I don’t think this information should be hidden. I hope others create sites that make clear who the leaders are that may be causing harm to them, by just parsing their filings. There should be accountability. And while I am not a fan of laws being broken for that accountability, let’s also be honest: being denied claims in illegal, or at least deeply unethical ways, is an experience MOST American adults have been through. These insurance companies make profit by denying the service you think you’re paying for. Normally that’s called stealing but when a company does it under direction from their CEO, it’s somehow legal. But when it comes to life and death situations of patient health, it’s a lot worse than just stealing.
This has the same energy as that guy that put lemon juice on his face when robbing a bank because he thought it would prevent the cameras capturing his image.
The public reaction has been unsympathetic to the victim and unsurprised. I think the definition of "wrong" that plausibly inspired the shooter is widely-held.
The words written on the casings found on scene, “Deny Defend Depose”, is the name of a book that talks about the unethical and illegal practices of the healthcare industry. That book is “Delay, Deny, Defend”:
https://en.wikipedia.org/wiki/Delay%2C_Deny%2C_Defend
Yes, hence why "if you have nothing to hide" is infamously so stupid a phrase. You don't get to decide that, the accuser does and who the accuser is may vary and may in fact be utterly deranged by all normal points of view. You don't want the information out there period because it can only end in an especially twisted form of Pascal's Wager based upon who is in power at the moment. And that this is not in fact a paranoid hypothetical but something very real which has happened throughout history.
Surely not all that blood is on the hands of the CEO, or even UHC. But everyone has either been denied claims or knows someone that has, through some of the most disgusting treatment witnessable from corporate america. It'd be one thing if you were denied a claim for.... any variety of reasons that follow from the inherent difficulty of managing health insurance as many countries can attest to. But overriding doctor concerns to withhold funding for necessary treatment and withholding as much as possible while raking in profits leaves people with very bitter tastes in their mouths.
Mine included: I'm paying for a medical procedure for a friend next week because her insurance won't cover anesthesia and she can't afford the out of pocket. I had multiple relatives die much sooner than they had to because they were denied funding for critical medication. I've had multiple friends talk about "rationing insulin" (thankfully, both times referring to the past). And naturally healthcare interests—UHC included—lobby both parties heavily, so there's a lot of incentive to continue ignoring the elephant in the room.
The job of health insurance is to vet and deny claims. Their pay is regulated and capped by law as a percent of benefits. The fewer benefits they provide, the less they make.
This is the system Americans have chosen. Im not saying its the best or shouldnt be improved.
Im for a public option, but there will still be rationing and denial of care. people will still die.
> The job of health insurance is to vet and deny claims.
It would be nice if they did that consistently and fairly, but they don’t.
Using an AI to review and deny claims with a (claimed) 90% error rate or denying claims without reading them is not vetting, it’s straight up negligence and fraud.
Sure, that's the insurance company itself. One way around that is for the insurance company to own the medical providers they send people to, allowing them to keep more of the premiums by cycling them around other companies. United Health has been doing these "intercompany eliminations" for years, trailblazing this method of keeping ever more of the premiums.
The majority of American voters have chosen this system multiple times, and have voted for a president who has explicitly said he'll make this system worse by repealing the ACA. He almost did it the first time, too, and it only failed by one vote.
Maybe this UHC CEO event will get more people talking about healthcare, and ultimately get more people voting for candidates who want to improve the system next time around. I support a public option, so I hope it does. But I won't hold my breath.
Good point, he didn't campaign on making the system worse and the way I phrased that made it sound like he did. He campaigned on repealing the ACA and replacing it with something better.
> But you can't then assume the people who voted for him were voting for the system to be worse.
At least in 2016, some of his voters that I knew personally just wanted the ACA to be gone and to have "freeloaders" kicked off of the system. They weren't voting to make it worse for themselves, per se, but voted vindictively to make it worse for others.
I didn't choose it, it was chosen for me. And you can say "that's democracy", but it doesn't change the fact that "Americans have chosen" is wildly different than saying "I have chosen" and has radically different and wide-spread implications.
"People will still die" is the kind of thing narcissists and sociopaths tell themselves when they are pretty sure that the set of "people" does not include themselves.
Great, when are you going to blame the people who are actually, actively responsible? Are you going to start shooting the claims processors who push the button? Or is this just more deranged, terminally online teenagers screaming about things they don’t, even vaguely, understand as usual?
So tired of the dumbest people having the loudest voices online because populist bumper stickers work better than actual thoughtful commentary.
This isn't terrorism. But, even if it met some technical definition, you might be surprised to learn that nobody cares. Digging your heels into this makes you look like a fool.
There's a 100% chance that NYPD have family that have been put to death by UHC. You simply do not appreciate the gravity of contempt for insurance companies and how little anyone cares about the death of their executives. If that startles you, perhaps some serious introspection is in order.
NYPD can simply loose evidence. Or, have it stolen or destroyed in a myriad of "accidents" as is often the case in politically sensitive cases. Just because this case isn't politically sensitive doesn't mean NYPD isn't familiar with these practices. Remember, NYPD gets away with these things when both the public and people with power are watching. What makes you believe critical evidence won't just disappear in this situation?
But even if I am wrong and this hero or champion is arrested and put on trial. What makes you believe an extremely progressive NYC jury will do anything other than nullify the charges?
The only crime here is:
- security cam was not 4K
- security cam did not have audio of the CEO's screams of agony
AthenaHealth has a different type of rational self-interest, suddenly backing off an awful policy changes about anesthesia coverage. "Maybe we're pushing the overton window on acceptable levels of apathy a bit too fast?" is probably a common thought on the minds of corporate policy makers at the moment. Not, you know, goodness-of-the-heart or anything like that, just "pitchforks today mean political will for healthcare reform tomorrow, and we can't have that..."
Even burning buildings down and rioting, while people don't like it, it forces change.
Note how they are spending so much effort to prevent copy-cats like somehow they know there is a reason for many people to be mad and that the evil practices among businesses have been going on too long unchecked. If they treated people fairly and honestly there would be nothing to worry about.
You refer to Anthem walking back its decision to charge anesthesiologists according to Medicare standards (average time of procedure, rather than recorded time). I agree that the timing of the new policy announcement (if not the policy change itself) was probably influenced by the recent murder and public reaction.
But I’m not convinced this is actually a positive thing.
Notice that word in my previous paragraph: Medicare. One of the promises of single‐payer healthcare like Medicare is to lower bloated procedure costs by having a powerful, unified negotiator (the government) on the side of the patient. The fact that Medicare charges anesthesia this way seems to be an intentional example of this.
Is cutting costs here justified? Obviously it would be unjustified if the anesthesia were necessary. On the other hand, it would be justified if the anesthesia charges didn’t actually reflect the cost of the procedure. Personally, I don’t assume Medicare is in the business of maliciously cutting necessary healthcare to lower costs (the “death panels” argument famously put forth by Sarah Palin), at least not without evidence. So what does the evidence show? Well, it’s easy to find stats saying recorded anesthesia procedure times are considered unreliable, that an unusual number of procedure times are measured in round numbers, that the unusual procedure times are consistently and significantly longer than average procedure times, and suggesting (though not proving) fraud on the part of anesthesiologists and doctors.
The main group I’ve seen advocating against BCBS following Medicare’s charging rules has been the American Society of Anesthesiologists. Which makes sense—of course anesthesiologists would be against policies that decrease their pay. (By the way, the mean anesthesiologist salary in the US is $340,000 per year. https://www.bls.gov/oes/2023/may/oes291211.htm) This walkback is a great PR victory for them.
Insurance companies are, of course, evil grifters. They have incentive to lower costs by cutting necessary care. But this particular policy is copied from Medicare, which doesn’t have the same incentives as an insurance company. Part of the dysfunction of the US health care system is that our procedure costs are unreasonably high. That doesn’t come from insurance companies and Medicare, it comes from doctors and hospitals. We can’t paper over that.
You refer to Anthem walking back its decision to charge anesthesiologists
according to Medicare standards (average time of procedure, rather than
recorded time).
Medicare reimburses anesthesia providers for the entire time the patient was under anesthesia. This is captured by time units. Anthem was planning to implement a hard cap based on Physician Work Time which is entirely different. In essence Anthem is weaponizing Medicare in an attempt to deflect blame.
You're right, I misunderstood how Medicare covers anesthesia. But the GAO report you shared strengthens Anthem's argument: they pay far more for anesthesia compared to Medicare, a sign that the providers are overcharging. And the stats about unreliability of recorded procedure times are still compelling.
Or a sign that private insurance companies are too burdensome. UHC is well known both for constantly changing the claims process and for preemptively denying valid claims. Arguably private insurance companies need to pay more because they are a significantly bigger hassle to deal with than Medicare and require a legion of support staff.
