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Cigna saves millions by having its doctors reject claims without reading them

propublica.org

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Re: Cigna saves millions by having its doctors reject claims without reading them

#141

Post by b59831 »

jfengel wrote: post #106
rr808 wrote: post #101

Earlier quoted context omitted.

> Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Dont exaggerate. I've lived in 3 European countries and Australia. My American healthcare is easily better than those. Sure I'm lucky to have a good job that pays for it, but you can't say its terrible without looking at how those public systems are really struggling right now.

The article suggests that your health care isn't as good as you think it is. You never know if you'll be one of those cases where they make you fight for every bit of care you get. Some Americans do get excellent care with a minimum of grief. Others think their insurance is fine while they're healthy and only discover later that it doesn't really cover what they imagine it does. And the difference is entirely arbitra…

> The article suggests...

Maybe because it's a politicized topic? How can you smugly dismiss their point like that?

Re: Cigna saves millions by having its doctors reject claims without reading them

#142

Post by TylerE »

ryanSrich wrote: post #107
rr808 wrote: post #101

Earlier quoted context omitted.

> Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Dont exaggerate. I've lived in 3 European countries and Australia. My American healthcare is easily better than those. Sure I'm lucky to have a good job that pays for it, but you can't say its terrible without looking at how those public systems are really struggling right now.

Yeah this is a very common sentiment. I feel like most people in the US haven’t actually talked to someone that has experience with socialized healthcare at scale. I had a German professor that was very clear about just how much better healthcare is in the US.

US is great if you’re either basically helpful or incredibly sick.

It’s not so great for those in the middle.

Re: Cigna saves millions by having its doctors reject claims without reading them

#143

Post by honkycat »

But hey: at least they owned the libs this month by passing a disgusting anti-trans bill.

That is what is important right? Not stopping the massive corruption from every mega-corporation in every sector that is making our earth uninhabitable and our lives miserable. Lets hyper focus on people's sexuality.

Re: Cigna saves millions by having its doctors reject claims without reading them

#144

Post by LocalH »

pantulis wrote: post #115
specialist wrote: post #80

Earlier quoted context omitted.

What are some real world examples of beneficial privatized healthcare?

IMHO in privatized healthcare you are not the patient, you are the customer. As such, you should be having a better "customer journey" than in public healthcare: more immediate test/diagnostics, better experience in the hospital (like a room for yourself). And that's it. As a counterpart, it's not clear you are receiving the best medical attention. And of course you (through your employer) are paying for something th…

"Being the customer" doesn't matter one bit to most modern megacorps, because people are fungible to them. We constantly hear about big money screwing over little money.

Small-time capitalism is quite good. Make a few millions, sure. I have no problem with that. But when the amounts concerned are in the billions? There needs to be massive oversight and regulation, regardless of the relevant field.

Re: Cigna saves millions by having its doctors reject claims without reading them

#145

Post by slaw »

winrid wrote: post #79
dafelst wrote: post #7

Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Any system that requires balancing human suffering against profitability is inevitably going to optimize for profitability. The fact that this is even a thing is mind boggling.

I have literally spent years trying to get an MRI for my knee after an accident. Both Kaiser and Anthem won't cover it.

MRI accessibility is regulated at the state level, which determines the number of MRI machines available to the public. I was able to obtain an MRI while on vacation in Europe without any appointment or referral from a physician. The process was straightforward; I explained my needs to the receptionist, and a technician conducted the MRI. The cost was 180 euros.

Re: Cigna saves millions by having its doctors reject claims without reading them

#146

Post by casenmgreen »

dafelst wrote: post #7

Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Any system that requires balancing human suffering against profitability is inevitably going to optimize for profitability. The fact that this is even a thing is mind boggling.

I may be completely wrong, but I understand in the US normally people have health care through their employer? so they are not themselves paying the insurer, and cannot change insurer.

If this is the case, then it is no wonder the insurer has no particular care for them. It is the power of the consumer to change provider which gives them influence over the provider.

Re: Cigna saves millions by having its doctors reject claims without reading them

#147

Post by Dobbs »

ryanSrich wrote: post #107
rr808 wrote: post #101

Earlier quoted context omitted.

> Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Dont exaggerate. I've lived in 3 European countries and Australia. My American healthcare is easily better than those. Sure I'm lucky to have a good job that pays for it, but you can't say its terrible without looking at how those public systems are really struggling right now.

Yeah this is a very common sentiment. I feel like most people in the US haven’t actually talked to someone that has experience with socialized healthcare at scale. I had a German professor that was very clear about just how much better healthcare is in the US.

As someone who has lived in the US, UK, and NL. I'll happily take the UK (pre-running it at such a budget that it fell apart) or NL systems over the US anyday.

There is no fun surprises like finding out that while your surgeon and hopsital were in-network your anaesthetist was out of network.

Re: Cigna saves millions by having its doctors reject claims without reading them

#148

Post by ugh123 »

rr808 wrote: post #101
dafelst wrote: post #7

Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Any system that requires balancing human suffering against profitability is inevitably going to optimize for profitability. The fact that this is even a thing is mind boggling.

> Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Dont exaggerate. I've lived in 3 European countries and Australia. My American healthcare is easily better than those. Sure I'm lucky to have a good job that pays for it, but you can't say its terrible without looking at how those public systems are really struggling right now.

> a good job that pays for it

If that's whats necessary to get decent health care in this country, then something isn't right.

Re: Cigna saves millions by having its doctors reject claims without reading them

#149

Post by ratg13 »

ryanSrich wrote: post #107
rr808 wrote: post #101

Earlier quoted context omitted.

> Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Dont exaggerate. I've lived in 3 European countries and Australia. My American healthcare is easily better than those. Sure I'm lucky to have a good job that pays for it, but you can't say its terrible without looking at how those public systems are really struggling right now.

Yeah this is a very common sentiment. I feel like most people in the US haven’t actually talked to someone that has experience with socialized healthcare at scale. I had a German professor that was very clear about just how much better healthcare is in the US.

Healthcare in the US can be higher quality, but you never know what you’re going to pay for it.

When I was starting my career, I had to go to an ER that was out of network, I checked with my insurance and they said they would cover it. They decided after all not to honor their word and charged me 10’s of thousands of dollars.

Being young and independent, this was devastating, despite having a good job, good insurance, etc.

I largely credit this with my push to move to Europe, and have never looked back.

Sometimes knowing you can get any healthcare you need without it potentially a bankrupting you is it’s own reward.

Re: Cigna saves millions by having its doctors reject claims without reading them

#150

Post by lotsofpulp »

ugh123 wrote: post #148
rr808 wrote: post #101

Earlier quoted context omitted.

> Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Dont exaggerate. I've lived in 3 European countries and Australia. My American healthcare is easily better than those. Sure I'm lucky to have a good job that pays for it, but you can't say its terrible without looking at how those public systems are really struggling right now.

> a good job that pays for it If that's whats necessary to get decent health care in this country, then something isn't right.

Technically, you just need money to pay for it. However, buying the employer’s choice lets you pay for premiums with pre tax funds, and the employer usually subsidizes 70% of the premiums.

So for an individual, it is roughly a $10k per year benefit to get it via employer and for a family of 4, $40k per year benefit.

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