We would need to see more years to see if this is normal or them actually cashing out heavily. The article says this figure was $2.6 billion in 2018 so the last couple years it’s been steady and I would guess it’s probably similar for prior years too
Yeah you’re probably right actually. Criminal Justice and Healthcare are the only two systems in this country that absolutely have to be demolished, their foundations uprooted, and started over from scratch. Education is close to needing a total tear down, but it’s not quite as bad as CJ and Healthcare… so live another day I suppose.
Certainy not great, but also important to note:
“The bill is technically an explanation of charges, and because Flor has insurance including Medicare, he won’t have to pay the vast majority of it. In fact because he had COVID-19, and not a different disease, he might not have to pay anything…”
“…There also are special financial rules that apply only to COVID-19. Congress set aside more than $100 billion to help hospitals and insurance companies defray the costs of the pandemic, in part to encourage people to seek testing and treatment (including those with no insurance). As a result, Flor probably won’t have to pay even his Medicare Advantage policy’s out-of-pocket charges, which could have amounted to $6,000.”
Right, the point is the cancer patient is fucked but COVID patients are fine. Absurd.
I don’t disagree with the general point. This is still a bad case to illustrate that. If you’re looking for something like medicare for all, this guy already has medicare. We’re trying to get everyone to what he has.
With this guys insurance, he consumed a fuckton of medical care, and if not for special COVID rules, would have had to pay approx $6K. Now I get that for some people even that is onerous, but for 62 days of extremely specialized care that’s not that bad. You’d be hard pressed to stay in a hotel for 62 days, for under $6K.
If cancer patients had to pay only $6K for $1.1 million of (inflated cost) cancer care, we would be in infinitely better shape than we are right now.
The point is that it is not the cancer patient who is fucked, it’s the cancer patient who is not on medicare or other good insurance that is fucked.
RANT INCOMING
I’ve bitched itt before about issues with health insurance. I (or my parents) have been battling with them over coverage for some 18 years. I have surgery this upcoming Monday to fix a labral tear in my hip as well as a femeroacetabular impingement (basically reshaping the bone at the top of the femur so that it can properly fit in the socket without shearing the cartilage to shreds). I had the same surgery on my other hip in February.
In February my insurance initially denied coverage because I had not first undergone hip injections as a treatment. A peer to peer review with the surgeon explaining that injections are 100% worthless for this issue because they can’t fix a tear or remove the excess bone that caused the tear was thankfully successful.
Fast forward to today. Just got a call from the orthopedic surgeons office saying that Monday’s surgery was denied and they had to do another peer to peer. It was still denied after the review. He explained again why it is pointless to do an injection and explained that they approved the same surgery in February. Insurance company said “well that review was done by a different dr and it’s up to each individual dr doing the review to decide. No means no.”
So now I have to go get an ultrasound guided hip injection tomorrow for absolutely no reason other than to satisfy my insurance companies idiotic requirements. And then hope they approve the operation after another review on Thursday.
Fuck the healthcare system in this stupid fucking country.
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That is absurd. Sorry you’re going through this nonsense.
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That’s completely absurd. I’m sorry.
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On the other hand, I called a dentist today, got an appointment for tomorrow and will have to pay the equivalent of $40 to get an abscess lanced. The prescription antibiotics will be free.
So yeah UHC doesn’t cover all dental procedures in the CR but what it doesn’t it discounts massively.
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Thanks. Completely ridiculous, and that’s coming from someone who has a built up tolerance of dealing with insurance bullshit.
The surgery coordinator who called me today said they just had to cancel someone’s surgery that was scheduled for tomorrow because of a similar issue. Apparently the insurance companies often wait until the last minute to deny coverage. Makes you think the cruelty is the point.
Gotta maximize shareholder value.
Paying for healthcare is no way to run an insurance company.
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The insane part is this is just going to cost the insurance company more money. The doctor, who stands to make more money by giving the ultrasound guided injection, is advocating for not doing it.
I’m sure the insurance companies have it all figured out down to an eight of a cent so that they make out better in the long run over a large sample size, but in this individual case they are being fucking stupid.
What, exactly is the mechanism for making an insurance company cover a procedure? Because it sure seems to me there is functionally zero penalty, and a huge financial incentive, to roll with the “fuck you, no” plan.
As far as I understand the mechanism is the peer to peer review. A doctor representing the insurance co.panies meets with the prescribing physician who explains why the procedure is medically necessary. The insurance companies doctor than makes a ruling.
It’s a pretty big loophole that insurance companies use to do exactly what you suggest. They probably save billions a year by denying necessary care, and that’s why the CEOs can make the big bucks as reported a little up thread.
Yes, there’s a new in-house doctor now - meaning we fired that other doctor who approved too many procedures.
Not to mention the waste of resources to have someone take up a spot in medical school and presumably residency to then be a fucking whore for an insurance company.
They absolutely do this shit on purpose. I had to file an appeal and have my doctor draft a letter of medical necessity for an orphan drug. We sent everything in early and never heard back until after the deadline when they claimed they didn’t receive anything.
The incentive is employer clients can switch insurers if their employees complain. Which does sometimes happen.