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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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1. pdonis ◴[07 Sep 25 18:51 UTC] No.45161075{3}[source]▶
> 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.

Most health care is not like this. Most health care is fairly routine: periodic physical exams and checkups, or getting evaluated when you have cold or flu symptoms. These sorts of things are much better provided for in a free market.

It's true that, if you have an emergency, it's probably not something that could have been forecast, and you don't have much of a choice about what care you need. That is indeed the sort of situation that insurance is intended for. But what we call "health insurance" isn't limited to those things. It also covers everything else--all the stuff above that isn't unpredictable or time sensitive. The result is a mess.