Microblog Memes

Universal health care? I don't want government making my health care decisions! We have for-profit companies for that.

i have a friend who's a transplant patient and has been taking the same meds for over 10 years post transplant-- every year it's a furious battle with insurance who, every year, decides the meds are no longer "medically necessary" and drops coverage for it. fucking helloooo these are anti-rejection pills, the textbook definition of "medically necessary."

it's not that insurance companies are stupid, it's that they're saving money on people dying when those people don't get what they needed to live.

insurance is the biggest fucking scam of all time

Frank didn't even look at it. He just fed your claim into their computer and it spat out a rejection.

I work for a neurologist practice, and the amount I have to argue with insurance (and inevitably have to get the neurologist on the phone to directly request something for many) is insane. A good chunk of my job isn't providing care, but arguing with insurance that the care is necessary. These companies are actively delaying patient care, and try to blame the physician whenever possible.

Wildly infuriating, especially when the denials are worded along the lines of "we reviewed this, and don't consider it medically necessary". Motherfucker, a doctor said it was necessary and listed the clinical reasons why this test or procedure would be beneficial. Nothing has radicalized me for universal healthcare more than working in healthcare.

Had my buddy over who brought over his incredibly questionable 30yo brother who shared some real incel levels of talk. He used my bathroom and asked if I wore tampons since a pack was visible. Like bro, I have a wife and a daughter.

Anyways, that guy works in health insurance!

I don't know how much decisions he can actually make. But that dude has a middle-school level education about sex ed and struggled to explain what a period is. And he is one of the barriers to approving/rejecting your health care.

So here is a question:

A medical professional examined the person IN PERSON and has a requirement.

In comes the insurance to tell you your doctor is wrong and that you're perfectly fine, your doctor is basically lying to you.

Question: how the fuck did any of this ever become legal?

Sometimes the Frank is an AI that is wrong 90% of the time. That's fine, because reasons.

Also, there's this common "feature":

Dr: "You need this procedure."

Me: "How much will it cost me?"

Office Manager: "I won't know until I bill your insurance and find out if it is covered."

Me: "What is the cash price I would pay you if it isn't covered by insurance."

Office Manager: "I have no idea."

Prior authorization should 100% be outlawed. It's either insurance adjusters practicing medicine without a license, or insurance doctors making diagnoses without examining a patient, both of which are unethical or illegal.

Though I think the real solution is a system where every time a prior authorization denial is overruled by the DOO or a court, the insurance company has to pay punitive damages of at least $200,000 to the patient.

Last time my doctor had to bill my insurance he said he would just run it immediately, because apparently "routine denial" is a thing where they just automatically deny it because if you really need it the doctor will then have his office try again with more justifications. He hated this a lot, because it basically meant he had to just assume first denial for no real reason and then his staff had to take the time to almost always go back and resubmit. He said sometimes he would submit it with the info, it would be denied, and then he would resubmit it two more times and suddenly it would be approved.

Like seriously, what the fuck. But only does that hold up necessary care, it also makes doctors do more bureaucratic work and hire more staff, which, of course, makes medicine more expensive. Brilliant.

The cruelty of the US American for-profit health system is what should be uniting all US Americans in protest, riot, and violent overthrow of the current system.

I love how the insurance company, the party that has no medical expertise whatsoever, gets to unilaterally decide how much that MRI will cost you today.

The private for profit health insurance industry - because what could make number go up better than a (LEGALLY MANDATED) do nothing middle man who's only purpose is to take your money and ensure as little as possible is spent on healthcare sitting between you and not dying?

American health insurance in a nutshell: https://youtu.be/llx-SaGq4Fs?si=eDIny0fqcGYFkB2a

And before non-Americans ask, yes, that's actually how it is. The humor in this video isn't from exaggeration, the comedy derives from the unexpectedly clear way the absurdity of the system is explained.

And when the patient turned out to be fine after the scan, the insurance company will try to blame that the doctors are lying so that the insurance company has to pay the hospital more It's like they thought that the doctors must be able to see through the patients' body as if they forgot that the reason for these equipments to exist in the first place is that because the doctors can't really be 100% sure about what's actual situation inside human body

They hire doctors who can't handle being practicing doctors to prop up their delusions. I've only had one on the line in a dispute and he acted quite offended when I asked for his license to prove he was a real doctor. Turns out he was barely a doctor at all. He decided instead of practicing medicine and killing people he would work for a insurance company and kill them that way.

I had a friend who needed a CT head, chest and abdomen. The insurance company decided she could have the head and abdomen, but not the chest, and couldn't really explain why when asked. American health care is a joke.

My insurance that I pay a ridiculous sum of money for has started doing this neat new thing. When the doctor orders imaging, they mark it as “requested more information but never received any”, and reject the claim. They don’t actually request any additional information, and they ignore me when I contest their decision. So glad that I pay like $400 per month for this coverage.

Maybe if you can't afford to pay premiums that allow you to have an IRM, just ~~don't indulge in expensive illnesses~~ die already.

This shit really needs to end.

tl;dr: It doesn't.