ELI5: Why was the UnitedHealthcare CEO considered evil? : r/healthcare
I'm trying to understand the criticisms surrounding the UnitedHealthcare (UHC) CEO and other health insurance companies. The Affordable Care Act (ACA) imposes rules like the 80/20 rule (for smaller insurers) and the 85/15 rule (for larger insurers like UHC). This means they are legally required to spend 85% of premiums on client medical expenses, leaving only 15% for administrative costs and profit source. Given this: Insurance companies mainly compete by managing costs—either by reducing benefits or increasing claim denials. Consumers can choose from a spectrum of insurers with different levels of benefits and claim approval rates. If one insurer starts paying out more claims, premiums would rise, allowing more affordable competitors to enter the market, and the cycle would repeat since clients who can't pay the higher premiums would move to the cheaper higher denial insurance offering the same benefits (on paper). How can a "good" CEO do anything differently for a health insurance co
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