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My husbands suicide shows theres something very wrong with US insurance industry

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Re: My husbands suicide shows theres something very wrong with US insurance industry

#91

Post by tracker1 »

JohnTHaller wrote: post #30

The goal of their insurance company is to make a large return for their shareholders. And, thus, a large bonus for the C-suite execs. Their goal is not to provide care. In this particular instance, the insurance company saved money to give to shareholders and their C-suite by not treating the patient further. They lose no money by allowing him to die. This is all by design.

I wish that rather than the closed govt medical programs we have... we simply funded a public, non-profit health insurance provider that is motivated by fiduciary responsibility, but not profit driven. While this may seem heartless as some would fall through the cracks, such as cases like tfa that wouldn't be covered, at least there would be more competition against the private insurance companies.

I'm not a fan of fully socializing medicine, but having a non-profit with negotiating power in the mix could only help.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#92

Post by petilon »

toss1 wrote: post #71
petilon wrote: post #7

Yes, there is something wrong with the insurance industry. But there is something wrong with the hospitals, doctors and drug companies too. The whole system is broken. Hospitals try to eke out the most out of insurance companies, often providing services that are unnecessary. Pharmaceutical companies charge US patients significantly higher rates than in other countries. Don't put all the blame on insurance companies.

NO The insurance companies are running the system more than any of the others — it is the finance "wizards" there who put the constraints on the rest of the system. I'll agree somewhat on the pharma companies too, who are also extractive. You even said it yourself: "Hospitals try to eke out the most out of insurance companies...". Exactly! Because the hospitals and doctors are constrained to do "WHAT IS IN THE BEST I…

An itemized bill from the hospital for about four weeks of his hospital stay. It came to a little over $4 million. https://www.cbsnews.com/news/covid-19-deaths-families-60-min...

Woman charged $143,396.66 for a breast biopsy https://www.marketwatch.com/story/a-doctors-prescription-to-...

Numerous studies have found that when doctors have a financial stake in a hospital, they tend to order more tests and procedures, raising costs for Medicare and other insurers. https://www.nytimes.com/2011/12/13/health/policy/republican-...

Re: My husbands suicide shows theres something very wrong with US insurance industry

#93

Post by EvanAnderson »

JohnFen wrote: post #36
EvanAnderson wrote: post #22

Earlier quoted context omitted.

If you have enough money for that gamble to pay off over the long haul the cost of health insurance would be immaterial to you anyway. You might get away with it in your youth, or you might have a catastrophic loss and have your finances wrecked. You're often able to negotiate discounts for cash payment from providers, but back when I had insurance that excluded a pre-existing condition I ran into providers who stead…

> you might have a catastrophic loss and have your finances wrecked. If you have health insurance (in the US) and you have a catastrophic event, your finances are going to be totally wrecked anyway. You're likely to have to declare bankruptcy unless you are pretty wealthy. At least, that's how it's gone with every friend and family member of mine that had to navigate such an event. That's on top of the painful nightm…

I would agree that it's objectively terrible dealing with insurance companies, providers who are incredulous you care about the pricing of services, etc. There is no free market for healthcare services. Advocating for yourself is tremendously draining.

I'm happy with the ROI I've had with my insurance premiums over my life. I haven't had a catastrophic event but I've certainly had reasonably sizable claims. If I'd invested the last 20+ years of premium expense (about $400K to date) and had no claims I'd have a ton more money, but not enough to cover a catastrophic event later in life. The principal would also have been completely wiped-out a couple of times when I did have claims, however.

I pay the premiums because I'm not comfortable holding bets on both the market and on my health. I'm also unwilling to consider bankruptcy as a morally / socially acceptable solution.

This mixed socialized and capitalist "system" we've allowed to grow up feels like the worst possible one. Healthcare and health insurance expense are a mechanism to extract value from the middle class (i.e. everyone who has money but isn't wealthy enough to buy their way out of the "system").

My preference would be for a fully socialized system, built primarily around protection for catastrophic loss, where everyone contributes w/ no opting-out permitted.

Failing that I'll grudgingly take a fully capitalist system where people who can't afford to pay are left to fend for charity or die.

What we've got is a mix of the worst parts of both.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#94

Post by starkparker »

recursive wrote: post #14

This is a far cry from the gravity of the post, but here's my personal anecdote about trying to navigate health care and insurance. A month or two ago, I was trying to set up a pediatric dentist visit for my son. Not a medical emergency, but a matter of some urgency. I spent about three hours on a total of a dozen phone calls or so. Some to the insurer, and some to various dentist offices in the region to inquire abo…

Insurance refused to cover imaging to identify my spouse's squamous cell carcinoma on an ovary because initial bloodwork didn't come back positive for ovarian cancer (squamous cell required different bloodwork, at least at the time).

It took a doctor offering to misdiagnose it as a dermoid cyst to get the imaging and hysterectomy ordered and approved, and that still took 2 months. By the time it happened, the cancer had metastasized.

The imaging would've cost a few thousand dollars. The hysterectomy would've cost about $20k-40k. Chemo was unsuccessful, and she died 9 months and about $2 million in medical bills later.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#95

Post by starkparker »

rayiner wrote: post #73
JohnFen wrote: post #36

Earlier quoted context omitted.

> you might have a catastrophic loss and have your finances wrecked. If you have health insurance (in the US) and you have a catastrophic event, your finances are going to be totally wrecked anyway. You're likely to have to declare bankruptcy unless you are pretty wealthy. At least, that's how it's gone with every friend and family member of mine that had to navigate such an event. That's on top of the painful nightm…

[flagged]

It's wild how differently the press release you linked to frames that.

> WASHINGTON, D.C. – Nearly half (49%) of cancer patients and survivors report being burdened by medical debt alongside some (13%) who report expecting to incur medical debt as part of their treatment plan, according to a new Survivor Views survey by the American Cancer Society Cancer Action Network (ACS CAN). Interestingly, nearly all (98%) were insured when medical debt occurred.

> Among those with cancer-related medical debt, nearly half (49%) have carried more than $5,000 in debt, a majority (69%) of whom have carried this debt for more than a year. Respondents also reported most commonly owing their medical debt to a hospital (76%).

...

> According to the survey, an individual with cancer-related medical debt was three times more likely to be behind on recommended cancer screenings in comparison to those who have been able to pay for their care without accumulating debt. Nearly half (49%) saw their credit score decrease with 30% having difficulty qualifying for loans.

> Cancer-related medical debt is also not felt equally and further deepens disparities. Black (13%) and Hispanic (14%) patients and survivors with medical debt were twice as likely as White respondents to report being denied care due to their debt. Black respondents were also more likely to report being contacted by collections agencies (66%) and to feel harassed by them (44%).

Re: My husbands suicide shows theres something very wrong with US insurance industry

#96

Post by foco_tubi »

rayiner wrote: post #59
mannanj wrote: post #28

Earlier quoted context omitted.

What is evidence then? Something of choosing that is impossible or just impractical to meet, or who's goalposts can keep changing indefinitely?

A bad result is not evidence that a system failed or did anything wrong. To show a problem with the system, you need to show, for example, that other systems do things differently in a way that would have avoided what happened here.

In what world is a "bad result" not recognized as a problem?

Re: My husbands suicide shows theres something very wrong with US insurance industry

#97

Post by foco_tubi »

rayiner wrote: post #23
goda90 wrote: post #16

Earlier quoted context omitted.

>Randy needed immediate psychiatric care, and as an emergency physician I knew the options. We put our trust in the mental health team at a local crisis receiving unit, and they kept Randy overnight in temporary safe housing where he could be observed. By morning they had devised a plan to transfer Randy to a retreat-like inpatient psychiatric facility that was in-network with our insurance. The psychiatrist felt Ran…

> This is definitely a case where the insurance company holds the majority of the blame. What facts are the basis of your conclusion? There is no health system in the developed world where a doctor's recommendation will guarantee expensive inpatient treatment without a layer of bureaucratic review.

I'd imagine you'd struggle to find a healthcare system in which a doctor's prescribed care is assuredly covered by insurance, by the insurance provider, and then later rescinded after care has already started.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#98

Post by tliltocatl »

jmpman wrote: post #80
anonymousiam wrote: post #57

This article makes a good case for the abolition of health insurance. If everybody had to pay for medical care, medical care would need to be affordable to survive. It's hard for me to believe that a doctor couldn't afford medical care for her husband. She just couldn't get outside of the box and consider that the treatment was more important than the cost.

An alternative approach would be health care for all - with the caveat that there is NO private pay option. The unfortunate situation is that that ultra wealthy have greater influence over the political process due to citizens united, and are also the ones who would benefit from lower funding towards public health care. With their ability to access premium treatment via a private option, their incentive is to use the…

> with the caveat that there is NO private pay option

I don't think there is a society in the world that ever had that successfully executed in practice. I live in Norway, and even if the public heath system is probably as good as it gets here, I often use private providers for non-urgent things simply because waiting time can be up to six month otherwise.

And even if you somehow manage this on paper, you'll be very surprised on how markets work. They don't need legal recognition. They don't even need money. See: USSR. Health care was public and medics weren't even a particularly attractive profession because there were too much of them already. Still if you wanted to survive an appointment you'd better have a package of some deficit wares ready.

What denies public healthcare money isn't "wealthy trying to cut public spending down". It's bureaucrats wanting their share of the pork barrel.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#99

Post by elevation »

petilon wrote: post #7

Yes, there is something wrong with the insurance industry. But there is something wrong with the hospitals, doctors and drug companies too. The whole system is broken. Hospitals try to eke out the most out of insurance companies, often providing services that are unnecessary. Pharmaceutical companies charge US patients significantly higher rates than in other countries. Don't put all the blame on insurance companies.

John Stossel explained in _Give Me A Break_ that the US once had a variety of pharmaceutical labs researching different cures and conducting trials. But US courts allowed a frenzy of frivolous lawsuits to extract astronomical payouts on behalf of former trial participants, even demanding payouts from the companies that stocked the supply and janitorial cabinets of research companies. One by one, we bankrupted our competitive machines of innovation until the few remaining pharmaceutical companies had grown large enough to defend themselves against injury claims. Big Pharma was created by lawyers.

> often providing services that are unnecessary

Thank a lawyer. "Patient with symptom X would have survived if only the doctor had tested him for Y". Now every patient with symptom X is issued a $5600 scan for Y -- not because of medical science, but because of liability. Every time a courts awards 10 figure settlement because "that insurance company is good for it," all of society pays for it.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#100

Post by ButlerianJihad »

tracker1 wrote: post #87
EvanAnderson wrote: post #22

Earlier quoted context omitted.

If you have enough money for that gamble to pay off over the long haul the cost of health insurance would be immaterial to you anyway. You might get away with it in your youth, or you might have a catastrophic loss and have your finances wrecked. You're often able to negotiate discounts for cash payment from providers, but back when I had insurance that excluded a pre-existing condition I ran into providers who stead…

The collection laws also vary from state to state on this... in some states, medical collections are all but toothless, short of actually filing a lawsuit, which isn't likely, except some facilities actually have staff lawyers willing to harass and sue.

Well, you can try for sure to default on medical debts without suffering a hit to your credit, but goood luck obtaining future care from any provider that you’ve stiffed.

How many big medical systems/districts in your region can you run up a balance until none will serve you, except through the E.D.?

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