[galimaufry]

I wonder if there is a niche to ameliorate this sort of thing by offering payday loans on insurance payouts.

The incentives are pro-social: insurance companies have an incentive to delay payouts, because their profits come from interest (they pay out more money than they take in) so the longer they can hold onto money the better. But that's reversed for this hypothetical loan issuer - they want to make the payout as fast as possible in order to earn as much interest as possible as quickly as possible.

And if there's a systematic tendency for medicaid advantage plans to deny claims that eventually get approved, and if you could predict which ones will get approved 'just' by really understanding what medicaid would approve, then this might be self-sustaining or even profitable?

[intended]

There is no niche, that makes a fundamentally inefficient system, more efficient.

If any such niche existed, for any system, then this niche would be the system.

[jml78]

The solution is disallow private insurance being the middle man between medicare and the patient.

What possible benefit to the patient is having a whole bureaucracy sit between the gov't insurance and the person in need of medical care? It only exists to make money off the backs of the people they are harming.

Now, if you don't know why people sign up for them, you don't understand what they are doing. My mom, like many others, was on a fixed income. If you sign up for a medicare advantage plan, they will do things like give you an extra $100 a month to you directly. Why would insurance be willing to PAY you? Because they make all their money billing medicare and denying you coverage.

18 billion in profits last year running a middle man between patients and medicare

[lotsofpulp]

> Why would insurance be willing to PAY you?

Why would the government introduce an intermediary in the first place?

[sizzle]

Network effects. They outsource all the medical billing and management to the big insurance racket companies. Protip: go with a PPO Medicare plan and medigap supplemental plan if you want your loved ones to see any specialists and go to any hospital. I switched mine off the HMO advantage plans to BCBS PPO cause HMO Medicare advantage plans deny everything by default fighting tooth and nail.

[lotsofpulp]

Wikipedia says the government introduced intermediaries to cut costs (i.e. create a scapegoat people can blame for denying claims or reducing payments to providers and not have the finger point at the government).

https://en.wikipedia.org/wiki/Balanced_Budget_Act_of_1997

> The act had a five-year savings goal and a ten-year savings goal following its enactment in 1997. The five-year savings goal was $116.4 billion which would be achieved by limiting growth rates in payments to hospitals and physicians under fee-for-service arrangements.[7]

>This plan also involved the change of the methods of payment made to rehabilitation hospitals, home health agencies, skilled nursing facilities, and outpatient service agencies as well as the reduction of payments to Medicare managed care plans and the slowing of growth rates of these same care plans.[7]

>The ten-year savings goal was $393.8 billion using the same savings methods as the five-year goal to achieve the savings in 2007.[7]

[MoreMoore]

Is it just me or does this sound like a terrible bill? I've gone through the page and it just sounds like it was trying to save money by making healthcare beneficiaries worse off.

[jml78]

I haven't researched how all these came to exist but I assume it is the typical conservative talking point about the free market being more efficient so why wouldn't we want this. It will save us all money. And no, I don't believe any of that BS.

[lenerdenator]

Or, I don’t know, maybe we do what every other Western nation has done and just present a public option for healthcare coverage to the average person?

Nah, better to have millionaires lying to the sick and dying about the company not having the money to pay for the coverage that the sick person paid a hefty monthly premium to provide.

[sofixa]

Nice, a hyper capitalistic solution to a problem which only exists because of a hyper capitalistic system. Why not add another middleman with a financial incentive to a system overburdened by middlemen with financial incentives?

The solution would be to remove useless leeches providing no value or benefit to anyone other than shareholders, not add more of them.

And what do you know, most of the rest of the developed world has managed to do that. And even the parts that have private healthcare have managed to put strict rules controlling it, and costs and outcomes are much better.