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UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

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Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#201

Post by mrangle »

laimewhisps wrote: post #196
mrangle wrote: post #189

Earlier quoted context omitted.

> just what happens It's not "just what happens". That's a politically opportunistic narrative that seeks to incite violence and murder. No one knows why the CEO was killed. None of this type of reasoning justifies or begins to explain the murder even if this were the reason in the shooter's head. Morals aside, it's nonsensical reasoning in total. You're justifying and providing propaganda support for domestic terror…

They printed "defend", "deny", "depose" on the bullets so it's reasonable to assume that was the motive.

[flagged]

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#202

Post by laimewhisps »

peitho_pls wrote: post #148
lenerdenator wrote: post #70

The events of the last week are just what happens when a company decides to refuse to meet its customers in the marketplace of sane ideas. You could probably have gotten away with what UNH did if the money wasn't so ridiculous. Thompson himself had a compensation package worth $10.2 million[0] a year. It's reasonable to think that other c-suiters at the company, along with those of its parent organization, made simil…

> People will say that this is necessary to remain competitive, but it just isn't Out of curiosity, What makes you think executive compensation can be easily cut? Wouldn't the shareholders happily do that if they could?

If it becomes a risk to the CEO to have high compensation, then yes the shareholders will want a cut.

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#203

Post by lijok »

SpicyLemonZest wrote: post #175
lijok wrote: post #131

What a poorly designed system. If the insurer truly prioritizes client care as they claim, why on earth would the doctors contracted to review the treatments of the insured, have access to the insurance policies? Shouldn't the output of their review simply be whether or not the treatment seems appropriate, period? Why are the doctors weighing their review against the insurers policies? Honestly, this just seems like…

> What a poorly designed system. If the insurer truly prioritizes client care as they claim, why on earth would the doctors contracted to review the treatments of the insured, have access to the insurance policies? Shouldn't the output of their review simply be whether or not the treatment seems appropriate, period? Why are the doctors weighing their review against the insurers policies? All healthcare systems ultima…

So are you saying the doctors contracted to review the treatments need access to the clients insurance policies in order to make a decision on whether the treatment is appropriate? For what purpose? My, arguably naive, understanding is that the reviewer should only need to provide two things for the adjuster to take it from there; whether the treatment is appropriate, and alternative potentially cheaper treatment options. If there are alternative potentially cheaper treatment options available, those should be discussed with the care provider and ruled out.

I just don't understand why the reviewing doctors report is required to take into account the policies of the contracting insurance firm?

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#204

Post by mgraczyk »

maxerickson wrote: post #170
mgraczyk wrote: post #161

This guy's condition is tragic, but it's crazy to me that people can read this and come away thinking the insurance companies are the bad guys. Many drugs don't work, they are expensive. If there are no voices in the room saying "we will not pay for expensive drugs that do not work", then healthcare costs will continue spiraling out of control. Single payer healthcare will "solve" this by ensuring that the medication…

It seems the insurance company was happy to pay for treatment that wouldn't work though (the approved treatment had already been tried), they denied a treatment that was working.

One costs $60/year, the other is over $2M/year and not tested and not widely used outside the US

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#205

Post by slt2021 »

breadwinner wrote: post #138

Insurance companies are hardly the only ones at fault here. Hospitals and Pharma companies are guilty of price gouging [1]. When insurance pays hospitals hike up the prices. When the patient pays (such as for cosmetic or plastic surgery) the prices charged by hospitals and doctors are more reasonable. [1] https://www.dolthub.com/blog/2022-05-31-hospital-price-gougi...

not true, Insurance Pharmacies Doctors and Hospitals all work together.

The high list prices you see are only exist there to scare uninsured/underinsured Americans and to force them to buy/pay more expensive insurance.

As soon as you get treated, these list prices magically get reduced on the backend by factor of 2-3x.

Doctors themselves cannot price gouge patients, but they can price gouge via middleman (insurance). The same procedure that costs $50 will be billed to insurance as $500 procedure.

same with pharma drugs, there is a very complex system in place to keep the face of expensive prices, while keeping a system of rebates/discounts/pre-negotiated contracts between each big player.

Americans are simply getting taken for a ride and their money being stolen by Pharma+Hospitals and Insurance is simply acting as a financial middleman.

Also insurance literally FORCES americans to work, because thats the only way to get affordable health insurance. Aint noone is paying COBRA (list prices). If you do you are stupid and throwing money away.

American population is being squeezed and extracted of their labor due to system that forces you to work to stay alive and healthy.

for comparison, just go to Thailand or Vietnam to any of the private hospitals: you can get the same western standard treatment but for pennies (the actual cost of care). This is the healthcare that Americans COULD have, but unfortunately the American system would lose too much money so Americans are not allowed to have affordable health care.

A lot of things in America is simply regulatory capture and requires Americans to keep ignorant of what they could have, what other countries enjoy, but Americans are not allowed to

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#206

Post by IncreasePosts »

standardUser wrote: post #180
cruffle_duffle wrote: post #163

Earlier quoted context omitted.

Let’s not forget if you go against the grain and post “people are celebrating murder, which is gross” you are probably going to get downvoted—even on this site! This whole celebration of murder thing is so bizarre. The fact it seems to be the default “way to get upvotes” and speaking out is “downvote city” is… well… disconcerting to say the least.

It speaks to the deep and broad frustration among Americans towards our healthcare system. This isn't just executives or politicians "screwing people over" like we see in so many other realms. There's a significant number of Americans who love someone who has actually died or suffered severer/permanent physical distress for the sake of insurance company profits. When someone's family gets blown up from the sky and th…

We actually have no sure idea what the motives of the individual were.

There's the obvious angle.

Then, maybe Thompson paid someone to kill him, so his family could get an insurance payout.

Maybe Thompson was fucking the shooter's ex girlfriend, and he wanted to mislead investigators as to why Thompson was killed.

Maybe it's a Russian operation to sow discord in the US.

Etc

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#207

Post by breadwinner »

davideous wrote: post #184
breadwinner wrote: post #138

Insurance companies are hardly the only ones at fault here. Hospitals and Pharma companies are guilty of price gouging [1]. When insurance pays hospitals hike up the prices. When the patient pays (such as for cosmetic or plastic surgery) the prices charged by hospitals and doctors are more reasonable. [1] https://www.dolthub.com/blog/2022-05-31-hospital-price-gougi...

Setting prices by supply-and-demand and having insurance "pay for whatever is needed regardless of the cost" are incompatible. Insurance blocks the pricing cost signal back to the patient. Insurance also prevents better doctors that provide better service from charging more because the patients will pay for it. An example: about 20 years ago I had just a major medical plan and I was at urgent care for a problem. Afte…

Patients must be incentivized to understand their care and question care that is unnecessary and wasteful. The partial solution you mention is the way to go, and if every employer adopted it, it will change the culture, and will at that point become a full solution.

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#208

Post by ineptech »

mgraczyk wrote: post #161

This guy's condition is tragic, but it's crazy to me that people can read this and come away thinking the insurance companies are the bad guys. Many drugs don't work, they are expensive. If there are no voices in the room saying "we will not pay for expensive drugs that do not work", then healthcare costs will continue spiraling out of control. Single payer healthcare will "solve" this by ensuring that the medication…

The point of single payer is to tell doctors and patients unambiguously how much they can spend. The free market puts the insurer(s), the provider(s), and the patient in a competition to see who can stick whom with the bill. The savings come more from not doing that than from the insurer's profit margin.

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#209

Post by loeg »

gopher_space wrote: post #157
threemux wrote: post #37

Earlier quoted context omitted.

Don't be so sure. It's interesting how quickly the places where this ghoulish view is proliferating (Reddit) have forgotten what they learned a month ago. The Internet is not reality and online posts are not a representative sample of the population. Instead, every survey of Americans shows around 80% are satisfied with their health coverage.

> Instead, every survey of Americans shows around 80% are satisfied with their health coverage. Weird how heath coverage is the only thing in America 80% of the people are satisfied with. It's such a nice round number, too. I'm assuming it's men only, or were women polled before Roe v. Wade was dumped?

GP is rounding. It's an approximate centroid of a variety of numbers over time, but pretty consistently in the 70s or 80s.

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#210

Post by lijok »

peitho_pls wrote: post #158
lijok wrote: post #131

What a poorly designed system. If the insurer truly prioritizes client care as they claim, why on earth would the doctors contracted to review the treatments of the insured, have access to the insurance policies? Shouldn't the output of their review simply be whether or not the treatment seems appropriate, period? Why are the doctors weighing their review against the insurers policies? Honestly, this just seems like…

The insurer is a business, its ultimate priority is the make money. Same as the hospital, the drug producer, etc. I am sure they all want to prioritize client care but that have to ration it by cost at some level.

Insurance firms have the unique benefit of being able to offload their costs to their customer base in the form of premiums. That and excess would be the appropriate level to ration in the cost. Is that not verbatim how insurance works?
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