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Teen ODs and died after UnitedHealthcare ‘denies addiction treatment’: lawsuit
(www.independent.co.uk)
this post was submitted on 30 Apr 2025
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I was listening to the Acquired episode on Epic and they touch on the severe cost overruns in our healthcare system. They make a point to share that hospitals aren't the ones making a killing. It's insurance companies.
They make a compelling argument that if you add up the total that you pay to insurance, taking into account what your employer pays, there's no way you get that much value out of your health insurance annually.
I have a number of complex chronic health problems and I usually hit my out-of-pocket limit around April every year. I find spiteful glee in costing my health insurance tens of thousands of dollars every year. (And every penny of it is actually medically necessary.)
insurance is always a gamble, and the house always wins
don’t insure anything you can afford to lose, and save up money you’d put into insurance in a HISA
that said, things you can’t afford to lose probably include your house, someone else’s lamborghini, your health
buuuuuuut US health care is set up for bargaining: hospitals overcharge, pharmacies overcharge, drug companies overcharge because they all know insurance companies aren’t gonna pay what they actually charge because they have bargaining power… which, if you don’t have insurance, leaves you holding the fucking ball with no bargaining power
… all of this is said as an aussie, with universal healthcare and only a passing (but real life) experience of the US healthcare system (and in general a system that will protect me from fucking up so hard i can’t even imagine being completely destitute), so grain of salt n all that
It's a metaphorical gun to the head. It's not designed to help. The purpose of the system is what it does.
Oh man, epic is such complicated garbage that even with a company brought in to set it up, the center I worked at during the rollout was a fucking mess. I left 14-18 months after initial deployment and they were still ironing bugs out, and I heard they rolled back within a year or so of leaving. Also, it's almost hilarious how often I hear nurses bitching about using epic just when I have to go in for anything, and none of them are related to the place I worked.
I respectfully disagree after you try other EHRs like Cerner lol
I also haven't heard complaints about Epic with bugs at least in my org. They are pretty user friendly especially when we have some staff that can barely type. The only complaint was documentation. Nursing documentation was tedious with like over 250 options for "adult assessment" but they've slimed it down to like 50 earlier this year for my healthcare system. Lastly, I think things work better the more money hospitals put in the EHR. I was per diem for another healthcare system. It was pretty cool how many other features they had than ours.
Must just be one of those "yeah my product is awful but have you seen the other guy?" sort of situations. I never had to use the EMR directly outside of troubleshooting, but both epic and the previous EMR were pretty garbage so I don't really have a good baseline to go off of.
The Acquired episode made it clear that the customer isn't the people who use the software. Their customer is the CEO and the CIOs of hospital systems.
That would explain a lot. I'm pretty sure the CEO/CFO (can't remember which) got let go for embezzlement or something a year or so after I was gone.
Yeah, it's this. I worked at Epic somewhat recently, and I've since worked with former Cerner/Oracle folks too. To Epic's credit, they've never been acquired, and are better for it.
There's a lot of vocational awe across the board, people genuinely trying their best to make the product good. But healthcare is inherently complicated, because people are complicated. Each individual health system needs it customized to their specific needs, and over time this can get hairy to support. Add on to that that regulations and guidelines literally change every year, and it can become really hard to make headway on more meaningful changes when you're just trying to stay compliant.
This leads to burnout on the software support side, Epic churns through new hires like crazy - average tenure has been way down since COVID-19 (you can Google their response to that), so it's a revolving door of 21-25 year olds keeping that ship afloat.
Also, yes, insurance companies are the ones making the big money, by a mile.
That's kind of interesting because I used to work in health insurance (mental health specifically, so it has its own quirks), and it felt like things were always in financially dicey territory. It must be different in medical.
The costs are inflated for sure, but compared to to cost of paying for cancer treatment entirely out of pocket, it's still cheaper. That's the whole point of insurance, to cover the event of a catastrophic cost.
I'm not as sure about that. If you paid your premiums, etc. into a low yield savings account, especially when you start when you're young, I think the value proposition would be more than insurance where you have no way to control payment decisions.
Please do not read this as me saying don't get insurance. Read it as our insurance is failing to provide the value that we pay into it and need something better.
The Acquired episode goes into detail how we ended up with a private payer system and it's so infuriating. Our health system was being set up around the same time as the UKs and they show how different incentives lead to where we are.
Why do you think the cost of paying out of pocket is so high? Private insurance bears a significant part of the responsibility for causing that problem.
Structurally, yes, you need a system that amounts to healthy people saving, and sick people being taken care of from those savings, whether it's individual or social. But our current system of private for-profit insurance is about as bad as such a system could be while still technically sorta working.