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My husbands suicide shows theres something very wrong with US insurance industry

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Re: My husbands suicide shows theres something very wrong with US insurance industry

#61

Post by LoganDark »

ceejayoz wrote: post #42
LoganDark wrote: post #35

Earlier quoted context omitted.

I mean, I don't agree with the assumption that he was simply irrational and chose this because he wasn't thinking straight. I would much rather believe that he had strong reasons for this and that there is something to be done about the circumstances that led to it. Suicide is more often than not a systemic failure and not simply an outlier to be ignored. If you read the article and see all the shit that he went thro…

> I mean, I don't agree with the assumption that he was simply irrational and chose this because he wasn't thinking straight. And I don't agree with the assertions that that's not a possibility .

I don't consider it a possibility that state of mind would not have been a result of his mistreatment. You seem to recognize it can be brought about by situations, and I consider that reasoning enough. You don't have to perfectly calculate suicide as the only practical answer in order for your actions to be reasoned. Even primal reasoning can count.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#62

Post by arjie »

In my experience, one can always continue care if one is willing to pay. Insurance companies do not deny care; they deny claims for care. In fact, numerous times they make mistakes and deny valid claims. Only the healthcare provider can choose to not provide care: either because they believe they will not get paid or they believe you don’t need it or some other such reason.

Considering this person has a high-paying job and it seems like a short-term intervention would have created a long-term positive outcome, it’s not clear to me why they didn’t simply insist on the care without insurance coverage.

My contingency plans for these situations are to pay out of pocket and figure out reimbursement later. In practice, paying out of pocket is just a promise to pay out of pocket. Often one isn’t charged until afterwards and I experienced sufficient mechanisms to delay payment until the whole thing had been sorted out.

Permanent conditions (like, say, brain death) are a different story. But in my case, the bill I was ostensibly facing was hundreds of thousands of dollars and I proceeded with it on the grounds that rapid intervention would yield results and I can figure out the payment structure later. If I were facing the worst case scenarios of a family medical bill bankruptcy or family member loss I think that usually I’d prefer the former. It’s hard to make a decision in the moment, but if the healthcare provider determines that more care is required and the insurance provider that it is not, I am more likely to follow the former though not without bound.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#63

Post by Apocryphon »

rayiner wrote: post #41
jgon wrote: post #29

Earlier quoted context omitted.

You've come into this thread, which is about an article where a doctor talks about insurance denying care for her husband, ultimately resulting in his death, to basically say "This doesn't prove anything, and also in systems with government provided healthcare the same thing happens, the AI said so, so what can you do!?" I just can't even imagine what your response would be to writing about your own experience in the…

The article doesn't just tell a story about one person, it makes a general point about the healthcare industry. The title is: "My husband’s suicide shows there’s something very wrong with the U.S. insurance industry ." How else are you supposed to evaluate the author's conclusion, other than to compare it to how other healthcare industries handle similar situations?

Why don't you ask it if there are similar personal stories to this happening in other countries?

Re: My husbands suicide shows theres something very wrong with US insurance industry

#64

Post by zehaeva »

ceejayoz wrote: post #32
JohnTHaller wrote: post #30

The goal of their insurance company is to make a large return for their shareholders. And, thus, a large bonus for the C-suite execs. Their goal is not to provide care. In this particular instance, the insurance company saved money to give to shareholders and their C-suite by not treating the patient further. They lose no money by allowing him to die. This is all by design.

This happens with (theoretically) non-profit insurers, too. Like the BCBS networks.

I nominally agree with this sentiment. BCBS does have issues like this happen, but not at the same level others, in my experience.

Anecdotally though, I've found that my current insurer (United) denies and delays care far, far, more often than when I had a similar plan with BCBS. And I'm not talking about small bills, my son was in the NICU for 41 days, at a cost of ~$150,000. Through BCBS I paid like a grand of that. United denies the most random things, a referral to a specialist, meds for on brand usage while they'll pay for other meds that are off brand, for instance.

I do have a platinum level plan, I am _extremely_ lucky to have this. I know the vast majority of Americans, most of my friends and family, fight with their insurance companies for far less than my complaints.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#65

Post by ceejayoz »

anonymousiam wrote: post #57

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.

> This article makes a good case for the abolition of health insurance.

Yes.

> If everybody had to pay for medical care, medical care would need to be affordable to survive.

How would people with zero income afford it?

Re: My husbands suicide shows theres something very wrong with US insurance industry

#66

Post by ryandrake »

rayiner wrote: post #23
goda90 wrote: post #16

Earlier quoted context omitted.

>Randy needed immediate psychiatric care, and as an emergency physician I knew the options. We put our trust in the mental health team at a local crisis receiving unit, and they kept Randy overnight in temporary safe housing where he could be observed. By morning they had devised a plan to transfer Randy to a retreat-like inpatient psychiatric facility that was in-network with our insurance. The psychiatrist felt Ran…

> This is definitely a case where the insurance company holds the majority of the blame. What facts are the basis of your conclusion? There is no health system in the developed world where a doctor's recommendation will guarantee expensive inpatient treatment without a layer of bureaucratic review.

You are right--Doctors absolutely share blame. Take my dentist's behavior, for example. When the oral hygienist is done doing all the real work, my dentist sits down for 10 minutes to count my teeth and say the words "You should floss more." She bills $85 for that sentence and calls it "Oral hygiene instructions". My insurance company (IMO rightly) denies paying for this. It's ridiculous and the dentist knows they're going to call bullshit on it, but they bill it anyway, and then I'm technically on the hook to pay for it. So far, the dentist has not yet attempted to balance bill that charge, and I will drop them like a bad habit if they ever do.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#67

Post by foco_tubi »

anonymousiam wrote: post #57

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.

> It's hard for me to believe that a doctor couldn't afford medical care for her husband

Why's that? Between mortgage, repaying education debt, supporting children, recovering from a husband's failed business venture...what is hard to believe about having trouble paying for another expense, especially after you've been reassured that the expense would be at least partially recompensated and that turns out to not be the case?

Re: My husbands suicide shows theres something very wrong with US insurance industry

#68

Post by pstuart »

LoganDark wrote: post #20
ceejayoz wrote: post #8

Earlier quoted context omitted.

No, selfish would be more like knowing it, being of reasonably sound mind, and doing it anyways. Being convinced of something by wonky brain chemistry isn't necessarily a personal failing.

I feel like ascribing it to "wonky brain chemistry" serves to erase agency. I read the article and there are very real and reoccurring reasons of incredible mistreatment for why this happened. It is not because he was simply unstable and decided to try suicide for no reason. He had such a reason that I am incredibly disappointed in the entire system that led to this.

Sometimes brain chemistry obliterates agency.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#69

Post by foco_tubi »

arjie wrote: post #62

In my experience, one can always continue care if one is willing to pay. Insurance companies do not deny care; they deny claims for care. In fact, numerous times they make mistakes and deny valid claims. Only the healthcare provider can choose to not provide care: either because they believe they will not get paid or they believe you don’t need it or some other such reason. Considering this person has a high-paying j…

> One isn’t charged until afterwards

This is not a universal billing practice, often clinic visits are billed upfront before meeting with the provider.

Re: My husbands suicide shows theres something very wrong with US insurance industry

#70

Post by rayiner »

pyuser583 wrote: post #48

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…

It sounds like this guy needed around-the-clock, in-patient care. That's inherently expensive. While those facilities exist in countries with publicly funded healthcare, there's a huge shortage of in-patient beds, so there is some mechanism to funnel patients to outpatient care.
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