Comment by acdha
7 hours ago
Don’t do pro bono PR for those companies. Healthcare isn’t so complicated that every other country in the world hasn’t been able to solve it for significantly less money and far less stress for users, not to mention better health outcomes in most cases.
Providing a chain of reasoning to support a logical conclusion is not “pro bono PR for those companies”. Claiming that someone doing that seems like an emotional kneejerk reaction to an idea that does not jive with the model of the world you would like to have.
I even provided an example of a healthcare provider choosing to be more transparent. It is always Eli Lilly’s choice to sell their medicine at a flat price to everyone. But it is also in Eli Lilly’s benefit to engage in price discrimination, so that they get paid more by people who can pay more:
https://en.wikipedia.org/wiki/Price_discrimination
Another example of this was when I was in college, US textbooks cost multiple times more than the international version of the textbook I could buy on Abe books or whatever website. Or, coupons for grocery stores. The insurance company has no hand in this.
To be clear, insurance companies also cause waste, because the government does not audit them, and the insurance companies are not staffed appropriately to resolve disputes in a timely manner.
What you gave us wasn’t a chain of reasoning: you just regurgitated the industry’s preferred excuses (“it’s complicated”, “people will use too much healthcare if it’s cheaper”, “liability!”) while begging the questions of whether those are true or why they affect the United States far more than any other advanced country. If you wanted to construct a logical chain of reasoning, that would be far more interesting than repeating another round of simply asserting that the status quo is inevitable.
If you need proof that delivering cutting edge services requiring split second decisions and multiple highly qualified people who are liable to the tune of millions of dollars for each decision is not complicated, then we are living on different planets.
> If you wanted to construct a logical chain of reasoning, that would be far more interesting than repeating another round of simply asserting that the status quo is inevitable.
You are welcome to explain why an insurance company would want to make things so complicated. They don’t make it so complicated for claims on a vehicle or a house. They are earning meager profit margins with the situation as is. There is literally nowhere they could go except up…why are they choosing not to?
And if you can come up with a more efficient system to administer insurance, I’m sure a few rich people like Dimon and Buffett and Bezos would be interested in your services. These two “titans” of industry couldn’t figure out how to make it better.
https://www.forbes.com/sites/brucejapsen/2021/01/04/amazons-...
> it has a problem of supply being nowhere near demand,
Get rid of the patents and this will solve itself in no time.
> The insurance company has no hand in this.
False. Insurance companies in the US own stock in big pharma firms like Pfizer, Johnson & Johnson, Eli Lilly, etc. They maintain substantial investment portfolios and generate returns on premiums and reserves. They also have voting rights as institutional investors.
Yes, no one is stopping US (or other countries’) taxpayers from paying for all the drug trials so that the resulting medicines are in the public domain.
> False. Insurance companies in the US own stock in big pharma firms like Pfizer, Johnson & Johnson, Eli Lilly, etc. They maintain substantial investment portfolios and generate returns on premiums and reserves. They also have voting rights as institutional investors.
This is a wild assertion. The sum total of all 7 publicly listed insurance companies’ market caps is less than Eli Lilly, just one pharmaceutical company. I would need some evidence before believing that health insurance company leaders have any influence on pharmaceutical companies.
I would also be surprised to learn insurance companies hold specific stocks, seems like a risk insurance companies would not take, especially ones that have lots of routine cash expenses. They spend ~85% of their premiums on medical expenses, and probably at least 5% to 10% on their own staff, so they shouldn’t even have much extra cash left to invest for the long term.
https://www.oliverwyman.com/our-expertise/insights/2023/mar/...
Edit: hit posting limit, so to respond to comment below about net income, that Yale link does not seem relevant as it is for all healthcare companies. All 7 publicly listed insurers’ combined annual net income is $35B or less for the previous 20 years, at a profit margin of 3% or less, which is peanuts. The pharmaceutical companies earn much more money than them, which is why the pharmaceutical companies have higher market caps.
> Why are we using market cap as a metric ? Look at investment value.
Because a company that owns influential portions of another company would have that reflected in their market cap. Like Berkshire Hathaway does. with the exception of UNH (due to its healthcare provider business), the other insurance companies are relatively tiny businesses compared to pharmaceutical companies and so cannot be holding any influential amount of stock.
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> US textbooks cost multiple times more than the international version of the textbook
I mean, I think a lot of the incentives behind textbook pricing in the US are honestly not that dissimilar to the ones in healthcare. I know Pearson is particularly egregious for price gouging students because they have exclusive deals with schools to provide the textbook for some specific class or subject. They raise prices because f*ck it why not, they won’t get pushback, which is not a valid reason to do so in most other countries.
"they raise prices because f*ck it why not, they won’t get pushback"
This applies to more and more businesses these days. Textbooks, hospitals, colleges, veterinarians and so on. They basically have a captive audience so they do whatever they want.