United healthcare to exit most Obamacare exchanges....

I can't believe it's 2016 and the US still doesn't have free health care. Otherwise, don't know how to take this article. The lobbyist spin might be getting to me because I started it angry, then I was happy, then I was angry again at the finish.
 
ultramanhyata said:
Still, Wall Street applauded the news. Shares of UnitedHealthcare rose nearly 1.5%.

I understand they also applauded at the end of Hillary Clinton's $225K speech to the gang at Goldman Sachs.
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well, GS did get to do a line of coke off hillary's tits

funny how I wrote a thread about obamacare failing a few day ago
 
Ricos Green Tea said:
I can't believe it's 2016 and the US still doesn't have free health care.
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Because the Democrats don't want it, and neither does the GOP. The voters may want it, but who cares about them when there is lobby and special interests money up for grabs?
 
Generate said:
Because the Democrats don't want it, and neither does the GOP. The voters may want it, but who cares about them when there is lobby and special interests money up for grabs?
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I don't live in the States or have a very large knowledge of politics. But from my perspective, and many other of my friend's I talk to, it is ridiculous that political campaigns and parties are allowed to take "donations" from corporations in the States. That seems like it is just asking for trouble.

Again, I may be wrong about that.
 
There's some challenges with underwriting and asymmetrical payoffs that are magnified on the exchanges since, my understanding (which may be off) the flexibility with rates is much more limited on the exchanges.

To make an analogy using a less polarizing insurance, home owners insurance in a very simple world. The biggest risk with home insurance is distance to coast since hurricanes are a covered risk. Proximity to coast would provide your FREQUENCY or LIKELIHOOD of a major loss. The other risk is the value or size of your home, this informs the SEVERITY of a potential loss. So let's consider what that does to insurance. Mansion on the coast - high risk so I charge high premium. Two bedroom ranch in the middle of the desert - low risk so I charge a low premium. So now we know risk and premium are correlated.

Now lets consider the asymmetrical payoff. Let's say I charge you $1,000 to insure your $10M home (exaggerated for illustration) and your deductible is $5,000. In any given year your maximum loss is $6,000 (premium + deductible) so if your entire house is obliterated in a hurricane, I am on the hook for $10M. You essentially paid $6,000 to "make" $10M (emotional toll and inconvenience aside).

In health insurance exchanges there are limitations to underwriting, partially due to incomplete data (e.g., I may not know your most recent blood panel) and partially due to restrictions (IIRC, the highest and cheapest insurance have to be within a factor of 3). So there are situations where the lowest risk policies are over-priced but the highest risk policies are under-priced. Curve ball number one: the cost of the policy for the lowest risk population is too high relative to the penalty, so there's little to no incentive to buy insurance "for nothing". As a result there is a selection bias towards the higher risk, under-priced policies. Curveball number two: even the stingiest health plan has an out of pocket maximum which caps the policyholder's exposure to financial loss in the event of a severe episode, which is more likely for these higher risk populations. Need a $500K liver transplant? That'll be $5,000 dollars please. Had a $250K NICU baby? That'll be $15,000 please. Are you a hemophiliac and have a $300K+ Rx tab every year? $5,000 for you too. This is that asymmetry again.

Lets combine the two: over-representation of under-priced, high risk policyholders and they have stop-losses but the insurance company doesn't. It doesn't take much for this to tank the loss ratio(s) for the product(s) and if it tanks hard enough, it can drag down the loss ratio for the insurance company as a whole.

Without getting into politics or other dimensions of this complex topic, it seems obvious why a for profit company would pull out of this, especially if we use home insurance to ground the conversation.
 
Ricos Green Tea said:
I can't believe it's 2016 and the US still doesn't have free health care. Otherwise, don't know how to take this article. The lobbyist spin might be getting to me because I started it angry, then I was happy, then I was angry again at the finish.
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If anything health care should cost far more. People would work harder to get it. A simple, effective move.
 
Ricos Green Tea said:
I don't live in the States or have a very large knowledge of politics. But from my perspective, and many other of my friend's I talk to, it is ridiculous that political campaigns and parties are allowed to take "donations" from corporations in the States. That seems like it is just asking for trouble.

Again, I may be wrong about that.
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I don't see how you can avoid money from mixing with political campaigns in any country serious about respecting free speech. Sure, you could ban the money from being given to the candidate directly, but you can't prevent someone--a private citizen or a company--from doing what they like with their money as far as advertising for that candidate.

Let's say they made a law saying no corporate donations. Let's say I'm a billionaire and I like the guy who is campaigning on a platform that contains a tax plan that will save my corporation tens of millions a year. Well, since there's freedom of speech and I have the means, I'll make ads promoting that guy and plaster them all over TV, radio, and the internet. I'll hire social media dorks to do their thing on Twitter, Instagram, etc. No collusion necessary. I know that candidate won't forget how I helped him get elected.

There can't be any "solution" to that situation unless you want the government to start telling people they can't publicly support a politician--something I'm sure no person that respects freedom of expression desires.
 
You mean companies dont want to actually compete with other companies and would rather use rent-seeking behavior to attain profits in a crony capitalist system? What a shocker....
 
Rex Kwon Do said:
I don't see how you can avoid money from mixing with political campaigns in any country serious about respecting free speech. Sure, you could ban the money from being given to the candidate directly, but you can't prevent someone--a private citizen or a company--from doing what they like with their money as far as advertising for that candidate.

Let's say they made a law saying no corporate donations. Let's say I'm a billionaire and I like the guy who is campaigning on a platform that contains a tax plan that will save my corporation tens of millions a year. Well, since there's freedom of speech and I have the means, I'll make ads promoting that guy and plaster them all over TV, radio, and the internet. I'll hire social media dorks to do their thing on Twitter, Instagram, etc. No collusion necessary. I know that candidate won't forget how I helped him get elected.

There can't be any "solution" to that situation unless you want the government to start telling people they can't publicly support a politician--something I'm sure no person that respects freedom of expression desires.
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youre probably right because the problem is just a symptom of how the countries are run to begin with

our countries shouldnt be run like a business, our leaders should not be business men, IMO our leaders should be the forerunners in education, science, health and agriculture
 
Skarr said:
youre probably right because the problem is just a symptom of how the countries are run to begin with

our countries shouldnt be run like a business, our leaders should not be business men, IMO our leaders should be the forerunners in education, science, health and agriculture
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You've gotta take that up with the people. They should decide. If they want businessmen, let them have businessmen. I don't believe in technocracy at the sake of democracy.
 
Rex Kwon Do said:
You've gotta take that up with the people. They should decide. If they want businessmen, let them have businessmen. I don't believe in technocracy at the sake of democracy.
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so if 51% of the population tell you that you have to believe in technocracy, you will believe in it?
 
Ricos Green Tea said:
I can't believe it's 2016 and the US still doesn't have free health care. Otherwise, don't know how to take this article. The lobbyist spin might be getting to me because I started it angry, then I was happy, then I was angry again at the finish.
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I don't think "free" healthcare would make it any cheaper. There's too many other levers to pull that would reduce cost, IMO.

More doctors (especially general practitioners), more nurses (every rank), more low acuity care options, more high acuity care options. I'm not saying let anyone with a HS diploma and a first aid certification practice medicine, that's ridiculous, but throttling the supply of providers makes their time more valuable as demand organically increases faster than the supply. Literally every single person has a health, there is no threat to healthcare drying up, so if we really want to take a huge bite out of cost, aggressive supply side growth is what I think the first line of attack should be. This would also help drive healthcare cost transparency and provider vs provider competition and / or patient consumerism. People spend more time picking a washing machine than they do picking a surgeon.

Another potential idea, truly national health insurance. No more state by state constructs or barriers, it poses an artificial limit on the ability to distribute risk. If a firm can't compete across 50 states, it should get pounded into oblivion by adverse selection. This risk pooling will help lower premiums and give payers more negotiating strength in a theoretically more vibrant provider market. This looks like it would apply further downward pressure on costs.

Risk factor based underwriting - I think the pendulum swung too far here with ACA. Before, coverage for anyone with a pre-existing condition was cost prohibitive or simply not offered. Now underwriting struggles to adequately price in risk. A happy medium is probably ideal. Something that penalizes avoidable lifestyle risk factors but is more tolerant of congenital ones. I need to think harder on the topic but it's another angle to reduce systemic cost.

These are just a few thoughts. I've tinkered with, some are less mature than others and I'm sure I could find more.
 
Skarr said:
youre probably right because the problem is just a symptom of how the countries are run to begin with

our countries shouldnt be run like a business, our leaders should not be business men, IMO our leaders should be the forerunners in education, science, health and agriculture
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Well we do have a community organizer in the White House.;)
 
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