Insurance company profit: makes one want to vomit, no?

[thegenius]

UnitedHealth calls for revenue between $317 billion and $320 billion for 2022

UnitedHealth Group Inc. undefined late Monday said it expects 2021 revenue of around $287 billion, and per-share adjusted earnings between $18.75 and $18.90...

www.marketwatch.com

TTM (Trailing Twelve Months) Revenue = ~ 280B
TTM Operating Income = ~22B

22 BILLION profit.

Imagine all the extra care they can pay for if they had...say...just 2B in profit. I wouldn't mind if they had 2B in profit and paid out 278B in health care

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[Birdstrike]

I does make me want to vomit. Keep these profits in mind next time they talk about "cutting costs." When you hear that phrase as justification for degrading patient care, or your working conditions, know that it translates to: "Our profits are massive, but we want them to be obscenely massive."

 

[southerndoc]

My health system refused to succumb to their hardball tactics. They claimed we were the most expensive health system in the Southeast, but oddly enough, they used that same claim last year for another health system in my metro area. I'm glad we stood our ground and refused to take cuts. Unfortunately, the patient suffers because we're now out-of-network for many UnitedHealth patients. Several large employers have expressed their intention of moving away from UnitedHealth as their health insurer/claims processor (for those self-insured).

 

[maxxor]

My health system refused to succumb to their hardball tactics. They claimed we were the most expensive health system in the Southeast, but oddly enough, they used that same claim last year for another health system in my metro area. I'm glad we stood our ground and refused to take cuts. Unfortunately, the patient suffers because we're now out-of-network for many UnitedHealth patients. Several large employers have expressed their intention of moving away from UnitedHealth as their health insurer/claims processor (for those self-insured).

This is a lie because I know at least one other system in our state that’s more expensive than yours.

 

[EctopicFetus]

This is a lie because I know at least one other system in our state that’s more expensive than yours.

Wait a health insurance company would lie? NO way!

 

[southerndoc]

This is a lie because I know at least one other system in our state that’s more expensive than yours.

The sad thing is that patients believe it. Someone from my township sent an email on our township directory about how my health system charges exorbitant fees and screws people over. There was silence when I mentioned the record profits UnitedHealth had during a pandemic.

 

[Rekt]

The sad thing is that patients believe it. Someone from my township sent an email on our township directory about how my health system charges exorbitant fees and screws people over. There was silence when I mentioned the record profits UnitedHealth had during a pandemic.

No physician wants to say it, but the amount that is charged to patients is absolutely absurd, across the board. The entire healthcare system is abysmal beyond imagination.

 

[allantois]

No physician wants to say it, but the amount that is charged to patients is absolutely absurd, across the board. The entire healthcare system is abysmal beyond imagination.

It is in fact absurd that we try to charge uninsured patients more than what insurance companies have negotiated.
But how else are these companies gonna make a profit but by raising premiums and reducing payouts

 

[doctalaughs]

No physician wants to say it, but the amount that is charged to patients is absolutely absurd, across the board. The entire healthcare system is abysmal beyond imagination.

It is in fact absurd that we try to charge uninsured patients more than what insurance companies have negotiated.
But how else are these companies gonna make a profit but by raising premiums and reducing payouts

The amount charged to patients is obscene due to the massive amount of administrative bloat and middle-men in our system.

If we said even 50% of the dollars had to go to salaries of people who directly provided care, and drugs/devices only get approved if they are definitively 20% better than older/generic offerings that would immediately cut our costs massively.

 

[d2305]

Corporations are in business to make money. UNH has done well over the years.

 

[EctopicFetus]

Listen teamhealth will charge 1800 for a level 4 Ed visit done by a pa or an fp doc in some rural Ed.

The charges have to be the same to all. Then there are the negotiated rates. Many hospitals have policies and programs to either not charge patients or charge them less than Medicare rates.

 

[EctopicFetus]

DocumentCloud

www.documentcloud.org

Screw teamhealth. I think if there isn’t a em boarded doc they shouldn’t be allowed to bill as an ED.

 

[Arcan57]

The system makes no damn sense. UHC making that much in profits has real consequences, and unless you're a shareholder the consequences are all negative. That profit comes directly from money that was spent with the intention of providing healthcare but didn't. That profit is from people that paid ever more of their eroding wages to buy insurance who's deductibles may have been too high to actually access care. That profit comes from doctors and hospitals that are trying to provide healthcare for their entire community. That profit comes from businesses who are saddled with ever rising costs for a benefit with ever shrinking utility. And that profit is so vast that it allows UHC to write the law of the land to ensure that nothing cuts into that profit.

 

[southerndoc]

The system makes no damn sense. UHC making that much in profits has real consequences, and unless you're a shareholder the consequences are all negative. That profit comes directly from money that was spent with the intention of providing healthcare but didn't. That profit is from people that paid ever more of their eroding wages to buy insurance who's deductibles may have been too high to actually access care. That profit comes from doctors and hospitals that are trying to provide healthcare for their entire community. That profit comes from businesses who are saddled with ever rising costs for a benefit with ever shrinking utility. And that profit is so vast that it allows UHC to write the law of the land to ensure that nothing cuts into that profit.

The Affordable Care Act required that they spend 80% of their revenue on patient care. Did that get rescinded/reversed?

 

[maxxor]

The Affordable Care Act required that they spend 80% of their revenue on patient care. Did that get rescinded/reversed?

With the 20% cap, the only way for these public companies to increase revenue is to increase total cost so their 20% can also increase. It’s starting to turn me against the concept of publically traded, for profit insurance companies.

These guys play really weird games with shared savings strategies and alternate models. I wonder if the shared savings shenanigans are somehow exempt from the 20% cap.

See Nevada Team Health vs UHC lawsuit

Nevada jury sides with TeamHealth, rules UnitedHealthcare underpaid its providers

A Nevada jury ruled this week that UnitedHealthcare underpaid physicians at three TeamHealth affiliates in the state, dealing the insurer a blow in its ongoing back-and-forth with the physician sta | A Nevada jury ruled this week that UnitedHealthcare underpaid physicians at three TeamHealth...

www.fiercehealthcare.com

 

[Arcan57]

The Affordable Care Act required that they spend 80% of their revenue on patient care. Did that get rescinded/reversed?

At least in 2019, their medical loss ratio was 82.5%, FWIW. I’m not sure how much of their revenue gets funneled through Optum which I don’t think has MLR apply. Kaiser’s rate was 89.7% in 2019 by way of comparison.

 

[RustedFox]

"Medical loss ratio" ... Explain.

 

[maxxor]

"Medical loss ratio" ... Explain.

That’s what they are capped at: 80%. They are only allowed to have overhead of 20%, in theory.

Where it gets weird is when the insurance companies play tricks to subvert the overhead/profit cap, like alternative payment models or wholly owned subsidiaries which provide medical care (UHC owned Optum which is buying practices, specialty pharmacies, and some imaging center chains).

 

[Birdstrike]

That’s what they are capped at: 80%. They are only allowed to have overhead of 20%, in theory.

There are lots of ways to finesse the books of a company to alter these numbers. Call it creative accounting.

 

[Arcan57]

That’s what they are capped at: 80%. They are only allowed to have overhead of 20%, in theory.

Where it gets weird is when the insurance companies play tricks to subvert the overhead/profit cap, like alternative payment models or wholly owned subsidiaries which provide medical care (UHC owned Optum which is buying practices, specialty pharmacies, and some imaging center chains).

It’s a little more complicated because MLR factors in quality improvement and certain taxes and fees as part of health care expenditures. Thus allowing them to have a higher profit before they have to rebate.

It's like if a CMG said they limit their overhead to 25% but then you find out that malpractice insurance, billing fees, CME, and the stipend for the system quality doc aren't overhead but are part of payment to physicians.

 

[EctopicFetus]

YOu guys are missing the elephant in the room. It is easy for us to only consider commercial insurance but UHC is a major player in Medicare (See AARP) and Medicaid. Throw in OPtum. FOr those of us who saw when the government paid out their stimmie money to medical practices the government used..... OPTUM to disperse that money. I am confident they didn't do it for free. Oh and keep in mind the MLR doesn't apply to medicare and Medicaid nor does it apply to optum, Sound physicians (who they own) rob peter to pay paul?, davita (who they own) etc.

Thats how the game is played.

 

[Arcan57]

YOu guys are missing the elephant in the room. It is easy for us to only consider commercial insurance but UHC is a major player in Medicare (See AARP) and Medicaid. Throw in OPtum. FOr those of us who saw when the government paid out their stimmie money to medical practices the government used..... OPTUM to disperse that money. I am confident they didn't do it for free. Oh and keep in mind the MLR doesn't apply to medicare and Medicaid nor does it apply to optum, Sound physicians (who they own) rob peter to pay paul?, davita (who they own) etc.

Thats how the game is played.

Single payor but that payor is UHC.

 

[EctopicFetus]

Single payor but that payor is UHC.

Might be. Real issue with single payer is you would destroy a $1T industry and tons of people and small businesses want no part of single payer.

 

[Arcan57]

Might be. Real issue with single payer is you would destroy a $1T industry and tons of people and small businesses want no part of single payer.

They want no part of it because of a massive, decades long campaign started by us but hijacked by the insurance companies. Which is funny because all of the evil stuff that was supposed to happen with single payor is actually happening with our current setup. I run into a lot of people that are forced to switch doctors pretty regularly due to changes in their insurance.

That being said, the $1T industry means nothing is going to change.

 

[Backpack234]

There's a ton of brainwashing by corporations to tell you exactly how good they are for society and how evil public services are. It's been going on for years and has framed so many of the conversations we have among each other that the corporations have, more or less, already won.

I'd like to see a similar series to the Climate Town youtube channel, except instead of climate change covering how we've been lied to about healthcare over the years.

 

[EctopicFetus]

There's a ton of brainwashing by corporations to tell you exactly how good they are for society and how evil public services are. It's been going on for years and has framed so many of the conversations we have among each other that the corporations have, more or less, already won.

I'd like to see a similar series to the Climate Town youtube channel, except instead of climate change covering how we've been lied to about healthcare over the years.

To be fair the government is fairly terrible at everything they do. I wouldn't want to put those dildos in charge of anything that mattered to me. Heck even the military uses tech from private industry. Its not like some self sustaining thing.

 

[RustedFox]

The word "dildo" is not autocensored.
The word "ret@rd" is autocensored.

This is America in 2021.

 

[Groove]

No physician wants to say it, but the amount that is charged to patients is absolutely absurd, across the board. The entire healthcare system is abysmal beyond imagination.

Totally right. I actually feel bad for patients. I once checked in after a self injury at home to get a CT scan. It wasn't something that could wait unfortunately and my partner ordered the CT scan and that was it. The whole thing ended up being about $2500-$3000. I ended up getting a separate bill regarding $350 for services to the ED doc. I know he probably only saw about $80-$100, if that, for the whole encounter.

The problem is that most patients think we are making off with most of their charges. It's an exercise in futility trying to convince the public that somehow their doctor is only seeing a fraction of their costs. They see the bill and know docs make 6 figures and just tie the two together and their brain shuts down.

 

[xaelia]

The word "dildo" is not autocensored.
The word "ret@rd" is autocensored.

This is America in 2021.

I, for one, welcome our new sex-positive overlords!!!

 

[DoctwoB]

The word "dildo" is not autocensored.
The word "ret@rd" is autocensored.

This is America in 2021.

OK Boomer

In all honesty though that is as it should be (if autocensoring is used at all, another debate). One is an insult that is highly offensive to a subset of the population. The other is an inanimate object designed to bring pleasure.

 

[Groove]

One is an insult that is highly offensive to a subset of the population.

Wallstreetbets on Reddit would disagree with you on that one! LOL

I surf that forum almost daily for entertainment. The memes alone have provided me hours of belly laughs.

Ret@rd​

Ret@rd is an anagram for trader, because lets face it most day traders could qualify for special needs when looking at some of the trades they perform. You’ll notice most users of Wall Street Bets refer to themselves as ret@rds. This may confuse you because its not meant as a compliment. However, unlike Boomers, Millennials and Zoomers are much more self deprecating than your generation. They feel comradery in their stupidity and it also gives acknowledgement to the fact that many of their trades are dumb gambles that should probably be spent on their monthly rent check to mom and dad for living in the basement.

 

[Rekt]

Wallstreetbets on Reddit would disagree with you on that one! LOL

I surf that forum almost daily for entertainment. The memes alone have provided me hours of belly laughs.

Ret@rd​

I don't even invest/trade, but WSB is probably one of the funniest pages on the internet. It'll get cancelled eventually, but until then.

 

[RustedFox]

Ret@rd is a verb as well. A useful one.

 

[VA Hopeful Dr]

Ret@rd is a verb as well. A useful one.

Also a super easily replaced one.

 

[DoctwoB]

Also a super easily replaced one.

Reminds me of when everyone (myself included) would say “that’s so gay” to refer to things in a negative way that are neither happy nor homosexual. It’s unnecessarily pejorative towards a subset of our population and we have plenty of other words that will suffice. We can be better then that. .

 

[Fart Daddy Smooth]

Might be. Real issue with single payer is you would destroy a $1T industry and tons of people and small businesses want no part of single payer.

What's the downside for small businesses? Employer insurance costs can be pretty big, even an increase in taxes would likely be offset by the savings

 

[Siggy]

The word "dildo" is not autocensored.
The word "ret@rd" is autocensored.

This is America in 2021.

In what world should dildo be censored?


Also, since we're talking about slurs, why is a tool a slur? Tools are useful. People who are "tools," however, are not. It's like when people falsely malign ivermectin as horse dewormer... it's a great person dewormer too.

 

[Siggy]

Reminds me of when everyone (myself included) would say “that’s so gay” to refer to things in a negative way that are neither happy nor homosexual. It’s unnecessarily pejorative towards a subset of our population and we have plenty of other words that will suffice. We can be better then that. .

I wonder how much of this is the euphemism treadmill at work. I remember playing "smear the queer" in elementary school. We didn't know what a queer was (either the older definition of different or the newer definition referring to LGBT), but we did know that the person holding the football should be tackled.

 

[hundreddaysoff]

What's the downside for small businesses? Employer insurance costs can be pretty big, even an increase in taxes would likely be offset by the savings

The downside would be that if this were done in a naive way, then tens or hundreds of thousands or millions of people in this $1T industry would suddenly be structurally unemployed. That may well reduce small businesses' profits by reducing demand.

I have no idea what the balance would ultimately be and I dislike our current system as much as anyone, but just saying.

 

[EctopicFetus]

What's the downside for small businesses? Employer insurance costs can be pretty big, even an increase in taxes would likely be offset by the savings

Do you believe this? Government means bloat and waste in my book. They don’t do anything well or Efficiently. Downside for small biz is huge taxes that they will bear. Keep in mind single payer means insuring many millions and that comes at a cost that is much easier passed onto businesses than onto people. (I’m not arguing if we should insure the 10+% of people currently uninsured just that there is a major cost to doing so.

 

[Arcan57]

Do you believe this? Government means bloat and waste in my book. They don’t do anything well or Efficiently. Downside for small biz is huge taxes that they will bear. Keep in mind single payer means insuring many millions and that comes at a cost that is much easier passed onto businesses than onto people. (I’m not arguing if we should insure the 10+% of people currently uninsured just that there is a major cost to doing so.

Government meaning waste and bloat is a narrative that's been sold for decades to justify the mass transfer of public resources to the private sector. When government spends money where any percentage of that money doesn't go towards achieving it's specified aim, that's waste. Waste is bad. When government gives that money to a corporation who spends some of it and has a small pool of already wealthy people pocket the rest, that's profit. Profit is good. Almost all of the terms we use to discuss this have connotations and overtones that have been carefully crafted over many years. They're crafted to make an objective discussion of the way we divide public and private sectors resources and responsibilities impossible.

 

[EctopicFetus]

Government meaning waste and bloat is a narrative that's been sold for decades to justify the mass transfer of public resources to the private sector. When government spends money where any percentage of that money doesn't go towards achieving it's specified aim, that's waste. Waste is bad. When government gives that money to a corporation who spends some of it and has a small pool of already wealthy people pocket the rest, that's profit. Profit is good. Almost all of the terms we use to discuss this have connotations and overtones that have been carefully crafted over many years. They're crafted to make an objective discussion of the way we divide public and private sectors resources and responsibilities impossible.

Gonna slightly disagree. As a business my incentive is to do the work as efficiently as possible. Government doesn’t care because they view things as an open checkbook. legistlation is the most obvious source of inefficiency. Want to pass a bill ? Throw in some pork for some random idea. We have all heard of the 1k+ toilet seat the government bought. This is but one example. If you have a letter that absolutely must get somewhere you use fedex. You don’t even consider usps. would Love to see what government pays for a project vs the same project being done for a private business where money (and profit matter).

 

[Arcan57]

Gonna slightly disagree. As a business my incentive is to do the work as efficiently as possible. Government doesn’t care because they view things as an open checkbook. legistlation is the most obvious source of inefficiency. Want to pass a bill ? Throw in some pork for some random idea. We have all heard of the 1k+ toilet seat the government bought. This is but one example. If you have a letter that absolutely must get somewhere you use fedex. You don’t even consider usps. would Love to see what government pays for a project vs the same project being done for a private business where money (and profit matter).

How many 10s of billions have been passed on to private companies on the back of the $1k toilet seat story? My point isn’t that government is hyper efficient. My point is that the ultra wealthy are looting the country and one of the main mechanisms giving cover to this is the “government can’t do anything useful” narrative. You’ll note that in the one sector of government where public funds flow completely frictionless into private companies, this narrative doesn’t exist.

 

[EctopicFetus]

How many 10s of billions have been passed on to private companies on the back of the $1k toilet seat story? My point isn’t that government is hyper efficient. My point is that the ultra wealthy are looting the country and one of the main mechanisms giving cover to this is the “government can’t do anything useful” narrative. You’ll note that in the one sector of government where public funds flow completely frictionless into private companies, this narrative doesn’t exist.

I think it depends on your perspective. I presume the one sector you refer to is the military? Regarding the toilet seat it has as much to do with political shenanigans. The people who spend the money have no tie to the actual funds. Need more money go create it. I’m sure you heard of Modern monetary theory.

private companies should have a goal of maximizing profit. The purchase of a toilet seat for 1k doesn’t make the private company a bad guy it makes the person who chose to spend this an idiot. i would say the same if this was a private company I ran or invested in.

i cant speak to everyone else But people i know who served in the military will happily tell you about the idiotic way the military spends money. The military industrial complex is indeed flush with cash and spending just happens. I think this is a joke as well. I also don’t believe we should be policing the world. The last 20 years in Afghanistan and the lives and money spent there only add proof.

 

[MechEDoc]

If you have a letter that absolutely must get somewhere you use fedex. You don’t even consider usps.

I live somewhere snowy and hilly.

The postal service is still driving Grumman Long Life Vehicles. They're based on a 1982 Chevy S10 chassis, a mid-80s to 90s 2.4L 4 cylinder Chevy engine with a 3 speed automatic, get ~10 mpg, are rear wheel drive, and suck harder than those stats would make one think. Meanwhile Fedex is driving a 4wd Sprinter with snow tires, 50% greater fuel economy, better emissions, safety, and payload. USPS kind of throws packages and mail from the road while Fedex can actually drive down driveways!

Sounds much like how Medicare and Medicaid are going...

 

[Atlas Shrugged]

Gonna slightly disagree. As a business my incentive is to do the work as efficiently as possible. Government doesn’t care because they view things as an open checkbook. legistlation is the most obvious source of inefficiency. Want to pass a bill ? Throw in some pork for some random idea. We have all heard of the 1k+ toilet seat the government bought. This is but one example. If you have a letter that absolutely must get somewhere you use fedex. You don’t even consider usps. would Love to see what government pays for a project vs the same project being done for a private business where money (and profit matter).

This is so naive. Tell me how you haven’t worked for the government either directly or as a contractor in one post.

 

[Matthew9Thirtyfive]

The purchase of a toilet seat for 1k doesn’t make the private company a bad guy it makes the person who chose to spend this an idiot.

We don’t always have a choice. For many things, the military is contractually obligated to use one of only a few vendors. These people know this and will sometimes jack up prices. Doesn’t happen with everything. I’ve been involved in many a supply run back in my enlisted days, and we definitely got a lot of stuff for less than it would have cost for us to just buy it as an individual.

 

[d2305]

Fat Leonard come to mind. Navy bribery scandal still unfolding 8 years after the arrest of 'Fat Leonard'

 

[EctopicFetus]

Fat Leonard come to mind. Navy bribery scandal still unfolding 8 years after the arrest of 'Fat Leonard'

Its mind boggling the inefficiency. I get it and we see it not infrequently in the private sector. The difference is the government happily spends the endless amounts of money they are handed. If you run an entity for the government you better spend the money or else there will be less next year. In a good private entity that win will come back in some way as a bonus etc.

 

[Birdstrike]

Government meaning waste and bloat is a narrative ...

I've got two letters for you: VA.