There is a curious irony regarding retirement funds that invest in health insurance companies: if one is healthy and pays into the system, the insurers will reap ample profits, and one's retirement plan will reap the benefits. Get sick, and one may never make it to retirement....
Cigna saves millions by having its doctors reject claims without reading them
81–90 of 434 posts
Re: Cigna saves millions by having its doctors reject claims without reading them
#82Earlier quoted context omitted.
This might be true, but as someone who has lived in the U.S. and Europe I can say utterly unequivocally that I preferred Health Care in Europe. I wasn't even in one of the European countries with a great reputation for Health Care. Health Care in the U.S. isn't just bad, its outright fucking brutal. An elderly friend of mine recently fell and went to an urgent care where they couldn't get him into the x-ray machine.…
I’m fully insured and have always been well taken care of in the United States health care system. Never wait more than 30 minutes if I were in an emergency room, and usually I’m attended to within 10-15. Doctors appointments are easy to get, never paid much for prescriptions. If I was in a public system, I’d fear I’d be fighting for attention alongside the general public, so I’m not convinced it would be better.
I find it hard to believe you have never waited more than 30 minutes in an emergency room. I can't ever remember waiting less and I've always had pretty good insurance.
Re: Cigna saves millions by having its doctors reject claims without reading them
#83Privatized 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.
All claims being reviewed by big health insurance conglomerates is the antithesis of privatized healthcare. It incorporates the worst part of public healthcare and destroys the best potential benefit of privatized healthcare.
The best potential benefit of privatised healthcare comes to those wealthy enough to just pay cash for what they need.
Re: Cigna saves millions by having its doctors reject claims without reading them
#84Privatized 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.
All claims being reviewed by big health insurance conglomerates is the antithesis of privatized healthcare. It incorporates the worst part of public healthcare and destroys the best potential benefit of privatized healthcare.
This is not properly referred to as health insurance. It is a sickness, aging, and death payment plan. There's no such thing as major medical anymore.
It was private healthcare that backed public law forcing minimum coverage. Why? Because their pool was shrinking. They were getting sick people who needed care, but with premiums skyrocketing, what benefit is there for healthy people to buy in?
But I agree that the private for profit health care system is an abomination only made much worse by making it public law requiring we buy into it. Instead of Medicare for all.
Re: Cigna saves millions by having its doctors reject claims without reading them
#85Privatized 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.
Public health care can be similarly dystopian in other ways: Very long wait times due to limited resources, subpar medical care, limited prescription options and drugs, beauracracy. No matter what society you live, the advice is the same: try not to get sick.
Sounds exactly like my private for profit health care provider.
Re: Cigna saves millions by having its doctors reject claims without reading them
#86Earlier quoted context omitted.
This might be true, but as someone who has lived in the U.S. and Europe I can say utterly unequivocally that I preferred Health Care in Europe. I wasn't even in one of the European countries with a great reputation for Health Care. Health Care in the U.S. isn't just bad, its outright fucking brutal. An elderly friend of mine recently fell and went to an urgent care where they couldn't get him into the x-ray machine.…
I’m fully insured and have always been well taken care of in the United States health care system. Never wait more than 30 minutes if I were in an emergency room, and usually I’m attended to within 10-15. Doctors appointments are easy to get, never paid much for prescriptions. If I was in a public system, I’d fear I’d be fighting for attention alongside the general public, so I’m not convinced it would be better.
> I’d fear I’d be fighting for attention alongside the general public
Are you not a part of the "general public"? If it is true that there is a class of people who don't have your advantages and therefore have worse medical care, is that a situation that you see as acceptable?
It always seems strange to me when people argue this about this issue from a hypothetical perspective, when we have a wealth of actual data that we can use to compare health outcomes. We can just look at the results and see what works better!
https://www.pgpf.org/blog/2022/07/how-does-the-us-healthcare...
(TLDR: the US spends much more per capita on healthcare, especially in administrative costs, and has worse health outcomes than most wealthy countries).
Re: Cigna saves millions by having its doctors reject claims without reading them
#87Earlier quoted context omitted.
You can have good public healthcare without the need of the notion of 'claims'. The Scandinavian healthcare system is a good example ( https://en.wikipedia.org/wiki/Healthcare_in_Denmark ).
> The central government plays a relatively limited role in health care in Denmark. So the exact opposite of what people usually mean when they say they want public healthcare. Words mean something.
Public healthcare means health care paid for via public funds, nothing more.
Many public health care systems aren't entirely centralized, even though they use public funds. For example even the UK's NHS has regions with allocated budgets they manage based on the number of patients they see, which they then spend as they see fit.
You're trying to attach your biases and assumptions onto an amorphous phrase, and then pretend others are using it wrong because they don't have the same expectations. That isn't reasonable.
Re: Cigna saves millions by having its doctors reject claims without reading them
#88Earlier quoted context omitted.
This might be true, but as someone who has lived in the U.S. and Europe I can say utterly unequivocally that I preferred Health Care in Europe. I wasn't even in one of the European countries with a great reputation for Health Care. Health Care in the U.S. isn't just bad, its outright fucking brutal. An elderly friend of mine recently fell and went to an urgent care where they couldn't get him into the x-ray machine.…
I’m fully insured and have always been well taken care of in the United States health care system. Never wait more than 30 minutes if I were in an emergency room, and usually I’m attended to within 10-15. Doctors appointments are easy to get, never paid much for prescriptions. If I was in a public system, I’d fear I’d be fighting for attention alongside the general public, so I’m not convinced it would be better.
Where is the wait only 30 minutes? Every time I've been to the emergency room the wait has been 6+ hours. I think the only way it would be that fast at the hospitals I've been to is if you'd die waiting longer, otherwise it's a long wait.
Re: Cigna saves millions by having its doctors reject claims without reading them
#89Earlier quoted context omitted.
This might be true, but as someone who has lived in the U.S. and Europe I can say utterly unequivocally that I preferred Health Care in Europe. I wasn't even in one of the European countries with a great reputation for Health Care. Health Care in the U.S. isn't just bad, its outright fucking brutal. An elderly friend of mine recently fell and went to an urgent care where they couldn't get him into the x-ray machine.…
I’m fully insured and have always been well taken care of in the United States health care system. Never wait more than 30 minutes if I were in an emergency room, and usually I’m attended to within 10-15. Doctors appointments are easy to get, never paid much for prescriptions. If I was in a public system, I’d fear I’d be fighting for attention alongside the general public, so I’m not convinced it would be better.
Don't you think it's a worthy goal to strive for this for all people in your country? Would you really try to block progress towards that goal due to your fear of being treated as they are right now, instead of putting your energy towards nobody being treated that way?
Sincerely, if anyone can explain to me - how can we as a species both have figured out game theory, AND consider this as a position that is in any way acceptable?
Re: Cigna saves millions by having its doctors reject claims without reading them
#90Earlier quoted context omitted.
Public health care can be similarly dystopian in other ways: Very long wait times due to limited resources, subpar medical care, limited prescription options and drugs, beauracracy. No matter what society you live, the advice is the same: try not to get sick.
This might be true, but as someone who has lived in the U.S. and Europe I can say utterly unequivocally that I preferred Health Care in Europe. I wasn't even in one of the European countries with a great reputation for Health Care. Health Care in the U.S. isn't just bad, its outright fucking brutal. An elderly friend of mine recently fell and went to an urgent care where they couldn't get him into the x-ray machine.…
As someone who has dealt with many folks suffering from AIDS, I can say that it may even rise to the level of crimes against humanity.
It's a well-known trope (probably proven, but I don't know the studies) that insurance companies routinely delay healthcare to AIDS and other patients with terminal diseases, in the direct hope that the patient dies.
With AIDS patients, there's a big moral component to the diagnoses, and companies can "get away with it," because there's such stigma to the disease, but I have also heard of the same thing happening to cancer patients. In fact, it can sometimes be a matter of life and death. If a treatment is delayed enough, it can change the outcome.
I have been told (but don't know it for a fact) that this is actually the point of the delays, and that the delays are triggered by the diagnosis.
In many cases, delaying payment, also delays treatment. Most patients don't have an extra 500K, floating around, that they can pay the hospital for a procedure, in the hope they get reimbursed. No promise of payment, no treatment.
So that means that refusal to pay is the same as withholding treatment, and these companies know it.
I think that AI is likely to make this worse, as they will probably give these decisions to an AI, thus removing any hope that there may be a caring human in the process that could possibly feel shame.