Universal health care? I don’t want government making my health care decisions! We have for-profit companies for that.
Don’t be so sure it would be different. I collapsed, nearly drove off the road 3 times in one week and decided that it was enough and went to the doctor. He sent me home, wrote me in as extreme burnout (completely true, I had to sleep at work for every coffee break to make it through the day and 30 mins before driving home to actually make it). So I thought Great, I will rest for a few months and go back to work after that! Nope. The state heath insurance office said Our specialists decided, that you are perfectly fine. No sick pay. Get back to operating the industrial concrete blender. The health center doctors signed a letter, but no, I was fucked. So on top of this I got extreme financial stress. We got out of this crap by renting our cabin and starting going full into an outdoor adventure business. What a great time. Where was this? In Sweden in January 2019.
It’s cute that you expect Americans to feel sympathy because your employer didn’t take your burnout seriously
Oh, most of us do, we’re just too burnt out ourselves to do much but grunt out, “sorry, bub. I know it sucks.”
Sounds like a flaw in the system. I fail to see how health insurance should ever be involved between patient and doctor in a “universal” health care system. Sure doesn’t happen where I live.
Well, they got denied by Försäkringskassan, “Swedish Social Insurance Agency”. Basically wouldn’t be able to get sick-pay, but that’s about it. Which is a bit weird, as nearly all first-time requests get approved, but of course it happens.
So it’s not really the same thing as American insurance denying; they’re still able to seek care, just that the suggested treatment for burnout (pause from working) wouldn’t be economically comfortable if Försäkringskassan denies their sick-pay.
Do people believe that there? I can assure you the government has no roll in our health care decisions, and what the doctor wants the patient can always get.
Oh yeah, it was a major propaganda position back in the 00s and it’s part of how obamacare got that way.
Yep. The two main arguments were that the ACA would create death panels and that people would no longer have a choice in their healthcare providers. But both of those were, and still are, the status quo with private, for profit health insurance providers being involved in care.
Frank didn’t even look at it. He just fed your claim into their computer and it spat out a rejection.
Bold to assume he bothered to feed it to a computer when you can just reject without having to do that. Feeding something to a computer takes time, and time is money y’know.
Frank bought a self-inking stamp that says “REJECTED” and saw a 70% productivity increase.
Sometimes the Frank is an AI that is wrong 90% of the time. That’s fine, because reasons.
I fucking wish. At least then I wouldn’t have to be put on hold for 30 min just to have to eventually explain to a person who was hired 3 weeks ago how to do their job.
Private insurance always has you speak to an actual adjuster for authorization, mainly because they know any sort of automated system would be more accurate and faster than having you talk to their undertrained and understaffed employees.
Private insurance’s goal is to erect as many barriers between the provider and the patients as possible, and then blame the provider for all the barriers. It works every time.
“I have the best insurance, they told me it would be covered”. Nope, Medicare is the best insurance and you traded that away for a privatized Medicare supplemental that lies to you about your coverage.
Maybe if you can’t afford to pay premiums that allow you to have an IRM, just don’t indulge in expensive illnesses die already.
The health insurance company has little motivation to care about your health, but doctors have little motivation to care about money and money is actually important too. Ultimately you end up paying for all that unnecessary testing and there has to be some mechanism for controlling cost.
With that said, one time I was appealing a rejection of home care for my grandfather and I mentioned that his condition had declined and he was currently in the hospital. The guy from the insurance company said that clearly someone in a hospital doesn’t need home care and so my appeal should be rejected and I should file a new claim (which can take months) after my grandfather was home again. The arbitrator didn’t agree with that (although she said that she could postpone the hearing until he was discharged if that was what the insurance company wanted) but I was still so angry.
That study is idiotic. It’s literally an embodiment of the joke: “You could have found it faster if you looked in the last place first”.
Standardized triage testing has been shown over and over to save many more lives than doctor intuition alone. Just because a test rules out a diagnosis doesn’t make it “unnecessary”.