3 ms·

Do you have any examples? I am quite confident I have never been in this situation, I have never heard of anyone except Kaiser patients (who are FWIW very happ

Do you have any examples? I am quite confident I have never been in this situation, I have never heard of anyone except Kaiser patients (who are FWIW very happy with their service) getting this.

tmpz22 2y ago
My extended family has been Kaiser for decades and it has plenty of faults (Bay Area region). I’ve personally had multiple severe misdiagnosis by tired over worked doctors. I’ve had massive ER bills with trivial operations. I’ve gotten damagingly inaccurate mental health care, and at times long delays to see various specialists. The partnership of Kaiser and Reagan are largely responsible for the healthcare system America has today. Do not give them a pass.
timschmidt 2y ago
United Health Group is covered in "What Happens When Your Insurer Is Also Your Doctor and Your Pharmacist" - https://www.wsj.com/health/healthcare/what-happens-when-your-insurer-is-also-your-doctor-and-your-pharmacist-8df727af https://www.wsj.com/health/healthcare/what-happens-when-your... There's also https://en.wikipedia.org/wiki/Centene_Corporation https://en.wikipedia.org/wiki/Centene_Corporation You mentioned Kaiser Permanente who acquired Geisinger Health System's network of hospitals: https://en.wikipedia.org/wiki/Kaiser_Permanente https://en.wikipedia.org/wiki/Kaiser_Permanente See also: https://pahealthaccess.org/promises-made-promises-broken-what-really-happens-when-local-hospitals-are-acquired/ https://pahealthaccess.org/promises-made-promises-broken-wha... https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/ https://www.kff.org/health-costs/issue-brief/ten-things-to-k...
solarpunk 2y ago
I think the term used to describe the imposed cost regulation is 'Medical Loss Ratio (MLR)', and the providers that own both ends of the claims transactions can use inflated costs to artificially manipulate their MLR.
dumbmrblah 2y ago
Kaiser is great, until you get sick. Then it’s a nightmare, especially if you have anything complex going on. I’m a physician that works at an ultra specialized hospital.
- Brian_K_White 2y ago
  And I saw some chart of percentage claims denied that said KP denied the least at 7% while UHG the most or almost, at something like 39%. Even if that were true that KP deny the least, it ends up meaning nothing if they also own the hospital who they graciously never deny claims from. Ugh.
  - dumbmrblah 2y ago
    The gunman etched ‘Delay, Deny, Defend’ in those bullets. UHG denies. KP delays. Both can lead to disastrous consequences. Edit: And by delay, I don’t mean delay in seeing a specialist, I mean delay getting the most modern and up-to-date care. They have a tendency to practice population based treatment (and fiscally responsible), which may not be what is the most up to date. I understand it as an hospital administrator, but I can see the consequences as a physician.
    - inemesitaffia 2y ago
      Population based treatment is where nationalized care ends in

Do you have any examples? I am quite confident I have never been in this situation, I have never heard of anyone except Kaiser patients (who are FWIW very happy with their service) getting this.

tmpz22 2y ago

My extended family has been Kaiser for decades and it has plenty of faults (Bay Area region). I’ve personally had multiple severe misdiagnosis by tired over worked doctors. I’ve had massive ER bills with trivial operations. I’ve gotten damagingly inaccurate mental health care, and at times long delays to see various specialists. The partnership of Kaiser and Reagan are largely responsible for the healthcare system America has today. Do not give them a pass.

timschmidt 2y ago

United Health Group is covered in "What Happens When Your Insurer Is Also Your Doctor and Your Pharmacist" - https://www.wsj.com/health/healthcare/what-happens-when-your-insurer-is-also-your-doctor-and-your-pharmacist-8df727af https://www.wsj.com/health/healthcare/what-happens-when-your... There's also https://en.wikipedia.org/wiki/Centene_Corporation https://en.wikipedia.org/wiki/Centene_Corporation You mentioned Kaiser Permanente who acquired Geisinger Health System's network of hospitals: https://en.wikipedia.org/wiki/Kaiser_Permanente https://en.wikipedia.org/wiki/Kaiser_Permanente See also: https://pahealthaccess.org/promises-made-promises-broken-what-really-happens-when-local-hospitals-are-acquired/ https://pahealthaccess.org/promises-made-promises-broken-wha... https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/ https://www.kff.org/health-costs/issue-brief/ten-things-to-k...

solarpunk 2y ago

I think the term used to describe the imposed cost regulation is 'Medical Loss Ratio (MLR)', and the providers that own both ends of the claims transactions can use inflated costs to artificially manipulate their MLR.

dumbmrblah 2y ago

Kaiser is great, until you get sick. Then it’s a nightmare, especially if you have anything complex going on. I’m a physician that works at an ultra specialized hospital.

Brian_K_White 2y ago
And I saw some chart of percentage claims denied that said KP denied the least at 7% while UHG the most or almost, at something like 39%. Even if that were true that KP deny the least, it ends up meaning nothing if they also own the hospital who they graciously never deny claims from. Ugh.
- dumbmrblah 2y ago
  The gunman etched ‘Delay, Deny, Defend’ in those bullets. UHG denies. KP delays. Both can lead to disastrous consequences. Edit: And by delay, I don’t mean delay in seeing a specialist, I mean delay getting the most modern and up-to-date care. They have a tendency to practice population based treatment (and fiscally responsible), which may not be what is the most up to date. I understand it as an hospital administrator, but I can see the consequences as a physician.
  - inemesitaffia 2y ago
    Population based treatment is where nationalized care ends in