Health Insurance doing the Bare Minimum

Disawhatnow?

[@Rrt98]

Insurance companies do not discriminate against any patient population. Everyone is treated equally horribly.

[@morgothable]

You finally found the one positive of insurance coverage. It is one of the few things in the US that doesnt discriminate.

[@stephaniehowe0973]

Facts

[@privacyvalued4134]

Actually, they do discriminate against smokers. You pay a significantly higher insurance premium if you smoke. But, in general, your observation holds.

[@stephaniehowe0973]

​@@privacyvalued4134 That isn't discrimination. You made that choice. Smoking can & does kill millions. Statistics show that smokers need more medical care.

[@christansdad]

Wrong. People of color, children, and the disabled are treated worse. Have you ever seen a disabled child of color? Probably not. Most don't survive long.

[@gamerboy244]

"I don't know, that sounds cosmetic" I'm gonna steal that for everyday use.

[@jedinxf7]

cosmetic like my cataracts surgery actually letting me see. doctor puts in a new lens as shitty as my natural one? covered. doctor does exactly the same amount of work to replace my lens with one that corrects myopia? "cosmetic," i should have worn glasses.

[@zarinaromanets7290]

"Sorry boss can't come in to work today, that's cosmetic." 😂

[@firemermaid1980]

My sister had to have her eyeball removed. The silicone implant was covered but the glass piece to make it look like an eye wasn't as it is just "cosmetic." She raised 10k on gofundme to get one. Just disgusting.

[@KassFireborn]

My partner recently got her first mammogram, and as often happens the first time, there was something on it potentially suspect that they wanted to double-check. The first mammogram was covered, but the second, "We see a shadow, let's get another scan and make sure that's not a tumor"? That they decided was something she was doing just for funsies, no coverage. (Doesn't help that the insurance in question is UPMC, which literally bases out of a giant black tower that is only missing its lidless eye.) We've been joking about luxury mammograms ever since. Who wouldn't want to get a second one of those!

[@ahbutler57]

@@firemermaid1980 this is absolutely insane. What other place in the world resorts to go fund me to cover their healthcare?

[@M1911jln]

My favorite United Healthcare story: I was getting PT and my PT therapist wasn't getting paid by United Healthcare. They repeatedly said that they never received the claims. So I sent them again. They claimed that they still didn't receive it. So then I overnighted copies of the claim to the CEO, the head of United Healthcare's QC Department, with a cc: to our state's Attorney General. My PT therapist got a check within a week.

[@Urziel99]

I was actually rejected by UHC because a third party (a charity) was paying my premiums. I was on the phone with the agent and said, "So let me get this straight, you're an insurance company that doesn't want money?" They made some excuse that they didn't like the charity, to which I responded, "Money is money, and don't think for a second that anyone believes any insurance company can grow a conscience." Fck United Healthcare Forever.

[@norniea]

That is awesome! Good for you, so glad you got the results. If everyone did that maybe...just maybe things could change?

[@kukui79]

This is awesome, although it probably depends on the state. In plenty of states (looking at you, deep South) ccing the attorney general and CEO are probably BFFs.

[@echognomecal6742]

Amazing 🥰 but something I don't understand. "Overnighted" sounds like it's physical mail. How does the cc: work?

[@nancylindsay4255]

@@echognomecal6742 You're kidding, right? Please reply if you actually need this explained. I get it that some younger people don't know what, say, a slide rule is, but this is the first I've heard (if serious) that some may truly not know how copying someone when using snail mail works.

[@veraR2125]

"why would I make the building accessible, I never see any disabled people here?!?!?"

[@Frostbiker]

That's one of the most common complaints against building cycling infrastructure, especially on the most dangerous roads.

[@galatea5455]

omg, had almost this exact conversation with a restaurant manager when we (rehab) did a community outing with one of our patients with a new spinal cord injury. The tables were not high enough for the patient to get their wheelchair under, so we told management they could make the restaurant more accessible if they had some higher tables, and the manager was like: "well that's never been a problem before." Me: ......... well yeah, no one in a wheelchair is going to come here if they can't get pull up under the table....." The manager: .....*realization dawns* "I'll talk to the owner😳"

[@rickharvey4727]

Let’s also not forget that these durable medical supplies are HEINOUSLY expensive even if you pay out of pocket. Affordable prosthetics would be amazing for a lot of people.

[@michelleponzio]

There's only 2 companies in my state that I know of that are easier to deal with and can bypass the insurance companies altogether. Just need an office note with the diagnosis and a script. Komfort & Kare, and Ocean Home Health.

[@pamelas1002]

Agreed!

[@eric_has_no_idea]

JerryRigEverything just got into this and the ridiculousness of it all. He made non-medical-wheelchares to get around a bunch of red tape, and is moving to not-manual-wheelchaIrs next. That this is needed for something that is so easy to manufacture is revolting.

[@MrSourceplease]

Another KZbinr, Ian Davis has done some amazing DIY hand prosthetics. I think he's also collaborated with Creality on 3d printing parts.

[@2-minutephysiatry506]

Come to India. The "Jaipur Foot" and other prosthetics are quite affordable. Of course, there are quite a few insanely-priced ones in the market too.

[@IRLTheGreatZarquon]

My father in law is a double below-the-knee amputee who's paralyzed from the chest down. When he needed a replacement power wheelchair, insurance was an absolute nightmare. He had to use a manual one for months. Insurance companies are the actual devil.

[@AG-cy3em]

Broken system insurance is

[@plyoung11]

I don’t know how you Americans do it. Canada in the UK or not perfect but we don’t go bankrupt when we or a familymember get sick

[@cheesi]

@@plyoung11 Yeah, I can complain about things in the UK all day--it takes disastrously long to get anything non-urgent done, it's been getting worse and worse every year, it's weird and archaic that optometrists are still private--but at least I don't pay for anything except my glasses. I just can't imagine having those financial worries, it's stressful enough to have health issues without them!

[@wendys7334]

​@plyoung11 In America if we had the Canadian or UK healthcare system and some right-wing politician proposed the "system" we have now, we'd think they were nuts. They stand in the way of change, yet we vote them in... I don't understand my country any more.

[@TansyBlue]

"Disabled people go outside?" "They'd LIKE to" - this line as my seal of approval as a disabled person who hasn't left the house in a fortnight because I can't get the medical treatment I need.

[@Stephen-Fox]

"Disabled people go outside?" 'They'd like to.' just... God that sums up _everything_ in a funny but depressing sentence. (and also why wheelchair bound is a frowned upon term by wheelchair users - Because the wheelchair lets people go to where they want to go, rather than restricting them)

[@juliaprudhoe6118]

Oh, that makes sense! Wheelchair enabled would be more accurate then.

[@xXxFallenAnglexXxx]

In my language (and probably some others as well) we call people in wheelchairs wheelchair drivers, which is a lot cooler in my opinion.

[@hatework4282]

If things with wheels were intended to be outside the home, there would be places outside the home for things with wheels to be.

[@Stephen-Fox]

@@xXxFallenAnglexXxx I love that.

[@Joy21090]

​@@hatework4282 like cars and bicycles?

[@user-xyz411]

As a mom of a child that requires a wheelchair, they won't even pay a few extra dollars for you to have the transport option on the wheelchair itself. As pointed out in this video, they will approve wheelchair options for IN the home, not OUT. This is extremely petty because how else does someone get their child to doctor's appointments if not by a wheelchair van/bus?

[@twitaw]

"We don't think about the future" 😂 that's a feature, not a bug in health insurance

[@bigredmed]

Yep. If these companies had to insure you for more than a calendar year, maybe 10 calendar years, getting things covered that cost money today, but save more in 3-5 years would be a lot easier to get approved. Just as making insurance companies have to practice as if they were licensed physicians and absorb the liability risk for their decisions would.

[@tomnar3054]

But they think about the future? The end of quarter bonus for the CEO IS in fact in the future!

[@BionicMilkaholic]

I went to the Dr yesterday morning, and insurance denied a CT. By evening, I felt much worse and went to the ER where I got a CT. If the first CT had been approved, the Dr could have treated differently and would have been able to avoid the ER. I'm going to meet my max out of pocket this year anyways, so it doesn't cost me extra. But it would have saved the insurance company money by having me avoid an ER visit. That's not even far in the future. It's 8 hours later.

[@sarahlongstaff5101]

They think about the future of their bank accounts

[@30pranaypawar17]

"The day is TODAY!"

[@aphelion42]

Oh man. Had to comment on this one. I couldn't get a wheelchair through health insurance because I can walk at home and can do about 100 yds outside on flat ground. I ended up buying a used manual chair out of pocket (which is very difficult, since the chair needs to have my correct dimensions to be functional/not cause harm over time, and still not cheap), and my health has improved drastically since being able to be more active, get out of the house, run errands independently, get to work more easily, etc. I have saved my health insurance far more money than the chair would have cost through this improvement in health. There used to be days when I wasn't well enough to get up at all, and now I can transfer to my chair and still be out and about. Chairs don't last forever, and I am already saving money for when I need to buy this chair's replacement. It's absolutely maddening that insurance would rather have me isolated at home and occasionally stuck in bed for days at a time than provide a piece of medical equipment that allows me to be a fully functioning member of my community.

[@TarzansMom]

I'm so sorry, but so happy that you were able to solve the situation (albeit until you need a new chair) for yourself. Keep on keepin' on!

[@samdumaquis2033]

You need a healthy dose of socialism

[@rayzerot]

​@@samdumaquis2033"Health is only for those who work hard enough to afford it" -Some capitalist, maybe

[@horizon319]

I swear the insurance companies think: “The sooner you die, the sooner we don’t have to cover you.” They are the devil.

[@solemnace]

That implies they care enough about you as a human to even be interested in what you're doing. As far as they're concerned, as long as you keep paying them and they don't have to return any of the money, it doesn't really matter what happens to you.

[@marcroberge23]

US Health insurance: because someone looked at Hell and said, "Not evil enough"

[@gagaplex]

Thinking only in terms of short-term benefit is the biggest ailment we have as a society, be it healthcare, economics, climate policy and on and on and on. Short-term profits will kill us all.

[@TreeHairedGingerAle]

This ☝🏾✨

[@falconerd343]

Welcome to Late Stage Capitalism where we've replaced The Divine Right of Kings with the Golden Rule, he who has the gold makes the rules.

[@mylifewithmarmalade4624]

100% can confirm. Worked in long term care and rehab for years and it just made me constantly furious the lengths we had to go to in order to get properly fitted basic wheelchairs and walkers. Let alone even the most basic pads or add ons. Had one lady that had a great many melanoma recurrences that had metastasized to her lungs, bones, and brain. (Wear your sunscreen kids.) She wasn’t expected to live more than a couple years and was wheelchair bound and extremely oxygen dependent. They paid for the wheelchair and the high volume oxygen concentrator without too much fuss. What did they fight the hardest? The pads needed to protect her very fragile skin from pressure/friction, the attachment for the oxygen concentrator that would pressurize and fill portable tanks and a wheelchair mounted holder for the tank so she could leave her room for a couple hours at a time and go live what little life she had left. She had really “excellent” private insurance, but they refused to cover those. Joke was on them, her daughter was an attorney and after multiple frustrated conversations and multiple letters written by all her mom’s providers about how these things really were necessary, she filed suit for, if I remember correctly, unlawful imprisonment (ie they were making it impossible for her mom to leave her room without risking mortal consequences, and were therefore imprisoning her). Company settled so fast and approved the equipment the next week. But not everyone has an attorney as an immediate family member that is ready, able, and willing to follow through on a threat to sue.

[@granthughes8857]

As a home health physical therapist, this is so true and it drives me up a wall.

[@Emilio1985]

Given that literally any person who is not currently disabled can become disabled in an instant or can develop impairments and disabilities over the course of normal everyday living, you'd think more people would care to defend people with disabilities and protect their rights, but we have institutionalized a perspective that has valorized keeping these human beings out of sight and out of mind so that they can be more easily ignored.

[@kd_1421]

That's what I've been saying for years, thank you! If we're lucky, we all get old one day. There are exceptionally few people who DON'T develop some kind of disability when we get to a certain age... why don't we make things like this easier and more accessible? It makes no sense!

[@gblb788]

Excellent post. It’s very true. The message seems to be those with disabilities are less than. This is the heart of the matter, and we must do better. Many with proper accommodations can lead full and productive lives. The burden of obtaining necessary accommodations or paying outright for mobility aids or accommodation not covered, which adds additional barriers.

[@Davidsladky135]

Spot on, took my disabled friend a year to get a motorized wheelchair because they said he wasn't disabled enough. He can only use 3 fingers on his left hand!!!!

[@Vishnu-B]

The last line man... gold, absolute gold. Doc, God forbid but be careful, I'm concerned for your life. I dont know if Insurance companies will take all this lying down.

[@I.m-Me]

Gold, indeed. I replied aloud, "Less than, even"

[@rachellebasset4671]

I'm concerned about the same.

[@Joy21090]

Silkwood 2.0?

[@evilsharkey8954]

Everyone already knows insurance companies suck. What they’re doing is legal suckage, so they have no need to off whistleblowers like a certain negligent airplane company.

[@rayzerot]

Why though? Everyone knows health insurance companies are awful. The Doc isn't leaking trade secrets, he's saying what everyone already knows ​@@rachellebasset4671

[@turtlegirlman]

My fave part about them only using mobility "around the home" as a metric is that stuff that DO actually let people move around their home (like a stairlift) isn't covered at all. I gave up a while back and have been mostly using wheelchairs from thirft stores which are neither fitted nor in great working condition unless i get REAL lucky. Had to save my cash after buying a stairlift worth more than any car i ever purchased 🙃 Also a general and sincere thank you because this channel has helped me stay sane during my own medical Adventures over the years 💛

[@jcgraff1]

Wow! Will, I’ve been watching your videos for years. I am always amazed at how you are so in touch with the challenges that specialties outside of ophthalmology face, as well as the spot on personality traits peculiar to each of the specialties. As a neurologist (trained at UIHC like you) trying to get coverage for seating/electric wheel chairs is a challenge. The paperwork is thick, and is so voluminous that we have to send folks to PT for a specific type of appointment to be able to fill in all the blanks of the paperwork. Keep up your fine work. Sure wish the general population would see and digest your videos about the problems with our healthcare and payor systems.

[@michelleponzio]

So true! The authorization to even get a rollator walker for my Parkinson patients is insane. But, I have developed a love for cursing out insurance reps😅

[@briangasser973]

You should not be cursing out anyone. You think a CSR has the power to decide a claim?

[@leafyveins4985]

​@@briangasser973No, but what other route is there to take????? You literally HAVE to raise a fuss in these instances or you don't get what you need.

[@donnaleeah5075]

Does your area have a second hand medical I'll say store though not the right word. I live in the Greater Portland Maine area. World Partners for Health mails medical equipment around the world. An average seated walker (all in excellent condition) 20$. I got a knee scooter $60. Hospital bed 500. I wish all larger cities did this. Hospitals etc contribute them since they were disposing them anyways.

[@waffles3629]

​@@briangasser973 I had a csr tell me that my claim was denied because I'd done the thing insurance told me I needed to do to get the claim approved and that it wasn't their fault I couldn't follow instructions. I was told "If you want X paid for you have to do Y", I did Y, "Oh, well then we can't cover X because you did Y".

[@woodysmith2681]

"The date is today" is a calendar at private equity firms too. Probably make a fortune selling them to Wall Street, until you got bought out and downsized.

[@scittw22]

Family med bro here. You have no idea how frustrating this is. I get these patients to a physical medicine office and if we're lucky after a year and a half of back-and-forth paperwork they might get their powered wheelchair

[@vanessavallette4809]

I 1000% agree with this. I have MS and they don't cover crap. I'm still fairly mobile but occasionally need assistance so I'm "not disabled enough"

[@violaplayer26]

Fellow MSer here. I’ve had to fight UHC when I had them for insurance for almost everything! It was insane. I cheated though - I work in appeals and denials. 😅

[@Hope-rh8bi]

Omg 😢😢😢😢 thank you for covering this. We have been fighting with Insurance people for assistive devices for so long 😢😢😢😢

[@trishayamada807]

At my annual exam a few weeks ago, my dr could NOT talk to me about a new medication I started a month ago, because that is not covered on my annual exam. I am going back this week, for a “recheck” of how my new medication is working. That is ridiculous. How is this saving anyone any money? My Dr was so apologetic. It wasted all of our time.

[@Joy21090]

Phhht. I would use the Portal for that.

[@KxNOxUTA]

😑 Oh, the horror stories. Good job speaking up about this. Honestly thank you. Even just giving ppl the room to speak about their experience and see how many others struggle the same way, is morbidly uplifting. At least shared suffering can feel a bit lighter. 😮‍💨

[@AndreaHernandez-zt6cx]

One of the best so far! I have worked with adults with disabilities for nearly a decade and I have seen people who want to be independent stay on Medicaid because of crap like this. Even Medicaid will only cover a wheelchair once every 7 years or so with major hurdles. Because people want to live their lives in a wheelchair....

[@jeanclaudevanslamme]

I wasn't expecting such a glowing endorsement of insurance companies. The bare minimum seems like it would be an improvement.

[@ffvgr255]

Not all people who use wheelchairs need them at all times! Sometimes we get bad days, and sometimes we're able to walk to do stuff. Thanks for this; our household is all disabled and it gets hard at times to be taken seriously.

[@violaplayer26]

Amen to this! As a person with MS, I know very well that some conditions are variable. Some days I feel just fine. And some days my hair hurts, my eyelids are 50 pounds each, and blinking takes too much energy.

[@economycollapseimminent]

God, please protect this man. He out here spitting truth. 💛💛💛

[@potterpal5]

I work in Jacobi which is a major trauma center. Patients are often stuck in the hospital for weeks while waiting for the equipment that they need to be discharged, long after being medically cleared.

[@markallman418]

I'm always glad to have Dr Glaucomflecken around to make me feel better about Canadian medical care.

[@user-yc4fz7vv6u]

He's certainly making me feel better about Australian health care..

[@leanykakicsi6152]

Health Insurance’s term for equality: doing the bare minimum for everybody! No exceptions!

[@johnpaul5316]

Because this is the bar that was set. You wanted equality.

[@zyonbaxter]

It took me about 3 years to get my powered wheelchair and later I found out the one I was given was not only NOT what was ordered but a display piece because the examiner was scamming people with her husband who sold medical supplies. She would recommend wheelchairs with expensive features and only give the cheapest option while they pocketed the rest from the build commission. She was obviously fired when this was discovered but I didn't find out about this until 2 years later when another examiner saw my chart and brought it up to their colleague. Even when I got it, her husband came to my home without notifying anyone, by himself(which is against several protocols), just backed his truck to the front porch that didn't have a ramp, and left it on the porch because it couldn't fit through the front door(because it wasn't what was specifically ordered to fit) and quickly left without giving any instructions on maintenance or how to use it.😡😡😡🤬🤬

[@goodfortunetoyou]

Not a lawyer, but that sounds like insurance fraud to me.

[@monicamesecar9126]

As a power wheelchair user with Cerebral Palsy, thank you for bringing attention to this!

[@RegisteredNurseL.A.]

1:07 But first and foremost is insurance fraud. Not from individuals, but from these horrible insurance companies taking our money and not covering basic needs of human beings

[@cheft]

Love the United Health Care logo on the calendar

[@abby_unhinged]

I've learned how true this is through working with people with disabilities; whether that be in a hospital setting or a home setting, trying to get DME or repairs to them is ridiculous. One of my old patients told me that their electric wheelchair was $25,000 cash. Thank God we have an equipment loan organization near us but the wait list for equipment can be over a year.

[@briangasser973]

Seems a market for Chinese manufacturing to dominate in. unless the FDA blocks low cost models from the market.

[@shrimpdance4761]

$25,000?! There are cars cheaper than that!

[@MsVilecat]

*disabled people As a group, we prefer this term over what abled academia decided to pick for us. The disability(ies) is part of us and our everyday life, it's not just attached to. Having a disability shouldn't be seen as a negative, just a potential need for accomodations to be able to do what we want to accomplish.

[@waffles3629]

​@@MsVilecat yep, like it's a disability, not a backpack, I can't just put it down when I'm tired of it.

[@abby_unhinged]

@@MsVilecat my apologies and thank you for educating me. 🙂

[@isabelleblake8732]

this!!!! my mother is going through the end of her life with a degenerative nerve disorder, and has been progressing to need mobility and speech devices quickly in the last two or three years. working with UHC has been HELL to get these, as they want “trial periods” to prove we will use the devices or else the loads and loads of unnecessary documentation about the disability (which is difficult to obtain in the first place - my mom can’t type, write, or drive). UHC will typically only cover one chair every five years, without any repairs or anything unless a doctor specifically orders them. it’s infuriating

[@deeps6979]

It really is laughable when a treatment/recommendation could save insurance companies money, but they still won't cover it. Had something similar with allergy treatment. They would cover weekly shots ($40 copay for me, weekly billing for them), but not a 90-day sublingual serum that cost me $300 out of pocket and one seasonal visit. My copays alone would've run $480 per season with shots, so whatever insurance had to pay would've been far more.

[@schrodingerscat4503]

This extends to other things as well. Like some people are so hateful or stupid that they would go against their own self interest in order to screw others over.

[@Joy21090]

Did the serum work for you? We paid a *$TON$* of money and it didn't help my child.

[@maryreynolds8568]

I am on oxygen and need a wheelchair if I'm going anywhere that I have to walk more than 50 feet or so. I don't need it at home. It's ridiculous the stuff I've had to go through to get things covered.

[@jsaunt90]

Spot on (as usual). The DME companies are terrible too. I called 1 to see when my mom's hospital bed would be delivered. They wouldn't tell me, saying it was a HIPAA violation. I had to call back and impersonate my 96 yo mother to find out. Thanks for all you do! (SLP here...if you ever do Speech Therapy, be kind. LOL)

[@tsnap4]

I just want you to know that you're doing a great job at pointing out the issues w/American healthcare, and I always have to wait to watch these b/c I can't let myself get too mad before trying to go to bed.

[@saml193]

As a person in a wheelchair, I absolutely lost it at “Disabled people go outside?” 😂😂

[@lifeinflight7778]

Lol you should have a sketch where United Healthcare dresses up for Halloween 🤣🤣🤣

[@MullingInk]

Thank you for posting about this! I’m a wheelchair user and it took me eight months to get my power wheelchair, and it does the bare minimum to meet my needs. I’m a part time user, and there are many times I go without my wheelchair because the one they allowed me to have is a 250lb monstrosity that I don’t have the right equipment to get in and out of the car safely. I make do with an eight foot folding aluminum ramp. Unfortunately, that means on days when I’m feeling the worst, I don’t have the energy or strength or grip to wrangle it, and I have to make do with my rollator or walker. Naturally my medical professionals think I’m doing better when I show up with a “lesser” mobility aid, and will comment on it. Fun fact: insurance companies have redefined “neurological condition” to exclude peripheral neuropathy as a reason to give someone a higher tier power wheelchair, and I wouldn’t be surprised if it was due to it being a common comorbidity of diabetes. It makes this skit extra funny, in a dark way.

[@BruceP]

Going outside is cosmetic. lol

[@Zelmel]

I love the health insurance videos. Love them in that they are really well done, and the fact that they're so close to reality enrages me.

[@MaxWa]

Okay, Doc bro, you got me. How do we fight against the Health Insurance lobby in a meaningful way.

[@MortMe0430]

These insurance (and private equity) focused skits are absolutely scathing, rightfully so and I'm here for it.

[@2-minutephysiatry506]

Thank you so much for speaking up on this topic. As a Physiatrist, it is so frustrating to write 3 pages of "reason" only to have the claim denied by a single line, "Does not fulfil criteria" ! They never say which one, and I'm sure no one ever reads the explanations / rationale that we write.

[@Joy21090]

Thank you for being a Physiatrist.

[@landysue9009]

My friend's current power wheelchair cost $46,000! Fortunately, both her parents had good insurance, and Medicaid covered parts of it, but she's independent of her parents now and is looking into a standing wheelchair to help with bone density and independence. The cost for this one is upwards of $60,000. Despite a doctor's prescription for this chair, it will probably be denied several times and then have to go before a judge. We've started the mountains of paperwork over a year before she will need the new chair. Costs of necessary medical equipment are extensive, and the process of acquiring it is exhausting.

[@jodiwinship2457]

Thank you thank you thank you for bringing attention to this! Everything in here: from not covering equipment for community use, to the length of time it takes to get equipment, to the asinine criteria for medical necessity…it’s so true and so infuriating. One thing you forgot to mention is that most of the time they’ll only pay for equipment once every 5 years…. I work with low-income older adults and I got so tired of seeing folks with broken unsafe rollators (4-wheeled walkers) I started a nonprofit (in part) to do free rollator repairs because all the DME vendors said it would be cheaper to just get a new rollator than pay for repairs (which is fine if you’ve got money, but the folks I’m with struggle to even afford food).

[@caspenbee]

Every single sentence of this one was pure gold

[@XanderKuro]

You don't have to worry about sustainable profit if the government will bail you out since it's "too big to fail".

[@shawnahipple4818]

This hits home. My daughter is extremely special needs,and we are always fighting with insurance. They are monsters.

[@skpokerface1]

Will never forget how insurance hounded us to return my grandpa’s wheelchair literally a day after his funeral. Especially during COVID when we could barely mourn

[@amykarnehm3602]

Love these, Doc G! Was able to do my company’s high deductible option this year and learned so much more than I already knew. It’s criminal.

[@fabrisseterbrugghe8567]

I'm so thankful that I just use a cane. But getting PT or help with mental health has been a struggle. The referrals have gone through, insurance has approved, but there are so many people who need one or the other, that the waiting lists are weeks (PT) or months (talk therapy) before an assessment appointment.

[@MsVilecat]

There are less and less therapists who are in-network to these days too in multiple states. Most people can't afford $200+ per visit!

[@amylandry4108]

“Everybody would want one… “ Sheeeesh! Jimothy ❤😢❤

[@ellamcdonald-lee2186]

Yes! More people need to know this. Plus, at least with our insurance they will only cover one wheelchair at a time, but if you have a power wheelchair, you need a manual for back up.

[@brunigminecraft1660]

Bro no views? Also "We're doing the bare minimum for everybody" love that lol

[@feha92]

I honestly expected him to rather assert that they don't reach it for anybody.

[@carolstettheimer9906]

Oh my goodness. Yes. And my disabled person had the "advantage" of a disease that does get covered relatively quickly and that has supporting organizations that aid with supplying devices. Even though I only lived in the world of disability for 8 months, it was so eye opening, including the concept of disabled people disappearing from society because it is so incredibly hard to get out of the house. And we had knowledge and means.

[@Joy21090]

Re "I only lived in the world of disability for 8 months...." I am sorry for your loss. Wishing you all manner of peace and happiness.

[@SMJCMKA]

Why do people have insurance anymore..it looks like they don't cover anything anymore 🙄

[@fabrisseterbrugghe8567]

Primary Care. I had Bronchitis recently. It had been three years since I had health insurance, so it didn't occur to me to see a doctor until my sister reminded me. I had an appointment the next day, ended up with a shot in my butt, a prescription for a short course of steroids and heavy duty cough medicine, and half an hour on a nebulizer. It helped.

[@M1911jln]

Over the course of the past 18 months, I spent 6 weeks inpatient. I was in the ICU twice, had 2 surgeries, 6 endoscopic procedures, a dozen anaesthesia events. The total bill from the hospitals was over $500k. My portion of the bill was under $5k. So there are good insurance companies. And then there is United Healthcare...

[@lennierofthethirdfaneofchu7286]

A few years ago I was hospitalized for a week. The EOB said the submitted charges were $85,000, the allowable charges were $45,000, and I owed the hospital (in-network) $350.

[@briangasser973]

Insurance is good for covering catastrophic loses. If you have cancer treatment, hospitalization, surgery, expensive drugs,... It is not good for covering lower cost care (physical therapy, equipment, OTC drugs).

[@Joy21090]

​@@M1911jlnGET WELL SOON!

[@hyperflares2879]

Yeah, we'd like to go outside! Voluntarily.

[@FunSam]

I'm totally stealing "paperwork mountain" and will be incorporating it into my common vernacular at the VA.

[@iainballas]

My favorite is when my health insurance decided that my ADHD and depression medication were no longer essential to my quality of life, and were now out-of-pocket. Funny enough same month my car insurance decided that the value of my totaled car was the scrap value, not the pre-wreck value. I got 850 bucks for my 5-month-since-factory dodge dart that had less than 20k miles on it. 2020 was a good year!

[@fightinjack]

As someone who got recently approved for a $1.2 million/year medication. Thank you! Now wish me luck climbing paperwork mountain while being chased by ultrasound techs and ophthalmologists!

[@AGL01772]

As an occupational therapist, I approve this message.

[@lifeonholidae]

I'm an OT and this IS SPOT ON. It should be criminal the things insurance denies.

[@sarahprice659]

Like how dental insurance (if you are lucky enough to get it) will not cover a penny of a night guard- which you are getting so that you won’t further damage your teeth by grinding them at night… but they will pay for some of the procedures necessary to put your broken (cuz you ground them so badly) teeth back together!

[@Kojak0]

The more I learn about the US healthcare system, the happier I get I'm not American.

[@crabman2010]

"The Day is Today" I NEED THAT CALENDAR!

[@waffles3629]

Yep. I know someone who was denied a wheelchair because she could walk 20 steps. She had to sit down every four steps, and it took like 15 minutes, but apparently that was "proof" she didn't have mobility difficulties.

[@22Too]

Keep preaching, doc!

[@msg3tr1ght]

As a power chair user, I’ve never felt so seen by a piece of content before. THANK YOU!!!👏🏽👏🏽👏🏽

[@Knightwrath333]

*cries in home health physical therapist who has to climb that paperwork mountain on a weekly basis*

[@xxMurmaiderxx]

Healthcare equipment manufacturer's, government red tape, and insurance companies all work together to make things like stretchers and wheelchairs cost $10,000. Such great teamwork :)

[@ChelseaJeanBentley]

wow I genuinely don't think I've watched something the second its dropped before haha

[@lunams7]

2 points. 1) When I had double knee surgery I asked for an ice machine because the last time I had surgery on one leg, which was agony in itself, I learned it was a life saver having it but at the time I was under my mother's insurance. The 2nd surgery with marketplace insurance I asked and called multiple times to get one and it never came. My poor mom had to cycle through so many ice packs. 2) The kicker that forced me to go PPO was how long it took for me to get a referral to see an eye specialist for my very rare visual impairment. 6 months, 3 doctor recommendations, and a lot of money I didn’t have later and they barely paid for 3 visits. If I needed more I had to fight again. 😡

[@DaTimmeh]

"We don't think about the future here" is so infuriating. Seen it in many struggling big companies, refusing to pay a (to them) trivial amount to get back on track in the next year or 2. Instead of doing the tiniest bit of planning. And we suffer when jobs are lost, government has to support them, dollar value goes down, etc., etc.

[@juliee3154]

Im a PT. I ordered TRANSPORT chair for a pt to go to appointments today. The prompts to clarify if this was necessary were "will this make a patient more independent in their home?" NO its for transport! The thing exists to be easily lifted by a caregiver into a car!

[@Scalooosh1]

I have literally gone back and forth with insurance companies on behalf of patients because they’re requesting an MRI before a CT scan. Then when the MRI is requested, they deny it because they need a CT scan before an MRI. Let the cycle continue. Doctor even wrote a letter and spoke to the board. Then the insurance Dr said the patient doesn’t have a tumor, they’re just “mentally ill” I wanted to scream.

[@Joy21090]

Your patient needs Texaco Mike's Combinatron (®️) CT and MRI all-in-one.

[@waffles3629]

Ugh, yep. I was told I had to do a home sleep study before doing a lab sleep study. So I did the home study, they approved the lab study, I did the lab study and...they revoked the approval for the lab study **because** I did the home study first. They also tried to deny my migraine meds because my MRI was clear. Do you know what can't be imaged in any way? Oh yeah, migraine.

[@TheDemosMirak]

I'm a big fan of your optimism that they're doing the bare minimum for everybody

[@erinnorwood6124]

Thank you for this. I had to buy wheelchairs off of craigslist until i could get one from my insurance.

[@aduck2230]

My daughter became dependent on hearing aids at the age of 19. They are not covered by our health insurance and cost thousands of dollars. Horrible!

[@DemonicNightmare]

Flashbacks to when I was working customer rep for an HRA.... I learned how to make sure people got what they needed as best I could...

[@birdbrainz32]

I've been working for an assistive tech nonprofit for the last two years, and I hate how true this is. The majority of people who come into my office have this struggle with insurance companies, and it's infuriating. I can't understand why insurance does not cover devices that are critical to a person's independence and general well-being. Don't even get me started with pediatric mobility devices. Every problem that adults have with insurance is like 10x worse for kids because companies don't want to pay for a device that the kid is going to grow out of in a couple years. Never mind the fact that mobility devices are critical for kids with disabilities to interact with the world and develop as best they can.

[@Joy21090]

This problem needs WAY more visibility. I work in an elementary school so I see some of this. G-d Bless the work you do.

[@fuzzypickle9537]

As an ambulatory wheelchair user this is extremely accurate. I've spent the past 2 years trying to get a wheelchair but because I can usually make it around my apartment with my cane they refused to pay for it. I ended up having to pay out of pocket for a fully motorized wheelchair. The only way it was possible was that I finally got my back pay from disability

[@sylv_ain]

as a person living with a T1D spouse, this video hits right in the feels. insurance companies, why ????

[@Dingodogo220]

Ouch this one was painful because I just waited 18 months on a wheelchair. Got it last month but could not be happier. Of course whenever it comes to going over anything but a flat surface it's quite difficult because they only wanted to cover a manual wheelchair and yes I did have to pay separately for the seat cushion and backrest.

[@rebeccat715]

This reminds me of that tweet or whatever where a guy said disabled parking spots should only be available m-f 9-5 because he didn't see any reason disabled people would be out outside those hours. The response was "we're disabled, Daniel, we're not werewolves"😂 Seriously though, anyone who lives long enough will become disabled in some way (not to mention it could happen to any of us at any point), so this below bare minimum healthcare should be more worrisome to more people

[@kidsis]

I have a manual wheelchair I purchased out of pocket using my FSA funds because I originally was going to have my ankle fused. We found out that I have no bones left in my ankle and midfoot, so I’m going to have to have my leg amputated below the knee instead. We also have a rollator walker we got on Amazon. I had a knee scooter from a previous foot injury and I have crutches. We also have a standard walker in the house. We’ve basically collected durable medical equipment the last couple of years. I have no clue what or how much my insurance will cover for my prosthetic leg, but I do know that I have extra funding to help with the costs.

[@evastickler3298]

The cut to the United Healthcare calendar got me.

[@noelparker741]

Going through this process right now. Thank you for bringing awareness in a humorous way! Feels validating.

[@katwitanruna]

As someone who has been permanently disabled since 2009, I’ve had the best luck with Cigna.

[@marshallrobinson1019]

These need to be collected and edited into a documentary style long form movie narrative

[@evilsharkey8954]

The boss is lying. They do the bare minimum for everybody except their executives and shareholders.

[@sachemsiouxx]

Here in France, the reason your sketches still look exotic is partly called Ambroise Croizat. French communist resistant who became minister after the liberation and implemented our healthcare system. Feel free to build statues, we sure dont build enough of em. Cheers from a rural public psychiatric french nurse.