Re:Who Will Rein in Facebook? Challengers Are Lining Up
by nradov on Sunday October 29, 2017 @11:10PM
(#15582889)
Medical "insurance" barely even exists anymore in the US. Most large employers and other group buyers self insure and hire an insurance company mostly to just administer claims. So the insurance company isn't really paying, although they still have an incentive to hold down costs and prevent unnecessary procedures for competitive and quality reasons.
Re:Who Will Rein in Facebook? Challengers Are Lining Up
by Spooky23 on Monday October 30, 2017 @01:14AM
(#15583217)
The consolidation of providers into big networks broke that virtuous cycle.
Your health provider has zero financial incentive to improve your health, and your employer or insurer will get more ROI from nitpick things like delaying claims or pushing out prescription fulfillment to reduce the spend this quarter.
Re:Who Will Rein in Facebook? Challengers Are Lining Up
by redler on Sunday October 29, 2017 @09:16PM
(#15582517)
One big problem is that insurance companies are looking to optimize financial outcomes, not health outcomes. Sometimes these coincide but often they do not.
Re:Who Will Rein in Facebook? Challengers Are Lining Up
by altstar on Sunday October 29, 2017 @11:14PM
(#15582903)
For health insurers it is exactly the same thing.
Re:Who Will Rein in Facebook? Challengers Are Lining Up
by greenyoda on Monday October 30, 2017 @02:12AM
(#15583367)
If you're currently healthy, your insurance company maximizes its profits if you stay healthy (nothing to pay for except routine checkups, etc., which cost far less than the thousands of dollars in premiums your employer pays for you every year). But if you have cancer, the insurance company might maximize its profits if it refuses to pay for expensive treatments, causing you to die sooner.
Over the long run, it would seem to be in the insurer's best interest to keep everyone healthy for as long as possible.
The healthcare industry has two sides: the providers and the insurers. A hospital may not have the incentive to steer you away from unnecessary surgery, but your insurance company definitely does, since they'll be the ones paying for it. And your insurance company may have even more information to base its models on, since it knows about all the procedures you've had at any provider. So I'd expect insurance companies to be pioneering this kind of health-improvement software, not hospitals.