The Egg Bandits Made a Thousand Times the Fine They Just Paid for Price Fixing

> If a criminal misuses his own resources to commit crimes and then you take that away from them, it only affects him.

There is certainly a case to be made here for “if it seems too good to be true…”, but realistically we are not going to impoverish the retired teachers of X state because X state chose poorly.

>Denying their customers claims for healthcare coverage they are entitled to under the plans they pay for is the opposite of their job.

Can you provide some examples? The examples I heard of are never straightforward like "person has a broken hip, insurance refuses to pay for a hip replacement". There's always some complication like "the doctor thinks they need some special procedure/drug that costs extra". If it's in the area where there's a plausible judgement call to be made, I don't see how it's any different than a public healthcare system denying care due to cost reasons, even if theoretically taxpayers are "entitled" to some vague standard of care, and without the care the patient might actually die.

>United Healthcare alone was wrongfully denying claims over 90% of the time.

AFAIK that claim was claimed by plaintiffs with no supporting evidence, and denied by the defendants.

The key factor that nearly everyone misses or perhaps, deliberately ignores, is that chicken eggs are worth their weight in gold to pharmaceutical manufacturers.

There's a significant number of pathogens, er I mean, vaccines, that are tested and/or cultured only inside of eggs, and for the seasonal flu vaccines, those pathogen factories are unfathomably gigantic in scale.

So essentially, any drain on the supply of chicken eggs for the consumer market may be attributed to the overwhelming and ever-increasing demand from the pharmaceutical industry to use up these eggs so that they can grow viruses, bacteria, and other nasties to, er, checks notes inoculate the population and keep the world safe for democracy. That's the ticket.

> The examples I heard of are never straightforward like "person has a broken hip, insurance refuses to pay for a hip replacement". There's always some complication like "the doctor thinks they need some special procedure/drug that costs extra".

There are a couple examples in the legal complaint (https://cdn.arstechnica.net/wp-content/uploads/2023/11/class...) where the insurance company denied extremely typical things like physical therapy and skilled nursing facilities (the most common form of post-acute care). Nothing special there.

Here's another one for you:

Deirdre O'Reilly's college-age son, suffering a life-threatening anaphylactic allergic reaction, was saved by epinephrine shots and steroids administered intravenously in a hospital emergency room. His mother, utterly relieved by that news, was less pleased to be informed by the family's insurer that the treatment was "not medically necessary." (https://kffhealthnews.org/health-industry/denials-of-health-...)

Now, I don't have all the details of this case, but neither epinephrine shots or steroids are a special procedure/drug. That would be considered the standard treatment for life-threatening allergic reactions depending on the circumstances and how long ago this occurred.

I can't think of any reason why they'd ever deny epinephrine, and although steroids have fallen out of favor in recent years as standard treatment in every case, they are still called for in common situations like when epinephrine alone isn't doing the job, or when the reaction has triggered an asthma attack.

The article that came from links to https://www.npr.org/series/651784144/bill-of-the-month which is filled with all kinds of examples including one where the insurer eventually relented after phone calls, appeals were filed, a complaint was made to state agency, and letters were sent to elected officials ( https://www.npr.org/sections/health-shots/2024/01/25/1226552...)

Social media is full of outrageous examples (https://www.buzzfeed.com/morgansloss1/stories-of-healthcare-...) but you're probably going to get the best examples from news segments like that Bill Of The Month series.

Evaluating these can be challenging. Even though many people are sharing their stories of how they've been screwed over online (and publicly exposing their private medical matters in the process), there's often a lack of hard details. Both government regulations intended to protect patients and insurance industry policy intended to protect the corporations can make independent verification of these complaints difficult.

The best source for examples will be lawsuits against insurance companies which can surface instances collected through the discovery process and used as evidence at trial, but that can take many years and may never come to light if those lawsuits get settled first with the victims and their surviving loved ones paid off and silenced.