We blame the sick for being expensive': the mother whose baby cost AOL $1m | Hacker News Reader

We blame the sick for being expensive': the mother whose baby cost AOL $1m

theguardian.com

31 pointsjhartmann20 comments

What a total dick, to single out two babies' cost, especially when compared to his own compensation. One of my children was born premature and even though it was nothing compared to what these people went through it makes me very much aware of the kind of thoughts that go through your head during and afterwards. To have the CEO of the company you work for use you as a scapegoat (and in an easily identifiable context too) for cutting benefits is absolutely un-acceptable.

I realize this rant doesn't add much to the conversation, but here's someone who will never in his life have to worry about his OWN access to health care, indeed will never have to worry about any kind of vital personal expense for himself or anyone in his family, whining in public about the cost (that he doesn't personally bear) of one of those commoners. It's really sickening. Sickening that there will be no consequences to him for his comments. Sickening that he will always have his next job waiting for him, no matter what. Sickening that the US system is pretty much set up to keep people like him rich in perpetuity, unless they deliberately do something to destroy themselves.

That's just the insanity of having health care coupled with the employer.

Agreed. In my mind that is the second biggest problem the system has. The first is the lack of an open market accepting only direct payments.

Oddly, neither one of those was fixed in with the recent reforms.

The Republicans (representing the insurance companies, essentially lobbying on their behalf as opposed to merely being lobbied to) were the largest proponents against such changes, as it would cost the Republicans tens or hundreds of millions of dollars out of their private investment accounts.

The ACA was passed with zero republican votes - so it's hard to say their love for insurance companies is the reason it is the way it is.

The insurance companies lobbied heavily in favor of the ACA as written. After all, millions of people would now be required to buy their product and if the person couldn't afford it, the government would cover some portion of the gap.

The real bill - total liabilities - will be paid later by the next CEO/management but the current people got their bonuses.

Do you have a source for this? The ACA itself a huge boon to the insurance companies is it not? And conservatives opposed this bill strongly, for one reason because it adds layers of bureaucracy between doctors and patients that inflate and hide costs to the consumer. Also it mandates purchase of insurance (surely a benefit to insurance companies) which they strongly opposed.

My point is simply, one could easily argue that the Democrats would be the largest opponents of such changes because of the very nature of the affordable care act, and as a libertarian / conservative myself I'm absolutely for policy that increases direct payment, price transparency and a more open market in health insurance. I'd be interested to see who opposed this.

Without meaning to kick the political hornets-nest... the real problem is trying to fund healthcare through insurance at all. It creates moral hazard, conflicting incentives and information asymmetry, which combine to make it an extremely inefficient market.

A efficiency comparison; Medicare alone (which only covers the elderly and disabled) costs the US more per capita than the NHS costs the UK to cover the entire population.

I'm not claiming that state-funded medicine is the perfect solution, and it has its downsides, but without those toxic incentives caused by insurance it generates much better health outcomes per dollar.

That's the way the system works though, and I don't see other employers make these kind of statements.

I just can't get over how shitty a human being Armstrong seems to be. When you offer health benefits to employees by self-insuring, paying for premature babies is just part of the obligation you took on. Complaining about it publicly is not only shameful and illegal, it's an admission that you're an asshole that doesn't want to hold up your end of business dealings.

> “This is what we do in the US. We blame the sick people for being expensive, but the same sick people everywhere else – in the UK – they wouldn’t be causing excess costs to the system,” said Peel.

This line bugs me.

Regardless of who pays for medical care, the costs just don't disappear. With a bigger pool, they're spread across more people so the marginal costs might be lower but the total cost remains the same.

Not the same - look at the per-person overhead costs of insurance compared to a single-payer system, they're gigantic.

Don't corporations insure themselves against these risks?

Many larger companies self-insure. They still pay a traditional insurance company to handle the claims process and negotiate with providers, but they get a discount for taking on the risk themselves.

I wonder, is 2 premature babies in one year in a 5,000 person company very unusual? Did their actuaries just do a horrible job? Or is that really a truly extraordinary event for a company their size?

Reminds me of when I balked at my home insurance company trying to bump my rates 20% one year- they said it was because of the 2011 Japan earthquake (I'm in Canada). I laughed and walked right out.

You're presuming their decision to self insure was based on an actuarial assessment.

From my experience, it's also plausible that some poor schlep in the accounting department was tasked with looking into self insuring, and created a not-very-robust risk model. At AOL's size one would hope an actuary was involved, but that may not be the case.

As well, even if am actuary was involved, that doesn't stop upper management getting peeved when payouts are towards the upper bound of the model, as all they likely saw was the potential cost savings of the lower bound of the model, not the full risk.

Even if they did, you can see it doesn't prevent them form lobbying to cut benefits (i.e. your salary).

Yes, and it also doesn't stop people from quitting AOL and AOL being unable to retain employees (which seems to be happening due to this and other issues caused by AOL's leadership).

Let's skip the word "blame". Is it a fact that sick people is the cause for being expensive? Our company also had to increase premium because a few extreme cases last year, but the company did not identify them. The employees figured out anyway.

Of course, blame the sick people could be wrong, when the sickness is not caused by the sick people, like the one in the article. However, the implicit message in the title troubles me: it is always wrong to blame the sick -- which is not true.

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