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Small-Scale Question Sunday for December 8, 2024

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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Re: United Health CEO, I feel that I'm among the extreme minority of the population that thinks it's bad to celebrate political assassinations and also that it is a social good for companies to offer insurance in the US. I am astounded by how relatively unprofitable being an insurance company is and also why anyone would go into this industry and put up with the abuse and general scorn.

Imagine being at a party and saying you work at a health insurance company. Total hatred from almost everyone.

It's amazing that people do this at all?

It is a very important job. Somebody has to tell doctors and patients no. That said, I sure wouldn’t want to do it.

I think it is hypothetically possible for a health insurance CEO to be so cartoonishly evil that murdering him on the street becomes ethically justified. I haven’t seen the evidence yet. I assume if it existed it would be plastered all over the internet.

It is a very important job. Somebody has to tell doctors and patients no.

And, empirically, making that a for profit middleman who gets to keep the money when he says no works badly. There is a reason why self-insured employer plans are the majority of the private market, and the insurers with the best reputation are provider co-ops (like Kaiser) or non-profits (like most of the BCBS affiliates).

The situation in the UK is different because private insurance is a top-up to the NHS, but once you exclude self-insured employer plans the biggest non-profit insurer is sufficiently dominant that "BUPA" is used as a generic term for private healthcare in the same way as "Hoover" or "Xerox".