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Joined 6 months ago
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Cake day: July 8th, 2025

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  • Premiums are revenue. You posted stats showing they are not already getting the 20% portion for themselves, and that 20% portion is for running the business. Rebates never come into play because they never hit the 20%.

    If they only get 15% of the revenue from premiums they are only getting 75% of their potential cut which is used to run the fucking business before the possibility of profit comes into play. That means they have a huge incentive to cut any costs they can to approach their 20% cut WHICH THEY ARE NOT ALREADY GETTING.

    I already posted the simplest math possible. Your math is wrong. Your assumptions are wrong. Just fucking accept that you don’t understand and believe literally everyone else that understands how this works including the people who write professional articles about the topic.







  • The first step is that the insurance company bets on how much someone will cost them on average. So they have estimated that x number of people being insured will cost the company y dollars. Then they collect those premiums and being able to keep 20% of that AFTER paying for the medical care AND the costs to process the medical care. If an individual costs more to provide medical care to the company loses money on that person and the costs are averaged out with others that cost less than the average amount.

    So if they can get the majority of people to cost less then they come out ahead and can keep some of it as the 20%. If they guessed low on the premiums they might lose money. They do NOT automatically get the 20% portion and that portion has all their operating costs and what is left over is profit. The incentive to lower hospitalizations and deny care is that it increases the proportion they can possibly turn into profit.