mrsparkle001
45639
1581
17
Dec 5, 2024 2:29 PM
mrsparkle001
45639
1581
17
Mperrotta913
I was told my dad walked into our insurance company's office with a metal baseball bat asking for the manager when they were denying some of my treatment for a brain tumor when I was 8 years old. It was later clarified that the bat stayed in the trunk of the car but still. Apparently the manager was extremely upset to be pulled from his golf game
BigFatUglyBugFaceBabyEatingOBrien
Yup, I had a diagnosis of HG during pregnancy. Zofran WHICH IS NOT AN EXPENSIVE MEDICATION barely took the edge off my nausea and vomiting. My doctor wrote me a script for one pill every 8 hours. My insurance decided I only needed 20 pills a month and sent me a pamphlet on ways to deal with morning sickness. Apparently the HG isn't a real diagnosis. I ended up paying out of pocket for the zofran.
CobainsSarcoma
ps: suck all of my dick
SavageDrums
P. S. I hope someone kills your CEO.
nothingunused
"someone"
JonWallace1985
Seems a corpse talks louder than a strongly worded letter these days.
bigboneded
I left a healthcare career (SA/Psychiatric) due to burn out. Telling patients they're life-saving coverage was denied by their insurance company, to whom they paid monthly premiums, because the company's coverage matrix disagreed with my assessment as a practitioner, was a special hell.
Isiel89
Who denies a sick child anti-nausea pills?!? Oh, right. American insurance companies.
Cyandvai
More of them need to get Got before things start to change.
jacobssis
It can really help explain the medical necessity and make the case clearer, so it’s important to include detailed medical information and treatment history. You can also check reviews and experiences on PissedConsumer like this page about United Medicare Advisors https://united-medicare-advisors.pissedconsumer.com/review.html , where people share customer experiences, service issues, and advice, which can help understand the process and what to expect when dealing with insurance or advisors.
Hekatombe
Image first seen two years ago. Title similarity: 0 / tau /gallery/9rgh0Sf
mrsparkle001
I did not know that. Well it’s highly relevant now.
Hekatombe
Hemelsblauw
Where is the bot who used to do this? The repostbot?
blueKD
The good old days
rudejohn
@repoststatistics
Hemelsblauw
Yep, thanx
TheJomsborgViking
Well that was a strange nostalgic feeling.
Valkor
did something happen to our beloved bot?!
PrincessLeliana
>beloved
psugab
Didn't it die several years ago?
hyperchondriac
Zofran and scopolamine are generic , cheap, and broadly used including in the developing world. And insurance to bean count on that isn't worth the time it takes to write a denial letter
nightripper
It used to be extremely expensive. It's probably automated from when this made sense but they likely wanted him on Haldol instead from the era where it's a horrible enough drug if you can even stand the shit you must need it.
Unfortunately he's in for a shock when he sees cash price. They have contracts where if you have insurance you MUST use it. I had an $800 pill and a $95 copay with an actual cash price of fucking $16 once.
AGrammeIsBetterThanADamn
unless denials are immediate and automatic, which they are
Userlivewire
Just open Medicare to the rest of us.
oo0ORB0oo
I don't understand when people say the US is the best country in the world and this happens.
dogdayafternoon13
What is needed is a not for profit health insurance company. The people working there would still make great money but not at the expense of the people they service. Pass that bill congress.
Ehvilmonkey
Your healthcare system is so fucked up. As european this whole consept is quite hard to even crasp
moreSaucePlease
I’ve worked both for healthcare facilities and health insurance carriers. It’s a shell game that’s all politics and the health insurance game should be abolished altogether and replaced with government funded healthcare. Let the providers do what they need to do and just let the govt cover the cost.. you know, like the military.
TheJayGur
I was excited to see you call it a "shell game!" I have similar experience to you and left the industry because I just couldn't go on working for a "shell game." This is the first I've seen someone else use the same terminology.
mrsparkle001
Yes the middle man insurance companies need to be abolished, but the government won't cover the costs reasonably. I know plenty of practicioners that would leave healthcare entirely if they had to rely on medicare and medicaid payouts, medicaid especially. It's a big problem but it can't stay the way it is.
moreSaucePlease
Yeah, I’m not saying we replace everything with Medicare, but that we get insurance out of most day-to-day care and govt-run hospitals so it’s not the hospital trying to bill the govt but that the govt just covers the cost of taking care of its population
mrsparkle001
The fear is that would just be an expansion of medicare.
merxman
Medicare has 2% administrative overhead, 6 to 10 times less than private insurance. But the money is in lobbying, so we have status quo.
moreSaucePlease
I’m saying we need to change the funding model altogether. You don’t see the local police billing the govt to pay for individual services. You have it funded based on the needs of the community it serves.
merxman
Oh I agree, for-profit makes no sense, and every other developed country does it cheaper etc. etc.. Just saying I don't see it changing while the money and interests in lobbying from these multi-billion dollar insurers and middlemen still exist. There's little to no lobby and almost 0 money in pushing for a complete overhaul to socialized medicine, for instance.
Michaels365
Not only do insurance companies add directly to the cost of medical care without actually providing any actual medical care, every medical facility has to have people who do nothing but deal with insurance.
spookyu
Having been in the military and also been a medic....fuck yeah. It's better for both patient and provider in nearly every way. Are there still issues to overcome? Fucking of course, but ones that can be solved without an sacrificing care. It's often a joke that military medicine sucks, that can sometimes be true by virtue of the need to train 18 year olds to be medical support personnel inside of 3 months, but realistically it's still pretty damn good even then lol.
spookyu
I also take great joy in expounding upon the virtues of America's largest socialized system (in terms of socialized policy top to bottom)... the military, to people that think I'm gonna agree with their stupid right-wing-capitalist half-baked circle-jerk because I'm a vet. No...I disagree with that shit BECAUSE I'm a vet, socialized systems work, it'd would've been great if I didn't have to (further) ruin my mental health to have been a part of one.
spookyu
*it
19marcurious57
Coincidence? Cryptic text on bullet casings found after fatal shooting of health insurer CEO UnitedHealthcare New York, outside a Midtown Manhattan hotel. Police launched a manhunt for the masked assailant, who fled on a bicycle and was last seen near Central Park. During the investigation, three words were found scratched into the casings of the bullets used in the killing. Could they be 'zofran, scopolamine and bausea....? Front page news in a Dutch newspaper, today.
thesmelge
"Deny", "defend" and "depose".
19marcurious57
There's a book written on this subject: https://delaydenydefend.com/
androgenoide
A succinct manifesto.
ahbrannon1
My wife has been arguing with our insurance company over a bill. They said she didn't get prior authorization for doctors visit and are refusing to pay. They said she needed a referral, but when you look at her medical card it says in big bold letters "NO REFERRAL NECESSARY." How she was supposed to have known that information. They have ho answer and when you push them, the go to words are "let me transfer you to a supervisor," who never answers the phone, and then you are disconnected.
nightripper
I had similar but they caught it before the appointment. Some healthcare agencies have an internal policy requiring a referral. PPO coverage ain't all its cracked up to be.
KRicci
Stuff like this is insidious. People who have never had to interact with these systems see that there's a process that's *supposed* to fix things, and that makes them feel comfortable blaming people who are struggling
ahbrannon1
A large proportion of these individuals are really just that mean and cruel. They even make up jokes about those less fortunate. The cruelest and least understood is "Money doesn't buy you happiness." There is a point where money does bring happiness or at least makes you think it happiness, when you are hungry, homeless, and no job, well I think money will buy you happiness. I have been to that place and it sure is a unhappy place to be.
KRicci
Definitely agree, I have unfortunately also encountered these people. They think they've avoided problems because they're just so clever and hardworking, but they're just lucky
tocfanke4
Why the fuck is health insurance a for-profit enterprise? What innovation or treatment is an insurance company researching? What treatments are they creating or physically treating people with? At least drug companies can say they made something new when they fuck your ass. Insurance companies are just money pushing middle men. I noticed that pet healthcare became way more expensive when pet insurance became more common. Fucking parasitic leaches
1TrueKingInTheNorth
Reagan. Almost any question about whats wrong with American government/policies can be traced back to Reagan.
volock
Add Dodge vs Ford and that any public business in America was determined to have a duty to its shareholders over its employees or mission
Ffudmethen
Because Republicans still exist
digiorno88
The mighty dollar in capitalism. Wait until you understand that the prison system is also ran for profit. Things start to make sense once you understand them
moreSaucePlease
Because they gained traction to benefit businesses instead of being built to benefit the patients.
frigidmagi2
Because we, Americans, keep voting in people who focus on dismantling even modest reforms and refuse to elect enough people who want to change it.
Americans say they hate this and want to change but then go out and take actions that ensure it's continuation.
JohnSmithterms
Because american society is sick. Waving from europe.
SilverHornet
Same reason as housing is. Privatise essentials, sell them back at insane rates, dangle carrots, you have a slave class that (mostly) thinks they're not.
MechanicalRomance
Really any form of insurance being for profit confuses me. Like, isnt the point of insurance that i get more put of it than i put in when a disaster happens? If it works like that for everyone how does the insurer make money? Everyone is getting more out than they put in.
Is the idea really that so many people will never make a claim that it makes up the difference? But like, life insurance exists, EVERYONE dies.
I dunno maybe im dumb.
strangewomenlyinginponds
I'm an insurance professional (non-medical). Yes, that's exactly the idea. Otherwise we don't have any money to pay your claims. Some people have to not need to claim.
MechanicalRomance
But life insurance...
vericon151
Cause… reasons
awkungen42
They get subsidies from the government to make new medicine and then Jack up the price by 800% for Americans. Meanwhile the government rolls over and lets it's citizens get fucked by the corporations who used OUR tax dollars to make the medicine in the first place.
jetact12
Rapacious zero societal benefit creditor.
TitleWeHaveTalked
Many actually are non-profits, like most/all Blue Cross Blue Shields but that doesn't stop them from being blood sucking parasites either just tend to be slightly less horrible
AtmaDarkwolf
Only just another argument to do away with lobbyists. THEY are what causes this. It is ONLY due to someone saying 'but if our company stands between the source and the practice, we can make YOU sooooo much money' - in the end the only 'efforts' the middle ever does is to 'bribe' elected officials to allow them to parasite the regular people. They do not, nor ever have, been required for either to function, and only ever act as a 'tollbooth' between the two. (And to feed the greed of a few)
KillingTlme
Capitalism
sadurdaynight
I think the issue started when doctors were charging for visits and some folks were too poor to get medical care. So, gov't wanted to help, but decided to go ask docs to itemize all their stuff. Docs were like "um, we just charge a flat fee to see a patient, but.. if you mean I can itemize every little thing and charge more, sure!" So, medicare/medicaid got the ball rolling on itemized healthcare services. Then insurance companies formed b/c they realized they could provide discounts or full 1/
sadurdaynight
coverage to folks... b/c insurance was becoming a thing to help folks cover the ever-increasing costs of everything through the 70's+ as costs rose but wages stagnated. Instead of having to save thousands for care, you could just pay a monthly fee. Then doctors had to deal with insurnace companies, and the ins companies said "hey, we have all these customers.. if you want access to them you have to play by our rules which means we get a discount on your services." So, doctors started joining 2/
sadurdaynight
insurance networks. Then docs got sick of getting low-balled by insurance companies for payouts, so a competition happened between docs/ providers/ hospitals/ etc increasing prices while ins companies demanded deeper discounts. Eventually ins companies got the idea that instead of being full coverage they'd just provide a discount and make the customer pay part of the bill. Then they did that more and more, and justified it with deductables and other bullshit. So, now insurance is just a 3/
sadurdaynight
discount to provider services. And the discount amounts become less and less as time goes on. The caveat to all this is they're all basing pricing on the medicare itemized pricing, which, when implemented, had a rule in place saying the itemized list goes up a certain % in cost per-year if Congress doesn't review it. Congress hasn't reviewed this list in a LONG time to re-adjust prices to something more reasonable. So, they prices have sky-rocketed and nothing is being done about it. Then 4/
sadurdaynight
insurance companies got the bright idea to "hire" docs "in network" and pay those docs to reduce or avoid treatments. B/c it was cheaper to just pay a doc six figures per-year on payroll than to have some outsider doc keep trying to bill you millions in procedures. So, insurances have their own providers that try to avoid treatments on patients. Insurance companies also have their own medical review boards that work hard to dismiss or deny claims. So, it's a clusterfuck now./
AwetasticAdventures
Because everything in the US is monetized (or banned if that makes the monetized stuff more profitable), with increasing potential.
mjperk
Because capitalism. And MAGAts want to privatize it even further! JFC, what idiots. It hurts people like them most.
SpectralSpider
I'm always thinking this. Insurance is a big bucket of money that people put into and take out of. That's it. There is no fucking way to innovate it. The only way to make it "more efficient" in terms of profit generation is to charge more or provide less. But in a real world sense, where healthcare insurance is about providing fucking healthcare insurance, you're just creating a shittier product... which in most other markets would be annoying... but this literally ruins and/or ends lives.
Outlavv
Because they pay the gov millons so they can make billions. The gov is for sale if you can afford it, always has been, always will be
BetterDemosthenes
Republicans. That's why.
Rubium
Because Capitalism insentivises making as maximum a profit as possible, by all means necessary. Boy howdy, I love that our survival needs are pay gated.
SubTrout
Because America is a failed state to everyone except businesses. We have let capitalism win. The second our air becomes too toxic to breathe, they'll be privatizing oxygen too.
vrockurmouth
The lorax
CoinedWatcher
Not even true capitalism. All those companies that got bailouts should have went under. Instead the govt gave them our money so they can continue their bad practices that tanked them already
nubblebun
Yeah America isn't an actual country, it's just a big fucking corporate scam where you're born just to be picked apart for every cent you could produce for somebody else. You're not a citizen of your country, you're just a victim of the corporatocracy. And it's only going to get worse now.
mjperk
Just imagine Ole Musky boy settling Mars. That douchebag would surely charge the colonists for every volumetric unit of air they breathe. Can't afford your monthly air quota? Suffocate to death in space.
VonSnootingham
Dannoboyo
Privatization of public heath, welfare, and utilities is strictly to monetize universal services for the enrichment of the already wealthy. Which is why when they go low, we need to go higher. Do you get my meaning? They want to make the US a third world country. This is part of that. This happens in third world countries all the time.
Dannoboyo
Aim higher. All the way to the top. Don’t miss.
sfrinlan
A lot of people have a quaint notion that the way capitalist business works is every company running like a mom & pop shop. People running the company charge enough to cover the costs of the business plus a reasonable salary for themselves. They have no idea what corporations are or how shareholders and investments work or really how big business works at all. So, it's for-profit because someone makes money, and people don't really understand it enough to realize they should be fighting it.
rgraz65
And they've been sold this stupid idea that government should be run like a business. What that does is make government run in the exact opposite way that it should.
Stuffyhead
This. And we are allowing them to make us more ignorant. Over 52% of the population side with DonCheeto and are on their knees waiting for their reward.
bloodtaker3
Because Reagan "deregulated" the health insurance industry.
Fuck Reagan
SpectralSpider
Ronald Reagan? The actor?!
shewfleck
It seems like a lot of modern enshittification started with Regan...
rgraz65
And during the Bush II years, everything with insurance companies went into high gear. CEO pay rates went through the roof, becoming commonly over $10 million, profits started their record climb, and stock buybacks became allowable with the repeal of the acts that prevented them in '82, Reagan's second year, they became a way for execs to get bigger bonuses and much higher pay.
ilikepot8os
>Why the fuck is health insurance a for-profit enterprise?
Because it's profitable. Anytime you find something fucked in America and you ask why it's that way the answer will always come down to 'because it's profitable'
muffmunchies
Because it's great capitalism to exploit human needs at the highest possible cost - which can stretch pretty far when the alternative is death. If selling a necessity then you never really have to worry about attracting customers, just to make it extra secure for their bloody pockets, they also monopolize the market to ensure the labor chattel that make up the majority of the population have literally no choice but to $ for their privilege of survival also earned through selling your soul daily.
muffmunchies
Remove reproductive care to enable maximum breeding potential (regardless of age apparently) and you've got a massive self replacing profit farm! You don't even need to take good care of your chattel as the young will be ignorant of how it could be any better with each generation as you strip and corrupt education into the perfect training to funnel them into replacing whoever isn't defeated enough to satisfy the demands of capital overlords. Reward blind obedience above all for successful rule.
bluntforcedrama
And because we've been told that the only measure of success is profit, that profit must grow every quarter, and the reason we're the best country in the world is because we're just so good at making money. Even hobbies have to become side hustles.
It is definitely a bullshit take that I'd guess way more than half of Americans genuinely believe.
jesuisgur
It. Should. Not. Be. Profitable. It should just redistribute.
johnxbear
I've seen it said before that if libraries were invented today nobody could afford a Library card because they would charge insane amounts for it.
ThEtAbLeGoAt
God don't give them any ideas
AudioRyan
They’re literally trying to do away with the USPS… guess what’s after that..
thatwoodguy
They're just like a middleman that interposed themselves between you and your health care. Just like Ticketmaster got in the way between fans and music so to reach out unreasonable profits. Just scalpers By Any Other Name
rgraz65
And Ticketmaster has pushed for stiffer punishments for scalpers online and on the street. They want to be the only ones committing that crime, erhm, doing that business.