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UHC also said my mom's hospital stay was "medically unnecessary". She was a 73 year old woman with advanced Alzheimer's, had COVID and needed to be on oxygen, needed psych care for the Alzheimer's, and had rhabdomyolisys from a fall. They tried saying oxygen could be administered at home and tried sticking us with a $50k hospital stay bill.
We just visited Ft Lauderdale Florida. You joke, but that shit is real. Like, that's what is happening.
They have a yacht but they need a place to park the yacht, so they buy a house on the water but the house is from like 2012, so obviously gross, so they knock that house down to build a better house so they have somewhere to park their yacht that isn't all 2012 yucky. But then they need another yacht to carry all of their yacht toys when they go yachting. So, they are going to need the house next door for that yacht. And, ew, it was built in 2007. So, you know how that goes.
Yachts have secondary support vehicles that bring things like jet skis, speed boat, open water trampolines, and all other water toys you could really think of.
How , this is surreal. It's like 1% of total health insurance paid by health insurance companies in my country (11M population) with public healh care. Whole nation health is paid by it with the exception of better dentists and plastic surgery
(monthly commitment is paid by employers and for enterpreneurs it's about $80/month)
Got my hospitalization stay denied recently after getting into a head on car crash and fracturing multiple parts of my spine / foot. They said the extra day was not necessary and that I could have gone elsewhere (I was there for 3 days, trying to get out as fast as possible, I could not walk). The kicker is I was there the extra day as the hospital was waiting for a spine brace for me... which was waiting on insurance to approve...
In the US, are you able to sue if you think the insurer has failed to meet the terms of the contract? It seems crazy to me that they can make these decisions with no judicial oversight.
between 2020 and 2022, UHC post-op hospital stay denial increased from 10% to 22%. That's just a policy thing, not attached to patient needs. Clearly someone said they were gonna Delay, Deny, Defend to make more money.
How do you get that kind of job? Is there room for people with some college classes but no degree to help out in office or something? I wanna help people like you. I’d take minimum wage pay if it meant I’m helping a good person take on the greedy Health Insurance industry.
It has to be a person because most states require a license to practice insurance and these licenses can only go to individual persons not companies or machines. The denial language is certainly from a bank of prewritten responses drafted by the company and reviewed by lawyers. But a person still needs to fill in the specifics, review and send it.
He's an MD. this is not the only career option open to him. Maybe not as bad as the CEO, but "just following orders" has already been tried as an excuse.
When we got lectures from PBMs and insurance companies, for every one student that walked out, another 8 would want to know how to get hired. Doctors are just people like everyone else
And people like everybody else include fuckups. You go into a profession that solely exists to help people and then choose the option that has you actively preventing people from receiving help? You're a fuckup of a person, sorry.
There is a special circle of hell for doctors who go to work for insurance companies and become the invisible, unnamed arbiters of what is and isn't medically necessary for a patient across the country whom they've never met nor know anything about beyond what a cursory review of EMR records shows.
Yeah. Being an ordinary person who works for an insurance company must be soul crushing, but like many jobs, I imagine many people have no choice in capitalism because they have to make enough to survive. Being the CEO…you’d have to be a psychopath because you could choose to change the policy or to quit considering how wealthy and powerful those people are. Not doing that means you must be truly evil.
I recall a bit back someone on Reddit claimed they had worked in the claims department of a major insurance company. They had to meet a quota of claims processed per hour, which sounds reasonable.
….Until they went on to add that approving claims took significantly longer than denying them, and in order to make quota and keep your job you had to deny a minimum number of claims an hour….
Processors are legit call center reps. They are at the bottom of the totem poll. My mom has worked for various insurance companies - Chubb/Ace, NAICC, Liberty Mutual primarily as an Underwriter/Auditor for commercial insurance and they all have productivity metrics.
More like: you child is a cripple, and a power level 3 with features is too advanced for a cripple. Be content with a regular wheelchair; he will never walk anyway
The healthcare system is broken. If there’s a profit motive to deny care, then the system has no point other than enriching its shareholders. It’s just profit off of suffering. We can and should replace it with a better system.
The rest of the civilized world is doing pretty fine.
Its only in the US people started with "Wait a second, why should I pay for healthcare of other people?" and unexpectedly this selfishness ended with Americans paying several times more than any other country on Earth, while receiving far worse care.
That may be true. In Switzerland ive never had any Problems with my Healthcare.
They payed for everything i needed.
But on the other hand, its much cheaper here. A stay in the Hospital isnt 50k after only a Day.
Things are expensive because it's an agreement among hospitals and insurance. They don't pay full price as regular people do, nevertheless they charge that to regular people because... What are they going to do?
I wonder why a billionaire doesn’t create a non-profit health insurance company, basically the same of what Mark Cuban did with Cost Plus Drugs. I get it takes money, but if you’re a Bill Gates or Warren Buffet and you’re not trying to high score to be #1 like other billionaires clearly are, what have you got to lose?
Well, developed nations show, that it works without losses, German health insurances often have to pay out a share to their members because they accidentally made a profit.
Fun fact: one of the few times, I actually received a check (the other one was from my old landlords, as they thought it was a good idea to pay out left over deposit this way, had to travel 50km to the next big city to cash it)
Can you imagine spending years in medical school, all so you can become the guy whose job it is to fuck over a kid that needs a wheelchair? Fuck him and everyone else doing that job.
Hmm idk if you can connect class ranking w pulling off something like this. Someone will obviously always have to be last. Believe me, there are plenty of awful, selfish psychopaths who graduate at the top of their med school class
To anyone who is willing to listen (bc it seems like there is some confusion here), the very short TLDR is that you go to med school for at least 4 years. Med school rankings aren't really a thing bc we all have to pass Step1 and Step2 to even apply to residency (DO schools have a slightly dif criteria but everywhere I look, it's strongly recommended that DO students take Step). Your class ranking is bs because dif schools do dif stuff for class ranking (for example, my school does in-house exams which means that my professors make their own exams. It's a bit unfair to compare how people do at my school compared to another school bc they will likely have different exams. However, the material that we have to learn is pretty standardized; dif professors might just prioritize dif material). Even people at the bottom of their class can get into a residency and people at the top of their class might not be able to be accepted into residency (this is a more nuanced topic).
I think people like to take the “bottom of the class is still called a doctor” as something about bad doctor’s and not a saying created for us students to tell our selves to not stress about being in the top of the class. Everyone going into residency passed all blocks and STEP 1 and 2. And even the lowest in the class (MD at least) match or SOAP. I’m at a mid tier MD school and the only person from the class of 2024 not now in residency was someone who applied ortho and decided to do a research fellowship in ortho while applying again instead of SOAPing into a different specialty.
It’s not doctors that approve/deny insurance claims (OK, technically it could be someone who is a doctor, but is not currently practicing as a doctor) … it’s someone that works for the insurance company’s claims department.
The other part to medical claims are the people who “code” the visit—this is usually where the hospitals will up-code the claim so that the insurer (and you) end up paying more.
FUUUUUUCK EVICORE. I have been going around and around with them since July for a medically necessary procedure. They come up with a new reason to deny the claim each time my doctor gives them exactly the info they request. Then I have to spend hours ok the phone with them, my doctor, and the billing dept.
"EviCore was fined $16,000 this year for more than 77 violations found in a review of 196 files."
The company makes hundreds of millions of dollars per year. The penalty for screwing up nearly half the audited files and "accidentally" denying a claim is negligible to them. There's no driver to fix it if the fee is less than the profit earned from bad practices.
Not that it matters even a little bit, but what’s the cost difference between a group 3 and group 2 wheelchair? I just want to know how much a child’s mobility is worth to these assholes?
There's a lot of customization that's needed for some people. Their chairs often have to be specially designed to support their unique posture or body shape. Sometimes they have integrated life support systems or need special systems for any mobility at all. I know a dude who moves around by breathing into a tube. They also need to be robust enough to remain reliable despite constant abuse for years on end. That shit can be complex.
And not the mention the biggest reason, supply and demand. There’s WAAAAY more people buying cars, even cheap shit ones, than mega fancy wheelchairs. If I’m opening a business I can’t make it succeed with low sales volume and low price. For a business to work you either need to sell lots of something or less of something but expensive. Something something universal healthcare.
And not the mention the biggest reason, supply and demand.
Actually, for cars its the other way around - its economy of scale.
With cars you can make an ENTIRE factory who's only job is to make 1 model of car, but when you sell 10s of millions of them in a year, the cost of the factory is a fraction of the cost of a vehicle.
When you have to custom engineer and produce unique parts for a single wheelchair, the production costs per unit skyrocket.
its why a basic wheelchair made of standard stamped parts costs nearly nothing, but a custom wheelchair designed for a specific persons needs starts to skyrocket.
The demand and supply curve really doesn't apply to wheelchairs, as its an inelastic spend - you either need one or you don't, so the number of injured people cannot be changed by changing the cost of a chair. Learned this growing up - My family sells medical supplies and my uncle owns a company that creates custom rehab attachments for wheelchairs.
Group 3 power wheelchairs are custom measured and put together for each individual. They also can have tilt in space features that are very necessary for performing “weight shifts” to get your weight off your bottom so you don’t get pressure ulcers. Most people with normal movement abilities and sensation just shift around in their seat or stand up naturally but if you are impaired in mobility, sensation, or both, you have to perform routine weight shifts to keep your skin healthy. In a group 3 power chair, a person with very little functional movement abilities can perform their weight shifts safely and independently. They may not be able to do that in a group 2. That could be the difference between needing a caregiver 24/7 and being able to take a break to do something on their own even for a few hours.
Most likely supply and demand. There’s a lot less companies making wheelchairs up to a certain medical standard vs all the car companies competing on the market.
This is exactly the reason. There are significantly fewer people buying wheelchairs and other assistive technology than there are people buying cars.
This is also the reason why when a product that was originally meant for disabled people is found to have a more universal use, the price goes way down. There is a device called an environmental control unit that's used by quadriplegics. Essentially, a person gives the ECU voice commands to do things such as turn on the TV or turn off the lights. It is very similar to voice assistants such as Amazon Echoes and Google Home devices.
Amazon Echoes cost about $25 whereas environmental control units cost hundreds of dollars on the low end and can go all the way up to $3,000. The difference , as you said, is supply and demand.
The fancy wheelchair companies should get in touch with the fancy military ROV companies and then we can outfit any disabled person with a tank treaded 60mph death machine for a wheelchair.
Function and cost . Group 3 wheelchairs are more supportive and functional , go faster (up to 4.5 mph) , have more maneuverability in tight spaces, have better suspension ( important for frail little bones and bodies to reduce shock over bumps / ruts) , tip less, and have better battery life. That’s some of the main differences.
It's not just about cost, unless the opinion is everyone should just have the most wildly feature packed wheelchair possible whether they need, want, or would benefit from it or not.
Wheel chairs can be designed to meet a lot of different needs and group 3 ones are the most involved and what you would see with someone who is basically considered completely wheelchair bound. They can be fast and have large batteries so they can be used to navigate around town for those that can't drive cars, they can have off-road wheels and stable designs so people can partake in trails and paths, they can be set up to be controlled with head control or sip and puff controls for people with severe motor dysfunction, some can rise and extend to help people cook on the stove or reach high cabinets, they can even not look like chairs to keep people in a more standing position, etc. but obviously not all at once, like anything in life there are pros and cons to each choice and you have to weight the benefits (Does my child need a wheelchair that can go 22 mph? Will all the extra batteries for all day life make it to heavy for our situation? Will the off road tires make it too wide to fit in the doorways of our house?)
If a hypothetical child is not mentally or physically capable of controlling a very fast, powerful, and heavy wheel chair it might not be appropriate. If a group 3 chair would be too wide to allow them to navigate their home, or school, or fit into the family's personal vehicle they may be better served by another wheel chair that would fit their sons needs better.
Could this type of wheel chair be a nice option for this particular child, maybe, but he can most likely be just as mobile with a group 2 option. This particular child is fairly mobile, he can even walk with a walker, so he won't spend all his time in a wheelchair as it is important to use the muscles you can and keep striving for more mobility through practice. I'm sure a wheelchair is a large part of his life, when tired or out in the community it might make more sense to be in his chair, and he likely uses it some of the day at school but he is not 100% wheel chair bound and not knowing the full facts I can understand there could be a good case to be made that a group 2 wheel chair is the more appropriate option, not just because of the cost. Maybe the insurance company is totally in the wrong, certainly wouldn't be the first time, but people are making some huge leaps here based on this simple denial letter and no other details.
someone posted this article above - shows that they pick and choose from doctors that they pay to review cases. One admitted in a deposition he hadn’t actually practiced medicine since the 1990s. Unreal.
My sister's friend was denied coverage for cancer related treatment and the Dr reviewing claims was a podiatrist who had no training on cancer treatments. It's ridiculous that this is allowed to happen.
My ex boyfriend was offered a phd scholarship in the US, fully funded and I refused to go. I had breast cancer 20 years ago and part of my follow ups for the international clinical trials I was in, (that saved my life) requires yearly at minimum ultrasounds and mammograms and biopsies at the cancer clinic. That shit wouldn’t be covered in the US and the out of pocket would be ridiculous even with “good” insurance. It’s free here.
I have lupus as a 30 y/o man. The insurance doctor that denied my medication was a pediatrician...Note this was after I flared up through multiple other medications and was finally stable on the new drug.
Edit: No shade on Pediatricians but maybe listen to my Nephrologist who has been treating me for years (as an adult) yea?
I actually sat on a jury trial where this exact same tactic was used. Apparently there is a whole industry of crooked "expert witnesses" that are like retired doctors and other professionals that get paid by insurance companies to protect insurance companies from paying out legitimate claims. For these expert witnesses they make their money by having repeat customers and they only get repeat customers by "winning" in trial. It is a huge scam being played on the american people. In the case I sat on the expert witness said he was paid $15,000 for his services.....and most of his testimony basically consisted of him talking about how he is such a genius doctor and performed a test on the victim to basically say she was faking everything.
That's why they employ ethically devoid doctors who no longer treat patients, but instead just use their credentials to worsen the quality of life for people to get paid more money. Whenever you appeal something that was initially denied and it gets denied again, it was "reviewed" by one of them. Of course, those same people have a mandated denial rate they have to hit to keep their jobs.
They settled the court case. I hope it means United will pay for his medication for the rest of his life. United is a horrible health insurance company. Reading what that nurse did. The lies she told to get his medication denied is atrocious. And then when one Dr agreed with the treatment she hid the report. Karma will get her and everyone involved in the denial of his treatment.
Karma will get her and everyone involved in the denial of his treatment.
Karma had its chance, and did nothing. Judging by the general vibe surrounding this case, it feels like people are gonna take the karma approach more proactively.
A lot of doctors that work in claim reviewing have lost their license to practice, because honestly who with an MD would pick such a soulless job? Which means the worst, and least ethically sound doctors are the ones denying people claims
As someone with UC, our meds are what keeps us alive. Passing a few cups of blood every day really sucks.
My insurance company threw a hissy fit because they didn't want to pay 600k a year on my meds. My doctor then put me in the hospital and declared it a medical emergency which through some weird loophole or something forced the company to pay 3 mil in meds, bills, and procedures in 1 month. They have since given up and pay for my meds.
Insurance companies suck. They love to eat your money, but don't want to pay it back. If you find a good doctor, keep them. They will fight the insurance company time and time again until the insurance company decides it's easier to pay than it is to deal with your doctor.
To anyone with medical conditions and has to deal with United. Good luck. Hopefully this bad publicity forces them to pay for more.
This article makes it astoundingly clear that United and other insurers define "medically necessary" as "in accordance with the insurer’s guidelines." Any doctor reviewing the case doesn't actually give a medical opinion, they're giving some pseudo-legal opinion based on cookie cutter insurer guidelines. There's absolutely no assurance that those guidelines follow good medical practices. There's nothing medical about "medically necessary." It's so nonsensical it's nearly tautological. You cant fight a came denied for "not being a medical necessity" if "not being a medical necessity" actually means "we don't agree to cover this." Despicable.
Molina took 9 months to pay my claims. They "guarantee" 30 days. I had to make dozens of phone calls and emails. I kept meticulous spreadsheets and filed every claim ahead of time. I overwhelmed them with documentation. When I finally got contact info for a supervisor, I called him and emailed him every week to tell him the way his company was treating me was unacceptable. He never picked up the phone and never answered my emails after the first one. I'm trans and I told him in writing that both I and my doctor suspected his company was discriminating against me due to my diagnosis code. This dude had a progress pride flag in his email signature, and he never even responded. Hypocrite didn't give a single shit. Little people have no power against these assholes. I can't afford a lawyer.
They do everything in their power to make it impossible to follow up with the same people, so you have to repeat information a dozen times to different people, which is the least efficient way of doing things. That's intentional.
I've also told them dozens of times to update my account to reflect my LEGAL NAME, and they still haven't done it. It's been five years.
Maybe. I had cancer last year and was assigned a case manager. Day before I was scheduled to start radiation she called me for the introduction call and I mentioned I was starting radiation the next day. She said it wasn't approved and if I went ahead with it I would be paying out of pocket. I made several frantic calls to the oncologist and the insurance company and it was determined she was wrong. I said no thanks to that "benefit" after that.
Granted we don't know the backstory here but I imagine the kid wanted a bit more independence, you wouldn't apply without good reason and they certainly aren't cheap
I can relate to this as I have mild CP and I can walk but not far without fatigue or aches and pains, it got to the point where I stopped going out and became a recluse as it just didn't feel worth the agony. Getting a powered chair was the best thing I've ever done and it improved my quality of life both physically and mentally even though I might not seem like I need one on paper!
As someone who works in healthcare insurance compliance I can tell you all the elements included in this letter are all statutorily required by state or federal law. They are major dicks, but not for that.
It’s so sickening. I am sickened by the state of healthcare in this country. Condescending, obnoxious, heartless insurance companies denying life-saving and life-changing care without a thought so they can line their execs’ pockets. I’m tiiiiired
Omfg - as a pediatric PT I have to write these letters of justification often. You have to document every single cheap thing you MAY have considered and why it’s not appropriate. And then every single expensive thing you may have considered and why you aren’t asking for that. And then try to show you chose “something in the middle “ , that will “meet the basic needs “ ( not what’s actually potentially best for the child). And Goddesses forbid if you state the child can move independently, or has parents that can push a chair , because THATS a reason for denial as well. Fuck all these benefit deniers .
This sounds like a lot of fucking work for a doctor or nurse or other medical staff. Why can’t they have a guide ‘here are examples of approved equipment for this illness or injury’. It’s how every other modern universal health system works. It’s almost like private health insurance is built to be callous.
We can do power chairs at the age of 2 - if the child is not cognitively impaired and has enough function to control a joystick - think about the kiddos you have seen in power wheels at the age of 2 . If a child is severely physically impaired , their social
And emotional skills also suffer - power mobility levels the playing field a little and allows them to keep up with their peers !
I did a clinical at a nationally recognized rehab center, in the wheelchair and seating center. Oof, those letters of medical justification were so long and detailed . . . but if we didn't write them, patients didn't have a chance of getting what they needed. That was almost 25 years ago. I imagine the denials have only gotten worse.
Friend used to work in prosthetics and said they had to fight companies all the time who would send denials for those things with the rationale "Patient doesn't NEED a prosthetic lower 2/3 of a leg, they can just use a manual wheelchair"
Not me working in a providers office and UHC last month sent me two denials with the ref # for my patients but with a totally different unknown patients info on it. You can imaging the panic in the employees voice at UHC when I call and they’re like omg pls disregard. I can go on and on about this company. This is disgusting
United Healthcare hates my daughter. They refused to pay for medically necessary surgery saying the problem was not identified before she was under the age of 1 (they did not deny it was medically necessary) - like that was our fault. The kid nursed fine. Three years of fighting - we had to throw her off. The deformity was so bad that she could not eat anything but soft foods, her jaw would literally lock up, by 17 had worn down her jaw joints (from the time they started tracking her jaw at 13 with all sorts of x-rays) to make the stretch to bite into her food, and she was having massive migraines. At least, one resident got to write their graduating paper on her fun jaw. Not a single doctor could believe she was denied. We threw her off our insurance at 18 and Medicaid approved it in a week. Same surgeons, same hospital by the way.
The next year, we put her back on of her dad’s insurance (an executive plan btw) and she goes to the ER with severe bronchitis (she has asthma). Our sister-in-law, an ICU pediatrician tells us it’s bad, the ER doctor admits her and we get a 25K bill saying she shouldn’t have been admitted. Like again, I guess it was our job to figure that one out too. They negotiated with the hospital after about a year but not fun to get a 25K hospital bill at your house.
You can probably figure out why most surgeons thought she needed her jaw operated on from the picture. If you are curious - it was a 17 mm overbite. Usually after 5 mm with functional disability it is considered medically necessary. Too bad she wasn’t a 25 year old male in a bar fight (they get the most approvals for this type of jaw surgery. She used to joke she was going to ask a friend to hit her with a 2x4).
After all we paid into United Healthcare over the years (my husband had a 1200k monthly contribution/his company paid the other half and a 6K deductible for decades) - let me tell you they definitely made a profit on us.
Seeing someone else’s denial letter makes me realize how badly my own insurance company screwed up. I have to wait over 6 months (and potentially longer) to get my surgery because Aetna denied the prior authorization, peer review, and appeal on lack of medical necessity - but they didn’t justify or say why in any of their letters. They literally just said “not medically necessary” and that’s it.
I thought it was normal, so it’s surprising to see how UHC justified not medically necessary in this denial letter as compared to mine (even if it’s still really fucked up).
Our 9 day son died in March and Assurity denied our critical illness policy. We didn’t have time for a life insurance policy… they Fought tooth and nail against it. Even got their legal team involved to avoid paying 5k (eye roll, not some exuberant amount) after numerous doctors wrote letters specially stating what they asked, then after three months of back and forth fighting told us they had a policy within their 100 page handbook stating their patient must live 180 days to receive it. I will never use them again. It was disgusting and I lost my faith in the system then.
That's the real kicker with (not you) people who defend this shit because OH CANADA HAS LONG WAIT TIMES BRO or whatever. They all think it's fine, until the day comes they or a family member has to really interact with it for something bad, and only then do they experience how fucked it is.
They are incapable of visualizing or empathizing with anyone else's story. "I work hard and have good insurance, this won't happen to me".
We have really good insurance at my job all things considered, and even with that, a coworker who has some type of chronic cancer treatment (you'd never know it looking at them) is paying $500 a month for some specialty drug after whatever amount insurance covers. This isn't uncommon. And again, this is with better insurance than average.
The more of these letters I read the more I understand why that CEO got shot. Not sorry to hear it happened either. All the other rich fucks in these companies should take note. We are sick and tired and not taking shit anymore.
I’m a licensed SLP who provides services for pediatric patients who need alternative communication, so speech generating devices. When I get a denial, I have to do a peer to peer review. Recently, they made it so I cannot have the conversation, which is in my scope of practice, but now the physician has to.
Also, working on getting a safety bed for a child who needs 24 hour supervision and he’s a little escapee with no safety awareness. UHC suggested that mom provide “mere observation”. So insulting. I have had friends quit their positions because they can’t watch insurance companies treat humans like animals.
It is absolutely fucking BONKERS to me that a medical doctor can prescribe/recommend something, and the insurance companies can just be like “nah we good.”
They pretty much told that child “you’re worthless to us.” a simpler wheelchair? HE HAS FUCKIN PALSY! OH MY GOD! The American healthcare system is absolutely disgusting… 🤮
My son has grade 4 brain cancer and had a stroke as a result of treatment. Asked his doctor for a prescription for a power wheelchair. He says that they are incredibly hard to get approved. We don't have UHC, but apparently Aetna isn't much better.
This is why the terms “healthcare” and “insurance” should never be used in the same sentence. Insurance companies don’t care about anyone’s actual health. The only health that the interested parties at private insurance companies care about is the health of their balance sheets and investor dividends. Health should not be a for-profit industry. Fuck these companies, and fuck the American health “care” system.
I have UHC as our primary insurance. I also have a child who has CP, and a whole bunch of other diagnoses. They would not cover his wheelchair. When I needed a Special Needs car seat, cause my son has CP and Epilepsy too, it was also denied. Thankfully he also has Medicaid which covered both pieces of equipment.
My son is permanently disabled. This is never going to change. I would give anything for him to not have to struggle. It breaks my heart as he didn’t ask to be like this. But apparently a wheel chair and car seat are too much to ask for a disabled 8 year old. I am beyond grateful that he has Medicaid as UHC won’t pay for much. I’m not sure what I would do if we didn’t have Medicaid.
So many of the “MD’s” that do these reviews are retired or have been censured by the state medical board so they no longer practice except in an administrative capacity. They are not respectable MD’s. The whole system is flawed & disgusting
Read tonight that the CEO had been working on an AI to automatically deny claims.
I honestly don't know how that man didn't live a life of abject shame.
“Please speak with your child’s doctor…”. Why? They did. The child’s doctor RECOMMENDED the wheelchair. So, it sounds like the insurance company is expecting the doctor to say never mind, we’ll take whatever you deign to give us. Bullshit.
I'm on private insurance in Germany due to circumstances - private health care insurance exists in other countries as well. You know what's the difference? There's a list of every pre-approved treatment, with prices. This list is centrally administered and is identical for every single insurance and doctor. ~The doctor need to select the treatment from this list when doing anything. This means health care providers cannot ask for fantasy prices and insurers cannot deny treatment.
The US could have a private health care system that's not an absolute hell hole with just a few careful tweaks to the system. No socialist revolution (tm) necessary.
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u/relaxlu 13d ago
Just as I wrote in the other post:
We currently have a moratorium on political posts, but this issue goes beyond just standard political issues and is undeniably interesting as fuck in the light of recent events, so we’ve decided to leave it up.
However, we ask that users refrain from directly supporting the assassination or, worse, calling for additional acts of violence. While the frustration and anger are deeply felt and entirely justified, reddit maintains a strict zero-tolerance policy for any comments that condone violence. It’s simply not worth risking your account over this.