• quarrk [he/him]@hexbear.net
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    6 hours ago

    The discussion about the 80/20 rule is just miserable. Classic example of hiding behind industry lingo and scolding tone to shame others into shutting up.

    The rule is supposedly that health insurance providers must pay a minimum percentage of their gross income in claims.

    For all their smugness, this zb2929 is missing some obvious ways that this magic rule solves nearly nothing about the problems of ordinary customers.

    All the rule does is enshrine a “legitimate” profit margin for insurers. It doesn’t do anything to protect people from inflated premiums or the delay, deny, depose tactics used to get these insurers to their “deserved” profit margins.

    • SixthSunOfASixthSun
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      6 hours ago

      All the rule does is enshrine a “legitimate” profit margin for insurers.

      Ding ding ding.

      It’s almost as if the ACA was an insider bill that was accepted by the entire industry because it allowed them to reset the economics of the business without one insurer feeling like they were taking a loss.

      The vast majority of the ACA is literally about risk portfolio balancing between private companies.

      The regulations on profit essentially changed the game and is why most insurance companies are now vertically integrated with pharmacies, concierge medicine, or even entire medical systems. It’s the only way you can charge more for insurance without having to rebate out is by capturing your own payouts which allows you to keep MLR.

      • Year 1: You pay $100 for insurance and insurance pays $80 for your meds to the insurance company pharmacy.
      • Year 2: You pay $105 for insurance and insurance pays $84 for your meds to the insurance company pharmacy.

      Creative accounting. That’s why every insurance company makes special pharamcy benefits rules for the in house pharmacy and spams you with “switch your prescription to Optum RX”

        • SixthSunOfASixthSun
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          6 hours ago

          Yeah look up Kaiser Permenete, absolute leaders in the shit, they have contracts on a whole bunch of public employee health care too in Western States.

          They also take from both ends, since they have some of the most overworked nurses and hospitals. They’re unionized but almost every contract negotiation ends up in a strike.

  • FunkyStuff [he/him]@hexbear.net
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    5 hours ago

    I clicked on this thinking I wasn’t gonna get mad, then I saw someone with a JOHN BROWN flair? A self proclaimed neoliberal? And my cortisol has spiked so much I don’t know if I’ll sleep tonight.

  • PKMKII [none/use name]@hexbear.net
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    9 hours ago

    The insurance Industry being opaque about their denial numbers doesn’t absolve them. FFS if Gerber says “we’re not disclosing how many babies get lead poisoning from our food,” the conclusion from that is not “well we don’t have solid numbers so must not be a problem.”

  • happybadger [he/him]@hexbear.net
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    9 hours ago

    When such people try and justify the murder of a man because UnitedHealth supposedly has the highest denial rate or because Brian Thompson was supposedly being investigated for insider trading, these are likely just after-the-fact justifications. If Brian Thompson was the CEO of Coca-Cola, I’m sure they’d try and justify his murder by pointing to obesity rates, plastic waste, and evil chemicals like HFCS.

    Organ donation. Now.

    If Brian was any of the other Brians of the world, he would be just as guilty of mass murder. Stopping any of them is self-defense. Coca Cola is the worst plastic polluter in the world and anyone who doesn’t see them as an existential threat to humanity can join this mod in the organ donation line.

    • MolotovHalfEmpty [he/him]@hexbear.net
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      8 hours ago

      If Brian Thompson was the CEO of Coca-Cola, I’m sure they’d try and justify his murder by pointing to obesity rates, plastic waste, and evil chemicals like HFCS.

      How about if a death squad of paramilitaries adventurists broke into Coca Cola headquarters and murdered half a dozen of their board and executives, like they did to workers in bottling plants in Colombia? i-think-that

    • Are_Euclidding_Me [e/em/eir]@hexbear.net
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      8 hours ago

      If Brian Thompson was the CEO of Coca-Cola, I’m sure they’d try and justify his murder by pointing to obesity rates, plastic waste, and evil chemicals like HFCS.

      knight-nod

        • GrouchyGrouse [he/him]@hexbear.net
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          7 hours ago

          One of the most haunting photographs I’ve seen was a black dude whose skin was covered in scars because of stirring boiling sugar pots to make molasses by hand and gobs of molten sugar would stick to his skin and burn the fuck out of him. The misery around the sugar industry goes back centuries.