High-profile killing of UnitedHealthcare CEO in New York

hasanejaz88 said:
Maybe there is a bit of joking in there but it's horrific to say stuff like this. He was the CEO, it's his mandate that he has to maximize profits for the shareholders. CEO's don't determine that, it's the board of directors who do. If the person tries to be moral and doesn't do their job, they'll get fired and the directors will find someone else who can maximize profit then.
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Göring was just following orders from der Führer, there was a mandate from the NSDAP to follow outside his control. If he didn't do the job, someone else would have.

Can't believe the Nürnberg trials sentenced him to death, tbh.
 
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TwoSheds said:
If costs are higher then every claim denied gives you more profit. It's clear that they benefit directly from high healthcare costs (particularly when they act immorally), and they also probably benefit indirectly too through e.g. referral fees kicked back from providers, investments in related healthcare firms. My wife has a $1800 bill that her US health insurance still refuse to pay over 6 months later because they spelt her name wrong when they processed the insurance documents and it didn't match up to the name on the healthcare provider's form. They are not honest actors in any of this, no matter what the theory might imply about them bringing healthcare costs down. Fact is the costs are astronomical and they are in on it.


It's the same shit car insurance companies in the UK have been pulling for years but wrote large. Every year it seems to me the insurance firms claim to make very little profit or even a loss, and yet they're all still in business 20 years later. If you look at their parent companies in Ireland or the Bahamas though...the garage referral fees and stuff seem to collect offshore somehow and somewhere along the way somebody is miraculously making lots of money.
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I don't know why you're arguing about this. The insurance companies can do plenty of things wrong without being the reason behind the extremely high healthcare costs in the US. But the situation very simple, hey foot the bill for these extreme costs, so they are definitely not the cause of them. As per my previous post, the fact that they will do everything possible to avoid paying the costs is why they're so unpopular. Because if they won't pay then the patient has to (or doesn't get the care they need). None of this is defending these companies, or their business practices. I'm just explaining that they are not the cause of the insane healthcare costs in the US.
 
Weird feeling hoping this guy can outrun the police and stay free. It's cold blooded murder ffs. But he has got that Robin Hood vibe going on and he fully put the spotlight on te absurdity that is commercial health insurance companies.

Still, a murderer...
 
AjaxNL said:
Weird feeling hoping this guy can outrun the police and stay free. It's cold blooded murder ffs. But he has got that Robin Hood vibe going on and he fully put the spotlight on te absurdity that is commercial health insurance companies.

Still, a murderer...
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Robin Hood probably shot a few people back in the day himself.
 
Tarrou said:
you've painted a black and white picture there

what's the grey bit?
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That they do good and bad at the same time. You can't think of them as 100% bad because they do help people to cover medical costs, even the unaffordable ones. But they're not exactly good either, they're profit driven and have control over what they want/don't want to pay. I know people who work in the insurance industry and they themselves admitted that there have been cases where they denied a claim by linking a specific disease (that is covered) to another that "aren't covered" so the company doesn't have to pay. They do it after a careful consideration of course, after all, if it resulted in deaths it will be a bad PR for them. But still it's a scummy practice. That's why when it comes into health insurance, it's best to choose an agent you personally know. At least they'd try to help you. It's easy to be morally grey working in healthy industry because human condition is not binary.
 
AjaxNL said:
Weird feeling hoping this guy can outrun the police and stay free. It's cold blooded murder ffs. But he has got that Robin Hood vibe going on and he fully put the spotlight on te absurdity that is commercial health insurance companies.

Still, a murderer...
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It’s better if they catch him anyway

This could be the beginning of a grass roots movement and cultural shift where Americans start to reject this system on mass

I mean, it probably wont be.. but America loves a hero, and the ‘support’ for his cause, if you can call it that, will only grow if he’s doxxed

Imagine a future where elections are fought on issues like this instead of all the bullshit.. one can dream!
 
Pogue Mahone said:
How to overhaul it is really complicated.

My main beef with insurance in Ireland right now is that they charge insane premiums for anyone who wants to set up a small business which involves risk. Climbing gyms is a consequence I experience personally but also a huge issue for kids play centres, swimming pools, adventure playgrounds etc etc. The insurers have all pulled out of Ireland, leaving only one or two companies left. They charge so much money that all these small businesses are going bust, one by one. There hasn’t been a new swimming pool built in Dublin in decades. That’s fecked up.

The reason it’s so expensive is because we’ve always paid out incredibly high compensation for people who hurt themselves at one of these businesses. High pay-outs and a court system that makes it very hard for the business to win its case. Combine this with the insurers need to grow/make profit and we are where we are.

How you go about changing all of this is not easy. Where do you start?
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Unfortunately for Ireland this is spot on, I work for a multinational insurer and Ireland & the US ring huge alarm bells for our Liability teams because the compensation pay outs are massive.

Insurers get a bad rep, and some of it is justified and some of it is due to people not reading their policy documentation, but also a huge amount of underwriting isn't profitable in itself and people would be shocked if they had to actually pay premiums large enough to ensure profitable underwriting. Most of the money is made by investing the premiums held. Which is somewhat fine for insurance that doesn't decide whether a person lives or dies but having for profit medical insurance in a country with no universal healthcare is about the stupidest thing in existence. I get private healthcare through work in the UK and I know exactly what I'm covered for and for how much money, how you can have insurance where the insurer seems to change their minds on a whim is lunacy.

Sorry I know most of this isnt relevant for your post I just chimed in from there :lol:
 
Pogue Mahone said:
I don't know why you're arguing about this. The insurance companies can do plenty of things wrong without being the reason behind the extremely high healthcare costs in the US. But the situation very simple, hey foot the bill for these extreme costs, so they are definitely not the cause of them. As per my previous post, the fact that they will do everything possible to avoid paying the costs is why they're so unpopular. Because if they won't pay then the patient has to (or doesn't get the care they need). None of this is defending these companies, or their business practices. I'm just explaining that they are not the cause of the insane healthcare costs in the US.
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You’ve said that “they will do everything possible to avoid paying the costs”. Surely this means they are cause of the insane healthcare costs that the average American is forced to pay?

If I run a waste disposal plant and send out trucks to collect the waste, but instead of bringing it to the plant I instruct them to dump it in the streets and let the citizens pick it up at their own expense, I am causing that situation. I didn’t create the waste, but by doing everything in my power to pass on the cost of doing business to the citizens purely in order to increase my companies profit margins, I am the cause of their financial loss.
 
Snowjoe said:
Unfortunately for Ireland this is spot on, I work for a multinational insurer and Ireland & the US ring huge alarm bells for our Liability teams because the compensation pay outs are massive.

Insurers get a bad rep, and some of it is justified and some of it is due to people not reading their policy documentation, but also a huge amount of underwriting isn't profitable in itself and people would be shocked if they had to actually pay premiums large enough to ensure profitable underwriting. Most of the money is made by investing the premiums held. Which is somewhat fine for insurance that doesn't decide whether a person lives or dies but having for profit medical insurance in a country with no universal healthcare is about the stupidest thing in existence. I get private healthcare through work in the UK and I know exactly what I'm covered for and for how much money, how you can have insurance where the insurer seems to change their minds on a whim is lunacy.

Sorry I know most of this isnt relevant for your post I just chimed in from there :lol:
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Yep, all of the things you’ve mentioned here confirm why the free market is awesome for most things, but a horrible fit for those where a profit motive necessitates perverse incentives.
 
Daydreamer said:
You’ve said that “they will do everything possible to avoid paying the costs”. Surely this means they are cause of the insane healthcare costs that the average American is forced to pay?

If I run a waste disposal plant and send out trucks to collect the waste, but instead of bringing it to the plant I instruct them to dump it in the streets and let the citizens pick it up at their own expense, I am causing that situation. I didn’t create the waste, but by doing everything in my power to pass on the cost of doing business to the citizens purely in order to increase my companies profit margins, I am the cause of their financial loss.
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Eh, no. Obviously not.

Why do you lot find this so hard to grasp? A healthcare system involves providers and payers. Providers are hospitals, doctors etc Payers are either insurers or (if not insured) patients (in a private healthcare system). The more expensive healthcare is the more money earned by providers, not payers. Come on, this is basic stuff!

In a nationalised health service, the government is both provider and payer, so is wholly responsible for the spend per head on healthcare in their country. In a fully privatised system like the US, they rely on the free market to dictate costs. Providers apply upward pressure, payers downward pressure. The idea being that the market will achieve some sort of reasonable equilibrium. But this clearly isn't working, as providers are charging way to much and payers are deflecting too much of these costs onto patients. What payers are definitely not doing, is causing these inflated costs.
 
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Snowjoe said:
Unfortunately for Ireland this is spot on, I work for a multinational insurer and Ireland & the US ring huge alarm bells for our Liability teams because the compensation pay outs are massive.

Insurers get a bad rep, and some of it is justified and some of it is due to people not reading their policy documentation, but also a huge amount of underwriting isn't profitable in itself and people would be shocked if they had to actually pay premiums large enough to ensure profitable underwriting. Most of the money is made by investing the premiums held. Which is somewhat fine for insurance that doesn't decide whether a person lives or dies but having for profit medical insurance in a country with no universal healthcare is about the stupidest thing in existence. I get private healthcare through work in the UK and I know exactly what I'm covered for and for how much money, how you can have insurance where the insurer seems to change their minds on a whim is lunacy.

Sorry I know most of this isnt relevant for your post I just chimed in from there :lol:
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It's very relevant to my post (and interesting) albeit slightly depressing!
 
TwoSheds said:
Do tell, why is their healthcare so expensive then?
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Don't know who would be responsible. I have little knowledge of America's healthcare system. But know that it doesn't make sense for the HMO/insurers to be responsible. Their role is payouts. The larger the payouts, the bigger their loses.
 
Isn't part of the problem the insane cost of medical drugs in the US? Have heard stories of people paying hundreds/thousands for things which cost a fraction of that in the UK and Europe.
There surely cannot be such a discrepancy in the "actual" cost of producing these drugs, its just in the US companies bump up the prices to ridiculous levels.
Apologies for the slight derail, but I think something similar is going on with vets in the UK. My 1 year old Springer got a nasty cut on her leg and had to have it stitched up. It cost £700 and insurance paid 75% of that. Going through line by line, it reads stuff like £50 on dressing the wound. £50? for a roll of bandage and maybe some antiseptic cream? Scandalous, but I and by extension my insurer has no choice but to pay up.
 
Am fairly well-placed to weigh in on this one, I work in a different type of insurance, but the missus works in healthcare. For me, there is simply no world where privatised health insurance that isn't universal makes sense.

The entire reason insurance exists is to spread the risk of major costs across a population, whereby the average cost factoring in likelihood of an event is lowered. Makes lots of sense for houses that could get hit by a hurricane, or cars that could get into accidents etc. Would also make sense in healthcare, but only if those least-likely to need expensive health items are in the same pool as those that are. What the US system desperately tries to do is create pools of the least-likely, and exclude anyone else. Then it's up to the state/individuals to pay. For me it fundamentally doesn't make sense. All healthcare insurance does is extract value from the system.

And that's before you get into what the health insurance/healthcare system has actually done in the states, which is genuinely insane. The symbiosis of care providers/insurance/lobbying is utterly terrifying.
 
Pogue Mahone said:
Eh, no. Obviously not.

Why do you lot find this so hard to grasp? A healthcare system involves providers and payers. Providers are hospitals, doctors etc Payers are either insurers or (if not insured) patients (in a private healthcare system). The more expensive healthcare is the more money earned by providers, not payers. Come on, this is basic stuff!

In a nationalised health service, the government is both provider and payer, so is wholly responsible for the spend per head on healthcare in their country. In a fully privatised system like the US, they rely on the free market to dictate costs. Providers apply upward pressure, payers downward pressure. The idea being that the market will achieve some sort of reasonable equilibrium. But this clearly isn't working, as providers are charging way to much and payers are deflecting too much of these costs onto patients. What payers are definitely not doing, is causing these inflated costs.
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His company was denying more than 1 in 3 claims, more than twice the industry average. I understand that insurance companies are a payer in the system (I’m not sure why you have to be so condescending - I think everyone understands that concept). United healthcare had net income of over $22b last year. The revenue comes from the premiums charged to their customers and they derive sizeable portion of their profit from denying genuine claims.

If a payer makes it their business practice to unjustly pass on what should have been their costs to another payer, they become one of the causes of that ultimate payer's financial loss. Especially when they have already extracted money from the ultimate payer in the form of premiums, but then proceeded to do everything in their power to avoid providing the service they were paid for.

This is both quite obviously directly the case (I’m not sure how anyone can argue that denying a rightful claim leads to higher cost for citizens than accepting the claim). It is also indirectly the case. As insurers make it a business practice to deny rightful claims, they remove incentive for costs to go down as they don’t intend on paying them.

Insurers do not set the price of healthcare. But they are the most impactful link in the chain in terms of what it costs the end user.
 
IMO, the only sane way to construct healthcare insurance companies is one where the insured are the shareholders of the company.
 
Daydreamer said:
His company was denying more than 1 in 3 claims, more than twice the industry average. I understand that insurance companies are a payer in the system (I’m not sure why you have to be so condescending - I think everyone understands that concept). United healthcare had net income of over $22b last year. The revenue comes from the premiums charged to their customers and they derive sizeable portion of their profit from denying genuine claims.

If a payer makes it there business practice to unjustly pass on what should be their cost to another payer, they become one of the cause of that ultimate payer's financial loss. Especially when they have already extracted money from the ultimate payer in the form of premiums and then proceeded to do everything in their power to avoid providing the service they were paid for.

This is both quite obviously directly the case (I’m not sure how anyone can argue that denying a rightful claim leads to higher cost for citizens than accepting the claim). It is also indirectly the case. As insurers make it a business practice to deny rightful claims, they remove incentive for costs to go down as they don’t intend on paying them.

Insurers do not set the price of healthcare. But they are the most impactful link in the chain in terms of what it costs the end user.
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This tangent started talking about why the cost of healthcare in the US is so expensive. That is a completely separate issue to the out of pocket costs from individual patients, whose costs aren't covered by insurance. The costs are what they are, whether paid for entirely by the insurer or not at all. I'm sorry if explaining that came across as condescending but you were being weirdly stubborn, instead of just accepting the facts of the situation. And now you're doubling down. Classic.

Oh and this..

As insurers make it a business practice to deny rightful claims, they remove incentive for costs to go down as they don’t intend on paying them.
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...is complete and utter nonsense.
 
Adisa said:
Don't know who would be responsible. I have little knowledge of America's healthcare system. But know that it doesn't make sense for the HMO/insurers to be responsible. Their role is payouts. The larger the payouts, the bigger their loses.
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The main reason is the lack of regulation and the lack of a singular national health plan to negotiate prices. Medicare, which might constitute such an actor, is explicitly not allowed to negotiate the price of drugs. Yes, that is as insane as it sounds.

A third reason is PBMs - the middlemen industry that exist as negotiators in the absence of the above. When Novo for example are called on to explain their US prices, they usually point the finger at PBMs. And they continue to eat into the margins everywhere, with recent estimates putting 42% of every dollar paid for a drug being PBM costs.
 
Adisa said:
Don't know who would be responsible. I have little knowledge of America's healthcare system. But know that it doesn't make sense for the HMO/insurers to be responsible. Their role is payouts. The larger the payouts, the bigger their loses.
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It makes sense if you look at it differently. The higher the costs, the more insensitive there is to have a private health insurances but the potentially high costs also justify relatively high insurance costs but here is the kicker, Health insurances have no intention to actually pay you back. So if you create a system that is potentially crippling without insurances, you put insurances in a context where they can virtually extort people and create higher revenues than if costs where reasonable.

And keep in mind that they make money on the vast majority of people that aren't sick but still pay just in case something happens while also trying to deny payment for people that are actually sick. If the costs are high it's a win-win situation. It's like racketeering from the Mafia, I burn your shop so that you pay me to prevent people from burning your shop, you pay them to not have to maybe pay enormous medical bills that they lobby for.
 
Snowjoe said:
I work for a multinational insurer
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But everything is more expensive in the US, not just drugs.

inpatient service are ridiculously high compared to other first world countries. Partly due to "defensive" treatment, ie over-diagnosing patients to avoid lawsuits.
Partly due to the competitive nature of private hospitals - each aims to be a full-ranged provider, whereas public hospitals can share services between them and maintain equipment and personnel for many things at different hospitals when the deman is not high enough to merit each hospital providing it.
Similarly to drugs, the lack of a single health plan department means that doctors are able to negotiate vastly better salaries for themselves than in Europe. They earn about three times the median salary of German doctors.
And of course finally, the hospitals themselves exist for profit.
 
Pogue Mahone said:
This tangent started talking about why the cost of healthcare in the US is so expensive. That is a completely separate issue to the out of pocket costs from individual patients, whose costs aren't covered by insurance. The costs are what they are, whether paid for entirely by the insurer or not at all.
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The CEO of a insurance company wasn't assassinated in broad daylight to very little public outcry because the shooter and society in general disagreed with the aggregated cost of healthcare in US. It's because of what healthcare in the US costs individual patients. It's the only developed country where medical bankruptcy is real possibility.

And I'm not talking about cost that aren't covered by insurance, I'm talking about claims that should be covered by insurance that companies like United Healthcare evaded through a business practice of intentionally denying rightful claims.

Pogue Mahone said:
Oh and this..

...is complete and utter nonsense.
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It's only nonsense if you don't have even a passing knowledge of incentive structures. In that case, yes, it literally wouldn't make sense to you.
 
B20 said:
But everything is more expensive in the US, not just drugs.

inpatient service are ridiculously high compared to other first world countries. Partly due to "defensive" treatment, ie over-diagnosing patients to avoid lawsuits.
Partly due to the competitive nature of private hospitals - each aims to be a full-ranged provider, whereas public hospitals can share services between them and maintain equipment and personnel for many things at different hospitals when the deman is not high enough to merit each hospital providing it.
Similarly to drugs, the lack of a single health plan department means that doctors are able to negotiate vastly better salaries for themselves than in Europe. They earn about three times the median salary of German doctors.
And of course finally, the hospitals themselves exist for profit.
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Yup. And the rest. They pay more for blood tests, more for x-rays, MRIs, CT scans, pharmacy dispensing fees, consults from allied health professionals (physiotherapists, occupational therapists etc) It all adds up. The cost of a hospital stay for the most trivial illness is always astronomical.
 
Daydreamer said:
The CEO of a insurance company wasn't assassinated in broad daylight to very little public outcry because the shooter and society in general disagreed with the aggregated cost of healthcare in US. It's because of what healthcare in the US costs individual patients. It's the only developed country where medical bankruptcy is real possibility.
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No shit, sherlock. However you waded into a discussion about the very high aggregated cost of healthcare in US. Specifically, you responded to me explaining why this is not caused by health insurance companies

And I'm not talking about cost that aren't covered by insurance, I'm talking about claims that should be covered by insurance that companies like United Healthcare evaded through a business practice of intentionally denying rightful claims.
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Good for you. And that is why the CEO was shot. But, once again this is irrelevant to the post you replied to.

It's only nonsense if you don't have even a passing knowledge of incentive structures. In that case, yes, it literally wouldn't make sense to you.
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Nope. It's just nonsense. And I reckon you're smart enough to be aware of this, deep down, if you weren't so desperate to find an angle to use to double down.
 
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Pogue Mahone said:
Yup. And the rest. They pay more for blood tests, more for x-rays, MRIs, CT scans, pharmacy dispensing fees, consults from allied health professionals (physiotherapists, occupational therapists etc) It all adds up. The cost of a hospital stay for the most trivial illness is always astronomical.
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It is a complex issue. The high price of healthcare in the US is caused by the astronomical cost of drugs, for profit hospitals that overcharge and insurers that overcharge and try to get out of paying. Everyone gets a piece of the pie.

BTW, many doctors aren‘t paid enough and don‘t take insurance anymore. We also have big waitlists. It is a thoroughly broken system.
 
Pogue Mahone said:
Nope. It's just nonsense. And I reckon you're smart enough to be aware of this, deep down, if you weren't so desperate to find an angle to use to double down.
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Is it though?

I mean, if DRUGS has a median cost of 10k per capita, then insurers will set the price at 11K and make a profit of 1k per customer. But if they then deny 25% of all claims, they've made a median profit of 3.5k.

Whereas, if DRUGS have a median cost of 50k per capita, the insurer can set the price at 51k. But then make a median profit of 13.5k when they deny 25% of all claims.
 
NLunited said:
It is a complex issue. The high price of healthcare in the US is caused by the astronomical cost of drugs, for profit hospitals that overcharge and insurers that overcharge and try to get out of paying. Everyone gets a piece of the pie.

BTW, many doctors aren‘t paid enough and don‘t take insurance anymore. We also have big waitlists. It is a thoroughly broken system.
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Sadly, healthcare systems all over the world are broken. Thanks to aging populations and governments who are trying to keep on top of spiralling debts. It's really difficult to find an example of any system, anywhere, that is in great working order and massive waitlists and declining health outcomes are happening all over the world (small, very wealthy countries like Norway or various gulf states are probably as good as it gets?) What makes America kind of unique, though, is the off the charts expense of making sick people well. I do think it's a big outlier on that specific issue.
 
B20 said:
Is it though?

I mean, if DRUGS has a median cost of 10k per capita, then insurers will set the price at 11K and make a profit of 1k per customer. But if they then deny 25% of all claims, they've made a median profit of 3.5k.

Whereas, if DRUGS have a median cost of 50k per capita, the insurer can set the price at 51k. But then make a median profit of 13.5k when they deny 25% of all claims.
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I really hope that made sense to you when you typed it...
 
Pogue Mahone said:
Sadly, healthcare systems all over the world are broken. Thanks to aging populations and governments who are trying to keep on top of spiralling debts. It's really difficult to find an example of any system, anywhere, that is in great working order and massive waitlists and declining health outcomes are happening all over the world (although I reckon small, very wealthy countries like Norway or various gulf states are probably as good as it gets) What makes America kind of unique, though, is the off the charts expense of making sick people well. I do think it's a big outlier on that specific issue.
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And that cost is by design. The higher the cost, the more money health institutions and insurers make, in fact one should also had lenders to this equation because they also make a fortune out of these high costs.
 
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