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Comment by bushbaba | Hacker News Reader

The profit margin of anthem insurance is ~5%. The profit margin of all state insurance is ~7%.

The us health INSURANCE system is not hugely profitable. as care costs go up, the insurance deductible/premium must also go up or the amount of services covered needs to decrease.

The way to fix this is to fix the system. Lower Doctor pay, lower drug cost, showing pricing up front, allowing medical suicide, removal of middle-parties, ..etc all would allow the Us to get more care for money they spend.

Also do realize the U.S. doesn’t have healthCARE but health INSURANCE. Insurance is geared towards covering unexpected large cost events. Americans use their health insurance as health care.

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Pricing up front is a start. Hospital overbilling is probably a bigger issue than doctor pay. They have billing departments equivalent to a corporation’s team of accountants, but instead of paying no tax, their mission is to maximize what you’ll pay. Procedure costs vary wildly, and hospitals will often bill for a doctor’s time when an NP or technician did the work.

Elevance Health (aka Anthem) has a profit margin of 3% to 4% most years:

https://www.macrotrends.net/stocks/charts/ELV/elevance-healt...

It is funny to see discussions about managed care organizations earning too much money on a forum where most presumably work for businesses that earn 20%+ profit margins.

Although, this doesn’t take away from the fact that MCOs have been getting away for too long with criminal prior authorization practices that waste a lot of people’s time (and health). But I bet fixing this would involve spending a lot more on labor, which people also would not like (higher premiums/deductibles/taxes).

> It is funny to see discussions about managed care organizations earning too much money on a forum where most presumably work for businesses that earn 20%+ profit margins

Hilarious!!! Or it would be, if making margins by denying lifesaving care, weren't totally different from making margins on a bag of juice.

Why is that relevant? The important piece of information is operating a business at low profit margins is hard (obviously because a zero or negative profit margin is a charity and not a business).

People working for software companies with enormous lock in pricing their products (and we can talk about Epic healthcare software’s profit margins here) complaining about profits earned by businesses under much more competitive pressure is funny, because they obviously would have no better solution than what the executives of the business barely eking out a profit are doing.

And on top of that, all insurance pricing has to be approved by the government.

The conclusion is only that people like to complain. They complain about high premiums/deductible, they complain about prior authorizations, they complain about fraud, they complain about denied coverage.

And then they will still choose to purchase from the company offering the lowest premiums.

> Why is that relevant?

Thank you for asking. I would be happy to help you understand here.

The answer to your question is: The important piece of information is that people should not be denied lifesaving care just to increase or maintain margin. Thus, someone who does the former is bad, and someone who criticizes a bad person is totally okay in doing so.

Compare to marking up a bag of juice at 100%, which is also totally okay because you aren't effectively killing people by doing so. Thus, no contradiction exists.

To dig even deeper: because a life is worth more than the markup on a bag of juice. A thousand bags of juice marked up 100% would be morally better than denying lifesaving care just to increase margins 1%.

> people like to complain

This type of commentary is better suited for Reddit.

>The important piece of information is that people should not be denied lifesaving care just to increase or maintain margin.

So you want a business to go out of business? This discussion is not about whether or not the government should pay for everyone's healthcare, no matter the cost. The American public has already decided that should not be the case, and there should exist a business that adjudicates whether or not an appropriate amount of healthcare and cost is being distributed.

>This type of commentary is better suited for Reddit.

Not really. The root of the issue is that the American public wants something it cannot afford (or at least wants it for themselves but not for others). This manifests as nonsensical complaints about the entity that earns the lowest profit margins. The MCO raises the premium/deductible, complaints. The MCO denies coverage, complaints. And this will actually go all the way back to an untenable population histogram where fewer and fewer young people will be bled to support more and more old people.

> So you want a business to go out of business?

I didn't say that. They can raise premiums, or they can decide that being in a position where you effectively kill people for profit isn't a great place for a company to operate, and abdicate to the government. Either way, profiting off death you contribute to, is generally a Bad Thing. Based off the UHC CEO's murder and the reactions to it, it seems I am not the only one who thinks this.

> This discussion is not about whether or not the government should pay for everyone's healthcare

Actually, that's precisely one of the options I'm discussing! :)

Point being, pointing out "this is hard for a corporation to do and still make money" doesn't excuse the badness of profiting off your contributions to killing people. Like maybe don't do it as a corporation if it's so hard?

> The American public has already decided that should not be the case, and there should exist a business that adjudicates whether or not an appropriate amount of healthcare and cost is being distributed.

Have they? I must have missed that individual question was explicitly on the ballot as you describe.

Given that a lot of the reoccurring is not just for emergency coverage but standard healthcare services and purchases. It might also be interesting if there was an investing account that you could withdraw from tax free to use for those types of things. This might minimize some of the incentive to lean on your employment and insurance as a middle man for this.

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