>The wider implications of this are left to the reader.
IMHO, it's actually worse than we realize. The Medical Loss Ratio requirement is good because it requires insurance companies to spend 80% or 85% of premiums on health care. It's bad because one way for insurance companies to make more money is to have inflated health care prices to justify increasing premiums so they can get 80% of a bigger pie. It also gives them incentives to provide care themselves so they can capture some of that 80% spend.
> For the uninsured this sort of thing is actually really common. Had an online friend who had to get emergency treatment and they sent him a bill for $20k.
I experienced this personally with my own insurance. My bill was over $20k, and it took a year to convince the insurance company that removing a few feet of my intestines was actually emergency surgery. I ended up paying $800. My roommate in the hospital had no insurance and ended up not paying anything (which I did not begrudge them at all, since the reason for no insurance was debilitating back pain that led to unemployment)
Or, the likelier explanation, is that health insurance prices are highly regulated and have to get their prices approved by a government official(s), and B) they don't have a lot of pricing power due to the competition and they are not colluding.
See almost any of the proxy filings and you will see much of the compensation is based on hitting targets other than just revenue, and most of the compensation itself is equity:
> since another insurance company would just steal their customers by having lower
LOL. Meanwhile, in real-life America, there are only four or five major carriers that control the market, and none of them are incentivized to do this "competition" thing you speak of by engaging in damaging price wars. Why would they when continuing to be part of the problem makes them more and more profits each year? See also: military contracting. Do you see them constantly undercutting each other? No, they buy each other, reducing the number of bidders on every contract.
And in real-life America, the only people health insurance companies engage in price wars with is the state insurance regulator who gets to deny requested price increases.
Fascinating observation, thanks for challenging my assumptions here. Just seems to further point out how useless health insurers are, even to their shareholders.
My most sincere wish is that all insurers would be nationalized, every last employee summarily fired, and their HQs all imploded and replaced with memorials to all the people whose lives they have cut short over the years. Not a thing of value would be lost IMO. Worse than paying people to dig holes and fill them in again.
Four or five competitors is plenty for a healthy market.
Where I live, they do compete on price - prices vary by about 30% for similar coverage. They can't engage in the kind of price war you're thinking of since insurance companies, by law, have to maintain a fund able to cover costs, have to get rate changes approved by regulators and are largely banned from price discrimination.
I understand the desire to shift blame entirely onto insurance companies rather than providers. After all, one is all about money and the other is seemingly all about healing.
Heck, when a provider does bill people directly because an insurance company refused to pay, we blame insurance companies - even when the charges on those bills are highway robbery - like those in the article itself.
The fact is, the net cost of health insurance was about $279 billion in 2022. Meanwhile, $3.7 trillion went to healthcare providers, pharmacies and the like for care. The ones who stand the most to gain from higher prices are providers.
Frankly, decades of lobbying from the healthcare provider lobby to enrich themselves should have made it this obvious, but sadly, people see doctors as selfless angels and it blinds them.
Aren't they doing some kind of turf non compete agreement like isps do?
I had read that comcast won't go into century link territory and viceversa, and something along those lines for the major isps, in order be local monopolies and set prices as they like.
My dad died of cancer when I was 26, and I had very frequent
dreams where it felt like he was real and present, though never speaking or interacting directly with me. The grief persisted for years.
Nearly 25 years later, my mom passed away this summer, and it's been a totally different experience. The grief was just as intense as when my dad passed, but contained to a few weeks.
In general, many (most?) internet plans specifically prohibit running a web server with a residential account. A business account would be necessary in these cases.
The very first DVD player I ever purchased was a Pioneer model with all the possible outputs, from composite to component video, 5.1 discrete audio channels, and coax + optical digital audio outs.
I purchased it somewhere in the 1996 to 1998 timeframe. When I graduated to Blu-Ray, I gave it to my mother who used it once or twice a week up until she passed away this year.
Obviously that's purely anecdotal, but that one unit was a workhorse.
I have a Pioneer DVD player of the same vintage, and it's still working to this day. The remote is sturdy, too. Currently lives in a summer house but gets regular use.
The Zune was 100% uncool, but man did I like the hardware and software sooo much better than the iPod / ITunes. I was just sad that I never found anyone to "squirt" at.
> You’re not paying for a service, you’re bidding in an open market.
IMHO, this isn't a new phenomenon. Close to 18 years ago, I lived in a city with a popular pizza spot that was about a 10 minute walk away. Normally I'd walk, but having a newborn make that challenging, so I'd get delivery.
Typically, the delivery would take 60+ minutes on a busy night, but after a few consecutive Fridays of a decent tip for the order, the pizza would arrive "burn your fingers" in about 20 minutes.
App Store rules are completely arbitrary. Many moons ago, I worked at a startup that made a mobile messaging app (back when SMS cost money). We were mostly a consumer app, but had a trio of businesses that wanted white-label versions of the app for their own employees, and we naturally obliged.
The white-label versions where 100% identical in appearance and functionality except for name in the app store, startup logo, and color scheme. Our original app had been in the App Store rules for many years. Our results in submitting the three white-label apps to the App Store for review were: 1 approved immediately, 1 approved after some back-and-forth w/explanation of purchase model, and another that never got approved due to every submission receiving some nonsensical bit of feedback.
We did white-label GPS navigation apps (before the dominance of Google Maps and Apple Maps), and saw the same pattern. Approvals and disapprovals seemingly random, with the endless feedback/explanation cycle happening on one app, where the other (functionally identical) app slid right through.
> And most importantly you have to write. A lot. Writing allows our brain to structure our thinking. Enables us to have a structured dialogue with ourselves.
I feel like to goes beyond writing to really any form of expressing this knowledge to others. As a grad student, I was a teaching assistant for an Electrical Engineering class I failed as an undergrad. The depth of understanding I developed for the material over the course of supporting students in the class was amazing. I transitioned from "knowing" the material and equations to being able to generate them all from first principles.
Regardless, I fully agree that using LLMs as our form of expression will weaken both the ability to express ourselves AND the ability to develop deep understanding of topics as LLMs "think" for us too.
>This will almost never be the case. This doesn't account for different share classes, liquidation preferences, preferred stock, all of which get exercised before common shares.
>Equity as an incentive truly favors the employer. With vesting, equity rarely works out to be better than having a market rate salary, unless the company becomes a household name
I've worked at 4 different startups. Two were acquired and two are still going, with one making a small profit and being a lifestyle business for the founder, and the other having a great product and still growing.
For the two acquisitions, one of which I held 1% equity in, the value of my options was $0, which was very disappointing. In that case, I did get a cash bonus as the VP Engineering and an offer from the acquiring company that was 3X my cash comp, but the stock was worthless.
At this point in my career, I value stock in private companies at exactly $0 and treat it like a nice bonus should it ever amount to anything.
IMHO, it's actually worse than we realize. The Medical Loss Ratio requirement is good because it requires insurance companies to spend 80% or 85% of premiums on health care. It's bad because one way for insurance companies to make more money is to have inflated health care prices to justify increasing premiums so they can get 80% of a bigger pie. It also gives them incentives to provide care themselves so they can capture some of that 80% spend.
> For the uninsured this sort of thing is actually really common. Had an online friend who had to get emergency treatment and they sent him a bill for $20k.
I experienced this personally with my own insurance. My bill was over $20k, and it took a year to convince the insurance company that removing a few feet of my intestines was actually emergency surgery. I ended up paying $800. My roommate in the hospital had no insurance and ended up not paying anything (which I did not begrudge them at all, since the reason for no insurance was debilitating back pain that led to unemployment)