the point of being actually evil. There have been plenty of evil human beings throughout history, and having a wife and children doesn't change their fundamental human character.
Normally we can trust the justice system to deal with bad-actors in our world. That is the point of the justice system.
However, in my career, I've had more than passing interactions with the health care industry. I don't know it deeply, but I've done consulting for some health care companies. My first exposure was a client that would be hit by the federal "surprise billing" legislation that came up a few years back. I watched the company mobilize every financial resource to defeat that legislation. In the end it was watered down to such a degree as to make it meaningless.
I also attended an annual dinner for our local Biotech association. They gave awards and thanks to the PHRMA representatives that were personally responsible for killing state-level legislation designed to cut costs in the health care industry.
This is just a long way of saying that there is no due-process when it comes to the healthcare or health insurance industry. The insurance industry has a liability shield written into law that prevents them from being sued for these decisions. The laws are written by and for the health insurance industry. Even when it comes to behavior that I consider to be outright evil.
If the state is working in collusion with corporate bad actors, what options are there other than vigilante justice? This isn't a rhetorical question. I despise the idea of vigilante justice, but am failing to find due process that can be used to hold these companies accountable.
-
@NorCal All that your family was managing over that period sounds incredibly difficult, indeed. I hope that the prognosis and outlook is positive moving forward.
I was not aware of the liability shields written into those laws. It is odd to me that decisions overriding doctors are shielded from liability, while decisions and actions of doctors are not. My SO has been called in to testify at multiple cases even in her short time of practice to date, so it's not like cases are not being brought for medical liability. I guess the doctors are so busy filling out the forms, notes, and documentation so that their work meets billing standards that they don't have the cohesion to advocate as effectively for themselves as the insurers. Make no mistake: the reason that you are weighed, height measured, and blood pressure taken at every doctor visit is because it is to meet the criteria for billing as a doctor's visit, not because it is necessarily appropriate for every appointment with a doctor.
I think the disconnect is that we (the public) want a system where we pay into a common fund and that fund is used to pay for our health care when we need it. Most years we will pay more than we get in services, but it is there when SHTF.
-
@NorCal All that your family was managing over that period sounds incredibly difficult, indeed. I hope that the prognosis and outlook is positive moving forward.
I was not aware of the liability shields written into those laws. It is odd to me that decisions overriding doctors are shielded from liability, while decisions and actions of doctors are not. My SO has been called in to testify at multiple cases even in her short time of practice to date, so it's not like cases are not being brought for medical liability. I guess the doctors are so busy filling out the forms, notes, and documentation so that their work meets billing standards that they don't have the cohesion to advocate as effectively for themselves as the insurers. Make no mistake: the reason that you are weighed, height measured, and blood pressure taken at every doctor visit is because it is to meet the criteria for billing as a doctor's visit, not because it is necessarily appropriate for every appointment with a doctor.
I think the disconnect is that we (the public) want a system where we pay into a common fund and that fund is used to pay for our health care when we need it. Most years we will pay more than we get in services, but it is there when SHTF.
I don’t have time to search for it now, but I recall the WSJ (I think) doing a piece on this liability shield a while back.
The short version is that a big insurance company pulled a coverage denial on a litigation attorney.
This attorney dedicated multiple years of his life to recovering tens-of-thousands of dollars. He wasn’t able to recover significant damages, or even enough money for attorneys fees. This is the best legal outcome possible.
The firearms industry has a similar liability shield in place.
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
Also, this was paired in the ACA with a requirement for universal coverage. If you were young and fit (and invincible) and so skipped coverage, you were fined essentially the amount of premium. This was exactly to keep the insured pool from reducing to the most sick, and making premiums spiral. Republican efforts during the first Trump administration eventually led to that penalty being lowered to $0, in the hopes said death spiral would happen. Only, it hasn't. The ACA has continued to grow enrollment since then.
Universal coverage means the young and healthy subsidise the premiums of the old and chronically ill. It would be like all drivers being categorised as having the same driving history. Great for someone who's had a DUI conviction. Not so good for the person without a speeding fine in 20 years.
Not a fair comparison. You can choose not to drive drunk but you can't really choose not to become ill or disabled. The whole point in insurance is that you can't predict who it will happen to and when.
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
It's true that you can't predict your future state of health, which is why you take out insurance in the first place. The question is whether the insurance premium itself should vary depending on risk factors. For one, failure to vary it means that adverse selection is more likely.
-
Kind of what the point of insurance is, isn't it?
The comparison of health insurance with car insurance risk pooling is fallacious as it rests on a false equivalency:
Car insurance is required to cover a risk that is imposed on others while exercising the privilege of operating a piece of dangerous equipment in shared public space.
Stratifying the pool of the insured into risk pools with premiums proportional to the risk brought to bear on the public makes perfect sense when it comes to car insurance.
Poor reasoning. You might be right if car insurance solely covered third-party damage. However, it (at least comprehensive insurance) also covers damage caused by your own fault to your own vehicle.
Not to mention that public funds are a public good, the same as public space.
In addition, the comparison fails on the grounds that the pool of the young and healthy is somehow comparable to people who forego driving a car and therefore do not require insurance.
It does not take much to realize that young and healthy people do carry a risk of becoming ill, whereas it is impossible for a person who does not operate a car to become involved in an at fault motor vehicle accident while driving a car.
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
It might be fair if we all were required to buy lifetime health insurance. In that sense, most of us lose out when we're young, and recoup the gains when we're old. However, that's not the case.
If everyone across society had to pay, say, $3000 per year for insurance from age 18 to age 100, I'd be fine with that. Maybe that's how it works in the US under the ACA - I don't know. In Australia, private health insurance is *mandatory* for anyone earning over $90k, whether you want it or not, and risk is community rated. So someone who is young and healthy and doesn't want to take out insurance (similar to the pedestrian in your example: someone who is happy to just privately pay for private medical care, or otherwise rely on the public system to which her taxes contribute) is nonetheless forced to take it out. And the premiums aren't adjusted for your own healthy lifestyle. Doesn't seem fair to me.
We seem to get a lot of weak thinking and opinionating from relatively clueless Australian posters who for, some reason, are interested in American politics - is there something in the water over there or is it simply that life is so boring on the island that even discussions of US healthcare become a source of entertainment.
Play the topic, not the man. Weak post.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
True, but you don't know which group you're in, except in retrospect.
People who stay healthy their whole lives and die peacefully in their sleep are treated "unfairly" in that they pay for coverage they never need. People who get critically ill from disease, get badly hurt in accidents, get cancer, etc., are treated "generously" in that their care is subsidized by others and they pay less than the value of the treatment they receive. But you can't predict in advance which of those groups you're going to belong to. No one can.
That's why insurance exists, to spread out those risks. It's an application of John Rawls' veil-of-ignorance argument: because I can't choose whether I'll be sick or healthy, I'd prefer to live in a society that helps everyone who needs it, rather than a society where some live and some die based on a roll of the dice.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
True, but you don't know which group you're in, except in retrospect.
People who stay healthy their whole lives and die peacefully in their sleep are treated "unfairly" in that they pay for coverage they never need. People who get critically ill from disease, get badly hurt in accidents, get cancer, etc., are treated "generously" in that their care is subsidized by others and they pay less than the value of the treatment they receive. But you can't predict in advance which of those groups you're going to belong to. No one can.
That's why insurance exists, to spread out those risks. It's an application of John Rawls' veil-of-ignorance argument: because I can't choose whether I'll be sick or healthy, I'd prefer to live in a society that helps everyone who needs it, rather than a society where some live and some die based on a roll of the dice.
You can have some sense of which group you belong to. For example, if you have a chronic condition already, or diabetes type 2, or emphysema from smoking, you are going to (if you are rational) realise you have a higher propensity for needing future medical care than someone with no medical history whatsoever. True it is that either of them could be hit by a car tomorrow and need medical care, but that doesn't exclude the first consideration. To say that you can't know the future doesn't cover the field; neither a good driver nor a driver with 5 DUI suspensions knows the future.
As I said above, you can deal with this issue with some degree of fairness by requiring everyone to pay the same insurance premium from birth (or effectively from age 18), in which case I would argue it's fair, as it adheres to the Rawls principle. Fair is fair from birth. However, as I understand it, not everyone has to pay for ACA coverage. Certainly here in Australia, many people are exempt from insurance, including the people who need it most. The cost of insuring them then gets passed on to the rest of the community, including people who are forced to take out insurance when they (on a probabilistic view) don't want or need it.
Having forced community rating leads to adverse selection and ex-ante moral hazard in insurance scenarios. For example, if you gave me a rental car and told me that my insurance premium would be identical whether I crashed it or took good care of it, I would have a lot less incentive to drive well, even if I didn't specifically want to crash the car (and even if some random factors affect things outside my own control).
-
Arguing Australian insurance on aca criteria or vice versa is unnecessarily complicated. The original aca required insurance throughout and rates coyld be adjusted for adverse behaviors. The same conservativet/libertarian that would support many of your arguments also gutted the requirement for participation.
At some lwvelnit comes down to a political philosophical decision on if we are a society that benefits from mutual support or "rugged infuvifuslism". I think my previous posts indicate where i stand on these issues.
-
I'm frankly disgusted at the inequality of treatment. 100 policemen beating the bushes of Central Park!
+1
Yep. Pretty sure this guy is a hero and it will somehow work out ok for him.
In CO my insurer (Cigna) subcontracts to American Specialty Health to deny people coverage. So when you want to dispute a denial Cigna points the finger at ASH and then ASH doesn’t answer the phone and you just suck it up.
-
Arguing Australian insurance on aca criteria or vice versa is unnecessarily complicated. The original aca required insurance throughout and rates coyld be adjusted for adverse behaviors. The same conservativet/libertarian that would support many of your arguments also gutted the requirement for participation.
Insurance throughout + rates being adjusted for adverse behaviours seems extremely fair to me.
I think people should be free to elect not to participate also, but then they have to wear the consequences, i.e., no healthcare.
-
Arguing Australian insurance on aca criteria or vice versa is unnecessarily complicated. The original aca required insurance throughout and rates coyld be adjusted for adverse behaviors. The same conservativet/libertarian that would support many of your arguments also gutted the requirement for participation.
Insurance throughout + rates being adjusted for adverse behaviours seems extremely fair to me.
I think people should be free to elect not to participate also, but then they have to wear the consequences, i.e., no healthcare.
This brings to my mind the anti-vaxxers who begged for a Covid vaccine in the ICU. Nope, too late--your immune system can't take it. Thanks for playing!
But, hospitals that take public money in the US can't deny ER patients. (Even for-profits take research money and Medicare / Medicaid patients) And hospitals can't kick out non-payers. (even those anti-vaxxers took up ICU beds) So, society would have to have some "exile island" to put people who failed to prepare. Otherwise, their chronic conditions eat up resources, as well as costing everyone since hospitals have to make up for the losses.
I doubt many individuals could raise their hand and say they could stomach it. I can't imagine what that would be like for the healthcare workers, to give up on people. (Yes, they already do, when the science and services fail--bad enough already)
Advocate for a direction or line, but think through a few iterations to the ultimate end. What would work for 100M people or more, in close proximity?
Smoking is a common behavior that is accepted to ask about in different kinds of risk assessments. In fact, so many questions are not allowed--ethnicity, for one--that smoking is used as a proxy for overall bad behaviors. You use what you can measure.
-
The FBI has now added to the reward money being offered for information leading to the arrest of the killer. https://www.forbes.com/sites/lindseychoo/2024/12/07/what-we-know-unitedhealthcare-ceo-brian-thompsons-shooting/
Notably, United Healthcare -- a company with with $370 billion in revenues in 2022 -- has not yet chipped in anything to up the reward. It would be sweet irony if somewhere in the bowels of that company a request for funds to pay more reward was bureaucratically denied.
-
Two more random comments from someone who uses the ACA and is also frustrated as hell with the system...
The ability for parents to keep dependents on their health plans until 26 was a huge wiff by politicians. At 18 the insured should have to go into the ACA pool. This subsidizes corporate insurance pools and universities offer their own low cost health plan to the healthiest population, making the ACA pool a higher risk / adverse selection group.
Medicare for all would be great, but politicians won't adequately fund medicare as is because payroll taxes would have to go up 2.5x. Payroll taxes only cover around 40% of expenses today, the rest is made up surcharges and government borrowings. Why not increase payroll taxes? They'll be voted out of office. Medicare for all fails for that reason. I'd be fine paying the $1,000/mo for two people in taxes vs. health insurance, but most voters will remove whoever does this thanks to a bunch of political adds that'll say "Mr. Smith raised your taxes!!"
-
Medicare for all would be great, but politicians won't adequately fund medicare as is because payroll taxes would have to go up 2.5x. Payroll taxes only cover around 40% of expenses today, the rest is made up surcharges and government borrowings. Why not increase payroll taxes? They'll be voted out of office. Medicare for all fails for that reason. I'd be fine paying the $1,000/mo for two people in taxes vs. health insurance, but most voters will remove whoever does this thanks to a bunch of political adds that'll say "Mr. Smith raised your taxes!!"
History has also shown that voters are easily swayed by the idea of health care choice. I think Medicare For All only works if you can voluntarily buy into it like any other health plan. For instance, if Medicare was listed as an option alongside ACA plans during open enrollment.
-
Medicare for all would be great, but politicians won't adequately fund medicare as is because payroll taxes would have to go up 2.5x. Payroll taxes only cover around 40% of expenses today, the rest is made up surcharges and government borrowings. Why not increase payroll taxes? They'll be voted out of office. Medicare for all fails for that reason. I'd be fine paying the $1,000/mo for two people in taxes vs. health insurance, but most voters will remove whoever does this thanks to a bunch of political adds that'll say "Mr. Smith raised your taxes!!"
History has also shown that voters are easily swayed by the idea of health care choice. I think Medicare For All only works if you can voluntarily buy into it like any other health plan. For instance, if Medicare was listed as an option alongside ACA plans during open enrollment.
I think this could be easily addressed by a bunch of Medigap choices with different benefits and price points.
-
Medicare for all would be great, but politicians won't adequately fund medicare as is because payroll taxes would have to go up 2.5x. Payroll taxes only cover around 40% of expenses today, the rest is made up surcharges and government borrowings. Why not increase payroll taxes? They'll be voted out of office. Medicare for all fails for that reason. I'd be fine paying the $1,000/mo for two people in taxes vs. health insurance, but most voters will remove whoever does this thanks to a bunch of political adds that'll say "Mr. Smith raised your taxes!!"
History has also shown that voters are easily swayed by the idea of health care choice. I think Medicare For All only works if you can voluntarily buy into it like any other health plan. For instance, if Medicare was listed as an option alongside ACA plans during open enrollment.
I'd be all in favor of a public option, but there'd have to be a way to prevent for-profit insurers from dumping all their sickest and most expensive patients on it.
-
I always come back to asking the question of why we pay for medical care through insurance in the first place.
Why don’t we have integrated care options available in every market?
There’s a reason I get my care through Kaiser and the VA. I pay Kaiser directly and they provide me health care. There’s no middleman. There’s no third-party-payer problem to load down the process with economic inefficiency.
In the rare cases something isn’t covered, it’s a conversation with the doctor and not an after the fact AI driven decision.
I care less about whether my insurance is corporate or government provided than whether there’s a third party between me and my doctor.
Kaiser certainly has its flaws, but they manage to avoid all of the billing nonsense traditional insurers are bringing to the table.
-
Medicare for all would be great, but politicians won't adequately fund medicare as is because payroll taxes would have to go up 2.5x. Payroll taxes only cover around 40% of expenses today, the rest is made up surcharges and government borrowings. Why not increase payroll taxes? They'll be voted out of office. Medicare for all fails for that reason. I'd be fine paying the $1,000/mo for two people in taxes vs. health insurance, but most voters will remove whoever does this thanks to a bunch of political adds that'll say "Mr. Smith raised your taxes!!"
History has also shown that voters are easily swayed by the idea of health care choice. I think Medicare For All only works if you can voluntarily buy into it like any other health plan. For instance, if Medicare was listed as an option alongside ACA plans during open enrollment.
The other issue is that Medicare payments don't actually cover the cost of care. (https://www.healthcarevaluehub.org/advocate-resources/publications/medicare-rates-benchmark-too-much-too-little-or-just-right#:~:text=There%20is%20a%20debate%20as,that%20were%20less%20than%20cost.) They are still broadly accepted, because their covered group consumes a lot of healthcare--it's hard to be in business without it. But like any underpaying group, private payers have to make up the gap.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
-
If only there were literally dozens of examples in the world of single payer or universal health care that are both cheaper (overall) and more cost effective than the current flustercluck of a 'system' that operates in the US. Boy, sure would be nice to see what else might work.
From the outside looking in, US Health care debates are a bizarre circus of insanity. You spend more on health per capita than anyone, and get less actual health care with worse outcomes than almost any other developed nation. But you get caught up in arguments about who pays a trivially disproportionate amount of the costs, yada yada yada, all completely ignoring the huge chunk of expenses that go to either side of the administration of insurance (please pay us - why - because these reasons - not good enough - etc). Not to mention the absurdity of also having to add (massive, unaccountable) profit to the system.
It all makes sense if the world stops at your borders. Once you are outside your borders it looks like a slow motion squid game.
-
It doesn't make sense inside the borders either.
-
It doesn't make sense inside the borders either.
Not have I seen many Americans in this thread saying that any of it makes sense. It's mostly the Australian poster who is advocating those positions.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
Metalcat, the point is, if you’re sick, it’s your fault. Keep up.
/s
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
Metalcat, the point is, if you’re sick, it’s your fault. Keep up.
/s
Better go die then...oh well, it's been a good run.
-
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
I was diagnosed with a rare aggressive cancer about 2 years ago, didn't expect to be alive and in remission today. I have zero known risk factors. I was a healthy weight, exercised 3-5x/week, balanced diet, low alcohol consumption, not a smoker, no known genetic factors, and about 20 years younger than the median age for this.
So while you can reduce personal risk factors, your health *is* ultimately wholly outside your choice. You can do everything right and still end up sick. This is often extremely unsettling when sharing my story with others because people want a sense of control. This usually means I get a lot of questions as folks try to find something to blame. Early on I found this rather peculiar and annoying, but I understand now that it's driven by their anxiety.
I will add that, in my experience, the insurance+medical system in the US is broken. Thankfully I was part of a health sharing ministry, so no pre-approvals, no denials, etc. The health sharing ministry covered all but $1500 of our massive medical bills (multiple major surgeries, chemo, months in the hospital). But the cost of healthcare and the way prices are negotiated is very opaque and bureaucratic.
One thing I haven't see mentioned on this thread: The Medical Loss Ratio (MLR) for UnitedHealthcare is 85%, which is higher than the mandated 80% and in line with its peers. This means that $0.85 of every $1 in premiums is paid to cover claims. Yet apparently UHC has a much higher denial rate. Not sure what explains this discrepancy. Maybe UHC has a sicker/older than average pool, or is this initial denials with many being reversed on appeal?
While I have no love for insurance companies and think there should be a public option, due to the reality of MLR these are not hugely profitable businesses. There are not a lot of inefficiencies to be gained at the insurance level -- even a public option or single-payer system would have a decent amount of overhead. What needs to happen is reducing the cost of healthcare, but that's a very difficult issue.
-
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
I was diagnosed with a rare aggressive cancer about 2 years ago, didn't expect to be alive and in remission today. I have zero known risk factors. I was a healthy weight, exercised 3-5x/week, balanced diet, low alcohol consumption, not a smoker, no known genetic factors, and about 20 years younger than the median age for this.
So while you can reduce personal risk factors, your health *is* ultimately wholly outside your choice. You can do everything right and still end up sick. This is often extremely unsettling when sharing my story with others because people want a sense of control. This usually means I get a lot of questions as folks try to find something to blame. Early on I found this rather peculiar and annoying, but I understand now that it's driven by their anxiety.
I will add that, in my experience, the insurance+medical system in the US is broken. Thankfully I was part of a health sharing ministry, so no pre-approvals, no denials, etc. The health sharing ministry covered all but $1500 of our massive medical bills (multiple major surgeries, chemo, months in the hospital). But the cost of healthcare and the way prices are negotiated is very opaque and bureaucratic.
One thing I haven't see mentioned on this thread: The Medical Loss Ratio (MLR) for UnitedHealthcare is 85%, which is higher than the mandated 80% and in line with its peers. This means that $0.85 of every $1 in premiums is paid to cover claims. Yet apparently UHC has a much higher denial rate. Not sure what explains this discrepancy. Maybe UHC has a sicker/older than average pool, or is this initial denials with many being reversed on appeal?
While I have no love for insurance companies and think there should be a public option, due to the reality of MLR these are not hugely profitable businesses. There are not a lot of inefficiencies to be gained at the insurance level -- even a public option or single-payer system would have a decent amount of overhead. What needs to happen is reducing the cost of healthcare, but that's a very difficult issue.
MLR is federally set at 85% for large groups and 80% for small groups with states able to adjust these numbers locally. If a insurer pays less than this amount in claims, then they have to issue a rebate to policy holders. The MLR cost percentage is intended to cap admin and profit costs relative to premiums taken in. The actual calculation of the MLR appears includes a lot of parsing and room for adjustments of the numerator and denominator. For example "quality improvement" costs are multiplied by 2 in the MLR calc to incentivize insurers to do more of that. I downloaded the UHC MLR filings for New Jersey 2022 and their large group MLR was calculated at 83.2% and 83.9% after some adjustments, which then became 85% after a rebate was issued. It appears that this calculation has the admin/profit capped at 15% of the premiums taken in, not claims paid out. I have many questions about how some of the details of physician review of claims etc are categorized, but I decided to stop going down that rabbit hole for the sake of sanity.
As a counterpoint, studies of the administraive overhead for Medicare are: Part A B D (1.35%), Part C (14.84%). Parts ABD are the public options while Part C is the Medicare Advantage privatized version discussed in some of the prior posts.
Additionally note that hospital internal administrative costs are lumped in with the claims paid, not the overall administrative part of the MLR calculation. So, the cost of the administrative burden of dealing with the byzantine health insurance system is also reflected there and could be reasonably expected to be streamlined in a broadly adopted single-payer system.
-
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
I was diagnosed with a rare aggressive cancer about 2 years ago, didn't expect to be alive and in remission today. I have zero known risk factors. I was a healthy weight, exercised 3-5x/week, balanced diet, low alcohol consumption, not a smoker, no known genetic factors, and about 20 years younger than the median age for this.
So while you can reduce personal risk factors, your health *is* ultimately wholly outside your choice. You can do everything right and still end up sick. This is often extremely unsettling when sharing my story with others because people want a sense of control. This usually means I get a lot of questions as folks try to find something to blame. Early on I found this rather peculiar and annoying, but I understand now that it's driven by their anxiety.
I will add that, in my experience, the insurance+medical system in the US is broken. Thankfully I was part of a health sharing ministry, so no pre-approvals, no denials, etc. The health sharing ministry covered all but $1500 of our massive medical bills (multiple major surgeries, chemo, months in the hospital). But the cost of healthcare and the way prices are negotiated is very opaque and bureaucratic.
One thing I haven't see mentioned on this thread: The Medical Loss Ratio (MLR) for UnitedHealthcare is 85%, which is higher than the mandated 80% and in line with its peers. This means that $0.85 of every $1 in premiums is paid to cover claims. Yet apparently UHC has a much higher denial rate. Not sure what explains this discrepancy. Maybe UHC has a sicker/older than average pool, or is this initial denials with many being reversed on appeal?
While I have no love for insurance companies and think there should be a public option, due to the reality of MLR these are not hugely profitable businesses. There are not a lot of inefficiencies to be gained at the insurance level -- even a public option or single-payer system would have a decent amount of overhead. What needs to happen is reducing the cost of healthcare, but that's a very difficult issue.
MLR is federally set at 85% for large groups and 80% for small groups with states able to adjust these numbers locally. If a insurer pays less than this amount in claims, then they have to issue a rebate to policy holders. The MLR cost percentage is intended to cap admin and profit costs relative to premiums taken in. The actual calculation of the MLR appears includes a lot of parsing and room for adjustments of the numerator and denominator. For example "quality improvement" costs are multiplied by 2 in the MLR calc to incentivize insurers to do more of that. I downloaded the UHC MLR filings for New Jersey 2022 and their large group MLR was calculated at 83.2% and 83.9% after some adjustments, which then became 85% after a rebate was issued. It appears that this calculation has the admin/profit capped at 15% of the premiums taken in, not claims paid out. I have many questions about how some of the details of physician review of claims etc are categorized, but I decided to stop going down that rabbit hole for the sake of sanity.
As a counterpoint, studies of the administraive overhead for Medicare are: Part A B D (1.35%), Part C (14.84%). Parts ABD are the public options while Part C is the Medicare Advantage privatized version discussed in some of the prior posts.
Additionally note that hospital internal administrative costs are lumped in with the claims paid, not the overall administrative part of the MLR calculation. So, the cost of the administrative burden of dealing with the byzantine health insurance system is also reflected there and could be reasonably expected to be streamlined in a broadly adopted single-payer system.
For sure, there are savings to be had. It's just that ~15% is the upper limit. This isn't nothing, totally worth doing, but it's not at big as many seem to believe. I think the bigger benefit to a public option or single-payer is getting away from the dysfunctional adversarial triangle of patient, insurer, and health care.
-
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
I was diagnosed with a rare aggressive cancer about 2 years ago, didn't expect to be alive and in remission today. I have zero known risk factors. I was a healthy weight, exercised 3-5x/week, balanced diet, low alcohol consumption, not a smoker, no known genetic factors, and about 20 years younger than the median age for this.
So while you can reduce personal risk factors, your health *is* ultimately wholly outside your choice. You can do everything right and still end up sick. This is often extremely unsettling when sharing my story with others because people want a sense of control. This usually means I get a lot of questions as folks try to find something to blame. Early on I found this rather peculiar and annoying, but I understand now that it's driven by their anxiety.
I will add that, in my experience, the insurance+medical system in the US is broken. Thankfully I was part of a health sharing ministry, so no pre-approvals, no denials, etc. The health sharing ministry covered all but $1500 of our massive medical bills (multiple major surgeries, chemo, months in the hospital). But the cost of healthcare and the way prices are negotiated is very opaque and bureaucratic.
One thing I haven't see mentioned on this thread: The Medical Loss Ratio (MLR) for UnitedHealthcare is 85%, which is higher than the mandated 80% and in line with its peers. This means that $0.85 of every $1 in premiums is paid to cover claims. Yet apparently UHC has a much higher denial rate. Not sure what explains this discrepancy. Maybe UHC has a sicker/older than average pool, or is this initial denials with many being reversed on appeal?
While I have no love for insurance companies and think there should be a public option, due to the reality of MLR these are not hugely profitable businesses. There are not a lot of inefficiencies to be gained at the insurance level -- even a public option or single-payer system would have a decent amount of overhead. What needs to happen is reducing the cost of healthcare, but that's a very difficult issue.
MLR is federally set at 85% for large groups and 80% for small groups with states able to adjust these numbers locally. If a insurer pays less than this amount in claims, then they have to issue a rebate to policy holders. The MLR cost percentage is intended to cap admin and profit costs relative to premiums taken in. The actual calculation of the MLR appears includes a lot of parsing and room for adjustments of the numerator and denominator. For example "quality improvement" costs are multiplied by 2 in the MLR calc to incentivize insurers to do more of that. I downloaded the UHC MLR filings for New Jersey 2022 and their large group MLR was calculated at 83.2% and 83.9% after some adjustments, which then became 85% after a rebate was issued. It appears that this calculation has the admin/profit capped at 15% of the premiums taken in, not claims paid out. I have many questions about how some of the details of physician review of claims etc are categorized, but I decided to stop going down that rabbit hole for the sake of sanity.
As a counterpoint, studies of the administraive overhead for Medicare are: Part A B D (1.35%), Part C (14.84%). Parts ABD are the public options while Part C is the Medicare Advantage privatized version discussed in some of the prior posts.
Additionally note that hospital internal administrative costs are lumped in with the claims paid, not the overall administrative part of the MLR calculation. So, the cost of the administrative burden of dealing with the byzantine health insurance system is also reflected there and could be reasonably expected to be streamlined in a broadly adopted single-payer system.
For sure, there are savings to be had. It's just that ~15% is the upper limit. This isn't nothing, totally worth doing, but it's not at big as many seem to believe. I think the bigger benefit to a public option or single-payer is getting away from the dysfunctional adversarial triangle of patient, insurer, and health care.
I agree with you on getting rid of that triangle. Or third party payer problem as I call it.
Be careful when reading about the various policies on this. Most “single payer”or “public option” proposals out there involve the government behaving as an insurance company. They don’t fundamentally change the dynamic, just replace the corporate entity with a government entity. They don’t fundamentally solve the problems you’re getting at.
-
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
I was diagnosed with a rare aggressive cancer about 2 years ago, didn't expect to be alive and in remission today. I have zero known risk factors. I was a healthy weight, exercised 3-5x/week, balanced diet, low alcohol consumption, not a smoker, no known genetic factors, and about 20 years younger than the median age for this.
So while you can reduce personal risk factors, your health *is* ultimately wholly outside your choice. You can do everything right and still end up sick. This is often extremely unsettling when sharing my story with others because people want a sense of control. This usually means I get a lot of questions as folks try to find something to blame. Early on I found this rather peculiar and annoying, but I understand now that it's driven by their anxiety.
I will add that, in my experience, the insurance+medical system in the US is broken. Thankfully I was part of a health sharing ministry, so no pre-approvals, no denials, etc. The health sharing ministry covered all but $1500 of our massive medical bills (multiple major surgeries, chemo, months in the hospital). But the cost of healthcare and the way prices are negotiated is very opaque and bureaucratic.
One thing I haven't see mentioned on this thread: The Medical Loss Ratio (MLR) for UnitedHealthcare is 85%, which is higher than the mandated 80% and in line with its peers. This means that $0.85 of every $1 in premiums is paid to cover claims. Yet apparently UHC has a much higher denial rate. Not sure what explains this discrepancy. Maybe UHC has a sicker/older than average pool, or is this initial denials with many being reversed on appeal?
While I have no love for insurance companies and think there should be a public option, due to the reality of MLR these are not hugely profitable businesses. There are not a lot of inefficiencies to be gained at the insurance level -- even a public option or single-payer system would have a decent amount of overhead. What needs to happen is reducing the cost of healthcare, but that's a very difficult issue.
MLR is federally set at 85% for large groups and 80% for small groups with states able to adjust these numbers locally. If a insurer pays less than this amount in claims, then they have to issue a rebate to policy holders. The MLR cost percentage is intended to cap admin and profit costs relative to premiums taken in. The actual calculation of the MLR appears includes a lot of parsing and room for adjustments of the numerator and denominator. For example "quality improvement" costs are multiplied by 2 in the MLR calc to incentivize insurers to do more of that. I downloaded the UHC MLR filings for New Jersey 2022 and their large group MLR was calculated at 83.2% and 83.9% after some adjustments, which then became 85% after a rebate was issued. It appears that this calculation has the admin/profit capped at 15% of the premiums taken in, not claims paid out. I have many questions about how some of the details of physician review of claims etc are categorized, but I decided to stop going down that rabbit hole for the sake of sanity.
As a counterpoint, studies of the administraive overhead for Medicare are: Part A B D (1.35%), Part C (14.84%). Parts ABD are the public options while Part C is the Medicare Advantage privatized version discussed in some of the prior posts.
Additionally note that hospital internal administrative costs are lumped in with the claims paid, not the overall administrative part of the MLR calculation. So, the cost of the administrative burden of dealing with the byzantine health insurance system is also reflected there and could be reasonably expected to be streamlined in a broadly adopted single-payer system.
For sure, there are savings to be had. It's just that ~15% is the upper limit. This isn't nothing, totally worth doing, but it's not at big as many seem to believe. I think the bigger benefit to a public option or single-payer is getting away from the dysfunctional adversarial triangle of patient, insurer, and health care.
I agree with you on getting rid of that triangle. Or third party payer problem as I call it.
Be careful when reading about the various policies on this. Most “single payer”or “public option” proposals out there involve the government behaving as an insurance company. They don’t fundamentally change the dynamic, just replace the corporate entity with a government entity. They don’t fundamentally solve the problems you’re getting at.
Can you clarify this part further? How is the government similar to an insurance company trying to make a profit?
-
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
I was diagnosed with a rare aggressive cancer about 2 years ago, didn't expect to be alive and in remission today. I have zero known risk factors. I was a healthy weight, exercised 3-5x/week, balanced diet, low alcohol consumption, not a smoker, no known genetic factors, and about 20 years younger than the median age for this.
So while you can reduce personal risk factors, your health *is* ultimately wholly outside your choice. You can do everything right and still end up sick. This is often extremely unsettling when sharing my story with others because people want a sense of control. This usually means I get a lot of questions as folks try to find something to blame. Early on I found this rather peculiar and annoying, but I understand now that it's driven by their anxiety.
I will add that, in my experience, the insurance+medical system in the US is broken. Thankfully I was part of a health sharing ministry, so no pre-approvals, no denials, etc. The health sharing ministry covered all but $1500 of our massive medical bills (multiple major surgeries, chemo, months in the hospital). But the cost of healthcare and the way prices are negotiated is very opaque and bureaucratic.
One thing I haven't see mentioned on this thread: The Medical Loss Ratio (MLR) for UnitedHealthcare is 85%, which is higher than the mandated 80% and in line with its peers. This means that $0.85 of every $1 in premiums is paid to cover claims. Yet apparently UHC has a much higher denial rate. Not sure what explains this discrepancy. Maybe UHC has a sicker/older than average pool, or is this initial denials with many being reversed on appeal?
While I have no love for insurance companies and think there should be a public option, due to the reality of MLR these are not hugely profitable businesses. There are not a lot of inefficiencies to be gained at the insurance level -- even a public option or single-payer system would have a decent amount of overhead. What needs to happen is reducing the cost of healthcare, but that's a very difficult issue.
MLR is federally set at 85% for large groups and 80% for small groups with states able to adjust these numbers locally. If a insurer pays less than this amount in claims, then they have to issue a rebate to policy holders. The MLR cost percentage is intended to cap admin and profit costs relative to premiums taken in. The actual calculation of the MLR appears includes a lot of parsing and room for adjustments of the numerator and denominator. For example "quality improvement" costs are multiplied by 2 in the MLR calc to incentivize insurers to do more of that. I downloaded the UHC MLR filings for New Jersey 2022 and their large group MLR was calculated at 83.2% and 83.9% after some adjustments, which then became 85% after a rebate was issued. It appears that this calculation has the admin/profit capped at 15% of the premiums taken in, not claims paid out. I have many questions about how some of the details of physician review of claims etc are categorized, but I decided to stop going down that rabbit hole for the sake of sanity.
As a counterpoint, studies of the administraive overhead for Medicare are: Part A B D (1.35%), Part C (14.84%). Parts ABD are the public options while Part C is the Medicare Advantage privatized version discussed in some of the prior posts.
Additionally note that hospital internal administrative costs are lumped in with the claims paid, not the overall administrative part of the MLR calculation. So, the cost of the administrative burden of dealing with the byzantine health insurance system is also reflected there and could be reasonably expected to be streamlined in a broadly adopted single-payer system.
For sure, there are savings to be had. It's just that ~15% is the upper limit. This isn't nothing, totally worth doing, but it's not at big as many seem to believe. I think the bigger benefit to a public option or single-payer is getting away from the dysfunctional adversarial triangle of patient, insurer, and health care.
I agree with you on getting rid of that triangle. Or third party payer problem as I call it.
Be careful when reading about the various policies on this. Most “single payer”or “public option” proposals out there involve the government behaving as an insurance company. They don’t fundamentally change the dynamic, just replace the corporate entity with a government entity. They don’t fundamentally solve the problems you’re getting at.
Can you clarify this part further? How is the government similar to an insurance company trying to make a profit?
Part of the problem of "single payer" and "government option" is that different people take those terms to mean very different things.
As @FINate mentioned, a key part of the dysfunction is the third party payer problem (or at least that's my interpretation of it).
Hospitals (mostly, but not always profit seeking organizations) maximize their revenue by billing insurance companies everything they can. Insurance companies (mostly, but not always profit seeking organizations) keep insurance prices in check by denying claims and increasing deductibles/copays etc.
Most policy proposals for "single payer" or "government option" replace the insurance company with a government led insurance plan. The options for a government led insurance plan to keep prices in check (and to reduce fraud) are effectively the same as a for-profit company. The overall equation only changes at the margin of admin costs, fraud, and organizational efficiency.
What many people actually want (that the policy proposals ignore) is to eliminate the need for the insurance middleman at all. Think of the VA. It's not a government insurance policy. The hospital itself is government run. Any payments or copays are between the patient and the VA, and not a third party.
Kaiser operates in a somewhat similar fashion, while still being insurance. You pay Kaiser your insurance premium, but you go to Kaiser hospitals. Your insurance company and your medical provider is the same entity.
-
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
I was diagnosed with a rare aggressive cancer about 2 years ago, didn't expect to be alive and in remission today. I have zero known risk factors. I was a healthy weight, exercised 3-5x/week, balanced diet, low alcohol consumption, not a smoker, no known genetic factors, and about 20 years younger than the median age for this.
So while you can reduce personal risk factors, your health *is* ultimately wholly outside your choice. You can do everything right and still end up sick. This is often extremely unsettling when sharing my story with others because people want a sense of control. This usually means I get a lot of questions as folks try to find something to blame. Early on I found this rather peculiar and annoying, but I understand now that it's driven by their anxiety.
I will add that, in my experience, the insurance+medical system in the US is broken. Thankfully I was part of a health sharing ministry, so no pre-approvals, no denials, etc. The health sharing ministry covered all but $1500 of our massive medical bills (multiple major surgeries, chemo, months in the hospital). But the cost of healthcare and the way prices are negotiated is very opaque and bureaucratic.
One thing I haven't see mentioned on this thread: The Medical Loss Ratio (MLR) for UnitedHealthcare is 85%, which is higher than the mandated 80% and in line with its peers. This means that $0.85 of every $1 in premiums is paid to cover claims. Yet apparently UHC has a much higher denial rate. Not sure what explains this discrepancy. Maybe UHC has a sicker/older than average pool, or is this initial denials with many being reversed on appeal?
While I have no love for insurance companies and think there should be a public option, due to the reality of MLR these are not hugely profitable businesses. There are not a lot of inefficiencies to be gained at the insurance level -- even a public option or single-payer system would have a decent amount of overhead. What needs to happen is reducing the cost of healthcare, but that's a very difficult issue.
MLR is federally set at 85% for large groups and 80% for small groups with states able to adjust these numbers locally. If a insurer pays less than this amount in claims, then they have to issue a rebate to policy holders. The MLR cost percentage is intended to cap admin and profit costs relative to premiums taken in. The actual calculation of the MLR appears includes a lot of parsing and room for adjustments of the numerator and denominator. For example "quality improvement" costs are multiplied by 2 in the MLR calc to incentivize insurers to do more of that. I downloaded the UHC MLR filings for New Jersey 2022 and their large group MLR was calculated at 83.2% and 83.9% after some adjustments, which then became 85% after a rebate was issued. It appears that this calculation has the admin/profit capped at 15% of the premiums taken in, not claims paid out. I have many questions about how some of the details of physician review of claims etc are categorized, but I decided to stop going down that rabbit hole for the sake of sanity.
As a counterpoint, studies of the administraive overhead for Medicare are: Part A B D (1.35%), Part C (14.84%). Parts ABD are the public options while Part C is the Medicare Advantage privatized version discussed in some of the prior posts.
Additionally note that hospital internal administrative costs are lumped in with the claims paid, not the overall administrative part of the MLR calculation. So, the cost of the administrative burden of dealing with the byzantine health insurance system is also reflected there and could be reasonably expected to be streamlined in a broadly adopted single-payer system.
For sure, there are savings to be had. It's just that ~15% is the upper limit. This isn't nothing, totally worth doing, but it's not at big as many seem to believe. I think the bigger benefit to a public option or single-payer is getting away from the dysfunctional adversarial triangle of patient, insurer, and health care.
I agree with you on getting rid of that triangle. Or third party payer problem as I call it.
Be careful when reading about the various policies on this. Most “single payer”or “public option” proposals out there involve the government behaving as an insurance company. They don’t fundamentally change the dynamic, just replace the corporate entity with a government entity. They don’t fundamentally solve the problems you’re getting at.
Can you clarify this part further? How is the government similar to an insurance company trying to make a profit?
Part of the problem of "single payer" and "government option" is that different people take those terms to mean very different things.
As @FINate mentioned, a key part of the dysfunction is the third party payer problem (or at least that's my interpretation of it).
Hospitals (mostly, but not always profit seeking organizations) maximize their revenue by billing insurance companies everything they can. Insurance companies (mostly, but not always profit seeking organizations) keep insurance prices in check by denying claims and increasing deductibles/copays etc.
Most policy proposals for "single payer" or "government option" replace the insurance company with a government led insurance plan. The options for a government led insurance plan to keep prices in check (and to reduce fraud) are effectively the same as a for-profit company. The overall equation only changes at the margin of admin costs, fraud, and organizational efficiency.
What many people actually want (that the policy proposals ignore) is to eliminate the need for the insurance middleman at all. Think of the VA. It's not a government insurance policy. The hospital itself is government run. Any payments or copays are between the patient and the VA, and not a third party.
Kaiser operates in a somewhat similar fashion, while still being insurance. You pay Kaiser your insurance premium, but you go to Kaiser hospitals. Your insurance company and your medical provider is the same entity.
Interesting. Do you know if one or the other is more prevalent worldwide?
-
Good points @NorCal
I view a public option or single-payer as an intermediate step, something perhaps more achievable in the medium term. This would at least remove the often for-profit entity even though the third-party remains. I still remember the panic from the insurance industry when the public option was proposed during the ACA negotiations.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
You're straw manning my position. I think that is quite clear. I said earlier in this thread that a fair solution would be that health insurance be (1) required as a lifelong thing so as to satisfy the Rawls principle (and mitigate adverse selection) and (2) be adjusted for adverse behaviour.
-
Good points @NorCal
I view a public option or single-payer as an intermediate step, something perhaps more achievable in the medium term. This would at least remove the often for-profit entity even though the third-party remains. I still remember the panic from the insurance industry when the public option was proposed during the ACA negotiations.
Public health insurance is exactly what we have in Canada and it's a vastly different patient experience up here.
I'm in an ER as I type this. I handed over my provincial insurance card and that's it. I'll never once have to discuss whether I can get a procedure, no discussion of pre-approval, I will never know the price of anything, I won't get any bill, and I'll never need to speak to the insurer. I'm just here and the only thing I have to worry about is the health issue that landed me here and whether this tiny, rural hospital has the imaging equipment necessary or if I'll need to be transfered to the bigger hospital 1.5 hrs away.
Our system up here has its issues, largely because the provincial governments have neglected it so badly and many conservative governments have actually been trying to kill it so that they can usher in private systems.
But when it's not being run into the ground through criminal levels of neglect and/or malfeasance, it's an extremely easy system for patients to navigate even though there is technically a middle man. He's just invisible for the most part.
As someone who has many, many specialists, has had many surgeries, and countless ER visits, I can't even fathom adding worrying about the arcane billing rules while worrying about what body parts might need to be cut out of me next while sitting fucking terrified in a hospital waiting room during a medical crisis.
-
I agree with you on getting rid of that triangle. Or third party payer problem as I call it.
Be careful when reading about the various policies on this. Most “single payer”or “public option” proposals out there involve the government behaving as an insurance company. They don’t fundamentally change the dynamic, just replace the corporate entity with a government entity. They don’t fundamentally solve the problems you’re getting at.
Also worth noting that the government itself doesn't necessarily have the resources (tax receipts) to fully cover all healthcare, so even with a strong public health system, a private insurance is still required. That's what we have in Australia - lower earners are covered by public Medicare, while higher earners are required to take out private health insurance which pays extra to hospitals and doctors who operate through the private health system. While it is possible for any given person to seek care only through the public gateways, as a whole, the system (i.e. hospitals and doctors) rely on private funding because there's not enough money in it otherwise. Public specialists will usually have a hybrid practice consisting of some private patients - they get extra money for treating private. Likewise hospitals. With the increasing cost of health care, a public system based solely on tax receipts isn't going to pay enough, so you need some form of public/private hybrid.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
You're straw manning my position. I think that is quite clear.
No, I'm not.
I honestly can't figure out what you think should be done with all of the very expensive sick people if you don't think that healthier, wealthier people should be on the hook for their care.
What should happen to them?? Serious question.
If your answer is that their care should become prohibitively expensive, then what happens to them? If they can't readily access early interventions, then their urgent care will just become even more burdensome.
Really sick people don't tend to make a lot of money, so how will they afford their more expensive care?? Unless I'm missing something, that either leads to death or very, very expensive emergency care.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
You're straw manning my position. I think that is quite clear.
No, I'm not.
I honestly can't figure out what you think should be done with all of the very expensive sick people if you don't think that healthier, wealthier people should be on the hook for their care.
What should happen to them?? Serious question.
If your answer is that their care should become prohibitively expensive, then what happens to them? If they can't readily access early interventions, then their urgent care will just become even more burdensome.
Really sick people don't tend to make a lot of money, so how will they afford their more expensive care?? Unless I'm missing something, that either leads to death or very, very expensive emergency care.
Health insurance fees should be paid by all adults and that should give them access to emergency/necessary procedures. Those who literally have no income can be exempted, but as soon as you cross a threshold (say the bare minimum required to sustain yourself) then you should be required to contribute. Alternatively it can be baked into the payroll/income tax system.
For elective medical treatment, there should be a second tier of private insurance that you can elect to have or not have. You are free to not pay this insurance. If you want to get this private insurance, it should not be community rated - the premium should be based on your individual demographics or claim history, same as a car insurance premium.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
You're straw manning my position. I think that is quite clear.
No, I'm not.
I honestly can't figure out what you think should be done with all of the very expensive sick people if you don't think that healthier, wealthier people should be on the hook for their care.
What should happen to them?? Serious question.
If your answer is that their care should become prohibitively expensive, then what happens to them? If they can't readily access early interventions, then their urgent care will just become even more burdensome.
Really sick people don't tend to make a lot of money, so how will they afford their more expensive care?? Unless I'm missing something, that either leads to death or very, very expensive emergency care.
Health insurance fees should be paid by all adults and that should give them access to emergency/necessary procedures. Those who literally have no income can be exempted, but as soon as you cross a threshold (say the bare minimum required to sustain yourself) then you should be required to contribute. Alternatively it can be baked into the payroll/income tax system.
For elective medical treatment, there should be a second tier of private insurance that you can elect to have or not have. You are free to not pay this insurance. If you want to get this private insurance, it should not be community rated - the premium should be based on your individual demographics or claim history, same as a car insurance premium.
Never mind. Not engaging.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
You're straw manning my position. I think that is quite clear.
No, I'm not.
I honestly can't figure out what you think should be done with all of the very expensive sick people if you don't think that healthier, wealthier people should be on the hook for their care.
What should happen to them?? Serious question.
If your answer is that their care should become prohibitively expensive, then what happens to them? If they can't readily access early interventions, then their urgent care will just become even more burdensome.
Really sick people don't tend to make a lot of money, so how will they afford their more expensive care?? Unless I'm missing something, that either leads to death or very, very expensive emergency care.
Health insurance fees should be paid by all adults and that should give them access to emergency/necessary procedures. Those who literally have no income can be exempted, but as soon as you cross a threshold (say the bare minimum required to sustain yourself) then you should be required to contribute. Alternatively it can be baked into the payroll/income tax system.
For elective medical treatment, there should be a second tier of private insurance that you can elect to have or not have. You are free to not pay this insurance. If you want to get this private insurance, it should not be community rated - the premium should be based on your individual demographics or claim history, same as a car insurance premium.
Thanks for explaining. I could not possibly disagree with you more, but you're entitled to your extremely strong and distinctive opinions.
-
Health insurance fees should be paid by all adults and that should give them access to emergency/necessary procedures. Those who literally have no income can be exempted, but as soon as you cross a threshold (say the bare minimum required to sustain yourself) then you should be required to contribute. Alternatively it can be baked into the payroll/income tax system.
For elective medical treatment, there should be a second tier of private insurance that you can elect to have or not have. You are free to not pay this insurance. If you want to get this private insurance, it should not be community rated - the premium should be based on your individual demographics or claim history, same as a car insurance premium.
What?
So if you have a healthcare system just for urgent/emergent care, you incentivize waiting until problems become urgent - and WAY more expensive - than preventative care.
And, what is consider elective care? Is that anything where a person isn't dying in front of you without it? So it's ok to skip giving the diabetic person a nutritionist who can help them manage their diet so they minimize their health impacts, but once that person needs a limb to be amputated so they don't die you'll cover that?? Technically a surgery to remove a cancerous tumor would meet the definition of elective care, it's planned in advance and won't kill you immediately - but you'll die MUCH faster without that cancer treatment.
Or if you go by only "necessary" - that's everything that's covered now. ERISA health plans aren't actually allowed to spend health care dollars on non-medically necessary treatment. Not sure on government plans, but I'm guessing there's a reg out there requiring them to act similarly. That's why you have "wellness" plans that might offer you a few hundred dollars for lifestyle activities like joining a gym or getting a massage, and it's not directly your health plan that offers it.
-
Health insurance fees should be paid by all adults and that should give them access to emergency/necessary procedures. Those who literally have no income can be exempted, but as soon as you cross a threshold (say the bare minimum required to sustain yourself) then you should be required to contribute. Alternatively it can be baked into the payroll/income tax system.
For elective medical treatment, there should be a second tier of private insurance that you can elect to have or not have. You are free to not pay this insurance. If you want to get this private insurance, it should not be community rated - the premium should be based on your individual demographics or claim history, same as a car insurance premium.
What?
So if you have a healthcare system just for urgent/emergent care, you incentivize waiting until problems become urgent - and WAY more expensive - than preventative care.
And, what is consider elective care? Is that anything where a person isn't dying in front of you without it? So it's ok to skip giving the diabetic person a nutritionist who can help them manage their diet so they minimize their health impacts, but once that person needs a limb to be amputated so they don't die you'll cover that?? Technically a surgery to remove a cancerous tumor would meet the definition of elective care, it's planned in advance and won't kill you immediately - but you'll die MUCH faster without that cancer treatment.
Or if you go by only "necessary" - that's everything that's covered now. ERISA health plans aren't actually allowed to spend health care dollars on non-medically necessary treatment. Not sure on government plans, but I'm guessing there's a reg out there requiring them to act similarly. That's why you have "wellness" plans that might offer you a few hundred dollars for lifestyle activities like joining a gym or getting a massage, and it's not directly your health plan that offers it.
But if it works with car insurance it should work with healthcare as well!
After all, doctors offices and hospitals are repair shops of a sort, aren't they?
And when it's too expensive to repair, junk it no sweat.
Easy peasy, a simple world for simple souls.
-
Good points @NorCal
I view a public option or single-payer as an intermediate step, something perhaps more achievable in the medium term. This would at least remove the often for-profit entity even though the third-party remains. I still remember the panic from the insurance industry when the public option was proposed during the ACA negotiations.
I have a different take, but neither of our positions would be taken seriously enough in policy circles to have a chance of passing. So it doesn't matter much anyways.
I think having a publicly run insurance entity would create one of those scenarios like public utilities or the defense industry. It would combine the worst aspects of profit run systems (as health providers are still largely profit seeking and lobbying entities) with the worst aspects of government run agencies (cronyism, lobbying, ineffective decision making).
I think the best intermediate step would be for every hospital system of a certain size to offer an integrated care option on both the ACA marketplace and for corporate buyers.
-
Health insurance fees should be paid by all adults and that should give them access to emergency/necessary procedures. Those who literally have no income can be exempted, but as soon as you cross a threshold (say the bare minimum required to sustain yourself) then you should be required to contribute. Alternatively it can be baked into the payroll/income tax system.
For elective medical treatment, there should be a second tier of private insurance that you can elect to have or not have. You are free to not pay this insurance. If you want to get this private insurance, it should not be community rated - the premium should be based on your individual demographics or claim history, same as a car insurance premium.
What?
So if you have a healthcare system just for urgent/emergent care, you incentivize waiting until problems become urgent - and WAY more expensive - than preventative care.
And, what is consider elective care? Is that anything where a person isn't dying in front of you without it? So it's ok to skip giving the diabetic person a nutritionist who can help them manage their diet so they minimize their health impacts, but once that person needs a limb to be amputated so they don't die you'll cover that?? Technically a surgery to remove a cancerous tumor would meet the definition of elective care, it's planned in advance and won't kill you immediately - but you'll die MUCH faster without that cancer treatment.
Or if you go by only "necessary" - that's everything that's covered now. ERISA health plans aren't actually allowed to spend health care dollars on non-medically necessary treatment. Not sure on government plans, but I'm guessing there's a reg out there requiring them to act similarly. That's why you have "wellness" plans that might offer you a few hundred dollars for lifestyle activities like joining a gym or getting a massage, and it's not directly your health plan that offers it.
The question of what is necessary is up to doctors to determine. I don't think anyone would argue that cancer surgery is elective, for example. For what it's worth, that's how the public healthcare system in Australia is set up, and we manage to deal with the distinction. In practice, anything to do with cancer is publicly funded, but here are some examples of 'elective' operations: knee/hip replacements in a lot of cases (depends on the degree of mobility impairment), spinal surgery where there isn't radiculopathy. Publicly funded patients can still access this, but they have to go on a fairly long waiting list until a spot frees up, whereas private patients get it instantly on payment.
-
Health insurance fees should be paid by all adults and that should give them access to emergency/necessary procedures. Those who literally have no income can be exempted, but as soon as you cross a threshold (say the bare minimum required to sustain yourself) then you should be required to contribute. Alternatively it can be baked into the payroll/income tax system.
For elective medical treatment, there should be a second tier of private insurance that you can elect to have or not have. You are free to not pay this insurance. If you want to get this private insurance, it should not be community rated - the premium should be based on your individual demographics or claim history, same as a car insurance premium.
What?
So if you have a healthcare system just for urgent/emergent care, you incentivize waiting until problems become urgent - and WAY more expensive - than preventative care.
And, what is consider elective care? Is that anything where a person isn't dying in front of you without it? So it's ok to skip giving the diabetic person a nutritionist who can help them manage their diet so they minimize their health impacts, but once that person needs a limb to be amputated so they don't die you'll cover that?? Technically a surgery to remove a cancerous tumor would meet the definition of elective care, it's planned in advance and won't kill you immediately - but you'll die MUCH faster without that cancer treatment.
Or if you go by only "necessary" - that's everything that's covered now. ERISA health plans aren't actually allowed to spend health care dollars on non-medically necessary treatment. Not sure on government plans, but I'm guessing there's a reg out there requiring them to act similarly. That's why you have "wellness" plans that might offer you a few hundred dollars for lifestyle activities like joining a gym or getting a massage, and it's not directly your health plan that offers it.
The question of what is necessary is up to doctors to determine. I don't think anyone would argue that cancer surgery is elective, for example. For what it's worth, that's how the public healthcare system in Australia is set up, and we manage to deal with the distinction. In practice, anything to do with cancer is publicly funded, but here are some examples of 'elective' operations: knee/hip replacements in a lot of cases (depends on the degree of mobility impairment), spinal surgery where there isn't radiculopathy. Publicly funded patients can still access this, but they have to go on a fairly long waiting list until a spot frees up, whereas private patients get it instantly on payment.
That's how Medicare for all with supplemental insurance would work, and that is similar to healthcare systems elsewhere in the world.
You do not understand the US situation at all - what you are proposing here would be heresy among the libertarian/reactionary set here.
Just cut out the libertarian mumbo jumbo and the inane car insurance comparisons and you might just be up to something.
-
Sorry, this is long.
Here (I personally have experience with Quebec and Ontario) the insurance fees come out of taxes. So you never see your insurance fees being paid. Ontario does have a tax surcharge for very high income earners. And yes, we know it is not free, we know we are paying for it. The point is that it is universal, we all have access (provided one is a resident with enough days per year actually living in the province - snowbirds need to be careful). And provinces generally honour each others health programs.
Yes older people may use it more, but we have been paying for it for a very long time. Younger people can have issues, they are not immune.
I just look around my circle of acquaintances and am so glad they never had to worry about their health insurance when they had: kidney transplant (in their 20s), double lung transplant, gall bladder turned into pancreatitis turned into blood clots and a 3 day stay in the ICU, flesh-eating disease in the abdomen (67% mortality rate, this person survived), emergency surgery for ectopic pregnancy, cataract surgery, plus lots of knee and hip replacements, and gall bladders out (no-one talks about it, but I know so many people with no gall bladder).
Because there is no insurance penalty, people go to their GP or a walk-in clinic or their pharmacy (pharmacists have some leeway about minor prescriptions) if they are sick, so things don't get out of hand. We don't have all the home remedies that Americans seem to depend on.
Because the province is the buyer, material costs are kept down. Billing is simplified. Clinics are private, they just bill the province instead of a private company. We all take our OHIP cards with us when we go to the doctor, or for lab tests/xrays/whatever, and it is covered.
Most vaccinations are covered, but not all - childhood ones definitely, adult ones based on need - so shingles vaccine after a certain age, same with pneumonia. Here seniors in group living get free RSV vaccine, I don't - a year too young and living on my own. So I will be checking my private insurance to see if they cover it. If you need hepatitis vaccination for a vacation you will pay for it.
There are limitation - OHIP will pay for testing blood vitamin D levels if the person has osteopenia/osteoporosis. If not, they won't pay. But they pay for bone mineral density scans.
A provincial system also means more public health - when I lived in a rural area our local health unit subsidized rabies vaccination for dogs and cats.
We still have private insurance - it may cover drugs that our provincial insurance doesn't, it may cover a private hospital room instead of sharing a room with someone, it may cover dental/physiotherapy/other not quite medical things.
The thing is, health insurance is not usually a factor in choosing one job over another, because most of our health care is covered.
Mind you, Metalcat is totally correct about provincial governments messing around in the ways she describes. I see it mostly in more rural areas, where hospitals are further apart and specialists are less likely to practice. I know when a friend in Eastern Ontario broke her leg badly, the local hospital immediately transferred her to a hospital in Ottawa that could do a better job. She went back to the local hospital once her physiotherapy needs were less. But there was no issue with her moving from one hospital to another, the doctors decided where she would be best served. Same for my other friend who was in a head-on collision (literally a Florida man in a pickup truck) - months in hospital, including several weeks in a coma, then more months of physiotherapy, then more months of home physiotherapy visits. OHIP covered almost all, his car insurance covered the rest.
And I know some of the European countries do it better than we do. We just look good because our easiest comparison is so bad
-
I agree with you on getting rid of that triangle. Or third party payer problem as I call it.
Be careful when reading about the various policies on this. Most “single payer”or “public option” proposals out there involve the government behaving as an insurance company. They don’t fundamentally change the dynamic, just replace the corporate entity with a government entity. They don’t fundamentally solve the problems you’re getting at.
Also worth noting that the government itself doesn't necessarily have the resources (tax receipts) to fully cover all healthcare, so even with a strong public health system, a private insurance is still required. That's what we have in Australia - lower earners are covered by public Medicare, while higher earners are required to take out private health insurance which pays extra to hospitals and doctors who operate through the private health system. While it is possible for any given person to seek care only through the public gateways, as a whole, the system (i.e. hospitals and doctors) rely on private funding because there's not enough money in it otherwise. Public specialists will usually have a hybrid practice consisting of some private patients - they get extra money for treating private. Likewise hospitals. With the increasing cost of health care, a public system based solely on tax receipts isn't going to pay enough, so you need some form of public/private hybrid.
This is similar to the system in Ireland. Everyone has access to the medical system, but it is quite typical for high earners to have emplyoer-paid private insurance and access to a tier of so-called "high tech hospitals," with more procedure options and less of a wait. We had to go to the A&E early in our residence there, technically before I had insurance or had even paid onto the public system,, and paid $0 because we went on the advice of our (just selected for the occasion) primary care physician. Our private care prescription coverage was 50% of the cost, up to (I kid you not) $25 per person, per year. DW is the only one of us who "maxed out" her meds, and just barely, even though her meds were literally thousands of dollars in the US.
We also had a very pleasant experience at the NHS in Northern Ireland. DW sprained, possibly broke her ankle. Transported ourselves to the nearest A&E after the on-site medics had a look. The staff there were quite proud to say all emergency care would be free, and profusely apologized that should we need some follow-up care, there might be a charge. They accepted our Irish status (learned what an orange card was!) We didn't pay a dime, and came away with souvenir crutches.
I also have European friends that have waited years for knee replacements, been "housed" in a gurney in the hallway for lack of beds (way before the pandemic) and people who talk medical tourism to Thailand, like Americans talk about Mexico. They do it, at a proposed extra cost, to avoid the wait; somewhat the Reverse of US discussions.
Medical technology is full of miracles, with more just around the corner. There will never be enough to pay for all the need, when expressed as everyone who could benefit, does benefit. There are models of service, and the resources are duly prioritized and rationed. No matter what the model is.
I also recall that it was after paying privately for her mother's end of life care that Suze Orman started saying $5M isn't enough saved for retirement. You could say it was her private island, too, but she had that long before.
-
I think having a publicly run insurance entity would create one of those scenarios like public utilities or the defense industry. It would combine the worst aspects of profit run systems (as health providers are still largely profit seeking and lobbying entities) with the worst aspects of government run agencies (cronyism, lobbying, ineffective decision making).
Why do you think that would be the case in the US? What makes the US so different from all the countries that have such a system - like my Germany or, from what Metalcat wrote earlier, Canada?
FunFact: We once had a "Free Market" Add-on on our "give me the card, thank you, sit down" system where you had to pay 10€ the first time you visited the doctor in a quarter. It was meant to reduce unneeded visits.
It lasted only a few years because everyone hated it. Especially the - what would you call it in English? Doctor's helpers? Nurses? - who had to collect that money at the start of the quarter from hundreds of people.
It actually reduced the number of visits a bit - but only from a small group. Can you guess which one? Yes, the poorest. (And ER visits from that group increased, but I think it was outside statistical confidence.)
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
Metalcat, the point is, if you’re sick, it’s your fault. Keep up.
/s
Better go die then...oh well, it's been a good run.
At least you have a lovely selection of ice floes!
-
I wonder what kind of health care the NY prison system has. When (if) this guy gets caught that will be his insurance plan.
-
This doesn't go to the heart of the point, which is that a forced acceptance of common risk treats some people unfairly and others generously.
That is kind of the fundamental foundation of society. Some of us contribute more than our 'fair share', some less -- but we all win if the system works for everyone.
Right??
People exist. Sick people exist. Are we just supposed to go die because we're inconvenient and expensive? JFC
Metalcat, the point is, if you’re sick, it’s your fault. Keep up.
/s
Better go die then...oh well, it's been a good run.
At least you have a lovely selection of ice floes!
Good point
-
I wonder what kind of health care the NY prison system has. When (if) this guy gets caught that will be his insurance plan.
I had a doctor neighbor that occasionally rotated through the hospital that treated patients from the SuperMax prison.
As he put it, he would have some very kind and lovely patients he had to treat for shank wounds.
On the bright side, prisoners are never going to get a claims denial.
-
I wonder what kind of health care the NY prison system has. When (if) this guy gets caught that will be his insurance plan.
I had a doctor neighbor that occasionally rotated through the hospital that treated patients from the SuperMax prison.
As he put it, he would have some very kind and lovely patients he had to treat for shank wounds.
On the bright side, prisoners are never going to get a claims denial.
The wife of a colleague of mine was a dental hygienist at a State prison. So, they have dental, too.
-
I couldn't post them on FB, but the memes on this are wild:
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
You could before the Affordable Care Act in 2010.
Also, this was paired in the ACA with a requirement for universal coverage. If you were young and fit (and invincible) and so skipped coverage, you were fined essentially the amount of premium. This was exactly to keep the insured pool from reducing to the most sick, and making premiums spiral. Republican efforts during the first Trump administration eventually led to that penalty being lowered to $0, in the hopes said death spiral would happen. Only, it hasn't. The ACA has continued to grow enrollment since then.
Universal coverage means the young and healthy subsidise the premiums of the old and chronically ill. It would be like all drivers being categorised as having the same driving history. Great for someone who's had a DUI conviction. Not so good for the person without a speeding fine in 20 years.
Not a fair comparison. You can choose not to drive drunk but you can't really choose not to become ill or disabled. The whole point in insurance is that you can't predict who it will happen to and when.
I don't agree that your state of health is wholly outside your choice. Even something that is partly genetic - say lung cancer, diabetes type 2 or obesity - still has a strong lifestyle component.
It's true that you can't predict your future state of health, which is why you take out insurance in the first place. The question is whether the insurance premium itself should vary depending on risk factors. For one, failure to vary it means that adverse selection is more likely.
This opinion shows an extreme lack of experience with the word. For example, the 20-something tennis pro at our club had a random brain bleed stroke, and I've never ever seen a more fit and health conscious person.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
I doubt he planned on becoming an internet sensation and meme. That development greatly increased his recognizability with the public and greatly increased the law enforcement response.
Note that people who murder poor people are not investigated anywhere near this level. Our reaction to this case is part of the reason why.
But assuming it's him, and assuming he got caught going to a McDonald's, here are some of his probable mistakes:
- Should have grown a beard before the murder and shaved it off afterward.
- Should have driven at least 500 miles after the murder, and had somewhere to hide for at least 6 months. A few of those Costco bug-out-buckets would have been a good investment. Have an abandoned house to squat in, or tent camp.
- Have someone else carry around your cell phone out of state while you commit the act. E.g. hide it in a friend's car. Take other steps to develop an alias the cops can see early in the investigation to get yourself off the suspect list.
- Always dispose of the murder weapon where it can never be found.
- Change out of your normal mode of dress for the murder. E.g. Athleisure > preppy, gangsta > suits, mainstream casual > ethnic
- Going to McDonald's was a dumb move. Do not frequent malls, stores, shopping centers, or places with cameras. If you absolutely need something that's not in your bug-out kit, consider breaking into an unoccupied home (while wearing gloves and far away from your bug out location) to obtain it. Those little donation food pantry boxes could be utilized.
-
The main difficulty is that if you commit a murder while being surrounded with CCTV at all points in your journey, it's going to be almost impossible to evade detection.
-
I'm hearing the guy at McD's had a ghost gun, silencer, and fake ID that all appear to match the items used in the shooting. For all the folks that thought this guy was doing some legendary trolling with the bookbag full of monopoly money, etc. it seems quite stupid to still be carrying around those items.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
-
I'm hearing the guy at McD's had a ghost gun, silencer, and fake ID that all appear to match the items used in the shooting. For all the folks that thought this guy was doing some legendary trolling with the bookbag full of monopoly money, etc. it seems quite stupid to still be carrying around those items.
Yeah, honestly that doesn’t add up to me. I don’t think he would be that stupid. Sets my spidey senses tingling.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
Why blame the insurer (middleman)? Blame the hospitals for not providing cheaper medical care. Blame the government for not having more universal healthcare. Blame the citizens for voting in parties that allow this to happen.
This type of reasoning is slippery and fallacious to the nth degree.
-
I'm hearing the guy at McD's had a ghost gun, silencer, and fake ID that all appear to match the items used in the shooting. For all the folks that thought this guy was doing some legendary trolling with the bookbag full of monopoly money, etc. it seems quite stupid to still be carrying around those items.
Yeah, honestly that doesn’t add up to me. I don’t think he would be that stupid. Sets my spidey senses tingling.
It’s literally got to be the rarest type of murder there is. Theatrics, engraved (?) bullets… but also, how did he find and target the victim? There’s also his review of Kazinsky’s manifesto online. Definitely way too much of a trail left by this guy, and under his own name…
OTOH it could be like those Idaho murders where the killer thought he was so smart but revisited the scene of the crime and was surveilled driving across the country. Or maybe he wanted to be caught…
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Doesn't an insurance claim denial mean that the person received the care they needed, it's just not being covered by the insurance company? I'm not trying to defend the awful practices of UnitedHealth or it's CEO, but it seems odd to say that a claim denial caused the death of the person that just received the service they needed. Sounds more like a money problem than a killing.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
Why blame the insurer (middleman)? Blame the hospitals for not providing cheaper medical care. Blame the government for not having more universal healthcare. Blame the citizens for voting in parties that allow this to happen.
This type of reasoning is slippery and fallacious to the nth degree.
There's rent seeking and monopolistic practices on the part of both insurers and hospitals. I highly recommend "Deaths of Despair and the Future of Capitalism " by Anne Case and Angus Deaton if you want to know more about the US system ( It's a much easier read than the title makes it sound). "The Nordic Theory of Everything" by Anu Paartanen also provides good basic comparisons f the US with other countries on healthcare and other topics.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
Why blame the insurer (middleman)? Blame the hospitals for not providing cheaper medical care. Blame the government for not having more universal healthcare. Blame the citizens for voting in parties that allow this to happen.
This type of reasoning is slippery and fallacious to the nth degree.
It's like blaming landlords for a housing crisis... which happens, so none of this is surprising to me.
-
Cory Doctorow has a great summary (https://pluralistic.net/2024/12/09/radicalized/#deny-defend-depose)of how and why people are so callous about this particular CEO's assassination. A few key points:
"During the most acute phase of the pandemic, the company charged the US government $11,000 for each $8 covid test:"
"UHC is a vertically integrated, murdering health profiteer. They bought Optum, the largest pharmacy benefit manager ("A spreadsheet with political power" -Matt Stoller) in the country. Then they starved Optum of IT investment in order to give more money to their shareholders. Then Optum was hacked by ransomware gang and no one could get their prescriptions for weeks. This killed people:"
"Take Navihealth, an algorithm that United uses to kick people out of their hospital beds even if they're so frail, sick or injured they can't stand or walk. Doctors and nurses routinely watch their gravely ill patients get thrown out of their hospitals. Many die. UHC kills them, for money:"
"Doctors and nurses hate UHC on behalf of their patients, but it's also personal. UHC screws doctor's practices by refusing to pay them, making them chase payments for months or even years, and then it offers them a payday lending service that helps them keep the lights on while they wait to get paid:"
No idea what the actual killer's motivations are. I also have no idea if they actually got the guy, or if they've just picked up some random lookalike and planted some stuff on him to make the attention go away.
I do think that when you create a system as monstrously corrupt and destructive as the US 'health' system, bend the laws and the rules to cause people unimaginable suffering, and corrupt the political system to protect the corruption - something is going to happen. People who are dealt with at least mostly fairly generally just get on with things.
-
Cory Doctorow has a great summary (https://pluralistic.net/2024/12/09/radicalized/#deny-defend-depose)of how and why people are so callous about this particular CEO's assassination. A few key points:
"During the most acute phase of the pandemic, the company charged the US government $11,000 for each $8 covid test:"
"UHC is a vertically integrated, murdering health profiteer. They bought Optum, the largest pharmacy benefit manager ("A spreadsheet with political power" -Matt Stoller) in the country. Then they starved Optum of IT investment in order to give more money to their shareholders. Then Optum was hacked by ransomware gang and no one could get their prescriptions for weeks. This killed people:"
"Take Navihealth, an algorithm that United uses to kick people out of their hospital beds even if they're so frail, sick or injured they can't stand or walk. Doctors and nurses routinely watch their gravely ill patients get thrown out of their hospitals. Many die. UHC kills them, for money:"
"Doctors and nurses hate UHC on behalf of their patients, but it's also personal. UHC screws doctor's practices by refusing to pay them, making them chase payments for months or even years, and then it offers them a payday lending service that helps them keep the lights on while they wait to get paid:"
No idea what the actual killer's motivations are. I also have no idea if they actually got the guy, or if they've just picked up some random lookalike and planted some stuff on him to make the attention go away.
I do think that when you create a system as monstrously corrupt and destructive as the US 'health' system, bend the laws and the rules to cause people unimaginable suffering, and corrupt the political system to protect the corruption - something is going to happen. People who are dealt with at least mostly fairly generally just get on with things.
It's literally impossible to be the CEO of a company with that track record and not know that you are personally responsible for killing thousands of people.
-
Doesn't an insurance claim denial mean that the person received the care they needed, it's just not being covered by the insurance company? I'm not trying to defend the awful practices of UnitedHealth or it's CEO, but it seems odd to say that a claim denial caused the death of the person that just received the service they needed. Sounds more like a money problem than a killing.
No. A lot of things (expensive medicines, procedures, surgeries, etc.) require something called "prior authorizations" meaning the doctor has to get the insurance company's approval first. If you get denied, you will not get the surgery, test, medicine, etc. Maybe the doctor will do it if you can pay cash up front and are willing to do it. (It's hard for a lot of people to shell out that kind of money for testing if you don't know if it will show anything helpful...)
I've had to get a prior authorization for:
1. a specialty antibiotic (I waited two weeks! for an antibiotic!!)
2. a preventive migraine medication
3. an abortive migraine medication
4. surgery that had been recommended by three different doctors - denied days before surgery date, had to appeal
5. trigger point injections - this took months to get approved and I regained a ton of ROM in my shoulder
6. epidural steroid injection
7. physical therapy
8. EMG tests when I had apparent nerve damage in both hands
9. MRIs for my brain, neck, and shoulder
Probably other stuff I'm forgetting. Some insurance companies are nuts with this stuff. Just endless delays of necessary care.
-
Cory Doctorow has a great summary (https://pluralistic.net/2024/12/09/radicalized/#deny-defend-depose)of how and why people are so callous about this particular CEO's assassination. A few key points:
"During the most acute phase of the pandemic, the company charged the US government $11,000 for each $8 covid test:"
"UHC is a vertically integrated, murdering health profiteer. They bought Optum, the largest pharmacy benefit manager ("A spreadsheet with political power" -Matt Stoller) in the country. Then they starved Optum of IT investment in order to give more money to their shareholders. Then Optum was hacked by ransomware gang and no one could get their prescriptions for weeks. This killed people:"
"Take Navihealth, an algorithm that United uses to kick people out of their hospital beds even if they're so frail, sick or injured they can't stand or walk. Doctors and nurses routinely watch their gravely ill patients get thrown out of their hospitals. Many die. UHC kills them, for money:"
"Doctors and nurses hate UHC on behalf of their patients, but it's also personal. UHC screws doctor's practices by refusing to pay them, making them chase payments for months or even years, and then it offers them a payday lending service that helps them keep the lights on while they wait to get paid:"
No idea what the actual killer's motivations are. I also have no idea if they actually got the guy, or if they've just picked up some random lookalike and planted some stuff on him to make the attention go away.
I do think that when you create a system as monstrously corrupt and destructive as the US 'health' system, bend the laws and the rules to cause people unimaginable suffering, and corrupt the political system to protect the corruption - something is going to happen. People who are dealt with at least mostly fairly generally just get on with things.
It's literally impossible to be the CEO of a company with that track record and not know that you are personally responsible for killing thousands of people.
Exactly.
-
He seems to be among the better educated and "healthier" killers we have seen in a while.
(https://nypost.com/wp-content/uploads/sites/2/2024/12/luigi-mangione-man-held-pennsylvania-95080464.jpg?resize=1024,948&quality=75&strip=all)
-
Damn! He has prison abs pre-prison!
-
Wow. SNL did a bunch of weekend update jokes already and this pic and the one with the scarf in the police station are definitely going to fuel more of those.
-
I'm hearing the guy at McD's had a ghost gun, silencer, and fake ID that all appear to match the items used in the shooting. For all the folks that thought this guy was doing some legendary trolling with the bookbag full of monopoly money, etc. it seems quite stupid to still be carrying around those items.
Yeah, honestly that doesn’t add up to me. I don’t think he would be that stupid. Sets my spidey senses tingling.
He graduated from Penn and was valedictorian at his prep school, so he’s not dumb. Keeping the items was not smart and quite puzzling given his intelligence.
But he had a manifesto. I imagine he wanted that to be read, and he had it on him. Maybe he expected to get caught?
-
Apparently he comes from a very wealthy family, so maybe he thought they would buy his way out of trouble?
-
He's a young guy from a very wealthy family, elite schools, tons of privilege. The most likely explanation is he overestimated his abilities, figured he's smart enough to get away with it.
-
I think he knew he would get caught and didn’t bother ditching weapon, IDs etc. He has a story to tell. If he just disappeared the story would disappear from the headlines. He went all in on this.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
Why blame the insurer (middleman)? Blame the hospitals for not providing cheaper medical care. Blame the government for not having more universal healthcare. Blame the citizens for voting in parties that allow this to happen.
This type of reasoning is slippery and fallacious to the nth degree.
It's like blaming landlords for a housing crisis... which happens, so none of this is surprising to me.
Per my doctor and my prior rant about ASH/Cigna: “I think they just automatically deny almost everyone pre authorization, and then I have to call them and explain my diagnosis. They never answer the phone and they rarely call back when you say you can be available to talk.” With a plan that covers my needed treatment and a referral from my PC I probably have to wait until January to continue treatment because Cigna is trying to hit its numbers. I don’t think this is like blaming landlords. Edit- I do get your point, that a lot of people just have rage over the system or were denied coverage their plans don’t cover, but there is also a lot of unethical f**kery happening at these insurers as well to deny you healthcare you paid for.
-
He reminds me in so many ways of the Idaho murders guy. Weird.
With regard to UHC and all the horror stories, I truly believe it boils down to what type of policy you have. A dear friend of mine died of cancer in 2020 and she had UHC during her entire illness. She never had one single problem getting a test done, surgery performed or any treatment a provider suggested. Heck, UHC even approved sending her to Stanford (out of state) for surgery by the world renowned surgeon for her issue. UHC was simply fabulous during her entire ordeal. Clearly, there are lots of horror stories out there but this is not one of them. In her situation, cancer killed her, not UHC.
FWIW, my stepmom also has UHC and was diagnosed with breast cancer in 2021. Zero issues getting the treatment she needed. No delays, no denials. I’m not cheerleading for UHC but, again, I think experiences differ based on the policy you have. In other words, choose wisely.
-
I agree and the Idaho guy was also handsome… his murders didn’t capture the public’s enthusiasm, more their horror. Either way, both are premeditated murderers aka very scary psychopaths.
So interesting how a Robinhood-like tale changes the perception.
Hmmm…. What if he wanted to get caught so that he wouldn’t do it again? Like, he knew he wouldn’t be able to control the urge? Especially with the public cheering him on. Or, like the Idaho guy, he was still high off having committed the murder and not really worried about anything.
I still want to know how he chose and staked out his victim. It seems hard to believe that it was completely based on researching who the CEO was. Or was the CEO named in the book?
-
It's very clear that his motivation was... fuck. I don't actually know. We'll find out over the coming days/weeks/months. It will likely be a combination of shit we can relate to and shit that is unhinged.
The silver lining appears that it has given voice to society wide frustration with the current privatised insurance system. The question is if that dies out in the next couple of weeks or maintains enough momentum to actually change something. Trump is so fucking approval hungry that he might actually be a vehicle to change something if his approval from monied individuals doesn't win out.
-
I’m not cheerleading for UHC but, again, I think experiences differ based on the policy you have. In other words, choose wisely.
Sorry, how many choices do you think most Americans are given by their employers? Every year but one that I worked I had no choice: your insurance options were take it or leave it. The one time I did have choices it was three different plans from one insurer.
Why do you think people are so mad? Stop victim blaming. And it's not like you can change insurance easily when you have a bad experience, either. You are locked in for a year at minimum.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
I doubt he planned on becoming an internet sensation and meme. That development greatly increased his recognizability with the public and greatly increased the law enforcement response.
Note that people who murder poor people are not investigated anywhere near this level. Our reaction to this case is part of the reason why.
But assuming it's him, and assuming he got caught going to a McDonald's, here are some of his probable mistakes:
- Should have grown a beard before the murder and shaved it off afterward.
- Should have driven at least 500 miles after the murder, and had somewhere to hide for at least 6 months. A few of those Costco bug-out-buckets would have been a good investment. Have an abandoned house to squat in, or tent camp.
- Have someone else carry around your cell phone out of state while you commit the act. E.g. hide it in a friend's car. Take other steps to develop an alias the cops can see early in the investigation to get yourself off the suspect list.
- Always dispose of the murder weapon where it can never be found.
- Change out of your normal mode of dress for the murder. E.g. Athleisure > preppy, gangsta > suits, mainstream casual > ethnic
- Going to McDonald's was a dumb move. Do not frequent malls, stores, shopping centers, or places with cameras. If you absolutely need something that's not in your bug-out kit, consider breaking into an unoccupied home (while wearing gloves and far away from your bug out location) to obtain it. Those little donation food pantry boxes could be utilized.
You've given this a lot of careful thought. If I ever decide to murder anyone, I will request a consultation with you first, lol.
-
Apparently he comes from a very wealthy family, so maybe he thought they would buy his way out of trouble?
He's going to need cash transfer in prison for protection from being "passed around", that's for sure.
-
He's a young guy from a very wealthy family, elite schools, tons of privilege. The most likely explanation is he overestimated his abilities, figured he's smart enough to get away with it.
I'm not sure that's the most likely explanation, you are assuming largely mentally healthy reasoning.
Someone can be extremely smart and do things that appear very stupid because their process of reasoning is fundamentally distorted.
Even your average bipolar person is capable of doing extremely stupid-seeming shit because their brain is telling them in their manic episodes that consequences won't happen.
If someone shoots someone else in this manner, I'm putting my money on mental illness, which means logic as mentally healthy people understand it, doesn't apply the same way.
Virtually everyone is capable of murder, but this kind of behaviour doesn't look to me like run-of-the-mill, sane person pushed too far, murder. From where I'm sitting, I'm inclined to think a certain level of delusion is likely involved.
To people with delusional thinking, their behaviour makes perfect, logical sense. Their internal logic is entirely reasonable, it's just not compatible with everyone else's logic.
So there could be a "logical" reason for him taking the actions that got him caught. Not logical to us, but perfectly intelligent and logical to him.
I could be wrong, but if you were to ask me what's most likely, I'm going with mental illness on this one, not affluenza.
-
It’s interesting that you can’t deny coverage for pre-existing conditions in the U.S.
Of all the morally reprehensible things that US insurers do, I feel that hypothetically increasing premiums or instituting a waiting period for pre-existing conditions would be nowhere near the top of the list. Forcing all insurers to cover for pre-existing conditions raises premiums, and leads to adverse selection. It would be like a car insurer having to assume that you’ve had your licence suspended in the past, when in fact most of us haven’t.
I have no doubt that some insurer practices are immoral and deceptive – including the use of AI to process claims. I work in litigation and sometimes I act against insurers (sometimes I act for them) and I see the gamut of conduct from good faith to bad faith. To the extent that they make bad faith decisions, they deserve criticism. If it's bad faith to a criminal standard, they deserve punishment. But the immorality lies in the deceptiveness of a decision or the failure to abide by terms. It doesn’t lie in the deprivation of resources as such.
there are 2 tiers. There is private insurance which can have standards to qualify (like they may reject you if you have pre existing conditions you are a smoker etc) usually have a 6 month waiting period.
and the cost is better than ACA. But again not everyone qualifies, and they may drop you or not cover if get a serious condition. Aca costd more but covers pre existing. And I'm not going to get into private insurance through a job, Medicaid, Medicare, supplemental. It a complicated system, possibly intentionally so. And anyone who has gone through a medical experience can attest to how much billing and paperwork is involved.
As far as the killer yes it is puzzling how he didn't do much in precautionary planning. As far as surprising we in the US have a lot of guns, a lot of disgruntled people and mental the only difference this was a rich white guy who died ( vs family members, spouses, schoolchildren, etc).
-
Apparently he comes from a very wealthy family, so maybe he thought they would buy his way out of trouble?
He's going to need cash transfer in prison for protection from being "passed around", that's for sure.
He's not a child molester, and both the guards and inmates have dealt with health insurance, or have family members have family members who have dealt with the health insurance industry. He'll be fine.
-
The latest from WaPo is that he might have had a serious back injury or condition, leading to major surgery. So maybe he blamed UHC (which apparently owns some hospitals in addition to being an insurer) for the outcome of that?
Would be interesting if it did turn out to be both personal and insurance/money related, given how wealthy his family seems to be.
-
The latest from WaPo is that he might have had a serious back injury or condition, leading to major surgery. So maybe he blamed UHC (which apparently owns some hospitals in addition to being an insurer) for the outcome of that?
Would be interesting if it did turn out to be both personal and insurance/money related, given how wealthy his family seems to be.
Most funny thing would be if he had brain damage that caused him to murder (see metalcat "diagnosis") because his back injury was not treated because the hospital needed to negotiate with UHC.
I am loading my "Karma is a Bitch" gun just in case.
-
I think he knew he would get caught and didn’t bother ditching weapon, IDs etc. He has a story to tell. If he just disappeared the story would disappear from the headlines. He went all in on this.
If his goal was to enact some kind of change to the system, he probably should have planned more than one executive assassination.
-
Apparently he comes from a very wealthy family, so maybe he thought they would buy his way out of trouble?
He's going to need cash transfer in prison for protection from being "passed around", that's for sure.
That doesn't really happen anymore. The Prison Rape Elimination Act largely did away with them. The people who are most likely to face some sort of "inmate justice" in prison are the child molesters, not people like this guy.
-
Apparently he comes from a very wealthy family, so maybe he thought they would buy his way out of trouble?
He's going to need cash transfer in prison for protection from being "passed around", that's for sure.
That doesn't really happen anymore. The Prison Rape Elimination Act largely did away with them. The people who are most likely to face some sort of "inmate justice" in prison are the child molesters, not people like this guy.
Are you kidding?
https://bjs.ojp.gov/document/svraca1920st_sum.pdf
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
Why blame the insurer (middleman)? Blame the hospitals for not providing cheaper medical care. Blame the government for not having more universal healthcare. Blame the citizens for voting in parties that allow this to happen.
This type of reasoning is slippery and fallacious to the nth degree.
It's like blaming landlords for a housing crisis... which happens, so none of this is surprising to me.
I disagree...the insurance lobby is quite powerful and actively lobbies against a single payer system, opposed the ACA, and works hard to maintain the current system. They are at least partly responsible for the current system.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
Why blame the insurer (middleman)? Blame the hospitals for not providing cheaper medical care. Blame the government for not having more universal healthcare. Blame the citizens for voting in parties that allow this to happen.
This type of reasoning is slippery and fallacious to the nth degree.
It's like blaming landlords for a housing crisis... which happens, so none of this is surprising to me.
I disagree...the insurance lobby is quite powerful and actively lobbies against a single payer system, opposed the ACA, and works hard to maintain the current system. They are at least partly responsible for the current system.
Agree completely. I despise the idea of vigilante justice.
But the medical industry (pharma, insurance, hospitals, medical devices, etc) have engaged in such a level of regulatory capture that there is no due process. The medical insurance industry literally has a liability shield in place to prevent them from being sued for denial of care. The industry has moved beyond amoral profit seeking into true evil behavior. They are doing this in collusion with federal and state governments, because they write their own rules.
There’s plenty of blame to go around, but it’s impossible not to blame industry due to the level of regulatory capture involved.
-
Back to the shooter, who has apparently been apprehended at a McDonald’s in PA… I’m thinking it was a big mistake for him not to wear sunglasses. He also should have run farther away, though maybe openly crossing borders would have been impossible.
Or at least used the app to order.
It will be a large disappointment if this is him. Would make for a much better story if he simply faded away.
Seems very likely to be the guy based on the evidence coming out. Assuming it is, I'm glad they got him because anyone that does something as cold and calculating as this is likely to do it again. Let's not forget that he murdered another human. I also hope he gets all the due process and legal protections he didn't provide to his victim.
I saw a statement that the UHC CEO was responsible for killing more people than Osama bin Laden, given the AI that was implemented that denied 90% of claims. Ouch.
Health insurance is highly regulated. Again, Medical Loss Ratio and all that. Not saying it's perfect, clearly many problems (and using AI for this should be banned). But all health care systems have to make choices about who gets treatment and for how long, because there aren't enough resources to cover every possible treatment, especially end of life stuff that can get very expensive for very marginal results. By this logic bureaucrats in government run systems that deny treatment (it happens) are also killing people. Equating this to terrorists who intentionally plan to murder others for ideological reasons is just way off.
Why blame the insurer (middleman)? Blame the hospitals for not providing cheaper medical care. Blame the government for not having more universal healthcare. Blame the citizens for voting in parties that allow this to happen.
This type of reasoning is slippery and fallacious to the nth degree.
It's like blaming landlords for a housing crisis... which happens, so none of this is surprising to me.
I disagree...the insurance lobby is quite powerful and actively lobbies against a single payer system, opposed the ACA, and works hard to maintain the current system. They are at least partly responsible for the current system.
Agree completely. I despise the idea of vigilante justice.
But the medical industry (pharma, insurance, hospitals, medical devices, etc) have engaged in such a level of regulatory capture that there is no due process. The medical insurance industry literally has a liability shield in place to prevent them from being sued for denial of care. The industry has moved beyond amoral profit seeking into true evil behavior. They are doing this in collusion with federal and state governments, because they write their own rules.
There’s plenty of blame to go around, but it’s impossible not to blame industry due to the level of regulatory capture involved.
Yes, vigilante murder seems especially harsh. I might have less aghast with a shot to the kneecap or two as a sufficient "wake up" call. I understand this is a tried and true way of sending a message.
-
Are you kidding?
https://bjs.ojp.gov/document/svraca1920st_sum.pdf
3,600 substantiated assaults among a prison population of 1.8 million. So that's about 0.2% chance per year. In the US, about 400,000 women are sexually assaulted each year, and there's about 170 million women in the US. That's also about 0.2%.
So, if we go only by substantiated assaults, he'll be about as likely to be sexually assaulted in prison as the average women in the US. If 100% of the allegations are true, then he's about 10x more likely to be sexually assaulted in prison than the average women.
Of course, the prison numbers don't separate out child molesters and rapists, and I'd suspect they are way over represented in the number of sexual assaults. If, for the sake of argument, we assume that half the sexual assaults are chomos and rapists and only count confirmed assaults, then he'll be less likely to be sexually assaulted in prison than the average women in the USA.
-
Are you kidding?
https://bjs.ojp.gov/document/svraca1920st_sum.pdf
3,600 substantiated assaults among a prison population of 1.8 million. So that's about 0.2% chance per year. In the US, about 400,000 women are sexually assaulted each year, and there's about 170 million women in the US. That's also about 0.2%.
So, if we go only by substantiated assaults, he'll be about as likely to be sexually assaulted in prison as the average women in the US. If 100% of the allegations are true, then he's about 10x more likely to be sexually assaulted in prison than the average women.
Of course, the prison numbers don't separate out child molesters and rapists, and I'd suspect they are way over represented in the number of sexual assaults. If, for the sake of argument, we assume that half the sexual assaults are chomos and rapists and only count confirmed assaults, then he'll be less likely to be sexually assaulted in prison than the average women in the USA.
The 400k a year estimate include unsubstantiated sexual assaults against women. Only about 30% of women report sexual assault to police. Of that 30%, only a fraction will ever be investigated and fully substantiated. That doesn't seem like a fair comparison with only substantiated sexual assaults on prisoners. (Especially considering that the prison system collecting the data has reason to hide the scope of the problem.)
-
Looking at this recent murder and also the attempts on Trump and others related to politicians, it seems officials and CEOs live in a dangerous country now. Plenty of guns to be had. More guns than people it seems. A gun's trigger doesn't care who you voted for. Perhaps the proposed “draining of the swamp” cuts to “deep state” federal law enforcement agencies will not be so urgent, LOL.
-
It would be ironic if after a few CEOs get gunned down, gun control becomes a hot topic on the right.
-
It would be ironic if after a few CEOs get gunned down, gun control becomes a hot topic on the right.
Didn't happen after their flag-bearer was wounded on the ear (and would have been dead but for that inch or two miss), ain't gonna happen because of this either.
-
The latest from WaPo is that he might have had a serious back injury or condition, leading to major surgery. So maybe he blamed UHC (which apparently owns some hospitals in addition to being an insurer) for the outcome of that?
Would be interesting if it did turn out to be both personal and insurance/money related, given how wealthy his family seems to be.
Most funny thing would be if he had brain damage that caused him to murder (see metalcat "diagnosis") because his back injury was not treated because the hospital needed to negotiate with UHC.
I am loading my "Karma is a Bitch" gun just in case.
Symbolic that the CEO was shot in the back then? Maybe he didn’t mean to kill him, but give him a taste of his own medicine, so to speak.
-
Looking at this recent murder and also the attempts on Trump and others related to politicians, it seems officials and CEOs live in a dangerous country now. Plenty of guns to be had. More guns than people it seems. A gun's trigger doesn't care who you voted for. Perhaps the proposed “draining of the swamp” cuts to “deep state” federal law enforcement agencies will not be so urgent, LOL.
Taking advantage of people starts to lose its appeal when getting dead becomes a possible consequence of doing so.
-
Looking at this recent murder and also the attempts on Trump and others related to politicians, it seems officials and CEOs live in a dangerous country now. Plenty of guns to be had. More guns than people it seems. A gun's trigger doesn't care who you voted for. Perhaps the proposed “draining of the swamp” cuts to “deep state” federal law enforcement agencies will not be so urgent, LOL.
Taking advantage of people starts to lose its appeal when getting dead becomes a possible consequence of doing so.
Nope, criminals by definition are convinced that consequences won't happen to them, or they will evade them somehow. Think of all the white collar criminals who have stolen millions or billions and had minimal or no consequences. They even have a president now.
Consequences are for poor people. CEOs and billionaires will now have to act a bit more like the feudal lords they aspire to be, keeping retainers of bodyguards and security details. If only they would start assassinating each other and leave the rest of us alone.
-
Looking at this recent murder and also the attempts on Trump and others related to politicians, it seems officials and CEOs live in a dangerous country now. Plenty of guns to be had. More guns than people it seems. A gun's trigger doesn't care who you voted for. Perhaps the proposed “draining of the swamp” cuts to “deep state” federal law enforcement agencies will not be so urgent, LOL.
Taking advantage of people starts to lose its appeal when getting dead becomes a possible consequence of doing so.
I'm not sure the data supports this position. Plenty of people are perfectly fine engaging in activities that could cost them their lives, and for a lot less comp and prestige than being a CEO.
-
Maybe this is just a big conspiracy choosing this person as the fall guy in the new explanation as to why CEOs should make so much money.... it's dangerous after all!
-
Looking at this recent murder and also the attempts on Trump and others related to politicians, it seems officials and CEOs live in a dangerous country now. Plenty of guns to be had. More guns than people it seems. A gun's trigger doesn't care who you voted for. Perhaps the proposed “draining of the swamp” cuts to “deep state” federal law enforcement agencies will not be so urgent, LOL.
Taking advantage of people starts to lose its appeal when getting dead becomes a possible consequence of doing so.
Nope, criminals by definition are convinced that consequences won't happen to them, or they will evade them somehow. Think of all the white collar criminals who have stolen millions or billions and had minimal or no consequences. They even have a president now.
Consequences are for poor people. CEOs and billionaires will now have to act a bit more like the feudal lords they aspire to be, keeping retainers of bodyguards and security details. If only they would start assassinating each other and leave the rest of us alone.
That's because the perceived risk isn't high enough. It's sure gone up a few notches in the last few months though.
-
I think the allusions here to conspiracies are a bit surprising. It was pretty clear from early on this was no master-criminal. And it seems the suspected shooter has been tagged repeatedly on X in recent months by concerned friends who hadn't heard from him in months and were worried, so there are clear signs that something was amiss with this person. I read an article that said his Goodread's account shared a 4-star rating of Ted Kaczyniski's "Industrial Society and Its Future". Again, this seems like something that preexists his arrest, unless someone thinks that law enforcement was able to somehow retroactively add these posts?
Horses, not zebras--it seems logical and entirely plausible that this guy--who may or may not have been mentally well and who certainly had physical health (and therefore health insurance)-related issues--is the shooter. Maybe he wasn't, but it seems more plausible that he was than that he was framed. How it can seem more likely that he's being framed is a bit of a mystery to me.
-
Looking at this recent murder and also the attempts on Trump and others related to politicians, it seems officials and CEOs live in a dangerous country now. Plenty of guns to be had. More guns than people it seems. A gun's trigger doesn't care who you voted for. Perhaps the proposed “draining of the swamp” cuts to “deep state” federal law enforcement agencies will not be so urgent, LOL.
Taking advantage of people starts to lose its appeal when getting dead becomes a possible consequence of doing so.
Nope, criminals by definition are convinced that consequences won't happen to them, or they will evade them somehow. Think of all the white collar criminals who have stolen millions or billions and had minimal or no consequences. They even have a president now.
Consequences are for poor people. CEOs and billionaires will now have to act a bit more like the feudal lords they aspire to be, keeping retainers of bodyguards and security details. If only they would start assassinating each other and leave the rest of us alone.
That's because the perceived risk isn't high enough. It's sure gone up a few notches in the last few months though.
The risk only applies if you're CEO of a particularly disliked company - which is not a lot of CEOs.
Still safe and easy to become rich in a way that doesn't get your name splashed in the news. Stealth wealth.
-
I think the allusions here to conspiracies are a bit surprising. It was pretty clear from early on this was no master-criminal. And it seems the suspected shooter has been tagged repeatedly on X in recent months by concerned friends who hadn't heard from him in months and were worried, so there are clear signs that something was amiss with this person. I read an article that said his Goodread's account shared a 4-star rating of Ted Kaczyniski's "Industrial Society and Its Future". Again, this seems like something that preexists his arrest, unless someone thinks that law enforcement was able to somehow retroactively add these posts?
Horses, not zebras--it seems logical and entirely plausible that this guy--who may or may not have been mentally well and who certainly had physical health (and therefore health insurance)-related issues--is the shooter. Maybe he wasn't, but it seems more plausible that he was than that he was framed. How it can seem more likely that he's being framed is a bit of a mystery to me.
Maybe I'm wrong, but I've read most of the conjecture here from a more light hearted, not serious perspective.
Is anyone really seriously thinking zebras and not horses??
-
His manifesto is still up: https://archive.is/7jUsF
He details his mother’s chronic pain and suffering and denied treatments.
-
I think the allusions here to conspiracies are a bit surprising. It was pretty clear from early on this was no master-criminal. And it seems the suspected shooter has been tagged repeatedly on X in recent months by concerned friends who hadn't heard from him in months and were worried, so there are clear signs that something was amiss with this person. I read an article that said his Goodread's account shared a 4-star rating of Ted Kaczyniski's "Industrial Society and Its Future". Again, this seems like something that preexists his arrest, unless someone thinks that law enforcement was able to somehow retroactively add these posts?
Horses, not zebras--it seems logical and entirely plausible that this guy--who may or may not have been mentally well and who certainly had physical health (and therefore health insurance)-related issues--is the shooter. Maybe he wasn't, but it seems more plausible that he was than that he was framed. How it can seem more likely that he's being framed is a bit of a mystery to me.
Maybe I'm wrong, but I've read most of the conjecture here from a more light hearted, not serious perspective.
Is anyone really seriously thinking zebras and not horses??
Entirely possible I'm tone deaf, but quotes like this (I can't get the multi-quote feature to work for some reason) read to me as serious, "I also have no idea if they actually got the guy, or if they've just picked up some random lookalike and planted some stuff on him to make the attention go away. " and "Yeah, honestly that doesn’t add up to me. I don’t think he would be that stupid. Sets my spidey senses tingling."
-
Entirely possible I'm tone deaf, but quotes like this (I can't get the multi-quote feature to work for some reason) read to me as serious, "I also have no idea if they actually got the guy, or if they've just picked up some random lookalike and planted some stuff on him to make the attention go away. " and "Yeah, honestly that doesn’t add up to me. I don’t think he would be that stupid. Sets my spidey senses tingling."
The first quote is mine. I'm referring to the fact that any information I get about the event is going to be secondhand at best. And the fact that law enforcement has form for rounding up a few likely suspects and pinning it on someone, especially if the spotlights are on them.
I don't see it as a conspiracy of competence. But I do see plenty of examples of law enforcement getting it wrong. His collection of possessions sure sounds like a 'convict me' package, nicely tied up in a bow. There are plenty of people who are bad at criming - I would be one, for example - so it is all possible and even probable. But I have seen little reason to trust law enforcement in the past few years, so I am left with doubts.
That is at least a part of the long-tail effect of the ongoing assault on the credibility of institutions. Which is definitely a topic for another thread.
-
We may have vigilantes assassinating healthcare CEOs whose policies kill thousands of people at a time, and who are more deadly than Osama bin Laden, but at least we don't have a single-payer healthcare system because that would be CoMmUnIsM like all those poor peasants in Australia, Japan, South Korea, Germany, France, the UK, Italy, Switzerland, Sweden, Norway, Denmark, the Netherlands, Austria, Spain, Portugal, Greece, Finland, Canada, and freakin' Mexico have to deal with.
Yes I will happily go without my heart medication, and will forego lifesaving surgical procedures, because it's the price I pay to live in the country with the Greatest system!
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
The overhead created/needed for administration of the inefficient insurance method of doing health care is significant and employs millions of people. Useless and net negatives for society though they may be, a lot of people would be out of jobs if health care in the US was fixed.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
Because the healthcare industry buys the laws & markets that benefit them. End consumers aren’t a consideration.
While the insurance industry is a powerful corporate lobby, PHRMA is considered the most powerful lobbying group in Washington. They’re considered more influential than even Wall Street or oil & gas lobbyists.
The dysfunction in American healthcare isn’t by accident. It’s by design.
Health care providers and pharmaceutical companies like the status quo, because they can bill insurance companies almost whatever they want. The only real constraint is the in-network designation. Although Private Equity has figured this out, and now they’re putting out-of-network employees at in-network hospitals (but I digress).
Insurance companies like the status quo because their MLR’s are written in law and because they are protected from liability in ways very few industries are.
-
Or in other words: It's the economy, stupid!
It's like the private pension insurances always firing broadsides against the state pension. That one has costs of roughly a half percent.
At my employer pension plan the insurers take 2% of incoming money, 1,5% of outgoing money and something like 3/4% of the worth just for holding on to it and some sign-up costs for first 5 years. All for basically maintaining a database with me in there. I still do it because I get a 100% match for 100€, but I get angry every time I think about it.
But looking at those fees it's no wonder they lobby heavily for private pension insurance, right?
-
I saw this in my morning newsfeed....
McDonald’s had to have Google stop mass review-bombing of its brand. An overwhelming number of derogatory and one-star reviews flooded McDonald’s after Mangione’s arrest, due to individuals in the store spotting him and calling police. Said one review: “This location has rats in the kitchen that will make you sick and your insurance isn't going to cover it.”
-
His manifesto is still up: https://archive.is/7jUsF
He details his mother’s chronic pain and suffering and denied treatments.
That wasn't published till after his arrest, so it's probably fake.
-
Unless I missed it, did we already talk about how he must have had some inside help regarding the timing?
The investors meeting schedule would have been easy to find out, but how did the shooter know that the CEO would walk to that location at that exact time? It's a pretty short window of opportunity, so some are speculating that he had help with whoever would know the CEO's schedule.
-
Unless I missed it, did we already talk about how he must have had some inside help regarding the timing?
The investors meeting schedule would have been easy to find out, but how did the shooter know that the CEO would walk to that location at that exact time? It's a pretty short window of opportunity, so some are speculating that he had help with whoever would know the CEO's schedule.
People are creatures of habit. It's very common for folks to take the same routes and similar timing every day. I'd guess that some observation would probably yield this information in short order. And these days it's very likely that you could pull information off social media to work out these patterns too.
-
Unless I missed it, did we already talk about how he must have had some inside help regarding the timing?
The investors meeting schedule would have been easy to find out, but how did the shooter know that the CEO would walk to that location at that exact time? It's a pretty short window of opportunity, so some are speculating that he had help with whoever would know the CEO's schedule.
Hanging around the entrance to a hotel where the CEO was expected didn't require inside info. He got lucky that the dope was walking without security even after his wife mentioned threats.
-
Unless I missed it, did we already talk about how he must have had some inside help regarding the timing?
The investors meeting schedule would have been easy to find out, but how did the shooter know that the CEO would walk to that location at that exact time? It's a pretty short window of opportunity, so some are speculating that he had help with whoever would know the CEO's schedule.
The simplistic answer is the most likely.
The shooter went to where he knew the CEO would be, and looked for opportunities. He may have attended prior investor meetings as preparation.
He didn’t need to know that the CEO would be there at that exact moment to know that he would be going in or out of the building at some point within a couple hour window.
-
Unless I missed it, did we already talk about how he must have had some inside help regarding the timing?
The investors meeting schedule would have been easy to find out, but how did the shooter know that the CEO would walk to that location at that exact time? It's a pretty short window of opportunity, so some are speculating that he had help with whoever would know the CEO's schedule.
People are creatures of habit. It's very common for folks to take the same routes and similar timing every day. I'd guess that some observation would probably yield this information in short order. And these days it's very likely that you could pull information off social media to work out these patterns too.
Yeah, people don't really recognize how murderable they are to a decently motivated individual. Hell, 8% of sitting US presidents have been assassinated so what hope is there for the rest of us.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
See the remark starting at ~38:35:
https://www.c-span.org/video/?457040-1/howard-dean-remarks-american-bankruptcy-institute-health-care-event (https://www.c-span.org/video/?457040-1/howard-dean-remarks-american-bankruptcy-institute-health-care-event)
Transcript from C-SPAN:
…. THINK ABOUT WHO'S ON HOSPITAL BOARDS. THE MOST INFLUENTIAL PEOPLE IN THE COMMUNITY. I OFTEN TELL PEOPLE, THIS DOESN'T OCCUR TO THEM, EVEN IN WASHINGTON, THE BEST LOBBY IN THE COUNTRY IS THE HOSPITAL LOBBY. HAS NOTHING TO DO WITH THE AMERICAN HOSPITAL ASSOCIATION. HERE'S WHY. 80% OF ALL THE -- FIRST OF ALL, 50% -- 55% OF ALL HEALTH CARE DOLLARS IN THIS COUNTRY ARE SPENT IN HOSPITALS. OF THOSE 80% ARE NONPROFITS. I WANT YOU TO THINK ABOUT YOUR COMMUNITY, BIG OR SMALL, WHO IS ON THE BOARD OF THE NONPROFIT HOSPITALS? WHETHER IT'S NEW YORK CITY OR IOWA. IT'S THE MOST PRESTIGIOUS PEOPLE. WHY? BECAUSE THE HOSPITAL C.E.O. WANTS PEOPLE WHO CAN RAISE MONEY, WHO ARE REALLY WELL RESPECTED AND BY LUCK OF THE DRAW THEY'RE GOING TO BE BOTH DEMOCRATS AND REPUBLICANS. SO LET'S USE IOWA FOR FUN AND PRETEND I'M THE GUY WHO WANTS TO BE GOMBER -- GOVERNOR OR SENATOR FROM IOWA. WHO DO I CALL TO HELP ME? WHO DO I CALL TO VOUCH FOR ME AND WHO DO I CALL TO FUND RAISE FOR ME? THE MOST PRESTIGIOUS PEOPLE IN ANY COMMUNITY. SO I WIN, I GO TO WASHINGTON, I SIGN ON TO A BILL THAT'S GOING TO REDUCE MEDICARE REIMBURSEMENT BECAUSE IT CAUSES WHATEVER, OR IT'S GOING TO REQUIRE HOSPITALS TO DO SOMETHING DIFFERENT, TO NOT SPEND SO MUCH MONEY. I GET A CALL FROM MY FRIEND ON THE HOSPITAL BOARD. SAYS, HEY, HOWARD, YOU'RE DOING A GREAT JOB. I SAID, OH, JEEZ, THANKS SO MUCH. IF IT WASN'T FOR YOU I WOULDN'T BE THERE. AND HE SAYS, YA YOU KNOW, I'M ON THE HOSPITAL BOARD. I SAID, I KNOW YOU ARE. THAT'S SO GREAT. YOU'RE SUCH A WELL RESPECTED PERSON. WASHINGTON POLITICS. RIGHT? [LAUGHTER] AND HE SAYS, YOU KNOW, YOU JUST SIGNED A BILL THAT'S GOING TO REDUCE THE REIMBURSEMENT, WE'RE THE LARGEST EMPLOYER IN THE COUNTY. WE'D HAVE TO CLOSE IF YOUR BILL PASSES. I'D HATE TO TELL EVERYBODY IN THE COUNTY THAT YOU COST US 250 JOBS. MY NAME SON THAT BILL, THAT MUST HAVE BEEN SOME STUFF -- NAME IS ON THAT BILL, THAT MUST HAVE BEEN SOME STAFF MEMBER. THAT'S THE END OF THE BILL. THAT'S IT'S THE POWER OF HOSPITAL LOBBYISTS. IT'S THE BEST GRASSROOTS ORGANIZATION BY PLENT ACCIDENTIST DON'T THINK C.E.O.'S THINK ABOUT, LET'S PUT THIS GUY ON OUR BOARD BECAUSE HE HAS A PIPELINE TO SENATOR SO AND SO. THEY JUST WANT REALLY WELL RESPECTED PEOPLE WHO KNOW HOW TO RAISE MONEY AND HAVE BEEN SUCCESSFUL. THEY HAPPEN TO BE EXACTLY THE PEOPLE POLITICIANS CALL TO GET ELECTED. NOW WE WONDER WHY IT'S SO HARD TO CHANGE THE SYSTEM. BECAUSE EVERYBODY IN THE SYSTEM HAS A TREMENDOUS ROLE IN THE POLITICAL PROCESS AND MOST OF THEM ARE NOT EVEN AWARE OF IT.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
Have you actually received much healthcare (or read about problems with denials and “AI” auto-denials)? There are probably a lot of people in this camp, but a lot of the stuff people are upset about is how UHC and others try to ration it to people who pay for it and it’s covered benefits.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
The overhead created/needed for administration of the inefficient insurance method of doing health care is significant and employs millions of people. Useless and net negatives for society though they may be, a lot of people would be out of jobs if health care in the US was fixed.
This is the gist of the problem in a country where dollars buy voters.
Once an inefficient or destructive activity becomes an industry, government policy is unable to affect it. Instead, the industry affects government policy, perpetuating itself and its harms. Tobacco, fossil fuels, automobiles, and fast food all did their damage, in the same way as the insurance lobby works today.
Many of the millions of people employed to squabble over who pays for whose healthcare (including the portion of time spent by healthcare providers) might as well be employed digging holes and filling them back in. Hole digging/filling started as a humorous suggestion by John Maynard Keynes for how to increase employment and GDP during the Great Depression, but it is essentially what we are doing now with all the futile activity around healthcare payments.
"Healthcare" is now the 3rd largest sector (https://www.financecharts.com/etfs/SPY/summary/sector-weightings) in the S&P500, comprising 12.6% of market cap. Some of that would be necessary even in a single-payer system with private providers, like REITs, pharmaceuticals, and service provision. Proponents of single-payer are essentially talking about deleting the business models for a large chunk of the stock market - perhaps 2-5% of it? And as efficiencies were realized that reduced healthcare spending, GDP would go down. Add a possible recession to the political costs! Everyone would be mad about the job losses, recession, and stock market losses, even if we were able to eradicate most rent-seeking from the insurance world, unleash small business formation from the requirement to offer expensive benefits plans, and save thousands of lives.
It all returns to the American consensus that GDP and stock market growth are to be maximized at any cost. We can't agree to pay the costs described above, but we can generally agree to make the numbers go up. Whoever dies in the process just dies. It's really hard to balance the risks of being extorted by exorbitant insurance rates or denied care, versus the risk of losing one's job and having one's stock investments decline. Those in ex-US countries who are not paralyzed by this debate should feel lucky not to have even started down this pathway.
The root problem, as with all problems in a prosperous democracy, is that money can buy our votes. We're too plugged into media/social media, and not thinking clearly enough about our own interests.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
Perhaps you have a good employer plan where your out of pocket expenses are affordable and predictable, and you dont have to fight for every service to be covered. Maybe your local hospital is in network and even has doctors who are employees so you dont have to worry about surprise out-of-network bills, and if you get admitted or have surgery you wont pay more than your in network oop max. Good for you. That is not everyone's experience.
-
I'm overall very happy with my plan, though I admit it's not perfect. But I'm also aware enough of other's experiences that I can acknowledge our system is incredibly broken. To say otherwise seems to me like saying our justice system doesn't need reform, because I've never been falsely arrested or convicted, or beaten by a cop.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
This may be a pretty privileged take.
How much do you use it?
Who pays for it? Is it an employer sponsored plan? If so, how much does your employer pay? (My employer pays roughly 70-80% of my premium costs.)
Do you have any pre-existing conditions? Are you healthy? Are you on any special medications? Do you have back pain, celiac, Crohns, Lupus?
TLDR, whether or not you are happy with your health care depends on how much you need it and what you pay for it. Using it for an annual physical and some occasional pharm benefits and maybe a physical therapist for injury is a FAR cry from having an infant in the NICU, dealing with long term disease or emergency surgery, chronic pain, etc.
-
I'm overall very happy with my plan, though I admit it's not perfect. But I'm also aware enough of other's experiences that I can acknowledge our system is incredibly broken. To say otherwise seems to me like saying our justice system doesn't need reform, because I've never been falsely arrested or convicted, or beaten by a cop.
I am pretty happy with ours as well, and I have a fuck ton of chronic incurable health conditions that require a lot of specialist visits and testing regularly. We are very lucky.
-
The purpose of a system is what it does. In the case of much of the US Health System, the system maximizes profits. It is constructed to do that - 50 years of Friedmanist ideology has created this system. 'Maximizing shareholder value' has been the defining religion of economics for most of the past few decades, with a careful ignoring of any nuance in the terms 'shareholder' or 'value'. The CEO who died was just an exemplar of a system that does not exist to do what everyone seems to think it is supposed to do.
If you are required to maximize and increase profits every year you are eventually expected to do the impossible. Demanding the impossible will almost always result in the unethical. Probably some of the people whose claims were unjustly denied were 'shareholders' of UHA, but I doubt their 'value' was maximized when they were killed to preserve their stock price. Certainly almost everyone on this forum is at least indirectly a shareholder in almost all of the 'Health Industry' (?lol?) in the US, but our value isn't served when people we care about are harmed by that system of maximization of profits to the exclusion of all other concepts or values.
It isn't just health, though that is an obvious and easy symptom of a much larger disease. Nobody is served by a maximization of profits at the expense of our planet's carrying capacity, yet oil company execs will be fired or sued if they don't do just that. Even the actual shareholders are harmed by that maximization, but with the childishly simplistic current understanding of what a company is supposed to do, the result is inevitable. Health companies have acquired enough capital to capture every regulatory system that might limit their ability to maximize profits through harm. The political system is incapable in its current form of changing that, and the legal system is even less useful.
I wish it wasn't so, but I suspect there will be a lot more of this kind of thing. If you forbid all forms of peaceful change, you inevitably get violent change. Which is messy, and usually does more harm than good. But wow, if my kid was dying and an algorithm decided that she should suffer because shareholder value I would be very, very angry and upset. In a country that has raised the fetish of 'man with a gun' to a near religion, I am actually astonished that there isn't more of this stuff already.
-
The purpose of a system is what it does. In the case of much of the US Health System, the system maximizes profits. It is constructed to do that - 50 years of Friedmanist ideology has created this system. 'Maximizing shareholder value' has been the defining religion of economics for most of the past few decades, with a careful ignoring of any nuance in the terms 'shareholder' or 'value'. The CEO who died was just an exemplar of a system that does not exist to do what everyone seems to think it is supposed to do.
If you are required to maximize and increase profits every year you are eventually expected to do the impossible. Demanding the impossible will almost always result in the unethical. Probably some of the people whose claims were unjustly denied were 'shareholders' of UHA, but I doubt their 'value' was maximized when they were killed to preserve their stock price. Certainly almost everyone on this forum is at least indirectly a shareholder in almost all of the 'Health Industry' (?lol?) in the US, but our value isn't served when people we care about are harmed by that system of maximization of profits to the exclusion of all other concepts or values.
It isn't just health, though that is an obvious and easy symptom of a much larger disease. Nobody is served by a maximization of profits at the expense of our planet's carrying capacity, yet oil company execs will be fired or sued if they don't do just that. Even the actual shareholders are harmed by that maximization, but with the childishly simplistic current understanding of what a company is supposed to do, the result is inevitable. Health companies have acquired enough capital to capture every regulatory system that might limit their ability to maximize profits through harm. The political system is incapable in its current form of changing that, and the legal system is even less useful.
I wish it wasn't so, but I suspect there will be a lot more of this kind of thing. If you forbid all forms of peaceful change, you inevitably get violent change. Which is messy, and usually does more harm than good. But wow, if my kid was dying and an algorithm decided that she should suffer because shareholder value I would be very, very angry and upset. In a country that has raised the fetish of 'man with a gun' to a near religion, I am actually astonished that there isn't more of this stuff already.
This is well articulated.
-
https://abcnews.go.com/US/executive-hit-lists-wanted-posters-nypd-warns-threats/story?id=116662519 (https://abcnews.go.com/US/executive-hit-lists-wanted-posters-nypd-warns-threats/story?id=116662519)
Let's see if the pitchforks are coming out... yikes.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
Umm, health care in countries with universal coverage isn't free. We know it isn't free. It is paid for by our taxes. You know those countries with high income tax and business tax and so on? That money is going to pay for health care, education and other social programs.
For instance, my health coverage in Ontario is OHIP. That stands for Ontario Health Insurance Plan. Note the word insurance in there. My health costs get billed to OHIP, it is my insurance plan, and the plan of every other Ontario resident. And we all know darn well that part of our provincial taxes (and since the federal government subsidizes the provinces, some of our federal taxes as well) go to it.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
This may be a pretty privileged take.
How much do you use it?
Who pays for it? Is it an employer sponsored plan? If so, how much does your employer pay? (My employer pays roughly 70-80% of my premium costs.)
Do you have any pre-existing conditions? Are you healthy? Are you on any special medications? Do you have back pain, celiac, Crohns, Lupus?
TLDR, whether or not you are happy with your health care depends on how much you need it and what you pay for it. Using it for an annual physical and some occasional pharm benefits and maybe a physical therapist for injury is a FAR cry from having an infant in the NICU, dealing with long term disease or emergency surgery, chronic pain, etc.
I'm just responding to the "no one seems happy with their healthcare" and saying, along with others apparently, that I am happy with it. I'm a very healthy individual, but with my entire 5-person family on the plan we've had our fair share of ER visits, medications, 3 hospital deliveries (one being a c-sect), etc. The plan is a work sponsored HDHP that I pay a portion of. We've had a few "gotcha" denials of coverage, such as one I can remember very clearly was opting to get what turned out to be an extremely expensive DNA test of our 1st child that wasn't covered. I get that it's broken for a lot of people, but I really don't have any complaints about how it's been for me and my family for the last 20 years or so since I've been on my own.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
This may be a pretty privileged take.
How much do you use it?
Who pays for it? Is it an employer sponsored plan? If so, how much does your employer pay? (My employer pays roughly 70-80% of my premium costs.)
Do you have any pre-existing conditions? Are you healthy? Are you on any special medications? Do you have back pain, celiac, Crohns, Lupus?
TLDR, whether or not you are happy with your health care depends on how much you need it and what you pay for it. Using it for an annual physical and some occasional pharm benefits and maybe a physical therapist for injury is a FAR cry from having an infant in the NICU, dealing with long term disease or emergency surgery, chronic pain, etc.
I'm just responding to the "no one seems happy with their healthcare" and saying, along with others apparently, that I am happy with it. I'm a very healthy individual, but with my entire 5-person family on the plan we've had our fair share of ER visits, medications, 3 hospital deliveries (one being a c-sect), etc. The plan is a work sponsored HDHP that I pay a portion of. We've had a few "gotcha" denials of coverage, such as one I can remember very clearly was opting to get what turned out to be an extremely expensive DNA test of our 1st child that wasn't covered. I get that it's broken for a lot of people, but I really don't have any complaints about how it's been for me and my family for the last 20 years or so since I've been on my own.
This is the same way that generally healthy people in Canada are pretty happy with our healthcare system despite the fact that systemic underfunding and neglect combined with the pandemic have plunged it into a tailspin.
Generally healthy people tend to have very little understanding of why people hate healthcare systems. It's the same way that people who've mostly only ever had cleanings don't understand why so many people hate dentists.
-
No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
FWIW I am happy with my health care. Maybe the difference is I don't expect it to be "free".
This may be a pretty privileged take.
How much do you use it?
Who pays for it? Is it an employer sponsored plan? If so, how much does your employer pay? (My employer pays roughly 70-80% of my premium costs.)
Do you have any pre-existing conditions? Are you healthy? Are you on any special medications? Do you have back pain, celiac, Crohns, Lupus?
TLDR, whether or not you are happy with your health care depends on how much you need it and what you pay for it. Using it for an annual physical and some occasional pharm benefits and maybe a physical therapist for injury is a FAR cry from having an infant in the NICU, dealing with long term disease or emergency surgery, chronic pain, etc.
I'm just responding to the "no one seems happy with their healthcare" and saying, along with others apparently, that I am happy with it. I'm a very healthy individual, but with my entire 5-person family on the plan we've had our fair share of ER visits, medications, 3 hospital deliveries (one being a c-sect), etc. The plan is a work sponsored HDHP that I pay a portion of. We've had a few "gotcha" denials of coverage, such as one I can remember very clearly was opting to get what turned out to be an extremely expensive DNA test of our 1st child that wasn't covered. I get that it's broken for a lot of people, but I really don't have any complaints about how it's been for me and my family for the last 20 years or so since I've been on my own.
This is the same way that generally healthy people in Canada are pretty happy with our healthcare system despite the fact that systemic underfunding and neglect combined with the pandemic have plunged it into a tailspin.
Generally healthy people tend to have very little understanding of why people hate healthcare systems. It's the same way that people who've mostly only ever had cleanings don't understand why so many people hate dentists.
Are we happy?
I mean, I am glad that my heath care is looked after by OHIP.
But I am so pissed at Ford for wanting to shift funding to private care. He is such a stereotypical old-style Conservative (get his friends wealthy and screw the rest of us). I do know that when people I know have had emergencies (post Covid) they have been taken care of. The not so urgent takes too long, we all know that. And I know of one doctor who should no longer be in in practice at his hospital, but I am guessing they are so short of staff that they have kept him. With the shift to the right across the country I am not sure what we can do other than trying to keep Conservatives out of office (PP) or get them out of office (Ford, Smith, etc.).
-
I guess it depends: is the question whether I'm happy with *my* healthcare, or happy with healthcare? The answers are yes and no, respectively.
-
I'd imagine for a lot of folks it depends on income level. For our family of 3, going over the ACA subsidy cliff of $103,000 (which I'm sure will be returning under Republicans) would mean we are responsible for our entire health insurance premium. The cheapest bronze plan in our state has premiums of $13,200. So at an income $1 over the cliff, our health insurance premiums become 12.8% of our annual income. That's before we've spent the first dollar on actual healthcare, and it's for an insurance plan with a $15,000 family deductible. If you have any kind of ongoing health needs, you're potentially looking at upwards of five figures in actual medical costs per year. I suspect a family losing ~20% of their income each year to healthcare alone would indeed be unhappy with their health insurance. Add in federal taxes, state taxes, and FICA taxes and that's probably close to 50% of a ~$103,000 gross income gone before the first dollar is spent on regular day-to-day living expenses.
-
It would be ironic if after a few CEOs get gunned down, gun control becomes a hot topic on the right.
Based on the court filings, it seems like Luigi used a 3D printed ghost gun. Short of banning all ammunition sales (and justifying all the "they're coming for our guns!" hype), there's not much that could have been done to prevent the murder.
-
It would be ironic if after a few CEOs get gunned down, gun control becomes a hot topic on the right.
Based on the court filings, it seems like Luigi used a 3D printed ghost gun. Short of banning all ammunition sales (and justifying all the "they're coming for our guns!" hype), there's not much that could have been done to prevent the murder.
It is an interesting thought experiment to see if gun control will have more traction in response to rich CEOs getting gunned down than in response to rafts of school children getting gunned down.
-
It would be ironic if after a few CEOs get gunned down, gun control becomes a hot topic on the right.
Based on the court filings, it seems like Luigi used a 3D printed ghost gun. Short of banning all ammunition sales (and justifying all the "they're coming for our guns!" hype), there's not much that could have been done to prevent the murder.
He was a few feet away - even if guns didn't exist, there are plenty of other portable options for something so up close and personal.
-
It would be ironic if after a few CEOs get gunned down, gun control becomes a hot topic on the right.
Based on the court filings, it seems like Luigi used a 3D printed ghost gun. Short of banning all ammunition sales (and justifying all the "they're coming for our guns!" hype), there's not much that could have been done to prevent the murder.
He was a few feet away - even if guns didn't exist, there are plenty of other portable options for something so up close and personal.
It's certainly possible, but is much harder to murder someone without a gun. A gun is effectively instant, and doesn't require effort beyond moving a finger. Physically stabbing someone multiple times, garroting them, or bludgeoning them to death with a baseball bat requires a very different mindset and a lot more physical effort. They also tend to be more survivable attacks by the victim. Guns exist solely to make killing stuff simple and effortless.
-
It would be ironic if after a few CEOs get gunned down, gun control becomes a hot topic on the right.
Based on the court filings, it seems like Luigi used a 3D printed ghost gun. Short of banning all ammunition sales (and justifying all the "they're coming for our guns!" hype), there's not much that could have been done to prevent the murder.
He was a few feet away - even if guns didn't exist, there are plenty of other portable options for something so up close and personal.
Pretty impressive that he got the kill actually. Looked like a couple meters or more. That’s a tougher shot, especially with a printed gun, than the Trump shooter missed. Of course, the Trump guy knew he was discovered, but still.
I have fired thousands of rounds through all sorts of weapons, and I would have wanted to close the gap considerably. He was one cool customer, clearing a jam, or whatever else happened, and still scored a lethal hit.
-
The memes on F/b are all over the place. One struck me. Some neo-lib explaining they feel the same way about Luigi and neocons feel about Kyle Rittenhouse. A flawed hero but the one they have been waiting for...
-
The memes on F/b are all over the place. One struck me. Some neo-lib explaining they feel the same way about Luigi and neocons feel about Kyle Rittenhouse. A flawed hero but the one they have been waiting for...
Let's see if Luigi tries to employ a justifiable homicide defense... "The CEO was about to go to a meeting and condemn many more people to death. I had to stop him!"
-
For what it’s worth, according to Gallup, a majority of Americans have been satisfied with their healthcare for 20 years. That’s on three metrics. 1. Quality of care 2. Quality of Coverage 3. The cost they pay.
The reason why the system is so hard to change is because most people are just fine with it.
-
For what it’s worth, according to Gallup, a majority of Americans have been satisfied with their healthcare for 20 years. That’s on three metrics. 1. Quality of care 2. Quality of Coverage 3. The cost they pay.
The reason why the system is so hard to change is because most people are just fine with it.
If you actually linked to the poll, people might see that the article released by Gallup is titled "View of U.S. Healthcare Quality Declines to 24-Year Low". And they might see that only 19% of people are satisfied with the cost of their healthcare and that 70% of people say that healthcare in this country has major problems or is in a state of crisis.
https://news.gallup.com/poll/654044/view-healthcare-quality-declines-year-low.aspx
I suspect the system is hard to change because *the people with the power to change it* are fine with it - people with plenty of money with secure, high-paying jobs living in population centers with a lot of doctors and hospitals.
-
For what it’s worth, according to Gallup, a majority of Americans have been satisfied with their healthcare for 20 years. That’s on three metrics. 1. Quality of care 2. Quality of Coverage 3. The cost they pay.
The reason why the system is so hard to change is because most people are just fine with it.
If you actually linked to the poll, people might see that the article released by Gallup is titled "View of U.S. Healthcare Quality Declines to 24-Year Low". And they might see that only 19% of people are satisfied with the cost of their healthcare and that 70% of people say that healthcare in this country has major problems or is in a state of crisis.
https://news.gallup.com/poll/654044/view-healthcare-quality-declines-year-low.aspx
I suspect the system is hard to change because *the people with the power to change it* are fine with it - people with plenty of money with secure, high-paying jobs living in population centers with a lot of doctors and hospitals.
There's plenty of survivorship bias in those polls (I mean that literally, dead people can't fill out surveys). Also plenty of confounding variables e.g. how tying reimbursement to "patient satisfaction " was part of what drove providers to overprescribe opioids.
-
I'm definitely not happy with the cost considering what we pay as healthy people with few if any recent claims. Of course that's how it works - it takes healthy people to share the cost for the sick people's care.
Still I've toyed with raising our deductible to reduce our costs.
Visisted with a friend in the healthcare business today and they weaved a tale of paperwork procedures, fees, companies within companies, non-profits with for profit subsidiaries, and tales of poor (dangerous) care. All rumor grade stuff I want to read about that barely understood. Or maybe ignorance is bliss. Sausage factory and so forth.
-
Well, it's nice to see that United Healthcare has learned absolutely nothing from their CEO being gunned down and the ensuing celebration. Just talk about their CEO being a caring farm boy while completely ignoring their sky-high claim denial rates.
https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html (https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html)
-
Well, it's nice to see that United Healthcare has learned absolutely nothing from their CEO being gunned down and the ensuing celebration. Just talk about their CEO being a caring farm boy while completely ignoring their sky-high claim denial rates.
https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html (https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html)
I think I vomited in my mouth a little bit when I read this last week. It was just such a pile of empty corporate drivel. This seemed more about putting something out there to help share prices and PR than anything actually substantive. Even the mea culpa about the generic system sidesteps actual responsbility as a kind of "we didn't start the fire" that sidesteps even the remotest possiblity that the solution is to scrap the existing health insurance middlemen system altogether.
"We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better. We are willing to partner with anyone, as we always have — health care providers, employers, patients, pharmaceutical companies, governments and others — to find ways to deliver high-quality care and lower costs."
An interesting companion piece is Brett Stephen's op ed that Brian Thompson was the actual working class hero because he gew up on a farm yet somehow managed to become a big shot CEO while Luigi M came from a prominent family and got an ivy league education. This one also misses the mark, because it attempts to reframe this as ivy league vs working class as opposed to effect of profit only capitalism effects on human lives and the inherent dichotomy between those goals in health care insurance systems. To write an article effectively asking why the working class isn't inspired and awestruck by Brian Thompson's rise to absurd wealth through being good at denying claims is pretty far off the mark.
https://www.nytimes.com/live/2024/12/04/opinion/thepoint#brian-thompson-luigi-mangione
The simple fact of the matter is that people are frustrated by the health insurance system that we have today.
-
Well, it's nice to see that United Healthcare has learned absolutely nothing from their CEO being gunned down and the ensuing celebration. Just talk about their CEO being a caring farm boy while completely ignoring their sky-high claim denial rates.
https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html (https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html)
I think I vomited in my mouth a little bit when I read this last week. It was just such a pile of empty corporate drivel. This seemed more about putting something out there to help share prices and PR than anything actually substantive. Even the mea culpa about the generic system sidesteps actual responsbility as a kind of "we didn't start the fire" that sidesteps even the remotest possiblity that the solution is to scrap the existing health insurance middlemen system altogether.
"We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better. We are willing to partner with anyone, as we always have — health care providers, employers, patients, pharmaceutical companies, governments and others — to find ways to deliver high-quality care and lower costs."
An interesting companion piece is Brett Stephen's op ed that Brian Thompson was the actual working class hero because he gew up on a farm yet somehow managed to become a big shot CEO while Luigi M came from a prominent family and got an ivy league education. This one also misses the mark, because it attempts to reframe this as ivy league vs working class as opposed to effect of profit only capitalism effects on human lives and the inherent dichotomy between those goals in health care insurance systems. To write an article effectively asking why the working class isn't inspired and awestruck by Brian Thompson's rise to absurd wealth through being good at denying claims is pretty far off the mark.
https://www.nytimes.com/live/2024/12/04/opinion/thepoint#brian-thompson-luigi-mangione
The simple fact of the matter is that people are frustrated by the health insurance system that we have today.
Not to mention that "Guy from humble beginnings climbs the ladder to success and pulls it up after him, flips bird at the people below as he walks off" is not the kind of story that resonates with the labor class.
-
Not to mention that "Guy from humble beginnings climbs the ladder to success and pulls it up after him, flips bird at the people below as he walks off" is not the kind of story that resonates with the labor class.
Putting aside the specific situation (I don't think many people are going to defend the practices of this particular CEO), I've always been intrigued to see that the rags-to-riches tale holds sway for a lot of people, but then also a lot of other people completely reject it. For me and people from my background (2nd generation migrants whose parents came overseas with nothing at all and often worked menial jobs to support us while investing in our education), the rags to riches thing is a real embodiment of the American dream. For others, it's a fairy tale at best.
-
Not to mention that "Guy from humble beginnings climbs the ladder to success and pulls it up after him, flips bird at the people below as he walks off" is not the kind of story that resonates with the labor class.
Putting aside the specific situation (I don't think many people are going to defend the practices of this particular CEO), I've always been intrigued to see that the rags-to-riches tale holds sway for a lot of people, but then also a lot of other people completely reject it. For me and people from my background (2nd generation migrants whose parents came overseas with nothing at all and often worked menial jobs to support us while investing in our education), the rags to riches thing is a real embodiment of the American dream. For others, it's a fairy tale at best.
It is possible to recognize that the rise to riches is one version of the American dream without accepting that the monetary ascent come with a halo of morality. I think the ability of people with drive to succeed due to a mostly meritocratic environment is great. However, I also think that the desire to succeed and increase profit regardless of moral or ethical boundaries is not worth celebrating. This is just like condemning murder while also appreciating and understanding the vein of frustation that Luigi M tapped into in killing a figurehead with moral responsibilty for setting up a system that methodically denied healthcare claims that should have been paid under the respective policies. Celebrating meritocracy does not require setting aside ethics.
-
Well, it's nice to see that United Healthcare has learned absolutely nothing from their CEO being gunned down and the ensuing celebration. Just talk about their CEO being a caring farm boy while completely ignoring their sky-high claim denial rates.
https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html (https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html)
I think I vomited in my mouth a little bit when I read this last week. It was just such a pile of empty corporate drivel. This seemed more about putting something out there to help share prices and PR than anything actually substantive. Even the mea culpa about the generic system sidesteps actual responsbility as a kind of "we didn't start the fire" that sidesteps even the remotest possiblity that the solution is to scrap the existing health insurance middlemen system altogether.
"We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better. We are willing to partner with anyone, as we always have — health care providers, employers, patients, pharmaceutical companies, governments and others — to find ways to deliver high-quality care and lower costs."
An interesting companion piece is Brett Stephen's op ed that Brian Thompson was the actual working class hero because he gew up on a farm yet somehow managed to become a big shot CEO while Luigi M came from a prominent family and got an ivy league education. This one also misses the mark, because it attempts to reframe this as ivy league vs working class as opposed to effect of profit only capitalism effects on human lives and the inherent dichotomy between those goals in health care insurance systems. To write an article effectively asking why the working class isn't inspired and awestruck by Brian Thompson's rise to absurd wealth through being good at denying claims is pretty far off the mark.
https://www.nytimes.com/live/2024/12/04/opinion/thepoint#brian-thompson-luigi-mangione
The simple fact of the matter is that people are frustrated by the health insurance system that we have today.
The media has become a joke. I always thought “what an a&$hole” when Trump would call it the lamestream media but I’ve come around to that belief. The big outlets are almost no better than state run media at this point. The thing they use to manipulate the most is biased headlines as most people don’t get that far. At any rate, let’s tout Brian Thomson as a rags to riches hero and ignore the people hurt by his company and DOJ fraud and insider trading investigation that was in progress.
-
The big outlets are almost no better than state run media at this point. The thing they use to manipulate the most is biased headlines as most people don’t get that far.
Funny that you say that, because that is the result of capitalism - everything is an ad, every newspaper a clickbait producer.
The contrast to that are state sponsored media, who are, by and large, not only more qualitative but also less biased.
Which of course is why the right wingers try to shut them down, may it be Germany ("They only talk about climate change and vaccinations!!!") or the BBC. The BBC for f**** sake!
We don't need them, because we have unbiased news and truth on X, right? Right!?
-
The big outlets are almost no better than state run media at this point. The thing they use to manipulate the most is biased headlines as most people don’t get that far.
Funny that you say that, because that is the result of capitalism - everything is an ad, every newspaper a clickbait producer.
The contrast to that are state sponsored media, who are, by and large, not only more qualitative but also less biased.
Which of course is why the right wingers try to shut them down, may it be Germany ("They only talk about climate change and vaccinations!!!") or the BBC. The BBC for f**** sake!
We don't need them, because we have unbiased news and truth on X, right? Right!?
Fair enough, it depends on which state we are talking about. I had Russian state media in my head at the time. But it’s clear to methe way US mass media covered the election and this “assassination” is not at all objective and preserving status quo has been the goal.
-
Apologies if this has been covered, but curiosity got the better of me, so I did a tiny amount of google-fu and got these:
AI served up this: "Brian Thompson's total compensation at UnitedHealthcare was $10.2 million in 2023. This included a base pay of $1 million, plus cash and stock grants. As CEO of the company, Thompson was one of its highest-paid executives."
"Thompson’s net worth was approximately $43 million, according to Wallmine, per Daily Beast. Wallmine reported that Thompson’s net worth allegedly included over 72,000 units of UnitedHealth Group stock, valued at around $42.9 million, and stock options that were worth over $21 million. The Daily Mail reported that Thompson earned around $10 million per year with his salary at United Healthcare."
Wow.
-
Yep. Our CEO's total comp is over 20 million a year. So people here get upset with the never-ending rounds of layoffs (monthly for well over a year now), outsourcing, and shrinking bonus pools and benefits to "reduce opex". I can't believe they're charging the shooter with terrorism. Shows where our priorities are, I guess.
-
Well, it's nice to see that United Healthcare has learned absolutely nothing from their CEO being gunned down and the ensuing celebration. Just talk about their CEO being a caring farm boy while completely ignoring their sky-high claim denial rates.
https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html (https://www.nytimes.com/2024/12/13/opinion/united-health-care-brian-thompson-luigi-mangione.html)
I think I vomited in my mouth a little bit when I read this last week. It was just such a pile of empty corporate drivel. This seemed more about putting something out there to help share prices and PR than anything actually substantive. Even the mea culpa about the generic system sidesteps actual responsbility as a kind of "we didn't start the fire" that sidesteps even the remotest possiblity that the solution is to scrap the existing health insurance middlemen system altogether.
"We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better. We are willing to partner with anyone, as we always have — health care providers, employers, patients, pharmaceutical companies, governments and others — to find ways to deliver high-quality care and lower costs."
An interesting companion piece is Brett Stephen's op ed that Brian Thompson was the actual working class hero because he gew up on a farm yet somehow managed to become a big shot CEO while Luigi M came from a prominent family and got an ivy league education. This one also misses the mark, because it attempts to reframe this as ivy league vs working class as opposed to effect of profit only capitalism effects on human lives and the inherent dichotomy between those goals in health care insurance systems. To write an article effectively asking why the working class isn't inspired and awestruck by Brian Thompson's rise to absurd wealth through being good at denying claims is pretty far off the mark.
https://www.nytimes.com/live/2024/12/04/opinion/thepoint#brian-thompson-luigi-mangione
The simple fact of the matter is that people are frustrated by the health insurance system that we have today.
Oh good grief. Brett Stephens is ridiculous and completely out of touch. I unsubscribed to the NY Times earlier this year, but that sounds exactly like something he would write. As noted above, the traditional "corporate" news media is increasingly owned by billionaires, so they have a vested interest in publishing this sort of thing.
-
I find it horrific how people using social media will rant about how bad "the media" is, as if the platform they are using isn't also "the media". Sorry folks, but YouTube IS "the media" and so is X and so is your favorite podcaster.
We're demonizing the evening broadcast news and the few remaining papyrus papers but almost nobody in the U.S. gets their information from these sources. Most get their news from TikTok, YouTube, X, Facebook, Reddit, and others. Apple, Google, and Microsoft will helpfully curate a list of information sources they calculate is slanted just enough to hold your attention a little better.
If you want to talk about billionaire control over everything we see and think or ads dictating content, it's a much, much worse problem on the social media side than it is on the swiftly-dying legacy media side.
Does it make you wonder where we get the notion that legacy media is the villain? I see this idea repeated over and over again on social media all the time. And then regular people, having seen that message enough times, subscribe to it and start acting as repeaters. That's fucking terrifying.
-
I find it horrific how people using social media will rant about how bad "the media" is, as if the platform they are using isn't also "the media". Sorry folks, but YouTube IS "the media" and so is X and so is your favorite podcaster.
We're demonizing the evening broadcast news and the few remaining papyrus papers but almost nobody in the U.S. gets their information from these sources. Most get their news from TikTok, YouTube, X, Facebook, Reddit, and others. Apple, Google, and Microsoft will helpfully curate a list of information sources they calculate is slanted just enough to hold your attention a little better.
If you want to talk about billionaire control over everything we see and think or ads dictating content, it's a much, much worse problem on the social media side than it is on the swiftly-dying legacy media side.
Does it make you wonder where we get the notion that legacy media is the villain? I see this idea repeated over and over again on social media all the time. And then regular people, having seen that message enough times, subscribe to it and start acting as repeaters. That's fucking terrifying.
People love to complain about the “mainstream media”. I don’t even know what that means anymore.
I can’t think of any news source that commands enough attention span to be considered “mainstream”. The few that are close many times complain about the “mainstream” media. It’s a word that’s lost all meaning.
While the changes to the media have been dramatic over the past few decades, I’ve been noticing a couple trends that are combining to cause legitimate lost trust in journalism.
The first is that newsroom budget cuts have converted most “news” to political coverage. Political coverage is cheap. Investigative journalism is expensive. Campaign operatives and lobbying firms will even write their own coverage for overworked reporters on tight deadlines. 80%+ of news seems to be politics, whereas my ideal reporting would have no more than 20% politics.
Another trend that has become more obvious is who gets quoted. I remember as a kid hearing interviews with experts on topics. They could be doctors or professors, or professionals in their field. These people are no longer allowed to speak to the media due to corporate policies. All quotes either come through PR professionals, campaign staffers, lobbyists, or other bullshit artists. A lot of trust has been lost as all information is filtered through those with an agenda.
-
I find it horrific how people using social media will rant about how bad "the media" is, as if the platform they are using isn't also "the media". Sorry folks, but YouTube IS "the media" and so is X and so is your favorite podcaster.
We're demonizing the evening broadcast news and the few remaining papyrus papers but almost nobody in the U.S. gets their information from these sources. Most get their news from TikTok, YouTube, X, Facebook, Reddit, and others. Apple, Google, and Microsoft will helpfully curate a list of information sources they calculate is slanted just enough to hold your attention a little better.
If you want to talk about billionaire control over everything we see and think or ads dictating content, it's a much, much worse problem on the social media side than it is on the swiftly-dying legacy media side.
Does it make you wonder where we get the notion that legacy media is the villain? I see this idea repeated over and over again on social media all the time. And then regular people, having seen that message enough times, subscribe to it and start acting as repeaters. That's fucking terrifying.
Well yes, X and Facebook are also famously owned by billionaires, which is only partly why it's a really bad idea to get news from social media (there's also the fact that there are no standards or fact checking and anyone can have a platform without having any idea what they're talking about). I've always preferred to get my news from more reputable sources like the NY Times and WaPo. But I've found their coverage of the CEO murder disturbing in a different way. Basically everything is owned by large corporations and a few really rich people who are trying to push their perspective. Sometimes it seems like the only thing we have left that's not completely corrupted is public broadcasting/PBS/NPR.
-
I find it horrific how people using social media will rant about how bad "the media" is, as if the platform they are using isn't also "the media". Sorry folks, but YouTube IS "the media" and so is X and so is your favorite podcaster.
We're demonizing the evening broadcast news and the few remaining papyrus papers but almost nobody in the U.S. gets their information from these sources. Most get their news from TikTok, YouTube, X, Facebook, Reddit, and others. Apple, Google, and Microsoft will helpfully curate a list of information sources they calculate is slanted just enough to hold your attention a little better.
If you want to talk about billionaire control over everything we see and think or ads dictating content, it's a much, much worse problem on the social media side than it is on the swiftly-dying legacy media side.
Does it make you wonder where we get the notion that legacy media is the villain? I see this idea repeated over and over again on social media all the time. And then regular people, having seen that message enough times, subscribe to it and start acting as repeaters. That's fucking terrifying.
Most news sources these days are slanted in some form, though probably not as badly as social media. Still, nothing that a bit of critical thinking can't fix.
There are reliable sources of information and statistics out there - chiefly from government agencies, peer-reviewed papers, reputable non-profits and a few newspapers of record. I also think Wikipedia is largely accurate, as long as you occasionally check the source material.
It's really up to individuals to use their critical thinking skills to get this stuff down pat. Particularly with the internet opening up vast sums of knowledge for free or nearly free. And nearly everyone in the developed world has access to the internet.
-
But look at the double standard we employ when we expect objective Truth from legacy media, with no editorial bias, no hidden agenda, and no corporation pulling the strings. Just a robot speaking what actually happened, or else it's trash!
And then what is the social media alternative? All the worst of everything we're concerned about with legacy media, dialed up to 11?
Regarding critical thinking skills, I recall from the olde days that such skills were honed by listening to reasoned debates and feeling one's attitude shift as evidence was contradicted by counterevidence, and arguments we had accepted were pointed out to be fallacies. One learns from such experience about rhetoric, about how data and statistics are used and misused as evidence, about how there are multiple sides to all stories, and about the humbling experience of realizing one is actually wrong about something. The only way to have such learning experiences is through exposure to different sides in a reason-based format. These are the basics of democracy that we've forgotten in today's tribal, bubble-seeking mindset.
Thus, even if one's legacy media sources are biased, one can learn a lot from consuming the different sources. Read the editorial pages of both the New York Times and the Wall Street Journal, and see how they contradict each other. One can learn a lot about reading/watching a hack job and then setting oneself on a personal assignment to find out why it might be overdone.
More importantly, we need to drop the attitude that ANY information source could ever possibly be the Objective Truth. That mindset has only led to people putting their brains on remote control to Fox News, or Joe Rogan, or whatever online information cult appears to be "authentic" that day. There is no Objective Truth available to us through our electronic devices, only arguments and angles and conflicting data on any question that matters. The practice of wading through that IS critical thinking, and always has been.
-
Yep, I couldn't agree more, a classic case of market failure:
Americans are sick of the health insurance grinches who steal our money and our lives
Lynn Parramore, Institute for New Economic Thinking
December 28, 2024
In the 21st century, Americans have expressed their view that healthcare is deteriorating, not advancing. For example, according to recent Gallup polls, respondents’ satisfaction with the quality of healthcare has reached its lowest level since 2001. Key point: Americans in those polls “rate healthcare coverage in the U.S. even more negatively than they rate quality.”
Coverage is the core failure, driven by the insurance industry’s profit-first approach to denying care.
It’s a textbook case of “market failure.” Instead of healthy competition lowering prices and improving services, what we have is an oligopoly that drives up costs and leaves millions uninsured.
https://www.rawstory.com/health-insurance-grinch/
-
Believe it or not, I remember during the campaign for the Affordable Care Act how many conservatives railed against it.
They claimed the U.S. healthcare system was more expensive because the U.S. invented so many pharmaceutical drugs that were needed, and we also provided cutting-edge medical treatments not available elsewhere.
And finally, that it wasn't a big deal to not have insurance coverage because
a) emergency rooms provided care for free;
b) you could always file bankruptcy to avoid paying medical bills.
I'm glad to see that 13 years of the ACA has started to shift those beliefs.
-
They claimed the U.S. healthcare system was more expensive because the U.S. invented so many pharmaceutical drugs that were needed, and we also provided cutting-edge medical treatments not available elsewhere.
I mean, this isn't wrong.
https://aspe.hhs.gov/reports/comparing-prescription-drugs#:~:text=In%202022%2C%20U.S.%20prices%20across,adjustments%20for%20estimated%20U.S.%20rebates.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10317843/
Those aren't the only reasons for the high costs of course - high physician pay, hospital systems merging and then increasing prices, and other factors are involved. But our drive to subsidize drug and other medical research has costs for Americans.
-
The other big topic before the ACA passed was, "is health care a right or a privilege?"
Yes, that was the exact phrase and opinions were strong. I can only imagine Europeans listening and thinking, WTH?
-
The other big topic before the ACA passed was, "is health care a right or a privilege?"
Yes, that was the exact phrase and opinions were strong. I can only imagine Europeans listening and thinking, WTH?
Universal health care is taken as a right in a lot of countries, but its implementation shows that we don't really consider all aspects of health care to be a right. For example, in Australia most adults don't get dental care covered - if you want to see a dentist, you have to pay out of pocket (or have private insurance). If you need urgent care or have a severe health issue then you will be fully covered, but for 'elective' procedures - even ones that are not strictly elective like spinal surgery - then if you don't have money, you will be put on a long waiting list. And if you want flexibility, promptness and choice of doctor, you need to pay. So in that sense, only a very basic level of healthcare is seen as a right, and the rest of it is a privilege you pay for - just like most other things in life.
-
The other big topic before the ACA passed was, "is health care a right or a privilege?"
Yes, that was the exact phrase and opinions were strong. I can only imagine Europeans listening and thinking, WTH?
Thinking about how to make payments for healthcare in ideological terms like "rights" or "privileges" is why the U.S. has been unable to solve this problem for decades. If you want a bitter debate about anything, talk about who deserves what from other people.
I suspect the countries where healthcare services are more directly supported by taxes simply looked at payments and remittances for services as a pragmatic problem that needed to be solved. They independently arrived at very similar systems. The U.S. meanwhile, remains mired in battles over the justice aspect of resource redistribution.
-
The other big topic before the ACA passed was, "is health care a right or a privilege?"
Yes, that was the exact phrase and opinions were strong. I can only imagine Europeans listening and thinking, WTH?
Thinking about how to make payments for healthcare in ideological terms like "rights" or "privileges" is why the U.S. has been unable to solve this problem for decades. If you want a bitter debate about anything, talk about who deserves what from other people.
I suspect the countries where healthcare services are more directly supported by taxes simply looked at payments and remittances for services as a pragmatic problem that needed to be solved. They independently arrived at very similar systems. The U.S. meanwhile, remains mired in battles over the justice aspect of resource redistribution.
Makes sense to me. Like how making prisons nicer places (where there is zero inmate on inmate crime tolerated and counselling/high quality retraining happens) significantly reduces recidivism and helps to control crime long term, improving society. But it's a total non-starter in North America because we view prisons as a place to get retribution on criminals (rather than address the problems that led to the crime), which tends to make more and worse criminals and worsen things all around.
But we gets our eye for an eye, and that makes us happy down in the cockles of our hearts.
-
I picked up a prescription recently and needed to talk to the pharmacist because my insurance isn’t going to cover this anymore and I’ll have to switch to something else.
You know who isn’t all broken up about this “incident”? Pharmacists. Yikes - I thought they were going to start waving red flags!
-
I picked up a prescription recently and needed to talk to the pharmacist because my insurance isn’t going to cover this anymore and I’ll have to switch to something else.
You know who isn’t all broken up about this “incident”? Pharmacists. Yikes - I thought they were going to start waving red flags!
Why should they? They get paid this way or the other. Why wasting valuable employee time for doing the work the customer is supposed to do?
Per-so-nal Res-pon-si-bi-li-ty!
It's like you live in Japan where you would get a call and a 5 minute long "please forgive us for this change" from them.
-
I picked up a prescription recently and needed to talk to the pharmacist because my insurance isn’t going to cover this anymore and I’ll have to switch to something else.
You know who isn’t all broken up about this “incident”? Pharmacists. Yikes - I thought they were going to start waving red flags!
Why should they? They get paid this way or the other. Why wasting valuable employee time for doing the work the customer is supposed to do?
Per-so-nal Res-pon-si-bi-li-ty!
It's like you live in Japan where you would get a call and a 5 minute long "please forgive us for this change" from them.
I don’t really know what you’re trying to say, but these guys seemed to actually care about people getting the medication they need.