121–130 of 179 posts
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The way they used to before medical insurance took over that industry: charity
So everyone had their healthcare needs addressed in the 1800s? Which charities have the funding to cover a $1M NICU stay?
> I am an emergency physician living in the U.S., and we had one of the top commercial health insurance plans. You see, dear, your critical error was in believing that psychiatry is “medicine”, and that mental health treatment is “health care”. Oh for sure, they present you “doctors” and “nurses” with the same credentials, wearing white lab coats, ties, scrubs, and even stethoscopes. They can prescribe “drugs” and ru…
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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, r…
And your examples justify obviously incompetent insurance people vetoing doctor's orders, exactly how?
Doctors are generally forbidden to treat patients without directly examining them and knowing their cases. How is it that insurance companies are allowed to make life-and-death decisions over medical care —with less competent bureaucrats (who may or may not have a medical license)— without ever even seeing the patient? How is this good for the patient?
Of the 33 developed countries, 32 have figured out how to deliver medical care to all of their citizens, and do so for roughly half or less of the cost in the US. Moreover, those countries are seeing continued longer lifespans, while lifespans in the US are declining, again while spending twice the money. Clearly, for-profit medicine and insurance performs worse on every metric.
I’ve been through this situation with family members. I understand the frustration and agony. I also understand the hesitancy to pay for two months at a “retreat-like inpatient psychiatric facility.” In publicly funded system, it’s likely facilities like this would not exist or would be strictly private pay. I’m not aware of any country that makes such a thing available on short notice like this. I also understand th…
What gets me is that they probably could afford it out of pocket but didn’t want to deplete savings. For a clear case like this, an insurance denial shouldn’t even be shared with the suicidal patient, their spouse should shield them from that and just pay from their checking account. The life of your spouse is worth more than a few more dollars in retirement.
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.
But... I've come to realize that it is impossible to make people understand it or change it.
So, I've been proposing a lesser change: In theory Insurance companies business model is to hedge against the risk of people getting sick ok? Well, let's make the bet fair and remove them the ability to decide who gets covered and who doesn't. In the case of the original article: Let a neutral third party panel of professionals be the ones that decide whether the Health Insurer has to cover or not the case.
Otherwise, Insurers are behaving like Casinos that decide to pay or not to pay to people who win a game.
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…
Fwiw, if one has a passport and some funds, one can travel abroad for cheaper surgery abroad. It won't guarantee an outcome, but it ought to be better than delaying it. Of course this in no way excuses the insurance firm.
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So everyone had their healthcare needs addressed in the 1800s? Which charities have the funding to cover a $1M NICU stay?
The more interesting hypothetical is: would a NICU stay still cost $1M if the factors inflating that cost (namely, insurance subsidizing hospital revenue) were no longer in place?
My kiddos were born the day before the third trimester and spent two months in the hospital. Staff it at minimum wage, cap the costs at just the stuff used, and you're still talking a lot of money.
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LLMs are notoriously good at getting even basic facts wrong. Especially when the information ecosystem around the issue is... adversarial.
Source? In my experience, LLMs are especially valuable in that setting. Human generated content tries to put a spin on facts. But with LLMs, you can pull the facts out of such content while making your assumptions explicit. For example, I could point you to this article talking about 12 month+ waiting lists for UK mental health treatment: https://www.rethink.org/news-and-stories/news-and-views/2025... . What is the o…
I go and ask Gemini about the American equivalent, and get this:
> Roughly 40% of the U.S. population resides in federally designated Mental Health Professional Shortage Areas (HPSAs). The shortfall is severe: the national average wait time for care is 48 days, with over half of all U.S. adults with mental illness going completely untreated.
Is an 18 month wait worse than an infinite wait?
What's the average wait in the UK? Gemini says:
> Average Initial Wait: National data shows the average wait for a first appointment is around 3 to 4 weeks (approx. 22 days).
See, if you get satisfied with "UK mental health care sucks" answers, you don't ask the fairly obvious follow-ups and wind up confirming your incorrect priors.
(And to be clear, I don't trust Gemini on this, really. But if you do… why not ask it these questions too?)