The insurance companies are running the system more than any of the others — it is the finance "wizards" there who put the constraints on the rest of the system. I'll agree somewhat on the pharma companies too, who are also extractive.

You even said it yourself: "Hospitals try to eke out the most out of insurance companies...". Exactly! Because the hospitals and doctors are constrained to do "WHAT IS IN THE BEST INTEREST OF THE PATIENT" — that is their charter (and BTW, that is also the magic phrase to use whenever questioning what they propose to do for a patient or escalating a case). Perhaps a few hospitals or physicians occasionally overdo it, and there are some frauds, but your accusation overall is BS.

The insurance companies have no such constraint — if they do have such a mission goal, it is to OBTAIN MAXIMUM VALUE FOR THE SHAREHOLDERS. And the insurance companies are literally so amoral that they will reward agents for killing people for profit. That is not rhetoric, it is sworn testimony before congress of a person who cut off a patient's coverage, causing their death, and got promoted.

I have seen directly and personally an insurance company deny coverage for a test ordered for a close family member by the Chief Of Cardiology at Mayo Clinic. Mayo Clinic, and that physician are so overbooked they have ZERO motivation to order anything not necessary for the patient in front of them. It took days, and significant extra expense to get it reversed.

There is no way on the planet that anyone in an insurance industry should be able to override the doctors orders of the Director of Cardiology for Mayo Clinic. Or any physician, for that matter.

Medicine is one of the things that should never be run for a profit, and if I were on Luigi Mangione's jury I would acquit on Jury Nullification.

▲

petilon a day ago | parent [-]

An itemized bill from the hospital for about four weeks of his hospital stay. It came to a little over $4 million. https://www.cbsnews.com/news/covid-19-deaths-families-60-min...

Woman charged $143,396.66 for a breast biopsy https://www.marketwatch.com/story/a-doctors-prescription-to-...

Numerous studies have found that when doctors have a financial stake in a hospital, they tend to order more tests and procedures, raising costs for Medicare and other insurers. https://www.nytimes.com/2011/12/13/health/policy/republican-...

▲

toss1 21 hours ago | parent [-]

And you are saying overcharging an insurance company is on the same level as an insurance company denying medical care and directly killing the patient because they don't want to pay?

And your examples justify obviously incompetent insurance people vetoing doctor's orders, exactly how?

Doctors are generally forbidden to treat patients without directly examining them and knowing their cases. How is it that insurance companies are allowed to make life-and-death decisions over medical care —with less competent bureaucrats (who may or may not have a medical license)— without ever even seeing the patient? How is this good for the patient?

Of the 33 developed countries, 32 have figured out how to deliver medical care to all of their citizens, and do so for roughly half or less of the cost in the US. Moreover, those countries are seeing continued longer lifespans, while lifespans in the US are declining, again while spending twice the money. Clearly, for-profit medicine and insurance performs worse on every metric.

▲

petilon 21 hours ago | parent [-]

As it is, insurance rates are rising far faster than inflation rates. Have you checked how much insurance rates have gone on the last few years? It goes up 6% to 25% per year. Where is all this money going? Is it all going to insurance companies? Nope. The price increases are attributable to hospitals, doctors, pharmaceutical companies and so on. These price increases are a form of healthcare denial because a lot of people can't even afford health insurance at all, let alone worry about what is approved/denied by insurance companies.

	▲	ceejayoz 2 hours ago \| parent \| next [-]
		> Is it all going to insurance companies? Nope. The price increases are attributable to hospitals, doctors, pharmaceutical companies and so on. The insurers are buying up the doctors (and paying their doctors more, as a bonus - https://sph.brown.edu/news/2025-11-10/unitedhealthcare-optum...) and the pharmaceutical side (https://en.wikipedia.org/wiki/Pharmacy_benefit_management) of things.
	▲	toss1 20 hours ago \| parent \| prev [-]
		Health insurers tripled their profits while covering 80,000 fewer people 2015-2025 [0] What is the difference between the 32 developed countries who successfully deliver healthcare to all their residents, vs the wealthiest country of all of them who still fails, and yet spends twice what the rest spend? Private Insurance runs the whole thing. And it is a sh*tty business. Insurance company profits do not account for near the 2X difference in spending. That is in the massive waste and bureaucratic overhead of every party trying to keep their heads above water while jumping through the insurer's hoops. Entire bureaucracies exist just to oppose the insurer's bureaucracies. And feeding those bureaucracies consumes an insane amount of physician resources. And exactly zero of it delivers any healthcare to patients. [0] https://healthcareuncovered.substack.com/p/2025-big-insuranc...