# The ethics of health insurance **URL:** \ **Category:** Miscellaneous and Personal Stuff I Must Share\ **Created:** [December 5, 2024, 3:45am UTC](https://boards.straightdope.com/t/the-ethics-of-health-insurance/1011177 "2024-12-05T03:45:03Z")\ **Posts on this page:** 1\ **Showing post:** 4
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [December 5, 2024, 4:15am UTC](https://boards.straightdope.com/t/the-ethics-of-health-insurance/1011177/4 "2024-12-05T04:15:44Z")
> [@UnitedHealthcare CEO fatally shot in Manhattan \[2024-12-04\]](https://boards.straightdope.com/t/unitedhealthcare-ceo-fatally-shot-in-manhattan-2024-12-04/1011159/128): > > [UHC has the worst record for claim denials](https://www.valuepenguin.com/health-insurance-claim-denials-and-appeals) While the CEO isn’t responsible for denying specific claims, the corporate cultue usually starts with him Wow – and by a wide margin, too! Exactly **twice** the industry average! As you say, the CEO does represent the major aspects of corporate culture. Whether or not it “started” with him, the rate of claims denial is an absolutely central aspect of the business that he must have recognized and condoned, if not encouraged. I don’t think there’s any getting away from the fact that he personally put “shareholder value” above the thousands of lost lives and the suffering that this caused. So how does one reconcile the fiduciary responsibility of a publicly held corporation to maximize profits with the ethical responsibility to fund the medical care to which policyholders are not only legally entitled, but morally entitled? The simple answer is that when such a fundamental conflict exists between business interests and fundamental human rights, then the business model is fundamentally the wrong model. This really is the basic problem with private health insurance for medically essential health care. > [@puzzlegal](#): > > Yes, it feels like it ought to be a not for profit things. I’m not an expert on these things, but my impression over the years from reading about the outcomes of various health care funding systems is that while non-profit insurers are theoretically better than for-profits (and non-profit hospitals demonstrably better than for-profits) that non-profit insurers tend to gravitate to being as self-interested as for-profits. Ultimately, there’s no substitute for either direct government funding of universal health care, or private insurance that is so tightly regulated (as in the statutory health insurance in Germany – _Gesetzliche Krankenversicherung_) that there’s no practical difference between that and single-payer. > [@puzzlegal](#): > > my PCP is salaried, not paid based on how much he can bill. I don’t believe this is a major factor, as long as the fundamental funding model I cited above is addressed. In Canada, with universal health care, the vast majority of physicians are either independent or working as small LLP type partnerships. All the ones I know have independent practices and work on the basis of fee-for-service (FFS). Here in Ontario there are some **[hybrid models](https://www.ontario.ca/page/primary-care-payment-models-ontario)** based on block payments for patient enrollment, but in my personal experience almost all physicians work on FFS. --- _[View the full topic](https://boards.straightdope.com/t/the-ethics-of-health-insurance/1011177)._