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How often do health insurers say no to patients? (2023)

(www.propublica.org)
94 points lentoutcry | 4 comments | 06 Sep 25 20:01 UTC | HN request time: 0.008s | source
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spyspy ◴[06 Sep 25 21:49 UTC] No.45153191[source]▶
> Health Insurance CEO Reveals Key To Company’s Success Is Not Paying For Customers’ Medical Care [1]

1. https://theonion.com/health-insurance-ceo-reveals-key-to-com...

replies(2): >>45154010 #>>45154035 #
avalys ◴[07 Sep 25 00:02 UTC] No.45154010[source]▶
If it’s not up to health insurers to limit healthcare spending, then which organizational role in the healthcare system do you think is appropriate to place this responsibility with?
replies(2): >>45154019 #>>45154168 #
kstrauser ◴[07 Sep 25 00:04 UTC] No.45154019[source]▶
Elected representatives answerable to their constituents would be a vast improvement in health outcomes.
replies(2): >>45154078 #>>45155344 #
firesteelrain ◴[07 Sep 25 00:13 UTC] No.45154078[source]▶
How would it all be paid for if not by increasing premiums (like what happened with ACA)?
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kstrauser ◴[07 Sep 25 00:21 UTC] No.45154124{4}[source]▶
The sheer amount of overhead induced by insurance is staggering. For example, the sum of the net profits of all insurers represents money extracted from the system without contributing to health. And the amount of time doctors spend documenting patient care over and above what’s medically necessary purely to make insurers happy is time not spent seeing patients. Clinic staff spending hours on the phone each day arguing against denials is wasted money. (Anecdote: an insurer refused to authorize an MRI for a patient until my wife xrayed their damaged tendon, which doesn’t show up on xrays. She had to conduct a useless medical procedure on the patient before they’d pay for one with actual diagnostic value.)

The whole overhead imposed by the useless rent seekers is money not spent on making people healthier.

replies(1): >>45155162 #
1. avalys ◴[07 Sep 25 03:33 UTC] No.45155162{5}[source]▶
Have you actually checked any of these numbers?

What do you imagine is the profit margin of a health insurance company?

According to this report by the national association of state regulators, the profit margin of the health insurance industry in 2023 was 3%, or $25 billion.

Compared to over $1T of premiums, and over $4T of total healthcare spending in the US, that doesn't seem "staggering" to me.

https://content.naic.org/sites/default/files/topics-industry...

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2. kstrauser ◴[07 Sep 25 04:12 UTC] No.45155337[source]▶
Yes. I owned a medical practice. These numbers affected how much money we took home every month, and I know them with far more personal interest than almost anyone else weighing in here.
3. noobhacker ◴[07 Sep 25 05:46 UTC] No.45155718[source]▶
Profit margin is the wrong metric in this debate. The person you are replying to is saying that the insurance companies as a whole is a waste, including all the salaries paid to their employees.
4. ceejayoz ◴[08 Sep 25 00:04 UTC] No.45163441[source]▶
If I can reliably sell people $1 bills for $1.03, in extremely large quantities, I'll be very, very happy.

Low margin, high volume is very different than low margin, low volume. The Walton family is very pleased with their tiny margins and the wealth it has delivered them.