Can't I just get care? I got a whole grown ass person's life to live, and i can't be an expert in everything.
Are you rich? Then yes. If you're not rich, then you need to suffer and struggle for needing to use valuable resources that could be used on people more deserving; like the wealthy.
It's not that they're hoarding scarce healthcare resources so they're available for the wealthy. They could provide care for everyone, but then the system wouldn't run at the desired profit level.
i didn't say healthcare resources. money is a resource and you must give it to your betters if you want access to affordable healthcare. they are hoarding one resource by denying access to another.
There is also a giant undercurrent of wealth ministry in the American upper classes. Since about the 1960's they've been pushing the idea that God blesses good people with money and punishes bad people by making them poor. It's mixed with the Protestant Work Ethic so they also see poor people as lazy and undeserving.
It's a completely self serving and self fulfilling ideology but it makes them feel good so we all have to suffer because we lost the lottery at birth.
In most countries you can, yes.
It must be exhausting to be an american
And your doctor will have to fight with the insurance company over the phone for an hour to do a pre-auth. When my doctor wants to perform something or give a certain treatment not covered, he assures me he will make this long and stressful call. I really wonder what they are discussing and what goes on in these conversations...
What doctor has time to do that? I'm in Canada and I can never trust my doctor to have any conversation with anyone, at any time longer than five minutes at a time for anything.
The best tactic I've found if you want to get anything done for yourself or someone close to you is for you to do the legwork and make calls, contacts and literally hound people to do their job. If no one is there to push things along, no one is going to magically appear to help you ... that is a fantasy that seldom and rarely happens, even in our publicly funded system.
You or someone who is capable should advocate for you every step of the way, otherwise you will just get lost and forgotten in the system ... whether you are in the US or Canada.
I’m in Canada and I can never trust my doctor to have any conversation with anyone, at any time longer than five minutes at a time for anything
The best tactic I’ve found if you want to get anything done for yourself or someone close to you is for you to do the legwork and make calls, contacts and literally hound people to do their job.
This is my experience in the US as well. Also nobody knows anything about anything.
Doctor A puts you on a medication, doctor B doesn't know until you tell them and then he says "he put you on that!? You shouldn't be on that, I'm taking you off it."
You go to have a surgery and say "hey guys, did you know that I'm difficult to intubate? Because I could die if you don't take that into account", they didn't know.
"Hey guys, I have reason to believe that the insurance card I was issued in the mail isn't completely correct, can anyone help me with this?", 4 different people at the company that issued the card have no idea what's going on, don't even know about the policy tied to the card in question and think you must have accidentally called the wrong company (you didn't).
"Hey guys how much is this going to cost?" it is literally impossible to say.
I have a doctor that actually cares. If I had one that didn't, I would not stop until I found one that did. It's mostly getting the insurance to cover medications that they don't. The doctor usually spends the last hour of his day doing this, for me and other patients. You have to find a local doctor outside of a major city with less client base so they DO have the time. I am in the US. My deductible is very high but the medication I take is life sustaining and I can never pay for it. I have to do this every 6mo to a year: make an appointment and hope the doctor gets their way. Once they didn't and that is why I am at my current doctor. There is not much negotiating a patient can do calling the insurance themselves. They will just look and see you don't know what you are talking about. No matter how you complain about the symptoms, your financial burden, your family, or the fact of it being life-sustaining. Best to have a medical professional advocate. I have even tried with doctor letters and emails forwarded before calling. That is why I wonder what the doctor actually says that gets through.
When I was a clinic assistant in a cancer-focused plastic surgery clinic, it was my job to fight with the insurance companies. I did prior authorizations for every surgery and they would do shit like approve the removal of a melanoma without requiring prior authorization, but performing the skin graft to repair the 10cm diameter hole required a prior authorization because the procedure code falls under the "Plastic Surgery" heading and they wanted to make sure you're not getting skin grafts for cosmetic reasons.
I've had doctors lead me to make certain statements so they can more readily justify a given treatment that they know I need.
It's a bit of a wink-and-a-nod situation.
It's even worse if you're part of an HMO, because the doctors are beholden to the business side, unlike independent doctors who don't have a management overhead telling them how many times a year they can prescribe a treatment, becuase they're doing it more frequently than other doctors in the system.
This demonstrates the major issue with socialized care, because it's also managed this way. I've been in both HMO and PPO systems - overall they both cost about the same despite HMOs acting like they cover more day-to-day stuff. It's just with PPO (independent doctors), I get care that's more tailored to me and my wishes, I don't get pushback from corporate, because there's no corporate involved. I may have to discuss with my doctor how to present things so my insurance won't push back, but at least the insurance company doesn't directly control my doctor's salary, bonus, etc.
All this crap started in the 80's as business management orgs started taking over healthcare organizations and consolidating them, and turning them into profit centers.
cause of death: not knowing the cheat code to getting treated like a human being that exists for some reason
It's hard as one having free (state paid) healthcare in EU, to imagine anything but just going to the doctor, and the doctor seeing to it, that you get the correct treatment.
No paperwork, no hassle, no bill.
I can't imagine why USA hasn't introduced something similar yet, but prefer all that bureaucracy that only makes the whole process way more expensive. Just to make sure some unemployed poor guy doesn't get free treatment!!
USA is a psychopathic society.
The US isn't a country.
It's a business dressed up as a country.
(More like 50 countries dressed up as a business dressed up as a country, but then even that gets more complicated)
"We" have been heavily propagandized into this. As a nation we're a masterclass in being brainwashed against our own interests
Once upon a time, I thought the arrival of the internet would mean ordinary people would be better informed. But Trump being elected twice has proven me wrong.
It's not used as much for information as it is used for misinformation and propaganda.
In the 70's I thought better information would end religion, it's insane how quickly we are getting absolutely nowhere.
I have come to realize, that I'm VERY naive in some respects. Hard not to turn into a cynic.
I can’t imagine why USA hasn’t introduced something similar yet, but prefer all that bureaucracy that only makes the whole process way more expensive. Just to make sure some unemployed poor guy doesn’t get free treatment!!
(concepts stolen from a very insightful reddit post from years ago) Nearly all modern conservative positions can be explained with two idea.
So apply this to healthcare:
Most arguing against medical-treatment-for-all view it as zero-sum. So for most its not just because they don't want some unemployed poor guy getting free treatment, but rather, "if the unemployed poor guy gets free treatment, then treatment won't be available at some point in the future when I need it". This is silly of course.
For others arguing against medical-treatment-for-all, the suffering is the point. The unemployed poor guy should suffer because that is his station in life. A life of comfort is reserved for those of higher classes. They believe, alleviating his suffering would go against the class he's in and should in. This is, of course, also silly.
They also use the higher taxes argument. They lean on the decades of anti tax propaganda and tell people your taxes have to go up for it to work. Of course your taxes go up by less than you save on premiums and deductibles, but they just shout, "taxes are theft" over anyone pointing that out.
They also use the higher taxes argument. They lean on the decades of anti tax propaganda and tell people your taxes have to go up for it to work.
This is a rephrasing of their zero sum argument. As in "for the poor to gain healthcare, you, the middle class, must lose wealth".
Wait until you find out that we actually get money deducted from our paychecks, a good some of money under "Medicare", that we don't get. We just pay for it on top of our monthly premiums for the insurance.
It's wild that Americans accept this idiotic healthcare system.
Unfortunately there are people here in Canada who think it's a better system. 😕
From an American: I'm so sorry our idiocy is bleeding into our neighbors up North. Learn from our mistakes!
Tell everyone you know that our healthcare literally bankrupts our working class, and that we still have crazy wait times for appointments due to our staffing shortages! Tell them there is absolutely zero upside to using anything remotely like our system!
we don't get a say, it's up to how much money they can make off us. system is rigged hard unless you have money or a ghost gun apparentlym
I don't think persuasion Checks are a good way to determine who lives and who dies in real life 🥲
Good luck getting them to give you an answer at all to any of those questions. You're going to need to get a lawyer and spend a lot of money and time getting any response at all from anyone who actually works for the company, since the customer service doesn't have access to any of that information and they wouldn't be allowed to reveal it even of they did. It's an insurance system, not a social service system where you have some kind of rights.
Insurance companies are designed to find any reason possible not to pay a claim, whether it's homeowner's insurance, liability insurance, or any other type of insurance. And they have plenty of lawyers on staff so they're happy to make the lawsuit take long enough to cost you more than the claim is worth to you and it barely costs them anything.
The reason why this would work is because it makes it appear as though you may get lawyers involved. Yeah, they don't want to pay out claims, but they also don't want to get sued and lose. This is an intimidation check to make them either back down and pay out or risk potentially going to court with someone who appears to know what's up. They'd rather just pay the bill at that point, at least as long as this doesn't become common.
I guess I get hung up on the whole:
Everyone knows this is true; it's not a secret in any way. But it's a violation of a number of regulations
bit.
So it seems like we could very easily stop these corporations from literally killing people with already existing regulations we are just choosing not to. COOL.
Bold assumption that "we" (meaning the government) includes anyone actually reading this, because as far as I can tell the only "we" the government considers is capital owners. Unless you're proposing some alternate method of behavior alteration.
Every time I learn something new about murica its a new horrifying thing that makes me wonder how your country hasn't been thrown into civil war.
What so many Americans seem to consider normal is sounding quite insane for more civilised countrys.
We're inching closer every day. Someday the pressure is going to exceed the limit and it will explode.
Semi related, recently I was referred to what I thought was a “specialist” from my doctor for a thing but I couldn’t myself determine if they were in-network with my insurance. Turns out what was implied to be a specialist was actually just a company that determines where to send people for this specific service, so we’re at the point that a primary care provider is working with a 4th party to deal with the 1st party and the 5th party is running services at the 2nd party and I am 1) the person responsible to figure out this insanity and 2) will likely be billed an obscene amount of money for something that should’ve been a 1:1 convo with a doctor and a hospital because one or five of the likely 30 people across 8 companies missed an email. (And you know all those people are they themselves dealing with the same nightmare and probably being paid a paltry $15/hr.
The free market is so much more efficient than the government!
I jump straight to filing a complaint with the Department of Insurance. The insurance company immediately gives me the authorization every time.
Can they respond to the DOI that I haven't followed proper escalation procedures? Sure. But they just fold because they know they're in the wrong and I am clearly willing to escalate matters.
So the Hippocratic oath is essentially meaningless in America?
It was always meaningless. It never had any legal repercussions if it was broken, just like ethics agreements politicians get to waiver.
This is more than mildlyinteresting.
No idea how effective this would be, I think the doctor would have to request this themselves. When I worked for an insurance company, member services didn't even have access to authorization details.
Its only illegal once you are prosecuted for it. That is how businesses operate. Its not just regulation we need but a justice system that has some teeth
There are also advocates who can help you navigate the insurance nightmare. We had to do it when I needed surgery a few years ago.
I tells ya it’s a situation awful enough to drive a man to stay in a hostel.
This is for strictly mildly interesting material. If it's too interesting, it doesn't belong. If it's not interesting, it doesn't belong.
This is obviously an objective criteria, so the mods are always right. Or maybe mildly right? Ahh.. what do we know?
Just post some stuff and don't spam.
