https://penncapital-star.com/uncategorized/americans-suffer-...

> In 2022, UnitedHealth Group made over $20 billion in profit. Cigna made $6.7 billion, Elevance Health made $6 billion and CVS Health made $4.2 billion. All told, America’s largest health insurers raked in more than $41 billion of profits in 2022.

Universal healthcare is good. America's for profit system is bad. You have to get rid of for profit insurers (to start, lots of other changes need to be made as well, PBM and private equity ownership, etc). Is there will to do that? What is it going to take to get there? Every other OECD country has a functioning healthcare system, to keep the existing system in the US is a policy choice.

Edit: Absolutely wild to see the apologists who say, "This is fine." to billions of dollars being sucked out of the healthcare system as profits instead of being spent on care or reduced premiums.

Investors Are Pressing UnitedHealth Group to Deny More Care - https://jacobin.com/2025/06/investors-unitedhealth-group-car... - June 10th, 2025

Democrat senators probe UnitedHealth over nursing home care denials - https://www.healthcaredive.com/news/democrat-senators-probe-... - August 8th, 2025

Revealed: UnitedHealth secretly paid nursing homes to reduce hospital transfers - https://www.theguardian.com/us-news/2025/may/21/unitedhealth... - May 21st, 2025

> UnitedHealth Group, the nation’s largest healthcare conglomerate, has secretly paid nursing homes thousands in bonuses to help slash hospital transfers for ailing residents – part of a series of cost-cutting tactics that has saved the company millions, but at times risked residents’ health, a Guardian investigation has found. Those secret bonuses have been paid out as part of a UnitedHealth program that stations the company’s own medical teams in nursing homes and pushes them to cut care expenses for residents covered by the insurance giant. In several cases identified by the Guardian, nursing home residents who needed immediate hospital care under the program failed to receive it, after interventions from UnitedHealth staffers. At least one lived with permanent brain damage following his delayed transfer, according to a confidential nursing home incident log, recordings and photo evidence.

As long as a profit motive exists, there will be incentives to reduce or avoid care for more profits.

I'd argue that the insurers are a big part of the problem, but not for the reason you state. Their profit is capped as a percentage of revenues by law (Obamacare). In order to get more profits, they have to increase costs, so it's the complete opposite of normal market forces. It's to their benefit that you have things like hospital monopolies that overcharge, because as long as all of the insurance companies are being overcharged equally, the insurance company makes more money with out of control costs.

Now, insurance companies also play games with this law by having a common corporate parent own a PBM which the insurance company contracts with, and then the PBM receives various kickbacks from drug companies, which it doesn't pass on to the prices it charges the insurance company, thus getting larger than otherwise allowed profits for the corporate parent.

I’m no lover of the US healthcare system - other countries get better outcomes for less than is spent by the US government - and basically all their costs are borne by the government, unlike in the US.

But: you have to be careful with large numbers. There are 0.3 billion people in the USA. United Healthcare says they cover 51 million. That $20 billion is $392 per insured person - a lot, sure, but hardly a large fraction of what they each pay.

Compared with other countries, the inefficiency of for-profit healthcare is a far worse problem than the amount of profit they make.

I agree with the gist of your comment overall. The system needs massive overhaul, which will take a lot of political will.

All you need to know about America’s health system is this graph comparing average cost to life expectancy of OECD countries.

https://ourworldindata.org/grapher/life-expectancy-vs-health...

USA has an order of magnitude higher cost but middling life expectancy comparable to Argentina, Poland, Peru, Colombia etc.

Your comment has been edited extensible since you first posted some misleading numbers, so I'm adding this new comment on one of your additions:

> As long as a profit motive exists, there will be incentives to reduce or avoid care for more profits.

This is reversed from reality. Insurer incentives are to increase care and costs all the time. Their profits are tied to a fixed percentage of total expenditure, so the only way to increase profits is to increase costs.

Start replacing cheaper scans with MRIs, etc. Then profits rise.

Look throughout the entire system, and everybody's incentive is to perform more healthcare. That's the profit incentive throughout the system, from care providers to test providers to insurance companies.

That's a major (but not only) reason healthcare expenditures are such a high percentage of GDP compared to other countries, why healthcare expenditures are $5T per year in the US.

Big numbers with no context come across as a way to misinform.

Viewed in light of total healthcare spending of roughly $5T per year, eliminating insurer profits does not appear to be even a drop in the bucket.

Our healthcare costs are certainly a policy choice, but eliminating profit does not fix the system, and many far more cost effective systems around the world are fully profit based.

Edit: absolutely wild to see somebody more focused on fringe political goals than caring about the health of the most vulnerable of our nation, and the bigger systemic changes that are needed. Fringe, frequently innumerate, and frequently wrong political rags like Jacobin are about politics, not about achieving better outcomes for the American precariat.

That is a sloppy generalization. The Heritage Foundation plan for market based universal medical coverage was put in place in Massachusetts by Mitt Romney and mostly works with related issues like low supply of doctors. There are many options being left of the table for political reasons and comprehensibility.

UnitedHealth has 147 million customers, according to google. 20 billion / 147 million = $136

So they're making $136 dollars per customer in profit. That doesn't seem unreasonable to me. 136 is much less than the crazy costs that people are complaining about.

Are people who like to quote these big numbers just not capable of critical thinking or is it just that they like the chance to rage at capitalism's supposed failings and they know their readers are too dumb to do division?