Don’t hate the player, hate the game. This may sound strange coming from someone who’s been very critical of health insurance companies and their actions, but you shouldn’t hate the people who run these companies, their CEOs or their medical directors. They’re only doing their jobs and if they did anything less, they could be removed for failing in their primary function.
I agree with all of your comments and appreciate your thoughts. My point of writing the article was not to defend or support the insurance industry or the executives that work there. My point was to point out that we have a flawed system that needs to be fixed. Thanks for reading!
You know what? This is a fallacious argument. I do hate the "players" who are running these companies -- because they are soul-less enough, gutless enough, and greedy-enough to hide behind the cloak of "just doing their job." FACT: They value their cushy salaries and bonuses over basic decency and humanity; they know it in their greedy little hearts -- AND THEY DO IT ANYWAY.
Here's a newsflash: competition and "how happy the customer is about the product" don't actually factor in, when it comes to healthcare and/or health insurance. We The People are pretty uniformly unhappy with ALL the so-called "products." What difference does it really make who screws you over? Cigna, United Health BCBS, Aetna, etc. all feature the "Sh*t-sandwich" as the chef's special on ALL of their menus.
I actually like how you wrote this out. It was tongue in cheek but it’s true. It’s not going to change.
We need to vote in November. Project 2025, Donald Trump & the GOP have been very clear on their healthcare plans which include slashing benefits, eliminating pre-existing conditions mandates, & more. The aim has always been to gut the ACA (Obamacare) but gutting Obamacare means hurting people who have employer-based healthcare as well. I paid $6k a year for a PPO that was supposed to cover out-of-network care, etc., & I was audited & scammed out of benefits. People who change jobs may be denied health insurance in their future. Your children may be denied healthcare or medicine. You think your premiums are expensive now? Hahahah I laugh at you! Like I said any hint of a pre-existing condition-you’re gonna be paying cash. Good thing President Biden is excluding medical debt from your credit reports isn’t it? You think that will last? Vote.
Then again, if they don’t have workers, if we all die, what will they do? The machines aren’t running the world yet. Vote.
The only thing that I would add, which I don't think you touched on, is that because the consumer generally doesn't either see or understand the true cost (when it is taken from the paycheck), they always want the most expensive item. So, in your Apple example, it would be like walking into the Apple store and always asking for the latest Iphone model, even when five generations ago is good enough.
The system is just completely broken. And, having worked in it for 22 years now (large IPA model), it is basically hopeless to think it will ever be fixed. There is simply too much money in the system.
Maybe we should rein in the "limited liability" enjoyed by shareholders in a "limited liability corporation". Limited liability is a privilege others don't have and shareholders don't have in other areas of life.
If I lend my friend money for books but my friend buys a gun and robs a bank the police would not believe I was not investing in his robbery and would lean on us to rat each other out and I could get sued by someone who was injured in the robbery.
A shareholder only risks losing the resale value of a share even if that share has likely already paid for itself with splits, dividends and buybacks. If investors were treated as complicit in corporate misbehavior they would keep executives on a shorter leash. If victims of Bhopal could sue Union Carbide shareholders and investors risked losing their houses Union Carbide would have been forced to operate more safely there.
If someone thinks ending limited liability would slow investment too much maybe someone much smarter than I am could create a malpractice insurance product for investors similar to malpractice insurance that doctors have
I am sorry I don’t agree with your analysis of this situation. While only 5% of the population may use an excessive amount of healthcare dollars in any given year, this population often changes from year to year. Sure there are many that have chronic illnesses that keep them in this category annually, there are many that require an intervention that is costly in any given year. Nevertheless all of them have relatives, friends, coworkers and employers that are directly and indirectly affected by that person’s illness and the poor quality of service provided by the insurance industry. The customer, the employer or government entity, is adversely affected by the lack of productivity of the ill person. This is magnified by the counterproductive measures the insurance industry takes to prevent the patient or consumer, as you call them, from getting healthy and productive. All the processes undertaken by the insurance industry just slow down or defeat the process of wellness. Prior-authorization is eventually authorized in the vast majority of cases. Physicians find work arounds for most of the ridiculous stepped care protocols but the patient and the employer suffer until this is completed. Minimal productivity from the patient (consumer) should make the employer (customer) very unhappy because not only are they paying for a poor insurance product, they are loosing revenue in their company due to lack of productivity by this worker. If we eliminated all the administrative red tape of the insurance industry, these workers would return to the job site more quickly and increase productivity and then their employer would benefit from not only increased revenue but lower premiums because they wouldn’t need to cover the administrative bureaucracy created by insurers. Thank you.
So you’re saying healthcare is not a commodity and shouldn’t be sold like a phone or a pair of shoes. I agree but still hate the greedy execs (and their industry groups and lobbyists) who think it’s fine. There are a few former execs whose conscience made them leave. I applaud them and am grateful for their voices.
I'm with the author on the argument all the way through.
I'll tell you who I despise: the government execs who will attack a family practice physician office for asking for a copay at a routine visit (yes, this happened- Medical Boards pick and choose whom to harass based upon "gut feelings"- inspector even admitted that to me and physically shoved me when she walked in the door) and cost the office $5000 in attorney fees just to have representation, but when said physician office reports borderline unfair shenanigans to the same state agencies, not only do they ghost the patients and office, they do nothing to correct the behavior of the insurance companies. This goes for state department of insurance companies, CMS, and state Medicaid. Yes, I've reported all of this to state legislators multiple times. It upsets them, but they can only forward the complaints to Medicaid or CMS, who... guess what? Get a whole lot of nothing done. It's a lot more fun for them to terrify the little guys (offices and patients) than to lift a finger to question a big company's use of Medicaid funds to systematically deny $5 hemoglobin A1Cs for all patients including diabetics.
I love the distinction between the customer and the consumer. It is very valuable. I have been thinking for a while about how best to make the point about the distribution of spending based on illness, 50% of the spending in the top 5% of sick folks, 3% in the healthiest 50%. We need to find ways to convert that to numbers that grab the imagination.
Hopefully SCOTUS ruling on Chevron will shut down the revolving door which has resulted in these companies self-dealing. It will take a few years to untangle the mess but it will be a good day for Americans who overpay for crappy care. Put your money back in the pot, players. It was fun for them while it lasted but just like all parasites, if they kill the host, they will not survive.
I agree with all of your comments and appreciate your thoughts. My point of writing the article was not to defend or support the insurance industry or the executives that work there. My point was to point out that we have a flawed system that needs to be fixed. Thanks for reading!
You know what? This is a fallacious argument. I do hate the "players" who are running these companies -- because they are soul-less enough, gutless enough, and greedy-enough to hide behind the cloak of "just doing their job." FACT: They value their cushy salaries and bonuses over basic decency and humanity; they know it in their greedy little hearts -- AND THEY DO IT ANYWAY.
Here's a newsflash: competition and "how happy the customer is about the product" don't actually factor in, when it comes to healthcare and/or health insurance. We The People are pretty uniformly unhappy with ALL the so-called "products." What difference does it really make who screws you over? Cigna, United Health BCBS, Aetna, etc. all feature the "Sh*t-sandwich" as the chef's special on ALL of their menus.
I actually like how you wrote this out. It was tongue in cheek but it’s true. It’s not going to change.
We need to vote in November. Project 2025, Donald Trump & the GOP have been very clear on their healthcare plans which include slashing benefits, eliminating pre-existing conditions mandates, & more. The aim has always been to gut the ACA (Obamacare) but gutting Obamacare means hurting people who have employer-based healthcare as well. I paid $6k a year for a PPO that was supposed to cover out-of-network care, etc., & I was audited & scammed out of benefits. People who change jobs may be denied health insurance in their future. Your children may be denied healthcare or medicine. You think your premiums are expensive now? Hahahah I laugh at you! Like I said any hint of a pre-existing condition-you’re gonna be paying cash. Good thing President Biden is excluding medical debt from your credit reports isn’t it? You think that will last? Vote.
Then again, if they don’t have workers, if we all die, what will they do? The machines aren’t running the world yet. Vote.
The only thing that I would add, which I don't think you touched on, is that because the consumer generally doesn't either see or understand the true cost (when it is taken from the paycheck), they always want the most expensive item. So, in your Apple example, it would be like walking into the Apple store and always asking for the latest Iphone model, even when five generations ago is good enough.
The system is just completely broken. And, having worked in it for 22 years now (large IPA model), it is basically hopeless to think it will ever be fixed. There is simply too much money in the system.
Maybe health insurance needs to play a different game.
They're taking on the work that belongs to a nation state. Just ask most of the rest of the developed world where costs are significantly less.
Maybe we should rein in the "limited liability" enjoyed by shareholders in a "limited liability corporation". Limited liability is a privilege others don't have and shareholders don't have in other areas of life.
If I lend my friend money for books but my friend buys a gun and robs a bank the police would not believe I was not investing in his robbery and would lean on us to rat each other out and I could get sued by someone who was injured in the robbery.
A shareholder only risks losing the resale value of a share even if that share has likely already paid for itself with splits, dividends and buybacks. If investors were treated as complicit in corporate misbehavior they would keep executives on a shorter leash. If victims of Bhopal could sue Union Carbide shareholders and investors risked losing their houses Union Carbide would have been forced to operate more safely there.
If someone thinks ending limited liability would slow investment too much maybe someone much smarter than I am could create a malpractice insurance product for investors similar to malpractice insurance that doctors have
Copied and pasted a remark I made before
I am sorry I don’t agree with your analysis of this situation. While only 5% of the population may use an excessive amount of healthcare dollars in any given year, this population often changes from year to year. Sure there are many that have chronic illnesses that keep them in this category annually, there are many that require an intervention that is costly in any given year. Nevertheless all of them have relatives, friends, coworkers and employers that are directly and indirectly affected by that person’s illness and the poor quality of service provided by the insurance industry. The customer, the employer or government entity, is adversely affected by the lack of productivity of the ill person. This is magnified by the counterproductive measures the insurance industry takes to prevent the patient or consumer, as you call them, from getting healthy and productive. All the processes undertaken by the insurance industry just slow down or defeat the process of wellness. Prior-authorization is eventually authorized in the vast majority of cases. Physicians find work arounds for most of the ridiculous stepped care protocols but the patient and the employer suffer until this is completed. Minimal productivity from the patient (consumer) should make the employer (customer) very unhappy because not only are they paying for a poor insurance product, they are loosing revenue in their company due to lack of productivity by this worker. If we eliminated all the administrative red tape of the insurance industry, these workers would return to the job site more quickly and increase productivity and then their employer would benefit from not only increased revenue but lower premiums because they wouldn’t need to cover the administrative bureaucracy created by insurers. Thank you.
So you’re saying healthcare is not a commodity and shouldn’t be sold like a phone or a pair of shoes. I agree but still hate the greedy execs (and their industry groups and lobbyists) who think it’s fine. There are a few former execs whose conscience made them leave. I applaud them and am grateful for their voices.
I'm with the author on the argument all the way through.
I'll tell you who I despise: the government execs who will attack a family practice physician office for asking for a copay at a routine visit (yes, this happened- Medical Boards pick and choose whom to harass based upon "gut feelings"- inspector even admitted that to me and physically shoved me when she walked in the door) and cost the office $5000 in attorney fees just to have representation, but when said physician office reports borderline unfair shenanigans to the same state agencies, not only do they ghost the patients and office, they do nothing to correct the behavior of the insurance companies. This goes for state department of insurance companies, CMS, and state Medicaid. Yes, I've reported all of this to state legislators multiple times. It upsets them, but they can only forward the complaints to Medicaid or CMS, who... guess what? Get a whole lot of nothing done. It's a lot more fun for them to terrify the little guys (offices and patients) than to lift a finger to question a big company's use of Medicaid funds to systematically deny $5 hemoglobin A1Cs for all patients including diabetics.
Great explainer! Everyone is doing their “job” (patients too) and those jobs have competing priorities.
I love the distinction between the customer and the consumer. It is very valuable. I have been thinking for a while about how best to make the point about the distribution of spending based on illness, 50% of the spending in the top 5% of sick folks, 3% in the healthiest 50%. We need to find ways to convert that to numbers that grab the imagination.
Sad but true.
Hopefully SCOTUS ruling on Chevron will shut down the revolving door which has resulted in these companies self-dealing. It will take a few years to untangle the mess but it will be a good day for Americans who overpay for crappy care. Put your money back in the pot, players. It was fun for them while it lasted but just like all parasites, if they kill the host, they will not survive.
You are just as bad as they are.