zlacker

According to this source, united healthcare profits were $14B in 2024. https://www.healthcaredive.com/news/unitedhealth-unh-2024-re...

So yeah, money out not matching money in is exactly the problem.

>>gretch+(OP)
So a bit under 5% per the rest of the numbers in that link.

>>gretch+(OP)
About half of those profits were from the Optum side of the business, not from insurance.

>>tbrown+K3
I can't find the detailed breakdown for 2025, but in 2024, they took in $308bn in premiums and paid out $264bn in medical costs. So even ignoring all of the downstream and systemic problems caused by insurance existing as a for-profit entity, they're taking 14% off the top just to exist as a middle-man.

https://www.unitedhealthgroup.com/content/dam/UHG/PDF/invest...

>>nradov+z7
If you’ve had UHC you’d know very well that Optum is intimately tied to their insurance business. UHC just “administers the plan” while Optum controls plan decisions. So when there’s a problem, which there always is with every claim more complicated than a PCP visit, you get bounced between both companies for hours until you find someone willing to take responsibility for answering questions.

>>delect+nn1
> they took in $308bn in premiums and paid out $264bn in medical costs ... they're taking 14% off the top just to exist as a middle-man.

In 2023, they had a 0.8% profit margin[0]. 9 billion dollars in a trillion dollar industry.

Ignoring the disingenuous framing ("taking off the top" including how much they pay their employees), how does that compare to other industries?

[0]https://content.naic.org/sites/default/files/2024-annual-hea...

>>parine+hO1
> including how much they pay their employees

Highlighting that was actually part of my point. What utility does insurance add to justify its existence as a middle man? How are we better off with a middle man taking a cut vs nationalizing the industry? And that 14% is at best, given the other externalities of the existence of insurance and its perverse incentives.

You're saying "how is that worse than other industries", but I'm saying, why is there an industry there at all?

>>delect+yT1
The government would still need employees to basically do everything that the people at insurance companies do. Theoretically it could be more efficient, realistically it would not.

The real problem with our system is that for anyone who is going to hit their deductible, or especially their out of pocket max, the costs no longer matter at all. Sure, that cancer drug can be $500,000. GLP1 drugs for $1,000 a month? Why not?

Of course, there's no free lunch on this. In a single payer system you get things like the UK not approving certain cancer treatments for people over a certain age, certain medications just aren't available, etc.

Otherwise you could make every plan a very high deductible plan, possible just not cover medications at all, etc. But then people will complain about people not being able to afford things, especially in the short term.