7 ms·

It’s beating a dead horse at this point, but private health insurance is quite possibly the worst middleman I have ever dealt with. They not only make the pati

• yieldcrv 2y ago
  I’m curious about why it wasn’t considered to switch insurers, the article has do many details on many processes and I felt this one was not investigated It’s definitely hard to cancel them and the expense adds up to pay premiums for two Was it a possibility?
  • siliconwrath 2y ago
    I obviously don’t know the specifics, but US healthcare plans only let you change during specific enrollment periods or qualifying life events. It’s possible he wasn’t able to. Additionally, it sounds like he picked what appeared to be the best rated plan available to him on the market. Others may have been even worse or prohibitively expensive.
    • yieldcrv 2y ago
      Yes I know it’s hard to cancel outside of enrollment periods, you can still have multiple Adding in the last minute flights and commitments throughout this article, I would say for other people that at some point the calculus can be re-evaluated to find that paying the premiums would be worth it. The loved ones can pay for that instead of last minute flights and time off
      • bumby 2y ago
        The man in the article was living in a studio apartment. I doubt he was in a position to be paying the equivalent of a mortgage for many insurance options. Even if he could, I’m not sure that’s the system/solution we’d want.
      • siliconwrath 2y ago
        If he had a lot of money he could have just paid out of pocket for care. It sounds like he couldn’t afford it.
      • klabb3 2y ago
        > you can still have multiple This can’t be for real. The only reason you pay for insurance is in case something happens. It has no value outside of that. That’s why it’s called insurance. And medical insurance in the US is very expensive, so much that a large part of the population can’t afford it. If you don’t get care when you need it, it’s worse than no insurance - now there’s less money left to pay out of pocket to the only places that will take you on in time. The solution to being scammed is not to sign up for another scam.
        • gomerspiles 2y ago
          Aside from how ridiculous it would be to buy double coverage, it can just make the problem worse with both companies trying to argue they aren't the primary and that their doing anything may be duplication of coverage. But some more paper work should resolve that once you are dead.
      • llamaimperative 2y ago
        Blame literally anything except the glaringly obvious perverse incentives produced by the profit motive. Glad we have folks willing to do the hard work of defending negligent insurance companies <3
        • yieldcrv 2y ago
          > I would say for other people It wasn't blame and I wrote that specifically for that reason
          • llamaimperative 2y ago
            Nobody is struggling with the problem of delivering good healthcare to people with tons of money. Yeah, you just pay more money.
  • mystified5016 2y ago
    You have the choice of a couple of large companies that will deny every claim always for any reason, and a few smaller players who no doctor in your area has heard of or can accept payment from. So yeah, you have a 'choice'
  • geraldwhen 2y ago
    Or pay cash for therapy. Or have the parent pay cash for therapy. Options existed, but there are none now.
    • Apocryphon 2y ago
      Most therapists don’t accept insurance. The problem then is that their services are expensive out-of-pocket.
• maxverse 2y ago
  Hands down the worst and most stressful part of living in America, and the only reason I - a child of immigrants who are grateful to have built a life here - would consider moving somewhere else
  • GFischer 2y ago
    It was one of the biggest considerations that made me decide against moving to the USA. One of my coworkers took advantage of the L1 Visa (which I can still qualify for) and she ended up moving back to my home country Uruguay even though she made 50% higher salary in USA. She did live some of the worst stuff in USA like Texas electricity failures, 20.000 dollar healthcare bills, etc.
• Der_Einzige 2y ago
  Integrated providers, such as Kaiser Permanente, have far fewer issues related to the problems brought up in this article compared to most others. Nothing like this would ever happen in a Kaiser hospital.
  • slantedview 2y ago
    Kaiser had its own very sordid history of denying people mental healthcare which has led to deaths, fines by the state of California, and new legislation.
    • tmpz22 2y ago
      My family has gone through three generations of Kaiser in California and it has its own tradeoffs I promise you and mental health is one of it’s most frequent complaints.
  • OldGuyInTheClub 2y ago
    [dead]
  • spease 2y ago
    > Nothing like this would ever happen in a Kaiser hospital. Kaiser’s mental health services were so bad that their providers went on strike a couple years ago. They’re paid a fraction of what they could make in private practice. https://www.healthcaredive.com/news/kaiser-strike-mental-health-california-hawaii-deal/634917/ https://www.healthcaredive.com/news/kaiser-strike-mental-hea...
    • Teever 2y ago
      What barriers prevent them from working in private practice? As a non-American I assume that Kaiser implements some sort of barriers to stop smaller competitors from rising up?
      • llamaimperative 2y ago
• jimbob45 2y ago
  Works well for me and I’m not even wealthy. I get the feeling that the universal healthcare advocates have convinced everyone that things are far worse than they actually are.
  • betaby 2y ago
    Canada got worst combination of private/public, not-really-a-singly-payer, not that universal care.
    • fakedang 2y ago
      I mean all you need is regulating the insurance industry in America. We do a fine job in Switzerland with private insurance, and yet they're some of the biggest insurance players globally. The government HEAVILY regulates health insurance. Also, health insurance isn't tied to employment.
    • dghlsakjg 2y ago
      Canadian healthcare isn’t a monolith. It is managed at the provincial level, so it varies between the provinces, I suspect this comment is more of political jab than a cohesive critique of the dozen or so systems at play. Glad for you to clarify your meaning though. That said, my experience in BC is that my tax burdens are much, much lower than my tax burden + insurance cost in the states. I’ve never had issues accessing healthcare in a way that impacted my health (which is not true in the states), although I have had to wait, since it is a triage system based on need, rather than ability to pay.
  • incangold 2y ago
    “Works on my machine, ticket closed”
  • treyd 2y ago
    I just had an antibiotic prescription denied because my insurance company thought I had a refill in 5 days, despite the last time I was prescribed it was as a one-off course, 8 years, and 3 insurance companies ago.
• wintermutestwin 2y ago
  If I could recover the cost of my time in small claims court, I’d be making a hefty sum from these parasitic insurance companies that constantly require me micromanaging their antics.
  • staticautomatic 2y ago
    In CA I wonder if a PAGA claim could be viable.
    • wintermutestwin 2y ago
      Could you elaborate ? This is what I got from chatgpt: “PAGA claim (Private Attorneys General Act) in California allows employees to file lawsuits on behalf of the state for labor code violations.” How would that apply here?
      • staticautomatic 2y ago
        See Cal Civ Code 1021.5. Idk if it would be available in this context but maybe there’s an angle.
• ponector 2y ago
  Public health insurance in other countries are not better. For instance, I pay 10% of my income for it and in some cases queues just to start treatment are for few years. And it does not cover teeth, implants, vaccines. If case is urgent, like a cancer, it can take 6+ month to actually start treatment due to all paperwork and queues everywhere.
  • weakfish 2y ago
    Sounds like poor implementation, not a reflection on the concept. Which sucks - don’t get me wrong, that needs to be improved! Private insurance has all the wrong incentives, and IMO profit should never be linked to the health of a human for that reason.
    • sokoloff 2y ago
      This could be a tech-heavy lens, but I feel like some of the innovation in healthcare is driven by a profit motive (and funded by same in a lot of cases). I don’t know if removing all profit from the system results in an optimal outcome, but I suspect it does not.
      • RobotToaster 2y ago
        My understanding is that most early stage medical research on finding specific targets for drugs, and often drug discovery itself is publicly funded. Private funding only really takes over once you start trialling the drug in animals and then humans.
        • sokoloff 2y ago
          It’s not just drugs; look at the difference in medical equipment now versus 40 years ago. I’d sure rather pay a little extra and have 2024 equipment than 1984. That 2024 equipment exists because someone imagined they could make a profit if they successfully created it.
          • 2y ago
• gigatexal 2y ago
  This could be said for all of private insurance: they've got a literal mandate to not pay out, pay out far below what is owed, or delay delay delay because what they keep is pure profit. I wonder if for a public provider if the incentives are better.
  • llamaimperative 2y ago
    I think they are saying it of all private insurance
  • weaksauce 2y ago
    > I wonder if for a public provider if the incentives are better. should be generally. the NHS in england was viewed more favorably than the queen and they loved the queen.
    • mu53 2y ago
      While it does a much better job, public providers can be become political targets for budget cuts. The NHS probably has a much lower approval these days and in the past, and the NHS failing to provide care has become a political topic in England after years of budget cuts from conversative governments.
• SkyPuncher 2y ago
  My wife is a doctor and dealing with insurance is one of the worst parts of the day. Far too often, she knows that a certain treatment plan is going to be the only and most effective plan for a patient. However, insurance will require her to exhaust several other options first. It seems the hope is enough patients give up on treatment that they never actually seek the proper care. They'll just get chucked the "cheap" option again in the future.
• _DeadFred_ 2y ago
  I recently had to juggle 'do I pay out of pocket for this skin cancer surgery and save $600 on the $3000 total, or use insurance so that what I pay goes towards my deductible (would have fulfilled 30% of my deductible for the year). It was better to pay out of pocket. In the last 30 years we went from affordable ambulances and insurance that worked to people too scared to use ambulances and insurance that our doctors encourage us not to use. Glad we are letting the free market work it's magic. Thankfully the market worked in our small town, the ambulance company went broke and we joined together as a community and now have county services that are not only better but much much cheaper and don't see peoples' emergencies as a profit center for some located elsewhere mega-corp. Weird how inefficient small town hick local government can now make work (and work better) what mega corp for profit 'big brains' couldn't. Side note: USE SUNSCREEN PEOPLE! I wish I could go back and slap dumb 'too cool for sunscreen' Santa Cruz surfer kid me.
  • cat5e 2y ago
    Another Santa Cruz loc
    • _DeadFred_ 2y ago
      Man I miss home so much. Sadly the saying 'you can't go home again' is too true. Wish I could have afforded to stay in the town I grew up in.
      • cat5e 2y ago
        Sorry to hear that. Yeah it’s a very special place.
  • GenerWork 2y ago
    >In the last 30 years we went from affordable ambulances and insurance that worked to people too scared to use ambulances and insurance that our doctors encourage us not to use. Glad we are letting the free market work it's magic. The healthcare market was arguably freer 30 years ago than it is today.
• madaxe_again 2y ago
  It’s crazy that you put up with it. Me, in Europe - I need healthcare, I go wherever I want, public or private. Public is free and good, but usually you have to wait a few weeks or months for non-critical care, and private can usually see you tomorrow. My insurance will cover it, no question - everyone is in network with everyone, and I’ve yet to find an exception. I pay €600 a year, and it covers all the root canals and colonoscopies I can handle. No copay. No excess, except on dentistry, which is like €25.
  • Scrapemist 2y ago
    Where?
    • dutchy57 2y ago
      In my case: The Netherlands (lived there > 10 years as adult). I've also lived in Germany for 5 years, and it was only slightly worse than NL. But nothing compared to the horror stories I hear from US colleagues.
      • ffsm8 2y ago
        I live in Germany. 800€/month for public insurance, some dentistry services are included - a lot aren't. Lots of doctors only service patients with private insurance, so I sometimes just have to pay it out of pocket. Specialty Care like skin is usually massively overbooked that you can't even get any appointment, as they don't accept any more patients. Your experience in Germany is likely >10yrs ago before the system was sabotaged for private profits by our current health minister
        • xtracto 2y ago
          Interesting, I lived 4 years in Germany (Sachsen Anhalt). I had to use an ambulance for emergency (syncope , hit my head , lots of blood , middle of the night). I also had colonoscopies, MRI, and several visits.to gastroenteroloist, and one proctologist (yikes!). I the 4 years I was there. I just remember getting some receipt for a very low sum from my insurance (Big Gesundheit) which was negligible (I think about 300 Eur) . All then other stuff was economically inconsequential. And I was on a Research Assistant salary. It was amazing. It was not better than NHS (lived in the UK for some time as well) , but it was pretty good.
• moffkalast 2y ago
  The horse is only dead because it didn't have the cash to pay the out of pocket, so it died from a preventable disease. And even if it had the cash, the lines are so long it would've died waiting instead.
• golergka 2y ago
  Keep in mind that there are different kinds of private health insurance, and american system is one of many. I live in Argentina right now. I pay about $150 per month for insurance (which is pretty expensive by local standards). They operate their own hospital, which is about 15 minutes from my home by car. I buy medicine with 50% discount, which already makes the insurance pay for itself. I don't have to search for doctors, I just open an app (or website, or call them) and make an appointment, almost all of them work in the same hospital building. My girlfriend had to use an ambulance, and now is prepping for surgery — of course, all of that is completely covered. Oh, and all the doctors give your their email or WhatsApp so you can follow up and ask them stuff anytime. I lived in Russia before, and I've had even better experience. I don't remember how much I paid (on the same order of magnitude), but home visits costed me may be around $20 a pop. (Personally, I'm buffled why more health systems around the globe don't have home visits, I'd gladly pay a reasonable extra fee). I've also used private health insurance subscription when I lived in Israel and had to see doctors in Turkey, Georgia, Serbia and Peru, paying out of pocket; in all these instances, prices were reasonable and the whole system very nice to interact with. For instance, in Georgia, my ex had to ride an ambulance and spend week in a hospital. The whole thing cost me around $300 out of pocket. Anyway, in any of these systems where I had a subscription, I've never had to pay and then file a claim; doctors were employees of the organisation that I paid my insurance to. Public health insurance, on the other hand, have always been an abysmal experience, with doctors and nurses not giving f about you. It was more expensive, too: you had to bribe people so that they actually did their jobs, and it didn't improve their attitude much. Nobody in that system has any incentives to help you. And, of course, it's much more expensive in the end.
• jabroni_salad 2y ago
  I need to see a doctor about once a quarter for an ongoing issue and ended up switching to a DPC doctor. I pay a subscription out of pocket and extras are a flat rate menu, and they simply do not take insurance. However, it's been way cheaper overall and I have had exactly zero phone calls aside from setting appointments. No billing issues, no surprises, no middlemen, no problems. Oh, and I can have an appointment as soon as this week if I need one. No 8 month runaround just to get a referral. The reason it works is because the doctors do not have to staff a billing department. the office runs like a '2 pizza team.' Just delete bureaucracy, it isn't helping us.
• xtracto 2y ago
  It's because it's a strsight full blown scam. And it's accepted by society... terrible. The only for profit business where you pay the company to give you a "service". But the company's main objective is to do EVERYTHING in their power to AVOID giving you the service. They will spend $100,000 to avoid covering g your $100,001 claim; that's $1 to their shareholders, which is what matters to a Corp ultimately. Insurance business is a scam.
• 0xcde4c3db 2y ago
  I feel like the problem is that it's set up as a virtuously adversarial system where everyone is expected to strenuously advocate for their side's interests and find the best possible compromise, but nobody can afford to give enough of a shit to actually put up a fight, so it just turns into an infinite recursion of lazy fake-out maneuvers.