People have forgotten that when Dems were pushing for big healthcare reform under Obama's first administration, Republicans lied and said the government would get between you and your doctor and that there would be death panels. Insurance companies are already between you and your doctor and they also control the death panels. But people don't want to acknowledge that part because it's easier to believe the Republican lies.
Yes! That's the most infuriating part, is all the right wing idiots who were so afraid to change our healthcare laws because of death panels was don't realize that they exist, however they exist for profit.
I have a chronic autoimmune condition. I take some really expensive meds to keep it from disabling me. My insurance pays probably over 10k a month for it.
I deal with a lot of pain everyday because of this. My GP gave me a mild pain killer prescription for the real bad days. My insurance denied filling the script and would only approve 7 days worth without the doctor justifying why I need it. Like WTF. It cost 10 bucks without insurance. It cost them more money denying it than if they paid.
Somebody messed up for them to be stopping the surgery to connect the insurance rep to the surgeon mid-procedure. Either the rep misrepresented the urgency or the hospital admin / charge nurse didn’t deny the rep access to the surgeon when they should have.
Regardless, the more upsetting concern here is the patient should have had coverage for the stay in the first place.
Absolutely not. "First, do no harm". A doctor might *refuse* service to a patient for the sake of strongly held convictions, but to deliberately hurt- even kill them- is utterly antithetical to the profession.
"First do no harm" is not even in the oath anymore. Why would it be? We do harm all the time. Also, no one in the medical field takes the oath to be a guideline for medical ethics in any conceivable way. It's purely ceremonial one time and then it's never brought up again. Actual medical ethics are far more complex
Sure, but do they involve purposefully harming a patient because they are a CEO? You may be reducing overall harm to the human population of the state/country/world, but is that a doctor’s choice to make? I wouldn’t think so, but correct me if I’m wrong ;)
People who willingly work for health insurance firms have to be psychotic, the industry comes off worse than the defence firms, as defence knows and will tell you they'll blow up your family instead of hiding behind them wanting to heal people then killing you because it affected the dividends.
Yeah. About 15 months ago I was rushed to the hospital with a stroke. Between my immediate treatment, rehab, and recovery my only interaction with my insurance company was handing them necessary documents concerning my employment so that they would pay my salary (well, 60 percent of it) during the four months of sick leave.
I keep hearing abt united doing this shit and it makes me glad I don't have them. As soon as I was diagnosed with cancer last year, I got a call from a case worker from my insurance company. She was nothing but helpful. There was one hiccup with them that my radiation oncogist solved. I talked to my case manager abt it and she apologized for being on vacation and letting someone else handle it. She even helped me obtain mental therapy for cancer as well. 2 thumbs up for cigna.
Cigna is a nightmare for me and many of my patients. They routinely deny coverage for evaluations for ADHD, autism, and other neurodevelopmental conditions.
They denied coverage for psoriasis meds (skyrizi) for me. They said I needed to go through the cream treatment (4 different creams) which I already did and they had record of it but it didn't work. They have a mental health arm as well, but prefer you go through them instead of other therapists. I really do not like that at all. I'm going to try again for an adhd diagnosis tho. (I was diagnosed as a kid but didn't take meds for it.)
We were switched to UHC on January 1. I lost my shit looking up my doctors and medications. My husband got an earful about it. Note: I wasn't yelling at him. I was raging against corporate greed and shit companies like UHC.
I am so glad you had so much help through Cigna. That's the one insurance company I have not wanted to completely torch.
I have Cigna too, and it seems like one of the lesser of many evils. I only had to get one letter of recommendation for my bottom surgery instead of the three that some other companies require. So there's that, I guess.
How is that dude gonna call a surgeon, DURING SURGERY to inquire about information that the company, HE WORKS FOR, has? Like she told him the justification yet he said that was a different department. Wouldn’t you call that department first? wtf?
Same here, I can't believe a "shithole third world country" like Argentina has this under control despite chronic inflation and general unrest, yet we continue paying our dues and keep that plan B since just having two kids in the US cost more than a very nice brand new car. We took out a higher level of Underinsured Driver insurance because with the pavement princess lifted trucks that have less visibility than actual tanks could paint the road with us as pedestrians/cyclists and bankrupt us.
Yup, Luigi was right. Insurance companies make profit by denying, delaying coverage and killing its own clients so they don’t have to pay for care. Insurance companies are profiting off the middle class by killing us. The media is controlled by millionaires who care more about one dead murderous millionaires than 700 dead middle class school children in America and 200k dead unarmed poor civilians in Gaza. Fuck Insurance companies, fuck the media, fuck the millionaires/ billionaires. Free Luigi
Holy shit, this is the hospital I work at! And I work with this surgeon and her post-op patients on my floor! I had no idea she was on social media. She's a wonderful person.
I save money every month by NOT having insurance. I have multiple chronic illnesses and take a ton of meds. They are CHEAPER without insurance and my doctor can prescribe the exact meds she wants, not what the insurance company dictates. I see my doctor twice a year. Costs me $150 each time. Meds went from $350/month OOP down to $135/month when I dropped my insurance. Yes, if I get hit by a bus or get cancer I'm fucked, but I was fucked paying $1000/mo when I had insurance anyway.
So, it's not the same in every state, but here in Illinois they established precedent that uninsured motorist coverage applies if you get hit as a pedestrian or cyclist, so there's people without cars taking out auto insurance just to protect them from the asshats that drive like they're in a videogame. Our Allstate agent said they've been working on making a plan specifically for defense against drivers for non-drivers. What a fucking country. https://www.youtube.com/watch?v=c6V88KIIe20
To me this sounds so crazy. But someone on here mentioned the name of his quite expensive medication and after insurance he still had to pay (copay?) almost 900 dollars a month for it. My mom has the same medication and the insurance bill (payed for in total by the insurance of course, because we don't live in the US) states the exact same medication, same brand (and same standard amount) costs 477 euros every 4 weeks. It's mindblowing.
Bill them for the call and interupting her, also tell the patient, they can maybe bring up a lawsuit for distress during an important medical treatment that was approved ??
If you want things to change start killing more CEO's. Also politicians that enable the CEO's. I through pretending that things can be changed without violence.
I have seen this remarkable statement a lot in the past weeks, but so far nothing (except for Luigi who did go through with it). I guess all these internetassassins are expecting óther people to do it.
Blue cross denied my inpatient sleep apnea test because I didn’t have “pulmonary issues or heart disease”. I had 100% blockage and 3 stents last January. For this I pay $700 a month and $8950 deductible. #Luigi
I got them back. My appt to p-up the cpap machine was mid Jan. I called the med supply company and said I needed it by the Dec. 31st or I’d go elsewhere. Picked it up on Dec 27th. 4 days shy of my deductible resetting so $0 for me. Fck ‘em. 😉
My mom's is broken, she has to have it sent off to be repaired and they're backed up...they will RENT her one of theirs in the mean time (prolly out of pocket) to the tune of 6-8weeks. Monopoly much?
Ah I understand the dance now, poor man was left to wander the parking lot after his spine surgery was interrupted mid operation by a healthcare company. Now this is America!
Some completely ass backwards hell hole where nobody sane would want to be I'm guessing. Somewhere really horrible, where the people are treated like they're worse than shit in the name of corpo profits. An absolute shit hole of a country where they're so brain washed they think their utter dogshit life is the norm, or worse "the best". Probably some piss poor place where children get shot on a regular basis... Y'know, one of those places...
To pretend we live in anything other than a shitty failed system that throws poors into the grinder is just plain silly. Unless you’re a bona fide genius, an exceptional athlete, or you want to sacrifice all the good things about life to work work work, you’re fucked.
And we have the most wealth… lol America #1 amirite?… guys?… (hand still held up in hi-five position)
We are about to Annex Canada and Greenland, our Putin puppet is about to fucking destroy SO goddamn much of our country, AND half the country is willing to follow him into the fire because "A trans person was on a beer can!!"
Healthcare is just the appetizer for this shit sandwich we call the U.S.
The Woman IS DYING of breast cancer. Why dont the insurance adjuster from United profit care. just do what ever is MORE PROFITABLE, and join the Dawwin awards. somehow, preferable in some way that vaporizes the usless corpse of a soul-less devil, other wise known as the surgurey intruppter.
Surgeon here and I would tell them to fuck right off to whatever hole they crawled out of. Anesthesia is not without risks and unnecessarily increasing those risks by prolonging surgery time is unacceptable.
Why did she leave the surgery to answer a phone!!? The moment she realized it was an insurance company on the other end, she should have stated her inflated hourly rate of $10000 per hour for private, emergency, uninsured, life threatening (by diverting her attention from her patient) telephone consultation. $166/minute
Providers have to sort of play ball. If they don't, they'll lose their ability to bill under that insurance and lose a decent chunk of caseload unless they can manage a private pay practice
'MURICA! We need to maximize profits and pay them shareholders! And if the only way that happens is some people (*cough, women and pools, cough, cough*) have to suffer then so be it. Its a small price to pay to live in the best, wealthiest country in the world! YEHAW! /S
It truly is. All business will be like this now. People worship and want to emulate a man who’s a crook. People think he’s a genius because he cuts corners, rips people off, and exploits loopholes. This is America.
Right. I'm all for jumping on the 'insurance is a fucking scam' train but in this instance, this dude is way out of line for thinking he has clout or reason to interrupt a doctor in surgery. Fucking stupidity abound, but not necessarily a good example of 'insurance bad'. If anything someone needs to put a complaint against that particular person. The practice overall shouldn't exist either, obviously, but it being exercised here was the really stupid choice.
the fact that the guy calling doesn't know, and that "it's a different department of UH that WOULD know, therefore I have to call the SURGEON rather than find someone in my job that *does* know the answer." is VERY telling of how shit Healthcare here is.
The person calling knows. They're hoping the surgeon will say a diagnosis that can be more easily denied than what they already have on file. "Oh, she has breast cancer? Sorry, she'd only be covered if she had breast cancer stage III with sequelae"
The person making the decision may be a totally different person than the person calling. They probably gave a group of employees a liat of cases to call doctors on only to send that information through some sort of CRM system to a person who decides what to do, who doesn't interact with the doctor or patient. If it's even a human making the decision at all and not an AI system.
I think it's on the individual here. I communicate with other departments in my company. It's not hard. I think it's more indicative of a failed education system and brain rot from poor diet and health. Have you seen the latest PIAAC results? It tests the competency in literacy, numeracy, and problem solving using a sample size representative of the adult population in countries that participate. The US resulrs are nothing short of depressing.
1/2 I've been through this with blue cross blue shield: "Our pharmaceutical dept and our procedure dept are co pletely separate and we don't communicate." Me: Um...youll pay over $400 for a single procedure but not cover the drugs that would let me do the procedure at home 5x for under $200? BCBS: "I have no control of what is covered" Me: my copay is $120 per procedure, and I can get enough for 5 treatments for under $200. But you won't cover the drugs, do you see how this hurts us both?"
Not necessarily. The insurance company wants every reason to deny claims. So why not put up obstacles like mucking up interdepartmental communications?
Banking on people's laziness but the people are still lazy. I have to hunt for contacts sometimes, too. But I have fielded enough questions to know some people would like to be spoon-fed answers rather than make an effort to try and figure it out for themselves first.
Completely by design, like every other corporation the most important part of running that corporation is making money for the shareholders. Just like hiding how to cancel a subscription can be tedious and hidden. ( I know the law just changed to fix that) if only healthcare was as popular as streaming.
This is all going to get worse unless we all band together and do something about it. Now that HMOs have decided it's a-ok to STOP PAYING FOR ANAESTHETIC IN MID-SURGERY every patient is going to be checked up on during their procedures. It's literally insane.
To be faaaaaaaiiiiir ... Anthem/Blue Cross did walk that back after the UHC guy was executed. But, it's only a matter of time before they try again. It won't get better over the next 4 years either.
They walked it back so you would type this, then they will do it again and someone will google it and see people respond and not look when it was posted. At this point they know the Internet better than we give them credit and use us against us, same as it ever was.
Murdered*. No matter how fucked up our system is, and how badly it needs to be changed, it is inescapably true that what happened to that guy was murder.
And the reason I say it is that more murders won’t fix anything, just like that murder didn’t fix anything. What needs to happen is systemic change through organizing and hard, thankless work. Not more vigilantism.
I think the French Revolution (not mention our own American Revolution) might take issue with that stance. Historically speaking, “murder” has been very effective at implementing societal change.
I really don't think you - or anyone - can say yet what the effects of that incident will be. Whether it fizzles to nothing or sparks a movement (violent or not), Mangione's alleged actions sent a very clear message.
Criminal charges don't work. The fines are so small, they don't even notice it. The judges let them off. Everything is rigged. The only thing we can do now is get another Luigi to make it right. Fucking team Luigi all the way. Go luigi! We fucking love you, man.
The UH employee *probably* didn't know she was mid operation, but the spineless admin in the hospital that called the OR to tell her to stop and take the call absolutely did.
That admin was apparently experiencing full-on, not-quite-paralysing-but-brain-freezing terror. That UH would have to - gasp! - actually pay for the surgery. Common, these days.
Hell, UH should be investigated for making the employee have to call in the first place. Why does a separate department have the relevant info? Why can't that employee access that info? Why are there two separate departments? I know inefficiency isn't illegal, but that level of it feels like it should be. Unless HIPA is way too strict.
You say this, but this is how they lose benefits and then have to fight for coverage after the surgery. The doctor stepped out because she knows the stress of the $200k hospital bill would also cause harm to her patient.
The entire point of getting surgical pre-approval is that since 2022 the 'no surprises act' protects the patient from encountering coverage gaps that cause those insane billing rates. In short, once a procedure is approved by insurance, no expenses related to that procedure can be billed at an out of network rate - meaning the worst case scenario, even with a dozen complications & unforseen issues, the patients maximum financial liability is their insurance's out of pocket maximum limit
Though it seems like common sense that communication between a surgeon and anyone outside the hospital should go through admin or an assistant so I still think blame can be put on the health insurance person for even asking to speak directly to the surgeon.
That'd just mean the admin would be a glorified switchboard for letting outside entities bother the hospital's workers, when the whole point of admin is to ensure that workers can focus on their actual job. So no, that's not what they should be saying, and the insurance company shouldn't have asked for anything that'd elicit such an answer either. They should've asked for the information they wanted without requesting the surgeon, admin should say *they*, not the surgeon, will be calling back.
Yes that *should* be what happens, but unfortunately having worked in medical insurance (got out years ago thank god) they hold the cards right now, and everyone has to dance to their tune. It's a deeply corrupt system, and I was entirely unsurprised watching this video. Prior authorization is a nightmarish concept which doesn't need to exist (like medical insurance)
You say this, but this is how they lose benefits and then have to fight for coverage after the surgery. The doctor stepped out because she knows the stress of the $200k hospital bill would also cause harm to her patient.
And whichever supervisor who told him to make that call didn't give a shit about that last part, bc all they saw was '$200k we might not have to spend'.
The employees supervisor should. That person was just likely doing what they were told, and of they didn't would have been risking their own job and livelihood. And I know it's easy to go on the internet and say, "Then find a new job," but even in the best cases, in areas with a strong job market, that can take months or years. And that also doesn't mean you'll find something comparable.
Oh, absolutely FUBARA, they're just pointing out that folk are often much too eager to throw blame at the lowest rank employee involved without stopping to consider how little involvement they had in it.
I wonder if you'd have the same mentality if the only employer in your area was a UH facility (or something similar), and you had mouths to feed and bills to pay. It's easy to point fingers and judge when you're not in the situation
Eh, I’ve been unemployed and desperately searching since February - but it’s only money. I’d rather keep living tight (poor) than work at a job where I knew my actions affected people negatively.
I was being sarcastic, I thought “shit show” would be clear enough. Nobody wants to be a part of this shit show, including me. If America invaded Canada I’d prefer to fight for Canada
I mean, I feel like the first half of your life you were just naive. It's not like these factions didn't exist or your cops weren't brutal thugs or whatever. This was always bubbling away in the background. Hell, you didn't even have gay marriage rights back then!
No. First half of my life I went to school with a pocket knife. The FFA kids had rifles in their trucks, disruptive kids got removed from class and Teacher were paid decent. There was no such thing as a DUI random stop to check your papers. You didnt have to take your shoes off to fly. McDonalds was a place to pay as well as get food, in fact there were "3rd places" everywhere. There were things to do outside, there were things to do with little or no money. People could peacefully assemble -
Healthcare was affordable, if still a bit expensive but Insurance worked and was a thing worth having. Jobs paid well - My father was able to own a home and a boat on a Restaurant managers salary. I walked a mile to middle school and nobody thought that was strange. I''m not saying this was a perfect world - but it was better. Noticeably better. Not just some sentimental psychosomatic fantasy.
TheHuntedSnark
The subtitles should read "in-patient stay" .... (ffs)
jwillustrat
getadogupya
The death panels were in the house with you all along...
newsguycraigevans
People have forgotten that when Dems were pushing for big healthcare reform under Obama's first administration, Republicans lied and said the government would get between you and your doctor and that there would be death panels. Insurance companies are already between you and your doctor and they also control the death panels. But people don't want to acknowledge that part because it's easier to believe the Republican lies.
Broken08
Yes! That's the most infuriating part, is all the right wing idiots who were so afraid to change our healthcare laws because of death panels was don't realize that they exist, however they exist for profit.
windsingr
Oh, they knew. They just wanted to profit.
the1truemorty
I have a chronic autoimmune condition. I take some really expensive meds to keep it from disabling me. My insurance pays probably over 10k a month for it.
I deal with a lot of pain everyday because of this. My GP gave me a mild pain killer prescription for the real bad days. My insurance denied filling the script and would only approve 7 days worth without the doctor justifying why I need it. Like WTF. It cost 10 bucks without insurance. It cost them more money denying it than if they paid.
Lepidopterous
Somebody messed up for them to be stopping the surgery to connect the insurance rep to the surgeon mid-procedure. Either the rep misrepresented the urgency or the hospital admin / charge nurse didn’t deny the rep access to the surgeon when they should have.
Regardless, the more upsetting concern here is the patient should have had coverage for the stay in the first place.
Immgoohr
'murica!!!!
stonebreaker6
Deny, defend, DEPOSE
mcsammymc
Luigi has shown us the way
Smidge204
Now I don't want to tell doctors how to do their job, but I'm just saying not all surgeries have good outcomes. Especially for CEOs...
TheMomaw
Absolutely not. "First, do no harm". A doctor might *refuse* service to a patient for the sake of strongly held convictions, but to deliberately hurt- even kill them- is utterly antithetical to the profession.
IHateApostrophes
"First do no harm" is not even in the oath anymore. Why would it be? We do harm all the time. Also, no one in the medical field takes the oath to be a guideline for medical ethics in any conceivable way. It's purely ceremonial one time and then it's never brought up again. Actual medical ethics are far more complex
dracklen
Sure, but do they involve purposefully harming a patient because they are a CEO? You may be reducing overall harm to the human population of the state/country/world, but is that a doctor’s choice to make? I wouldn’t think so, but correct me if I’m wrong ;)
IHateApostrophes
Probably not, but either way the answer to that question won't be determined by a doctor reflecting on the Hippocratic oath.
Snowman25
In Japan, Heart Surgeon. #1. Steady Hand!
Smidge204
PaperinoVB
You mean cranial perforations with high speed lead instruments could have avverse effects on the patients?
ADDGirl
In my 10 years of experience on the trauma floor, if you have that, you're gonna have a bad time. Even if you survive.
getadogupya
RagnarOfBallard
squishybaker
People who willingly work for health insurance firms have to be psychotic, the industry comes off worse than the defence firms, as defence knows and will tell you they'll blow up your family instead of hiding behind them wanting to heal people then killing you because it affected the dividends.
Lowland
Man I feel deeply for american citizens who have to live with this unethical praxis
NelsyBohecan
Don't. They literally want this. They had an opportunity and instead voted for this.
TsunamiJohn
I'm having bank accounts drained by collection agencies because of an ER visit from four years ago
knupauger
Yeah. About 15 months ago I was rushed to the hospital with a stroke. Between my immediate treatment, rehab, and recovery my only interaction with my insurance company was handing them necessary documents concerning my employment so that they would pay my salary (well, 60 percent of it) during the four months of sick leave.
ASERIOUSGOOSE
I solved my insurance issue by not being able to afford insurance.
SkamanSam
I keep hearing abt united doing this shit and it makes me glad I don't have them. As soon as I was diagnosed with cancer last year, I got a call from a case worker from my insurance company. She was nothing but helpful. There was one hiccup with them that my radiation oncogist solved. I talked to my case manager abt it and she apologized for being on vacation and letting someone else handle it. She even helped me obtain mental therapy for cancer as well. 2 thumbs up for cigna.
GreatOdinsTaint
Cigna is a nightmare for me and many of my patients. They routinely deny coverage for evaluations for ADHD, autism, and other neurodevelopmental conditions.
SkamanSam
They denied coverage for psoriasis meds (skyrizi) for me. They said I needed to go through the cream treatment (4 different creams) which I already did and they had record of it but it didn't work. They have a mental health arm as well, but prefer you go through them instead of other therapists. I really do not like that at all. I'm going to try again for an adhd diagnosis tho. (I was diagnosed as a kid but didn't take meds for it.)
Emiloo74
We were switched to UHC on January 1. I lost my shit looking up my doctors and medications. My husband got an earful about it. Note: I wasn't yelling at him. I was raging against corporate greed and shit companies like UHC.
I am so glad you had so much help through Cigna. That's the one insurance company I have not wanted to completely torch.
I hope you are doing well!
SkamanSam
Thank you! There have been issues with several insurance companies in my life, but cigna has definitely had less.
ArchonIlladrya
I have Cigna too, and it seems like one of the lesser of many evils. I only had to get one letter of recommendation for my bottom surgery instead of the three that some other companies require. So there's that, I guess.
JiffyGee
How is that dude gonna call a surgeon, DURING SURGERY to inquire about information that the company, HE WORKS FOR, has? Like she told him the justification yet he said that was a different department. Wouldn’t you call that department first? wtf?
baronvonpoo
I hope patients, doctors, and nurses continue to bring these things out into the open.
dbox
How is taking a call in surgery even a thing?
laserfork
In the OR you have a circulating nurse who isn't scrubbed in who can put the phone on speaker for you.
Canofminus
This is why I've asked my wife to keep her and my son's Japanese citizenship. A severe medical diagnosis would 100% bankrupt us here in the US.
mixiekins
Same here, I can't believe a "shithole third world country" like Argentina has this under control despite chronic inflation and general unrest, yet we continue paying our dues and keep that plan B since just having two kids in the US cost more than a very nice brand new car. We took out a higher level of Underinsured Driver insurance because with the pavement princess lifted trucks that have less visibility than actual tanks could paint the road with us as pedestrians/cyclists and bankrupt us.
fluffybaer55
Yup, Luigi was right. Insurance companies make profit by denying, delaying coverage and killing its own clients so they don’t have to pay for care. Insurance companies are profiting off the middle class by killing us. The media is controlled by millionaires who care more about one dead murderous millionaires than 700 dead middle class school children in America and 200k dead unarmed poor civilians in Gaza. Fuck Insurance companies, fuck the media, fuck the millionaires/ billionaires. Free Luigi
darkchiron
Hey insurance companies, how about whatever the doctor says is medically necessary is necessary and we just leave it at that?
baraseth
Holy shit, this is the hospital I work at! And I work with this surgeon and her post-op patients on my floor! I had no idea she was on social media. She's a wonderful person.
mixiekins
Please thank her on our behalf for keeping up the good fight!
mixiekins
Er, and thanks for you as well, naturally!
Kablooeeey
I save money every month by NOT having insurance. I have multiple chronic illnesses and take a ton of meds. They are CHEAPER without insurance and my doctor can prescribe the exact meds she wants, not what the insurance company dictates. I see my doctor twice a year. Costs me $150 each time. Meds went from $350/month OOP down to $135/month when I dropped my insurance. Yes, if I get hit by a bus or get cancer I'm fucked, but I was fucked paying $1000/mo when I had insurance anyway.
mixiekins
So, it's not the same in every state, but here in Illinois they established precedent that uninsured motorist coverage applies if you get hit as a pedestrian or cyclist, so there's people without cars taking out auto insurance just to protect them from the asshats that drive like they're in a videogame. Our Allstate agent said they've been working on making a plan specifically for defense against drivers for non-drivers. What a fucking country. https://www.youtube.com/watch?v=c6V88KIIe20
TechnicolorCheeseWedge
Can you have insurance, but just not bill to it for your chronic illnesses? That way you're not fucked if you get cancer
iusedtodream
Um, no, cuz still have to pay $400-2000 per month for that insurance.
Letstriptogether
To me this sounds so crazy. But someone on here mentioned the name of his quite expensive medication and after insurance he still had to pay (copay?) almost 900 dollars a month for it. My mom has the same medication and the insurance bill (payed for in total by the insurance of course, because we don't live in the US) states the exact same medication, same brand (and same standard amount) costs 477 euros every 4 weeks. It's mindblowing.
DontcallmeLen
KarlaAnne
Wow. Really seems like UHC learned their lesson, huh? 😠
Koldfront
Did they not get the fucking message??
SouYuck
Bill them for the call and interupting her, also tell the patient, they can maybe bring up a lawsuit for distress during an important medical treatment that was approved ??
ExplodingPortaPotty
If you want things to change start killing more CEO's. Also politicians that enable the CEO's. I through pretending that things can be changed without violence.
Letstriptogether
I have seen this remarkable statement a lot in the past weeks, but so far nothing (except for Luigi who did go through with it). I guess all these internetassassins are expecting óther people to do it.
Arkkeri
Ye, ppl that do violent stuff choose easier targets, like schools n daycares and don't hang in a site like this much..
IdiotSavantTinker
We tried non violence and we got violence in return. Only one thing left now.
Lepidopterous
Take a nap?
MostLikelyNotWearingPants
Blue cross denied my inpatient sleep apnea test because I didn’t have “pulmonary issues or heart disease”. I had 100% blockage and 3 stents last January. For this I pay $700 a month and $8950 deductible. #Luigi
Everyonesfavorite
Don't stop, appeal that bullshit
MostLikelyNotWearingPants
I got them back. My appt to p-up the cpap machine was mid Jan. I called the med supply company and said I needed it by the Dec. 31st or I’d go elsewhere. Picked it up on Dec 27th. 4 days shy of my deductible resetting so $0 for me. Fck ‘em. 😉
Everyonesfavorite
My mom's is broken, she has to have it sent off to be repaired and they're backed up...they will RENT her one of theirs in the mean time (prolly out of pocket) to the tune of 6-8weeks. Monopoly much?
TheJackKetch
In what sort of dystopian country is it ok to interrupt a surgeon in theatre?
arocktrucker777
The United States of America
johnvictor
The United States of America.
Leithoa
laDisparitionDesHeures
Ah I understand the dance now, poor man was left to wander the parking lot after his spine surgery was interrupted mid operation by a healthcare company. Now this is America!
crlast86
sethb1978
The United States of course. Make America England Again!!!
SquashDemon
The United States of America.
SomeFukinWizard
United Snakes of Amerika. Land of the Thief home of the slave.
OookOookOookMotherFudger
Some completely ass backwards hell hole where nobody sane would want to be I'm guessing. Somewhere really horrible, where the people are treated like they're worse than shit in the name of corpo profits. An absolute shit hole of a country where they're so brain washed they think their utter dogshit life is the norm, or worse "the best". Probably some piss poor place where children get shot on a regular basis... Y'know, one of those places...
Salpinus
The USA?
pastramionrye
Dude. The US.
To pretend we live in anything other than a shitty failed system that throws poors into the grinder is just plain silly. Unless you’re a bona fide genius, an exceptional athlete, or you want to sacrifice all the good things about life to work work work, you’re fucked.
And we have the most wealth… lol America #1 amirite?… guys?… (hand still held up in hi-five position)
TheJackKetch
I mean, i was asking in a kind of ironic way, because the answer was obvious,,,
MotherEffinSatan
We are about to Annex Canada and Greenland, our Putin puppet is about to fucking destroy SO goddamn much of our country, AND half the country is willing to follow him into the fire because "A trans person was on a beer can!!"
Healthcare is just the appetizer for this shit sandwich we call the U.S.
ArthurT
The Woman IS DYING of breast cancer. Why dont the insurance adjuster from United profit care. just do what ever is MORE PROFITABLE, and join the Dawwin awards. somehow, preferable in some way that vaporizes the usless corpse of a soul-less devil, other wise known as the surgurey intruppter.
IxnayOnTheOttenRay
aThingWithAKeyboard
None of it is ok. US medical is probably the best example of rampant late stage capitalism.
SecondSince
USA! USA! USA!
hobbitdoc
Surgeon here and I would tell them to fuck right off to whatever hole they crawled out of. Anesthesia is not without risks and unnecessarily increasing those risks by prolonging surgery time is unacceptable.
mcfedr
Right, which admin person didn't just tell them to piss off
mbiella
Errr... USA?
5m4llP0X
More CEOs need to die. This is unacceptable.
uberstyle
Yeah it seems to be making a big difference at UNH, doesn't it?
notadiddler69
Annual tradition could help. Sometimes at random real short ones like mercury or something
5m4llP0X
Maybe a few more need to die before they get the hint.
floatingPoi
So it needs to continue until it does. It’s not rocket science.
Arfulblastskat
Why did she leave the surgery to answer a phone!!? The moment she realized it was an insurance company on the other end, she should have stated her inflated hourly rate of $10000 per hour for private, emergency, uninsured, life threatening (by diverting her attention from her patient) telephone consultation. $166/minute
Mairoa
Providers have to sort of play ball. If they don't, they'll lose their ability to bill under that insurance and lose a decent chunk of caseload unless they can manage a private pay practice
Rpgjgb
'MURICA! We need to maximize profits and pay them shareholders! And if the only way that happens is some people (*cough, women and pools, cough, cough*) have to suffer then so be it. Its a small price to pay to live in the best, wealthiest country in the world! YEHAW! /S
cryptonat
Profit over people is now the American theme.
SpiralRazor
Lol "now"
Like it was ever different
BluePeaSoup
It truly is. All business will be like this now. People worship and want to emulate a man who’s a crook. People think he’s a genius because he cuts corners, rips people off, and exploits loopholes. This is America.
MundySeme
SecondSince
Now? It's been that way for long time. It's just more brazenly in the open.
Littledirtybirdyfeet
Not just interrupt, but to ask inane questions that they could have found the answer to themselves if they had any initiative or a functioning brain.
ebonyfaery
That's a different department.
Littledirtybirdyfeet
AnonsAndMinions
Right. I'm all for jumping on the 'insurance is a fucking scam' train but in this instance, this dude is way out of line for thinking he has clout or reason to interrupt a doctor in surgery. Fucking stupidity abound, but not necessarily a good example of 'insurance bad'. If anything someone needs to put a complaint against that particular person. The practice overall shouldn't exist either, obviously, but it being exercised here was the really stupid choice.
admiralawesome4213
the fact that the guy calling doesn't know, and that "it's a different department of UH that WOULD know, therefore I have to call the SURGEON rather than find someone in my job that *does* know the answer." is VERY telling of how shit Healthcare here is.
IHateApostrophes
The person calling knows. They're hoping the surgeon will say a diagnosis that can be more easily denied than what they already have on file. "Oh, she has breast cancer? Sorry, she'd only be covered if she had breast cancer stage III with sequelae"
HavelTh3Rock
furthermore, why does the fucking guy in charge of approving or denying claims not have that information?
euphoricopportunity
The person making the decision may be a totally different person than the person calling. They probably gave a group of employees a liat of cases to call doctors on only to send that information through some sort of CRM system to a person who decides what to do, who doesn't interact with the doctor or patient. If it's even a human making the decision at all and not an AI system.
Littledirtybirdyfeet
I think it's on the individual here. I communicate with other departments in my company. It's not hard. I think it's more indicative of a failed education system and brain rot from poor diet and health. Have you seen the latest PIAAC results? It tests the competency in literacy, numeracy, and problem solving using a sample size representative of the adult population in countries that participate. The US resulrs are nothing short of depressing.
Everyonesfavorite
1/2 I've been through this with blue cross blue shield: "Our pharmaceutical dept and our procedure dept are co pletely separate and we don't communicate." Me: Um...youll pay over $400 for a single procedure but not cover the drugs that would let me do the procedure at home 5x for under $200? BCBS: "I have no control of what is covered" Me: my copay is $120 per procedure, and I can get enough for 5 treatments for under $200. But you won't cover the drugs, do you see how this hurts us both?"
Everyonesfavorite
2/2 BCBS: "I understand, is there anything else I can help you with today?"
Ugh!!!!!
decarnatedame
Not necessarily. The insurance company wants every reason to deny claims. So why not put up obstacles like mucking up interdepartmental communications?
Littledirtybirdyfeet
Banking on people's laziness but the people are still lazy. I have to hunt for contacts sometimes, too. But I have fielded enough questions to know some people would like to be spoon-fed answers rather than make an effort to try and figure it out for themselves first.
ihaveanouttie
Completely by design, like every other corporation the most important part of running that corporation is making money for the shareholders. Just like hiding how to cancel a subscription can be tedious and hidden. ( I know the law just changed to fix that) if only healthcare was as popular as streaming.
Moonthatspellsmoon
This is all going to get worse unless we all band together and do something about it. Now that HMOs have decided it's a-ok to STOP PAYING FOR ANAESTHETIC IN MID-SURGERY every patient is going to be checked up on during their procedures. It's literally insane.
CgnCalling
The thing is - they are not checking on the patients, they are checking on the numbers, their payables.
smorsdoeuvres
thatiswhyyoushoulddoityourself
They should pay for the delay of this surgery. The anesthesia would’ve been shorter had they shut the f up.
stonecw
To be faaaaaaaiiiiir ... Anthem/Blue Cross did walk that back after the UHC guy was executed. But, it's only a matter of time before they try again. It won't get better over the next 4 years either.
Anotherwhitedude
They walked it back so you would type this, then they will do it again and someone will google it and see people respond and not look when it was posted. At this point they know the Internet better than we give them credit and use us against us, same as it ever was.
stonecw
You're not wrong.
transference
Murdered*. No matter how fucked up our system is, and how badly it needs to be changed, it is inescapably true that what happened to that guy was murder.
transference
And the reason I say it is that more murders won’t fix anything, just like that murder didn’t fix anything. What needs to happen is systemic change through organizing and hard, thankless work. Not more vigilantism.
stonecw
I think the French Revolution (not mention our own American Revolution) might take issue with that stance. Historically speaking, “murder” has been very effective at implementing societal change.
Moonthatspellsmoon
I really don't think you - or anyone - can say yet what the effects of that incident will be. Whether it fizzles to nothing or sparks a movement (violent or not), Mangione's alleged actions sent a very clear message.
Heavenissize17socks
I feel the UH employee who *interrupted her surgery* needs to be brought up under criminal charges
GiantFlyingLabia
He’ll be promoted for throwing the survival of a non profitable patient into question.
DreadZeppelin
"unnecesary interference in a life-or-death situation (with attempt to worsen it)"
Macwalrus
Reckless endangering
nubblebun
Criminal charges don't work. The fines are so small, they don't even notice it. The judges let them off. Everything is rigged. The only thing we can do now is get another Luigi to make it right. Fucking team Luigi all the way. Go luigi! We fucking love you, man.
Billis75
I'm Mario. I would like to introduce them to my brother.
ActionJohnnie
Billed appropriately
blessedarethecheesemakers
Yea, but what about the shareholders? Won’t someone think about the poor shareholders?! /s
Leithoa
And whomever was involved with creating the system where that is their SOP.
hovelhopper
The UH employee *probably* didn't know she was mid operation, but the spineless admin in the hospital that called the OR to tell her to stop and take the call absolutely did.
FlyingTigerRose
That admin was apparently experiencing full-on, not-quite-paralysing-but-brain-freezing terror. That UH would have to - gasp! - actually pay for the surgery. Common, these days.
DarkDuskBlade
Hell, UH should be investigated for making the employee have to call in the first place. Why does a separate department have the relevant info? Why can't that employee access that info? Why are there two separate departments? I know inefficiency isn't illegal, but that level of it feels like it should be. Unless HIPA is way too strict.
JuxtaposeIsANeatWord
You say this, but this is how they lose benefits and then have to fight for coverage after the surgery. The doctor stepped out because she knows the stress of the $200k hospital bill would also cause harm to her patient.
RobotDorsVenabili
The entire point of getting surgical pre-approval is that since 2022 the 'no surprises act' protects the patient from encountering coverage gaps that cause those insane billing rates. In short, once a procedure is approved by insurance, no expenses related to that procedure can be billed at an out of network rate - meaning the worst case scenario, even with a dozen complications & unforseen issues, the patients maximum financial liability is their insurance's out of pocket maximum limit
JuxtaposeIsANeatWord
Truth! But does this mean they won’t try and deny it and then put the patient through scary hoops? Nope! They can still do all that!
Colopty
Though it seems like common sense that communication between a surgeon and anyone outside the hospital should go through admin or an assistant so I still think blame can be put on the health insurance person for even asking to speak directly to the surgeon.
hovelhopper
All the person answering the phone should have said was, "I'm sorry, she is busy. I'll have her call her as soon as she is available."
Colopty
That'd just mean the admin would be a glorified switchboard for letting outside entities bother the hospital's workers, when the whole point of admin is to ensure that workers can focus on their actual job. So no, that's not what they should be saying, and the insurance company shouldn't have asked for anything that'd elicit such an answer either. They should've asked for the information they wanted without requesting the surgeon, admin should say *they*, not the surgeon, will be calling back.
keraos
Yes that *should* be what happens, but unfortunately having worked in medical insurance (got out years ago thank god) they hold the cards right now, and everyone has to dance to their tune. It's a deeply corrupt system, and I was entirely unsurprised watching this video. Prior authorization is a nightmarish concept which doesn't need to exist (like medical insurance)
JuxtaposeIsANeatWord
You say this, but this is how they lose benefits and then have to fight for coverage after the surgery. The doctor stepped out because she knows the stress of the $200k hospital bill would also cause harm to her patient.
Heavenissize17socks
The surgery was already approved, but I see your point. The insurance companies have leveraged total control over the hospitals.
Rogahar
And whichever supervisor who told him to make that call didn't give a shit about that last part, bc all they saw was '$200k we might not have to spend'.
iputthefiresout
The employees supervisor should. That person was just likely doing what they were told, and of they didn't would have been risking their own job and livelihood. And I know it's easy to go on the internet and say, "Then find a new job," but even in the best cases, in areas with a strong job market, that can take months or years. And that also doesn't mean you'll find something comparable.
jwillustrat
Can’t we all just agree that the entire system is completely fucked?
Rogahar
Oh, absolutely FUBARA, they're just pointing out that folk are often much too eager to throw blame at the lowest rank employee involved without stopping to consider how little involvement they had in it.
[deleted]
[deleted]
iputthefiresout
I wonder if you'd have the same mentality if the only employer in your area was a UH facility (or something similar), and you had mouths to feed and bills to pay. It's easy to point fingers and judge when you're not in the situation
Longbowgun
Found the orphan crushing machine operator.
iputthefiresout
Found the armchair activist
IdiotSavantTinker
Is this the new "I was just following orders"?
benc85
* lines them up and pulls down their blind fold *
Indeed. As. Am. I.
stonecoldstevebuschemi
Welcome to the true future. This is dystopia, the 2025 version.
heerobya
Eh, I’ve been unemployed and desperately searching since February - but it’s only money. I’d rather keep living tight (poor) than work at a job where I knew my actions affected people negatively.
iputthefiresout
I'm not sure how you've managed to be unemployed for a year, but I'm glad you're fortunate enough to survive that. Not everyone can do that.
heerobya
Ask anyone participating in this “strong job market” right now - it’s a shit show
RockKickass
I’m sure Canada wants to be the 51st state of this shit show
Cornchip2000
Please invade us...
RockKickass
I was being sarcastic, I thought “shit show” would be clear enough. Nobody wants to be a part of this shit show, including me. If America invaded Canada I’d prefer to fight for Canada
Cornchip2000
Written as an American
DefinitelyaHumanNotanAlien
Every day I thank my lucky stars that I wasn't born American.
BipedalHumanoidWithSlightlyDifferentNoseRidge
Or in an Oil rich country 'protected' by Murica.
SomeFukinWizard
First half of my life it wasn't like this. They used 9/11 to take away so many rights and it's just cascaded since then.
DefinitelyaHumanNotanAlien
I mean, I feel like the first half of your life you were just naive. It's not like these factions didn't exist or your cops weren't brutal thugs or whatever. This was always bubbling away in the background. Hell, you didn't even have gay marriage rights back then!
SomeFukinWizard
No. First half of my life I went to school with a pocket knife. The FFA kids had rifles in their trucks, disruptive kids got removed from class and Teacher were paid decent. There was no such thing as a DUI random stop to check your papers. You didnt have to take your shoes off to fly. McDonalds was a place to pay as well as get food, in fact there were "3rd places" everywhere. There were things to do outside, there were things to do with little or no money. People could peacefully assemble -
SomeFukinWizard
Healthcare was affordable, if still a bit expensive but Insurance worked and was a thing worth having. Jobs paid well - My father was able to own a home and a boat on a Restaurant managers salary. I walked a mile to middle school and nobody thought that was strange. I''m not saying this was a perfect world - but it was better. Noticeably better. Not just some sentimental psychosomatic fantasy.
Arkkeri
Was better. For ppl like you. But was worse for quite a bunch of ppl, you just didn't know about it.
DefinitelyaHumanNotanAlien
But...I couldn't marry who I wanted and you were all homophobic as fuck.
I'll take now over then any day.