take some time thinking about the bullshit policies for rejecting someone's claim. There were 2 messages sent with the death of United Health's CEO. The bullet had a message written on it....and the meaning of shooting the CEO is fairly obvious.
Perhaps the CEOs of our health insurance companies...
- Thread starter tigerGUY
- Start date
The sooner we all accept that we need universal health care the better.
Some of the messages around this have been absolutely appalling. I work in this industry and have several colleagues that were friends with Brian. He's a husband and father. This is a horrible tragedy and devastating for many people. That should be everyone's first thought. Not whining about claims denials, which is a symptom of many other issues in US healthcare. Not some devious plot by a chief executive many rungs removed from the claims process.
The sooner we accept that Americans need to be personally and financially responsible for their controllable health conditions, the better.
Isn’t it weird how countries that have universal health care are far healthier than the US?
Sigh. The US is unhealthy due to lifestyle choices (and food supply, IMO). Those choices result in Americans being much more overweight, having more chronic conditions and yes, being much less healthy.
The lack of universal healthcare doesn't make you fat. Being fat does make you significantly more likely to have chronic health conditions and more susceptible to almost every other negative health outcome.
US obesity rate = 43%
EU obesity rate = 17%
Obesity by country
There's your answer as to why the US is less healthy. It has nothing to do with universal healthcare.
I understand, and many people would say he had exactly zero issue denying help to tens of thousands of suffering husbands and fathers, along with their families. The first thought should be those people.
What happened is bad because murder is bad regardless of the victim.
So why is it that countries with universal healthcare have people who make better, healthier choices resulting in a significantly lower rate of obesity?
The government’s idea to put a publicly traded company with shareholders in charge of Medicare was not smart to begin with. I work in Complex Rehab equipment, high end custom power and manual wheelchairs, UHC has been denying Quadriplegics who have been in chairs 30 years saying it’s not medically necessary. It was only a matter of time beofre something like this happened. They are suppose to follow Medicare guidelines but they make up their own rules. Since I started at the recent company on 2016, UHC Stock has increased 400+%, if all you do is accept premium and deny everything, every company could increase their profits by a minimum of 400%.
Every week I have to make those calls for my crew to clients telling them their insurance has denied them parts or equipment.
I had an insurance company call me one day and say they wouldn’t pay $500 for a cushion for a client, they said it was too much. Insurance and manufacturers set pricing not me. So I explained if the client didn’t get this cushion instead of $500 they would pay close to $100k plus for wound surgery, hospital stay and wound therapy. Their response was well we will cross the bridge when we get to it. Since then the client has gotten a wound has had to have surgery twice and unable to lead a normal life the past year, all because the insurance denied the most basic of their needs for a wheelchair end user. Common sense couldve saved them close to a quarter million bucks
SINCE I HAVE EVERYONES ATTENTION IF YOU ARE EVER GETTING MEDICARE OR MEDICAID, NEVER AND I MEAN NEVER GO WITH AN ASVANTAGE PLAN OR HMO STICK TO STRAIGHT MEDICARE OR MEDICAID
Every week I have to make those calls for my crew to clients telling them their insurance has denied them parts or equipment.
I had an insurance company call me one day and say they wouldn’t pay $500 for a cushion for a client, they said it was too much. Insurance and manufacturers set pricing not me. So I explained if the client didn’t get this cushion instead of $500 they would pay close to $100k plus for wound surgery, hospital stay and wound therapy. Their response was well we will cross the bridge when we get to it. Since then the client has gotten a wound has had to have surgery twice and unable to lead a normal life the past year, all because the insurance denied the most basic of their needs for a wheelchair end user. Common sense couldve saved them close to a quarter million bucks
SINCE I HAVE EVERYONES ATTENTION IF YOU ARE EVER GETTING MEDICARE OR MEDICAID, NEVER AND I MEAN NEVER GO WITH AN ASVANTAGE PLAN OR HMO STICK TO STRAIGHT MEDICARE OR MEDICAID
You actually think there is significant causation between universal healthcare and healthier lifestyle choices? How exactly does that work?
I do think a big part is food supply and general food culture. The US allows way more shit in our food and eats food that is far more processed than our EU counterparts. I hope RFKjr goes ham on the US food supply.
So it's not all lifestyle, but it still has nothing to do with universal healthcare. And it's mostly lifestyle, eating habits, sedentarism and factors within control on the individual. You can look in the mirror and figure out pretty quickly if you are putting your health - and your anticipated healthcare costs - at increased risk.
Preventative care is also a major factor that you're overlooking. Our peer countries preventative care costs are a fraction of what the average US citizen pays in preventative care. People not going to the doctor for minor things because they don't want to spend an absurd amount of money, or find out early on that they have something they could fix, also leads to our staggeringly high medical debt bankruptcy rate.
There's also US workforce mobility being hindered due to our abysmal healthcare system, but that's a different topic.
Isn't preventative care covered 100% by most insurance plans? I know mine is - and we have a high deductible plan.
Only if recommended by a PCP, if I recall correctly. Even then, it's not all plans.
Edit: Also, insurance covering some of it is due to the ACA, which may be on its way out.
Certain elements will remain regardless. Preexisting conditions, etc. I imagine this is a universally supported one as well.
I can't speak for all plans I guess, but preventative care seems to be pretty much universally covered with no out of pocket cost for all that I have seen.
I think it's also more along the lines of those without health insurance (for whatever reason) refusing to engage in preventative care and then getting hospitalized, going bankrupt, and it driving costs up for everyone else.
Didn't Vance mention something about their new healthcare plan modifying the current preexisting conditions platform?
They’re going to shift pre-existing conditions to block-grant subsidized, state administered “high risk pools”, meaning that premiums for those in the high risk pools will be astoundingly high as the entire purpose of insurance is dilution of risk across large groups. This is direct from the 2023 house working group proposal and independent analysis has found that it raises costs for policyholders and reduces quality of and access to care.
Now, if the “party of business” is doing this it means they’re either a) incredibly stupid or b) in the same sort of business as our dearly departed here.
So it’s just pure, complete coincidence that every country with universal healthcare has a significantly lower obesity rate? There’s no link at all between every citizen having cheap, easy access to healthcare and those same citizens making healthier choices?
Just walk me through the logic. What about universal healthcare makes you less fat? Does it make you eat less? Eat less processed foods? Exercise more? Pay attention to nutrition? Not lead a sedentary lifestyle?
Not to mention, the majority of Americans have ready access to healthcare. Universal healthcare actually results in longer wait times, etc for appointments, so you could argue the majority of Americans have better access to healthcare than Europeans.
Guess what? The people with ready access to healthcare are still much fatter than their euro counterparts.
The shift I would like to see with pre-existing conditions is to separate "controllable" and "uncontrollable" conditions.
I have absolutely no issue with a kid with a brain tumor being thrown into my risk pool. Happy to play in the same financial support model for situations like that.
I have a huge issue with a morbidly obese person with 3 chronic conditions being thrown in my risk pool. That's their fault - not bad luck - and my premiums should be unaffected by their poor choices.
Depends on if its lifestyle induced or not. If you are fit, there are no controllable factors causing it and its simply due to genetics, then it should be in the uncontrollable category.
If you are overweight, smoke or do something else within your control that has caused the high blood pressure, you should bear 100% of the anticipated insurance risk associated with the condition.
These are the conversations/debates I would LOVE to be having rather than all the gender ****ery going on….
I’m surprisingly supportive of Universal Healthcare. In my previous life/career I spent ALOT of time in Europe and still have many friends over there. Their systems are perfect, but … clearly better than ours.
I also think there is A LOT we can do with our current system to improve it without adopting Universal Healthcare (i.e allow insurance companies to compete across state lines)
BUT … I do think that a HUGE underlying issue with the health of our nation is all the shit corporations are allowed to put in our food. It’s purely anecdotal, but whenever I had trips in Europe for more than a few days, I always felt better.
Is the government or insurance company going to follow me around and watch what I eat to make sure that it’s not lifestyle induced?
Absolutely not. I've always had insurance due to the white collar nature of my job, but back when I worked in SC and I had BC and BS coverage, my deductible was $350 or so a year. In other words, NOTHING compared to even a standard ER trip. But still, when I felt under the weather I was not very likely to make a Dr's appointment if I hadn't used my deductible, just b/c who wants to spend $150 when you are probably going to be fine in a couple of days. I imagine that's even worse when you don't have "good" insurance or none at all.
True Story:
Now that I'm in Idaho, I still have BC and BS, but the copay is handled differently and it only costs $20 to go to the Drs. even if it's the first trip or the 10th. Being past 50, I go to the Dr. twice a year for a wellness check and any time I feel under the weather. It's a no brainer. Back in September I went in for my 6 month and have a new Dr since my old one retired. He noted that I had a high iron content in my blood. My old Dr. had noticed that 4 years ago and ordered a DNA type test for me, confirming that I had a recessive gene that caused this, but only one, so it was not something to worry about. My new Doc says he saw that on my records, but he wanted me to go to a hematologist just make sure that I wasn't getting Iron deposited in my organs (particularly the liver). So I went. The hematologist agreed with my new Doc and ordered an MRI of my liver, however, he also said that my old Dr was almost certainly, correct in that it was probably no problem. He also ordered a full blood workup at the time and a couple of days later that came back all clear as well. Then I got the MRI and he called me back in. My liver was clean, but they noticed a large mass on my right Kidney that looked like it could be cancer. He has a friend that's a urologist, called him on the spot and got an appointment for that afternoon and a slot for a CT scan on my whole body the next day. Turns out that it was a baseball size tumor. The urologist said that it was growing right on the blood supply for the kidney and that the entire kidney had to go whether it was cancer or not (although in his opinion, the odds were 85%+ that it was cancer. The "good" news was that it appeared to still be stage one and that it didn't appear to have spread past my kidney. So on November 12th I went in and got my kidney removed (that's why I haven't been on here a bunch as sitting at my desk is not that comfortable, but I'm actually back at work this week). It turns out that it was indeed cancer and it was pretty aggressive. They "think" the tumor was almost certainly < 2 years old but they got it all and none of the lymph nodes around my kidney were affected. So I'm "cured". no chemo or radiation needed as the CT scan came back clean for the rest of my body.
Point being is that I had no symptoms. My blood work was normal. My kidney function was fine. The ONLY reason I'm not blissfully puttering about with a big malignant tumor on my kidney is because of cheap preventative health care and paid sick leave that make going to the Drs. easy instead of a chore.
Damn man, sorry to hear that but so glad you caught it and you'll be ok! No wonder we haven't heard from you in a while but know that you've been missed. Sending good vibes your way!
Sounds great and all, but almost impossible to implement. We are not nearly advanced enough to tell if something is genetic, environmental, or some combination of both. “Sorry sir, that brain tumor is not covered because you ate too much McDonalds”
Sounds like a disaster of complications and beuracracy if we are being honest.
How do explain people catching cancer? Chemo treatments should not put anybody into financial ruin.
I totally agree. I also agree that the Right's abortion policy sucks. I lean right and always will, but we require a 3rd Party now that straddles the present 2 parties.
Man I’m thrilled they caught that early and everything worked out.
But your point in the first paragraph isn’t relevant to preventative care. Going to the doctor because you are sick is acute care, not preventative. Your annual wellness check/physical that caught your issue is preventative. Colonoscopy is preventative. Stuff like that.
My proposal would be a requirement for an annual physical where you are evaluated for things like that. You only get the preferred insurance rate if you complete this physical and confirm you aren’t obese, don’t smoke, etc. Those people pay higher premiums commensurate with their elevated risk and the people who take care of themselves pay the lower preferred premiums. It’s just simply the fair thing to do.
Yea you can’t do it to that level of detail. See my post above. People who take care of themselves should get a lower rate more in line with their anticipated cost. People who treat their body like shit, are obese, smoke, etc should pay more because they are a burden on the rest of the risk pool. This can be evaluated at your annual physical and you must meet certain criteria to get the preferred rate.
As someone who does not go to the doctor regularly and does not have a PCP do you think that it is ever the case that things are over prescribed? Are things treated that do not need to be treated in order to make the $ ?
The covid shot comes to mind. People under the age of 60 being forced to get a shot was just utter ridiculousness and a waste of money.
I also have a son with physical disabilities and see the waste in insurance first hand sometimes. We have had things prescribed to us that we do not need, simply because it was known that insurance would cover it.
Not all things are preventative. Father time is undefeated after all.
Just thinking out loud. Healthcare is a difficult topic.
So you are adding a tax that you must get a physical every year? Not to mention a whole layer of bureaucracy to determine who fits your profile.
Sorry, but im going to pass. I want less government in my life. You don't get to decide what i eat or do.
Oh I think things are way overprescribed. We’re wayyyyy too dependent on pharmaceuticals rather than lifestyle changes.
And there’s a ton of waste in healthcare. We don’t need universal healthcare. We need to reshape American dietary habits, get the shit out of our food supply, reduce waste in healthcare delivery and rate people based on controllable health factors.
You can eat whatever you want. But I don’t want to pay for a bunch of fat fvcks’ chronic health conditions like I do now. The current system forces people who take care of themselves to subsidize people who don’t. It’s just wrong.
Just conversing and playing devils advocate, not trying to be a dick
Doesn't that just describe our whole government system of taxes?
The current system forces people who can pay taxes (take care of themselves) to pay for those who can't pay taxes (not taking care of oneself). Is that whole system just wrong?
Who wants to have to go to the doctor every year to get a physical? magine how annoying that would be. Remember when we had to take your car to get an inspection every year? And the place would inevitably find something wrong with your car so that you would have to pay them to fix it? It was a huge scam.
Thats how i imagine scotch's annual physicals going. The doctors office would be even more of a mess than it is now. Appointment scehduling would be a nightmare. You wouldn;t be able to get your insurance until you had this physical that some docotots would inevitably fudge for their friends etc.
Sorry Scotch, this idea has been summarily voted down and did not get out of committee. Back to the drawing board.
Thats how i imagine scotch's annual physicals going. The doctors office would be even more of a mess than it is now. Appointment scehduling would be a nightmare. You wouldn;t be able to get your insurance until you had this physical that some docotots would inevitably fudge for their friends etc.
Sorry Scotch, this idea has been summarily voted down and did not get out of committee. Back to the drawing board.
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