• jet@hackertalks.com
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    2 days ago

    But if they make you stop, and prove, and justify something obvious. Maybe the patient will die before you can order more expensive services. Think of how much money they could say if if their patients die when they’re in the hospital before running up a bill!!!

    • LandedGentry@lemmy.zip
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      2 days ago

      This is exactly the issue doctors are also now facing with abortion restrictions. These expectations are unbelievably onerous and lethal. This is a field where seconds can matter and they want to let lawyers and health insurance companies hem and haw as long as they want because God forbid they maybe occasionally enable something that wasn’t strictly necessary or spend a few dollars more in the pursuit of literally determining life and death.

  • Mouselemming@sh.itjust.works
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    3 days ago

    For every denial of claim, the burden of proof should be on the insurance company. The assumption should be, if a doctor ordered it, it was necessary.

  • Drusas@fedia.io
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    3 days ago

    That’s because they know the patient is going to die and it will be cheaper for them that way.

        • jmcs@discuss.tchncs.de
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          3 days ago

          That’s different from preventing death. Trying to stabilise a terminal cancer patient is significantly different from treating it before it becomes terminal, being in a coma might not be immediately live threatening but removing the patient from the hospital until it becomes so can remove any chance of recovery. And even if you survive, if you only get treatment when it’s already a life or death situation the outcomes can be much worse.

    • DolphinMath@slrpnk.net
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      3 days ago

      This is the reason I believe every health insurance plan should also include life insurance from the same company. You need to give those assholes an incentive to keep me alive and healthy.

      • __Lost__@lemmy.dbzer0.com
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        3 days ago

        No, then you would just get the equivalent of your car being totaled. If it costs more to fix your body than it does to pay out the life insurance, they will let you die and pay the life insurance.

    • Frozengyro@lemmy.world
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      3 days ago

      Even in countries with universal healthcare, these decisions also need to be made. We don’t have unlimited money or resources to spend when cases are likely hopeless.

      • ricecake@sh.itjust.works
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        3 days ago

        They do need to be made. By medical professionals. The people who can actually determine who’s viable to save and who can best utilize resources, and who actually know if there even is a shortage. Which there usually isn’t.

        The last people you want doing it are the people with a financial incentive to always deny care.

      • ysjet@lemmy.world
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        3 days ago

        That’s called a death panel. We shouldn’t have those, and insurance companies DEFINITELY shouldn’t have those.

          • ricecake@sh.itjust.works
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            3 days ago

            In the ideal world, an insurance company handles the paperwork of collecting money for risk pooling and paying the bills as they come in, as well as assessing individual risks to set premiums.
            Sort of like most other insurance industries. Maybe arguing about if you paid for coverage, but not actually arguing that you don’t need the fix.

            Your car insurance might argue you aren’t covered for damage that happened while the car was parked in the garage, but they won’t try to argue that your car might not actually require a new windshield since you haven’t tried plastic wrap yet.

            In this ideal world, the people making the decision to ration care would be… The doctors, who are perfectly positioned to do this, and actually do when there’s a real need to do so.

          • AeonFelis@lemmy.world
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            3 days ago

            A death panel fully acknowledges that the patient will die if they decide not to treat, and consider that against the possibility of saving more lives with the limited resources allocated to them. An insurance company pretends the patient doesn’t really need the expensive treatment that doctors have determined is crucial to save their lives, and the money saved doesn’t go into treating other people - it goes into profit.

        • dellish@lemmy.world
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          3 days ago

          Wasn’t “Death Panel” a bullshit line spouted by Sarah Palin? I am yet to see any evidence of them in countries that have social healthcare.

          • Passerby6497@lemmy.world
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            3 days ago

            That’s the neat part, we already had death panels and they were trying to make it sound like they’d be a new thing. Instead, we get some unaccountable fucking bean counters determining if you get to live instead of someone with a goddamned degree and a basic knowledge of your situation.

      • Maggoty@lemmy.world
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        3 days ago

        They’re in the ICU right now with Doctors saying they have the resources, they just need the authorization.

        You’re talking about triage which generally only comes into play after massive casualty events.

        • RunawayFixer@lemmy.world
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          3 days ago

          I’m not disputing that this isn’t triage, but I just wanted to clear something up about what triage is: Triage happens everyday in emergency rooms of hospitals. Just normal every day triage is sorting (= trier in french) the patients according to urgency of care and availability of resources. Someone bleeding out will be helped before someone with a broken bone for example.

          I don’t know if there is a separate term for the kind of emergency triage where some patients are left to die because of insufficient resources.

      • Lord Wiggle@lemmy.world
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        3 days ago

        So you’re saying it’s the insurance company’s job is to decide who is in a state to die, not a doctor. Why do we even have doctors? So when you have a medical emergency, why won’t you just go to the insurance company instead of a hospital, when the company is better in making medical decisions anyway?

        This may be new to you, but insurance companies have no medical training.

        The state of the woman in the ICU might sound hopeless but the coma can be medically induced due to the brain hemorrhage and with the proper medical care she could recover, if indeed her state isn’t too bad. This is something doctors are for, to calculate her chances and fight for her life if there is a chance of survival. If there’s no chance, it’s the family’s choice to pull the plug.

        But you’re fine with an insurance company calculating what it might cost to them then to make the decision to let her die?

        • shalafi@lemmy.world
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          3 days ago

          It’s my understanding that a doctor, employed by the insurance agency, makes these calls.

          • Kalysta@lemm.ee
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            2 days ago

            A doctor who has never seen the patient and often isn’t even the specialty needed to make the call.

            If an insurance company denys you, demand to know the name, speciality, and license number of the doctor who denied you. Often a doctor wasn’t involved. And when you find that out it’s illegal.

          • Passerby6497@lemmy.world
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            3 days ago

            If only those “doctors” had to put their malpractice insurance on the line when making these calls. Bet you’d have a lot less of this bullshit when the people making the call are liable instead of getting paid to kill people.

              • Lord Wiggle@lemmy.world
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                2 days ago

                A doctor is only allowed to be a doctor when they took the Hippocratic Oath. They will lose it when they would give up people their lives for the profits of an insurance company. Doctors do not work for them, the people judging whether they will payout your insurance claim have no medical training.

      • nova_ad_vitum@lemmy.ca
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        3 days ago

        Americans spend more per capita on health care thab anyone else. They just get shitty value for it, because of all these worthless parasites skimming off the top while actively hindering health care delivery.

      • 10MeterFeldweg@feddit.org
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        3 days ago

        But it is not up to any company to decide on life, even if the chances look very dim. Where I live you can can have a a written will for such cases or your relatives decide. If there are non you will be taken care of till the end, but you can have decided in advance that you don’t want life expanding care over a certain degree to minimise the chance for you to live the rest of your life not really being more than a hull.

      • blackbelt352@lemmy.world
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        3 days ago

        That’s where the doctor in charge of care says “nothing we can feasibly do will bring this patient to a better state.”

  • Jo Miran@lemmy.ml
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    3 days ago

    Just because it is legal doesn’t mean it shouldn’t be punishable.

  • Etterra@discuss.online
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    3 days ago

    United Health Care Executive Ghouls: We can prove that this isn’t medically necessary because if they turn off the life support then the patient will stop suffering from the described symptoms.

    I’m like 90% sure that health insurance executives are undead creatures that feed on the death and suffering of their “customers.”

    • Narauko@lemmy.world
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      3 days ago

      Have we checked that the CEO is still/actually dead, and isn’t just an undead playing possum?

      • chaogomu@lemmy.world
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        3 days ago

        The problem is, Brian Thompson was the CEO of UnitedHealthcare, but he wasn’t actually in charge. No that would be Stephen J. Hemsley, the Executive Chairman at UnitedHealth Group.

  • Flying Squid@lemmy.world
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    3 days ago

    I just was amazed at myself when I said, “oh thank god,” when my wife told me her health insurance would be switching from UHC to Anthem in January. Like no, no thank god, it’s still horrible.

  • JaggedRobotPubes@lemmy.world
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    3 days ago

    I know we hate it and they’ve really done and will still do some deeply fucked up shit, but man…maga is anti-establishment like the left. I’d rather have a class war than a civil war.

    A class war could mayyyyyyybe have a constructive resolution. But a civil war? 0% chance. None.

    I don’t want either at all but for Christ’s sake at least have it over the right thing if you’re gonna have one.

    • deaf_fish@lemm.ee
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      2 days ago

      In case you weren’t aware, we are in a class war. If you haven’t been paying attention to what is happening to Luigi. They are throwing the book at him. They want him dead. They want to send a message. It’s not about justice or law anymore.

      Your only option at this point is to acknowledge the class war is happening or stick you head in the sand and try to pretend it isn’t.

    • GodlessCommie@lemmy.worldOPM
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      3 days ago

      MAGA, whether it’s regular or Blue, isnt anti establishment. They fully support their own versions of establishment, and both defend the status quo. There will be no form of civil war among the citizens, but they will keep us divided with meaningless culture war bullshit because it doesn’t threaten their positions of power.

      • ReadMoreBooks@lemmy.zip
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        2 days ago

        MAGA, whether it’s regular or Blue, isnt anti establishment. They fully support their own versions of establishment, and both defend the status quo.

        I’m a brown skinned male and experienced backcountry hiker. A few months ago I finished a year living in a truck while traveling the US48, lots of time everywhere except Washington.

        My anecdotal experience is that the vast majority of Trump’s supporters are silent unless I’ve earned their respect somehow and solicit their perspective. Then they’ll readily communicate why they believe the system is broken, how they’ve reasoned out that nothing positive is achieved in the US without collective threats and acts of fiscal and physical violence, and the magnitude of their commitment to their principles.

        They don’t perceive the nuance of the problems. They can barely begin to reason out how to hypothetically solve them while also preserving the agency of others. They won’t while they continue to expose themselves to the propaganda often leveraged by their religious and political leaders. If the major trade unions continue to increase their educational efforts then the membership will continue to increasingly favor it.

    • monkeyslikebananas2@lemmy.world
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      3 days ago

      What civil war though? There are no possible civil or geographic divisions. A class and culture war are the only possible ways out of this mess.

      I am on the side where we destroy the culture of greed and eat the rich.

  • iAvicenna@lemmy.world
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    3 days ago

    hospital care is not necessary but because we care about our customers we will go the extra mile and cover her aspirin costs