NorthHawk wrote:It's sad that someone's father and husband was killed and there isn't much of an excuse for it, but it makes me wonder if this isn't the first of more to come considering the gap between the very wealthy and the rest.
The justification as I've heard it is UHC has implemented a new software that has a 93% rejection of claims and has allowed his company to reap many billions in profits. As I've read, their justification is his adoption and continued use of known faulty software has caused thousands of deaths and probably millions of people unnecessarily suffering.
I just hope it's not the beginning of a violent backlash against the current system where it's viewed that very few get so much and the rest go without.
c_hawkbob wrote:Sympathies for his family but these guys are no angels, they drain millions from our healthcare system to line their own pockets with with a total disregard for all of the people they are refusing coverage to for monetary reasons rather than medical. Our healthcare system is broken and this is just a symptom of the condition. And I fear it's just the beginning.
River Dog wrote:Of course, refusing coverage is for monetary reasons. What other reason would there be? They are a for-profit company. They are in the game to make money. Since insurance companies are heavily regulated by both the federal as well as state governments, we can assume that the majority of rejections are legitimate and are done so according to the terms laid out in the policy. So, before you start pointing your finger at some CEO who you seem to think deserved to die (sympathy only for the family members?), you need to point your finger at the institution that set up the system in the first place: The federal government.
The reason why these insurance companies reject claims is because the government allows them to. It's the government that allows them to sell policies with all sorts of strings attached, like pre-existing conditions, your age, that you have to seek providers only within your service area and/or within their network. If they had to accept people with pre-existing conditions, they're going to have to raise the premiums on all policy holders to cover the extra claims they're going to have to pay out. And the cheaper the premium, the more strings you have to accept in exchange for that lower price, so you might not get to go to that specialist that your PCP wanted to send you to. You get what you pay for.
But I do agree with you that the system is broken. In the case of Medicare Advantage, I've personally encountered a number of people that are completely unaware of the disadvantages MA has vs. traditional Medicare. And it's not just the stupid and illiterate that get taken advantage of. My best friend, a PhD and the smartest person I've ever called a friend, couldn't go to the back and spine specialist that my PCP provider suggested because he wasn't within his MA provider network. If he would have had my traditional Medicare plan, he would have been able to have seen him.
River Dog wrote:Of course, refusing coverage is for monetary reasons. What other reason would there be? They are a for-profit company. They are in the game to make money. Since insurance companies are heavily regulated by both the federal as well as state governments, we can assume that the majority of rejections are legitimate and are done so according to the terms laid out in the policy. So, before you start pointing your finger at some CEO who you seem to think deserved to die (sympathy only for the family members?), you need to point your finger at the institution that set up the system in the first place: The federal government.
The reason why these insurance companies reject claims is because the government allows them to. It's the government that allows them to sell policies with all sorts of strings attached, like pre-existing conditions, your age, that you have to seek providers only within your service area and/or within their network. If they had to accept people with pre-existing conditions, they're going to have to raise the premiums on all policy holders to cover the extra claims they're going to have to pay out. And the cheaper the premium, the more strings you have to accept in exchange for that lower price, so you might not get to go to that specialist that your PCP wanted to send you to. You get what you pay for.
But I do agree with you that the system is broken. In the case of Medicare Advantage, I've personally encountered a number of people that are completely unaware of the disadvantages MA has vs. traditional Medicare. And it's not just the stupid and illiterate that get taken advantage of. My best friend, a PhD and the smartest person I've ever called a friend, couldn't go to the back and spine specialist that my PCP provider suggested because he wasn't within his MA provider network. If he would have had my traditional Medicare plan, he would have been able to have seen him.
Aseahawkfan wrote:What do you mean by legitimate? Legal? Do you think a person watching their relative die from a refused claim is thinking, "This is legal of the insurance company" as a good reason? Especially if it is their child?
Aseahawkfan wrote:You do realize that our healthcare system puts a monetary value on life, including the life of children and family members. But the people who love these people do not put a monetary value on their loved one's lives. Their family members are priceless to them.
Do you see the incongruence in how each group values a life?
River Dog wrote:The insurance business isn't unlike the loan business in that regard, and I suspect that there are other businesses that have similar conflicts of interest. Suppose you have to foreclose on someone's house? Even in my former occupation, I once saw an employee of mine get fired because he was arrested for throwing rocks at his girlfriend's house. It was done according to our company's policy of not employing a person convicted of a felony.
River Dog wrote:The insurance business isn't unlike the loan business in that regard, and I suspect that there are other businesses that have similar conflicts of interest. Suppose you have to foreclose on someone's house? Even in my former occupation, I once saw an employee of mine get fired because he was arrested for throwing rocks at his girlfriend's house. It was done according to our company's policy of not employing a person convicted of a felony.
Aseahawkfan wrote:Housing is another area in America where a lot of scumbaggery occurs like what happened with balloon mortgages prior to the housing crash. I advised so many people against balloon mortgages, but they wanted the American dream of a house for them and their family. So they went for it. I couldn't believe the government was allowing balloon mortgages. It showed how much financial illiteracy exists in America and it makes me wonder why our school system focuses so heavily on subjects that are less valuable than financial literacy in our complex economic environment.
Healthcare is one of the dirtiest businesses. I doubt anyone cares if they filed a complaint or what not if their mother or child is dying. They're already under tremendous stress and experiencing severe emotion trying to care for a loved one while trying to think clearly as to how to manage the process and pay the bills.
You have loved ones. I know some of them have health issues. If you were getting the run around while they're dying or severely sick, you wouldn't be too happy. If they died due to an insurance denial and the only response from the insurance company was, "We followed the rules. Sorry, sir", doubt that would be comforting.
You're entering into another complex discussion with a lot of variables. We could even bring in the discussion of corporations that have done damage like selling cancer causing agents and refusing to pay medical costs associated, then really delve into the scumbaggery of the American healthcare system.
Or the fact that we the user of health care are not the main purchasers. We basically have socialized healthcare through corporations who decide our options according what a corporation is willing to pay within the rules.
it's not a great system. So a lot of people hate the health insurers that are making enormous profits managing insurance. You see United Healthcare's profits? Immense. How are they making such huge profits off our crappy health? It seems wrong.
NorthHawk wrote:I think in these types of cases people know something is wrong but don't know how to change it or think their efforts would be fruitless so in either desperation or anger they take the next step into violence.
In reading comments, it seems to me they don't think they have any other recourse where they can even be heard let alone influence changes. Stress, frustration, anger and more can cause a whole lot of damage to a society when that match is lit.
It's often how revolutions begin - with a seemingly singular act that is picked up and carried forward by others who've had a similar experience or know first hand of others who did. And to drift into the political realm it doesn't help having people like Musk talking about doing away with Medicare and social types of assistance. That part breeds fear and can encourage people to act in desperation.
Edit:
Here's a link to an interview with a former Executive of a Health Care Company and why he left it.
https://www.cnn.com/2024/12/11/business ... age-digvid
c_hawkbob wrote:Betcha if we start having CEO shootings as regularly as school shooting there will be some sort of gun control.
River Dog wrote:First of all, I don't care what the problems or justification is, I will never condone a cold-blooded murder like what occurred last week. Period. To defend that murderer for what he did is IMO unconscionable.
Secondly, I think that we are all in agreement that the system at the very least needs a major overhaul, but the question is what should be done. I can't speak for the entire industry, but I do see firsthand what goes on with Medicare as I've been on it for 5 years, and my wife for over 7 years, so I think I can speak with some kind of knowledge about the system. The first change that I would make would be to prohibit Medicare Advantage from advertising their products. There is not enough transparency, too much in fine print. There are people that I've talked to that were completely unaware that most specialists are not in many if not most of the Medicare Advantage networks. I would like to see them go to some type of format like they have with job fairs, college recruitment, etc., rather than advertising on television, which is a horrible way to get information.
Thirdly, the government, or some type of non-partisan, neutral authority, needs to be responsible for handling claims, not the insurer. Having the insurance company make those decisions is like asking the fox to guard the chicken coop. If the insurance company starts losing money on claims, they can raise their premiums. If they raise their premiums too high, they will no longer be competitive. Perhaps they can levy some type of business fee on companies for the purpose of funding a claims authority. Of course, like any fee or tax, it's going to get passed on to the consumer.
Forth, I want to see the same entity that handles claims provide free counseling, classes, fairs, etc. I learned most of what I know about Medicare via our local hospital's non-profit foundation. They used proceeds from the hospital gift store and community donations to pay their counselors, even set up one-on-one sessions with a specialist who gets paid by the foundation, not an insurance company. And being that they are a hospital, they are very familiar with the workings of Medicare. I make a charitable contribution each year.
As far as the issue you raised in your first paragraph, you're preaching to the choir. But rather than blaming the industry, I blame our educational system and parenting. People don't get the right guidance, either in school or at home.
River Dog wrote:First of all, I don't care what the problems or justification is, I will never condone a cold-blooded murder like what occurred last week. Period. To defend that murderer for what he did is IMO unconscionable.
Secondly, I think that we are all in agreement that the system at the very least needs a major overhaul, but the question is what should be done. I can't speak for the entire industry, but I do see firsthand what goes on with Medicare as I've been on it for 5 years, and my wife for over 7 years, so I think I can speak with some kind of knowledge about the system. The first change that I would make would be to prohibit Medicare Advantage from advertising their products. There is not enough transparency, too much in fine print. There are people that I've talked to that were completely unaware that most specialists are not in many if not most of the Medicare Advantage networks. I would like to see them go to some type of format like they have with job fairs, college recruitment, etc., rather than advertising on television, which is a horrible way to get information.
Thirdly, the government, or some type of non-partisan, neutral authority, needs to be responsible for handling claims, not the insurer. Having the insurance company make those decisions is like asking the fox to guard the chicken coop. If the insurance company starts losing money on claims, they can raise their premiums. If they raise their premiums too high, they will no longer be competitive. Perhaps they can levy some type of business fee on companies for the purpose of funding a claims authority. Of course, like any fee or tax, it's going to get passed on to the consumer.
Forth, I want to see the same entity that handles claims provide free counseling, classes, fairs, etc. I learned most of what I know about Medicare via our local hospital's non-profit foundation. They used proceeds from the hospital gift store and community donations to pay their counselors, even set up one-on-one sessions with a specialist who gets paid by the foundation, not an insurance company. And being that they are a hospital, they are very familiar with the workings of Medicare. I make a charitable contribution each year.
As far as the issue you raised in your first paragraph, you're preaching to the choir. But rather than blaming the industry, I blame our educational system and parenting. People don't get the right guidance, either in school or at home.
Aseahawkfan wrote:Well buddy, there's a lot of unconscionable actions out there. I think its unconscionable to look at three year old child with cancer and deny them care because their insurance isn't good enough. But it happens. What are you going to do? Blame the 3 year old for not having a good enough job or blame their parents for not having good enough insurance?
That's the world we live in. If the healthcare gets bad enough while Health Insurance companies are raking in 22 billion dollars, you're going to see more problems. When does it break? Who knows.
Most of the world has some kind of socialized and privatized hybrid system and America is paying the most for healthcare that isn't better than what many socialized or hybrid nations are payiing and they're getting it far cheaper with often better health outcomes.
I expect the number of Americans hating the health insurance industry to stay the same or grow. Though most people won't be driven to murder I would think. That's unusual.
NorthHawk wrote:Insurance in general has become or is becoming a predatory type of business. It's something we all need, but it seems there are very few options where the insurer lives up to what they present as coverage.
They rely on fine print and lawyer language to get around paying out what they present that they cover as well as delay claims. Even the adjusters that sell insurance are often frustrated by clear damage claims.
But what people really need to realize is insurance companies are in business to make money, not help those who bought policies regardless of their advertising.
Aren't there still claims that haven't been finalized from the floods in New Jersey about a decade ago? I read a few years ago that there were still some that hadn't paid out yet. And that's just plain wrong.
NorthHawk wrote:I just saw a poll that said 40% of younger people (they didn't identify what age range that was) thought he was doing the right thing.
Even if that poll is way off, in the back of my mind I wonder if a fair trial is possible as it seems a divisive topic.
Aseahawkfan wrote:The killer is from a wealthy family. I'm wondering what his real motive was. It seems very random to shoot the CEO of United Health. As this trial goes on, I wonder if more will come out that makes this case more understandable.
River Dog wrote:Wealthy family is an understatement. They were filthy rich. Tuition at the private high school he attended starts at $37,000/year. He graduated from the U of Penn, an Ivy League college, with a BS in engineering. He was not a customer of United Health, nor did he have any family members or known friends who were UHG customers. It appears that he singled out United Health because they are the largest health insurer in the country.
In my mind, that makes this murder even worse because he did not have any personal involvement, no hot-blooded incident that might have set him off. You could somewhat understand or explain an irrational act if a person gets emotionally stressed, like if he got fired at work or broke up with a girlfriend and suddenly snaps.
But this was a premeditated, cold-blooded murder. This scum bag deserves zero sympathy from any of us. He has no respect for the sanctity of life whatsoever. Had your father been the CEO of that company, he would have shot him just as easily.
Aseahawkfan wrote:I guess this guy could be looking to be a rich guy turned working class hero for getting back at the evil health insurance companies, but we'll see if something else comes out during the trial. Pretty crazy case.
River Dog wrote:I like to think of myself as being an open minded, objective person who doesn't jump to conclusions based on media reports. But unless something surfaces to contradict what has already been reported, it is hard for me to imagine a scenario which would excuse his actions as being justified.
But what really disturbs me is that a large number of my fellow Americans have embraced this cold-blooded assassin as some type of virtuosos Robin Hood and that due to the victim's position as CEO of a company they don't like that the man got what he had coming to him and that he deserved to die. Class warfare.
River Dog wrote:I like to think of myself as being an open minded, objective person who doesn't jump to conclusions based on media reports. But unless something surfaces to contradict what has already been reported, it is hard for me to imagine a scenario which would excuse his actions as being justified.
But what really disturbs me is that a large number of my fellow Americans have embraced this cold-blooded assassin as some type of virtuosos Robin Hood and that due to the victim's position as CEO of a company they don't like that the man got what he had coming to him and that he deserved to die. Class warfare.
Aseahawkfan wrote:'m thinking something more nefarious will come out like he was paid by someone that the United Health CEO pissed off or maybe United Health CEO was sleeping with this guy's girlfriend or something crazy. I'm thinking something really strange is going to come out during this trial. It doesn't make sense yet, but maybe it will.
River Dog wrote:This guy was from a very wealthy family, so if was paid to do this, it would have had to have been one helluva lot of money for him to have risked his life for it. I think that scenario is very unlikely.
I suppose that some sort of sex triangle is possible, but this guy posted a manifesto that said "The second amendment means I am my own chief executive and commander in chief of my own military", wrote the words "Deny", "Depose," and "Defend," terms used by insurance companies when they reject a claim, on the bullet casings. At least from what we currently know, this guy had a hard on for the health insurance industry if not corporate America in general.
River Dog wrote:This guy was from a very wealthy family, so if was paid to do this, it would have had to have been one helluva lot of money for him to have risked his life for it. I think that scenario is very unlikely.
I suppose that some sort of sex triangle is possible, but this guy posted a manifesto that said "The second amendment means I am my own chief executive and commander in chief of my own military", wrote the words "Deny", "Depose," and "Defend," terms used by insurance companies when they reject a claim, on the bullet casings. At least from what we currently know, this guy had a hard on for the health insurance industry if not corporate America in general.
Aseahawkfan wrote:The paid killer as a job scenario is unlikely. I'm not sure this guy expected to get caught. There is a possibility he wrote the words on the bullets to push the authorities away from his real reason for the killing. Being he is rich, does he really have a good reason to be mad at the insurance companies? If he planned the crime for other reasons, he would certainly want to push the authorities in that direction as that would have them looking for a leftist radical, likely less wealthy.
That's why I'm interested to see if something else comes out as the trial goes on. It could be as simple as he was a highly liberalized, violent person looking to start some revolution. Why take the all the effort to avoid notice and use a silencer if you want to make a statement? The evidence almost seemed obvious and planted, while the killing was done covering up his face and using a silencer, then disappearing from the scene of the crime. He was caught because we have a lot of cameras now and can do amazing stuff with them.
So going to make for an interesting trial that will prove he's a generic crazy or some darker reason for the killing comes out. Given how toxic political rhetoric has been lately, I guess another guy wanting to take it to violent levels would not surprise me.
NorthHawk wrote:From Newsweek:
An attorney has said that jury selection may be very difficult in Luigi Mangione's murder trial as there is so much public sympathy for the alleged killer of UnitedHealthcare CEO Brian Thompson.
Neama Rahmani, who was a federal prosecutor in California, said that Manhattan District Attorney Alvin Bragg will have to be very careful during the jury selection process.
"I've never seen an alleged murderer receive so much sympathy. To many people, Mangione is a hero of sorts," Rahmani said.
Rahmani, now president of West Coast Trial Lawyers law firm in California, said that prosecutors must look out for pro-Mangione sympathizers who may try to get on the jury.
"District Attorney Alvin Bragg's office is going to have to weed out 'stealth jurors' during voir dire. They may want to acquit to send a message to health insurance companies," he said.
Voir Dire is the process through which prosecution and defense teams ask jurors written and oral questions to assess their sympathies.
River Dog wrote:He probably thought that he had a chance to get away with it otherwise why go to such great lengths to conceal his identity and attempt to elude the police? But he was obviously a novice as he was very sloppy, left all sorts of clues. Heck, his gun jammed on him several times, so you know he wasn't too used to firing it.
There is a chance that he might have had an accomplice or someone coaching him, but I doubt seriously that anything will surface in the trial that would change my assumption about his motive.
I hope that they keep the TV cameras out of the courtroom and not turn this trial into another OJ Simpson circus. My fear would be that it might inspire a copycat crime.
I do hope that the insurance industry takes notice and enacts some reforms. My preference would be that the industry do it themselves, self-regulate, but if they won't, then I would have no problem with the government stepping in and force feeding them. Even if there is nothing wrong with how they are currently handling claims, there's a lot of mistrust amongst the public. But it's going to be a balancing act. If the government comes down too hard on them and makes their business more problematic, they'll pass their costs on to the consumer or, like what happened in California, decide that they can't make any money on it and get out of the business, quit writing policies. Either way, the consumer will end up paying more and/or they'll make it even more inaccessible.
River Dog wrote:Yep, that's exactly what I was afraid of. It's a very sad state of affairs when so many people think that a law-abiding citizen representing an industry they don't like deserved to die and are perfectly willing to turn him loose to perhaps kill another CEO.
River Dog wrote:Yep, that's exactly what I was afraid of. It's a very sad state of affairs when so many people think that a law-abiding citizen representing an industry they don't like deserved to die and are perfectly willing to turn him loose to perhaps kill another CEO.
Aseahawkfan wrote:Americans are hanging on to an idea of healthcare that doesn't fit the reality of our current situation. Even you do this as you try to prove privatization works when it clearly doesn't. It's a bad system. It's only going to get worse. It's unfixable as a private industry. It should be moved to a socialized industry with health being the focus, not profits.
For some reason Americans think highly of their privatized military, police, and fire department, but for some reason think they want a privatized healthcare system that makes more money the sicker people are.
McDonalds selling more Big Macs or Microsoft more software is capitalism in operation. United Healthcare selling more insurance while making more money doing so while wanting to pay out as little as possible to maximize profits while the healthcare industry makes money off more people being sick wanting to charge the highest possible rates for the maximum possible sickness is the very essence of a conflict of interest.
If people were healthy, doctors would be out of business. If health insurance companies pay too much to doctors or healthcare, they don't make as much money and may go bankrupt.
That is not great capitalism at all as capitalism utilizes competition to improve products and services wants to sell as much as possible, but when healthcare's money is made off something no one wants more of you're already starting off on the wrong foot. No one wants more sickness and they don't make more money the sicker they are which is the normal capitalist model.
The sicker you are, the less productive you are and yet your care costs more and more. So it is more profitable to let you die once you can't afford to pay more and more to fix your illness.
Terrible situation for the capitalist model.
NorthHawk wrote:I was reading about some models in Europe and the Gov't signs a contract with a private insurer. When a person needs treatment they just go to the doctor or clinic and they don't pay out of their own pocket.
If there is a fight about what is covered, the Insurance Company fights it out with the Gov't and the patient continues on with life largely oblivious to what's going on in the background.
It seemed an interesting model to me.
NorthHawk wrote:There’s still a large profit margin for European companies. If there wasn’t, companies like Bayer, Merck, and Roche Holding among others wouldn’t be successful multi hundred billion dollar companies. A lot of R&D is done in other countries than the US.
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