@186 I think you're missing the point. The goal is layoffs because that's the only thing they know how to do and anything else erodes the business. NOTHING else that keeps us a going-concern will materially improve IOI.
Looking at other developed countries, there are two major ways to materially cut cost out of the system in the USA:
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Change the way we deploy and educate healthcare providers. Elevate the PA route to be on par with MD/DO physicians so that PA+Residency = MD+Residency. Doctors are overpaid, those further down aren't compensated adequately. yadda yadda malpractice insurance, student debt, med school, sure but that's resolved using existing pathways from CNA/HHA to PA. Lower med cost = lower reimbursement = lower cream collected by Payers. No-go for UHG.
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Transition to single payer. 1,000+ companies that do the same thing, slightly differently, in an arcane way (versions of metric vs imperial) that ensures existence. They collude and billions are syphoned off from the general public to fund exec salaries. You don't need all the circles and hoops around reimbursement by severity, demographics, etc. Just pay for the care that's needed in a given geography. One pool of lives makes it simple.
This also means we don't need Optum selling to 1,000 Payers. You don't need 1,000 Payers with their own version of Optum and trying to commercialize. You have one single payer to buy/use a single set of "Optum" products many of which would be unnecessary anyway. Obviously no-go for UHG
Bonus #3 make for-profit/publicly traded companies in the Provider space illegal though "non-profit" execs are well paid.
We have a guy who built this company and is waaaaaaay over exposed to an asset that shouldn't exist. The fact his financial planner doesn't diversify is a testament to pigheaded hubris. It's like crypto. So of course, there's a lot of buzz about AI and consumer apps and VBC and [pretend] incremental steps like RFK prior-auth.