UHC CEO Gunned Down in Midtown Manhattan

[Anonymous]

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I suspect the apologist for the insurance industry who's been posting in this thread all day in fact is an employed wonk with the insurance industry. LOL.

Yeah, that poster seems to be worshipping soundbites.

workshopping

Well they aren’t working.

Honestly, healthcare IS a basic human right. As a society we’ve developed the science to treat disease and ease suffering. Why a big fat insurance CEO needs to get a big cash bonus before humans are treated is simply bizarre.

I think most people agree that healthcare is a human right but the rub is deciding how much healthcare and what kind of healthcare that is?

The question is, how do we make sure those decisions are made by people for whom health care is care, rather than those for whom it is first and foremost a financial investment whose value must by definition grow?

Well these are decisions that should not be made by people with a fiduciary duty to shareholders. No matter who is the CEO, they’re going to have conflicting legal duties to their investors and a moral duty (and contractual) to their customer.

Doesn’t matter who is paying they will have a fiduciary duty because we don’t have unlimited funds.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You always go to an ER with a broken bone. They set it and refer you to an ortho. My kids seem to always break things on weekends, so that’s been my experience.

Oh brother.

The very fact that we are having a conversation about whether one should go to an ER with a literal broken bone is a sign of how broken our system is.

We don’t have to live this way. Healthcare can exist FOR us.

I think the “you should wait for two weeks to get your broken bone set by an orthopedist” is just a troll. It is of course wholly irrational.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

I understand that's your perception. Is there any data anywhere to support that? Everything I've seen says that Americans consume less health care than in peer countries.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

This is only going to get worse as science advances. We now have 80 something yr olds getting dialysis multiple times per week and 90 something yr olds in nursing homes that are regularly sent to trauma center hospitals for full work ups because they “fell” or are confused and sent for a head CT. Then there’s the subset of very expensive people that are constantly going to the doctor demanding something and the doctor usually agrees or orders whatever they want because they don’t want a bad review, they get paid, and they are better off from a litigation standpoint point of they over-treat vs tell the patient no.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why is anyone the target?!

But what about the the unaffordable cost of health care and claims that get denied?

People except too much. Sorry, but they do. As a population we are over treated and over medicated. It’s not sustainable. I’m 40 and I honestly can’t think of a single female friend that isn’t on an SSRI, anti anxiety, or stimulant med. 75% of the population had eaten their way into diabetes, being overweight or obesity. Now we need an expensive drug to fix it because no one wants to eat less. Women want to wait to have kids into their mid 30s and 40s use IVF. People used to have kids in their 20s or just accept kids weren’t in the cards if it didn’t happen naturally. Not anymore. I don’t think our problem is healthcare, it’s our expectations. People want to live until 100 and have every single aliment and discomfort alleviated. Getting sick and dying is part of life. Curing and fixing everything on everyone, every time, at all ages (or using up tons of resources trying) is not sustainable

That’s because we eat poison. Whose fault is that?

Have seen the crap people willingly eat? Sorry, no. People make choices.

You are out of your depth. Can you just stop? You sound wildly uneducated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

I understand that's your perception. Is there any data anywhere to support that? Everything I've seen says that Americans consume less health care than in peer countries.

I'm PP. No data, just anecdotal from my immediate circle, and yes, I know anecdata is not science.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I suspect the apologist for the insurance industry who's been posting in this thread all day in fact is an employed wonk with the insurance industry. LOL.

Yeah, that poster seems to be worshipping soundbites.

workshopping

Well they aren’t working.

Honestly, healthcare IS a basic human right. As a society we’ve developed the science to treat disease and ease suffering. Why a big fat insurance CEO needs to get a big cash bonus before humans are treated is simply bizarre.

I think most people agree that healthcare is a human right but the rub is deciding how much healthcare and what kind of healthcare that is?

The question is, how do we make sure those decisions are made by people for whom health care is care, rather than those for whom it is first and foremost a financial investment whose value must by definition grow?

That's a nice theory, but you can't divorce health care needed, or wanted, from the cost of that care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

This really isn't it. Americans go to the doctor less and spend less time in the hospital than people in other countries. There's a perception that Americans are lazy and stupid and go to the doctor for everything, but we actually consume less health care than in peer countries.

The issue is that we pay more to doctors and hospitals for the same services. In our current system, each individual insurance company negotiates with providers to set reimbursement rates. Each insurance company has limited market power, so it can only negotiate the price down so much before the providers drop that insurer altogether.
In a single-payer system, the government is the primary purchaser of services, so it has tremendous market power, allowing it to negotiate the price far lower than any one insurance company could. The government, unlike insurance companies, also isn't trying to turn a profit, which provides further savings.

I'm not saying single-payer is the answer, but high costs aren't being driven by overconsumption of care.

https://www.healthsystemtracker.org/brief/what-drives-health-spending-in-the-u-s-compared-to-other-countries/#Distribution%20of%20difference%20in%20per%20capita%20health%20spending%20between%20the%20U.S.%20and%20comparable%20countries,%20by%20spending%20category,%202021

I don't disagree with any of this, but "health care providers are paid too much" is really going to have the knives out for you, PP. I wish you luck.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

I understand that's your perception. Is there any data anywhere to support that? Everything I've seen says that Americans consume less health care than in peer countries.

I'm PP. No data, just anecdotal from my immediate circle, and yes, I know anecdata is not science.

DP. No it's not. You also sound like an @ss or a sh-t friend who thinks they know everything. And, you most definitely do not.