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

(www.propublica.org)
94 points lentoutcry | 2 comments | 06 Sep 25 20:01 UTC | HN request time: 0.405s | source
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kstrauser ◴[06 Sep 25 22:24 UTC] No.45153451[source]▶
All the time. I have a UnitedHealthcare “platinum” plan, and it may as well not include pharmacy benefits because it never covers anything. Generic thyroid meds went from $2/month with Aetna to $70 with UHC. ADHD meds went from $10 to $300.

The threatened “death panels” we heard about when ACA was being debated are actually employees of insurers who decide what they’re not going to pay for.

I was raised a die-hard capitalist and in many ways still am. When it comes to healthcare these days, I’m somewhere to the left of Marx. What we have now is a failed system. It simply does not work. The turnip has been squeezed and there’s no blood left to wring from it.

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arwhatever ◴[06 Sep 25 23:01 UTC] No.45153712[source]▶
1. A properly competitive marketplace 2. Socialized medicine 3. What we have now

I would like to see #1 tried but at this point I’ll gladly accept #2

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mattnewton ◴[06 Sep 25 23:22 UTC] No.45153814[source]▶
I just don't think #1 is possible, how can you have a functioning marketplace for a good when the demand is hard to forecast for an individual, almost completely inelastic and often extremely time sensitive. I'd say the US really tried and the incentives just aren't there for a stable system.
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1. savanaly ◴[07 Sep 25 05:53 UTC] No.45155748[source]▶
>demand is hard to forecast for an individual, almost completely inelastic and often extremely time sensitive

These don't preclude a free market working well. For instance, they're all apt descriptors of me when I find myself needing an Uber home. I'm not completely inelastic, since I could take a series of long bus rides to get home, or walk, but accepting for the sake of argument those aren't life-threatening, the cab companies more or less have me over a barrel. Or do they? We all know what keeps them from charging me more they do, even given the time sensitivity, lack of prediction, or inelasticity. It's competition.

The USA system doesn't work well, and I'm not necessarily saying that free market is the right solution, just pushing back on the notion that just because a good meets those criterion we are forced to throw our hands up and say the free market could never provide that.

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2. mattnewton ◴[07 Sep 25 14:44 UTC] No.45158602[source]▶
Taxi demand is actually usually quite easy to forecast for an individual, which makes planning alternative competition easier, although we often don’t try anymore because we’re used to good app competition. This is before even getting to how much lower the infrastructure and personnel barriers are to competing in the medical space versus the taxi space.

I know that most nights I am going to want to sleep in my own bed, this is somewhat inelastic sure, but not a surprise. The apps can’t raise prices too much however because they are in competition with us making plans to use the bus or call a friend. There is not a good equivalent in the medical world, it’s webmd and herbal compresses versus licensed doctors and prescription only drugs, with your life on the line.