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PaperclipPerfector  22d ago (text post)   31100 thread views

Culture War Roundup for the week of December 2, 2024

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C) Health insurance companies have a terrible reputation. But it's hard to fix. It's a viscious cycle which goes something like this:

  • Company has bad reputation

  • Due to bad reputation, the company has trouble getting talent, so they compensate by paying a lot

  • This selects for people who care more about money than reputation

  • Money-grubbing behavior leads to bad reputation

If you were next in line at United Health, how would you fix the problem?

I don't think that vicious cycle is the main reason health insurance companies have terrible reputations. I'm not even sure if that vicious cycle even exists - it has a lot of assumptions baked into it that may or may not be true. Do health insurance companies actually have a lot of trouble getting talent? Do health insurance companies actually pay a lot more than other companies for equivalent workers? Do workers who care about money more than reputation actually lead to products that customers hate? Is money-grubbing actually the main reason health insurance companies have bad reputations? Maybe some of those are true to some extent, but I am highly skeptical that all of those things are true and that they explain the core reputational issue.

IMHO there are many reasons health insurance companies have terrible reputations, but I think the main two are:

  1. They are massive bureaucratic organizations, and massive bureaucratic organizations are really annoying to deal with when you venture off the happy path. And that often happens due to the complexity of the healthcare system.

  2. Health insurance companies are the part of the healthcare system that is mostly responsible for billing people and rationing care, which means they are highly visible to people.

Neither of those problems are really fixable as the CEO of UHC. The healthcare system will be massive, no matter what I do. And a health insurance company does need to charge money and ration care.

I hope that whoever is next in line at UHC is not worrying about fixing these impossible problems, and instead is focused on running the company as best he can.

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