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Feds help health insurers hide their dirty secret: denials on the rise

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Re: Feds help health insurers hide their dirty secret: denials on the rise

#111

Post by kstrauser »

seneca wrote: post #71
boxed wrote: post #58

Earlier quoted context omitted.

> A claim denial that results in denial of life-saving treatment could never be counted as either of those charges. First-degree murder is when you willingly, and with forethought, plans and carries out the killing of a human. Which seems to me to be 100% what you described.

Denying a claim can not kill someone. Disease and injury killing a person. Claim denial prevents financial support for intervention in resolving a disease or injury. That is not the same thing, and equivocating them is sophistry.

If you’re shot, and I pull up a chair and watch you die without saying a word or helping in any way, especially if I get paid extra for refusing, I’m not sure if I’d call it murder, exactly, but I bet your family and friends would describe me as a killer.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#113

Post by devilbunny »

jbb67 wrote: post #77
garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

But it's not usual to have an anesthetic for a colonoscopy is it? I've had two without. I was offered a light sedation but then I couldn't have driven home afterwards. It wasn't particularly awful without. It's it usual to be asleep? I've not really heard of that. Is it a US thing?

It is extremely common in the US. The only people who get colonoscopies without any sedation are those who want to be able to drive themselves home afterward.

We have people - covered in tattoos - who insist that they are terrified of needles. And that they want drugs before any even mildly painful procedure, like placing an IV.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#114

Post by chefandy »

voidfunc wrote: post #86
garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

I've done a colonoscopy without anesthesia before... it was a non-event. This is pretty common from what I understand elsewhere in the world. Americans are just super uncomfortable with their bodies so I guess we prefer being put under?

> I've done a colonoscopy without anesthesia before... it was a non-event. This is pretty common from what I understand elsewhere in the world. Americans are just super uncomfortable with their bodies so I guess we prefer being put under?

It depends on what they do while they’re in there. If they’re just taking pictures then it’s fine. If they find anything they usually cut it out immediately. I can tell you from experience that having a piece of inflamed colon cut of and cauterized while you’re conscious isn’t a “non-event” as cool as it might be to watch on the monitor.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#115

Post by timr »

garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

> I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake.

It sounds like something is getting lost in translation. Presence or absence of anesthesia does not change the medical necessity of the procedure.

> I'm 45. Colonoscopies are a thing. I had a friend die at 52 two years ago after he was diagnosed with stage IV during his first colonoscopy.

Without wading into the specifics of your situation, there's not great evidence justifying colonoscopy for normal people without family history at age 45. The USPSTF just kinda lowered the threshold based on crappy (pun not intended) observational data. And if you look at their recommendations, they actually don't recommend colonoscopy, specifically -- they just recommend "screening" [1] which includes FIT, DNA testing (again: not great evidence here), or flex sig, which is done without anesthesia, and all of which are cheaper than colonoscopy. It's a huge debate.

Anyway, I absolutely don't want to reflexively defend the health insurance industry in the US, but one the reasons we have skyrocketing health care costs in this country is because people are doing expensive procedures when cheaper ones would suffice.

[1] https://www.uspreventiveservicestaskforce.org/uspstf/recomme...

Re: Feds help health insurers hide their dirty secret: denials on the rise

#116

Post by runnr_az »

tjpnz wrote: post #89
jimbokun wrote: post #50

Earlier quoted context omitted.

Everyone wants to change it...until you propose a concrete new system including payment mechanism. "Give me universal health care...but don't increase my taxes!...and don't take away my current insurance plan!"

"Why should I have to pay for my neighbor's hip replacement?!!"

"Why should my treatment be limited?"

Re: Feds help health insurers hide their dirty secret: denials on the rise

#117

Post by tommilburn »

tedivm wrote: post #98
jbb67 wrote: post #77

Earlier quoted context omitted.

But it's not usual to have an anesthetic for a colonoscopy is it? I've had two without. I was offered a light sedation but then I couldn't have driven home afterwards. It wasn't particularly awful without. It's it usual to be asleep? I've not really heard of that. Is it a US thing?

Light sedation is anesthesia. > Anesthesia or anaesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia, paralysis, amnesia, and unconsciousness. "General anesthesia" is probably what you're thinking, which is a specific form of anesthesia where someone is put to sleep.

i was actually confused about this for a long time - i always thought my colonoscopies were "general" because i... couldn't remember anything, but all of them were really just propofol "twilight," which is just a deep sleep, i guess? i only learned this when i got a real surgery and had to actually go under general, it's a much more involved thing where you're essentially put in a coma

Re: Feds help health insurers hide their dirty secret: denials on the rise

#118

Post by ahupp »

tossandthrow wrote: post #5
andrelaszlo wrote: post #2

"No industry malfeasance could ever excuse murder. Period." Murdering a murderer to save many innocents could be considered ethical by some? (Not saying that's the case here, but nypost made an interesting categorical statement.)

It is funny that the sentiment that nothing excuses a murder is being circulated in the US - a country that still carried out death sentences.

Murder is by definition an unlawful homicide. This isn’t just pedantry; it’s the most parsimonious explanation for why someone would support the death penalty and object to something like the assassination.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#119

Post by tedivm »

tossandthrow wrote: post #42
jimbokun wrote: post #35

Earlier quoted context omitted.

I understand what you're saying. But a murder carried out by a random citizen is still worse than a death sentence after a fair trial and convicted by a jury of your peers.

It was not the justification of murder I was talking about. Simply the fact that murder as a solution is absolutely accepted in the US.

Murder isn't the same as homicide. By definition the death penalty isn't murder, because it's state sanctioned. Self defense, another example of legal killing, also isn't murder and most people who are against murder would consider a death in self defense to be justified and not murder.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#120

Post by mtalantikite »

paulproteus wrote: post #68
weberer wrote: post #15

Earlier quoted context omitted.

Everybody knows how bad it is. Everyone wants to change it. But I don't see how it can change as long as both parties are on the payroll https://www.opensecrets.org/orgs/unitedhealth-group/recipien...

Confusing statement when Republicans are the reason Obamacare shipped without a public option

I thought it was because of Joe Lieberman, a Democrat turned independent, from a state that tries to bill itself as the "Insurance Capital of the World" [2]

[1] https://www.theguardian.com/world/2009/dec/16/joe-lieberman-...

[2] https://connecticutifs.com/home/

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