[HN Gopher] Deny and delay: The practices fueling anger at U.S. ...
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Deny and delay: The practices fueling anger at U.S. health insurers
Author : pseudolus
Score : 39 points
Date : 2024-12-16 18:45 UTC (4 hours ago)
(HTM) web link (www.washingtonpost.com)
(TXT) w3m dump (www.washingtonpost.com)
| pseudolus wrote:
| http://archive.today/tGL72
| c22 wrote:
| I recently had a procedure denied (after the fact) because the
| price charged was apparently "excessively above the average"
| price for that procedure, leaving me on the hook for the full
| amount. It felt like the opposite of being _insured_.
|
| I also couldn't wrap my head around why they didn't just pay
| whatever they thought it was worth and let me cover the rest.
| xena wrote:
| Doing that would make sense, and we can't have that now, can
| we?
| cogman10 wrote:
| > I also couldn't wrap my head around why they didn't just pay
| whatever they thought it was worth and let me cover the rest.
|
| Because insurance would then just lowball the cost of
| everything.
|
| Insurance needs to either do what they say they do, cover x% of
| procedure cost with a maximum yearly deductible or we need to
| be talking about why we have insurance in the first place.
|
| We need new regulations around health and insurance. Ideally,
| public insurance.
| evoke4908 wrote:
| > Because insurance would then just lowball the cost of
| everything.
|
| They _do_. Many, many billable items are priced to the limit
| that insurance will pay. Insurance and providers have
| agreements on the prices they can charge for certain
| procedures or supplies.
|
| It _used_ to be the norm that insurance would pay their
| maximum and leave the rest to you. Sometimes the provider
| would waive the difference, sometimes it was billed to you.
|
| The cost of healthcare is 100% an artefact of insurance price
| fixing and absolutely nothing else.
| bfrog wrote:
| Insurance is a terrible name for what we have, its not
| insurance, its blackmail.
|
| You dying and zero being paid out by the insurance company is
| the best profit margin they can ask for, that's the entire
| _goal_ of an insurance company at this point.
| s1artibartfast wrote:
| If there are no payouts, then they have to return all
| premiums. They only get paid a percentage of covered care.
|
| This presents it's own set of tradeoffs, namely between
| decreasing premiums to attract subscribers, and what is
| covered, to keep subscribers happy.
| lovich wrote:
| > I also couldn't wrap my head around why they didn't just pay
| whatever they thought it was worth and let me cover the rest.
|
| Because nothing is forcing them to do so. If you don't like it,
| what are you going to do about it? Shoot their CEO or
| something? They have all the leverage.
| vjulian wrote:
| I resent that the Pentagon decides who the bad guys are and
| that the population large accepts what it's told.
| lovich wrote:
| Was this a non sequitor? Not entirely sure how it's related
| to my comment
| ChrisArchitect wrote:
| Related:
|
| _Feds help health insurers hide their dirty secret: denials on
| the rise_
|
| https://news.ycombinator.com/item?id=42408925
| ChrisArchitect wrote:
| Related:
|
| _Doctors Say Dealing with Health Insurers Is Only Getting Worse_
|
| https://news.ycombinator.com/item?id=42398069
| kelseyfrog wrote:
| Calling IncreasePosts to determine whether or not this is just an
| Internet bubble.
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(page generated 2024-12-16 23:01 UTC)