Thu: Don't You Just Love Private, For-Profit Insurance?

Don't You Just Love Private For-Profit Insurance?

Millions of Americans in the past few years have run into this experience: filing a health-care insurance claim that once might have been paid immediately but instead is just as quickly denied. If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ computer algorithms or people with little relevant experience to issue rapid-fire denials of claims — sometimes bundles at a time — without even reviewing the patient’s medical chart; a job title at one company was “denial nurse.”

It’s a handy way for insurers to keep revenue high — and just the sort of thing that provisions of the Affordable Care Act were meant to prevent. Because the law prohibited insurers from deploying a number of previously profit-protecting measures such as refusing to cover patients with preexisting conditions, the authors worried that insurers would compensate by increasing the number of denials.
A recent study by the Kaiser Family Foundation (KFF) of plans on the Affordable Care Act marketplace found that even when patients received care from in-network physicians — doctors and hospitals approved by these same insurers — the companies in 2021 nonetheless denied, on average, 17 percent of claims. One insurer denied 49 percent of claims in 2021; another’s turndowns hit an astonishing 80 percent in 2020. Despite the potentially dire impact that denials have on patients’ health or finances, data shows that people appeal only once in every 500 cases.
Sometimes, the insurers’ denials defy not just medical standards of care but also plain old human logic.

If You Don't Do Your Job, You Are Usually Fired, But ...

A bipartisan bill set to be unveiled Thursday by Reps. Abigail Spanberger, D-Va., and Brian Fitzpatrick, R-Pa., would block members of Congress from getting paid if the U.S. enters debt default or if the government shuts down.

Giving Away C$13 For a Factory. If There are 1,000 New Jobs, You Are Paying $13 Million Per Job. 10,000 Jobs? $1.3 Million Per Job.

Jeep maker Stellantis has threatened to shift a planned battery plant from Canada to the US unless it receives billions more in state subsidies offered to a rival, in the latest manoeuvre by a big manufacturer in the international battle over green incentives.

It comes as the world’s fourth biggest carmaker, which also produces Vauxhall/Opel, Fiat, Citroën, Peugeot, DS, Alfa Romeo, Maserati and Abarth vehicles, leads a campaign in Europe for the UK and EU to renegotiate tariff rules in the Brexit deal.

Stellantis and the South Korean electronics maker LG announced plans in March last year to build a C$5bn (£3bn) electric-vehicle “gigafactory” in the city of Windsor, Ontario, an investment that received nearly C$1bn in subsidies from the federal and provincial governments.

The factory opening date was set for 2024, with the deal touted by the governing Liberal party as a key win in luring multinational automakers to the country.

Months later, the US passed the Inflation Reduction Act, promising generous subsidies for battery production. In April this year, Ottawa matched incentives offered under the IRA in order to secure a deal with Volkswagen for a sprawling battery plant in St Thomas, Ontario, with subsidies that could cost as much as C$13bn over the next decade.

Now, Stellantis has demanded similar benefits from Canada, warning that otherwise it will move production to the US.