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It sounds like Blue Cross may be feeling the pressure of needing to avoid the bad PR of turning down claims, but those claims still not meeting their insurance
by mrangle 1y ago
It sounds like Blue Cross may be feeling the pressure of needing to avoid the bad PR of turning down claims, but those claims still not meeting their insurance terms and financial models.
So they are tactically not paying the doctors after agreeing to, as perhaps the best legal chance to escape payment that still avoids the primary PR focus: the patient.
The public is going to now have pity on doctors, and from a strict terms of agreement standpoint they may have a good point.
However, these aren't normal times. And what we may be seeing is a type of insurance industry early death throe.
First, lets preface any further commentary by the fact that it must be kept in mind that the sole reason that doctors make a lot of money, at least "a lot" relatively speaking from certain perspectives and in certain roles, is the insurance industry. Otherwise, they'd be paid mostly like plumbers.
And so a shifting of financial pressure to doctors, or anyone else who is both politically and legally vulnerable, may be expected during existential changes in the insurance industry.
Next, I'll suggest that when a portion of the public looks to break the system, even for noble reason in their minds, that what they finally get may be completely unpredictable. And I'm not primarily speaking of this specific tactic, but rather of an unforeseen end-point.
Some unavoidable truths:
a. The insurance industry can only remain financially solvent when it has the ability to turn down claims, specifically those that the terms allow it to.
b. A certain portion of the public wants Universal Healthcare.
c. Any future denied claims will be framed as catastrophically unjust by this portion of the public, even if insurance carriers were to significantly (somehow) adjust their models to be able to operate while paying more claims and keeping premiums the same. There is no placating this portion of the public within the current system.
d. Some within this sector of the public, like Luigi Mangione, are criminally insane. They are willing to engage in terrorism and murder to destroy the insurance industry in the hope of eventually arriving at Universal Healthcare.
e. Some of the Press is politically supporting this criminally insane contingent.
f. If the Insurance industry can no longer function, or is otherwise forced to raise premiums beyond which many can afford in order to be able to pay out virtually all catastrophic claims, what will happen is either it will cease to exist or people will go without individual insurance and then businesses will stop offering insurance.
g. There is zero guarantee that the next step is Universal Healthcare. Saying that it is inevitable, for the United States specifically and after destroying the private insurance industry, is like saying that a manned NASA mission to Mars is inevitable because private aviation is deeply flawed.
The article author is a complete piece of shit for suggesting that the Brian Thompson assassination was due to anything other than the psychosis of a maniac. Mangione is criminally insane, and so are his sympathizers. At least to the extent that they aren't too low IQ to understand what happened while somehow still having an opinion.
- BMc2020 1y agoBrian Thompson assassination was due to anything other than the psychosis of a maniac. Have you never seen a movie where the bad guy gets killed?
- Whoppertime 1y agoThe FBI thought that MLK Jr was a "bad guy". They wiretapped his phones, sent government informants to infiltrate his church meetings, they sent threatening letters to him saying that he should kill himself or tapes would be made public. The FBI leaked damaging or false information to the media about him regularly. Would you summarize all that as "A movie where the bad guy gets killed" because MLK Jr was assassinated?
- wnoise 1y ago"Criminally insane" and "psychosis of maniac" are incredible hyperbole. The only reasonable word there is "criminally". Of course assassinations are criminal. One doesn't have to be insane, psychotic, or a maniac to kill someone, or to let someone die. All it takes is valuing other things above the life taken. This is not that uncommon. Now, you can think Mangione is wrong about the effects, that he did not have a rational plan that would get him his desired end goal. I think that's obviously true even. But that's just how most humans act most of the time, and is not insanity.
- gruez 1y agoand is not insanity. So how would you define "insanity" then? You can nitpick about how those phrases don't match what the DSM-5 says or whatever, but the reality is that Mangione's actions are far beyond what the vast majority of people would do, even under the same circumstances.
- wnoise 1y agoOh, yes, highly unusual. So are startup founders. Many of these fail, precisely because they too did not have rational plans that would get them to their end goals.