Is Health Insurance A Scam?

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[@scenepunk09]

Anyone who says health insurance in this country isnt a scam is getting money from that scam.

[@mlee6050]

It's not, oh wait I am in UK

[@manuelight]

it’s definitely better than not having health insurance. you gotta change the whole system and pay taxes to health care instead of guns and coke

[@Excaliber158]

@@manuelight It’s not though. The best alternative is to put people in office who support universal health care. Know what doesn’t have to be argued over if everyone is on the same plan? Administration. It’s all the same. Complexity goes way down. We can let doctors handle medicine.

[@scenepunk09]

@@mlee6050 lucky!

[@scenepunk09]

@@manuelight I know. The stress of not having health insurance is real. Also I have a friend who isnt in the best of help who refuses to get health insurance even after a really bad incident. Its very worrisome.

[@HellowThar]

If your doctor tells you that you need this potentially life saving procedure or diagnosis, but your insurance company denies it, then your doctor is not the one in charge of your health.

[@taahasiddiqui1071]

Off not, your wallet is

[@NovaStrike118]

Insurance Companies are in charge of your health. They get to choose which medicines and treatments you do or don't get... which means they're practicing medicine, without a medical license.

[@Rolandasvt]

@@NovaStrike118 this is such a fact I remember I needed to go to therapy because I had a double knee surgery and my insurance kept on denying the form of therapy. My doctor wanted which was two weeks of heavy therapy and my doctor kept on making appeals my insurance kept on saying no, and they would only approve three weeks of basic therapy. Insurance companies will always pay for the cheaper procedures or medication, and would only approved if you need it.

[@glenmcgillivray4707]

A doctor will know a cat scan will show nothing related to your condition. The MRI will offer the resolution to inspect your health. But Cat scans are cheaper. So the insurance insists we do it first and confirm how useless it is, then try to find an alternative MRI provider, who will also lack the resolution and has a waiting list, so you end up with 3 scans done for a proceedure that could have been done in house within the week and take months. All to save your insurance company some possible cash

[@millasboo]

They aren’t but they can be ethically unethical and go around the system. Though this is a big big gamble as it can potentially be the downfall of a hospital if found out

[@butterbeanqueen8148]

My insurance denied my adult tonsillectomy because I hadn’t had strep throat enough times. I had a STAPH infection that wouldn’t go away. The doctor that denied it was a gynecologist and was basically following the guidelines set by the insurance company. I was sitting in the exam room listening to my doctor absolutely lose their $hit on the phone with the insurance doctor. After reaming the insurance doctor out for not even being qualified to make that call they got the surgery approved. “You are questioning me?” “You are second guessing my opinion?” “What medical school did you go to?” It got ugly. After my tonsillectomy I felt better than I had ever felt in my entire life. And I thank that doctor for standing up to the insurance company every time I see them. Thank goodness I had a doctor that was willing to fight my insurance company. But it shouldn’t have had to happen.

[@levigriffin5553]

Send them a thank you card or Christmas card or something like that. Showing personalized heartfelt gratitude like that will keep them going for other patients in the future and make those calls to the insurance company bearable to them when looking at it

[@butterbeanqueen8148]

@@levigriffin5553 she definitely knows she’s appreciated. ❤️

[@ngotemna8875]

What a G

[@justarandomstranger1]

​@@butterbeanqueen8148 Big W for your doctor

[@atishsingh8926]

The fact they had to do this is beyond a scam

[@mikegoodwin2386]

My mother was the business office manager of a small hospital for most of my life. She argued with insurance companies - a lot. I've heard this stuff so much. This doctor nailed it.

[@errol484]

"The objective of the insurance company is not to pay." Once you recognize this as both a patient and a physician, everything about the medical insurance industry will begin to make sense.

[@PowerPerPound]

Without a doubt this is the biggest take away and it begins to explain otherwise baffely things they do like suddenly denying coverage for a medication you've been receiving for months to even years. They will eventually apologize, give a bs excuse and cover the medication but by that time it's been weeks or even a month and that's extra dosages they don't have to pay for.

[@Veri7a]

Its not unique to them, this is every insurance. I think Medical passes around the most money however. Especially given how unhealthy Americans have become. Lots of predatory money to be made there unfortunately.

[@mikezappulla4092]

I realize this as a patient and a physician. What is suppose to make sense now?

[@TheAnnoyingBoss]

Its called fraud and its a crime. If they dont want to pay they shouldnt be an insurance company

[@benjaminlehman3221]

Yep. Sad but true. You can’t blame the insurance companies for doing what’s best for them. They need to make money. Insurance companies hope you never get sick. Problem is it causes all of those issues like the DR described.

[@infernoarmor]

The best part is he's arguing with someone at the insurance company without a medical degree

[@mariosblago94]

my responses to denials are usually along the lines of: "Can I please have your name down? So, when you kill the patient, I can point the family in the right direction."

[@TheQu3tzalify]

I believe insurance companies do have in-house doctors and pharmacists that check the claims and make sure that it's coherent.

[@mariosblago94]

@@TheQu3tzalify No, most don't. They generally just have a doctor signing paperwork in the background to comply with requirements but they don't pay them enough to actually discuss cases with the providers. Instead, they rely on cheap labor to be on the phone all day and deny claims as much as possible.

[@olorin3815]

​@@TheQu3tzalifyyeah there have been news how some insurance companies just made a system some things automatically get rejected and they just send them over to the doctor to mass sign a bunch of documents, actually they basically do that a lot then if you file a complaint doctor actually checks. So if some people dont complain for some reason insurance company just gets away with free money

[@rachellobello]

​​@@TheQu3tzalifythis is correct! I knew an RN who did this, she got bonuses for meeting quota for denying a certain # of people. You can't win.

[@i_heart_dollhouses7327]

Agree. My eyes were opened when I worked in medical billing. By the way, not just Health Insurance, a lot of other insurances run the same way. They will do anything not to pay.

[@ohanailo6681]

Thats a great observation of the, Corporate Structure.

[@webportal6659]

I find in most of the time, don't get insurance. Take what you would pay into that insurance and put it in a savings account meant for medical.

[@FrogGuy-tt1wq]

@@webportal6659no no no no no no no no no. just no

[@missydelcoglin4087]

@@webportal6659Choosing not to have health insurance is very dependent upon every person’s situation and requires a lot of deep thought and takes on a lot of risk. If you’re healthy and never see a doctor, it may be right for you. You may end up with a broken bone that requires surgery - the savings is not going to cover that. I had really thought of going without when I was 25. I’m so glad I took it instead. I ended up having an emergency total colectomy and permanent ileostomy on 25 December. There is absolutely no way it would have covered that. I’m now medically fragile and easily hit ur $5k deductible within the first to second months each year.

[@ghosthin3012]

At the small chain community pharmacy I worked at, they have a person just for billing the insurance. It is a full time job just to serve less than 1000 patients. It is insane how difficult it is to get insurance to pay.

[@DildoSchwaggins1]

Kinda crazy how insurance companies, who don't have any degree in medicine, are able to decide what is best for a patient.

[@nadzrinpuad1283]

Bcoz insurans not profitable. They loosing money..

[@uroczytofu]

​@@nadzrinpuad1283insurance* is very profitable. People are paying for insurance only for the company to fight them like they're about to get abolished so they don't have to pay. An insurance company would rather see you die than give you the money you gave them.

[@Inaa23]

They have doctors, therapist and nurses that work for insurances. I talk to plenty of them all the times.

[@jordanfelt5978]

​@@nadzrinpuad1283 clearly you don't know much about insurance. Most insurance companies have been around for awhile, and there's a reason for that. Because they are profitable for themselves.

[@captainteeko4579]

Like politicians who decide on autonomous/medical rights of people’s bodies 🫠

[@snowleopard1831]

Every insurance company has an entire floor of employees dedicated to making sure you as a customer don't get your bills paid, and don't get the care you need.

[@dickrichard5579]

And I hope they burn in hell

[@Zballin45]

My lady had our kid last August. Still getting bills. Each one is an argument. The latest one was 1800$ Kaiser claims we didn't have insurance. We did. What a joke

[@dors6143]

Entire floor? The entire insurance company. With one small office signing up new victims

[@christopherb501]

Remember Republicans chastising "Obamacare" because of "death panels"? Always projection; always.

[@tyardovdabulldht2340]

SOUNDS LIKE REPUBLICANS!

[@thebigomn2907]

Unreal the level of corruption . If he being a doctor orders a test or meds it's not up to the insurance to say what his parents need.

[@csnide6702]

What Mike isn't saying is that Doctors and hospital administration lack of taking action LED TO THIS HAPPENING... They are just as much to blame.

[@Melody-ym4do]

I think some really do try, but you're right about some of them, there are some that shouldn't be doctors, or in any health, medical, or mental health profession, sometimes the hospital hires flat out druggies and criminals too. Shouldn't be allowed at any places claiming to be any type of "health or wellness center"​@@csnide6702

[@267cal]

​​@@csnide6702they're doctors, not politicians

[@merrywalsh2809]

I worked as a triage nurse for a group of cardiologists. Once, an insurance rep wanted to know why the doctor ordered one test and not the one she thought should be done. In exasperation, the doctor told me to tell her, “because I am a cardiologist, and you are not.” Half the practice was spent on this nonsense. When I retired, I chose straight Medicare, not an HMO or Advantage plan, just so I would not be denied care by some bureaucrat in an office somewhere.

[@izabelle382]

I’m a neurologist and I am now convinced health insurance is the biggest scam. This is the first time I hear another physician verbalize this on KZbin. It’s the bane of my existence

[@A_Hylian_Not_An_Elf]

It’s really sad to think about how many deaths could have been avoided if the health insurance system wasn’t so corrupt.

[@antoniogallardo577]

Nice name (:

[@daniellescott477]

Very true Dr. Very true 👍🏽

[@andrewmikewilson]

I'm a TBI and I had to learn a lot of math to hack the system to get my basic needs.

[@pixpusha]

Of course it's a scam. How else would they make money?

[@alicat9173]

“But again the objective of the insurance company is not to pay” And that right there is why it's a scam.

[@dekipgamer]

Insurance companies: we don’t want to fulfill our purpose bit instead ruin an innocent cancer patient life because otherwhise it will cost us a little money

[@nil_system]

With how the behave like they got free health care it’s fare game to me

[@karlieriviere8445]

Literally like the whole point of insurance is to pay? Like??

[@nil_system]

@@karlieriviere8445 yeah but when u realize how fked America is and how much dumb people they have it gotta be hella expensive

[@karlieriviere8445]

@@nil_system which is why all these ppl in America are paying for insurance💀 being dumb shouldn’t affect your healthcare🤷🏽‍♀️ if anything you need it more cuz you’ll get into accidents by doing dumb things

[@madeleinegrayson8372]

About 30 years ago I realized that I needed to learn to be my own wellness primary care provider. It was very clear that overworked doctors and insurance designed not to pay for services meant stress on top of stress. Your best choice is to learn how the body works, learn how to communicate with your body and learn how to manage day to day wellness yourself.

[@denisesurber8176]

That sounds like a great idea.

[@Reikialchemieesthetix]

Yes, as the creator intended for us to do.

[@kascension]

Yes!

[@la6136]

Truth. Let’s be real the majority of doctors are clueless about how to heal the body anyways. They just pass out pharma drugs that cover up symptoms and cause more health problems long term. Be your own doctor.

[@beccastyver]

I worked in patient financial assistance at an oncology clinic. It’s usually support staff doing the initial work and calling for the prior auth. Doctors come in if a peer to peer review is requested by the insurance company. Which means a doctor of any kind talks with the oncologist about treatment plans for a cancer patient. It’s ridiculous.

[@elainebelzDetroit]

Her last line is really important. Insurance companies literally make their money by denying care.

[@danielm4436]

Not just in Healthcare too. Car insurance, fire insurance in california. I know people who got a ten thousand dollar increase in their fire insurance this year. How are people supposed to cover that? It's criminal.

[@NathanHedglin]

FALSE. That's not the function of insurance

[@itsnotatoober]

@@NathanHedglin I thought this comment was obvious but apparently there are some meatheads too dumb to even understand it

[@bigdrill8881]

@@NathanHedglinIt certainly is from the insurers point of view.

[@King__B.Logical]

Insurance agent here. That’s not the function of insurance companies. Insurance, depending on the insurers plan/policy is to get covered of what could be lost. It’s a transfer of risk.

[@suejohnson2608]

Amen!! I’m a nurse. I miss being “just a nurse”. Now I’m a coder, insurance rep, biller, secretary, hostess, pharmacist, referral specialist, etc….the list continues to grow.

[@fardinarnob5057]

you making bank

[@DantheManZ-wn6zg]

​@@fardinarnob5057 Possibly making same or similar amount as "just a nurse"

[@LogicalNiko]

To be honest I wish I could get out automation applications for this faster. It’s being worked on, and unfortunately that is just taking time. But the number one request I see in the field after providing a solution to help reduce physician work intrusions on (“pajamas time”) is those physicians begging to get more products to nursing staff. As nursing mental stress is unfathomable.

[@bribrownrobinson4934]

Understood. The work just continues to be passed down the line. I’m a pharmacist. We complete prior authorizations, therapeutic interchanges, etc. on the behalf of providers.

[@HOSS257]

​@@fardinarnob5057nurses don't make bank. My mom is a nurse with 30+ years experience and management and she still doesn't get paid her worth

[@aedsell]

Former medical transcriptionist here. Doctors are also completing their own medical records now too, making them the most expensive clerk in the system. Your medical records are now less accurate than they used to be.

[@Yellow-oc4sl]

Wonder how much less or more bc Everytime we turn around medical records are being hacked and exposed information smh , what a joke , it's better you try to identify what is going on with your body besides the doc now a days they are limited

[@kathleendinsmore7588]

Thank you for pointing this scam out. As a country collectively we need to bring this to a screeching halt. Too many people want to remain in their ignorant bliss and decry essential health care reforms as “too much government involvement.” As a society we have the responsibility of making sure everyone is taken care of not just those who can afford the exorbitant cost of insurance.

[@salishseas]

I’m an oncology nurse in Seattle. I have seen Group Health deny tests that would have saved the patient’s life. This needs to be criminalized. Insurance companies are killing people.

[@denisesurber8176]

And raking in a fortune in the process.

[@1retiredknight]

The real solution there is for all providers to stop accepting any insurance that requires pre-approvals.That would also mean refusing medicare and medicaid.

[@joaquinvargas6351]

Politicians have stocks in these health insurance companies

[@anflexboi]

That’s not true. There is no test that in a moment is going to save a life bc a test I not treatment and treatment is not instant. You all can vilify insurance but you won’t improve outcomed

[@SpecialK711]

absolutely 💯 tests reveal vitally impt details needed to make informed treatment decisions. If they don't approve needed tests, then they don't have to pay for the treatments.

[@naureenscreativecorner7354]

As a physician...I tell patients that Insurance companies aren't anyone's friends

[@hoaxygen]

And as a consumer and a patient, I'm left wondering why I should be paying for this service if it's useless when I need it most. How come I have to pay and they don't? This needs a major reform.

[@naureenscreativecorner7354]

@hoaxygen many people have demanded reform or removal of insurance, but politicians get lobbied by insurance companies, who don't allow reforms to happen

[@allme813]

FACTS! An I worked for them for a long time. Believe this comment.

[@APolishPlayer]

​@@hoaxygenstart hanging people

[@The_king567]

Yes they are

[@kaistockman6443]

Here in Illinois even Medicaid was privatized and they give the company running it a certain amount per person so of course they want to deny services because they will make more money. Unfortunately, in 2011 we passed a bill called The Smart Act which privatized Medicaid, but that wasn’t so smart.

[@MakaykayLAMB]

As someone who has worked with an insurance benefits team. It’s hard as hell. That’s all they do is wait for approvals, retry if you get a denial over and over. They’re constantly stressed too.

[@marymccarty9374]

He is correct. It's disgusting. I had an insurance company deny a patient's right to go home and die. After arguing with them for over an hour I hung up. They later called me back and told me after they thought about it they decided that they were going to let that patient go home. Patients rights are being controlled by insurance company personnel who may or may not be having a bad day.

[@printingwithpeek4897]

No, he's not correct. He's looking at a symptom of a much larger problem. Certificate of need laws.

[@FrancisR420]

​@@printingwithpeek4897 I don't know if you think writing "certificate of needs" is like a good enough explanation but when I Google it it says that it's something that prevents medical companies from large scale expenditures like new buildings. Doesn't seem to have anything to do with medical rights, insurance, or doctors. doesn't seem to contradict or really have anything to do with anything in the video You're really going to have to walk us down this road.

[@aangranaa5352]

@@FrancisR420 thank you for fact checking for us homie

[@indigoechos6796]

​@@printingwithpeek4897 death shmeath babe 😘 buncha babies they are

[@printingwithpeek4897]

@mauirandall8176 No, it prevents local emergency cares from purchasing equipment that is at a smaller scale such as MRIs, EKG machines, etc. It reduces competition and that's just one example of how government makes Healthcare more expensive. We had the cheapest medical care in the world until FDR made laws requiring insurance for private companies a thing.

[@kboyd268]

"The objective of the insurance company is not to pay." They should be BANNED. They have ZERO value in Healthcare.

[@publicserviceannouncement4777]

Agreed

[@zir456]

True, don't know who that person is but She sounded like people from Insurance company who always denied people no matter the reason to save more money💀

[@abellyold4859]

They are rent-seekers.

[@VierundDB]

​@@zir456 That's Barbara Corcoran, of Shark Tank fame. I don't know her politics, but it's probably safe to assume 'Bad.'

[@tgbluewolf]

Same for government. If we just let doctors be doctors and everyone else keep their noses out of it, maybe costs would come down, more people could pay their doctors, and more people might want to be doctors. Maybe also a barter system could help. Financial aid should come from local individuals or groups dedicated only to that; in order to be sure the person applying genuinely needs it rather than is trying to abuse the help, there are other, better ways to determine that than some bean-counter making health decisions for others. Unfortunately, at this point in history there's a better chance of discovering that unicorns and pegasuses?...pegasi?...whatever, flying horses lol...are real.

[@90836usaful]

Not as much today as years ago but I can remember arguing with an 18 year old kid about the necessity of a procedure and them saying no. When I asked them if they were a physician or had a medical background, the response was no. This used to be very common but now we have office managers etc. to handle this sort of thing.

[@VictoriaGarcia-to5rk]

As an MD I get this! Like the doctor i work for only does his PT and his notes, I and my coworkers follow through on everything else. Billing, codes, talking to insurance, attorneys and facilities regarding referrals MRIs stuff like that so I definitely understand.

[@justanalthere2187]

She perfectly summed it all up in the last line. Most companies exist to turn a profit

[@GBS4893]

No matter the consequences as long as they're fine

[@RaulBetancourtC]

Capitalism in a nutshell. It's not about caring for each but about how to best exploit each other.

[@ToyotaTacomaOfficial]

Yeah

[@witnessg431]

Thats why we need medicare for all. Get rid of all these scam insurance companies.

[@iandegiovani4703]

probably all of them.

[@samuelschneider9067]

Auh yes, the hidden evil of insurance companies. Story: My family had to pay for my mom's cancer out of pocket. Not because it wasn't covered. They simply said. "Sue us, you'll lose more money and delay her treatment." I still remember as a little 4th grader when we simply did not have the money to continue treatment. Our community pooled money for the bill.

[@vanessab.6682]

Wow! That's really nice of your community but you should still have sued. You might have gotten your money back to pay the community back. Maybe you still can.

[@clashthegamer4873]

At that point you not only sue you try to blow the situation up in their face. If other people who use that company find out that paying customers were refused coverage for a life threatening illness they'll take their premiums somewhere else. I can't imagine how that won't add up to thousands of lost customers leading to millions in lost revenue.

[@artifach]

Is this a US thing? I’m not familiar yet with how claims work in our country, but hearing more and more about insurance companies doing this really gives me second thoughts about getting health insurance

[@austinhernandez2716]

​@@artifach very common in the US

[@j.a.c3813]

I would have brought this to the national news and the local government and attorney general's office.

[@TheNinjaFam]

Finally people are speaking out on this. Thank you! We need politicians to speak up.

[@Nerazmus]

People have been speaking out on this for ages. But people don't own the government, companies do.

[@Archimedes1988]

Same for therapists in the mental health field. I spent an hour today on the phone for one patients claims.

[@WarriorStrong7278]

This is absolutely true. I have been a nurse for over 30 years. I now write appeals for the denials. Insurance companies will refuse to pay on technicalities no matter how medically necessary the service or hospitalization was! It is horrible.

[@xleticiax22]

!!!!

[@calicomm1481]

And time means nothing to them, they will “wait you out”. Hope you survive 😞

[@snowleopard1831]

@@calicomm1481 The insurance companies hope you die so they don't have to pay anything out.

[@navisanecrab9267]

Would you say Obamacare made things worse since then or has it not changed?

[@snowleopard1831]

@@navisanecrab9267 Obamacare is the only reason things have held together this long.

[@Pottercraft278]

I had a supervisor several years ago who used to work for Aetna. She said that she was told to deny a medication for a patient and when she argued that it wasn't right, her supervisor said to her, "yeah but he will be dead before he can sue us over it." She said that was the final straw that made her quit.

[@oreosaysb00]

That's a smart tactic

[@brettlarch8050]

That’s pure evil.

[@justr6982]

And now she's replaced by someone who will do it, and the major insurers have docs autodenying thousands of claims a day without reviewing them

[@susiex6669]

​@@justr6982Great, let that person deal with the negative karma of being employed in such a horrible position.

[@dianal8520]

AETNA IS THE WORST INSURANCE COMPANY. I had my baby and three months later they sent me an EOB saying the would not cover the delivery costs because my husband also had insurance and baby should be under his policy because “his birthday is first in the year than mine”. Boy, did I fight! It’s all a scam!!

[@kyrab7914]

And as a patient, I appreciate the time spent on that. I've gotten stuck with big bills before bc even tho the procedure should be covered, the Dr was not in network. And then one time insurance decided after the fact that a diff (painful) test was unnecessary, so to add insult to injury, bill. And then sometimes when I call insurance to find out if smthn IS covered, they have no clue 🤦

[@OSussannah]

In Australia, we all pay a levy through our taxation system. I can go to a bulk billing doctor, with no out of pocket expenses. Most of our prescription medications are also government subsidised, and we have free public hospitals. We can optionally pay additional health insurance, and then you have more choice with private hospitals and Doctors.

[@the0master200]

This is why I do not argue with the insurance company anymore. I tell them exactly what should happen and that it is medically warranted with the patient listening. We get this documented, and if they refuse i just tell the patient to file a case immediately. That gets results so much faster.

[@sparklemotion86]

Yes, but their insurance can drop them. I’ve seen this happen to nurses, they’re always hurting their backs work.

[@pysvtfa4]

They haven’t been able to do that since the Affordable Healthcare Act passed. Other things they can’t do: They can’t assign you doctors who don’t take your insurance without permission. There is no longer a pre-existing condition clause. Emergency care has to be covered if you’re somewhere in the country that doesn’t take your insurance. Unpaid medical bills don’t affect your credit score. Friendly reminder that this is the law that Republicans have desperately wanted to appeal. And everything except the pre-existing condition clause was added under this administration. Keep this in mind when you vote.

[@the0master200]

@sparklemotion86 I don't know how it works in your country. Over here we can give the patient documentation of their needs and why it is necessary, if they refuse they get sued.

[@sapphirelane1714]

@@pysvtfa4you know what else happened during this administration I’ll keep in mind when voting? My disabled, white male homeless friend was denied Medicaid; I, a black mother with a (once) hefty savings account & reliable support, was FORCED onto Medicaid after becoming disabled at work. Despite having more than enough means to pay for my and my son’s insurance, I was denied that, all while my homeless friend with no income was denied Medicaid and told his $0 income is enough to pay for insurance.😂 I will never believe democrats “care” again!

[@mariacastillo8060]

There is a bad faith law that I found by doing my research after they low balled me but of course there is a statue of limitations how is this legal. We pay for a service and trust they will provide us and receive the service we pay for.

[@gyinagal]

“The objective of the insurance company is not to pay.” That’s exactly why it’s unethical! The company’s continued existence depends on death and human suffering. We need a new system where human lives are not balanced against making a profit.

[@JanuWaray]

The existence of the health insurance company in the US defeats its purpose. Gosh.

[@annaw27]

Government oversight makes things worse.

[@danilicious2308]

​@@annaw27 yeah. Companies will totally not take the utmost advantage without any oversight. Just trust them bro.

[@7PlayingWithFire7]

@@annaw27 Yeah thats why healthcare is better in other countries, bcuz oversight bad mkay lmao

[@korhonenemilia1816]

​@AW So you'd rather trust faceless people in companies trying to make a buck off of you, instead of officials you yourself elect and who have to put their name behind all decisions made? Please. Even if we assume utmost selfishness, the private company will rather have you die than to lose money, while the government official will *have* to do something to benefit you in order to get ee-elected, therefore they'll have more incentive to help the people.

[@LifeisamesswithJess]

I agree I am a patient, and my doctor at usc would go above and beyond to fight for me with Insurance, but not all doctors are the same. Some could care less and won't help.

[@shraka]

It's also that you don't have very good protections for generic medications and don't bulk order. Aussie government bulk orders a lot of drugs through the PBS which slashes their prices significantly, and we have good laws around generics so you can't just jack the prices on older drug formulations, which keeps the prices of new drugs under control unless they're WAY better than the old formulations.

[@FancyUnicorn]

"The object of insurance companies is not to pay" the root of the problem right there

[@rs72098]

That's not necessarily the truth though. Insurance companies still make lots of money even if they make payouts. Especially if it's for lifesaving medications because they want the customer to stay alive to continue making payments. The U.S. health insurance is definitely monopolized by blue cross, so that's the real problem right there.

[@thomascleveland9777]

Thats what i have been saying for years.

[@1retiredknight]

That is the reality of the business. Insurance is gambling and every gambling establishment seeks to minimize pay-outs.

[@The92Waffles]

@@1retiredknight I agree. its about time we stop making a healthcare a "business" and nationalize it... this is very uniquely an american problem

[@KalijahAnderson]

A trick I have used for this is to ask them for the name of the doctor they used that said this isn't needed. They don't want to admit they have interns searching for keywords to make these decisions. I've never had an insurance company deny a scan or treatment after asking for the doctor that denied the request.

[@bayoubabe6698]

Thank you…I will try this the next time a treatment for my condition is denied by my insurance!! Ask for the name of the doctor that backed a denial!! Great approach, I’ve never heard anyone else advise this much less do it!!! We absolutely have to advocate for ourselves.

[@nancysmith2295]

The approved type of medication(s) to order can be included in software. Also codes are included on selecting what was done during exam. You check the correct box. The billing is often done by an accountant. A doctors office has always been a business. My dad had his own business. My mom did the books and was not paid separately. One complaint about a medical degree is basic business course(s) should be required.

[@dvan1759]

Insurance companies refuse to cover the procedures or pay the first time around. If you report this to your state’s insurance division, they will dispute it for you and the insurance companies always give in & cover the tests or procedures. I went back & forth emailing & faxing the same invoices to several diff people at Oxford Health for a year. They kept bullshitting me. I got my state’s insurance involved & Oxford covered everything immediately.

[@JohnDeaux161]

‘The objective of the insurance company is not to pay’. Never ever forget that sentence as long as you live because it is as close to truth as you can get in today’s world

[@nef11]

I have worked as a medical assistant and have been heart broken and stressed out when insurance companies don’t cover certain medications or imaging. Then we have to keep calling and sign forms which takes longer for patients to get appropriate care. I always felt bad when this happened, especially when they are older and can’t afford it :/. Insurance companies need to be held accountable. I hate passing by their giant fancy buildings 😑.

[@soulfulfilled4382]

This is why people are moving to homeopathy and more holistic ways of healing, it will be health insurance company own doing when it crumbles. It’s called karma. How you treat people will be how you are treated. Especially when it comes to caring about another life. This will make folks who are desperate and not financially able turn to that form of healing and when they see it actually works instead of temporarily putting a bandaid on it, health insurance is in trouble. This could be what is destined to be anyway. Car insurance is no different. Insurance was stemmed from slavery anyway.

[@joetoe9947]

@@soulfulfilled4382 … but there is also a problem with “homeopath/naturopath”- THEYRE TOO EXPENSIVE!”- particularly the, ahem, “well established” ones… RIDICULOUSLY EXPENSIVE!… “UNAFFORDABLY”- expensive!… “KEEP- LOOKING!”- expensive… effective “illness- treatment” SHOULD BE affordable- AND effective… sheesh! …

[@Kyiecutie]

Hehe. I feel you.. but, now imagine being chronically ill, having a genetic disorder with no cure but available treatments and requiring frequent tests and imaging, and medications that are atypical for a 25 year old. Having medication allergies that mean you must be prescribed something that requires a 1-year prior authorization form just to get it sent to the pharmacy so you don’t have to pay $1,000 out of pocket. Having to see half a dozen in-network specialists because the one provider in your entire STATE who treats your condition does not accept insurance and bills $450 AN HOUR, and you can’t afford it after already spending half your paycheck on medical insurance. And you are responsible for figuring out half the billing because nobody in each clinic seems to be able to communicate with another clinic leaving YOU to do the leg work. Imagine having to be dealing with this day in and day out, with no medical training 🙂 and the insurance company, when you ask for more information, says “well I’m not sure, we’re not medically trained” and sees no irony in expecting patients who are not medically trained to do the work. All of this, all while being chronically ill, having a full time job and being in pain, twenty. Four. Seven. 🙂 it’s me. The story is my life.

[@joetoe9947]

@@Kyiecutie … I’m empathetic about your situation and hope you find remedy… I too have had a need for remedy- and ZERO FAITH in the “allopathic” model (from prior experience)- and upon subsequently visiting with a “known” naturopath (of “Orthomolecular medicine”)- in which I paid upwards of $400 for a 1hr visit! (yes- “quite outrageous”/“absolutely- unsustainable”!)… there definitely needs to be a change (in favor of the individual requiring treatment) in how- “effective- less harmful/ MORE beneficial [curative!?] services and pricing for those “chosen” services are offered/PROVIDED!… best to you in your journey and DONT GIVE UP!- I haven’t!👍🏻

[@5hydroxyT]

and the frustration of dealing with this is leading doctors to burnout and or just retire early.

[@jjbud3124]

You've hit the proverbial nail on the head. This is a big part of the problem, but not the only problem. The rest of the expense is corporate profits - they are the middleman who take huge sums of money that should be going into actual health care.

[@metal-k9069]

More people need to talk about this! I’ve been in the hospital administration industry for 10 years it gets worse and worse every year!

[@skjexplorer]

Every day the insurance companies are adding more things that need prior authorization . yet they are cutting reimbursements to physicians.

[@mikemann1960]

Not to be violitile but, when people overstand that 1% is willfully trying to kill mass amounts of Americans for being the richest country for profit; then they become the hunted of the human hunger games!

[@craigharrison1274]

You’re not going to get any serious reform or progress in America without major bloodshed.

[@12yearssober]

Another truth is that most insurance companies do not allow the doctor to notify the patient of a potential issue found while looking for something else. Example is let’s say a patient goes to the ER after a fall and complains of rib pain. Doctor orders an X-ray. Patient does not have any broken ribs but the radiologist does notice a spot on patient’s lung in X-ray. Since the patient did not come in for a lung issue most insurance companies will not allow the doctor to tell the patient about the spot. Some time later the patient is having lung problems and is found to have lung cancer and at this point it is stage 4 and terminal. Insurance companies do this daily. Always after any test request all reports and documentation regarding your visit and look over them carefully.

[@Redditor6079]

​@@12yearssober thanks Jeff

[@wariannn1253]

As a breast cancer patient , this is spot on. I’ve had to call my insurance myself and ask why they keep denying my screenings. There is always a reason !!!!!

[@paige-vt8fn]

Yeah same here, I've had masses in my breast for at least 12 years and have an appointment next week with a specialist, finally, after 12 YEARS! Hopefully nothing else gets dismissed, but unfortunately I only have state aid so I'm not too confident

[@joe1071]

Denied because it’s Monday. Denied because it’s Tuesday. Denied because it’s Friday. Sorry, now it’s the weekend and we aren’t open til Monday!

[@davidm4566]

The reason is they want to collect money from you and buy expensive cars, boats, and private jets. Paying money to you makes it harder to do all of those things.

[@paige-vt8fn]

@@davidm4566 maybe. But j know for sure that my life and the lives of so many women suffering from breast cancer are far more valuable that a boat or a plane, and nobody can tell me otherwise

[@burgersnchips]

​@@paige-vt8fnyes they are, but not to the guy at the insurance company. They don't know you so they don't care.

[@eveneser12]

He's so right I'm sick and tired of the insurance denying MRIs when patient had good reasons to get one here in Las Vegas Nevada but I believe this applies for all United States😢

[@MariaMaria-sr8zg]

My son was premature and had jaw issues from birth. He had to have a procedure at a pediatric dentist. The insurance company would not pay. He had to have a second procedure and we went to the same place as first But when the insurance company refused the New doctor said they always do but I resend it until they do pay. He said usually by the second or third time they will. Not sure what all "sending it through " entails but it was paid.

[@nicoleanime400]

I had to fight to get my insurance to pay for me having my first child. Even though when I signed up they said it would cover the whole prenatal, delivery and post partem appointments.

[@TiffanyALuna]

Put 'em on BLAST and leave a public review so others know NOT to do business with them. Companies👹 like that don't deserve cuatomers!

[@jeanettewilliams8898]

Put them on blast because they lied. If they said we don't cover that you would have said Thank you and chose another one without a fight but they are dicks seriously

[@EvLSpectre]

Well how do we know YOU were the one who birthed the child?

[@navalsealsnipersports1199]

Did they say they’d cover the whole thing or the whole thing AFTER you reached deductible?

[@jeremylackey3477]

I know it's been a month since you posted this, but my wife and I went through the same thing with our daughter. They approved her C-Section and hospital stay but denied the nursery care because "they didn't know who the baby was". Like the outcome of a c-section isn't a new human who doesn't have a SS# yet... It's asinine.

[@cynthiaskaggs6645]

Our insurance company denied paying for my daughters medical transport from our local hospital to a level one childrens hospital not once but twice. Both times the transfer was ordered directly by her pulmonologist, both times she had pneumonia and required oxygen and monitoring while in the ambulance due to a partially collapsed lung. Their reason for denial was that ‘I should’ve just driven her myself’. Insurance companies don’t care about people.

[@nicoleowens2318]

You think that's bad? I was on Medicaid when my daughter died of SIDS. I recieved a $10,000 bill for the emergency services a few days later because she was dead on arrival, and I was confused. I got a letter from social services a day after that saying I "no longer qualified" for Medicaid because I no longer had a child at the time she was transported. They did not cover the ambulance because she was dead. I sh!t you not. I couldn't believe what I was reading. I still can hardly believe it 15 years later. I understand them ending the coverage, there was a specific criteria, but to refuse to cover the ambulance? That seems criminal. They ARE criminal. I'm sorry you went through that, I know how scary that is. I hope your daughter is doing better now, and pray she has a good doctor that fights for her.

[@lindaforetia8624]

You need to sue the health insurance company

[@juliemcdaniel499]

​@@lindaforetia8624 How can someone sue medicaid/welfare?

[@popeoftea]

​@@juliemcdaniel499 you don't.

[@millersam07]

Unfortunately an insurance company as a COMPANY, it's goal is to make money. This is why COMPANIES have no business in healthcare, bc unlike a new car, or fun hobby, you can't say "No" to a medical treatment, if you do you'll either be jailed for being a bad parent, have it forced on you anyway from being unconscious at the time, or die. Corrosion under penalty of death is not a choice. The only logical conclusion is to see healthcare as a human right, and make funding mandated by the government. Other countries do it. America could too with like 1/2 a percent of what's spent on the military!

[@fresnokidsr]

Right there that lady said it all. The insurance company's objective is Not to pay. So I have to ask why do so many people feel like we should work with something that doesn't want to work with us

[@dg8994]

I’m an older man having health issues and I deal with this insane bs everyday. I’ve paid my premiums for forty plus years and now that I actually need things done they don’t want to pay !!!

[@hasdrubalsosamarquez5430]

We need more guys like this that go the extra mile not only to expose the scam but to actually have a care in his heart

[@daveweisbrich1769]

Except he fully supported Fauci and big pharma during the pandemic.

[@stevensines7026]

I've often referred to it as the "HippoCritic oath, not Hippocratic.

[@captaingainzproductions1876]

This particular doctor partied without social distancing at the start of covid, without ever apologizing

[@willehq]

@@captaingainzproductions1876this particular doctor is also a human with a whole life and history of being a person. I’m sure there’s plenty of not-great things he’s done, just like all of us. That doesn’t make him less worth to listen to.

[@MsLucia4179]

​@@captaingainzproductions1876which honestly wouldn't be that bad except he was telling everyone else to mask up and social distance.

[@bjcomrie1]

“The objective of the insurance company is not to pay…”. As a Primary Care Physician, I agree with this statement, and that is the problem.

[@Taniz7683]

Not to pay, yet charge you

[@user-wj9bl5eu9o]

Well I should have read your post before I wrote mine.I agree with you

[@mitchellwood4133]

Well I've got news for you buddy. The rich lady from tv thinks you're wrong.

[@bjcomrie1]

@@chickontheright2771 I spend hours on the phone after patients are seen for their office visits, reviewing and defending the need for ordering the tests. Please don’t think most doctors don’t call the insurance companies back to complete peer-to-peer rebuttals to defend the need for these tests. The doctors are not in charge anymore. When the laws suits appear, however, the buck stops on the physicians’ licenses, which is why we call the insurance companies to plead our and the patients cases. Our phone calls also become our documented defense that we argued why the patients must have the tests performed.

[@GoBoltsGo]

That’s why no insurance should be allowed to be for-profit

[@laurenb3928]

I had a Dr argue with my insurance for an hr day of surgery because they denied it.. and I have a team arguing with my insurance now for IVIG treatment.. insurance companies are a bigger pain than my conditions 😢

[@tessawidenhofer]

I spent four years suffering needlessly because my insurance refused to cover a joint replacement surgery because arthritis in the jaw is something they can get away with not covering- had it been my knee or hip there would have been no questions, but because it was my jaw I was in misery for years trying to prove it was real. Luckily, we found a way around it, but I lost my entire early twenties to technicalities.

[@tatanation7091]

Imagine a doctor arguing what the patient needs with someone who doesn't have a doctor degree telling them what they need

[@SpecialKel66]

Exactly, and it happens every minute of every day.

[@iamlsusam]

How dare the insurance company overrule your medical doctor. They should be prosecuted for practicing medicine without a license!

[@queenj.8i895]

Technically, they don’t overrule him as the doctor, they just refuse to pay for what the patient needs. They tell the patient to pay themselves. That’s why it’s such a scam!

[@margaret4807]

EXACTLY!! 👍 💯🙌👏🤬🖕🤬🖕🤬🖕🤬🖕🤬🖕

[@shawntailor5485]

​@@queenj.8i895cuz mobsters became insurance Co.CEOs .

[@donanderson2264]

Technically,… they hurt us all. I’m an expat. Still having the cost of my medical insurance deducted from my social security. But I just self pay. And so far, it’s cheaper to pay 100% than paying my deductible or my owed portion of the bill. I don’t want to have another kidney stone take me down anywhere in the world. It’s all a crapshoot, but not for the insurance companies. Ever notice that their names are on the skyscrapers in the big cities?

[@chrismay2298]

You'll keep paying for the system that kills you, expecting the people profiting from it to stand up for you... Braindead normies everywhere. 😂

[@sstephens2175]

As the patient I called myself and spent nearly an hour negotiating with the insurance company to get a dental procedure approved. It took some work but they approved it, and I was able to get the procedure I needed. They denied it to start with.

[@beemerwt4185]

There was a tiktok that this Dr. Glaucomflecken made a while ago joking about how doctors work for the insurance companies. It's just so true.

[@MsAshleyCulp]

Truth, I once had to tell a25 year old cancer patient that she had met her lifetime limit of treatment. Basically her insurance refused to cover additional treatments regardless of how much she needed it. She died nearly a year later. I knew i had to get out of Healthcare at that moment. It's been over 5 years and i still think about her...

[@ashish4451]

The blood boiling hate I feel for the insurance companies after reading this message

[@N0xiety]

If i was in her place i would find where the insurance company executives live, i have nothing to lose anyways, might as well go out kicking...

[@TNikki93]

I’ve had similar experiences in school and it’s a big reason I decided against medical school at the last second. I hate the system and don’t want to be apart of it.

[@AcesAlliance]

I don’t see how this isn’t murder. Death by neglect

[@erickrodriguezarechiga7934]

​@@AcesAllianceit is so tragic. Her life was not profitable, so they let her die.

[@TheMayaangelsmommy]

As a former doctor's assistant, I fully agree with these statements! I spent half of my day on the phone or emailing insurance companies for approval for the doctor's orders. It was maddening! I miss my doctor and our patients but I choose not to continue once she retired. Medicine has changed.

[@kalijasin]

Why do you agree with him on doctors should be paid more? A lot of doctors are millionaires and doctors in the USA get paid more than doctors in all other countries.

[@Asdfgfdmn]

God bless you

[@Asdfgfdmn]

@@kalijasin Many doctors (primarily boomers) have become millionaires because they weren’t in deep debt like the younger generation of doctors. They got access to capital many years ago when they invested in the market and learned how compound interest works with stocks and real estate.

[@realtalktina]

I mean isn’t that what the billing department or person does I’ve never seen a doctor on the phone most have a billing assistant who went to school for that specifically

[@TheMayaangelsmommy]

@Real Talk Tina the billing "department" tells you that you coded something incorrectly and you need to fix it by "mo/day/year" or it will be rejected. BUT that's JUST billing for services rendered ... getting treatments and testing approved is a whole other process that requires negotiating patients care with someone that never met your patient, never went to med school, never set foot in your clinic, and has the sole priority of approving as little as possible. We (office vs insurance) have different priorities and it shows in the frantic way that doctors and their assistants have to interact with big insurance. It's like having to step into a ring to defend your patient against Thanos who would happily "snap" them away to cut costs. It's tiring and disheartening if you care about the patients' wellbeing.

[@karlas9961]

I’m an RN and I work in a peds clinic. Continually fighting with insurance companies. There is one large one in particular that denies everything and even takes back money for services rendered.

[@user-ol7tl1vf5m]

Great video topic! The connection between healthcare insurance and the fiat monetary system is indeed a complex and often debated issue. Under the current system, where the value of fiat currency is subject to inflation and manipulation by central authorities, healthcare costs can skyrocket, leading to exorbitant insurance premiums and out-of-pocket expenses for individuals. Moreover, the linkage between credit scores and insurance payments adds another layer of complexity to the equation. While credit scores are intended to assess an individual's financial responsibility, their correlation with insurance payments can result in discrimination and inequity, particularly for those who may have faced financial hardships or medical challenges. Ultimately, addressing the systemic issues within the healthcare and financial systems is crucial to ensuring equitable access to quality care for all.

[@celiaibarra8761]

I am so glad this Dr. Spoke up because it is true. My mom went into the hospital for a gallbladder emergency surgery and she passed away because the insurance didn’t give approval quick enough. Insurance companies just rip you off your money and then when you really need them, they give you the runaround or they just don’t cover the expense. To me they are useless and a total ripoff!

[@falconerd343]

The ideal patient for the insurance company is one who faithfully pays their premiums and then passes away quickly.

[@joetoe9947]

@@falconerd343 … or rather “then passes away years later”- and “quietly”- without a fuss🤫…

[@Slowburn726]

Sorry for your loss.

[@celiaibarra8761]

@@Slowburn726 🙏 thank you!

[@falconerd343]

@@joetoe9947 true to the years later, but years later tends to not be quiet. We usually start adding on meds, procedures, and surgeries.

[@antoniowebbmd]

Couldn’t agree more with you on this one doc! Very frustrating part of my job as well. Me spending 15 years training to become a surgeon where I have studied, mastered my craft and and being questioned by someone with less than a college degree. C’mon!!!!

[@sherride2002]

That is messed up. A true slap in the face.

[@Earlydoors272]

Hey you're webbmd!!!

[@middleagebrotips3454]

But they have money, if you do the surgery for free then none of this is a problem /s

[@magoo9279]

​@@middleagebrotips3454And how is the surgeon doing this for free? It's not like they can live for free.

[@middleagebrotips3454]

@@magoo9279 the insurance doesn't care if surgeons don't get to eat, as long as they don't have to pay.

[@user-dg6gq8gs9n]

Spot on. I'm a provider (PA-C). Tests, medications, etc are denied quite frequently, purely because insurance doesn't want to pay. And then when I need to have these 45 minute calls with insurance, it's always during my *unpaid* lunch break - and half the time, it still gets denied. And then, a lot of the time, patients think the denial is because I'm not trying hard enough or don't care. I hate it here ...

[@kathychanning1614]

Insurance Companies argue and or deny the request from the administrators making the requests calling for the doctor’s, too.

[@Pippop38]

As a human with two chronic illnesses, the WORST part of it all is the insurance. I literally have dead organs and the part that makes me crying is fighting with my insurance

[@mauryarriola9451]

revelation church

[@NuNugirl]

They didn’t cut them out? I had two removed by the time I was 26. Thyroid & spleen. I’m holding on to as many as I can, including my teeth. I’m starting Medicare next month. I chose a Supplement plan where I can go to any Doctor who takes Medicare, with no referrals needed. Some people think I’m nuts to pay so much for it, but I know better, because it’s there if I need to use it. I’ve had to fire Doctors in the past, so I can do it again.

[@tiffhamill567]

I believe God sees these wicked higher-ups in these organizations. They cannot get away w this forever. Have you looked into a naturopathic medicine Dr?

[@susanallen8214]

@@mauryarriola9451 ?

[@mikyma-jr2uj]

My eyes have strabismus and lazy eye the doctors say I need insurance and please get a job that will make you good money to pay for your insurance abbit ok

[@klc7275]

I remember, when I was a kid, I asked my parents how insurance companies make money if they're always giving the money they make to their customers. My parents said exactly what this woman said - their goal is to not give money to people. I haven't trusted insurance companies since then.

[@mtn1793]

Actually they’re more like banks, using the money from premiums to invest and grow so they have funds when the trouble comes. Course nowadays the financial markets are more casino than investment. And Republican politics are more cannibalism than leadership. The chamber of commerce is a parasite that calls itself business as usual.

[@Beemernow]

Well, the main way they make money is buy using your money that you pay for the policy combined with everyone else's to invest in the stock market, but yes, they want to keep that money by not paying out.. JustSaying

[@alejmc]

@@Beemernow I would have expected at least that by pooling resources, concentrating administration, armies of people finding the best deals that they could stretch each of our $ a whole lot more than if we went on our own pocket… except that bureaucracy knows no bounds. Just like government programs, if you give a $ today to a homeless person, that person gets a full fledged dollar… if you do it through government, that homeless person will get not even 10cents. Same with these insurances, pretty sure the money they receive gets diluted into oblivion, probably by paying a lot to the people that will deny health bills

[@matty_________]

It’s abit of both. I used to work in travel insurance in the UK and we had to hire people to negotiate the costs down in the USA. As doctors/ medical staff would charge through the absolute roof and carry out pointless tests for such small things, just because they knew the patient had insurance.

[@kendrikhawk7436]

I was just thinking about that, recently... Watch any tv show involving lawyers other than criminal cases, and at some point one of them will say, "I have to go... this time isn't billable."

[@shaafi1579]

Greed is the underlying problem 😢

[@NyJoanzy]

If it's incentivized it's what you get.

[@doribellan]

It’s like no one here understands how insurance, government , and companies work.

[@shaafi1579]

@doribellan True they are greedy on another level

[@MarkovChains223]

It's capitalism, my friend

[@doribellan]

@@MarkovChains223 Greed is not a result of capitalism… it’s one’s bad reaction. Having a free market capitalist society allows all access and prosperity.

[@clarainesgonzales93]

I'm a pharmacy technician, and believe me, the insurance will find all the loop holes to not pay. Each drug has its own unique code and the insurance company will have a list of medications they will cover. If it's not on the list, you have to pay out of pocket or just go without. The insurance companies are one of the biggest thieves and most merciless people I deal with. It's a fight to get them to agree to do anything for patients.

[@ivanmunoz2984]

The insurance policy is one that is bought by the employer lmao. They choose what drug lists they will cover, there's a lot of blame to be placed but ultimately your employer dgaf

[@syzygy4365]

​@@ivanmunoz2984 Not necessarily, many companies were skimpy "cheaper" policies in the belief they were getting a good deal once the insurance companies found a way to make "good standard" insurance policies affordable. They came in sold the idea that there's not really much of a difference between our old policies, and our new standard "GOLD" plan saving them a fraction of what they were paying. Insurance salesmen were told how to sell those new policies hiding the fine print. Guess who gets a nice bonus cutting costs everywhere? Everyone in HR including the company you work for.

[@MarkWadey]

Don’t act like the doctors arent at fault as well… they know what they are doing.. n they know most times a drug will reject and still prescribe it anyways. N they get paid trips n gifts to prescribe certain drugs over others

[@Indah_Lusion]

I agree I am on medicaid and they cover my test strips and my meter for my diabetes but they won't cover the lancets for for it. It doesn't make sense

[@ernestogarcia3193]

@@MarkWadey Doctors do not in fact have a list of what your insurance covers.

[@doretsnyman7022]

Im a Medical practice manager in South Africa. The doctor i work for has the same opinion as you. He is a doctor, he does health, science, the body and his patients' care takes priority. Thats why i am there, part of my expertise is knowing correct coding etc as to assist our patients to get authorised for their treatment. My doctor and i work closely together by him giving me detailed information of his diagnoses and treatment and for me to utilise the correct applicable coding to support that. Its important for doctors to have brilliant "support" staff!

[@doretsnyman7022]

I just called myself brilliant support staff...😂

[@Unreelness]

I have said it for years that administrative costs is where all this expense is going. Hospitals near me have one or two floors each dedicated just for this.

[@MHSMagicLuver]

I’m a PA and I hate insurance because like you showed.. they don’t let us make decisions! They are not clinical in any way and they decide what tests and medicines can be done or given. It really sucks. Leave it up to the medical providers who actually went to school for this!

[@loveinc.7438]

I just had cancer and went through chemotherapy, and I can confirm that health insurance does make everything harder. There were several times when my doctor prescribed me medication and the health insurance denied it so I was unable to get the important medications I needed because of my health insurance.

[@pabloriveraperezderada6223]

In Spain we have public health care and these things don't happen. Hope you are doing better!

[@vladislavohremenco3472]

In Austria we have perfect public health insurance and we don't have this kind of problems over here. My mom just beat her second cancer because of our health insurance. Over here, they first treat the patients with the best possible medication and treatments in the whole world and then fight over what's being payed for. That way, there are no delays and most of the patients problems can be resolved faster which then fights the cancer faster. She didn't had to pay for anything in end😅 cause the insurance took everything over. Best country in the whole world in my opinion.

[@ab-js2gw]

Because for your health insurance company it is better if you die rather than go through expensive treatment.

[@infinity2394]

ngl what is health care I'm a 16 year old kid turning 17 and I'm wondering why people keep paying insurance companies if they aren't doing their Job. When they can just get a loan or something?

[@coffee-with-sprats]

​@@infinity2394 Oh kid... You're in for a ride... That's a long-ass story, but to keep it simple - it's the only possible way due to so many reasons, unfortunately. I'm not an expert and can't really tell you much and make it easy-to-digest. So I'd really suggested you to research it on the internet yourself, because there's basically more than I personally know and it exists in many stages of complexity from "I am from the insurance field, need to make sure I remember it all and check if anything has changed" to "dumb it way down, so my distant cousin from another country with room temperature IQ (in Celsius), who can't speak, write or read English text, could understand this". I'm sorry, you're on your own, kid. I'm basically underqualified to teach, especially that subject. But remember one thing, if it may help you on this one: "there's always an interesting story, you just have to be creative yourself to spot it". Bon voyage.

[@lorraineburnett2973]

Thank God I'm the UK we have the NHS it may not be perfect but at least we don't have too worry about if we have enough money before going to the Doctor or hospital if you don't have private health insurance.

[@janicedobis6490]

He’s right. I got a bill for a surgeon PA who put the wrong code in for a surgery that was pre-approved. The amount of time I spent trying working that mess-out was hours over several days. I can’t imagine dealing with that for hundreds of patients. Insurance companies are in this to make money… and they make a lot of money!

[@ksgraham3477]

Insurance companies are practicing medicine without licensing.

[@hopeanna9201]

So good to hear a Dr tell the truth about what happens outside the patient rooms.

[@rehman1833]

There are a lot of people telling it, media just calls them socialists and americans immediately turn their brains off

[@GameChanger597]

I don't believe anything emotional related coming from this doctor. He's too arrogant and self-absorbed to trust

[@JenniferLane-lm8xv]

I'm a lab technician. I usually do the codes for the doctor myself, even though I'm not supposed to legally. I almost just go by pre existing codes to the insurance will take it.

[@kpoponbeet]

I’m a pharmacy tech. One of the biggest insurance rejections is that a medication isn’t covered by the insurance, or that the diagnosis code provided by the doctor isn’t covered for that medication. Sucks for people just trying to get/feel better :/

[@yomikuro6153]

I’m working as a medical assistant right now. Every single day, we get demands for prior authorizations, calls that a medication isn’t covered, denials for biologics; we argue for the patient and the doctors argue, but we never win 100% of all the arguments. And it’s heartbreaking.

[@therehastobesomethingmoore]

The US healthcare system is severely broken. We live abroad, stay as healthy as possible, and pay out of pocket for medical and dental.

[@swizzthesecond]

Good for you and keep winning.👍 Which country did you choose?

[@therehastobesomethingmoore]

@@swizzthesecond We still have many countries and cities to visit before we pick a place. I hope you join us as we go live in all of them. Next up is Guatemala and we will be there in February.

[@leannerobinson1536]

I subscribed! I want to leave this country so badly!

[@therehastobesomethingmoore]

@@leannerobinson1536 So happy to have you joining us on our journeys !

[@darkopz]

@@swizzthesecondI’m not sure you read what they said. If they have a severe medical issue they’re screwed. They’d need to be in a country that would pay for all their needs even if they’re not a citizen. If they are, then they’re good. If not, no amount of “healthy living” will stop an emergency medical condition.

[@patsymays6349]

I am a Mom of a child/ young adult now, I have been battling ALL OF THESE ISSUES for the last 12 years...I have had to step in and get involved when insurance co denied procedures our child needed , I have spent hours upon hours navigating talking to Dr.s , nurses, social workers all different entities of insurance dept to get procedures approved.. taking names and holding people accountable for doing their jobs...I could go on and on... It has been an everyday battle..I Pray for patience and knowledge in dealing with the whole health system....

[@92spice18]

This is very similar to the world of rehab. Why am I having to know every billing code? This is not what I studied in school. These insurance companies then deny the services and no one gets paid and the patient’s care is subject to long wait times. It’s gross and they should be investigated for negligence and doing a disservice.

[@xXReihachanXx]

Oh my god, I can relate to this. I'm a medical receptionist and there are soooooooo many different codes for every different scan/procedure/trreatment etc. Health care system is so strict with the criteria for what they cover and they will make it as hard for you as possible.

[@the_expidition427]

LMAO I think in this scenario the name applies

[@PatrickKQ4HBD]

​@@the_expidition427 Then it would be appropriate, IF op was actually expecting a response from him.

[@retired5218]

Because they are in business to make money. And they dont care if you die because they are saving $$.

[@Jukki_BatRat]

I'm not American, but I seriously feel bad for the people of America who aren't rich and needs medical care. I've heard so many awful and sad stories of people not being able to afford the help they need and go in to lifelong debt. The American health care system destroys lives. Even the cost of getting an ambulance is insane. Here in Denmark we pay some of the highest tax in the world, but it also means we have free healthcare among many other things. I know many people in the US gets paid minimum wage, so maybe they can't afford to pay more in taxes, but the government and businesses should want the best for their people, instead they're just greedy.

[@neckofkwoods4261]

Amen

[@angelataylor5241]

Never lived any where else but the states. The the thefts of our wages, our health, our freedoms, our intelegence and common sense, also our education and right to persue our own happiness are directly because of the rich (the 1%), the oligarchy. The experiment here needs to take a different direction because if we don't, off the cliffs we will go.

[@bibichannamini3873]

Yes it's wierd. Like a third world country. However it is the NHS is a godsend and I'm proud to work for it.

[@Threemore650]

Only good if immigration is under control.

[@bryanmavis8771]

@@KalebPrentice This is like telling a homeless man to just go get a house.

[@Pilarskiapril67]

Used to work for a specialty pharmacy and insurance would literally require a prior authorization every few months for a chemo drug a patient has been taking for years... It's ridiculous.. then it gets denied and they are forced to switch back to one that doesn't work or gives them more side effects

[@christianeaster2776]

I worked as a med tech. Even though our job was to test various body fluids, we had to make sure the codes for the tests ordered were correct in order to make sure th lab got paid.

[@mjmjmj28]

Exactly, maddening. Patients need to start suing insurance companies for negligence, breach of contract ect

[@shadowwolf143]

I tried to sue the medical insurance when they caused me life long health issues due to prolonging a surgery because they didn't agree with my doctor. I was told by lawyer its not worth the case because I would lose my insurance and then have no other insurance company interested in taking me. Granted this was almost 15 years ago now

[@shawnbottom4769]

That would never work. They have all the money and the lawyers. The only way to fix this is to vote the right politicians into office.

[@OmarOsman98]

@@shadowwolf143Are you self employed or have a job?

[@JW-bu3xt]

This was my headache as an RN. And administration harassed me until I quit when I insisted I needed a medical assistant to take vital signs so I could do all that paperwork he is speaking of, while my MD saw his patients. I still had to also help with procedures, refill prescriptions, triage phone calls, make appointments, and schedule procedures. You think doctors don't make enough money? Try being a nurse.

[@carolyperez8075]

Exactly. And they run a skeleton crew on purpose

[@JW-bu3xt]

@@carolyperez8075 Yes. And when the older more experienced nurses complain, they fire them or run them off, and hire fresh nurses right out of school so they can pay them entry level salaries. One place I worked even let a medical assistant call herself that MD's "nurse" because she had been there so long, and did everything a nurse did, including call in prescriptions! Illegal and dangerous much? They didn't care. That same office's "executive director" started out answering phones when the office opened, and got no additional education over the years. She is now in charge of a facility with last count 80 physicians of different specialties.

[@jhezzy]

​@@JW-bu3xt🤯😠

[@siesies000]

Truth

[@siesies000]

​@@JW-bu3xtexperience is sometimes better, but this is definitely crossing the line in the u.s.... maybe a 3rd world country it would be ok, because something is better than nothing

[@Raja-bz4yw]

I had to get an emergency laser eye surgery cuz of a dangerous high eye pressure levels due to a rare form of glaucoma i was diagnosed witg. The eye dr straight up said the insurance won't pay for it . She was right. They basically only paid $200 of it. The insurance company sent me the bill i called them told them not paying for it and haven't gotten anything since. I still got the surgery n my eyes were saved in the end. I have many stories similar to this due to having a disability. The American health insurance is ridiculous.

[@nuuget6996]

I work for a speciality pharmacy, and having to tell a 3 year old's parents that their insurance doesn't deem their child's cystic fibrosis meds as necessary so they're not paying is what changed me. The amount of conversations i've had with patients where i've had to tell them their insurance plan won't cover their life-saving medications and/or won't let them enroll in copay assistance has made me vow to NEVER work anywhere near health insurance companies ever again. They aren't helping people- they're killing people.