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Notes -
Again, this is true for every commercial company. Maybe in a glorious socialist paradise nobody makes any profit and still everything works just fine, too bad America is not a glorious socialist paradise and no country on Earth is or ever will be, because it is all an ignorant fantasy. In real world if you want shit to be done, you better pay people for doing shit, and yes, that means profit over replacement costs, otherwise they'd just go do something profitable instead. Healthcare is not some magic thing - any service you want you'd have to either pay for it or force people to do it by some other means. Experience shows people being threatened don't work that well. People having no motive to work better also work not that well - which you kinda sorta start to realize right here:
Welcome to the Real Government, as opposed to the Unicorn Farts Land Imaginary Ideal Government, which people somehow imagine could exist and take care of us all. The real government is humongously inefficient and corrupt, always has been so and always will be. So the obvious solution, of course, is to give it even more powers? Because if they have even more power, they surely stop being inefficient, corrupt and stupid - just because... of what exactly?
It is entirely possible to operate more efficiently and not cause death - in virtually any industry, including health care industry. Any seasoned professional would be able to point out dozens of ways.
I'm not sure how making the CEOs paid less is going to motivate them to commit less fraud. Let's say you are a worker on a puppy feeding factory (ignore the question why such factory exists), and you have a decision - if you choose one random puppy, and let it go hungry for a day, you can save some money, at the cost of a puppy suffering. Obviously, you have an ethical choice to make here. Now I come in and cut your salary in half. How exactly did it make you more motivated to make a more ethical choice? I mean, I understand the basic desire to stick it to those filthy rich assholes, but I am not sure how you get from there to incentivizing them to behave in ways you like them to behave.
Most companies can say, cut some labor, reduce the cost of manufacturing, remove some features. If the product becomes terrible people will stop buying it.
That doesn't apply here.
United's business model is:
-You are forced to buy eggs from us from your employer.
-You pay a yearly fee for eggs.
-When you ask for the eggs. 1/3 of the time you get an egg, 1/3 the time you get an egg that expired a month ago, 1/3 the time you get no egg at all.
-Sometimes if you complain long enough they'll give you an egg a year later.
-They were required to give you a fresh egg by law, they just didn't do it.
-The CEO's job at most companies is to reduce the cost of eggs, or provide lower quality eggs. The CEO at a health insurance company is finding new ways to not give people the egg they paid for, and trying to figure out how to do this without getting the government mad.
-Things like PBMs and Medicare Advantage plans are flat-out scams somehow permitted by the government, likely through some form of regulatory capture that bring the system much closer to collapse. These are complicated but to briefly explain the latter, medicare advantages plans are when a private insurance company takes everyone healthy/cheap away from Medicare, gets paid to do so (as if they were unhealthy), doesn't cover their coverage when they do need it, and as soon as they actually get sick punts them back into the medicare pool. If that sounds ridiculous and like that couldn't be a thing....that's why it is a scam!
Now, whose fault is that? Certainly UH CEO didn't put a geis on America to make it impossible to shop insurance providers, and yet... Whose fault is that and who could change that? Somehow nobody is interested in talking about it.
But why? Why you can't just go to the store and buy eggs, why you have to pre-pay them via some kind of ridiculous complex arrangement? Imagine you buy your bacon, orange juice and english muffins in a normal way, but have to go through this weird arrangement for eggs - aren't you going to ask what the heck is going on, why I can't just buy eggs like any other normal grocery item?
That's not true. Insurance CEOs also can reduce costs and provide lower quality service (e.g. generics vs. brand medications), denial of coverage is by far not the only tool in their arsenal.
I think several of your comments center around "the current system has some huge gaping flaws" which...yeah no argument from me.
That's not what we are talking about though. Fundamentally United makes a ton of its money from fraud. Therefore I think any amount of profit is absurd. Stop committing fraud! They seem to have managed to dodge regulatory oversight somehow but that doesn't change that a lot of what they are doing is some combination of illegal, fraudulent, a breach of contract, or a scam. A higher percentage of stuff is deeply unethical but that is more questionable to criticize.
I have significantly less problem with them making money legitimately but until they do any amount of profit is absurd.
Some people (which may include you?) have a more winning focused attitude - if the system will allow the activity (illegal or not) than its fine, old school Sirlin stuff.
However if the system allows this kinda stuff you'll have gross negative externalities like the impending collapse of U.S. healthcare and the likely copy cat increase in violent populist activity.
I cannot tell you the number of times my interaction with an insurance company has boiled down to "yeah we were always going to cover this, as we were contractually obligated to, but I wanted you to spend 5-10 hours of your own time suffering to make it happen, maybe next time you'll just take the loss or tell the patient they are better off paying cash for their medication."
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