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

(www.propublica.org)
94 points lentoutcry | 1 comments | 06 Sep 25 20:01 UTC | HN request time: 0s | 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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arwhatever ◴[07 Sep 25 00:04 UTC] No.45154018[source]▶
When did the U.S. really try?
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mattnewton ◴[07 Sep 25 01:49 UTC] No.45154647[source]▶
Isn’t this just a no true Scotsman? The US claims at least to have built a free market solution, and if nobody else has been able to make it work at scale, why isn’t that enough.
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1. arwhatever ◴[07 Sep 25 05:58 UTC] No.45155774[source]▶
I don’t think so, although that seems like a fair question of you to ask.

I’ve tried on numerous occasions to get pricing quotes for healthcare both paying fully out of pocket, and for getting an estimate for what I’ll be left covering after insurance negotiates ads pays their part.

In every attempt I get absolutely nowhere price estimate-wise and wind get this or that procedure done just hoping and praying that the ultimate bill will be remotely reasonable

We’re so far off the mark for having a healthy marketplace for healthcare pricing that I just can’t see considering it dysfunctional to itself be an appeal to some purity.

Perhaps one might argue that a formerly functional healthcare pricing system will inevitably degenerate into this robber Baron situation that we’ve got currently, but otherwise I don’t see the no true Scotsman.