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Well said. Really wish people understood this better and how utterly psychopathic and heartless the entire idea of "maximizing profits" in this context is.
Put another way - a for-profit insurance firm is a weird kind of company that does better when it refuses to provide what its customers pay for. It's not some surprising or counterintuitive result, it's baked into the business model, on purpose. That's deeply malignant just at a glance, and it's all we really need to know when deciding whether it should be involved with healthcare.
You know what's really insane? Before the ACA was passed, there was no federal requirement for how much insurance companies had to pay out on healthcare costs. The ACA set a minimum of 85%, so no less than 85% of premiums has to actually go toward paying for medical services.
Before that, they could literally just pocket 75 cents for every premium dollar if they wanted to with zero legal repercussions. I guarantee we'd be on our way there if the ACA were never passed.
For-profit health insurance should be illegal. Same thing with for-profit hospitals. I've read stories about doctors whose hospitals were bought by for-profits or VCs and turned into patient mills where they're forced to push unnecessary elective surgeries and provide the bare minimum of care to maximize profits.
A healthy population is good for society and it should be something we invest in. We shouldn't make a business out of someone getting sick, and then another business out of charging then exorbitant amounts of money for getting treatment, and then ANOTHER business to harass them because they can't pay that exorbitant amount.
You're absolutely right, I did kind of momentarily forget that, even having lived through it. They could also just deny care or coverage for "pre-existing conditions" and just drop you as a customer as soon as you get a major illness. And guess what, they did! That's maybe the most egregious, but hey, we're not lacking for contenders.
The ACA felt like a serious change for good in this country at the time. And I gotta say, watching the way it got ratfucked, misrepresented, deliberately destroyed...I dunno, it was heartbreaking. I think it showed me what we were in for, I guess, almost a straight line passing through that and other things like Citizens United, repeal of Dodd Frank, and everything else that led to today. Some of those I can't fault everyone for being unfamiliar with, but damn.
Seeing how we responded to the ACA in particular as a nation was really telling. I knew idiots whose lives got directly measurably better by using it for their own insurance, and still thought it should go and voted for the folks who said they'd get rid of it. What do you even do there? Sad stuff.
Insurance is not unlike gambling, but gambling seems comparatively more fair and less insidious.