[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)