• Drusas@fedia.io
      link
      fedilink
      arrow-up
      20
      arrow-down
      1
      ·
      2 months ago

      Well, they also profit from healthy people who don’t use their insurance much.

        • MentalEdge@sopuli.xyz
          link
          fedilink
          English
          arrow-up
          19
          ·
          edit-2
          2 months ago

          They literally do?

          Customers that pay their premiums for years without actually needing healthcare is literally free money for them.

          • originalucifer@moist.catsweat.com
            link
            fedilink
            arrow-up
            2
            arrow-down
            9
            ·
            2 months ago

            im not sure why you think the money coming in from premiums isnt the same money used to pay claims, but you go ahead and believe whatever you want.

            the fact is we have to pass laws forcing them to spend a percentage of their profits on claims. their income is premiums their output is either claims, profit or operating costs.

            their profit comes solely from them denying claims. if they paid all claims they would have no profit.

            • skibidi@lemmy.world
              link
              fedilink
              English
              arrow-up
              12
              ·
              edit-2
              2 months ago

              The argument the person above you is making is that they also profit off people who never file claims in the first place. In fact those people are more profitable since they do not consume labor to process claims.

              The Byzantine system of rules and coverage exemptions exists to disincentive people from filing claims just as it exists to give leeway to deny them.

              Of course the overall point that paid claims must be less than premiums charged (and investment income) is correct.

            • MentalEdge@sopuli.xyz
              link
              fedilink
              English
              arrow-up
              3
              ·
              edit-2
              2 months ago

              im not sure why you think the money coming in from premiums isnt the same money used to pay claims

              And I’m not sure why you’d assume I think that.

              You’re saying they make their money from denying claims, rather than from premiums paid by the healthy, which they then keep by denying claims from the sick (who also pay them premiums), is a distinction without a difference.

            • Mossy Feathers (They/Them)@pawb.social
              link
              fedilink
              English
              arrow-up
              1
              ·
              edit-2
              2 months ago

              their profit comes solely from them denying claims. if they paid all claims they would have no profit.

              Well, yeah. If someone claimed I owed them $20m because their dog died, I’d deny that too (unless it was life insurance for a show dog or something).

              Insurance was originally profitable because the idea was to bring in more money than you pay out, but set the margins so it’s worth paying for as a service (covering things so the cost of a payout is high to make the service worthwhile, but the chances of actually paying out are low, to make the service profitable).

              However, over time you are correct that it shifted to focusing on finding ways of putting profits over quality; which came with all kinds of legalese to avoid payouts, among other things (like rigging the healthcare system so the cost is always high, so their costs appear low in comparison).

              So you’re kinda right, but you seem to be conflating the American insurance market with insurance as a concept.

    • qjkxbmwvz@startrek.website
      link
      fedilink
      English
      arrow-up
      6
      arrow-down
      2
      ·
      2 months ago

      No, they make a profit if your premiums are more than your care+overhead. Preventative care is sometimes offered with no co-pay — presumably because you end up costing them less over the long haul if you keep up to date with your Dr. appointments.

      It’s not a great system; but it does work very well for some customers, and failing to recognize that tends to preclude having a productive discussion.

      • originalucifer@moist.catsweat.com
        link
        fedilink
        arrow-up
        9
        ·
        2 months ago

        the united states is #1 in medical bankruptcy, including people with insurance.

        insurance is a scam youve been taught to not see as a scam. its a terrible middleman which extracts profits from sick and hurt humans by denying them care. if they paid all the claims, they would have no profit. and why should they? how can anyone defend such a gross money grab.

        giving the scam credibility keeps those costs high . pretending it has value keeps us from moving to a cheaper, more universal system.