zlacker

>>tedsan+(OP)
The US appears to be fully in the grips of centralized economic autarky. A tiny coterie of industrialists who have the President's ear decide how to allocate a gigantic amount of capital for their pet projects while the state raises tariffs and implements bans to protect them from competition.

Didn't go well for South America in the 60s and 70s but perhaps, as economists are prone to saying, "this time will be different".

>>rchaud+592
this is private capital. yes, we are in an era of big projects and big capital deployment. is that synonymous with centralized autarky? i don’t agree

>>whimsi+Ba2
This is an amount that would be a meaningful change to most US states' gross annual economic output that we're talking about, and a few people control it. Sounds pretty centralized to me.

The fact that a handful of individuals have half a trillion dollars to throw at something that may or may not work while working people can pay the price of a decent used car each year, every year to their health insurance company only to have claims denied is insane.

>>lenerd+hb2
Free movement of capital and the ability to identify promising projects and allocate our resources there are why our society is prosperous and why we are able to devote more resources towards healthcare than any society that has ever come before us.

This money is managed by small amounts of people but it is aggregated from millions of investors, most of these are public companies. The US spends over 10x that amount on healthcare each year.

>>whimsi+Xc2
Having to spend thousands for insurance every year (even if you’re totally healthy) and not having it even be remotely effective, is not my definition of “prosperous”.

>>bbqfog+gi2
Individual insurers pay out tens of billions of dollars in claims every year, frequently have non-profitable years, and are the counterparty on pretty risky contracts.

There are lots of problems with our current approach to healthcare, but insurers aren’t charging you way more than the cost to counterparty on that contract should be.

>>whimsi+fj2
"Frequently have non-profitable years"

A graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years.

If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much.

Most of the rest of the industrialized world seems to grasp this concept, and their people live longer.

>>lenerd+Uq2
> graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years

Stock price ! profitability, but you're still correct. UnitedHealth's operations have churned out cash each of the last four years [1], as have Cigna [2] and Elevance [3]. Underwriting gains across the industry have been strong for years [4]. The only story I can think of where American health insurers lost money was Aetna with its underpriced ACA plans [5].

That said, whimsicalism is also partly right in that insurers aren't the cause of the unaffordability of American healthcare. They by and large pay out most of their premiums. (With some variance.)

[1] https://finance.yahoo.com/quote/UNH/cash-flow/

[2] https://finance.yahoo.com/quote/CI/cash-flow/

[3] https://finance.yahoo.com/quote/ELV/cash-flow/

[4] https://content.naic.org/sites/default/files/2021-Annual-Hea...

[5] https://spia.princeton.edu/news/why-private-health-insurers-...

>>JumpCr+cu2
Yes, if we subset to health insurance over recent years, they are profitable (not massive margins) - agreed. I was overstating the case.