3 ms·
Her Treatment Was Helping. That's Why Insurance Cut Off Her Coverage
- knowitnone 2y agoCEOs should to be held responsible
- basementcat 2y agoThe CEO is primarily responsible to [maximize profits for] shareholders, not necessarily to benefit patients. If shareholders wish for better care to be provided to patients, I’m sure they would be happy to accept a lower rate of return on their investment.
- superb_dev 2y agoOh okay, system is working as intended and there are no problems!
- xenihn 2y agoAre you saying the shareholders should be held responsible then? Isn't taking responsibility the reason that the CEO is being paid by them?
- basementcat 2y agoShareholders of publicly traded businesses have governance power; they can vote for or against board members and policy documents. Perhaps this is one of the concerns with the rise of index funds— fewer investors make use of their governance power and the index funds just vote according to the recommendations of the current board.
- nso 2y agoIt's almost like profits shouldn't be part of the equation when we are talking about humans lives and health. Noone should enrich themselves on others not getting the health care they need, and those who do it today are morally bankrupt -- and society should fight back.
- tux3 2y agoYou're painting a picture of CEOs and their investors as an ontological evil, not by choice, but by unavoidable virtue of their role. This could've been searing satire, had you intended it that way.
- jryb 2y agoMorality doesn't stop applying just because you agreed to accept money in exchange for hurting people.
- taylodl 2y agoI recommend reading Built to Last https://www.amazon.com/Built-to-Last-Jim-Collins-audiobook/dp/B0813QCVN9/ref=sr_1_1?crid=6IBP7TZO31RI&dib=eyJ2IjoiMSJ9.1lFVHqK4lD_0aRZ08e0hFo0zhaFp_6zQ0pRZ2tgZov_GM5_WqIrMzJxKU8nHuUejNxAWr1u1C1T0iy8aykEPDYYvPtBoEF0qh-r3EralH6d47xBN_8_yCQu1mMRbgCttxcEqrqTmOnyhEZITA9VvgF6y5iDrN7dkPB8stGPHv0tjuyK3ArtyP0bcMWRmGsyKNndU73fQImbDVLVShJ0zSzgehj38SMaDqq3sgPROrYI.zt96zfmOw_TKS49YCeaN40907ZPH_iMDRtbDFgeKb2c&dib_tag=se&keywords=built+to+last&qid=1735940321&sprefix=built+to+last%2Caps%2C148&sr=8-1 https://www.amazon.com/Built-to-Last-Jim-Collins-audiobook/d... It'll do a much better job than I can in showing why your thinking is so wrong-headed
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- surgical_fire 2y agoLast time someone held a CEO truly responsible he was arrested. I nonetheless agree CEOs should be held responsible.
- samoit 2y agoEurope here. It is sad to see the results of the EEUU healthcare system. I still do not get why people do not vote for a more rationale and public service. I guess the EEUU media have brainwashed their people into thinking that a private health system is better. People do not see the problem until it affects them ... until it is too late...
- raincom 2y agoWhat is EEUU?
- nso 2y agoIn Mexico that's the US, so maybe the poster is from Spain. The doubling of the letters (e.g., "EE." for "Estados" and "UU." for "Unidos") follows a convention in Spanish where plural abbreviations are indicated by duplicating the letters. The correct form would be "EE. UU." This practice aligns with historical Latin abbreviations (e.g., "SS." for "Sancti" (plural) or "S." for "Sanctus" (singular)).
- samoit 2y ago¡Correct!. I would not be able to explain it better.
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- dylan604 2y agoI see you seem to hold the notion that voters are rational beings. As long as you think that way, election results will never make sense to you
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- nine_zeros 2y agoThere is no excuse for insurance fraud like this. C-Suite and board of directors must be held criminally liable much like drug overlords are held criminally liable.
- Eddy_Viscosity2 2y ago> C-Suite and board of directors must be held criminally liable much like drug overlords are held criminally liable So... not liable then.
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- KittenInABox 2y ago> Their doctors are left to walk a tightrope trying to convince insurers that patients are making enough progress to stay in treatment as long as they actually need it, but not so much that the companies prematurely cut them off from care. And when insurers demand that providers spend their time justifying care, it takes them away from their patients. I don't know how this isn't considered the insurance companies practicing medicine without a license.
- devsda 2y ago> Insurers most often turn to two sets: MCG (formerly known as Milliman Care Guidelines), developed by a division of the multibillion-dollar media and information company Hearst, and InterQual, produced by a unit of UnitedHealth’s mental health division, Optum. Insurers have also used guidelines they have developed themselves. Presumably, the guidelines were written by medical professionals. > In interviews, several current and former insurance employees from multiple companies said that they were required to prioritize the proprietary guidelines their company used, even if their own clinical judgment pointed in the opposite direction. In medical care, the attending doctor should be the one taking final call. Otherwise, we'd all be receiving medical treatments based on a bunch of flowcharts.
- theGeatZhopa 2y agothey should be sued for billions by a patient's family, in case the cutting off of coverage lead to death/worsening. I really don't get, how it became like it is. In Europe, that would be illegal.
- jjulius 2y ago>A few hours after the session, Moore drove herself to a hospital and was admitted to the emergency room, accelerating a downward spiral that would eventually cost the insurer tens of thousands of dollars, more than the cost of the treatment she initially requested. I don't mean to diminish the struggle that Moore went (is going?) through, but at least there was some kind of karmic retribution here.
- Imnimo 2y ago>A few hours after the session, Moore drove herself to a hospital and was admitted to the emergency room, accelerating a downward spiral that would eventually cost the insurer tens of thousands of dollars, more than the cost of the treatment she initially requested. Is the issue here that most patients in this slot would have just made-do with the lower level of care, so the insurance company is saving money even if a handful end up in the emergency room? Or is it that the insurance company is inept and is not even saving money in expectation? I'm not sure whether "is too cut-throat at saving money" or "is too incompetent at saving money" is the worse problem to have, but they probably have different solutions.
- cyanydeez 2y agoIt just means that rather than "trust doctors" or "evaluate care" it's cheaper to hire a random doctor who evaluates and sets limits based on arbitrary reasoning about "excess" and that reasoning follows from what crimes they've gotten way with previously (lawyers). This is not a system of care; it's a system of squeeze the turnip, with a parade of MBAs who constantly need to turn the screws to ensure they can climb the latter. It's sociopathy, like the entire business capitalism. It's just that in this case, the consumers arn't directly the costumers.
- tomalaci 2y agoWith the horrible reputation US insurance gets, is there some reason why smaller insurance companies aren't popping up to deliver better quality (i.e. less denials)? Is the field simply heavily protected by lobbying and regulatory capture?
- KittenInABox 2y agoMany people don't have a choice in which company to go with. My employer chooses the company, not me.
- buffington 2y agoTo be fair, you can choose still by declining employer provided/subsidized coverage. The cost of doing so, of course, makes it very much not worth it.
- r00fus 2y agoA meaningless BS choice no one would actively choose is not a real choice. If you happen to have a working spouse, you can choose between which work coverage makes most sense for your family.
- bragr 2y agoProbably a combination of heavily regulated, the lack of choice for employer provided plans, and the difficulty in building out a network of doctors and other facilities. Would you sign up for an upstart health insurance with a tiny network?
- hagbard_c 2y agoIf those providers were local to where I live and I don't travel much or at all, yes I would - if I were an American that is. I'm a Dutchman living in Sweden so I'm used to two totally different systems.
- jjulius 2y ago
- Invictus0 2y agoSuppose insurance company doctors could lose their medical license if too many of their decisions are reversed in court. I imagine these doctors would command higher pay for their increased level of personal risk, but would end up making better choices for the insured. What does HN think?
- nso 2y agoWhat about if we instead of building more levels on top of this already falling building we build a new one a few blocks over. With blackjack, hookers, and free* and humane health care. * not really free of course, but you pay less on average than you do today and you do it on your taxes instead of to some profit chasing private company -- and most importantly those who don't pay today will have equal access to it as well.
- jjulius 2y agoI think that's just a tiny cog in a massively fucked up system.
- geocrasher 2y agoHealth insurance is not designed to heal people. It is designed to pay as little as possible to keep them paying their premium.
- lorekeeper68 2y agoWilliam Mayo said in 1910, "The best interest of the patient is the only interest to be considered." If we would design a healthcare system to follow this ONE PRINCIPLE, there would be no healthcare problem.