3 ms·

often, surgeries are denied if you can't pay. plenty pay insurance premiums diligently but then are routinely denied coverage. there was a story the other day a

often, surgeries are denied if you can't pay. plenty pay insurance premiums diligently but then are routinely denied coverage. there was a story the other day about an insurance provider not continuing anesthesia in surgeries if they (the surgery) takes too long and the patient didn't pay up. healthcare is the #1 problem in the US right now and our legislators are only making it worse due to accepting bribes (i.e. lobbying monies) to keep the status quo or worse, enrich the corporations in our for-profit healthcare system.

ttyprintk 2y ago
You can see the down-to-the-minute processes work in United in a specific case of ulcerative colitis (which has no cure): https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis https://www.propublica.org/article/unitedhealth-healthcare-i... It particularly interesting that high cost treatments seem to have motivated United to hire a college campus administrator as a secret budget specialist since the cost of a lifetime of treatment seemed high for younger people.
- wholinator2 2y ago
  My god. I have Crohn's disease and am on remicade. I've had it refused by aetna and must try two "biosimilars" before being allowed to take the medicine I've been on for over a decade. They asked me if I'd tried them before because "some people do not tolerate them". So now I'm faced with potentially up to a year of decline and ruining health just to take the drug I've been on for a decade, _that the manufacturer pays for anyways_.
  - FireBeyond 2y ago
    I had a 95% deviation to my septum. I spent years basically mouth breathing, because it was so occluded. Finally went to an amazing ENT (where I got that number, and saw how bad it was on imaging). "Great, so when can we schedule surgery?" He sighs. "First, I need to prescribe you these two nasal sprays so you can take them three times a day for four weeks and come back to me and tell me that surprise, surprise, they haven't realigned the cartilage in your nose. That way insurance won't deny the authorization of surgery."
    - lazystar 2y ago
      is that why the allergist prescribed that nasal spray... i had to wait 6 more months for the nasal surgery that turned my life around. son of a bitch....
      - FireBeyond 2y ago
        "Almost certainly", I'd say from my experience as a patient, as someone who worked in healthcare, and someone who worked for a company that wrote claims benefit management software for the industry.
dpkirchner 2y ago
> there was a story the other day about an insurance provider not continuing anesthesia in surgeries if they (the surgery) takes too long and the patient didn't pay up. Thankfully, they've walked back that policy (for some unknown reason).
- UltraSane 2y ago
  The system works! /s

ttyprintk 2y ago

You can see the down-to-the-minute processes work in United in a specific case of ulcerative colitis (which has no cure): https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis https://www.propublica.org/article/unitedhealth-healthcare-i... It particularly interesting that high cost treatments seem to have motivated United to hire a college campus administrator as a secret budget specialist since the cost of a lifetime of treatment seemed high for younger people.

wholinator2 2y ago
My god. I have Crohn's disease and am on remicade. I've had it refused by aetna and must try two "biosimilars" before being allowed to take the medicine I've been on for over a decade. They asked me if I'd tried them before because "some people do not tolerate them". So now I'm faced with potentially up to a year of decline and ruining health just to take the drug I've been on for a decade, _that the manufacturer pays for anyways_.
- FireBeyond 2y ago
  I had a 95% deviation to my septum. I spent years basically mouth breathing, because it was so occluded. Finally went to an amazing ENT (where I got that number, and saw how bad it was on imaging). "Great, so when can we schedule surgery?" He sighs. "First, I need to prescribe you these two nasal sprays so you can take them three times a day for four weeks and come back to me and tell me that surprise, surprise, they haven't realigned the cartilage in your nose. That way insurance won't deny the authorization of surgery."
  - lazystar 2y ago
    is that why the allergist prescribed that nasal spray... i had to wait 6 more months for the nasal surgery that turned my life around. son of a bitch....
    - FireBeyond 2y ago
      "Almost certainly", I'd say from my experience as a patient, as someone who worked in healthcare, and someone who worked for a company that wrote claims benefit management software for the industry.

dpkirchner 2y ago

> there was a story the other day about an insurance provider not continuing anesthesia in surgeries if they (the surgery) takes too long and the patient didn't pay up. Thankfully, they've walked back that policy (for some unknown reason).

UltraSane 2y ago
The system works! /s