News for hackers. Stuff that matters.
Re:Health insurance companies are useless by lotsofpulp on Tuesday August 06, 2019 @12:08PM (#20626466)
Who will double check a doctor’s orders? Voters clearly don’t want the government to do it. Do people have enough money to visit a second or third doctor to get opinions regarding decisions that costs tens of thousands of dollars?
Re:Health insurance companies are useless by jtdev on Tuesday August 06, 2019 @12:12PM (#20626516)
WTF?! There’s literally no entity I want less involved in healthcare decisions than the private insurance industry. The conflict of interest is shocking... how we arrived at this place is bewildering.
Re:Health insurance companies are useless by polytomous_ on Tuesday August 06, 2019 @12:12PM (#20626519)
Whether or not people want the government to do it implies nothing about whether the government would be good at doing it. And neither of those things imply anything about whether private insurers are good at checking doctor's orders.

I would say that for any reasonable definition of "good", whether in skill or virtue, private insurers have shown they are definitely not good actors in our health system. Our health system might just be better off without them.

As for your question, I for one would like _doctors_ to double-check doctors' orders. Not an actuary.

Re:Health insurance companies are useless by alistairSH on Tuesday August 06, 2019 @12:17PM (#20626570)
As for your question, I for one would like _doctors_ to double-check doctors' orders. Not an actuary.

To be fair, with private insurers, it's usually BOTH a doctor and an actuary reviewing care. Which isn't to imply I like insurance - I'd much prefer an NHS-style system where my taxes fund the majority of care and I can buy a private policy if I want a "Cadillac" plan.

Re:Health insurance companies are useless by dv_dt on Tuesday August 06, 2019 @12:12PM (#20626509)
Medicare is strongly supported by the seniors who receive it - surviving against decades of attempted rollbacks. I don’t know how one ends up thinking people are unhappy with government administered billing and payments in healthcare.
Re:Health insurance companies are useless by merpnderp on Tuesday August 06, 2019 @12:21PM (#20626617)
Strongly supported because they love it, or strongly supported because they have exactly zero other options?
Re:Health insurance companies are useless by dv_dt on Tuesday August 06, 2019 @12:35PM (#20626773)
They have Medicare Advantage private options. Anecdotally I think people vastly prefer the public Medicare over the more complex private versions.
Re:Health insurance companies are useless by howard941 on Tuesday August 06, 2019 @12:43PM (#20626882)
The MA programs typically offer better benefits than 80/20 Medicare part B because they selectively market to groups of seniors in relatively good health but mostly because they get one hell of a taxpayer subsidy.

To the surprise of no one the promised efficiencies never materialized.

Re:Health insurance companies are useless by dragonwriter on Wednesday August 07, 2019 @10:33AM (#20635024)
> The MA programs typically offer better benefits than 80/20 Medicare part B

...because the coverage of Medicare Part A + Part B is the legal minimum for Medicare Advantage, so they are necessarily on average greater coverage.

Re:Health insurance companies are useless by fucking_tragedy on Tuesday August 06, 2019 @01:23PM (#20627359)
> strongly supported because they have exactly zero other options?

Like all Americans, they're free to buy private health insurance.

Re:Health insurance companies are useless by mikeash on Tuesday August 06, 2019 @12:39PM (#20626823)
Seniors vote in large numbers. A politician with a good plan for giving seniors a better option would have a huge advantage. That nobody had used this tactic to attain high office suggests that better options are hard to come up with.
Re:Health insurance companies are useless by astura on Tuesday August 06, 2019 @12:40PM (#20626830)
Can't they get health insurance through the Obamacare marketplace now?
Re:Health insurance companies are useless by dragonwriter on Tuesday August 06, 2019 @03:43PM (#20628762)
No, eligibility for marketplace plans ends when Medicare eligibility starts.
Re:Health insurance companies are useless by refurb on Tuesday August 06, 2019 @03:42PM (#20628742)
Medicare Part D (which covers all Medicare patients) and Medicare Advantage are run by private insurers.
Re:Health insurance companies are useless by logfromblammo on Tuesday August 06, 2019 @12:39PM (#20626824)
A person needs to be at least a nurse, veterinarian, or pharmacist to meaningfully double-check a physician's orders. Accountants and actuaries can provide helpful inputs, but they lack both the training and patient familiarity to make those decisions medically that they are currently effecting through the back door, by controlling the payments.

As a society, we trust the government to employ lawyers as circuit judges, appellate judges, and supreme court judges. It would be little difference for it to employ double-check nurses to review diagnoses and treatment plans against published standards and procedures, triple-check physicians to review contested or flagged cases, and quadruple-check physicians to ensure that the patients involved in difficult cases are receiving the best available standard of care, and to establish or modify standards for future cases that may be similar.

A lot of people don't even have enough money to visit a first doctor. And aside from that, families may have enough money to send one member to one doctor, and everyone else with perceived-to-be-lesser medical problems then has to forego treatment altogether. The diabetic gets improved insulin, while the asthmatic has to make do with too-frequent use of rescue inhalers, because the maintenance inhalers are too expensive, and the beesting-allergic person panics every time something flies nearby, because then there's no money left over for epinephrine autoinjectors.

The system does not currently consider whole-family finances as a medical consideration. It attempts to maximize profit on a per-patient basis, ignoring that at some point, that strategy may force a parent to choose which one of their children gets to survive. That's something that not only influences votes, but also creates activists.

The voters might not want the government to do it, specifically, but they are clearly not satisfied with the status quo.

Re:Health insurance companies are useless by mywittyname on Tuesday August 06, 2019 @12:48PM (#20626919)
The government already does this via Medicare/caid. They are considered the gold standard of reimbursement for insurance companies and hospitals. Medicare/caid's guidelines on what they will and will not pay for are very clear and they stand by their rulings.

Insurance companies, on the other hand, will break their own agreements left and right. One major health insurance company in the US has an internal policy of blanket denials of claims. Meaning, if you have them as an insurance provider, it's about as effective as having no insurance. Unfortunately I can't name names.

Re:Health insurance companies are useless by reallydude on Tuesday August 06, 2019 @02:55PM (#20628307)
You mean Cigna? Not sure why you think they would hunt you down for name dropping. These policies aren't affected by you mentioning them on HN.
Re:Health insurance companies are useless by raspasov on Tuesday August 06, 2019 @01:00PM (#20627096)
Why not?
Re:Health insurance companies are useless by mywittyname on Tuesday August 06, 2019 @01:15PM (#20627276)
I can't provide proof without potentially going to jail and/or pissing off a billion dollar company. The chances may be small, but the risks are really high.

But perhaps some fellow HNers have anecdotes of an insurance company how's denied every claim they've made.

Re:Health insurance companies are useless by newen on Tuesday August 06, 2019 @01:55PM (#20627684)
Way too cautious, I think. Because the FBI is not going to ask HN for your IP address on behalf on an insurance company's complaint about somebody lying.
Re:Health insurance companies are useless by mywittyname on Tuesday August 06, 2019 @04:22PM (#20629167)
Providing proof surely would. But I will say this company is more concerned with shielding themselves than their clients.
Re:Health insurance companies are useless by howard941 on Tuesday August 06, 2019 @02:10PM (#20627832)
GRIC?
Re:Health insurance companies are useless by cryoshon on Tuesday August 06, 2019 @12:17PM (#20626575)
>Who will double check a doctor’s orders?

last i checked, insurance companies do not do this to any extent that is beneficial to the patient. in fact, my experience with this is that the insurance companies get in the way of the doctor doing their job and the patient getting the care they need close to 100% of the time. they only check to make sure the doctor isn't trying to use medical resources which are "too" expensive or similar.

i would be fine with getting the government to do it -- provided that the insurance companies were forced out of business in the process. at this point, i don't see a future where american life expectancy improves with insurance companies still existing in any form.

Re:Health insurance companies are useless by riffic on Tuesday August 06, 2019 @12:35PM (#20626783)
>Who will double check a doctor’s orders?

medical licensing boards perhaps?

Re:Health insurance companies are useless by decebalus1 on Tuesday August 06, 2019 @12:17PM (#20626574)
> Who will double check a doctor’s orders? Voters clearly don’t want the government to do it.

Which voters? Do you have any numbers to back up the 'clearly' statement?