Thread by @ok_post_guy

Not that anyone cares about actual data, but United Healthcare, like many insurance companies, does not actually make most of their money by denying care, they collect fees from large employers on a per-subscriber basis

Of their customers, almost 75% are "fee-based" (i.e. large, self-insured employers), who make the decisions about what services to cover, copays, etc. UH doesn't make any more or less money by denying your claims because, again, they are getting paid a fixed fee per member

"oh, but what about the individual plans, forgot about those, didn't you?!"

Haha no, they have a mandated Medical Loss Ratios (literally thanks Obama), which means they have to spend a minimum percentage of their premiums on actual medical care. Their rate for 2023 was 83%

Furthermore operating margins on their core insurance and prescription drug plans are less than 6%, that's like "very good grocery store" margins, not even "shitty software company" margins

"but I had my claim for [x] denied!" Yeah you should actually take that up with your company's HR/benefits dept, not the insurance company. A big part of their fee is earned by being the bad guy, even though *your* company decides what's covered, not "the insurance company"

"But ok_post_guy I hate our healthcare system"

yeah ok sure, but you should be way more angry at doctors and their assorted lobbying groups. Why does an American anesthesiologist make 3-4x what a British one does? Why did med schools just stop growing admissions for 30 years?

Anyway, the big point is that ever since the ACA imposed medical loss ratios on insurance companies, they don't actually benefit from denying your claim. *Your company's CEO* does, not United healthcare/Humana/BCBS/etc, take it up with them

And honestly the people who benefit the most are the doctors making MLB utility player salaries as attending physicians, or the specialists making NFL WR3 money