The US Healthcare Mass Debate

[Tero]

An old friend was recently laid off after 20+ years. His wife who had only three months ago been declared cancer free has just been told cancer is back.

Even when he was working the expenses were too much. Who knows what they’ll do now.

Of course the company owes him nothing. I’m sure with perfect information, and a perfect account of all things between them, we’d see clearly the scale is balanced, and any feeling otherwise about what may or may not be owed, is just that, a feeling…

I got my company insurance to continue after retiring. It cost the same as obamacare that year. But they were shits about it. They for instance demanded a copy of my marriage certificate to prove my wife was my wife. The same wife they had covered for 18 years already.

[macdoc]

and how much was that per month for the two of you?

[Sean Hayden]

An old friend was recently laid off after 20+ years. His wife who had only three months ago been declared cancer free has just been told cancer is back.

Even when he was working the expenses were too much. Who knows what they’ll do now.

Of course the company owes him nothing. I’m sure with perfect information, and a perfect account of all things between them, we’d see clearly the scale is balanced, and any feeling otherwise about what may or may not be owed, is just that, a feeling…

I got my company insurance to continue after retiring. It cost the same as obamacare that year. But they were shits about it. They for instance demanded a copy of my marriage certificate to prove my wife was my wife. The same wife they had covered for 18 years already.

Insurance is the worst.

[L'Emmerdeur]

The Republicans have a solution.

'New GOP Strategy: Skyrocket the Cost of Health Insurance and Prescription Drugs'

House and Senate Republicans and the Trump campaign are looking to repeal parts of President Joe Biden’s highly-successful Inflation Reduction Act (IRA) and President Barack Obama’s highly-successful Affordable Care Act (ACA), with a sharp focus on the provisions that protect access to health insurance and have lowered health care costs and prescription drug costs for millions of Americans – and will do so even more next year.

Republicans this week have been discussing plans to repeal the protections that require private insurance companies to provide the same coverage, and at the same cost, to people with pre-existing conditions as it does for those without them. They are also looking to repeal the hard-fought right the federal government now has to negotiate prescription drug prices for Medicare.

[L'Emmerdeur]

Can be unhealthy to run the largest for-profit 'health care' insurance company in the world.

'Who is the Citi Bike Assassin Who Killed UnitedHealthcare CEO Brian Thompson?'

The shooter struck on one of the busiest streets in New York. He fired once into the back of his target, the 50-year-old health insurance CEO. And then he cleared a jam in the weapon and fired two more times before escaping on a Citi Bike.

Who is the cyclist assassin now on the run? An aggrieved health insurance policy holder or a cold-blooded hit man? Or will some other motive be revealed?

...

Surveillance footage shows the killer “lying in wait” for five minutes on 54th Street and Avenue of the Americas outside the New York Hilton Midtown, blending into the morning buzz.

Thompson was scheduled to speak at a UnitedHealthCare investor conference in the hotel and his schedule was widely known.

At 6:45 a.m., the assassin struck—shooting Thompson in the back, methodically clearing a gun jam and then firing again. The CEO collapsed, fatally wounded in the back and calf.

...

[The shooter] was last seen in a black hat, black jacket, black ski mask, black pants, black sneakers with white soles and carrying a gray backpack.

[Brian Peacock]

We've all seen enough movies to know this was a professional job. Now we need a cop with a bit of a drink problem, a troubled relationship with his ex and kids, but a good heart and a willingness to break the rules (while avoiding all paperwork) to track down the killer and expose a conspiracy that goes all the way to the top.

[L'Emmerdeur]

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Too many medical professionals and customers making sardonic comments, let's deep six it.

'Moderators Delete Reddit Thread as Doctors Torch Dead UnitedHealthcare CEO'

Doctors in one of the Internet’s top medical communities have turned on the murdered UnitedHealthcare (UHC) CEO Brian Thompson in such brutal fashion that Reddit moderators deleted a thread on the killing.

The moderators of r/medicine closed the thread, posted Wednesday after news broke that Thompson was shot dead outside the New York Hilton hotel in Midtown Manhattan, after it racked up over 500 replies.

The commenters overwhelmingly criticized—and satirized—the insurer’s alleged denial of coverage to sick and dying Americans in order to juice profits.

The top comment, which received hundreds of supporting upvotes from other users, mocked UHC’s notorious track record for refusing to pay out insurance claims and is written as a lengthy, spoof rejection letter from the company.

Addressed to an unnamed applicant—following “a careful review of the claim submitted for emergency services on December 4, 2024″—it informs them they are being rejected for coverage because “you failed to obtain prior authorization before seeking care for the gunshot wound to your chest.”

...

One medical doctor, whose identity the Daily Beast confirmed, commented with sympathy for Thompson’s family and said the killer should be charged with murder, but then wondered about the damage the CEO had done.

“I cannot even guess how many person-years UHC has taken from patients and their families through denials,” they wrote. “It has to be on the order of millions. His death won’t make that better, but it’s hard for me to sympathize when so many people have suffered because of his company.”

...

Under Thompson’s leadership, UHC faced intense criticism for being one of America’s most ruthlessly profit-minded moneymaking healthcare firms.

According to research by ValuePenguin citing in-network claim data, it “is the worst insurance company for paying claims with about one-third of claims denied.”

...

UHC is a subsidiary of UnitedHealth Group, the country’s largest healthcare conglomerate, which made $371 billion in revenue last year, when Thompson’s compensation was $10 million.

[JimC]

https://www.abc.net.au/news/2024-12-07/ ... /104697310

Columbia University professor Anthony Zenkus, in an X post that's been liked more than 100,000 times, wrote: "Today, we mourn the death of United Healthcare CEO Brian Thompson, gunned down … wait, I'm sorry — today we mourn the deaths of the 68,000 Americans who needlessly die each year so that insurance company execs like Brian Thompson can become multimillionaires."

[Sean Hayden]

My friend, who now has Stage 4 breast cancer can't afford the drugs. They are outrageously expensive, as in, you ain't buying these unless you can convince a whole lot of people to help. Of course, it hurts too that after Stage 3 other forms of financial assistance aren't available...

[L'Emmerdeur]

The for-profit medical insurance industry in the US by its nature will chisel on coverage as much as it can get away with. The Democrats could be pushing for single-payer, but they prefer to fecklessly follow the Republicans to the right. We see how that's working out for them.

Meanwhile, Thom Hartmann continues ranting about 'Medicare Advantage' in which the government pays insurance companies to manage health care for the elderly folks who've been gulled by the insurance companies' annual bombardment of television ads.

'The Medicare Advantage Trap: What They Don’t Tell You'

When George W. Bush and congressional Republicans (and a handful of bought-off Democrats) created Medicare Advantage in 2003, it was the fulfillment of half of Bush’s goal of privatizing Social Security and Medicare, dating all the way back to his unsuccessful run for Congress in 1978 and a main theme of his second term in office.

Medicare Advantage is not Medicare. These plans are private health insurance provided by private corporations, who are then reimbursed at a fixed rate by the Medicare trust fund regardless of how much their customers use their insurance. Thus, the more they can screw their customers and us taxpayers by withholding healthcare payments, the more money they make.

With real Medicare, if your doctor says you need a test, procedure, scan, or any other medical intervention you simply get it done and real Medicare pays the bill. No muss, no fuss, no permission needed. Real Medicare always pays, and if they think something’s not kosher, they follow up after the payment’s been made so as not to slow down the delivery of your healthcare.

With Medicare Advantage, however, you’re subject to “pre-clearance,” meaning that the insurance company inserts itself between you and your doctor: You can’t get the medical help you need until or unless the insurance company pre-clears you for payment.

These companies thus make much of their billions in profit by routinely denying claims — 1.5 million, or 18 percent of all claims, were turned down in one year alone — leaving Advantage policy holders with the horrible choice of not getting the tests or procedures they need or paying for them out-of-pocket.

Given this, you’d think that most people would stay as far away from these private Medicare Advantage plans as they could. But Congress also authorized these plans to compete unfairly with real Medicare by offering things real Medicare can’t (yet). These include free or discounted dental, hearing, eyeglasses, gym memberships, groceries, rides to the doctor, and even cash rebates.

You and I pay for those freebies, but that’s only half of the horror story.

[macdoc]

[Tero]

I'm curious but I think I know the answer. We are a litigious country. Doctors are in fact carrying malparactice insurance. Why can't you sue the insurance companies for malpractice? They are deciding care.

[JimC]

They have the enormous power of their wealth and political influence, and can hire legions of lawyers...

[Tero]

Yes but if it is a sure case, a lawyer will take up the case and collect 2 million of the 3 million you would get.

[L'Emmerdeur]

I'm curious but I think I know the answer. We are a litigious country. Doctors are in fact carrying malparactice insurance. Why can't you sue the insurance companies for malpractice? They are deciding care.

You can, but there are many hoops to be jumped through.

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Meanwhile, a sensible answer to a question from the 'government efficiency' galaxy brain. Is he likely to listen?

'Jayapal, Sanders Offer Answer to Elon Musk's Healthcare Cost Question'

Two of the United States' most outspoken critics of the for-profit health system welcomed billionaire entrepreneur Elon Musk's criticism of the country's sky-high healthcare spending—and suggested that Musk, a potential Cabinet member in the incoming Trump administration, join the call for Medicare for All.

A social media post by Musk drew the attention of Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.), who reintroduced legislation to expand Medicare coverage to every American last year and have long called for the for-profit healthcare system to be replaced by a government-run program, or single-payer system, like those in every other wealthy country in the world.

"Shouldn't the American people be getting getting their money's worth?" asked Musk, posting a graph from the nonpartisan Peter G. Peterson Foundation that showed how per capita administrative healthcare costs in the U.S. reached $1,055 in 2020—hundreds of dollars more than countries including Germany, Canada, and the United Kingdom.

"Yes," said Sanders, repeating statistics he has frequently shared while condemning the country's $4.5 trillion health system in which private, for-profit health insurance companies increasingly refuse to pay for healthcare services and Americans pay an average of $1,142 in out-of-pocket expenses each year.

"We waste hundreds of billions a year on healthcare administrative expenses that make insurance CEOs and wealthy stockholders incredibly rich while 85 million Americans go uninsured or underinsured," the senator added. "Healthcare is a human right. We need Medicare for All."

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National Nurses United, which advocates for a government-run healthcare system, urged Musk and others who support the broadly popular proposal to "join the movement to win Medicare for All."

"The most efficiently run healthcare systems in the world," said the group, "have been proven time and time again to be single-payer systems."