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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)

#221

Post by cute_boi »

cogman10 wrote: post #126
Dalewyn wrote: post #11

Earlier quoted context omitted.

>But also horrifying that treatment costs so much. My mother underwent chemotherapy for her cancer. According to the statements from her insurance company, each round of chemotherapy cost as much as a new luxury car before hospital vs. insurance negotiations. Yeah. The value of health insurance isn't just the offloading of expenses, it's also their power to tell hospitals to get fucking bent with ludicrous bills.

The health industry is what's wrong with a captured market and few players. Every party is trying to extract maximum value for minimum input. That leads hospitals to 1000x every treatment price so when insurance companies come to negotiate they can negotiate down to 100x. It causes hospitals to understaff because is cheaper to pay for legal staff to handle malpractice claims than it is to not work your nurses and doc…

Well, there are many solutions but none of them works because politicians are in bed with insurace/hospitals/pharmacy.

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

#222

Post by Tryk »

JumpCrisscross wrote: post #185
laimewhisps wrote: post #132

Earlier quoted context omitted.

He was killing people though, and if his death stops that, it's a net positive. His life is not worth more than the thousands he has ended for personal profit.

> if his death stops that, it's a net positive One, it doesn’t. Two, this applies in loads of cases depending on your individual morality. (Intentionally-spicy takes: abortion providers. Medical researchers who experiment on animals. Farmers. Meat eaters. Anyone American because of our foreign military interventions.)

How can you be so sure it hasn't saved someone? You can make the case that doctors make less mistakes when they don't rush through surgery.

https://apnews.com/article/anthem-blue-cross-anesthesia-insu...

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

#223

Post by mgraczyk »

maronato wrote: post #219
mgraczyk wrote: post #204

Earlier quoted context omitted.

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

If the doctor prescribed it, it shouldn’t be the insurance company’s decision to deny it. That’s how it works in most countries. Too bad it’s expensive, but that’s why people pay a lot more than $60/yr for insurance.

No, that's not how it works. Which countries work that way? Where can a doctor prescribe untested drugs and have it paid for?

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

#224

Post by maronato »

willis936 wrote: post #194
AtlasBarfed wrote: post #141

Earlier quoted context omitted.

If he is found and sent to jail it would be fascinating to see how he is viewed on the inside. If there's one thing that crosses almost all class and racial divides, it is our shitty medical care system. My (now passed) uncle was in jail to challenge drug incarceration laws back in the 60s, since the opposition needed a case that wouldnt settle to reach the supreme court. No one would touch him in jail.

I think "stunned if he makes it to court" means "most likely outcome is that he is quietly assassinated by suits".

That’d make him a martyr and a symbol. I can’t see that going well for the suits.

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

#225

Post by willis936 »

samatman wrote: post #220
willis936 wrote: post #191

Earlier quoted context omitted.

You need consensus for conviction, not the other way around.

You need consensus either to convict, or to _declare_ someone not guilty. In the US there is an important distinction between the presumption of innocence, and its declaration in a court of law. Someone with a hung jury or mistrial is still presumed not guilty by the law, but may be tried again for the same crime, because the prohibition against double jeopardy only applies to those cleared of a charge, which mistria…

>no realistic chance of happening twice

This is where you lose me. If you have a hung jury that means you have at least an 11/12 chance of it happening again.

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

#226

Post by kelseyfrog »

IncreasePosts wrote: post #197
kelseyfrog wrote: post #137

Earlier quoted context omitted.

I've had conversations with real people in real life who also overwhelmingly share the sentiment. It's not an internet bubble.

Those people are probably reading the same websites as you. I swear, users of a site have no kind of memory. Literally a month ago everyone on reddits jaw was agape as trump was declared the winner. After months of redditors telling each other Kamala would win in a landslide and Trump was floundering, and no one was coming to his rallies, etc. And now they're doing the same thing, telling each other that everyone in…

Nah, this is just moving the goalposts from "it's an Internet bubble" to "it's your personal bubble". I don't buy it.

Neo-*ism ideologies share a common myth - the myth of necessary order. This forms a contradiction that if enforced by more order will self-correct with stocastic violence. Sorry, but that's simply reality.

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

#227

Post by Latty »

samatman wrote: post #96
77pt77 wrote: post #32

Earlier quoted context omitted.

And all it takes is one juror being inflexible.

That's all it takes for a hung jury, yes. In which case the prosecution will have plenty of grounds to screen for that in the next trial, that next trial will happen, and then the guy gets convicted of first degree murder. Presuming he's found in the first place. There's no world in which all twelve jurors vote not guilty if the defendant is demonstrated to be the assassin beyond reasonable doubt. That simply won't h…

In the UK a few years back a statue of a slave trader was thrown into the river in Bristol, and the people charged were acquitted in what is commonly considered to be a case of jury nullificaiton.

Now, it's definitely true that getting a jury to nullify a murder charge is significantly different, but I'd argue there is a lot more anger about the healthcare system and CEOs making huge profits from human suffering in the US than there was about that statue, and much more generally too.

You also have a climate where a convicted felon just got made president, and another in a long line of presidents pardoning people they have close personal relationships too with clear conflict of interest. If you wanted to pick a moment where people in the US were losing faith in the justice system, now seems like a good choice, and if you believe the system is rigged, are you going to judge it on technicalities, or how you feel?

Do I think it is likely? No.

"No world it could happen", "delusional", and "won't happen"? I wouldn't be so sure.

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

#228

Post by IncreasePosts »

kelseyfrog wrote: post #226
IncreasePosts wrote: post #197

Earlier quoted context omitted.

Those people are probably reading the same websites as you. I swear, users of a site have no kind of memory. Literally a month ago everyone on reddits jaw was agape as trump was declared the winner. After months of redditors telling each other Kamala would win in a landslide and Trump was floundering, and no one was coming to his rallies, etc. And now they're doing the same thing, telling each other that everyone in…

Nah, this is just moving the goalposts from "it's an Internet bubble" to "it's your personal bubble". I don't buy it. Neo-*ism ideologies share a common myth - the myth of necessary order. This forms a contradiction that if enforced by more order will self-correct with stocastic violence. Sorry, but that's simply reality.

"internet bubbles" don't exist solely on the Internet, they exist in the minds of people spending a lot of time on the internet on certain sites. They manifest on the Internet commonly. But they also manifest in the "real world" when those people communicate with others.

Go ahead and deceive yourself that you're not in an echo chamber.

I'm sure that will help you understand reality better.

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

#229

Post by SpicyLemonZest »

lijok wrote: post #203
SpicyLemonZest wrote: post #175

Earlier quoted context omitted.

> 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 opt…

The policies consist largely of guidelines regarding what the most cost-effective treatment option for a condition is likely to be. Good insurance companies do try and discuss with providers rather than firing off denial letters willy-nilly, but of course that still ends up being a conflict where your insurance might not let you have the treatment your doctor thinks is best.

This conflict is why I've always subscribed to Kaiser when I have the option. It's much less headache for me if there's no distinction between what a doctor wants to prescribe me and what they're allowed to prescribe. (Would I feel differently if I needed some crazy custom treatment protocol? Perhaps.)

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

#230

Post by _yb2s »

croissants wrote: post #77
_yb2s wrote: post #57

Earlier quoted context omitted.

It’s both working together- the basic research, including identifying targets and new chemistry and in some cases even the drugs themselves are mostly academia. However, clinical trials, and drug development that iterates the chemical structure itself and delivery approaches is very expensive, and almost entirely done by industry. Often the academics are working collaboratively with pharmaceutical- and can have eithe…

Thanks. Do you have some sense of the breakdown in actual expenses incurred by the basic research and subsequent industrial development? It may qualitatively be true that many governments sponsor basic research that is later productized, but if the second bit costs 1000x more than the first bit, it's not exactly a fairly shared cost.

I don’t know the numbers off the top of my head, but most likely substantially more of the money is from industry. However, just answering that requires really carefully defining the question- because much academic research that happens to lead to new drugs or drug targets is basic medical and biology research- do you also include all biological research that does not turn out this way? On the industry side do you include all biotech startups hoping to sell to big pharmaceutical companies including the majority that do not?

Clinical trials are incredibly expensive but also comparatively straightforward and require a very different set of facilities and skills from basic research. Pharma mostly could not recruit away the people with these skills from academia- they can’t offer the same freedom and job security, but the academics often found startups they work for on the side and ultimately sell to pharma if it works out. So comparing money spent isn’t the entire picture of relative contribution- as they are each doing parts the other is not equipped for.

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