[cduzz]

So, let's look at UnitedHealth Group; do they deliver health care?

If there were single payer, what would their role be in the healthcare delivery process?

Apparently they made 2.3 billion in profits on 113 billion in revenue in Q3 of 2025. How much of that friction would evaporate if they weren't in the healthcare delivery infrastructure.

Someone once said "the best part is no part" ?

[nickff]

Compare UPS or FedEx to USPS; the first two companies are profit-seeking, yet very competitive with the 'public-oriented' (and legally privileged) USPS. Having the government in control does not necessarily lead to better value.

[naasking]

They are very competitive in the places where most people live, but the USPS delivers to many more places that the others do not, and still maintains cost competitiveness.

This turns out to be a decent analogy to healthcare: insurance companies do not provide the coverage, universality and simplicity that a single payer system would; instead, you'll get something like insurance coverage networks providing spotty and inconsistent care.

Either approach has upsides and downsides, but single payer, universal coverage for basic and emergency healthcare seems like a no-brainer.

[cduzz]

I've lived in cities where the city ran the utilities; they were generally way cheaper than the utilities from PG&E.

The USPS is obligated to deliver letters at the same cost to everyone in the country, and they do a pretty okay job at it -- I've certainly had horrid events from UPS and FedEx, and those guys get to just pass the crap delivery tasks off to USPS if they don't like it.

Lots of old people in the USofA seem to like their government run medical insurance, same with people in the VA system.

The Doge crew spent months looking for fraud waste and abuse and I don't see any big law enforcement results from all the fraud they found, and I don't see anyone crowing over all the waste they curtailed.

It's possible that the world's more complex than you imagine, and that sometimes people just do their jobs (IE the bureaucrats) and hard problems get solved.

Now, tell me again, what part of the health care system is UnitedHealth? What critical problem do they solve?

[HDThoreaun]

$2.3 billion is nothing in a $5 trillion system. Doctors make around $500 billion in the US. Their wages are much more significant than insurance profits.

[naasking]

$2.3bn is profit after subtracting costs. Doctors charging time to deal with bureaucracy needed by insurance adds to the costs that are already factored into the revenue. Single payer wouldn't just eliminate the profit, but also those costs.

[cduzz]

Buddy.

That's 2.3 billion in ONE QUARTER of 2025, on a revenue of 115 billion. In a quarter. There are four quarters in a year.

$5 trillion is how much is spent in all of healthcare in the USA for the whole year.

UnitedHealth's revenue was $500 billion (and net profits is 10 billion) for the year. For one insurance company. There are 6 that each have more than $80 billion per year in revenue. This isn't to mention the billing departments for each hospital, the claims processing providers smaller doctors need to enlist, the endless hours interacting with insurance companies, etc.

And tell me, please, what specific healthcare outcomes are driven by insurance companies?