US Healthcare stinks thread (2 Viewers)

[Wildcat]

Naive MoP wanting to pivot off the murder for a minute to understand why folks are angry at their health insurance providers

-I thought a lot of this was cleared up in the ACA/Obamacare, and to be blunt we have decent health insurance coverage thru our work and largely do not visit the doctor much so I guess I don't understand what the problem is. I thought we addressed these issues back with the ACA

-I had to wait on the phone almost 45 minutes the other day to get an eye exam scheduled, is that the type of things people are discussig?
I think most folks need to try and be their own doctor and take action so they don't frequent the doctor's offices.

But I understand people have pre-existing conditions and cannot help but see the doctor semi-often so I'm probably clueless what is really happening

My example - I tore my meniscus 3 weeks ago - MRI confirmed. I need surgery, which was scheduled for next Wednesday the 11th. Doctor called yesterday - insurance is holding it up because we now need to wait 30-45 days to authorize for some reason. I have met all my out-of-pocket expense for 2024 and would have cost me zero dollars if I have the surgery yet this year. Now it's going to be January, full cost for me, and I need to limp along for another month in pain. It's a total ploy to defer the costs to me. I get why they are doing it, but don't lie to me and tell me it's because of something else.

 

[HellToupee]

There aren’t that many high profile murders that go unsolved are there? I think it is like 90% they find this guy, and likely very soon.

I’m going with 99% now

If these pictures are the same person I’m guessing they will have the killer soon

 

[HellToupee]

1

New photos out of shooter with a clear full face shot.

Link
@Ministry of Pain

Looks like a totally different backpack and jacket . I wonder where this is from

Thought the same thing re; the jacket and bag. Think I read this pic was from a hostile the suspect supposedly stayed at prior.

Who the hell stays in a hostel. Just another strange piece of the puzzle

 

[massraider]

People can really defend anything, can't they?
They can defend a guy murdering someone else, and they can defend insurance companies.

Unreal.

@FBG Moderator I don't think this is what you want on this forum.

What's the issue with an observation that people can, and DO, defend anything?

 

[Dr_Zaius]

Idk, I'm not sure if these guys really look that similar.

One guy looks like Eminem, the other with the thick eyebrows/smile looks nothing like that.

I've read other sites that claim this is not the same person.

Yeah I've seen the same, that the person pictured is a person of interest who may know the shooter but not the shooter himself. Early enough in the news story to not discount these facts circulating being wrong IMO.

 

[Ministry of Pain]

1

New photos out of shooter with a clear full face shot.

Link
@Ministry of Pain

Looks like a totally different backpack and jacket . I wonder where this is from

Thought the same thing re; the jacket and bag. Think I read this pic was from a hostile the suspect supposedly stayed at prior.

Who the hell stays in a hostel. Just another strange piece of the puzzle

Who stays in a Hostel?
Younger folks usually

 

[Scoresman]

Idk, I'm not sure if these guys really look that similar.

One guy looks like Eminem, the other with the thick eyebrows/smile looks nothing like that.

I've read other sites that claim this is not the same person.

Yeah I've seen the same, that the person pictured is a person of interest who may know the shooter but not the shooter himself. Early enough in the news story to not discount these facts circulating being wrong IMO.

What if this guy really is a pro and he hired someone who looks and dressed just like him to act as a red herring for authorities to go after?

 

[Grace Under Pressure]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

How do you increase your profit every year? Higher premiums, less coverage.

This CEO, every year he worked there, signed off on changes that he well knew were implicitly saying "we're going to cause more people to die, and more people to go bankrupt this year, but we will make more profit to appease our shareholders and match our expected growth rate".

It's not his fault. As CEO of a public company, that's his job. And he was paid handsomely (to the tune of about $25M/yr) to execute that job. But it shows the, for lack of a meaner word, "challenges" of a system designed in this way.

Good points in this post about health insurance and criticisms of how the US system is structured. Quick detail though about the UNH the company that gets often conflated, because the names of the corporation and its business divisions are confusingly similar.

The CEO of UNH, UnitedHealth Group, is Andrew Witty.

Brian Thompson was the CEO of UnitedHealthcare, one of the two divisions that comprise UnitedHealth Group. The other division is Optum. The names are similar, but even where they place spaces in them is slightly different.

This distinction has been conflated a lot on social media. What makes this noteworthy (IMO) is that the victim was seemingly very specifically targeted. A general search of UNH CEO largely leads to results bringing up Andrew Witty, so someone did their homework to specifically identify Brian Thompson as their target.

Maybe this detail won't matter much once we find out why this took place. Just wanted to point it out in case some readers may not be familiar with that nuance about the company. Really good post though, and sorry to be a guy who nitpicks here. If it wasn't potentially a distinction in the case of what happened, I wouldn't have.

 

[djmich]

People can really defend anything, can't they?
They can defend a guy murdering someone else, and they can defend insurance companies.

Unreal.

Its almost like people can distinguish between murder and a company meeting a market demand.

 

[Nugget]

Elon Musk recently had a retweet of a graphic that depicted much of the wasteful spending in HC...not sure of its accuracy. I'll try to find it. (not a political post)

Tell you something that grinds my gears - Moda Health slapped their name on the Rose Garden here in Portland for a mere $40 Million. How are people struggling to afford healthcare supposed to feel when their insurance provider raises rates and then spends $40 Million to name a sports arena? Infuriating.

And as a dad with a type 1 diabetic, I can relate with some parents who might feel a slight tinge of anger towards their health care providers. Darth Vader had a better heart than some of these evil empires.

GEHA Field at Arrowhead Stadium has also had me shaking my head.

GEHA (Government Employees Health Association) is a self-insured, not-for-profit association providing medical and dental plans to federal employees and retirees and their families through the Federal Employees Health Benefits (FEHB) program and the Federal Employees Dental and Vision Insurance Program (FEDVIP).

GEHA provides benefits to more than 2 million people worldwide.

 

[Stoneworker]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

 

[RCon]

Naive MoP wanting to pivot off the murder for a minute to understand why folks are angry at their health insurance providers

-I thought a lot of this was cleared up in the ACA/Obamacare, and to be blunt we have decent health insurance coverage thru our work and largely do not visit the doctor much so I guess I don't understand what the problem is. I thought we addressed these issues back with the ACA

-I had to wait on the phone almost 45 minutes the other day to get an eye exam scheduled, is that the type of things people are discussig?
I think most folks need to try and be their own doctor and take action so they don't frequent the doctor's offices.

But I understand people have pre-existing conditions and cannot help but see the doctor semi-often so I'm probably clueless what is really happening

My example - I tore my meniscus 3 weeks ago - MRI confirmed. I need surgery, which was scheduled for next Wednesday the 11th. Doctor called yesterday - insurance is holding it up because we now need to wait 30-45 days to authorize for some reason. I have met all my out-of-pocket expense for 2024 and would have cost me zero dollars if I have the surgery yet this year. Now it's going to be January, full cost for me, and I need to limp along for another month in pain. It's a total ploy to defer the costs to me. I get why they are doing it, but don't lie to me and tell me it's because of something else.

Exact same thing happened to me last year. They delayed because I had already hit my cap. Not only that, they waited until a few days before the surgery to deny, even though it had been scheduled and submitted for months. I got my state consumer board to sue them, won, and got the surgery a few days before 2023 ended.

 

[CletiusMaximus]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

How do you increase your profit every year? Higher premiums, less coverage.

This CEO, every year he worked there, signed off on changes that he well knew were implicitly saying "we're going to cause more people to die, and more people to go bankrupt this year, but we will make more profit to appease our shareholders and match our expected growth rate".

It's not his fault. As CEO of a public company, that's his job. And he was paid handsomely (to the tune of about $25M/yr) to execute that job. But it shows the, for lack of a meaner word, "challenges" of a system designed in this way.

Good points in this post about health insurance and criticisms of how the US system is structured. Quick detail though about the UNH the company that gets often conflated, because the names of the corporation and its business divisions are confusingly similar.

The CEO of UNH, UnitedHealth Group, is Andrew Witty.

Brian Thompson was the CEO of UnitedHealthcare, one of the two divisions that comprise UnitedHealth Group. The other division is Optum. The names are similar, but even where they place spaces in them is slightly different.

This distinction has been conflated a lot on social media. What makes this noteworthy (IMO) is that the victim was seemingly very specifically targeted. A general search of UNH CEO largely leads to results bringing up Andrew Witty, so someone did their homework to specifically identify Brian Thompson as their target.

Maybe this detail won't matter much once we find out why this took place. Just wanted to point it out in case some readers may not be familiar with that nuance about the company. Really good post though, and sorry to be a guy who nitpicks here. If it wasn't potentially a distinction in the case of what happened, I wouldn't have.

Also to further confuse - "UNH" is the NYSE stock ticker symbol for the company "United Health Group" - which is typically shortened to UHG. UHC and Optum are the two divisions of UHG, with UHC being the insurance arm (and other things). I speak with someone at UHC or Optum at least once per week, including a call this morning. My impression is that most of the people who work for UHG can't accurately describe the different affiliates and what they all do. At times it seems they are interchangeable and at other times it seems someone working on one floor has no ability to coordinate with someone else at a different affiliate. It doesn't help that they are constantly acquiring and integrating other companies with different systems. However, if this murder was intended to target the health insurance part of the company, it appears they were able to identify the person at the top of that service.

 

[Navin Johnson]

I don’t think I’ve ever had a claim denied. Is it really a common occurrence that people can’t get stuff covered?

As posted above, UHC's denial rate is double the industry average (32% vs 16%)

 

[Fat Nick]

I don’t think I’ve ever had a claim denied. Is it really a common occurrence that people can’t get stuff covered?

Same - and we've had UHC for coverage for about a decade or so. It's been fine. Not perfect, but covered our 2 kids, including a NICU stay, covered THREE meningioma spinal surgeries for my wife too. Probably close to $1M all-in for those. We were usually out of pocket $12K or so to hit our max, plus the cost out of my paycheck.

Admittedly my wife is very good at navigating the system. I think that's where the issues come in. You need an advanced degree to understand their fine print.

This has been circulating. Caveat: I'm not entirely sure of the source.

x.com

x.com

Just to be clear - I'm not saying I disagree (or agree) with any of those figures. UHC may very well be the worst of the lot...just agreeing with @dgreen that I've never had an issue. There's far too many stories out there about denials happening for me to think they don't, but with that said, as others have pointed out, I'm still far better off with coverage.

 

[FreeBaGeL]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

 

[matttyl]

The other interesting part of this health insurance debate is companies/organizations that self fund.

My work uses Aetna for the insurance. I work at a non-for-profit with 500-600 full time employees. I know my work self funds the health expenses. Therefore, we pay Aetna to administer the plan but any overage or under is paid by my employer. It almost seems like my employer pays Aetna to be the bad guy if things aren't being covered by the plan.

I'm not sure if @matttyl has any thoughts on this arrangement and how common it is. I would guess many large corporations do the same.

Yes, most do. Mine does. It puts you in an insurance network (examples above if that discount), but doesn’t provide (or rather may not provide) actual “insurance”. Sometimes you do in fact buy a policy, but it’s for those rare $1m+ claims that would totally drain your bucket.

 

[Stoneworker]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

No. They are not growth companies. They are well-run blue chip companies.

P/E ratios across the board are at historically high levels. The Dow (to which all those blue chips belong) is currently 36% higher than historical average.

So pulling out a P/E ratio in isolation without historical or comparable company context is misleading at best.

 

[djmich]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

No. They are not growth companies. They are well-run blue chip companies.

P/E ratios across the board are at historically high levels. The Dow (to which all those blue chips belong) is currently 36% higher than historical average.

So pulling out a P/E ratio in isolation without historical or comparable company context is misleading at best.

Someone mentioned earlier that margins were in the low single digits. A high PE can represent the markets expectation that they, god forbid, grow into the high single digit margins.

 

[Nugget]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

No. They are not growth companies. They are well-run blue chip companies.

P/E ratios across the board are at historically high levels. The Dow (to which all those blue chips belong) is currently 36% higher than historical average.

So pulling out a P/E ratio in isolation without historical or comparable company context is misleading at best.

Sherwin Williams and Disney are both in Vanguard Growth Index Fund - both as top 50 holdings.

 

[Nugget]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

No. They are not growth companies. They are well-run blue chip companies.

P/E ratios across the board are at historically high levels. The Dow (to which all those blue chips belong) is currently 36% higher than historical average.

So pulling out a P/E ratio in isolation without historical or comparable company context is misleading at best.

Someone mentioned earlier that margins were in the low single digits. A high PE can represent the markets expectation that they, god forbid, grow into the high single digit margins.

By law, insurance companies really can't grow their margin much higher. They have to provide 85% of their premiums to actual medical care costs. If they are around 11% admin costs, they can really only make around 4%. Most of their growth would be from additional customers or additional policies - more supplemental policies for medicare/medicaid perhaps. Link

 

[El Floppo]

Ah... So I see we've moved into the inevitable stock and business segment of the murder mystery conversation

 

[Stoneworker]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

No. They are not growth companies. They are well-run blue chip companies.

P/E ratios across the board are at historically high levels. The Dow (to which all those blue chips belong) is currently 36% higher than historical average.

So pulling out a P/E ratio in isolation without historical or comparable company context is misleading at best.

Sherwin Williams and Disney are both in Vanguard Growth Index Fund - both as top 50 holdings.

It's a large-cap fund that also includes GE, Texas Instruments, Costco and Mastercard. So I guess if that's the definition then go for it

 

[djmich]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

No. They are not growth companies. They are well-run blue chip companies.

P/E ratios across the board are at historically high levels. The Dow (to which all those blue chips belong) is currently 36% higher than historical average.

So pulling out a P/E ratio in isolation without historical or comparable company context is misleading at best.

Someone mentioned earlier that margins were in the low single digits. A high PE can represent the markets expectation that they, god forbid, grow into the high single digit margins.

By law, insurance companies really can't grow their margin much higher. They have to provide 85% of their premiums to actual medical care costs. If they are around 11% admin costs, they can really only make around 4%. Most of their growth would be from additional customers or additional policies - more supplemental policies for medicare/medicaid perhaps. Link

Thanks, agree. 3% to 6% is still 100% growth, but you are right in terms of how they grow...which to your point is generally not by denying claims.

 

[Scoresman]

People can really defend anything, can't they?
They can defend a guy murdering someone else, and they can defend insurance companies.

Unreal.

@FBG Moderator I don't think this is what you want on this forum.

What's the issue with an observation that people can, and DO, defend anything?

The issue is that you're being a dirtbag. Defending insurance companies is in no way similar to defending cold-blooded murder, and I think there is something psychologically wrong with you if you feel that way. I am being 100% serious. I don't like having to share a society with people like you.

I didnt necessarily read it like he was equating the two.

 

[IvanKaramazov]

People can really defend anything, can't they?
They can defend a guy murdering someone else, and they can defend insurance companies.

Unreal.

@FBG Moderator I don't think this is what you want on this forum.

What's the issue with an observation that people can, and DO, defend anything?

The issue is that you're being a dirtbag. Defending insurance companies is in no way similar to defending cold-blooded murder, and I think there is something psychologically wrong with you if you feel that way. I am being 100% serious. I don't like having to share a society with people like you.

I didnt necessarily read it like he was equating the two.

I did. This particular poster has a very long history of winking and nodding at open violence. I was actually wondering yesterday why he hadn't posted in this thread, because sort of thing is usually right his alley. I imagine he was having too much fun watching the video to pull himself away.

 

[Nugget]

And that will continue, because it's by design. UNH isn't just a for profit company. They have a P/E ratio of almost 40. They're a GROWTH company. They don't need to just make profit every year, they need to make MORE profit every year.

Wal-Mart's P/E ratio is 38. Is that a GROWTH company?

Sherwin-Williams' P/E ratio is 39. Is that a GROWTH company?

Walt Disney's P/E ratio is 43. Is that a GROWTH company?

Yes, of course they are.

Disney doesn't even pay a dividend. People only buy that stock for growth. Granted they've been bad at it the last few years, but growth is 100% the intent of Disney and people that buy the stock. That's why they created Disney+. That's why they just budgeted $10B for park expansions.

Walmart pays a tiny dividend and has increased profits virtually every quarter for the last 15 years. The stock is up 85% this year because those profits have grown so fast the last few years.

ETA: Disney did just start paying a tiny dividend.

No. They are not growth companies. They are well-run blue chip companies.

P/E ratios across the board are at historically high levels. The Dow (to which all those blue chips belong) is currently 36% higher than historical average.

So pulling out a P/E ratio in isolation without historical or comparable company context is misleading at best.

Sherwin Williams and Disney are both in Vanguard Growth Index Fund - both as top 50 holdings.

It's a large-cap fund that also includes GE, Texas Instruments, Costco and Mastercard. So I guess if that's the definition then go for it

To you original point, UNH is the #3 holding in the Vanguard Value Index fund, with Wal-Mart coming in at #9. Looking at both lists, I'm not sure I see a huge dividing line. I'd prefer to VTI and chill.

 

[massraider]

The issue is that you're being a dirtbag. Defending insurance companies is in no way similar to defending cold-blooded murder, and I think there is something psychologically wrong with you if you feel that way. I am being 100% serious. I don't like having to share a society with people like you

Well golly

 

[Joe Bryant]

That will be enough for this one.

I know nothing about the man who was killed but a person was murdered and kids lost a father. That sucks.

Let's drop this one for now.