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[-] riskable@programming.dev 95 points 2 weeks ago

What the insurance companies think of as "unnecessary care". Not what the doctors, nurses, or patients consider necessary.

[-] Olgratin_Magmatoe@lemmy.world 67 points 2 weeks ago

Sounds like we need more adjustment.

[-] avidamoeba@lemmy.ca 52 points 2 weeks ago* (last edited 2 weeks ago)

He said a bit more than that:

"We guard against the pressures that exist for unsafe care or for unnecessary care to be delivered in a way which makes the whole system too complex and ultimately unsustainable," Witty said.

He added that employees should "tune out" criticism of the insurance company, saying that it "does not reflect reality."

Witty said the company is going to "continue to make sure that we put patients, consumers, and members first, as we always have done. The mission of this company is truly to make sure that we help the system improve by helping the experience for individuals get better and better."

"There is nobody who did more to try and advance that mission than Brian Thompson. And there are very few people in the history of the U.S. health care industry who had a bigger positive effect on American health care than Brian," Witty said. "We are going to make sure that we not only acknowledge and honor that legacy of Brian, but we'll continue it."

[-] Zahille7@lemmy.world 54 points 2 weeks ago

So they're really lying to themselves too

[-] hypnicjerk@lemmy.world 23 points 2 weeks ago

nobody wants to believe that they're a villain, even mid-moustache twirl

[-] avidamoeba@lemmy.ca 16 points 2 weeks ago* (last edited 2 weeks ago)

Of course they are. You don't just marshall hundreds of thousands of people to harm others for a paycheck if they believe they really are harming others. All corporations I've worked for do this. It's corporate culture building.

[-] motor_spirit@lemmy.world 18 points 2 weeks ago

Even with all of that money, bringing yourself to say all that empty, whack bullshit has to feel very strange and uncomfortable on the heels of such an event. Man should be feelin a lot like Ronald McDonald rn 🤡

[-] codexarcanum@lemmy.dbzer0.com 7 points 2 weeks ago

He added that employees should "tune out" criticism of the insurance company, saying that it "does not reflect reality."

Anytime someone tells you to ignore the advice or criticisms of everyone else but them that is the reddest of flags. Literally abuser behavior.

[-] skygirl@lemmy.world 36 points 2 weeks ago

Nobody goes to get Healthcare just because they 'want it' but don't need it.

No doctor prescribes things that aren't medically necessary.

Health insurance as it exists in the US is a social cancer.

The fact that a licensed doctor has to make a case to an insurance company about what a patient needs is mind boggling to me. Every doctor I've talked to has told me that this is the worst part of their job.

Emergency services should never be privatized. Imagine firefighters having to ask some insurance company to cover the water they need to put your house out.

[-] WolfLink@sh.itjust.works 20 points 2 weeks ago

Imagine firefighters having to ask some insurance company to cover the water they need to put your house out.

It literally used to be like that. Firefighters would refuse to put out the fire if you didn’t have evidence that your fire insurance covered them.

Yeah, I believe the motivation for moving to public fire departments wasn't even a moral decision. Fire from uninsured burning buildings has an extremely high risk of spreading to an insured one, so putting out all fires minimizes risk to paid subscribers.

My takeaway is: The only way to get American systems to care about the poor is if the rich might receive some collateral damage.

https://www.firerescue1.com/fire-products/administration-billing/articles/how-todays-public-fire-departments-were-born-from-private-fire-brigades-M240qcm83TewqNsx/

[-] codexarcanum@lemmy.dbzer0.com 7 points 2 weeks ago* (last edited 2 weeks ago)

This is true of health care too and was a major driving factor behind the ACA. If you (if everyone) goes in for a yearly or twice yearly checkup and health screening, then dangerous conditions like cancer, disease, injury, and so on get caught sooner. The sooner you catch a problem, the easier and cheaper it is to fix.

If you dont get regular screenings, then people find out they have cancer too late, usually after an emergency (an ER visit), when cost of care is very expensive. The ACA made the case that getting everyone more preventative care would reduce overall health costs.

Another factor is that hospitals do help the uninsured, then pass those costs along to the insured. There are so many hidden costs in our system due to cruelty and inefficiency that would go away if we had universal health care. But the key difference is that the current system funnels all the benefits/value (all the money) into the hands of a small number of people, while actually universal healthcare spreads the benefits out over all of society.

[-] bdonvr@thelemmy.club 6 points 2 weeks ago* (last edited 2 weeks ago)

Which makes the price tag of not having free healthcare all that more astronomical.

How many people ignore pain, bumps, growths because they're BARELY getting that rent paid every month? Go to the doctor? Shit if it's a choice between having FOOD AND SHELTER and spending possibly quite a lot to get this funny new mark on your skin looked at guess what people are gonna choose?

I've lived that shit. Fuck I'm living it now. I pretty badly need dental work done and if I keep ignoring it it's probably gonna get badly infected, possibly quite dangerously. But it stopped hurting so bad (probably not a great sign) and everytime I check what my coverage and copays are I check my bank account and say "on maybe in a few months I can think about it"

Private healthcare KILLS. On a massive scale. And it's killing the poor/working class more by a long shot.

[-] Lost_My_Mind@lemmy.world 3 points 2 weeks ago

Oh, didn't you know? People in America get uneeded medical operations all the time! That's what this whole abortion fight has been about. Women all over the country, just loving getting abortions! It doesn't physically and emotionally devistate you at all! They LOVE getting these ticklish abortions!

And for guys? They are quite frankly addicted to getting colonoscopies, and double heart bypass surguries. Have you seen how often men get those? Can't get enough of it! And then there's this other thing they do. It's called an "annual health checkup". Serves no purpose. Makes no sense. It's just a friendly chat with these busy doctors. Just wasting their time!

And kids??? Don't even get me started on kids! It's always headlice this, and chicken pox that! Running snot out of their mouth, and coughing.....

Speaking of coughing! What the hell was that whole Covid-19 trend all about, eh? Just a fad. Just a bunch of people all claiming to be sick.....deny them all I say!

...........ok, all sarcasm aside, it really does feel like this is how our countries insurance claims handlers think. And then sometimes politics gets involved, and the whole thing is just innocent people suffering for some other asshole to buy a yacht. And it's not even the doctors that get the yachts. I'd actually be FINE with a doctor being rich. They're the ones out there who actually help people. No, it's not the doctors who get rich. It's these useless fuckclowns in suits, who deliver no benefit to society whatsoever. Sitting at a desk, in charge of peoples lives, and deciding that operation, or that treatment is just being done for no reason.

Which is why America has cheered on the act of murder. Myself included. Luigi murdered that CEO, and the world is a fractionally better place for him having done that. One of the other companies even just said they're "rethinking" their plan for placing limits on anastesia. So as a direct result of this murder, there other probably thousands of people who will go through surgury, who otherwise would have been in great pain, who now WON'T be. All because this CEO got shot, and these other CEOs are having a cause/effect on rethinking the concept of saving money at the expense of people's suffering.

THIS is why we're cheering Luigi. Yes, he murdered someone. Did it right in broad daylight. Witnesses around. Zero chance to say he didn't do it. And yet the country is BEGGING for jury nullification for Luigi. We WANT to see him set free, without consequence. The CEOs need to learn that these aren't just numbers on a line graph. These are people. These are human beings with physical and emotional feelings that their decisions affect. We empathize with Luigi because we understand he's been affected by this same shit system. We understood it LONG before he was identified. I even posted this comment days ago, before he was identified.

CEOs should take notice before it's too late. Because sometimes you don't get the chance to learn the lessions of cause and effect. Brian Thompson learned no lession. He just got shot, and never even knew who was shooting him or why. And while I'm not specifically advocating for that kind of violence, I am saying it IS the natural logical outcome from the situation these CEOs have created. I will cheer the next shooter, just as I have cheered Luigi. Until these guys learn that people are numbers, and earth is not a playground, I will not feel empathy for the consequences of their actions coming back to bite them. I may never be the one to pull the trigger, but I will openly support those that do.

[-] marron12@lemmy.world 3 points 2 weeks ago

Adding to that: I'd like to see the top dogs at insurance companies go through the same thing they put us through. No MRI or CT scan for you. You get ibuprofen and PT because nothing else is necessary. Maybe in a few years you'll get surgery, when the problem is almost hopelessly bad. You get to shell out 5 or 6 figures for it, and no, you don't get to use your millions. You have as much money as someone who absolutely can't afford it. Oh, and that time off work? Unpaid.

And make them pay for the consequences of their actions. How many people like Wilfredo Engalla have there been and will there be? He had lung cancer, but it was misdiagnosed as colds and allergies for 5 years. When he found that out, he sued Kaiser. They forced him into arbitration and dragged out the case so nothing happened until he died, because they thought they would only have to pay half as much that way. In the end, his family got $150,000 (minus tens of thousands in costs to get that far).

Do that to enough people for enough years, and eventually you find out people have a breaking point. Who would have thought.

[-] spaghettiwestern@sh.itjust.works 32 points 2 weeks ago

When I had United Healthcare my doctor would often perform multiple routine services when I saw him. UHC denied every single claim, saying services performed weren't the purpose of the original appointment. They wouldn't just deny the claim for those services, they denied the claim for the entire visit and it happened almost every time I saw my doctor.

United Healthcare obviously didn't want me to make multiple visits for the same services because that would have cost much more. The crooks running the company were instead pocketing huge unearned profits because they knew few people would appeal their constant denials. Health Net served up other flavors of the same shit.

These companies need to be put out of business permanently.

[-] granolabar@kbin.melroy.org 11 points 2 weeks ago

they knew few people would appeal their constant denials

They have learned over time how people behave and they weaponized it against the working people.

Who fucking time to shuffle paper like that when you got a full time job and/or severely sick.

They use same tactics in other industries too.

[-] BigDaddySlim@lemmy.world 30 points 2 weeks ago

The Adjustments will continue until society improves

[-] rimu@piefed.social 27 points 2 weeks ago* (last edited 2 weeks ago)

I would need to be paid to stay in a hospital a moment longer than necessary. Using a market-based supply & demand framing of healthcare doesn't really make sense because it's a service that nearly everyone who uses it wants to use the minimum possible. It's not candy where people will take as much as they can get. Everyone wants to get well ASAP.

[-] granolabar@kbin.melroy.org 10 points 2 weeks ago

The people currently in charge just make up arguments to support their position. This is just business 101.

They are incapable to operate differently.

System needs to be reformed and they need to be removed.

[-] Lost_My_Mind@lemmy.world 2 points 2 weeks ago

Upvoted because I agree with the actual point you're making.

Now I'm going to nitpick a completely off topic point that doesn't change what you're saying, but maybe we should use a different example.

There have been studies that show kids literally cannot get enough candy/sugar. So much so, that in the 1800s before medicine was understood, they used obscene amounts of sugar for kids as a pain reliever, which actuactually did work to a small extent.

Adults however will NOT eat candy unlimited, as they have a switch in their brain that tells them "Ok, thats enough. Now it's going to start tasting not as good". Eventually they won't even enjoy candy.

So I recomend your last bit of that message should read:

"It’s not candy for kids, or blowjobs/lickjobs for adults, where people will take as much as they can get. Everyone wants to get well ASAP."

[-] BigMacHole@lemm.ee 16 points 2 weeks ago

Good! I was HOPING this Event changed NOTHING even though that's why it Happened in the First Place!

Historically speaking, it's rare that one killing actually causes meaningful change.

Usually, it requires killing a whole bunch of the rich and making them good and scared that they'll be next before they'll give up one ounce of, well, anything.

So don't fret: if things get as bad as they might, there'll be more and maybe improvements will start happening.

[-] ZeroHora@lemmy.ml 16 points 2 weeks ago

Someone calls Mario!

[-] Aatube@kbin.melroy.org 8 points 2 weeks ago

Note that the UnitedHealth Group is UnitedHealthcare's parent company.

[-] Chozo@fedia.io 7 points 2 weeks ago

You mean that a company that treats humans as commodities isn't deeply affected by the death of one person? Wow, who would've guessed?!

These shit-suckers aren't going to change their ways until they're legally required to. Kill all the CEOs you want, but it won't change anything. You have to fix the legislation that allows these ghouls to fester and thrive in the first place.

[-] NastyNative@mander.xyz 6 points 2 weeks ago

Medicare for all… our healthcare system sucks.

[-] Lost_My_Mind@lemmy.world 3 points 2 weeks ago
[-] granolabar@kbin.melroy.org 1 points 2 weeks ago
this post was submitted on 11 Dec 2024
378 points (98.0% liked)

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