UHC has one of the highest rates of claim denials. Sure, there are some people getting the support they need but there are a lot of people who are not. What justification is there for that? The only justification is "profit", and that is not something that should ever be involved in healthcare.
It should be noted that not all claims denials mean people aren't getting the support they need.
For example I had an insurance company not want to pay for a particular prescription drug my doctor prescribed. They were happy to pay for treating me, but they wanted it be done with some other drug.
They actually had a medical reason for this. The drug I had been prescribed had recently been found to have a risk of bladder cancer. There were other drugs just as effective but that did not have that risk and so they had removed it from their formulary.
In this case I wanted the first drug because I had used it before and knew that it worked well for me and that I didn't get any of the numerous annoying side effects that it and the alternatives could all have, and I had good reason to believe that I'd only need to be back on it for a month or two and then would be permanently done with it.
I concluded that the risk of bladder cancer from a couple months of the drug were negligible and preferable to dealing with drugs I'd never had before.
My doctor probably could have convinced them to go ahead and approve a one month subscription with the possibility of one refill, but I realized the drug was one of the ones that Walmart had on their $4 drug list and so had my doctor send the prescription there and I bought it for the cash price.
BTW, that $4 cash price at Walmart was cheaper than what I would have paid if my doctor had convinced the insurance to cover it and I filled the prescription at my regular pharmacy.
Health insurance companies are also legally bound by payout ratios. Having a higher denial rate doesn't mean they're paying out less money than other companies.
Ahaha, yeah, right? It's just ridiculous. What a laughable debate, this whole insurance thing is. It's just the free market working to optimize outcomes.
By the way, can you help me understand what a 'pre-existing condition' is?
Literally nobody outside of America has experience with this term.
Most health insurance in most of the world has the concept of "pre-existing conditions".
How could it be otherwise? Insurance was invented to hedge risk. In the case of healthcare, if you literally already have a condition that has known and ongoing costs associated with it, it doesn't make any sense for an insurance company to insure you against that risk – the risk has already manifested.
No, that's not right. Public health insurance in the EU does not use that concept. Participating insurance companies are not allowed to set rates that way, since it doesn't serve the public good.
Only since the Affordable Care Act (“Obamacare”). Before that, it was common to not be able to get insurance with pre-existing conditions at all without being covered by your employer. And even sometimes your employer’s plan had a waiting period for pre-existing conditions. I got stuck without insurance for a long time after college (being able to stay on your parents’ plan after graduation is also an ACA provision) and still have nightmares about it.
Plenty of people outside the US will have experience with pre-existing conditions as a factor in health insurance.
For example many Germans will have experience with it because they have a system that has both a public and a private system. Those with high enough income (around 70k Euros) can opt out of the public system and use the private system instead. Also there are some classes of people that only can get part of their coverage from the public system and so need to buy additional coverage through the private system.
Insurers in that private system can take into account pre-existing conditions. They cannot reject an application over pre-existing conditions but they can charge higher premiums because of those conditions.
Another example is Switzerland. They have a universal healthcare system based on mandatory insurance from private health insurance companies. For that mandatory insurance pre-existing conditions are not a factor, but there is also supplemental insurance available that covers things not included in the mandatory insurance.
The supplemental providers can and do consider pre-existing conditions when deciding whether or not to provide coverage.
Only a “laughable debate” and “just the free market” if you haven’t actually had to deal with these insurance companies when you have a health issue and have never paid your dues late. I’m guessing you’re from somewhere in Europe with universal health care?
I'm foreign to the US and no longer work there (Thanks to Trump, literally and directly.)
While I was there... I literally worked for an insurance company. I have also done work for a pharmaceutical company.
The motivation in healthcare in the US is purely profit. It is not like that anywhere else in my experience.