• Nougat@fedia.io
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    1 month ago

    Universal health care? I don’t want government making my health care decisions! We have for-profit companies for that.

    • Kokesh@lemmy.world
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      1 month ago

      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.

      • Stovetop@lemmy.world
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        15 days ago

        In theory a government is beholden to its constituents, a corporation is beholden to its shareholders. Governments aren’t perfect, but there are at least avenues to effect positive change without financial incentives being a prerequisite.

      • AbsoluteChicagoDog@lemm.ee
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        1 month ago

        It’s cute that you expect Americans to feel sympathy because your employer didn’t take your burnout seriously

  • solsangraal@lemmy.zip
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    1 month ago

    i have a friend who’s a transplant patient and has been taking the same meds for over 10 years post transplant-- every year it’s a furious battle with insurance who, every year, decides the meds are no longer “medically necessary” and drops coverage for it. fucking helloooo these are anti-rejection pills, the textbook definition of “medically necessary.”

    it’s not that insurance companies are stupid, it’s that they’re saving money on people dying when those people don’t get what they needed to live.

    insurance is the biggest fucking scam of all time

    • Vox@lemmy.world
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      1 month ago

      The insurance system does not work in the medical field, it would never work because insurance is for managing risks that are unknown, like a house flooding or your car getting hit in an intersection.

      In medical “insurance” it is often dealing with known issues, and the insurance system is just not set up to deal with preventative care, annual check ups, mammograms, blood tests, or pre-existing conditions. It would be like trying to use car insurance to pay for an oil change, which is just as ridiculous as it sounds in your head.

      That’s exactly why the term “insurance” should be used when discussing a single payer system, it’s not really insurance, it should be a collective action group that works together with the medical community to find a middle ground where hospitals can still exist and pay wages to their staff, the people can get the medical care they need without getting thrown into poverty for daring to get sick, and the government benefits from having a healthier population as a whole.

      Too bad theres way too much money in the short term in keeping this all private, and having a sicker population, so we have decades of insurance company propaganda to work against, and a huge population of people that don’t understand that by doing single payer health care your taxes would go up, but you also wouldn’t be paying out the nose for medical insurance & medical care (because they don’t cover anything). Also think of a world where your health care isn’t beholden to your employment, all the different choices you’d make in your life.

  • TommySalami@lemmy.world
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    1 month ago

    I work for a neurologist practice, and the amount I have to argue with insurance (and inevitably have to get the neurologist on the phone to directly request something for many) is insane. A good chunk of my job isn’t providing care, but arguing with insurance that the care is necessary. These companies are actively delaying patient care, and try to blame the physician whenever possible.

    Wildly infuriating, especially when the denials are worded along the lines of “we reviewed this, and don’t consider it medically necessary”. Motherfucker, a doctor said it was necessary and listed the clinical reasons why this test or procedure would be beneficial. Nothing has radicalized me for universal healthcare more than working in healthcare.

    • givesomefucks@lemmy.world
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      1 month ago

      People love to shit on the VA, because they’re the largest American healthcare provider in the country so there’s a lot of bad stories

      But my last MRI went like this:

      Doctor: you need an MRI, let me check if it’s open. (Less than a minute on laptop). Ok, go down to room ____ and they can get you in now.

      There’s a huge up front cost for that machine, so for profit hospitals went everyone to use it to make the money back, and insurance wants no one to use it so they don’t have to pay.

      Take insurance out of the picture, take the hospital trying to make money out of the picture. And it’s really that easy. No one pushes for unnecessary tests, no one tries to prevent necessary tests. And there’s a huge push towards preventive medicine, because it’s cheaper to catch shit early.

      We already pay more than what it would cost, it’s just the healthcare industry donates to both parties, so as long as both standards are “at least they’re not the other team” shits never going to get fixed.

      If we hold higher standards than that, it won’t take many election cycles to get change to actually happen

    • BorgDrone@lemmy.one
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      1 month ago

      How is that even legal? How is someone who hasn’t examined the patient and isn’t their physician allowed to make treatment decisions? If they even have the necessary qualifications.

      • skulblaka@sh.itjust.works
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        1 month ago

        Because of money!

        Every time you see something that feels illegal but isn’t, or that makes no sense in general, look for the money trail. There’s always one, and it always leads to the explanation.

        In this case, insurance companies have made such an absolute ass ton of money by killing off their customers that they have become a political entity. They now use their deep pockets to lobby politicians to keep their scam legal.

      • WoahWoah@lemmy.world
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        1 month ago

        They’re technically not making treatment decisions, they’re making payment decisions about treatment decisions. Effectively it’s a distinction without a difference though. And it’s usually a “doctor” working for the healthcare company rubber stamping the denials. It’s a thoroughly shitty system.

        • frezik@midwest.social
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          1 month ago

          Specifically, it’s the doctors who technically passed med school, but only just. They’re not going to practice medicine anywhere else, but they can make good money writing up legally protected reports that say “in my professional opinion, this patient’s lack of arms does not prevent him from going back to his roofing job”.

    • Carrolade@lemmy.world
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      1 month ago

      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.

  • Phoenixz@lemmy.ca
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    1 month ago

    So here is a question:

    A medical professional examined the person IN PERSON and has a requirement.

    In comes the insurance to tell you your doctor is wrong and that you’re perfectly fine, your doctor is basically lying to you.

    Question: how the fuck did any of this ever become legal?

    • intensely_human@lemm.ee
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      1 month ago

      It became legal when we decided medicine was too important to be handled by a free market, and we created a labyrinth of laws governing how medicine must be administered.

      • Phoenixz@lemmy.ca
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        3 days ago

        You literally take the wrong takeaway from all this.

        A free market for healthcare is a disaster. A few big companies will form that will squeeze every last cent out of dying people, you get the US system. US healthcare and it’s free market literally is the worst. Be healthy and bankrupt or die