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From: Cryptoengineer <petertrei@gmail.com>
Newsgroups: rec.arts.sf.written
Subject: Re: [OT] Murder in New York
Date: Wed, 11 Dec 2024 19:22:49 -0500
Organization: A noiseless patient Spider
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On 12/11/2024 12:26 PM, Paul S Person wrote:
> On Tue, 10 Dec 2024 21:04:42 +0000, quadibloc <quadibloc@gmail.com>
> wrote:
> 
>> A few days ago, I had read in the news that the CEO of a major health
>> insurer was gunned down. This was shocking; it seemed to mean that no
>> one
>> was safe from crime.
>> Then I came across the following information on a web site: that the
>> health care insurer of which he was the CEO had used an AI system to
>> process claims; this system rejected 90% of all claims, including many
>> valid ones.
>> Maybe this site is a leftist one, and this claim is not true, I don't
>> know for sure. But if it is true, my sympathy for this homicide victim
>> basically evaporated. After all, if someone's health insurer doesn't
>> pay out on valid claims... that person might not get health care. That
>> kills people. But the legal system wasn't in the process of prosecuting
>> him as aggressively as any other murderer.
> 
> I saw the claim; I have no idea how true it is.
> 
> You must keep in mind that the USA does not have a "medical system".
> It has a Medical Industry composed of various competing business
> enterprises.
> 
> And the purpose of a business enterprise is to /make money/, not to
> /pay claims/.

This 'corporatism' is something I'm less and less in love with every
year.

No matter what their PR may tell you, the fiduciary duty of
the officers in every public corporations is the same: "Maximize
shareholder return on investment". NOT "Serve our customers". If
they fail to do so at every opportunity, they can be sued.

Particularly when their customers are individuals, there is an
enormous disparity in agency and power, and corporations will
use their power to ride roughshod over people, and every year
it looks like they have fewer ethics and less of a conscience.

I'd love to find a solution which rebalanced this.

pt