Want what? I dont think the majority of Americans endorse vigilante murder of law abiding citizens. That is just a vocal and bloodthirsty segment of the online population.
Literally everyone I know IRL was like, “nice. More please.” I was actually surprised and heartened to see the initial HN thread, even, was overwhelmingly supportive.
This is top of my list for conversation topics to steer things toward when I’m around Republican relatives, so we’ll have something we can agree on.
Law-abiding doesn’t mean much when you can kill lots of people for money and remain within the bounds of the law. Killing one such person is definitely far less bad than killing a bunch of people arbitrarily. Yet only one of these cases is illegal, and it’s the better of the two.
This is logic that makes sense inside of filter bubbles on the Internet that I think most people --- most people are not in any one particular filter bubble and certainly not this one --- would find absolutely repellant. To put it in perspective: it is literally the logic used by people who shoot up abortion clinics.
How do you feel about murdering doctors who demand pay for treatment, citizens that vote against single payer, or people that fail to donate to your gofundme?
I can’t begin to relate to seeing someone with a median income failing to donate to some particular go-fund-me as the same as choosing to head an organization that makes more money when people don’t get the health care they need, and overseeing operations that did that even more recklessly than the industry standard. One has taken on a business relationship already and is taking people’s money then screwing them, at a mass scale. The other just didn’t donate to a gofundme that may not even be legit and for someone they have no connection to.
Similar reaction for the other examples. I’m baffled that they look similar to anybody at all.
[edit] hold on, ok, another angle that may clear up why I’m confused: if my health insurer denies my legit claim, should I be more, less, or equally angry with the leadership of that company, or with every single person in the country who fails to donate to my resulting gofundme? I’m immediately inclined to wish horrible things on one of these groups, and to find the idea of wishing horrible things on the other confusing and repulsive.
There are laws enacted by our elected government (Democrats under Obama) that say exactly how much overhead is acceptable for a health insurance company, and all business expenses and CEO pay comes out of that portion. If they collect too much in premiums to and their profits exceed that percent, they have to refund the insurance members.
Health insurance has a fixed profit margin on claims paid. Denying claims costs them money. Pay 10 billion in claims and they make 2 billion. Deny half the claims and they make half as much.
The ACA’s loss ratio rules don’t apply to self-funded plans (many large employers use these) even if they’re administered (and possibly re-insured) by a health insurance company, which is usually the case. Just doesn’t apply at all.
Certain plans also allow much lower loss ratios, like 60/40 for expat plans.
A provider that manages to have a lot of new plans in a given state in a given year is immune from loss ratios rules in that state, for that year. I don’t know how gameable this is but my WAG would be it’s only state insurance commissions preventing this from being the case in every state, every year, for every provider, and keeping it to only some states in some years for some providers (I bet the biggies manage to rotate their state[s] and have at least one most years)
So a company the only business of which is health insurance can easily spend far less than 80 or 85% of income on payouts, and only need maintain that ratio on some subset—possibly small—of the premiums it’s collecting.
I don’t know how the game of this affects decisions for insurers that also own providers, but I bet there’s something beneficial there and that’s why they’ve been snapping up provider offices for the last several years.
Most of that makes sense to me. there is a self funded plan, my understanding is that the employer is collecting (and usually subsidizing) the premiums.
At the end of the day, my experience is that my UHC healthcare is about 10% more than healthcare from non-profit Kaiser, and Kaiser is far more stingy with services.
I think there is a hell of a lot wrong with healthcare in the US, but I don't think that constitutes murder just because the stakes are life an death.
Ethics depend not just on the outcome, but the processes that leads to that outcome.
The incentives in healthcare are terrible, but it is the government which has structured the system and those incentives.
Denied claims mean less profit for the insurer. They only get to keep a percent of what they pay to hospitals. Do you have a response to that?
One of the primary jobs of insurance companies is to vet claims. If we didnt want that, you could just make a shared bank account and let doctors and hospitals bill anything they want to it. You might save 10% on overhead, but it would collapse instantly.
If that were true then United Healthcare wouldn't have rolled out an automated system that (reportedly) denies ~90% of people regardless of their actual need.
I'm not going to stick up for UHC, which is an obnoxious company, but do you honestly believe UHC is denying 90% of claims? Have you thought the implications of that claim through?
What "problem"? You're not being clear about what you're trying to say. That a particular insurer has done bad things? Nobody was going to take the other side of that argument.
