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tyre 4 hours ago

> It would be in the insurance companies’ interests to band together to fund the research so they can save huge amounts of money in the long term but they do not do this.

Insurance companies do not want cheaper care.

In the US, insurance companies must spend 80% of premiums on care. So if you pay $1k/mo, they have to pay out at least $800/mo in care. (Not to you specifically, but averaged out across all subscribers.)

This is a cap on their potential profits. They always have to pay out 80% of premiums for care, so how do they make more money?

Well, imagine care is twice as expensive. Instead of paying $800, they have to pay $1600. That sounds worse, but, instead of $200/mo, they now $400/mo for themselves!

So, no, paradoxically, it is not in the interest of people paying for the treatment to save money. Quite the opposite.

radicalbyte 27 minutes ago | parent | next [-]

I tried to explain to people in The Netherlands this exact problem when they were thinking about switching from single-player to a commercial insurance company model.

Insurance companies always have an incentive to make healthcare services expensive. They have even more incentive to make healthcare expensive and do deals on the backside where their suppliers give them a kickback. Even better if said kickback comes via a side door.

So we went for the commercial insurance companies. It took them 4 years before they change the drug choice from decentralised (Pharmacies deal with drugs companies, received small discounts which funded a good quality of care) to centralised (Insurance deal with drug companies, receives kickbacks) and the Pharmacies funding was drastically cut leading to worse quality of care and more drugs being used. Double-whammy because in the previous system the Pharmacy did medication reviews which almost always result in a reduction in drugs (the thing with drugs is that quite a lot of them are given to reduce side effects of other drugs, the original drug gets cancelled but the side effect reducer gets forgotten and just continues ad infinitum).

Health insurance has been super inflationary since then when controlled for quality of care.

digi59404 an hour ago | parent | prev | next [-]

It's worse than this. Their cap is 80% of the Insurer's profit. Not the Insurer's Parent company. So often the parent company will own the Insurer as a subsidiary and own the Pharmacy, Hospital, Healthcare etc under the parent company.

This way as costs go up, it's really just bypassing the 80%. Because the hospital can charge the insurance subsidary X amount, and then the hospital profits to the parent company.

There needs to be a law in the US that health insurance organizations cannot be owned by anyone who owns a healthcare provider. Nor can the insurance company own healthcare providers.

We've allows the Ma Bell of healthcare to exist.

lesuorac 2 hours ago | parent | prev | next [-]

> So, no, paradoxically, it is not in the interest of people paying for the treatment to save money. Quite the opposite.

I'll assume they're on company insurance. Which is often "self-insured" in that the company actually foots the bill as opposed to the insurance company.

Why don't corporations just drop insurance companies that decide to not allow cheaper medicines?

doctorpangloss 2 hours ago | parent [-]

UNH is so big because its customer Apple has its own pool. Apple deducts $24k/y for your healthcare. Healthy 29 year old male doesn't use anything. UNH denies the claims anyway. It gives that money back to Apple, which doesn't give it to you.

The 80% rule has a lot of loopholes. It doesn't apply to employer funded plans. There's a reason UNH is so big!

ttoinou 3 hours ago | parent | prev | next [-]

They operate with similar supply and demand constraints and competition, even with prices increasing

lotsofpulp 2 hours ago | parent | prev [-]

>Insurance companies do not want cheaper care.

Why is there a continuous stream of healthcare providers threatening to or becoming out of network for various managed care organizations because they cannot come to an agreement on healthcare prices?