this post was submitted on 20 Mar 2024
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[–] Gaywallet@beehaw.org 23 points 7 months ago* (last edited 7 months ago) (1 children)

The author of this article has a clear bias and lets this bias lead their perception of accountable care organizations (ACO), despite it being perhaps the only existing lever within our system by which preventative and population health measures can actually be adopted. This complete misread of ACO and VBC (value based care) makes it difficult to view anything else the author says with credit. Which is a shame, because a fair deal of this history I'm familiar with and I completely agree that UHG is a fucking capitalistic nightmare plague on US healthcare costs.

[–] Glaive0@beehaw.org 10 points 7 months ago (1 children)

Genuinely curious:

Is the author saying that ACO and VBC were decent ideas that got UHG’s fingers grafted into the legal structure, or are they just saying that ACO and VBC are bad in general?

And I knew that we had some awful structures within our healthcare system, but I LOATHE UHG and didn’t realize that they OWN our medical system. Disgusting.

[–] Gaywallet@beehaw.org 7 points 7 months ago* (last edited 7 months ago) (1 children)

To me it sounded like they were saying ACO and VBC are both bad. In fact, it kinda felt like they were attributing their creation to UHG as some kinda malicious moneymaking scheme.

[–] sadreality@kbin.social 2 points 7 months ago* (last edited 7 months ago) (1 children)
[–] Gaywallet@beehaw.org 1 points 7 months ago (1 children)

Accountable care organization. VBC = value based care.

[–] sadreality@kbin.social 2 points 7 months ago (1 children)

I know how to read an abbreviation... Looking to understand what they actually do within the corruption scheme

[–] Gaywallet@beehaw.org 1 points 7 months ago (1 children)

I'm not sure how to answer your question in a manner which doesn't touch on the same points the author brings forward. Was something they said unclear or are there parts of my comment which you'd like me to elaborate upon?

[–] sadreality@kbin.social 2 points 7 months ago (1 children)

What job do they actually do?

You suggested they are not corrupt. I am trying to understand where you are coming from?

[–] Gaywallet@beehaw.org 1 points 7 months ago (1 children)

Explaining what an ACO and what VBC are is far outside the scope of the educational burden I'm willing to take on. Instead, have some links:

[–] sadreality@kbin.social 1 points 7 months ago (2 children)

https://en.wikipedia.org/wiki/Accountable_care_organization

https://en.wikipedia.org/wiki/Value-based_health_care

You attempted to discredit author of the article over him being critical of these concepts but are unwilling to explain how they benefit patients. I see promises being made but I also see steep administrative costs also, which is the critical defect in the US healthcare system.

Based on wiki pages, it appears that these are just another model that serves as band aid on fundamentally flawed system with a lot room for corruption to continue.

[–] mozz@mbin.grits.dev 1 points 7 months ago

This is the essential flaw in having the whole system designed and operated by people whose specialty is extracting the labor value from other people's effort, and skittering away with it like an 1800s movie villain with a big sack of money with a "$" on it.

😢

[–] Gaywallet@beehaw.org 1 points 7 months ago* (last edited 7 months ago)

She tried to paint ACOs as the brainchild of UHG specifically, as a means to extract wealth from an existing system. That ignores the current state of ACOs and the many which are able to reduce overall healthcare costs and in many cases reduce administrative costs. Yes, the US healthcare system is broken. Yes, it's very simple to view this as a "band aid on a fundamentally flawed system" and yes, there's still room for "corruption to continue". None of that is in conflict with what I stated. I merely took issue with the framing that UHG is responsible for the creation of ACOs and VBC as that's just factually incorrect, and it suggests the framing that ACOs are not providing any value to the system or being useful in any way- this is contradicted in the article I linked as well as plenty of other published literature by organizations which are notably not UHG.

[–] Maeve@kbin.social 8 points 7 months ago (1 children)

Get ready for clay tablets and possibly cuneiform record keeping. I saw this coming from a mile away before health records and billing were due to go live online, and everyone pooh-poohed my alarms. We can't go back to all paper, we're still squandering life-breathing trees. But a lot of this is simply board members and C-Suite not allocating enough dollars for proper hardware, software, and strongly knowledgeable minds to implement good security.

[–] Gaywallet@beehaw.org 5 points 7 months ago* (last edited 7 months ago) (1 children)

But a lot of this is simply board members and C-Suite not allocating enough dollars for proper hardware, software, and strongly knowledgeable minds to implement good security.

The stolen data was encrypted, so all the hackers were doing was stopping business from being run. With that being said, if you think it's just about 'implementing good security' I think you're out of depth when it comes to just how large of an attack vector it is and how sophisticated the attacks can be. We're talking about an industry where people are willing to cough up millions of dollars to recover data in some cases, meaning that it attracts some of the best talent in the world to coordinate attacks and the attacks can be extremely sophisticated.

[–] Maeve@kbin.social 3 points 7 months ago

Sure. Allow me to give you a little background about my area, from personal experience a hundred years ago in the industry: security by obscurity was the standard, a CTO had zero experience with anything computer related, beyond powering his on and pecking out emails, was not interested in learning about (let alone learning any) current or new technology, coding, or security related. The sysad couldn't code a lick, depended on an online scanner for malware removal (and it was a persistent problem), and did absolutely zero auditing, wondering why the better team members stayed long enough for a reference and ran screaming. This was the worst, but not by much, company I worked for in the industry in a very wealthy area. I'm sure things have changed over the years, but from friends in the industry, not by much. They still stay long enough for the reference of official experience, then end up moving companies, or the better ones go on to self-employme t, often contacting for the same companies, at 4x the hourly rate, because it's still cheaper than getting sued by by clients or the government.

The weird thing is, I'm about to try to re-enter the industry, personal and industry issues aside, at a later point in the year.