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[-] donuts@lemmy.world 224 points 1 week ago

You know, at face value he's absolutely right. We shouldn't claim care that is unnecessary or maybe even harmful. But where we disagree is that I think that decision should be left to our medical professionals

[-] Modern_medicine_isnt@lemmy.world 150 points 1 week ago

Really what it should be is that if a doctor prescribes unnecessary care, they should go after the doctor, not the patient. Doctors have malpractice insurance. If the health insurance can't win a case of malpractice, then they should pay the bill. Why are patients in the midfle here at all.

[-] Kichae@lemmy.ca 41 points 1 week ago

This is still validating the profit incentive of private health insurance.

If the doctor prescribes unnecessary care, it should be none of these peoples' business, because they shouldn't be allowed any stake in the decision whatsoever.

[-] SmoothLiquidation@lemmy.world 36 points 1 week ago

It’s the same trick as rebranding bank robberies to identity theft. It puts the blame on the consumer who can’t afford to defend themselves.

[-] Serinus@lemmy.world 15 points 1 week ago

Huh, I hadn't thought of that as a Crying Indian.

[-] rumba@lemmy.zip 33 points 1 week ago

Really what it should be is that if a doctor prescribes unnecessary care

That's the core problem. The entity that defines unnecessary care is health insurance. And there are TONS of stories of them denying Diabetes medication for people with diabetes and anti-nausea meds to pediatric patients getting chemo.

If they were doing the right thing, no one would be pissed off. The "recent target" was the one to decided to run on AI driven denials that were denying 90% of care for months.

They are not fulfilling their duty to take the money from the subscribers and pay their righteous medical bills and instead using it as raw profit.

They are employing their own 'doctors' to prove stuff that is definitely necessary is labeled unnecessary.

[-] NocturnalEngineer@lemmy.world 10 points 1 week ago

Reminds me of the Tobacco Instrustry setting up the "Tobacco Institute", to disprove any links between smoking being addictive, and lung cancer.

They were constantly gaslighting the public, even tried to discredit the Surgeon General for his report on second hand smoke.

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[-] Alexstarfire@lemmy.world 7 points 1 week ago

Patients usually have the least amount of power. That's why.

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[-] TheAlbatross 15 points 1 week ago

Insurance claims are approved or denied by medical professionals. In the state of NY it's even required for a specialist to approve or deny specialist care.

Some doctors are just absolute scum.

[-] Tinidril@midwest.social 40 points 1 week ago

They are done by medical professionals who have no obligation or incentive to serve the best interests of the patient. If your doctor fucks up, he can be found liable. If the insurance doctor fucks up, there is no liability whatsoever. Cases have been brought to court and then immediately thrown out because there is no legal basis for holding them accountable.

[-] donuts@lemmy.world 32 points 1 week ago

Except in this case, they used AI to help them make decisions. The lawsuit is still ongoing so I shouldn't speak in definitive terms, but considering the circumstances and evidence I think it's pretty clear than they have tried to automate some processes and didn't audit them properly.

[-] rumschlumpel@feddit.org 11 points 1 week ago

Did it not work as intended, though?

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[-] ayyy@sh.itjust.works 31 points 1 week ago

Medical professionals that spend an average of 6 seconds per case. And keep getting caught with revoked/expired licenses. And well outside their area of expertise (the classic example is failed dentists deciding on cancer treatments).

[-] simplejack@lemmy.world 12 points 1 week ago

There is a lot of crap that they’re able to instantly deny through your plan’s terms and conditions.

It’s worth reading the plan summary of what won’t be covered, even if it’s prescribed treatment. Some of the shit that’s hidden in there is fucked up.

This year someone in my family started to have to pay out of pocket for their GLP1s because their diseases didn’t progress far enough for the treatment to be covered. They’d rather you hurry up and die than pay for expensive drugs that keep you alive for longer.

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[-] nul9o9@lemmy.world 7 points 1 week ago

I don't have a source. But i've read they are incentivized to go through as many claims as they can, and not to approve too many.

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[-] Sterile_Technique@lemmy.world 80 points 1 week ago
[-] 2piradians@lemmy.world 15 points 1 week ago

I win! Whoosanext?

[-] rc__buggy@sh.itjust.works 49 points 1 week ago

I miss Anonymous. Those fuckers would be figuratively burning down UHC right now.

[-] GreenKnight23@lemmy.world 22 points 1 week ago

they were taken down and then turned into a shell org of the NSA.

it's a honeypot/scapegoat now.

[-] CuddlyCassowary@lemmy.world 22 points 1 week ago

What actually happened to them? Did key members get tracked down or something?

[-] spankinspinach@sh.itjust.works 37 points 1 week ago

I don't have sources, but I seem to recall reading somewhere that the OGs aged out or got caught, and the new gen that replaced them weren't as ideologically driven or competent or something. I think they still technically exist but aren't nearly as influential as they once were

[-] Tinidril@midwest.social 33 points 1 week ago

It's also not as easy to hack electronic systems anymore. It's not that they are invulnerable, but the vulnerabilities are generally more complicated and difficult to exploit. Setting aside people still running Windows XP or something, vulnerabilities get patched pretty quickly today. State actors have the time and resources to still do straight up electronic hacking, but opportunities for individuals are sparse.

Of course there is still the human element. Most data breaches done by individuals nowadays rely, at least in part, on social engineering.

[-] CuddlyCassowary@lemmy.world 20 points 1 week ago

Another thought this just popped into my head is that the next generation may not have been brought up with the same fundamental hacking skills that were somewhat inherent in being technical in the late 70s-mid 90s. Could you still learn them?…Of course, but having grown up with BBSs and LoD (Legion of Doom, and the like) and pre-WWW, some things were just more prevalent when it came to learning about the guts of systems and “cybersecurity” (that word didn’t really exist back then).

[-] Cornelius_Wangenheim@lemmy.world 10 points 1 week ago

On the other hand, learning hacking itself is easier than ever. It's turned legitimate under the guise of penetration testing.

[-] rc__buggy@sh.itjust.works 12 points 1 week ago

I think they all just got jobs, honestly.

[-] CuddlyCassowary@lemmy.world 11 points 1 week ago

In this economy?!?! /s…kinda

Actually that makes sense, and saddens me a bit there wasn’t a contingent to pass the torch to.

[-] Allonzee@lemmy.world 44 points 1 week ago* (last edited 1 week ago)

What did you expect?

We've been told for years that herp derp the economy is doing amazing! If you don't agree there's something wrong with you! if you got laid off or your corpo landlord raised your rent and you're now dying in the street well then... look everybody! An evil homeless person lowering your property values with their continued existence! Git em!

[-] Leate_Wonceslace@lemmy.dbzer0.com 26 points 1 week ago
[-] GreenKnight23@lemmy.world 15 points 1 week ago

More like, disconnected from reality.

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[-] Tronn4@lemmy.world 24 points 1 week ago

It's time for that green guy from that one video game that I can't mention because the auto mods are erasing free speech

[-] Gork@lemm.ee 24 points 1 week ago

Did he not have a PR person tell him that video was a bad idea? Or more likely, did he not listen to their advice?

[-] tkw8@lemm.ee 22 points 1 week ago

Headline says video was leaked. It was probably a private meeting. Agree that it was a stupid thing to say regardless.

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[-] oleorun@real.lemmy.fan 20 points 1 week ago
[-] Sanctus@lemmy.world 23 points 1 week ago

These dudes have their own dicks all the way down their throat.

[-] RQG@lemmy.world 16 points 1 week ago

And you wish that'd prevent them from talking. Alas here we are.

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[-] Nougat@fedia.io 17 points 1 week ago

Did that guy just paint a big ol' target on himself?

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[-] dQw4w9WgXcQ@lemm.ee 15 points 1 week ago

I feel like health insurance companies are putting a lot of pressure on people named Mario right now.

[-] frostysauce@lemmy.world 8 points 1 week ago
[-] RememberTheApollo_@lemmy.world 8 points 1 week ago

So many internet arguments revolve around binary choices that don’t need to be binary or appeals to authority or hypocrisy as the only leg they stand on.

[-] motor_spirit@lemmy.world 7 points 1 week ago

gonna put this dumb mother fucker on an airbrushed tee like he's already dead

chalk yourself out ya big dumb bastard, show the sharks where that menstrual leak is bitch-made mf

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this post was submitted on 11 Dec 2024
786 points (100.0% liked)

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