Comment by crazygringo
7 hours ago
> health insurers...'re on your team and benefit from lower prices just as much as you do
You're missing a very, very, very important piece here.
Which is that the lowest price of all is to deny treatment entirely.
They are not on your team, they are the opposite team. Their revenue is basically fixed, at the level of your premiums. But the more health care they pay for you to receive, the less profit they make. That's just arithmetic.
This is why there are so many horror stories of people being denied necessary treatment, or having to fight for months and years to get their treatment actually paid for. Insurance providers are incentivized to do their absolute best at taking your money and then not paying for care, through every sort of technicality and "mistake" and arbitrary judgment and limit they can come up with.
No, that's not how it works. Due to the ACA minimum medical loss ratio, most health plans have no direct financial incentive to deny treatment.
It's nice to know they do it just for the love of the game.
Mostly they do it because their customers (employers that sponsor health plans) ask them to in order to hold down costs.
The several+ times in my life I've had to sort out billing issues, the health "insurance" agents have been helpful and friendly, stating what bills should be in no uncertain terms, even offering to conference call with billing departments to get things resolved, etc... Meanwhile provider billing departments routinely try to defraud me, even going so far as to bully me to pay those fraudulent amounts, don't follow up on things (eg filing claims) that are their responsibility and that they've said they will take care of, and generally make their problems into my problems.
This certainly isn't a defense of health "insurance" companies though! I just think they're better modeled as Lovecraftian horrors animated by paperwork and compelling the creation of ever more paperwork to feed on, rather than money-grubbing cheapskates as the pop-political narrative goes. And the approaches for fixing one are much different than the approaches for fixing the other.