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

> 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...

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?

Elected representatives answerable to their constituents would be a vast improvement in health outcomes.

How would it all be paid for if not by increasing premiums (like what happened with ACA)?

Health insurance companies do not provide any medical services. They are the middle man between patients and the places/people that actual do provide medical services. So when they deny coverage, they just keep all the premiums paid by the patient. That money is sucked up by the middle man. So you don't need to raise premiums, you need to lower profits at health insurance companies. Every billion they make in profit is a billion paid by patients and not received in services.

> Health insurance companies do not provide any medical services.

This is substantively not true (though literally true at the level of a company, due to separate companies within the Kaier consortium) of the nation’s largest managed core organization, the Kaiser consortium consisting of the Kaiser Foundation health plans and the Kaiser Permanente Medical Groups.

> No when they deny coverage, they just keep all the premiums paid by the patient. That money is sucked up by the middle man. So you don't need to raise premiums, you need to lower profits at health insurance companies.

Something like limiting retained profits at the plan level to a fixed fraction of costs covered, and requiring refund of excess premiums to members?