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The Insurance industry is a bug vampire squid sucking money out of the system, and ironicly stopping many from getting the health outcomes they need.

• pigsty 4y ago
  A small group chat I’m a part of has one person who works for an insurance company. Reading his messages about his work day is just depressing. “Oh, yeah, if someone has that cancer and they’re under 45 it’s an auto-reject from me. Just too unlikely for them to have it” was one message that’s stuck with me. You (or your company) pays thousands of dollars a year (or more) to an insurance company to cover you for when the worst things happen—and despite you or your doctors trying to get your shit together, somebody chilling 1500 miles away skims your report and auto-declines any form of coverage just because it seems unlikely. Then it’s an uphill battle of trying to not only battle your illness and your daily life, but a company that has employees with worse judgement than an AI thrown together by some dude on Twitter in a weekend. It’s disgusting to think about.
  • bosie 4y ago
    how.... how... can they reject anything that the hospital says?
    • 1123581321 4y ago
      They are rejecting on the presumption that the billing is erroneous. The hospital would follow up and get it approved. It’s a crude system and I’m not excusing it.
    • soco 4y ago
      Because they are allowed to. Having no (useful) regulation allows that and more. And no it's not abuse, it's the system working as designed. If there's a problem with it, don't take it with the people in the system, as tempting as it might be. They will be replaced by others with the same reject-happy finger. It needs a new system, heavily regulated like in Europe, and this means exactly the uphill battle you would expect.
    • lotsofpulp 4y ago
      They are not rejecting what the hospital says. I imagine pigsty’s account is missing some nuance, such as an uncommon diagnosis or prescription requiring further proof. The doctor might think (and might very well be guessing correctly), but the protocols require a certain level of evidence that was not provided. It could also be malfeasance, but I doubt that is happening on a systemic level at the big health insurance companies. They benefit from more healthcare spending, so I do not see why they would want to tamp down on necessary expenses.
    • callahad 4y ago
      Propublica just ran a good article on UHG's attempts to deny coverage to a university student with severe ulcerative colitis. Apparently the insurer has its own panels of MDs that it can deploy to lobby the patient's doctor into different courses of treatment. In this case, UHG staff completely fabricated statements from the patient's doctor in order to justify reducing care to an ineffective level. https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis https://www.propublica.org/article/unitedhealth-healthcare-i...
• hackeraccount 4y ago
  You understand that if the Insurance industry didn't exist we would just re-create it right? I mean, if you tell people they can spend any amount of money on healthcare they will bankrupt whatever pot of money is available. You're just suggesting we go from saying the Insurance industry is terrible to saying whatever Government agency is running healthcare is terrible. Read about how doctors and patients talk about Medicaid, Medicare or Tricare. If you say they're popular I'd agree with you - but you need to see what people say when they're asked if they like their own private insurance; generally that's popular too. Most people like whatever health insurance they have most of the time because insurance only pinches in edge cases - not when I'm healthy and only in the subset of sick case called "I want a treatment that my insurance won't pay for." Those cases are always going to happen and sometimes it will be for legitimate reasons.