[frgtpsswrdlame]

So this guy had a few twitter exchanges with Luigi and he thinks the US healthcare system isn't that bad? Doesn't really seem like an article for HN. But as long as we're here I think, sort of like Luigi, I'll let other people argue about whether the US healthcare system functions well or efficiently. But as for this:

>While it’s true that UnitedHealthcare has the highest denial rate for medical claims, the CEO doesn’t set the approval rate of a health insurance company’s payouts — that’s done by the actuaries, who themselves are constrained by various considerations, such as the need to keep costs low, including for policyholders.

By this logic, what can Brian Thompson be said to be responsible for? It's very strange to me to assign more responsibility for a companies denial rates to its actuaries than the actuaries' bosses bosses boss. So why exactly does UHC have higher denial rates than other companies? It just happens to be that it's actuaries are more frugal? This explanation doesn't hold water and I think it's a strange response to the shooting of a CEO to say, well actually CEOs aren't responsible for the things their corporations do. Of course they are, now they aren't solely responsible, but they probably have more responsibility than any other single individual. It can be completely true that killing Brian Thompson was wrong AND that he was no saint, being responsible for (and getting rich off of) large amounts of human misery inflicted on UHC policy holders by the organization he headed.

[jnwatson]

One of the author's points was that if United took no profit, it could only very slightly increase services. The only ethical thing that Thompson could have done is advocated for the dissolution of his and his competitors' firms, which would have had him out of a job quickly.

The actual problem is the system where United exists at all. Health insurance provides exceedingly little value for a very high cost.

One issue now is that being in the way of healthcare is now so large as to have its own gravity. Just healthcare administration (no caregiving or treatment) is now about 2% of GDP itself. Restructuring healthcare would mean tens of thousands out of a job.

[tptacek]

No, you've misapprehended the critique; in fact, your comment here isn't even coherent. If you eliminate United altogether, you get a grocery store circular discount on health care; in other words: health care is still altogether too expensive. So the "actual problem" can't be the system supporting health insurance; the problem has to be elsewhere.

It's not hard to see where it is! Go look up the 2022 NHE, which includes a giant spreadsheet breaking down where all the spending is in the system (you want the "by type and program" sheet).

[zeven7]

This comment is a riddle. Say it plainly.

[tptacek]

"Insurers are clearly not the problem with our health care system, as you can plainly see from the NHE."

[gsf_emergency]

Like this one?:

https://www.macpac.gov/publication/national-health-expenditu...

Looked at the table and could not plainly see the problem. Would imagine that time series presented like with an analog of Tim Morgan's Energy cost of Energy for energy markets might help..

[FollowingTheDao]

> The only ethical thing that Thompson could have done is advocated for the dissolution of his and his competitors' firms, which would have had him out of a job quickly.

Since UHC is a publicly traded company, this action would actually be illegal sice teh CEO's job is to protect the shareholder.

I can image many people here have stock in these companies. So, tell me who is responsible? There is greed everywhere you look if you are honest with yourself.

[apothegm]

So a fraction of the number of tech employees out of a job in the last couple years due to interest rate increases and AI panic?

What’s the problem, again?

[jnwatson]

IT unemployment is currently under 4% because the folks that got laid off found new jobs. If you eliminate an entire industry, the unemployed will have a tougher time finding a new job.

The dislocation would be far larger than the tech layoff.