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According to this source, united healthcare profits were $14B in 2024. https://www.healthcaredive.com/news/unitedhealth-unh-2024-re...

So yeah, money out not matching money in is exactly the problem.


So a bit under 5% per the rest of the numbers in that link.

I can't find the detailed breakdown for 2025, but in 2024, they took in $308bn in premiums and paid out $264bn in medical costs. So even ignoring all of the downstream and systemic problems caused by insurance existing as a for-profit entity, they're taking 14% off the top just to exist as a middle-man.

https://www.unitedhealthgroup.com/content/dam/UHG/PDF/invest...


> they took in $308bn in premiums and paid out $264bn in medical costs ... they're taking 14% off the top just to exist as a middle-man.

In 2023, they had a 0.8% profit margin[0]. 9 billion dollars in a trillion dollar industry.

Ignoring the disingenuous framing ("taking off the top" including how much they pay their employees), how does that compare to other industries?

[0]https://content.naic.org/sites/default/files/2024-annual-hea...


> including how much they pay their employees

Highlighting that was actually part of my point. What utility does insurance add to justify its existence as a middle man? How are we better off with a middle man taking a cut vs nationalizing the industry? And that 14% is at best, given the other externalities of the existence of insurance and its perverse incentives.

You're saying "how is that worse than other industries", but I'm saying, why is there an industry there at all?


The government would still need employees to basically do everything that the people at insurance companies do. Theoretically it could be more efficient, realistically it would not.

The real problem with our system is that for anyone who is going to hit their deductible, or especially their out of pocket max, the costs no longer matter at all. Sure, that cancer drug can be $500,000. GLP1 drugs for $1,000 a month? Why not?

Of course, there's no free lunch on this. In a single payer system you get things like the UK not approving certain cancer treatments for people over a certain age, certain medications just aren't available, etc.

Otherwise you could make every plan a very high deductible plan, possible just not cover medications at all, etc. But then people will complain about people not being able to afford things, especially in the short term.


About half of those profits were from the Optum side of the business, not from insurance.

If you’ve had UHC you’d know very well that Optum is intimately tied to their insurance business. UHC just “administers the plan” while Optum controls plan decisions. So when there’s a problem, which there always is with every claim more complicated than a PCP visit, you get bounced between both companies for hours until you find someone willing to take responsibility for answering questions.

When enforcement is this shoddy, it’s easy to create corruption through selective enforcement.

“We don’t have the resources to go after everyone, so we must prioritize” - but it turns out there’s a bias to the selection process…

I believe that justice is only true when we are all treated equally under the law.


> The crossword has a similar sort of unwritten rule, maybe not as strict, but really hard technical words seldom appear.

Not my experience at all.

Ask me how I know what an EPEE is


EPEE is a common fill word from a lexicon informally known as crosswordese.

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

Really no harder than memorizing all the 2 and 3 letter words in Scrabble and many players will pick most up in a few months.


I didn’t know it was called crosswordese! I wonder what the most common term used is. As a very occasional player, for some reason ARIA, IBIS, and VENI/VIDI/VICI stick out, but I’m sure it’s actually one with an E.

VENI/VIDI/VICI are easy for anyone who studied Latin (as indeed used to be common), and ARIA is similarly easy for anyone who knows about opera. Basically, the crossword is for snobs.

I agree that crosswords often include cultural references that lean towards certain demographics / assuming particular education, and that can feel exclusionary if you don’t share that background - and there's even an argument to suggest snobbery might be behind those choices.

But I disagree that that makes it for snobs. Snobbery is more about an attitude of looking down on others or their tastes, whereas knowing Latin or being a fan of opera is really just about exposure.

Sure, there exist some (too many) opera fans who would say something like "it's real art compared to pop or hip hop being low class trash", but that's not a defining part of liking opera and plenty of people who like opera aren't snobs. Ironically it's a different form of snobbery (sometimes called reverse snobbery though personally I hate that term), to dismiss anyone who learned Latin or who likes opera as being a snob!


Major crossword offenders:

ERR, ORCA, OBOE, ALOE, ORE, ODE


The middle 4 are all fairly common words. "Ode" isn't super common, but I hear it in "An ode to..." phrases. And "err" I've only ever heard in 1 phrase: "To err is human."

> The middle 4 are all fairly common words.

That's not really the concept. People know what an orca is.

But if you see a crossword clue that says "black and white animal", you know that the answer is ORCA without even needing to look at the number of letters in the answer. (Could it be "skunk"? Could it be "panda"? No, those are stupid questions.) Same thing if the clue is "marine predator". (Could that be "shark"? No.) The words I listed are incredibly likely to appear in crossword puzzles. That's what's weird about them.


See also: "Err on the side of caution."

certain crossword authors like certain words, there is one that almost always uses OREO in their puzzles.

An épée is one of three types of sword used in the three styles of Western fencing. As such, it's about as technical as, say, the words "touchdown" or "mitt".

It's also just the regular French word that means "sword". But although crossword puzzles frequently ask you to know common French words, I've never seen one clue the answer EPEE that way.


Epee is not an obscure word. It's an olympic event for goodness sake.

> Ask me how I know what an EPEE is

That’s when you’re like, only tangentially involved with the making of a movie or tv show, but too famous to go without a credit?


> EPEE

They love that one.


If you took fencing at an Ivy League school for you PR requirement you would know all about foil, saber, and epee fencing. Not everyone gets to row crew.

Wholly offtopic but just posting because I thought it was awesome...

During Covid I saw an ad for a fencing school how it was the best sport during Covid.

You wear a mask

You keep your distance

And if someone doesn't, you stick em with the pointy end

:)


It's actually a terrible sport for covid, involving heavy breathing in close proximity to other people indoors.

Any outdoor sport would be better.


I'm not sure if this is a humble-brag and/or if it's a subtle dig at the out-of-touch lives of NYT crossword players.

Don't forget sailing and equestrian.


And any 4 letter instrument is usually OBOE and a fish related clue is EELS

Ah yes, good old ARA Parseghian. That guy.

No evidence or supporting material, just continued insistence that the author is correct.

“I can’t crawl inside your skull and prove you wrong. But this is how it works for most people, including most who insist it does not.“

Consider this direct excerpt of 2 back to back sentences and how 1 contradicts the other.

You can’t crawl inside my skull, but you can crawl inside everyone else’s?


The essay is a great example of a mindset that devalues the subjective and strives to rebrand it as objective. Paradoxically it shows insecurity. "My experience doesn't count unless it's The Truth."

You like a thing. That's fine. That's enough. There's no need to prove the worth of your own enjoyment by fantasizing that it conquers everyone else's brain too.

You're the adult now. You're allowed to like it just because you like it.


"Shall I compare thee to a summer’s day?"

Nah. I mean I like you and that's fine. Who wants to hear about your qualities. They probably don't or wouldn't like you anyhow.


Every other source for information, including (or maybe especially) human experts can also make mistakes or hallucinate.

The reason ppl go to LLMs for medical advice is because real doctors actually fuck up each and everyday.

For clear, objective examples look up stories where surgeons leave things inside of patient bodies post op.

Here’s one, and there many like it.

https://abc13.com/amp/post/hospital-fined-after-surgeon-leav...


"A few extreme examples of bad fuck ups justify totally disregarding the medical profession."

Please don't use quotation marks to make it look like you're quoting someone when you aren't. That's an internet snark trope, and we're trying to avoid that kind of thing here.

You're welcome to make your substantive points thoughtfully, of course.

https://news.ycombinator.com/newsguidelines.html


Yup make up something I didn't say to take my argument to a logical extreme so you can feel smug.

"totally disregard"

yeah right, that's what I said


"Doing your own research" is back on the menu boys!

I'll insist the surgeon follows ChatGPTs plan for my operation next time I'm in theatre.

By the end of the year AI will be actually doing the surgery, when you look at the recent advancements in robotic hands, right bros?


You are punished one way or the other.

These scammers are parasites on society, they add nothing while draining resources away from honest people.

If you participate in society, that net drag will affect you in subtle ways. Like if you have money invested in something, that thing doesn’t go up in value as much as it would have if x% of society isn’t simply parasitic.


Yeah so far there's not enough nuance in the discussion.

I also like to separate between 1) solvable vs unsolvable problems: e.g. you cannot solve a deceased relative.

Also 2) first time vs multiple repeat problems

If find it very irritate someone is venting to me repeatedly about solvable problems.

But if it's a 1 time unsolvable problem, then it's important to be in listening mode.


You are missing the point, though. The complainer decides whether it's a solvable problem or not, not the listener. So "I'll listen if it's unsolvable (to me)" is a non-starter.


Well I decide if it’s annoying to me and I’m going to tolerate it or lend support.


> it is a disastrously poor use of resources

For it to be a poor use of resources, you have to have some goal you are optimizing against.

And I think you'll come to find that the assumed goal in your head is not one that's widely shared across what people in society actually want.

Okay, maybe the digital ad is a waste of resources. But is it any more of a waste than the gender reveal confetti that it was advertising? How about even the idea of a gender reveal party.

What about an enamel pokemon fridge magnet?

After a very low bar (for 2026), human essentials are taken care of and people mostly want luxury/leisure consumer goods for entertainment.


An interesting thing I learned from reading the article is that Spain is the 4th largest exporter of turbines behind only China, Germany, and Denmark.

Reading the other comments, it's really a shame we can't have a discussion about something happening in the world before it immediately becomes about the US, on topics that are barely relevant.


Spain is also big in the utility scale solar and storage industry with the Power Electronics company providing inverters or other components to many of the worlds largest plants.


CATL is building one of the largest battery manufacturing factories in Europe in Spain.

China battery maker CATL to train Spanish workers for battery plant - https://news.ycombinator.com/item?id=46061492 - November 2025


I am interested. Tell me more. Any books / articles you'd recommend ? Given that Spain made such progress, there has to be atleast an FT article.


Search for Siemens Gamesa. Siemens fused their wind power branch with them a few years prior to the pandemic and finalized the full takeover in 2022.


Don Quixote.


> our government already doesn't like the government there.

Well yeah but we could drop even more bombs than we would have


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