A large fraction of UHG profits come from their Optum subsidiary selling software to other payer and provider organizations. This is separate from the health insurance business. If broken out separately they would be one of the 20 largest US tech companies.

Is there any legal way to remove the leeches from the system?

Obviously murdering healthcare CEOs and shareholders isn’t legal, and I wouldn’t endorse that method.

Are there alternatives?

Yes, the legal way is to change the laws.

Unfortunately that is rolling a boulder uphill, and even if you fire all of Congress (on this issue, you'd need to get rid of all the Republicans and at least a third of the Democrats) and replace it with people who give a crap, all it takes is one executive to stop enforcing the rules.

> you'd need to get rid of all the Republicans and at least a third of the Democrats

And then most voters: “71% of U.S. adults consider the quality of healthcare they receive to be excellent or good, and 65% say the same of their own coverage. There has been little deviation in these readings since 2001” [1].

[1] https://news.gallup.com/poll/654044/view-healthcare-quality-...

Quality of healthcare and quality of insurance experience are not the same statistic.

I'm very satisfied with my healthcare. I am not satisfied with my insurer.

> Quality of healthcare and quality of insurance experience are not the same statistic

The question was specifically about “the quality of healthcare you receive/your healthcare coverage.” Coverage doesn’t cover the insurer on cost, but it does on claims denials.

Most Americans like their coverage. If you want to reform the system, you have to start with that fact and convince them they aren’t risking what they have unnecessarily.

> the quality of healthcare you receive/your healthcare coverage

But that's two different things.

If you put me in a giant mansion with a $100k/month mortgage, I will be quite satisified with my house. Very briefly.

>Most Americans like their coverage

Even more Americans (81%!) are unhappy with the cost of their coverage.

Sure. We want the same system but cheaper. That’s an important difference for someone advocating to scrap the system to make it cheaper. We want those lower costs. But loss aversion marries us to the good enough.

The same system but cheaper is not the same system. There are leeches that need to be removed from the system.

> same system but cheaper is not the same system

Correct. You've identified why this debate has been frozen in American politics for decades. One man's leech is another's adored Cadillac insurance policy, trusted provider or prescribed placebo. Healthcare reform keeps dying on the rocks of conspiracy theories about the Congress of whatnot. The problem is surfacing a solution the electorate trusts and endorses.

> One man's leech is another's adored Cadillac insurance policy, trusted provider or prescribed placebo.

No, the plans aren’t leeches, the people using the plans aren’t leeches, the entire administrative / leadership staff at health insurance orgs are the leeches.

A majority of the electorate wants government provided healthcare.

https://news.gallup.com/poll/468401/majority-say-gov-ensure-...

> A majority of the electorate wants government provided healthcare

No. (Come on, read your own source.)

A majority say "it is the responsibility of the federal government to make sure all Americans have healthcare coverage." There is a 10-point preference for a "system based on private insurance" versus a "government-run system."

79% of Democrats want a government-run system. But only 46% of independents and 13% of Republicans. Which explains the gridlock. If one side only proposes government-provided healthcare as its solution, it will waste a bunch of energy on it and then be predictably shot down.

"19% -- say they are satisfied with its cost"

From your link.

That's why you vertically integrate.

https://www.truthrx.org/post/the-health-insurer-will-see-you...

> In 2017, 23% of the company’s insurance revenue went toward the provider unit called Optum Health, and 69% went toward OptumRx. So far in 2022, 38% of that money went toward Optum Health, while 56% was captured by OptumRx.

See: https://news.ycombinator.com/item?id=43017065

Even if you look at the company as a whole, there aren't much profits to go around.

> there aren't much profits to go around

I think we have different definitions of "much".

It's #9 in the world for revenue: https://en.wikipedia.org/wiki/List_of_largest_companies_by_r...

#1 on the list is Walmart, which has a similarly low on-paper 2-3% profit margin, but I don't think anyone is deluded into thinking the company, the Waltons, or its investors are barely scraping by.

#2 is Amazon. Again, low profit margin. Again, plenty of profit.

Nobody is arguing that you can't buy a luxury yacht or whatever with UNH's profits. It's pretty obvious from the original comment[1] is the argument is that even if all the profits were plowed back into approving more claims, that it would only only increase the approval rate by 5-6%, which is a totally minor amount.

[1] https://news.ycombinator.com/item?id=43016479

Walmart is amazingly efficient and basically the case for how economies of scale benefit the consumer. If you broke it up, prices would go up, not down.

Walton's do great because of the scale, but is a very lean and efficient organization. Take them entirely out of the picture and the consumer would hardly notice.