UHC Ceo assassinated

[RobertELee]

*if you like your doctor, you can keep your doctor...*

[Smit]

"Risk management" was a key strategy to claim denial and claims were often denied for horse shit nuanced justifications.

Not that what we have right now is any better. 

"Risk management" used to be taking somebody's premium payments then denying treatments for preexisting and/or other conditions. What a win/win strategy that was for the insurance company! I can understand how they'd be unhappy about losing that.

"Risk strategy" now is "deny, delay, defend" while people are going through some of the worst parts of their lives and the insurance they've paid to help them in those times is withheld while loved ones suffer.

I don't even think it's the for profit part that's so bad, but it's the pursuit of maximum profit part that really sucks.

But as a practical business model I think what we have now is the inevitable result what health care turns in to if it is driven by a for profit model. Why would anybody invest in UHC if Aetna is raking in much higher profits and yielding much higher returns? The investors aren't thinking deny and delay, they want returns on their investment. The insurance companies all have to be ruthless to compete.

If there is a God I hope he's got a special place in hell reserved for the people who maximize profit by denying or delaying claims they should be paying for.

[beej]

I don't even think it's the for profit part that's so bad, but it's the pursuit of maximum profit part that really sucks.

+1000

[gcode]

Don't forget another big player in the healthcare industry... trial lawyers
Liability Insurance is huge expense for doctors .
My doctor told me his insurance premiums were nearly double his annual income
and he's just a GP
It's even worse for specialty surgeons

[Del.]

"Risk management" used to be taking somebody's premium payments then denying treatments for preexisting and/or other conditions. What a win/win strategy that was for the insurance company! I can understand how they'd be unhappy about losing that.

"Risk strategy" now is "deny, delay, defend" while people are going through some of the worst parts of their lives and the insurance they've paid to help them in those times is withheld while loved ones suffer.

I don't even think it's the for profit part that's so bad, but it's the pursuit of maximum profit part that really sucks.

But as a practical business model I think what we have now is the inevitable result what health care turns in to if it is driven by a for profit model. Why would anybody invest in UHC if Aetna is raking in much higher profits and yielding much higher returns? The investors aren't thinking deny and delay, they want returns on their investment. The insurance companies all have to be ruthless to compete.

If there is a God I hope he's got a special place in hell reserved for the people who maximize profit by denying or delaying claims they should be paying for.

The Nations Healthcare System should follow the Medicare/Supplemental form. If insurance companies offer Advantage plans at no cost for those 65 and older they can do it for everyone. That way Doctors and Hospitals would always receive something for their services. People can choose their deductible. If you want you can get a supplement plan with several options. Some that only has a total of $240 out of pocket. Me and the wife have plans that allows us to go anywhere in the country that we want with no premiums for our drugs. We are basically 100% covered for a total for both of us at $600/month. People can get coverage for much less than that if their medical needs are minimal. Having a $10,000 deductible is worthless insurance in my opinion.

[Smit]

The Nations Healthcare System should follow the Medicare/Supplemental form. If insurance companies offer Advantage plans at no cost for those 65 and older they can do it for everyone. That way Doctors and Hospitals would always receive something for their services. People can choose their deductible. If you want you can get a supplement plan with several options. Some that only has a total of $240 out of pocket. Me and the wife have plans that allows us to go anywhere in the country that we want with no premiums for our drugs. We are basically 100% covered for a total for both of us at $600/month. People can get coverage for much less than that if their medical needs are minimal. Having a $10,000 deductible is worthless insurance in my opinion.

Medicare Advantage (Part C) companies get paid at a minimum the same amount as Part B is going for. I think next year that's $185 a month. Some charge more and give extra benefits such as gym membership and health purchases but read the fine print carefully. Some charge more and don't offer any additional benefits at all. They all required by law to provide the same basic services to qualify for offering Part C policies.

But be aware Part C comes thru an insurance company so you still need their approval.

I have Plan G medigap coverage that costs like $150 a month more but if I have a really expensive health care my max out of pocket expenses would be around $300 a year.

Before I made my Medicare choice I was talking to an insurance broker who was supportive of traditional medicare and his advice that struck a chord with me was "It's not if something will happen as you age, it's when." So even though I'm healthy now I might not be in 10 years.

Also, the first couple of years it's easier to move around in the Medicare without underwriting. But if you wait until you're really sick you won't be able to go back to traditional medicare. You'll be stuck where you are.

[Del.]

Medicare Advantage (Part C) companies get paid at a minimum the same amount as Part B is going for. I think next year that's $185 a month. Some charge more and give extra benefits such as gym membership and health purchases but read the fine print carefully. Some charge more and don't offer any additional benefits at all. They all required by law to provide the same basic services to qualify for offering Part C policies.

But be aware Part C comes thru an insurance company so you still need their approval.

I have Plan G medigap coverage that costs like $150 a month more but if I have a really expensive health care my max out of pocket expenses would be around $300 a year.

Before I made my Medicare choice I was talking to an insurance broker who was supportive of traditional medicare and his advice that struck a chord with me was "It's not if something will happen as you age, it's when." So even though I'm healthy now I might not be in 10 years.

Also, the first couple of years it's easier to move around in the Medicare without underwriting. But if you wait until you're really sick you won't be able to go back to traditional medicare. You'll be stuck where you are.

Yes I have the Plan G also. If someone takes an Advantage plan I don't think they can ever go back to a Medigap plan.

[neurosis]

[beej]

It looks like they are going to get this guy pretty quick, or at least identify him. And that just makes me all the more suspicious of the FBI's inability to find the J6 pipe bomber.

[Smit]

It looks like they are going to get this guy pretty quick, or at least identify him. And that just makes me all the more suspicious of the FBI's inability to find the J6 pipe bomber.

It looks like it's too late to get him pretty quick.

It's been 48 hours now. He could be a long way away by now.

[gcode]

It looks like it's too late to get him pretty quick.

It's been 48 hours now. He could be a long way away by now.

I saw a breaking news story on X a few minutes ago that said they had a name for the suspect.
No idea if it was true... or click bait ... I didn't bite.

[mkd]

Not saying the assassination was justified, but ....

[neurosis]

Just over a year before United Healthcare CEO Brian Thompson was murdered this week in Midtown Manhattan, a lawsuit filed against the insurance giant he helmed revealed just how draconian its claims-denying process had become.

Last November, the estates of two former UHC patients filed suit in Minnesota alleging that the insurer used an AI algorithm to deny and override claims to elderly patients that had been approved by their doctors.

The algorithm in question, known as nH Predict, allegedly had a 90 percent error rate — and according to the families of the two deceased men who filed the suit, UHC knew it.

As that lawsuit made its way through the courts, anger regarding the massive insurer's predilection towards denying claims has only grown, and speculation about the assassin's motives suggests that he may have been among those upset with UHC's coverage.

https://cdn.arstechnica.net/wp-content/uploads/2023/11/class-action-v-unitedhealth-and-navihealth-1.pdf

[CNCAppsJames]

The /reddit and cyber sleuths that historically have helped law enforcement on manhunts have so far refused to help find/identify this guy.

I have a feeling the FBI and law enforcement may be exaggerating what they have in order to try to force this guy to make a mistake.

The liklihood of someone giving him up is not anywhere near what it would be for your typical assasin, and I pretry sure if/when he gets caught, his canteen account will never run dry.

[CNCAppsJames]

https://cdn.arstechnica.net/wp-content/uploads/2023/11/class-action-v-unitedhealth-and-navihealth-1.pdf

Court filings are always interesting to read. When the media picks one up for anyngiven reason, they'll typically pick the most salacious detail and run with that, but often times avoid some of the details that would make pitchforks and torches great again.

Headline: UH uses AI not humans to deny claims.
Details: Employees who deviate from the nH Predict AI Model projections are disciplined and terminated, regardless of whether a patient requires more care. Uh patients are advised to enroll in the government-subsidized Medicare program while failing to cover care for which they are contractually and statutorily obligated to cover.