I see them as essentially the same. All of these people are choosing their financial interests over your health. People are dying from their inaction.
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.
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.
look up that ACA 85/15 law
Because there is a clear legal understanding of how much profit is acceptable.
Ahhh. I guess you're not aware of stuff like this?
https://www.newsweek.com/hospitals-are-reporting-more-insura...
https://www.theregister.com/2023/11/15/unitedhealthcare_ai_m...
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.
The CEO getting shot seems to indicate it's probably more true than less true.
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.
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.