Noah Smith joins to discuss what Tulsi Gabbard could do to America, the other anti-qualified nominees, the Penny/Mangione cases, and what Syria should remind us of.
With regard to Noah’s observation that women on the left appear to suffer the most negative consequences from exposure to social media. I would just say that it strikes me that’s perhaps more an issue of of who is more likely to self-report on psychological and emotional health issues than an actual statistical reality and my guess is it’s widespread across many demographics
Daniel Penny’s “controversial” “actions” ARE murder. NO person, no matter how marginalized and offensive with their acting out should be dead now because of ignorant prejudice (mentally ill, homeless and black) and feeling free to snuff out that life. Disgusting.
No, Noah Smith's comments are not helpful. In fact, they are lies. The average rate of denials is not around 3% - it's 17%, nearly 1 out of 5 claims. Some companies (among them United Healthcare - and what a misnomer that is) deny nearly HALF of all claims. Is there any other product or service we buy where we would accept that one out of five times we don't get what we pay for, much less that half the time we don't get what we pay for?
And while it's true that the profit margins are very small in health insurance, the profits are immense in real dollars. United Healthcare netted $20 billion in 2022. Someone who has just been denied treatment for their illness is not going to accept that it's because the insurance company can't afford it. And it's not just the profits that are enraging people, but the salaries. The CEO of the company makes $10 million per year - far more money that the average American will make in a lifetime.
It was chilling to hear Smith suggesting that a solution to denial of coverage is for companies to pay more claims, but at a lower percentage of cost, leaving patients to pick up the difference. People are already paying thousands of dollars in premiums ($20,000+ for families) and then have to pay deductibles and co-insurance before their plan pays anything. How much money does he think the average person has? This is not insurance - it is a racket.
The United States spends more per capita on health care, with the worse health outcomes of any industrialized democracy in the world. And we're the only industrialized democracy in which people go bankrupt because they can't pay their medical bills.
The only solution for people to be able to get the health care they need at an affordable price is national health insurance that covers everybody and is paid for by a tax assessed on personal and business income. All the money that goes to shareholder profits and that is spent on excessive executive compensation and benefits, as well as marketing and lobbying, would go to actual health care. Administrative costs would be substantially less for hospitals and physician practices by having just one entity (the US government) to pay, rather than a multitude of insurers. Billing would be simplified and collection costs non-existent.
This is all about mental health. I am reminded of John Hinkley Jr's assassination attempt of Reagen. I think we will find out soon enough about Luigi's mental health. That American's rejoice in someone's murder is sick and mentally ill in itself. Thompson's kids do not deserve having their father murdered. Does anybody think his choice of career is noble? No. Did he deserve to die? No. The man Penny killed was mentally ill. What Peney did was manslaughter. It's that simple. As the mother of a young man with Schizophrenia and Aspergers the American populace inability to understand mental illness and respond with compassion and the ability to de-escalate a health episode is frightening. Would we treat a person having a physical seizure and flinging themselves around by landing them in a hold with an arm on their neck and killing them in the process? This is my greatest fear for my son. He is a great citizen most of the time. And as a person with a pre-existing condition, over which I have little control, perhaps the system as designed should not exist. I don't give a rat's ass about their thin profit margin. Don't be in the business of making money on someone's suffering. The system we have by default is sick and mentally ill. While I agree with Bill, this is a dangerous moment, I really am done with this podcast. I find little understanding by the panelists of root causes and too many flippant political responses with laughter about mental illness.
Brilliant discourse. Thank you. Read "On Freedom" by Timothy Snyder. Americans cannot fathom what living in a country controlled by a sadist, but we may find out in round two.
I asked Google: "What is gross margin of United Healthcare?" The response: "UnitedHealth Group average gross margin for 2022 was 24.17%, a 2.38% increase from 2021. UnitedHealth Group average gross margin for 2021 was 24.76%, a 3.73% decline from 2020." The source here is a website called "Macrotrends." For 2023, UHC had earnings before interest and taxes of 32.358 billion dollars on revenues of $290,827 billion, a rate of profit of a little over 11%. So I don't know where Noah Smith is getting his numbers, but it's not from the annual report of UHC, and his summary of the business sounded very suspect to me. They did post a net loss in one recent fiscal year.
Hard disagree with Noah on the healthcare providers getting to give everything and insurance being the bad guy…. Who tells the patients they don’t have coverage for treatment or their insurance has denied claims, the doctors and medical professionals, we see the agony, we say no bc our hospitals won’t allow treatment without payment, and we take the anger and despair. Also no mention that they are not qualified to know what a patient needs, very irresponsible to not understand the real system and report this. Also, no mention of the extremely high salaries and billions in profits listed while doctors who have schooling for 10 plus years make much
Much less. I believe that this panel needs to speak to hospital systems or healthcare professionals before stating as fact how the process works.
When talking about insurance costs, we really need to be looking at administrative expenses and compensation at the top. Those who are not providing direct care and service are making way too much more than those on the front lives healing and saving lives.
I want to address a point raised in passing by Noah because I think it perfectly captures a problem with discussing healthcare.
What he said is that insurance is a tough business and that margins are 1-3% compared to an average 12% for the S&P 500. That fact ignores the outsized profit margins of the IT-heavy Magnificent Seven which artificially inflate the overall average.
That’s simple math. No advanced training in econometrics is required nor will it explain it away. As the mathematicians say, it’s an identity.
Plenty of industries operate at 1-3% margins. Notoriously, grocery stores do. No one argues that’s why there’s food insecurity.
Meanwhile, while lamenting the challenges facing Mr Thompson and his peers, we ignore the fact that medicine and healthcare are, in the US, a business.
I’m sorry to report that there are only a few ways for businesses to make more money. And businesses use all of them including degrading their products and raising prices. Productivity gains are nice to talk about but much harder to pull off consistently than the more blunt force methods.
So of course premiums rise and coverage shrinks. It is about rationing, as Mona says. But rationing that favors shareholders at the expense of the insured.
Aside from the irreversible risk to national security with Gabbard, (which is something no one wants talk about but since he nominated her) Trump may also be in line with which is why he picked her — she’s his direct line to Moscow?!
With Hegseth it’s what he will do to
Moral and also whether he is capable of handling any unexpected military crises. If he’s just there to be Trump’s “yes” man and carry out Trump’s desires. But then there is him potentially hollowing out the military with his discrimination and bigotry towards minorities and women serving at a time when recruitment in poor. He said he was okay with women as pilots just not in combat. And he doesn’t want LGBT in the military. Maybe the generals can stop him and it won’t trickle down and hurt moral, but it could hurt our readiness.
As to Kennedy, yes, maybe Americans learn the hard way in states that decide to follow his advice. Many parents are not do foolish as to not want their kids to get vaccines and I’m assuming there won’t be a country wide ban on them. But stop vaccination in babies in some states that adhere to his advice in this political science experiment seems to me to be cruel as the ones who survive could come out with life-long debilitating health problems. Do we want to see kids crippled by polio or rickets, getting measles or the mumps, etc.
But we all could suffer if there is another Covid-like contagious outbreak (which is being predicted) and Kennedy sits back and does nothing or tries to prevent vaccines from becoming available. Not to mention how this will impact the ability to travel outside the country or even outside certain states if blue states go it alone and provide vaccines but want to block people in highly contagious red states from coming in. This alone scares me personally the most.
I beg to differ. Noah Smith and panelists can spend some time with hospital and clinics and ask some questions about the denial process, the staff required to handle insurance requirements including denials, pre authorization and claims management while also facing declining reimbursement from all quarters. Call the American Hospital Associayion and the National Rural Health Association and ask about the razor thin margins, in comparison to the “thin” margins of insurance companies. Try again.
I bumped on the idea that healthcare companies are on the razor's edge of profitability. The claim was 1-3% of profitability, with an insinuation that it barely makes sense to run a business at that level. UnitedHealth Group had $371.6B in revenues and made $22B in profit. My math might be rusty, that's just a hair under 6%.
And then comparing it to the S&P500 average profitability? That's apples to steel. Apple has almost a 24% profit margin. Should UHG strive for that level and consider itself a failure if it doesn't get there? If you are concerned about the profit margin for a company you're invested in, sell your shares and buy in a different company.
Did not even one of you read what all the signs said in the closing weeks of the Harris campaign? Did you not listen to any of her speeches? FREEDOM. FREEDOM. FREEDOM. Sadly, the idea of losing or gaining freedom did not resonate with the majority of American voters.
see the last paragraph in the entry of her military service and the last sentenence of that paragraph.
In 2020, after serving with them for 17 years, Gabbard left the Hawaii Army National Guard for a new assignment with a California-based Army Reserve unit.[83] On July 4, 2021, Gabbard was promoted to the rank of lieutenant colonel, while she was deployed to the Horn of Africa working as a civil affairs officer in support of a special operations mission.[17][18][2] Subsequently, Gabbard was given the command of the 1st Battalion, 354th Regiment, based in Tulsa, Oklahoma.[84][85] As a lieutenant colonel, Gabbard has top-secret security clearance.[34]
With regard to Noah’s observation that women on the left appear to suffer the most negative consequences from exposure to social media. I would just say that it strikes me that’s perhaps more an issue of of who is more likely to self-report on psychological and emotional health issues than an actual statistical reality and my guess is it’s widespread across many demographics
Daniel Penny’s “controversial” “actions” ARE murder. NO person, no matter how marginalized and offensive with their acting out should be dead now because of ignorant prejudice (mentally ill, homeless and black) and feeling free to snuff out that life. Disgusting.
No, Noah Smith's comments are not helpful. In fact, they are lies. The average rate of denials is not around 3% - it's 17%, nearly 1 out of 5 claims. Some companies (among them United Healthcare - and what a misnomer that is) deny nearly HALF of all claims. Is there any other product or service we buy where we would accept that one out of five times we don't get what we pay for, much less that half the time we don't get what we pay for?
And while it's true that the profit margins are very small in health insurance, the profits are immense in real dollars. United Healthcare netted $20 billion in 2022. Someone who has just been denied treatment for their illness is not going to accept that it's because the insurance company can't afford it. And it's not just the profits that are enraging people, but the salaries. The CEO of the company makes $10 million per year - far more money that the average American will make in a lifetime.
It was chilling to hear Smith suggesting that a solution to denial of coverage is for companies to pay more claims, but at a lower percentage of cost, leaving patients to pick up the difference. People are already paying thousands of dollars in premiums ($20,000+ for families) and then have to pay deductibles and co-insurance before their plan pays anything. How much money does he think the average person has? This is not insurance - it is a racket.
The United States spends more per capita on health care, with the worse health outcomes of any industrialized democracy in the world. And we're the only industrialized democracy in which people go bankrupt because they can't pay their medical bills.
The only solution for people to be able to get the health care they need at an affordable price is national health insurance that covers everybody and is paid for by a tax assessed on personal and business income. All the money that goes to shareholder profits and that is spent on excessive executive compensation and benefits, as well as marketing and lobbying, would go to actual health care. Administrative costs would be substantially less for hospitals and physician practices by having just one entity (the US government) to pay, rather than a multitude of insurers. Billing would be simplified and collection costs non-existent.
This is all about mental health. I am reminded of John Hinkley Jr's assassination attempt of Reagen. I think we will find out soon enough about Luigi's mental health. That American's rejoice in someone's murder is sick and mentally ill in itself. Thompson's kids do not deserve having their father murdered. Does anybody think his choice of career is noble? No. Did he deserve to die? No. The man Penny killed was mentally ill. What Peney did was manslaughter. It's that simple. As the mother of a young man with Schizophrenia and Aspergers the American populace inability to understand mental illness and respond with compassion and the ability to de-escalate a health episode is frightening. Would we treat a person having a physical seizure and flinging themselves around by landing them in a hold with an arm on their neck and killing them in the process? This is my greatest fear for my son. He is a great citizen most of the time. And as a person with a pre-existing condition, over which I have little control, perhaps the system as designed should not exist. I don't give a rat's ass about their thin profit margin. Don't be in the business of making money on someone's suffering. The system we have by default is sick and mentally ill. While I agree with Bill, this is a dangerous moment, I really am done with this podcast. I find little understanding by the panelists of root causes and too many flippant political responses with laughter about mental illness.
Brilliant discourse. Thank you. Read "On Freedom" by Timothy Snyder. Americans cannot fathom what living in a country controlled by a sadist, but we may find out in round two.
I asked Google: "What is gross margin of United Healthcare?" The response: "UnitedHealth Group average gross margin for 2022 was 24.17%, a 2.38% increase from 2021. UnitedHealth Group average gross margin for 2021 was 24.76%, a 3.73% decline from 2020." The source here is a website called "Macrotrends." For 2023, UHC had earnings before interest and taxes of 32.358 billion dollars on revenues of $290,827 billion, a rate of profit of a little over 11%. So I don't know where Noah Smith is getting his numbers, but it's not from the annual report of UHC, and his summary of the business sounded very suspect to me. They did post a net loss in one recent fiscal year.
Hard disagree with Noah on the healthcare providers getting to give everything and insurance being the bad guy…. Who tells the patients they don’t have coverage for treatment or their insurance has denied claims, the doctors and medical professionals, we see the agony, we say no bc our hospitals won’t allow treatment without payment, and we take the anger and despair. Also no mention that they are not qualified to know what a patient needs, very irresponsible to not understand the real system and report this. Also, no mention of the extremely high salaries and billions in profits listed while doctors who have schooling for 10 plus years make much
Much less. I believe that this panel needs to speak to hospital systems or healthcare professionals before stating as fact how the process works.
When talking about insurance costs, we really need to be looking at administrative expenses and compensation at the top. Those who are not providing direct care and service are making way too much more than those on the front lives healing and saving lives.
I want to address a point raised in passing by Noah because I think it perfectly captures a problem with discussing healthcare.
What he said is that insurance is a tough business and that margins are 1-3% compared to an average 12% for the S&P 500. That fact ignores the outsized profit margins of the IT-heavy Magnificent Seven which artificially inflate the overall average.
That’s simple math. No advanced training in econometrics is required nor will it explain it away. As the mathematicians say, it’s an identity.
Plenty of industries operate at 1-3% margins. Notoriously, grocery stores do. No one argues that’s why there’s food insecurity.
Meanwhile, while lamenting the challenges facing Mr Thompson and his peers, we ignore the fact that medicine and healthcare are, in the US, a business.
I’m sorry to report that there are only a few ways for businesses to make more money. And businesses use all of them including degrading their products and raising prices. Productivity gains are nice to talk about but much harder to pull off consistently than the more blunt force methods.
So of course premiums rise and coverage shrinks. It is about rationing, as Mona says. But rationing that favors shareholders at the expense of the insured.
Aside from the irreversible risk to national security with Gabbard, (which is something no one wants talk about but since he nominated her) Trump may also be in line with which is why he picked her — she’s his direct line to Moscow?!
With Hegseth it’s what he will do to
Moral and also whether he is capable of handling any unexpected military crises. If he’s just there to be Trump’s “yes” man and carry out Trump’s desires. But then there is him potentially hollowing out the military with his discrimination and bigotry towards minorities and women serving at a time when recruitment in poor. He said he was okay with women as pilots just not in combat. And he doesn’t want LGBT in the military. Maybe the generals can stop him and it won’t trickle down and hurt moral, but it could hurt our readiness.
As to Kennedy, yes, maybe Americans learn the hard way in states that decide to follow his advice. Many parents are not do foolish as to not want their kids to get vaccines and I’m assuming there won’t be a country wide ban on them. But stop vaccination in babies in some states that adhere to his advice in this political science experiment seems to me to be cruel as the ones who survive could come out with life-long debilitating health problems. Do we want to see kids crippled by polio or rickets, getting measles or the mumps, etc.
But we all could suffer if there is another Covid-like contagious outbreak (which is being predicted) and Kennedy sits back and does nothing or tries to prevent vaccines from becoming available. Not to mention how this will impact the ability to travel outside the country or even outside certain states if blue states go it alone and provide vaccines but want to block people in highly contagious red states from coming in. This alone scares me personally the most.
I beg to differ. Noah Smith and panelists can spend some time with hospital and clinics and ask some questions about the denial process, the staff required to handle insurance requirements including denials, pre authorization and claims management while also facing declining reimbursement from all quarters. Call the American Hospital Associayion and the National Rural Health Association and ask about the razor thin margins, in comparison to the “thin” margins of insurance companies. Try again.
My exact thoughts, you stated this much more eloquently
I want Rupert’s trust to stay in place!
I bumped on the idea that healthcare companies are on the razor's edge of profitability. The claim was 1-3% of profitability, with an insinuation that it barely makes sense to run a business at that level. UnitedHealth Group had $371.6B in revenues and made $22B in profit. My math might be rusty, that's just a hair under 6%.
And then comparing it to the S&P500 average profitability? That's apples to steel. Apple has almost a 24% profit margin. Should UHG strive for that level and consider itself a failure if it doesn't get there? If you are concerned about the profit margin for a company you're invested in, sell your shares and buy in a different company.
Did not even one of you read what all the signs said in the closing weeks of the Harris campaign? Did you not listen to any of her speeches? FREEDOM. FREEDOM. FREEDOM. Sadly, the idea of losing or gaining freedom did not resonate with the majority of American voters.
Tulsi Gabbard is a Lieutenant Colonel in the US Army Reserve and already has top-secret clearance.
https://en.wikipedia.org/wiki/Tulsi_Gabbard
see the last paragraph in the entry of her military service and the last sentenence of that paragraph.
In 2020, after serving with them for 17 years, Gabbard left the Hawaii Army National Guard for a new assignment with a California-based Army Reserve unit.[83] On July 4, 2021, Gabbard was promoted to the rank of lieutenant colonel, while she was deployed to the Horn of Africa working as a civil affairs officer in support of a special operations mission.[17][18][2] Subsequently, Gabbard was given the command of the 1st Battalion, 354th Regiment, based in Tulsa, Oklahoma.[84][85] As a lieutenant colonel, Gabbard has top-secret security clearance.[34]
Her five-year periodic reinvestigation will be coming up soon.
Well like a commenter above stated, “she’s a tool for our enemies.”
“Politics abhors a vacuum” -and our incoming administration is isolationist.