The lack of health coverage has been what has stopped me from starting my own business. I do not want to risk any of my family getting sick and not being able to cover it, but I also don't want to blow through all my savings paying for health insurance waiting until I get a VC to give me money.

I’ve basically opted out. I can’t see that the healthcare system has any incentives to keep me healthy. In fact all the incentives are to keep me medicated indefinitely. No thanks. I have a plan for catastrophic coverage but I stay as far away from hospitals and doctors as I can otherwise.

But you'll get to learn about part D medication plans and Medigap part F*, G, N, and the other 7 gotcha plans that are run mostly by for-profit megacorps that get to change their prices every year. Oh and Medicare Advantage (part C, not to be confused with Medigap parts) is a total scam with lifetime limits that has already fooled 54% of recipients. Traditional Medicare is way too complicated and should be thrown away and replaced with a universal single-payer system without any for-profit corporate bullshit. Also not covered: dental, vision, hearing aids, long-term care, skilled nursing... you and your family need to be be completely broke to receive Medicaid for long-term care.

* So sorry, you can't have this one anymore because part B deductibles are no longer covered due to the neoliberal MACRA 2015 that doesn't care about costs borne by the poorest Medicare recipients.

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It’s not better elsewhere. Healthcare is fundamentally expensive. You can choose between cost, availability of specialists or new treatments, and speed of being seen. The bureaucracy and vague denials under some government healthcare programs make United, Aetna, etc look good.

Yeah I really like their rewards program: https://e-i.uhc.com/uhcrewards

Each year they pay me $1,000 (in the form of HSA deposits, which I can invest) to do basic things like get a checkup, get a flu shot, and get a blood test. I sync my wear-able data and they pay me $1-2 each time I exercise or get enough sleep.

It's great!

I had them via a previous employer and had serious surgery; they asked me to go through the “get a second opinion” process which was getting all the records to their system and then a virtual/video call, but after that, they paid for everything.

I don't. I have their "platinum" insurance, and they still seem to fight any claim we file.

For example, my wife got knee surgery recently, and the doctor recommended we rent a CPM machine to help her knee avoid atrophying. Renting the machine is $200 a week. Insurance said it was "optional" and refused to cover any of it. We ended up buying a used one on eBay for about $900, which is a lot but not insurmountable for us.

It kind of annoys me though, because not all their clients are yuppie software people who have disposable income. A lot of people can't afford to rent a machine for $200 a week or buy one for $900 on eBay, but they do make it much easier for the leg to heal better. Isn't "stuff that most people can't afford but would help with healing" the stated purpose for health insurance? It seems more than a little unfair that my wife's leg is more likely to heal better purely because she's married to a software engineer.

I really have no fucking idea what the difference between the cheap and expensive UHC plans. It sure seems like I'm paying many thousands of dollars more for medical stuff than I was for equivalent services with Anthem. Oh, well, at least my premiums are higher too, so that's fun.

Hopefully obviously I don't advise shooting a CEO for several reasons (both ethical and legal), but I have to say that I was unable to cry many tears when I heard it happened.

No, but working at a company that was founded by a bunch of former gov employees, the coverage is mostly ok and some having to manage the refusal bs. What was new to me - a gap that went employed -> consulting -> employed - (same company family) - how damn expensive top tier coverage for a family of three really is - $3700/mo. Insane.

if you don't have anything nice to say... :3

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Here's a point about all the insurance companies: UHC administers the medical plan on behalf of your employer. For all practical purposes, they are a whipping boy for the real 'man behind the curtain' (your employer).

Your company (for self-funded plans) actually decides what’s covered and what isn’t, sets copays and deductibles, and ultimately saves or spends money on healthcare costs. UHC’s role is to apply those rules, maintain the provider network, and handle the billing and customer service.

If your company offers insurance, there is someone who can tell the "insurance company" to cover the service they are not covering. Usually the HR Benefits Administrator, or 'plan sponsor'. And they do it all the time! If you have a sad story and the budget is ok for the quarter, they will help! If you are a company officer, you can also have whatever your company can afford.

We have a UHC choice plan at work and it’s been completely invisible, both for me and coworkers I know.

Health insurers are like Congressmen. Most people hate the institution, but are satisfied with their own insurer. https://www.kff.org/affordable-care-act/kff-survey-of-consum...

Afaict the original sin of the US healthcare system is having the healthcare providers chosen by employers. That means that the patient is not the customer, the patient's employer is. That in itself has dire consequences.

Privatized health care need not be so bad. Germany has privatized health care, but it's pretty much fine, at least for patients. It's regulated to the moon and back, but afaict so is the US system, just with very different goals. The ACA feels a bit like the beginnings of a German-style system.

> We cannot have corporations expecting to make a dollar off human life.

That's literally a political ideology.

The answer to problems like this isn't to pretend politics is some kind of abstract system imposed by higher-order beings, its to use political power to fix it.

> Somehow, healthcare MUST be decoupled from capitalistic incentives. I don’t pretend to have the answer but continuing on this path will lead to worsening patient outcomes. We cannot have corporations expecting to make a dollar off human life.

Give yourself more credit! You just stated the answer above.

> healthcare MUST be decoupled from capitalistic incentives

Capitalism pays for our healthcare.

The problem is that Healthcare has an infinite hunger for resources - there is always more that could be spent - and it is always morally correct to spend more (people's lives have high priority).

There needs to be some manner of allocating limited resources between different people with different needs.

Every country seems to find different ways to deal with the fundamental friction of healthcare (unlimited demand and limited resources).

Unfortunately voters don't like the reality of limitations.

But the answer is easy. Just look toward the North.

Food, housing, and a living wage too. The bare necessities to live must be decoupled from capitalistic incentives.

I think the incentive itself is good, but there's too much corrupt abstraction in between.

Ultimately I want good providers to be paid well and poor providers to struggle. That is a good system. We don't have that. We MUST recouple healthcare and capitalistic incentives.

United Healthcare isn’t the reason healthcare is unaffordable any more than Geico causes car repairs to be expensive. American demand for healthcare is insatiable, and doctors are a scarce and greedy bunch. That there is a middle man trying to get his 5% isn’t the problem.

My girlfriend is nurse practitioner and she says United is the worst to deal with. They deny everything and it sucks up enormous amounts of time to appeal.

I really hope my employer changes to pretty much any of the other ones eventually. I really hate having to argue on the phone with with a poor representative over everything.

Anthem BCBS and Aetna never gave as much trouble. I know they both have their scandals and it's not like I love any American health insurance company, but I definitely rank UHC lower.