[HN Gopher] U.S. Launches Antitrust Investigation of UnitedHealth
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U.S. Launches Antitrust Investigation of UnitedHealth
Author : moose_man
Score : 104 points
Date : 2024-02-27 21:46 UTC (1 hours ago)
(HTM) web link (www.wsj.com)
(TXT) w3m dump (www.wsj.com)
| moose_man wrote:
| https://archive.ph/meOGZ
| stop50 wrote:
| I sense a new glauckomflecken video.
| LordDragonfang wrote:
| My first thought as well. Everything I know about UH and Optum
| (all of it negative) come from his videos, and it makes me
| appalled that any company like this is allowed to exist, when
| every study seems to indicate that patient in private-equity-
| owned care experience worse, more expensive care. It's the
| opposite of "capitalism creating efficiency".
| NickC25 wrote:
| > _opposite of "capitalism creating efficiency"_
|
| It's rent seeking behavior by an actor that pretty much is a
| negative value-add from a patient's perspective. They are a
| cancer.
| stop50 wrote:
| Its my primary source of Schadenfreude, because whenever he
| says anything about insurance covering, i usually research it
| and come up with that it is covered.
| athenot wrote:
| For those not familiar, here is the one on Optum & United
| Healthcare:
|
| https://www.youtube.com/watch?v=_khH6pZnHCM
| mindslight wrote:
| How is there an argument of wrongdoing here when the regulatory
| fashion for healthcare is still based around this idea that
| multiple anticompetitive arrangements (price fixing between
| providers and "insurers") will somehow result in a functioning
| market?
| throwway120385 wrote:
| Given the way United Healthcare is organized, with Optum as a
| second party that all claims or other billing issues is directed
| to, this allows them to very effectively point the finger at each
| other whenever there is a dispute. Optum in turn owns a lot of
| care providers including a ton of providers in my area. They have
| used this as a cudgel in the past, as someone I know was slammed
| with a bill during Optum's takeover of one of their providers.
| The Optum employee wouldn't provide any information about the
| charge and simply fired them as a patient for not paying it.
| Because Optum is buying up clinics left and right where we live
| this person has lost access to their PCP on multiple occasions as
| Optum buys more and more healthcare groups.
|
| UHC and UnitedHealth group need to be broken up, and these
| incestuous relationships between insurance companies, private
| equity companies, and care providers need to be stopped by the
| SEC, because their only purpose is to exploit the wrapping up of
| care providers under one umbrella to extract more money for less
| work from people seeking essential services.
| NickC25 wrote:
| > _UnitedHealth executives have said that Optum and
| UnitedHealthcare don't favor one another_
|
| Yeah, that's laugh-out-loud levels of bullshit.
|
| You think executives are just going to admit to facilitating what
| effectively is a form of racketeering?
|
| NINJA EDIT: The Optum arm itself needs to be broken up into a
| bunch of smaller pieces. United Healthcare also needs to be
| broken up.
| AuryGlenz wrote:
| That's insane. The archive link isn't working for me so I can't
| read the article, but we received a letter that any long term
| prescriptions might need to go through Optum and that we'd only
| be able to fill a few at a local pharmacy before the refused to
| cover them.
|
| I was a bit flabbergasted as that didn't seem like it could
| possibly be legal.
|
| By the way - that's absolutely not great if you have controlled
| medications, as you need to sign for them and can't exactly get
| them filled early. I take three different ones. Luckily my wife
| and I work from home.
| bearjaws wrote:
| Go after all the healthcare giants. If people knew even half of
| how consolidated their treatment was, they would riot.
|
| For those who don't know about the significant conflict of
| interest present here:
|
| 1. United is a health insurer that has to make payments for
| people's
|
| 2. United owns several physician networks (totaling 90,000
| physicians), who then determine what your care should be--no
| conflict with the fact that they pay the bills...
|
| 3. United owns Optum, which determines how much your drugs are
| going to cost, and of course, who makes them--brand vs. generic,
| etc.
|
| 4. Optum runs its own mail order and specialty pharmacies. Optum
| also writes your care plans for many chronic diseases and ships
| medications all over the country.
|
| 5. Optum could require their own customers to use their care
| plans and software in order to receive medications at all, or
| mark up the price for anyone who doesn't.
|
| Let's step through a workflow.
|
| You, a patient, go to a physician for treatment. Later on, you
| get referred to a specialist, then get diagnosed with a chronic
| disease and need medication that you receive delivered monthly.
|
| That pans out to:
|
| United pays United, who refers you to United, that forwards you
| to Optum (owned by United), who gets paid by United. Each and
| every month.
|
| How is a health system or an independent supposed to compete with
| that level of integration?
|
| This, of course, does not result in any savings or quality of
| life improvement for the patient or the physician. United and
| Optum charge the same prices as everyone else, or more.
| mywittyname wrote:
| > If people knew half of how consolidated their treatment was
| they would riot.
|
| My partner deals with claims denials for care providers and if
| someone wrote a book on the stuff she's seen happen, I
| genuinely think it would be akin _The Jungle_ for modern
| audiences in terms of cultural impact.
| not2b wrote:
| Yep. I have UHC through work. I'm on an expensive medication
| and UHC requires that I order it through Optum, so they keep
| more of the money. At least neither of the doctors I usually
| see work for them, so I don't have that conflict.
| joncp wrote:
| And has Optum conveniently forgotten to ship refills, but
| only for the expensive drugs? That happened to my wife on
| multiple occasions.
|
| Or maybe they've rejected refill requests until right before
| your supply runs out, such that you have to go days without
| your meds while the new supply is shipped?
|
| Optum is the shadiest shitshow I've ever dealt with.
| not2b wrote:
| They make it extra painful sometimes when it's time to
| refill, requiring re-authorization every year. My doctor
| has a woman working for his practice who spends almost full
| time battling insurance companies so that patients can get
| their meds, and she's been my ally at managing these
| fights.
| khuey wrote:
| > My doctor has a woman working for his practice who
| spends almost full time
|
| Yep, and this is the sort of make work that the health
| care system is full of that drives up costs for everyone.
| joe_the_user wrote:
| _If people knew half of how consolidated their treatment was
| they would riot._
|
| Most Americans experience first hand how horrible health care
| here is. No one can upset at whatever little details are
| involved, however 'cause it's beyond them. Especially, you
| won't get people excited about more competition in a field
| where markets and competition seem neither logical nor have
| shown any benefit.
|
| The complex referral system you describe basically result in
| turn regulated monopoly behavior into unregulated monopoly
| behavior. And this is the upshot of breaking up the original,
| regulated monopoly Blue Cross/Blue Shield, which provided
| adequate insurance in America's "Golden Era". Which to say
| that, imo, "restoring the free market" isn't a useful action in
| this mess. State controlled medicine is essentially the only
| solution to the already partly collapsed US health care system.
| cyanydeez wrote:
| the healthcare complex employs millions. all these people
| would lose jobs.
|
| so there's really zero political will to crack the monolith,
| and why things like Obama care go forward, because they're
| bandaids.
|
| then there's the who employer leverage that businesses live
| having to immobilize a significant portion of their work
| force.
|
| it's absolutely not complicated to understand why nothing has
| moved the needle.
| SteveNuts wrote:
| Right. If these huge insurance companies had to "compete"
| with a real universal system, there's no way they could
| even exist. All they do is scrape profit off the top of
| every healthcare procedure in the US.
|
| The most useless middleman to ever exist, in my opinion.
| oatmeal1 wrote:
| > Which to say that, imo, "restoring the free market" isn't a
| useful action in this mess. State controlled medicine is
| essentially the only solution to the already partly collapsed
| US health care system.
|
| I don't trust the US government is competent enough to run
| healthcare. If it can do better than the existing system, let
| it create a new voluntary, unsubsidized insurer, free of the
| BS rules it has created. Competition is the source of quality
| and low prices. Any monopoly is an invitation for poor
| quality and high prices.
| rainsford wrote:
| That kind of extractive, anti-consumer business model would be
| worth going after in any industry, but it feels especially bad
| in health care. Most health care isn't optional for the
| patient, and of course the more non-optional the care is the
| more expensive it tends to be. And serious health problems are
| both rare and incredibly stressful for the patient. Someone
| with cancer is going to have no experience shopping around for
| oncologists and will be willing to pay almost anything not to
| die.
|
| It's almost the worst possible scenario for consumer driven
| free market dynamics. My personal opinion is that giant health-
| care conglomerates probably shouldn't exist at all. But if they
| do, they should be subject to _much_ higher standards when it
| comes to things like antitrust than regular companies.
| ChrisArchitect wrote:
| Related:
|
| _US pharmacy outage triggered by 'Blackcat' ransomware at
| UnitedHealth unit, sources say_
|
| https://www.reuters.com/technology/cybersecurity/cyber-secur...
|
| (https://news.ycombinator.com/item?id=39524514)
| Blackthorn wrote:
| Optum is the most garbage organization that has absolutely ruined
| local healthcare. I go out of my way to find places that aren't
| affiliated, even though they're much further distance, just to
| avoid them. It's about time this happened.
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(page generated 2024-02-27 23:00 UTC)