When arguing that health insurance isn't that inneficient he talks about "But when we look at United Health Group’s operating costs in the diagram above, they’re only 22.6% of the actual cost of medical care.". 22.6% for a middleman is not insignificant! Also providers have to spend a lot dealing with insurance so it's certainly an undercount of their total cost. This makes the burden of insurance seem like a huge % of the total medical costs in the US, which seems like the opposite of what he's trying to argue.

Overall, there are lots of nitpicks with this article but my personal takeaway is: if this is the best defense people can make for the US medical insurance system then that shows how bad it really is.

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polski-g 3 days ago | parent | next [-]

22% isn't bad to remove the need for me, personally, to negotiate prices for services. I wouldn't know where to begin on how to price a bone marrow transplant, but UNH does.

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pfannkuchen 3 days ago | parent | prev | next [-]

I don’t like the current system at all, but is insurance really just a middleman? Like part of their function is being a middleman, but they also apply some kind of cost smoothing that is outside what a pure middleman would do.

	▲	tdb7893 3 days ago \| parent [-]
		I don't think it's odd for a middleman to have some functions in a market (as long as they aren't actually producing anything) but also the definition of a middleman is unimportant to me. I am just highlighting how he glides over a lot in this article (some of which are actually common progressive critiques of the insurance system) and I don't come away from it sympathetic to medical insurance companies at all.

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collingreen 3 days ago | parent | prev [-]

Well said. If this is the steel man then it's worse than I thought.