Actuarial Outpost
 
Go Back   Actuarial Outpost > Actuarial Discussion Forum > Health - Disability
FlashChat Actuarial Discussion Preliminary Exams CAS/SOA Exams Cyberchat Around the World Suggestions

DW Simpson Global Actuarial & Analytics Recruitment
Download our Actuarial Salary Survey
now with state-by-state salary information!


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 12-20-2016, 02:41 PM
Big ole nasty fish Big ole nasty fish is offline
Member
 
Join Date: Jun 2011
Posts: 60
Default Can we get rid of UHC, Humana, Aetna, Cigna and BCBS?

Insurance is an antiquated and bureaucratic industry with an inherent conflict of interest at its core where companies make more money if they deny more claims.

With the current technology available, couldn't there be a simpler alternative to health insurance where families, friends, or other associations connect via some kind of mobile app to insure one another without all of the bureaucracy? Wouldn't this ultimately be much simpler and less costly then the current insurance business model?

I am very interested to hear your thoughts as to why or why not this is/isn't a good idea, or why it may/may not be possible under the current regulatory regime and if the ACA is repealed.

Thanks
Reply With Quote
  #2  
Old 12-20-2016, 02:49 PM
packman's Avatar
packman packman is offline
Member
SOA AAA
 
Join Date: Nov 2007
Posts: 232
Default

You will be lacking the bargain power to providers.
Reply With Quote
  #3  
Old 12-20-2016, 02:50 PM
JMO Fan's Avatar
JMO Fan JMO Fan is offline
Member
SOA AAA
 
Join Date: Sep 2001
Location: out in the woods
Favorite beer: Frostop Root
Posts: 5,406
Default

I believe you're talking about single payer, which would cost trillions, and promise bureaucratic inefficiency.

Vermont passed single payer, which only created more problems:
HHS told them ACA wouldn't permit subsidies for a government plan (as opposed to private).
Actuaries told them they would have to double all state taxes - so they repealed it, then their ACO failed.
State exchange was underfunded, works so badly that neither candidate for governor supported fixing it (then the Republican won).
Blue Cross Blue Shield sued them for ruining the insurance market (they were the only one left), all other carriers left the state.
SCOTUS told them their medical transaction database was unconstitutional, shut it down.
__________________
I thought this WAS a real job

Last edited by JMO Fan; 12-20-2016 at 02:55 PM..
Reply With Quote
  #4  
Old 12-20-2016, 02:50 PM
Dr T Non-Fan Dr T Non-Fan is online now
Member
SOA AAA
 
Join Date: Sep 2001
Location: Just outside of Nowhere
Posts: 97,800
Default

Hard to know where to start.
1. Assume that insurance is a fraudulent business.
2. Eliminate them, 'cause fraudulent.
3. Replace "app" with "government health plan" in your "idea" and voila, we're Cuba!
__________________
"Facebook is a toilet." -- LWTwJO

"45 es un titere" -- Seal of The President of The United States of America protest art
Reply With Quote
  #5  
Old 12-20-2016, 02:52 PM
Dr T Non-Fan Dr T Non-Fan is online now
Member
SOA AAA
 
Join Date: Sep 2001
Location: Just outside of Nowhere
Posts: 97,800
Default

Better idea:
1. Go to doctor, hospital, etc.
2. Get treated.
3. Don't pay the bills.
4. Free health care!

Win-win. Win.
__________________
"Facebook is a toilet." -- LWTwJO

"45 es un titere" -- Seal of The President of The United States of America protest art
Reply With Quote
  #6  
Old 12-20-2016, 02:59 PM
JMO's Avatar
JMO JMO is offline
Carol Marler
Non-Actuary
 
Join Date: Sep 2001
Location: Back home again in Indiana
Studying for Nothing actuarial.
Posts: 37,643
Default

Google Lemonaid. Also there's a thread here somewhere, "Why will this fail?"

It's P&C, not health, but the issues apply to health as well.
__________________
Carol Marler, "Just My Opinion"

Pluto is no longer a planet and I am no longer an actuary. Please take my opinions as non-actuarial.


My latest favorite quotes, updated Nov. 20, 2018.

Spoiler:
I should keep these four permanently.
Quote:
Originally Posted by rekrap View Post
JMO is right
Quote:
Originally Posted by campbell View Post
I agree with JMO.
Quote:
Originally Posted by Westley View Post
And def agree w/ JMO.
Quote:
Originally Posted by MG View Post
This. And everything else JMO wrote.
And this all purpose permanent quote:
Quote:
Originally Posted by Dr T Non-Fan View Post
Yup, it is always someone else's fault.
MORE:
All purpose response for careers forum:
Quote:
Originally Posted by DoctorNo View Post
Depends upon the employer and the situation.
Quote:
Originally Posted by El Actuario View Post
Therapists should ask the right questions, not give the right answers.
Quote:
Originally Posted by Sredni Vashtar View Post
I feel like ERM is 90% buzzwords, and that the underlying agenda is to make sure at least one of your Corporate Officers is not dumb.

Last edited by JMO; 12-20-2016 at 03:03 PM..
Reply With Quote
  #7  
Old 12-20-2016, 03:05 PM
JMO's Avatar
JMO JMO is offline
Carol Marler
Non-Actuary
 
Join Date: Sep 2001
Location: Back home again in Indiana
Studying for Nothing actuarial.
Posts: 37,643
Default

Quote:
Originally Posted by Big ole nasty fish View Post
Insurance is an antiquated and bureaucratic industry with an inherent conflict of interest at its core where companies make more money if they deny more claims. Thanks
I don't believe that. If they deny claims, their loss ratio will be too low and they will have to reduce premiums. Since profits are typically a percent of premiums, they will make LESS money, not more.
__________________
Carol Marler, "Just My Opinion"

Pluto is no longer a planet and I am no longer an actuary. Please take my opinions as non-actuarial.


My latest favorite quotes, updated Nov. 20, 2018.

Spoiler:
I should keep these four permanently.
Quote:
Originally Posted by rekrap View Post
JMO is right
Quote:
Originally Posted by campbell View Post
I agree with JMO.
Quote:
Originally Posted by Westley View Post
And def agree w/ JMO.
Quote:
Originally Posted by MG View Post
This. And everything else JMO wrote.
And this all purpose permanent quote:
Quote:
Originally Posted by Dr T Non-Fan View Post
Yup, it is always someone else's fault.
MORE:
All purpose response for careers forum:
Quote:
Originally Posted by DoctorNo View Post
Depends upon the employer and the situation.
Quote:
Originally Posted by El Actuario View Post
Therapists should ask the right questions, not give the right answers.
Quote:
Originally Posted by Sredni Vashtar View Post
I feel like ERM is 90% buzzwords, and that the underlying agenda is to make sure at least one of your Corporate Officers is not dumb.
Reply With Quote
  #8  
Old 12-20-2016, 03:26 PM
Big ole nasty fish Big ole nasty fish is offline
Member
 
Join Date: Jun 2011
Posts: 60
Default

Quote:
Originally Posted by packman View Post
You will be lacking the bargain power to providers.
Does this matter if you are paying cash? Often providers will give discounts for cash, right?
Reply With Quote
  #9  
Old 12-20-2016, 03:27 PM
Big ole nasty fish Big ole nasty fish is offline
Member
 
Join Date: Jun 2011
Posts: 60
Default

Quote:
Originally Posted by JMO Fan View Post
I believe you're talking about single payer, which would cost trillions, and promise bureaucratic inefficiency.

Vermont passed single payer, which only created more problems:
HHS told them ACA wouldn't permit subsidies for a government plan (as opposed to private).
Actuaries told them they would have to double all state taxes - so they repealed it, then their ACO failed.
State exchange was underfunded, works so badly that neither candidate for governor supported fixing it (then the Republican won).
Blue Cross Blue Shield sued them for ruining the insurance market (they were the only one left), all other carriers left the state.
SCOTUS told them their medical transaction database was unconstitutional, shut it down.
I'm not talking about single payer-- I'm talking about the opposite, which is a complete free market technology driven solution.
Reply With Quote
  #10  
Old 12-20-2016, 03:29 PM
Big ole nasty fish Big ole nasty fish is offline
Member
 
Join Date: Jun 2011
Posts: 60
Default

Quote:
Originally Posted by Dr T Non-Fan View Post
Hard to know where to start.
1. Assume that insurance is a fraudulent business.
2. Eliminate them, 'cause fraudulent.
3. Replace "app" with "government health plan" in your "idea" and voila, we're Cuba!
I'm saying that the large carriers will be put out of business because their business model cannot compete with the low cost business model of a small technology company
Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


All times are GMT -4. The time now is 03:57 PM.


Powered by vBulletin®
Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.
*PLEASE NOTE: Posts are not checked for accuracy, and do not
represent the views of the Actuarial Outpost or its sponsors.
Page generated in 0.39978 seconds with 9 queries