This is an excellently written comment, thank you!
but in fact the lawsuit appears to condemn their “anti-consumer tactics” while seeking damages from their “materially false and misleading” statement to investors in January.
I’m going to have to argue a bit here because you’re describing the legal case correctly, but the legal case is not the same as the reality.
Healthcare investors are fully aware that they profit over denying claims. That is their business model. They make money by denying claims. They are invested in profiting by denying as many claims as possible. Sure, publicly they will condemn “anti-consumer tactics”, but at the same time they’re lining their own pockets with the profits of those tactics.
The “misleading” statement by Healthcare United was that the profit would continue to be the same. Because claims would be denied at the same rate. Why was the statement misleading? Because claims were not denied at the same rate, more claims were paid out than before.
The medium article is sensationalized, but it’s also reading between the lines of the lawsuit. The investors are not stupid. The investors know full well that you cannot maintain the same profit if you raise your expenses. Profit = revenue - expense. Denying fewer claims raised the expenses. To be mad that profit didn’t stay the same, they are actually mad that claim denials did not stay at the same rate.
I guarantee you this lawsuit is not about improving healthcare and getting ordinary people the care they need. This is just another game of rich people making money.
This is an excellently written comment, thank you!
I’m going to have to argue a bit here because you’re describing the legal case correctly, but the legal case is not the same as the reality.
Healthcare investors are fully aware that they profit over denying claims. That is their business model. They make money by denying claims. They are invested in profiting by denying as many claims as possible. Sure, publicly they will condemn “anti-consumer tactics”, but at the same time they’re lining their own pockets with the profits of those tactics.
The “misleading” statement by Healthcare United was that the profit would continue to be the same. Because claims would be denied at the same rate. Why was the statement misleading? Because claims were not denied at the same rate, more claims were paid out than before.
The medium article is sensationalized, but it’s also reading between the lines of the lawsuit. The investors are not stupid. The investors know full well that you cannot maintain the same profit if you raise your expenses. Profit = revenue - expense. Denying fewer claims raised the expenses. To be mad that profit didn’t stay the same, they are actually mad that claim denials did not stay at the same rate.
I guarantee you this lawsuit is not about improving healthcare and getting ordinary people the care they need. This is just another game of rich people making money.