> the only way for them grow profits is to increase cost.
And, of course, things like spurious denials drive up costs for them and for the providers. More direct costs, more costs at the provider they have to cover...
From the insurance company perspective, it's a win-win!
Anecdote is not the singular of data, but when my late wife was dying of cancer, the oncologist was attempting to follow standard care procedures. Preauthorizations were denied even after physician consultation with the insurance company.
My research showed me that the insurance companies contract with other companies (who they may or may not own) to handle the dirty work. It was only after learning the magic incantations to directly contact the "third-party" company that I was able to get traction.
"We do not believe this treatment is warranted."
"Well, her doctor believes it, so she's going to get the treatment. The only question is whether you pay now, or after I file a small claims case."
It was miraculously authorized at that point. It's the same fucking thing with car insurance. The poor people who can't fight really get screwed.
By failing to provide adequate treatment early in a disease course, further exacerbations and comorbidities can appear, and these can become their own chronic conditions requiring further ongoing treatment.
By adding tons of paperwork and time and effort. When a denial happens, often the doctor himself has to communicate with the insurance company via phone, instead of, you know, doctoring.
This often proceeds over multiple rounds. And then either the company eventually pays, or the consumer has to pay and try to get reimbursed later.
You asked this question 30 minutes after even a casual reading of my other comment, and a little thinking about it, would have fully answered it.
I would like to assume good faith, but your other comments indicate a high probability that you are an insurance company shill.
And in response to your other question about collusion, no there doesn't have to be collusion. Insurance companies putting onerous bogus requirements on providers will automatically drive up the costs.
I am deeply offended by your allegation. Not everyone who disagrees with you is a shill. I would not make the same accusations about you, nor would I act as if I can estimate the probability that you are. HN's commentary guidelines address this.
You can consider my mistake to be in conceptualizing the cost of "medical services" too narrowly, as just the medicine, and not the providers' surrounding administration. To that end I take your point. In theory, at least. Do you know how much this has? In particular, you refer to the back-and forth negotiation of claims--on what do you base this claim?
Be offended all you want. It's a free country, but, to be perfectly frank, you are still making it difficult to believe you are writing in good faith, as I will show.
> You can consider my mistake to be in conceptualizing the cost of "medical services" too narrowly, as just the medicine, and not the providers' surrounding administration.
Which is fine, except that my very first comment that you responded to explicitly explained "More direct costs, more costs at the provider they have to cover..."
So I already explained that which you said you missed, before your first comment questioning it.
> Do you know how much this has? In particular, you refer to the back-and forth negotiation of claims--on what do you base this claim?
When I wrote "You asked this question 30 minutes after even a casual reading of my other comment, and a little thinking about it, would have fully answered it." I was serious.
You still asking this question, instead of looking at that comment, indicates that at best you are completely unserious. For your edification, here is a link to that comment:
Billing statements disguised as marketing nudges is a cromulent business practice until the SaaS start sending bills to collections.
I think the author is being kind, both to themselves and startup practicing dark patterns. He walks through his own thinking, raises important questions and also gives the benefit of the doubt that I wouldn’t give.
IMHO, the article gets ahead of criticism well: accepting the valid critiques while also confining the weird/lazy ones to downvotes.
If you read the other comments, you're certainly an outlier in this belief.
My own answer is that there is nothing (incromulent? uncromulent? well, anyway, not cromulent) about suing people who knowingly and deliberately racked up debts with you, but that common business practices, including the overwhelming abundance of free services everywhere in every product category, and the ability to immediately shut off internet services when you aren't paid, lead to sort of a gestalt of expectations about how things are done.
The article itself says that the terms of service only allow billing if a payment method have been provided, so suing absent that provision would probably be a non-starter anyway.
On the bright? side, suing would definitely keep them on the front page of hacker news longer.
I find that exploiting a difference between expectations and reality is a common way to make money, but I'm no good at it myself. I'm cursed with engineer-brain instead of business-brain.
> exploiting a difference between expectations and reality is a common way to make money
Maybe? Or maybe expectations catch up with reality? I mean, does anybody really go into a car dealership thinking the dealer isn't going to do their best to rip them off? Or believe that "their" real estate agent is "on their side?"
I think most people just accept that the world is full of rip-off artists.
Which is kind of sad, really. If one person pushes back on bad billing, the company still makes money, even if it has to do a refund.
But if everybody were to always push back? It wouldn't be worth it to try to tack on extra fees for non-rendered services.
Yes, lots of people who don't frequent HN think their real estate agent is on their side, and think car dealerships just sell cars for a fair price. They might even think politicians make laws to make society better.
That's why all these groups of people are able to make so much money. If everyone expected a car dealer to rip them off, car dealers wouldn't be able to rip anyone off and there wouldn't be so many of them.
1) They intended a bait-and-switch, where they were going to go after everybody for non-payment. According to the article, they might not even have a leg to stand on here.
2) If you take the quote from the company at face value, they realized that their free quota would be insufficient for conversion for some customers, and decided not to shut off services in the middle of evaluation. In this instance, the bill is a communication in advance -- if you provide a credit card in order to keep using our services, we want to get paid for everything you used after the free limit.
Now, you can argue (and many are) about whether this is a good business practice or not, but it really doesn't matter. After making the front page of hacker news, it's probably not one they're going to continue, simply because now that everybody knows about it, you'll probably have a lot of bad actors doing multiple signups, just to siphon off as much token usage as possible.
Seriously, that's a huge fricking red flag. Obviously, most of those companies I would never do business with anyway, but this puts it over the line for all the others.
If they don't understand the first thing about validating their putative customers' emails by, you know, sending an email saying "is this really you?" then they've completely proven their technical incompetence.
The worst one is robinhood. I have two different email addresses that different people have used to sign up for robinhood accounts (back when they were giving anybody an account).
Occasionally, I tweak them about sending me shit.
"Sure! Just send us a copy of your photo ID to prove you're not that person."
Nah, bro, you've proven you're clueless, and there's no way I'm sending PIA to clueless people.
> People start out wanting to achieve things, change things to be better, do a good job.
Like all generalizations, this is only partly true. There are bad actors.
> The active issue is disempowerment, created by other people (usually but not always senior) within the organisation.
Disempowerment (is that a word?) is necessary. So necessary, that entire departments incorporate it as a large part of their mandate. HR, finance, QA...
> So the question isn't "how to empower people", but rather "how to prevent disempowerment of people".
Or more, how to focus the disempowerment on things that matter?
> This isn't always popular, as it shifts the focus and responsibility for different behaviour away from the disempowered rank and file, towards the dysfunctional leadership.
Maybe it's not always popular because some disempowerment is necessary, and framing the entire issue as a necessity for its removal and those who disagree as dysfunctional is needlessly inflammatory and counterproductive?
> Like all generalizations, this is only partly true. There are bad actors.
Of course, but in the organisations I have experience of, I'd estimate that the 'bad actor' rate is very low - certainly a low-single-digit percentage. (I don't work in tech, BTW.)
> Disempowerment (is that a word?) is necessary. So necessary, that entire departments incorporate it as a large part of their mandate. HR, finance, QA...
I think we need to differentiate between different forms of disempowerment. For example, having a set budget to work within (i.e. the disempowerment that a finance department might generate) is structural in nature; and further may either be empowering if an individual or team has freedom to work within those constraints, or disempowering if the budget is too constrained, or changes unpredictably. In contrast, smart committed people having their ideas stamped on irrationally by a bad egotistical leader ultimately leads to disenchanted people who don't want to invest their energy any more.
> Maybe it's not always popular because some disempowerment is necessary, and framing the entire issue as a necessity for its removal and those who disagree as dysfunctional is needlessly inflammatory and counterproductive?
You're maybe not considering the background context of why such a discussion would even be taking place. These discussions spring out of leadership noting somehow (direct observations, discussions, workplace surveys, workplace transformation initiatives, etc.) that people in their organisations are less "empowered" than they (leadership) would wish (with perceived negative impacts) and therefore this is something they want to reverse. They're frustrated and confused: they think they're offering an environment for people to behave as they hope to see, and yet people aren't stepping through the apparently open door.
It's unpopular because asking why people are disempowered shifts the focus from the failings of individuals ("why is this employee not behaving as I expect them to; what stick or lever or additional incentive can I use to improve their behaviour?") to the failings of leadership ("what have I been doing wrong all along to result in this sorry state of affairs? Am I the cause?")
You would hope a light bulb would turn on, but management who needs those sorts of conversations might often not have the wherewithal to do the right thing, never mind respond positively.
Completely ignores the rest of the ongoing salient discussion about how, yeah, Flux-AI isn't really working for a lot of people here.
Astroturf probability > three nines.
It must be a difficult realization, when you're selling vaporware, that your intended market (a) has hard metrics, and (b) has the wherewithal to quickly determine whether those metrics are being met.
tl;dr -- customers, especially technical customers, even if those technical customers are early adopters and generally positive on the idea of the special sauce you claim to be adding, are much more critical than investors. At least until the investors understand what the customers are saying.
When you have a 12 inch ruler, you effectively have 13 numbers on the ruler. The fact that zero isn't marked is neither here nor there -- the numeral one is not at the far end of the ruler.
So if you extend the ruler to be as long as you can hold in eight bits, it will range from 0 to 255, and the total length will be 255.
The ruler analogy may seem overly simplistic, but then the real world is likewise fairly simplistic.
At the end of the day, the numbers presumably come from a sensor, or go to a display, and, often, in either case, zero represents as dark as you can get and 255 represents as light as you can get, so the physics dictate that the intervals associated with the 0 and 255 are half the size of the rest of the intervals.
Audio is more interesting than video, because in audio, you care deeply about not having an offset, and about having a balanced signal, so the question of whether the midpoint is actually on a number or not is pertinent.
In audio, it is often useful to simply discard a code so that 0 is the midpoint (e.g -65535 to +65535, discarding 0xFFFF). But this still gives you smaller intervals at both ends.
And, of course, things like spurious denials drive up costs for them and for the providers. More direct costs, more costs at the provider they have to cover...
From the insurance company perspective, it's a win-win!
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