[continued from previous message]   
      
   >>> All," there's one plan: take it or leave it (and private supplements   
   >>> are often banned). No tailoring.   
   >>>   
   >>> Profits are thin, and most money goes to care: Health insurers' net   
   >>> profit margins are consistently low—around 1-3% in recent years   
   >>> (e.g., 1.3% industry-wide as of late 2025). The ACA mandates they   
   >>> spend 80-85% of premiums directly on medical care. That modest   
   >>> profit incentive pushes them to innovate (apps, virtual care,   
   >>> preventive programs) and negotiate rates to keep premiums   
   >>> competitive—so they attract you, the customer.   
   >>>   
   >>> If they ignore your needs, you switch: Unlike a government monopoly   
   >>> where you're stuck, competition means if one insurer's plans suck   
   >>> for you (too stockholder-focused, bad coverage), millions switch   
   >>> during open enrollment. That pressure keeps them accountable to   
   >>> customers first.   
   >>>   
   >>> At the end of the day stockholders get returns because insurers have   
   >>> to earn your business by giving you options that fit your needs. A   
   >>> single-payer system replaces that with one-size-fits-all   
   >>> bureaucracy—no choice, no competition to personalize. I'd rather   
   >>> have plans competing for my needs than politicians deciding one plan   
   >>> for everyone. What do you think—would you prefer zero options or   
   >>> dozens tailored to different situations?   
   >>>   
   >>>   
   >>>   
   >>>>   
   >>>>   
   >>>>> budget, and preferences, with options for add-ons like dental or   
   >>>> vision.   
   >>>>> Single-payer is one-size-fits-all, dictated by bureaucrats, often   
   >>>>> resulting in rationing and long wait times. See Canada's system   
   >>>>> where median wait times for specialist treatment are over 27 weeks   
   >>>>> vs. under   
   >>>> 4   
   >>>>> weeks in the US for similar care.   
   >>>>>   
   >>>>> Incentives for quality: Profits motivate insurers to approve   
   >>>>> claims quickly and invest in preventive care to avoid bigger   
   >>>>> payouts later.   
   >>>>   
   >>>>   
   >>>>        You have it backwards. Insurance companies   
   >>>> don't profit from paying claims, they profit   
   >>>> from DENYING claims. The knee-jerk rejection of   
   >>>> claims is so rampant that even Republicans have   
   >>>> urged government to intervene.   
   >>>   
   >>> The idea that insurers primarily profit by denying claims isn't   
   >>> accurate.   
   >>   
   >>   
   >>       Of course it is. Why do you think health   
   >> care recission was so rampant before the ACA   
   >> outlawed it?   
   >   
   > Denying claims isn't the same as recission. But, let's have a look   
   > anyway.   
      
      
       Denying claims IS recission.   
      
       Whatever you call it it is insurance   
   companies denying medical coverate to sick   
   policyholders BECAUSE they are sick.   
      
       "Thanks for giving us your money,   
   sucks to be you, policy cancelled"   
      
      
      
   >   
   > Rescission was relatively rare, and affected a small fraction of   
   > policies, mostly in the non-group market (only ~5-10% of Americans   
   > pre-ACA). The bigger issues were upfront denials of coverage for   
   > pre-existing conditions or sky-high premiums.   
   >   
   > Routine claim denials (not rescissions) still happen today—around   
   > 17-19% for in-network claims in ACA marketplace plans—and that's   
   > what insurers primarily use to manage costs, not by dropping policies   
   > wholesale.   
   >   
   > So while rescission highlighted bad incentives in the old individual   
   > market, it wasn't the main way insurers profited by "denying care."   
   > Competition and regulations like the 80/20 MLR rule keep excessive   
   > denials in check more effectively than a monopoly system would.   
   >   
   >   
      
   Lawmakers to insurers: Stop dropping sick patients   
   Apr 27, 2010   
   https://tinyurl.com/muf877j3   
      
      
   Health insurer tied bonuses to   
   dropping sick policyholders   
   November 09, 2007   
   https://tinyurl.com/yc2yzvd5   
      
      
   Blue Cross praised employees who dropped sick policyholders   
   June 17, 2009   
   http://tinyurl.com/nmzvjk   
      
      
   States try to rein in health insurers   
   claim denials, with mixed results   
   MARCH 25, 2025   
   https://stateline.org/2025/03/25/states-try-to-rein-in-health-insure   
   rs - claim-denials-with-mixed-results/   
      
      
      
   Health Insurers Deny 850 Million Claims a Year   
   Feb. 12, 2025   
   https://tinyurl.com/mr2bt5ep   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)