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You shouldn't be downvoted for normal and reasonable questions, or even for self doubt. Aetna is terrible. The lobby against healthcare reform at every turn. T
by sqeaky 9y ago
You shouldn't be downvoted for normal and reasonable questions, or even for self doubt.
Aetna is terrible. The lobby against healthcare reform at every turn. They didn't want obamacare/ACA they didn't want to compete accross state lines, they want to be able to exempt people from pre-existing conditions, they want to give people the run-around.
They are not trustworthy and they are run by bad people. (don't beat up on their phone agents though, they are just trying to make ends meets).
- rcraft 9y agoAre there any other insurers that don't do/want many of these same things?
- sqeaky 9y agoI think BlueCross and United Health only do some of the evil things, but I wouldn't swear to it.
- chaosphere2112 9y agoFor those in one of the covered regions[1], Kaiser Permanente is largely not-evil. You have to go through your GP to get referrals to specialists, but it's a series of mostly consistent "I have X problem" "Try Y" "Didn't work" "Try Z" "Didn't Work" "OK, let's get you to a specialist" events. They have an interesting governance structure (https://en.wikipedia.org/wiki/Kaiser_Permanente https://en.wikipedia.org/wiki/Kaiser_Permanente) that tries to align incentives correctly. [1]: Coverage areas as divided by corporate entities: Northern California Southern California Colorado Georgia Hawaii Mid-Atlantic (vicinity of Washington, D.C., including Maryland and Virginia) Northwest (Northwest Oregon and Southwest Washington) Washington (except Southwest Washington)
- Cerium 9y agoLots of people complain about Kaiser. I was a member when I was growing up, and have signed up again now that I have a job offering Kaiser coverage. For me Kaiser is a couple things. First of all it is peace of mind. They won't screw you. Essentially everything they offer is covered at a reasonable rate. Example: I was sent to the emergency room once and was able to pay on the spot with the cash in my wallet. Secondly, if you go to one of their medical centers everything is in that building. When I am sick, I don't want to go to a few stops across town to get everything (doctors office, lab, pharmacy, etc). Additionally they actively do things to keep people healthy. They host farmers markets at some of their centers, run advertisements focused on getting exercise and eating well. In general, they make you feel like they are on your side.
- silencio 9y agoI have Kaiser too and I stayed an extra day (vs average) after my unplanned C-section because of pain management issues, and nobody bothered me about it despite the floor being full. Only $500 and that included a salmon and steak and apple cider in champagne flutes celebration dinner one night for me and my partner. Their prenatal and postpartum support is top notch too, including free lactation consultant visits and a hospital grade pump rental (would cost me $1k+ at this point in fees otherwise) to support breastfeeding for as long as I want. Compare to one of my friends with a bog-standard vaginal birth, was pressured to leave as soon as possible, partner kept getting kicked out of the room, and she paid $7k and counting while still getting random claims. LC visits also not covered despite wanting to breastfeed desperately, and she gave up due to issues that could have been resolved. It's not even just the baby stuff that is like this - my dad has their medicare advantage plan and he LOVES it and I love the integrated care since it's so easy for his specialists to talk to each other without me having to be the messenger. Kaiser gets a bad rap a lot of times, sometimes for good reason, but in the average case, they must be doing something okay that they don't fight me like Anthem used to do ALL THE TIME (plus remember when maternity coverage cost like $500 extra _per month_ on the individual market?)
- JohnTHaller 9y agoDon't forget about pulling out of the ACA in some states to try to make it look like the merger they wanted to do wouldn't harm competition and then lying about it.
- sqeaky 9y agoAetna is one of those companies that has no limits to the evil it will do.
- slantedview 9y ago> Aetna is terrible This is true, but I'd like to qualify this by saying that all of the for-profit insurers (and most of the non-profit ones) are terrible. Generating revenue is in direct conflict with providing patient care which is a fundamental flaw in the setup. It's a uniquely American problem.
- chimeracoder 9y ago> Generating revenue is in direct conflict with providing patient care Without revenue, there's no money to use to actually provide care. > It's a uniquely American problem. It's not at all. Aside from the fact that most of the world uses at least some degree of privatization in providing or paying for healthcare, even the few that don't do so at the metaphorical "last mile" (such as England) still suffer from the unavoidable problem that money isn't infinite, and sometimes decisions have to be made to deny people care that otherwise still would have a material benefit to the patient.
- bdamm 9y agoIn most developed nations outside America, a doctor's opinion carries more administrative weight. There may be an administrator, but if a doctor says a procedure is to be done, the payment can generally follow. A doctor is like an officer in that regard. In America, the insurance company and their payment policies carry more weight than the doctor's decisions. This matters a great deal if you have a traumatic accident and require many surgeries, as happened to a friend of mine. In America, if you have a trauma, you are recommended to get a lawyer immediately to help your medical expenses be handled properly. Think about that... in America, if you get hurt, you need a lawyer almost a badly as you need a doctor. Not because you need to sue the cause, but because you need to encourage the insurance company. There's something fundamentally miserable about that.
- chimeracoder 9y ago> In most developed nations outside America, a doctor's opinion carries more administrative weight. In America, the insurance company and their payment policies carry more weight than the doctor's decisions. No, in most developed nations other than the US, the doctor has approximately the same power that they do in the US. The difference is that, under capitated systems or systems like the NHS (which is not actually capitated yet, but functions more or less like it is), the doctor factors the cost into their decision-making process. That might sound like a good thing for patients, but it's generally not - it means they have an incentive to avoid unnecessary care, but they also have a very direct incentive to bias on the side of avoiding necessary care as well, to avoid eating into their budget. This is absolutely a problem with the NHS, although Hacker News readers tend not to be the demographics that suffer from it the most, so you don't hear about it as much here. > in America, if you get hurt, you need a lawyer almost a badly as you need a doctor I get that this is intended to be hyperbole, but even on that scale, it's absurd.
- emodendroket 9y agoWhat insurer is trustworthy? They make money by denying claims and coverage to people who actually need it; that's the business model.
- maxerickson 9y agoUnder the ACA they are not allowed to deny coverage. They certainly do act to minimize the claims they pay.
- emodendroket 9y agoJust add "to the extent permitted by law" if you want. There are still circumstances where you can't sign up, like missing an enrollment period.
- maxerickson 9y agoThat's intentionally built into the regulation though, if you can not carry a plan and then sign up for coverage whenever you need it, it isn't anything resembling insurance anymore. People are still really critical of the current regulation, where you can sign up during the enrollment period without any penalty.
- emodendroket 9y agoThat is really beside the point. The incentive for profit-driven insurers is not to pay for health coverage to whatever extent they can get away with.
- InitialLastName 9y agoMaybe we shouldn't be funding healthcare on a profit-driven basis then.
- emodendroket 9y ago
- mabbo 9y agoAwesome. I can't change my decision for another year, and then only to Blue Cross. Are they also terrible?
- Broken_Hippo 9y agoThe last time I had insurance in the states (before moving away) was with Blue Cross. I didn't personally have any problems, and generally zero problems with mental health car (my ex needed it). I don't know if it makes a difference, but my employer (a major pharmacy chain) merely hired them to administer their health plans and funded it through the company. When they dealt with me, they weren't really using their funds.
- shortoncash 9y agoIn our state, they are pure awful.
- nsxwolf 9y agoRight now I'm on the hook for 5 figures with BC/BS for my son's birth expenses, because HR screwed up his application. It's a Kafkaesque byzantine labyrinth of red tape and buck passing. I'm not sure they're evil, just bureaucratic.
- maxerickson 9y agoCompeting across state lines means all insurance will be regulated by the state with rules that most favor the insurer, it isn't all that likely to be good for consumers. The banking renaissance in South Dakota is a result of a similar situation. https://www.theatlantic.com/business/archive/2013/07/how-citibank-made-south-dakota-the-top-state-in-the-us-for-business/425661/ https://www.theatlantic.com/business/archive/2013/07/how-cit...
- chimeracoder 9y ago> Competing across state lines means all insurance will be regulated by the state with rules that most favor the insurer Not really; states are still free to set additional requirements for insurance plans that cover members of that state. To be honest, competing across state lines would not actually do much in the long run. It'd provide an extra degree of competition in the short-term, but ultimately then insurers would consolidate into multistate operations (which is already the case to a large degree).
- KekDemaga 9y agoIt seems insurer's scream louder about the "insuring across state lines" bit then they did against Obamacare in my estimation. On that metric alone I estimate that it will be more effective.
- maxerickson 9y agoIs that a fundamental aspect of state power or is it an aspect of the particular proposals that have been made? Cruz's proposed legislation from a couple years ago appears to restrict what "secondary" states can regulate quite a lot: https://www.congress.gov/bill/114th-congress/senate-bill/647/text https://www.congress.gov/bill/114th-congress/senate-bill/647... (b) Exemptions From Covered Laws in a .—Except as provided in this section, a health insurance issuer with respect to its offer, sale, rating (including medical underwriting), renewal, and issuance of individual health insurance coverage in any secondary State is exempt from any covered laws of the secondary State (and any rules, regulations, agreements, or orders sought or issued by such State under or related to such covered laws) to the extent that such laws would— Of course it spells out a bunch of situations where the secondary state would still have authority, but reducing the ability of states to regulate sure seems to be one of the goals there.
- noonespecial 9y ago>(don't beat up on their phone agents though, they are just trying to make ends meets). I've gotten very tired of this. Every time I'm on calls like this now I gently suggest to the phone agent that they know that what they are doing contributes to a system that hurts people and that they should try to do something more with their lives. Don't scream or bluster. Do it with gentleness and respect and get ready to be occasionally very surprised at the results.
- blackguardx 9y agoI worked in a call center during high school. Everyone is there just for the paycheck. These call centers are usually in places with terrible economies and these centers are the only job option for many people. I worked alongside many people in their 60s. Imagine doing that as a retirement plan.
- noonespecial 9y agoI accept that it sounds intensely condescending and harsh. I present it as an alternative to either screaming profanity (which they hear non-stop, all day), or meekly accepting the "there's nothing that can be done" lie they are instructed to feed you to get you off the phone in minimum time. Nine times out of ten, you'll get a dismissive hangup but every once in a while it shatters the script and you'll get a quick story of someone trapped in a bad situation and then a quick word of advice on how to proceed in a a way that will get results. Its a rhetorical phone nuke. Use it carefully. I started using it about 5 years ago when I noticed that the "heartfelt plea" had utterly stopped working. I also use it often when "Microsoft tech support" calls me to tell me that they have detected that my computer has a virus. Its a touch more appropriate in that situation.
- wjamesg 9y agoWow
- bitJericho 9y agoYou absolutely should beat up the phone agents. They are part of the problem just like everyone else in the health industry.