8 ms·

Used to do these “pre-authorizations” for Humana and wanted to kill myself after a week. Seniors write in about how they’re eating dog food to pay for their me

Used to do these “pre-authorizations” for Humana and wanted to kill myself after a week. Seniors write in about how they’re eating dog food to pay for their medicine, I forward the letter to insurance doctors, who deny it because they “have to try these 3 drugs before you can get what works”. Made me realize this whole country is broken and those at the top are morally bankrupt.

Abishek_Muthian 5y ago
Not just your country, Nothing throws spotlight on how wonderful capitalism has become(/s) like checking out health insurance industry in almost every country without a socialized health-care. Okay may be private-prisons would come close second. I get denied health insurance policy itself due to my physical disabilities against the local laws and regulations in my country[1]. That includes major International brands. How can I put this gently, capitalism thinks I'm not worth living or saving. [1] https://abishekmuthian.com/insurers-are-putting-the-lives-of-sick-and-disabled-at-risk-during-covid-19-pandemic/ https://abishekmuthian.com/insurers-are-putting-the-lives-of...
refurb 5y ago
Why is that broken? Even systems with universal healthcare have rules like this. Why use a $1000 per month branded drug unless you know the $5 per month generic drug doesn’t work?
- peteradio 5y ago
  If you have a past knowledge that the generic doesn't work and you also save money by withholding the real treatment, then that seems perverse.
- kemiller2002 5y ago
  It's because a lot of times the doctors know it isn't going to work on the outset. A number of generics don't work exactly the same. You're punishing the patient and questioning the expert simply for the fact that the insurance company (or the government in the case of geriatrics) might save a few dollars.
  - Dma54rhs 5y ago
    Well at least in Europe pharmacists always tell you about generics, that they are cheaper and work the same. Not sure who is spreading misinformation here. Maybe you're talking about different medicines that people are using (like different insulins), the generics use the same formula as the original.
  - AuthorizedCust 5y ago
    That’s exaggerated. Generics are well known to be effective, and exceptions are unusual. Here’s some commentary to that effect, talking about research to the contrary: https://www.health.harvard.edu/staying-healthy/do-generic-drugs-compromise-on-quality https://www.health.harvard.edu/staying-healthy/do-generic-dr... It’s reasonable to expect people to exhaust lower cost alternatives, that are reasonably expected to work, before stepping up costs.
    - kemiller2002 5y ago
      My bad. You are correct. I misspoke. What I meant to say that at times generics (and similar drugs, but not generics) won't work as well as the original drug. Not always, but sometimes they just aren't effective in certain circumstances. The doctor may know this, but can't immediately prescribe what is effective in the name of "saving money"
    - text70 5y ago
      Speaking of genetics, screening for the genetic profile of variable liver enzymes for known mutations and their associated drug interactions could actually save on the shotgun approach to dispensing medicines. The problem is, you won't be able to hammer down the health of the patient to the lowest cost option, only the most effective.
      - AuthorizedCust 5y ago
        Ha! My keyboard autocorrected generics to genetics! Fixed in the original comment.
    - 5y ago
- koenigdavidmj 5y ago
  My insurance did this for my kid’s eczema. Except the $5 one was an immune suppressant. For my toddler. For eczema. During a pandemic. The only sane response to that is “okay, I won’t give my kid either of those; we’ll just stick with OTC lotions”. Which is exactly what they intended.
  - refurb 5y ago
    A topical steroid I assume? Sure it’s an immune suppressant, since eczema is an immune condition. Topical steroids are standard of care.
- syki 5y ago
  In all healthcare systems some form of rationing occurs since there aren’t enough resources to provide the best care to everyone. A system that rations care based on ability to pay or on wether or not your employer is generous is immoral. It is also immoral to profit off of denying someone care. Tough decisions have to be made and financially rewarding a company by denying care is despicable.
  - BobbyJo 5y ago
    > A system that rations care based on ability to pay... is immoral. You lost me there. What makes it immoral? Money is an asset allocation tool, so why is it morally wrong to use it for medicine the same way we do for food and housing? Genuine question. I have a hard time understanding what sets medicine apart from everything else when people think healthcare should be universally free, but not food, water, clothing, housing, etc. especially considering those other things are more directly necessary for survival.
    - syki 5y ago
      Of course healthcare isn’t and can’t be free. Unless by free you mean free at the point of usage. I support government provided healthcare and government runs off of tax revenue. Denying a person cancer treatment for no other reason than because they can’t pay $x at the point of usage is an immoral system. An analogous situation occurs with federal courts. Those who can’t afford filing fees have those fees waived and those that can pay them do so. This is done because the court system recognizes that access to the court system based on the ability to pay at the point of usage is a bad system.
      - BobbyJo 5y ago
        That's a bad comparison. The filing fee is small compared medical treatment, and it's in support of the government itself. The cost of doing that for people is tiny and doesn't really take away from anyone else. Medicine is a scarce resource at this point, and, generally speaking, giving care to X often means Y won't get it. The fundamental problem with medical care is supply, lowering barriers for demand isn't a solution to that.
throwaway6734 5y ago
>those at the top are morally bankrupt. These seniors should vote for and advocate for a more expansive social safety net then.
- tragictrash 5y ago
  What twisted fucked up naive world view does this come from. These people are poor, vulnerable and sick. You should be ashamed of yourself. Why don't I throw you in a cage, and then you can try voting for someone to advocate for your release. The point is the seniors need help now, not being told to go organize. The healthcare system is broken, and until you get sucked into it, you don't understand the extent of it. It's different for people less fortunate than ourselves. We all mostly work tech jobs with great pay and decent insurance. These people don't have that. A lot of them can't pay for food. So yeah, I'm doubling down. Downvote away.
  - epmatsw 5y ago
    I think the point was that seniors as a demographic generally vote for politicians that don’t support those policies, against the wishes of the majority of the rest of the population.
    - tragictrash 5y ago
      Yeah, but that doesn't mean we should be denying care to anyone. Why is it so hard to say the healthcare system is broken instead of blaming the seniors. That dude's throwaway is doing real damage by normalizing the deflection of blame onto the patient.
      - deleted 5y ago
        [deleted]
  - throwaway6734 5y ago
    This is an overly paternalistic point of view that robs these people of their agency. They've spent their lives participating and interacting within the current political framework. Blaming all problems at the feet of "morally bankrupt leaders" is hyperbolic populist rhetoric to absolve personal responsibility.
agumonkey 5y ago
There's an absurdity about our time in that we have data, data analysis, extreme communication yet the efficiency and refinement of policies are still limited by the same bottlenecks.

Abishek_Muthian 5y ago

Not just your country, Nothing throws spotlight on how wonderful capitalism has become(/s) like checking out health insurance industry in almost every country without a socialized health-care. Okay may be private-prisons would come close second. I get denied health insurance policy itself due to my physical disabilities against the local laws and regulations in my country[1]. That includes major International brands. How can I put this gently, capitalism thinks I'm not worth living or saving. [1] https://abishekmuthian.com/insurers-are-putting-the-lives-of-sick-and-disabled-at-risk-during-covid-19-pandemic/ https://abishekmuthian.com/insurers-are-putting-the-lives-of...

refurb 5y ago

Why is that broken? Even systems with universal healthcare have rules like this. Why use a $1000 per month branded drug unless you know the $5 per month generic drug doesn’t work?

peteradio 5y ago
If you have a past knowledge that the generic doesn't work and you also save money by withholding the real treatment, then that seems perverse.
kemiller2002 5y ago
It's because a lot of times the doctors know it isn't going to work on the outset. A number of generics don't work exactly the same. You're punishing the patient and questioning the expert simply for the fact that the insurance company (or the government in the case of geriatrics) might save a few dollars.
- Dma54rhs 5y ago
  Well at least in Europe pharmacists always tell you about generics, that they are cheaper and work the same. Not sure who is spreading misinformation here. Maybe you're talking about different medicines that people are using (like different insulins), the generics use the same formula as the original.
- AuthorizedCust 5y ago
  That’s exaggerated. Generics are well known to be effective, and exceptions are unusual. Here’s some commentary to that effect, talking about research to the contrary: https://www.health.harvard.edu/staying-healthy/do-generic-drugs-compromise-on-quality https://www.health.harvard.edu/staying-healthy/do-generic-dr... It’s reasonable to expect people to exhaust lower cost alternatives, that are reasonably expected to work, before stepping up costs.
  - kemiller2002 5y ago
    My bad. You are correct. I misspoke. What I meant to say that at times generics (and similar drugs, but not generics) won't work as well as the original drug. Not always, but sometimes they just aren't effective in certain circumstances. The doctor may know this, but can't immediately prescribe what is effective in the name of "saving money"
  - text70 5y ago
    Speaking of genetics, screening for the genetic profile of variable liver enzymes for known mutations and their associated drug interactions could actually save on the shotgun approach to dispensing medicines. The problem is, you won't be able to hammer down the health of the patient to the lowest cost option, only the most effective.
    - AuthorizedCust 5y ago
      Ha! My keyboard autocorrected generics to genetics! Fixed in the original comment.
  - 5y ago
koenigdavidmj 5y ago
My insurance did this for my kid’s eczema. Except the $5 one was an immune suppressant. For my toddler. For eczema. During a pandemic. The only sane response to that is “okay, I won’t give my kid either of those; we’ll just stick with OTC lotions”. Which is exactly what they intended.
- refurb 5y ago
  A topical steroid I assume? Sure it’s an immune suppressant, since eczema is an immune condition. Topical steroids are standard of care.
syki 5y ago
In all healthcare systems some form of rationing occurs since there aren’t enough resources to provide the best care to everyone. A system that rations care based on ability to pay or on wether or not your employer is generous is immoral. It is also immoral to profit off of denying someone care. Tough decisions have to be made and financially rewarding a company by denying care is despicable.
- BobbyJo 5y ago
  > A system that rations care based on ability to pay... is immoral. You lost me there. What makes it immoral? Money is an asset allocation tool, so why is it morally wrong to use it for medicine the same way we do for food and housing? Genuine question. I have a hard time understanding what sets medicine apart from everything else when people think healthcare should be universally free, but not food, water, clothing, housing, etc. especially considering those other things are more directly necessary for survival.
  - syki 5y ago
    Of course healthcare isn’t and can’t be free. Unless by free you mean free at the point of usage. I support government provided healthcare and government runs off of tax revenue. Denying a person cancer treatment for no other reason than because they can’t pay $x at the point of usage is an immoral system. An analogous situation occurs with federal courts. Those who can’t afford filing fees have those fees waived and those that can pay them do so. This is done because the court system recognizes that access to the court system based on the ability to pay at the point of usage is a bad system.
    - BobbyJo 5y ago
      That's a bad comparison. The filing fee is small compared medical treatment, and it's in support of the government itself. The cost of doing that for people is tiny and doesn't really take away from anyone else. Medicine is a scarce resource at this point, and, generally speaking, giving care to X often means Y won't get it. The fundamental problem with medical care is supply, lowering barriers for demand isn't a solution to that.

throwaway6734 5y ago

>those at the top are morally bankrupt. These seniors should vote for and advocate for a more expansive social safety net then.

tragictrash 5y ago
What twisted fucked up naive world view does this come from. These people are poor, vulnerable and sick. You should be ashamed of yourself. Why don't I throw you in a cage, and then you can try voting for someone to advocate for your release. The point is the seniors need help now, not being told to go organize. The healthcare system is broken, and until you get sucked into it, you don't understand the extent of it. It's different for people less fortunate than ourselves. We all mostly work tech jobs with great pay and decent insurance. These people don't have that. A lot of them can't pay for food. So yeah, I'm doubling down. Downvote away.
- epmatsw 5y ago
  I think the point was that seniors as a demographic generally vote for politicians that don’t support those policies, against the wishes of the majority of the rest of the population.
  - tragictrash 5y ago
    Yeah, but that doesn't mean we should be denying care to anyone. Why is it so hard to say the healthcare system is broken instead of blaming the seniors. That dude's throwaway is doing real damage by normalizing the deflection of blame onto the patient.
    - deleted 5y ago
      [deleted]
- throwaway6734 5y ago
  This is an overly paternalistic point of view that robs these people of their agency. They've spent their lives participating and interacting within the current political framework. Blaming all problems at the feet of "morally bankrupt leaders" is hyperbolic populist rhetoric to absolve personal responsibility.

agumonkey 5y ago

There's an absurdity about our time in that we have data, data analysis, extreme communication yet the efficiency and refinement of policies are still limited by the same bottlenecks.