20 points
23 points

These dudes have their own dicks all the way down their throat.

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6 points

I know right?

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16 points

And you wish that’d prevent them from talking. Alas here we are.

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6 points

Or at least develop chronic backpain.

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5 points

Now I’m a bit jealous!

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17 points

Did that guy just paint a big ol’ target on himself?

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3 points

Tune out the noise!

#BANG!

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232 points

You know, at face value he’s absolutely right. We shouldn’t claim care that is unnecessary or maybe even harmful. But where we disagree is that I think that decision should be left to our medical professionals

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-5 points

Insurance claims are approved or denied by medical professionals. In the state of NY it’s even required for a specialist to approve or deny specialist care.

Some doctors are just absolute scum.

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7 points

I don’t have a source. But i’ve read they are incentivized to go through as many claims as they can, and not to approve too many.

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32 points

Except in this case, they used AI to help them make decisions. The lawsuit is still ongoing so I shouldn’t speak in definitive terms, but considering the circumstances and evidence I think it’s pretty clear than they have tried to automate some processes and didn’t audit them properly.

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9 points

Did it not work as intended, though?

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53 points

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15 points

My insurance’s tactic to this sort of demand is to just completely ignore my requests/demands. They log an acknowledgement of my action, and then never do anything with it, ever.

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12 points

There is a lot of crap that they’re able to instantly deny through your plan’s terms and conditions.

It’s worth reading the plan summary of what won’t be covered, even if it’s prescribed treatment. Some of the shit that’s hidden in there is fucked up.

This year someone in my family started to have to pay out of pocket for their GLP1s because their diseases didn’t progress far enough for the treatment to be covered. They’d rather you hurry up and die than pay for expensive drugs that keep you alive for longer.

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4 points

If they have cardiovascular disease or kidney disease, those are getting added as indications for the GLP-1’s so they might be able to resubmit the authorization/claim with those diagnosis codes added to get it covered.

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43 points

They are done by medical professionals who have no obligation or incentive to serve the best interests of the patient. If your doctor fucks up, he can be found liable. If the insurance doctor fucks up, there is no liability whatsoever. Cases have been brought to court and then immediately thrown out because there is no legal basis for holding them accountable.

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33 points

Medical professionals that spend an average of 6 seconds per case. And keep getting caught with revoked/expired licenses. And well outside their area of expertise (the classic example is failed dentists deciding on cancer treatments).

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2 points

Even if this were the case (it is not in any real sense, see your other replies), the fact that it is done by a for profit entity that will lose money by approving a claim all but ensures the process will not be neutral or correct.

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153 points

Really what it should be is that if a doctor prescribes unnecessary care, they should go after the doctor, not the patient. Doctors have malpractice insurance. If the health insurance can’t win a case of malpractice, then they should pay the bill. Why are patients in the midfle here at all.

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43 points

This is still validating the profit incentive of private health insurance.

If the doctor prescribes unnecessary care, it should be none of these peoples’ business, because they shouldn’t be allowed any stake in the decision whatsoever.

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36 points

It’s the same trick as rebranding bank robberies to identity theft. It puts the blame on the consumer who can’t afford to defend themselves.

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15 points

Huh, I hadn’t thought of that as a Crying Indian.

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34 points

Really what it should be is that if a doctor prescribes unnecessary care

That’s the core problem. The entity that defines unnecessary care is health insurance. And there are TONS of stories of them denying Diabetes medication for people with diabetes and anti-nausea meds to pediatric patients getting chemo.

If they were doing the right thing, no one would be pissed off. The “recent target” was the one to decided to run on AI driven denials that were denying 90% of care for months.

They are not fulfilling their duty to take the money from the subscribers and pay their righteous medical bills and instead using it as raw profit.

They are employing their own ‘doctors’ to prove stuff that is definitely necessary is labeled unnecessary.

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10 points

Reminds me of the Tobacco Instrustry setting up the “Tobacco Institute”, to disprove any links between smoking being addictive, and lung cancer.

They were constantly gaslighting the public, even tried to discredit the Surgeon General for his report on second hand smoke.

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3 points

Not just meds. Patients with chronic pain are expected to take painkillers for treatment but omg if the doctor prescribes therapy deny that shit. Even though therapy helps faaaar better than medications for chronic pain sufferers.

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2 points

It’s the conflict of interest in the “decision maker”

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7 points

My attitude is that if the doctor prescribes unnecessary care there’s a professional board for that.

Though let’s be real, the health insurance for profit industry is the problem and it’s not going to get better until we get rid of it

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1 point

Yeah, but the professional board is kinda like an HOA board. Should be more like a jury of all regular doctors or something.

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7 points

Patients usually have the least amount of power. That’s why.

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24 points

Did he not have a PR person tell him that video was a bad idea? Or more likely, did he not listen to their advice?

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23 points

Headline says video was leaked. It was probably a private meeting. Agree that it was a stupid thing to say regardless.

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7 points

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26 points

They simply don’t care. What are you going to do? Shoot them?

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5 points

You think a guy in a blue seersucker suit is going to listen to advice from other people?

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3 points

That’s a cute email address

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50 points

I miss Anonymous. Those fuckers would be figuratively burning down UHC right now.

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23 points

What actually happened to them? Did key members get tracked down or something?

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38 points

I don’t have sources, but I seem to recall reading somewhere that the OGs aged out or got caught, and the new gen that replaced them weren’t as ideologically driven or competent or something. I think they still technically exist but aren’t nearly as influential as they once were

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19 points

Another thought this just popped into my head is that the next generation may not have been brought up with the same fundamental hacking skills that were somewhat inherent in being technical in the late 70s-mid 90s. Could you still learn them?…Of course, but having grown up with BBSs and LoD (Legion of Doom, and the like) and pre-WWW, some things were just more prevalent when it came to learning about the guts of systems and “cybersecurity” (that word didn’t really exist back then).

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34 points

It’s also not as easy to hack electronic systems anymore. It’s not that they are invulnerable, but the vulnerabilities are generally more complicated and difficult to exploit. Setting aside people still running Windows XP or something, vulnerabilities get patched pretty quickly today. State actors have the time and resources to still do straight up electronic hacking, but opportunities for individuals are sparse.

Of course there is still the human element. Most data breaches done by individuals nowadays rely, at least in part, on social engineering.

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12 points

I think they all just got jobs, honestly.

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11 points

In this economy?!?! /s…kinda

Actually that makes sense, and saddens me a bit there wasn’t a contingent to pass the torch to.

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4 points

They all got arrested by the FBI.

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23 points

they were taken down and then turned into a shell org of the NSA.

it’s a honeypot/scapegoat now.

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