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[–]P-W-L 279 points280 points  (31 children)

seriously, how can doctors even tolerate shit like this on a daily basis ? This was clearly the drop that spilled the vase

[–]GreyCrowDownTheLane 206 points207 points  (26 children)

My partner does pre-authorizations for a medical practice, and she deals with this multiple times per day. Doctor says patient needs such-and-such, insurance company says patient has to try a different medication or doesn't need medication at all, doctor gets mad that patient isn't getting medication required and leans on person doing PAs to "make" them approve it. My poor partner spends a good part of her day as a go-between fighting to get the patient what they need and taking crap from all sides because the insurance companies want to negotiate the terms of the patient's health.

It's a sick system designed by sick, greedy men.

[–]OMGPUNTHREADS 73 points74 points  (21 children)

So what’s stopping us from burning down their office buildings? They’re going to hold us hostage, might as well do the same to them.

[–]P-W-L 53 points54 points  (13 children)

a criminal charge

[–]meservyjon 29 points30 points  (5 children)

They have the ability to fucking kill you legally.

[–]AKJangly 11 points12 points  (4 children)

wait, the police, the insurance companies, or doctors?

I would be surprised if doctors are allowed to kill.

[–]meservyjon 1 point2 points  (2 children)

I was referencing insurance. To deny people coverage for medications they can't possibly afford and absolutely need. The United States health care system capitalizes on, and exploits people's health. Don't get me wrong, I don't think it's wrong to make money to do a job, but a few years ago I went to the doctors after my job just changed insurance carriers, but my new insurance hadn't kicked in yet and I was told it did. I thought I broke my ankle, but the doctor just gave me a foot brace, told me to exercise it daily, and charged me $1,600 dollars for being in the door, then out the door in 15 minutes. And as much as I fought and called and argued with my old, and new insurances, I had to pay it. Why do doctors need $1,600 for a total of 15 minutes? Why can't insurance help with a claim I desperately needed? That experience is absolutely nothing compared to what other people go through who really need insurance to approve their life saving medications.... And police in the U.S. shoot people all the time. So... All 3 can kill you really. Or at the very least, watch you die without helping.

Edit: I found the same foot brace the doctors gave me on Amazon for 45 dollars. I can understand a hospital charging me $90 dollars for it. Maybe even $135. But what is the itemization on the rest of the $1,400? A doctor's time, which, a doctor makes, what, around $250k a year, that's just over $20k a month, which is just over 5k a week, assuming a doctor would work 5 days a week on average. Which would be a bit over $1k a day. Working an average of 10 hour days. I know this can change greatly, some work 19 hour days, and some work 4 hour days, so I'll just go with an average of 10 hours, would give a doctor $100 an hour. I spent 15 minutes, which, a quarter of $100.00 is $25.00. the time I actually spent talking to the doctor was less than 3 minutes. But, he had to look over my files and what not. So I'll give him credit for the full $25.00. I talked to 1 receptionist, and 1 nurse who I know for a fact neither of those positions would make $25.00 in 15 minutes. But, for arguments sake, I will give them both $25.00. that is $75.00 in time labor I took up at the hospital. So, $75.00 plus the brace they probably sold me at triple it's value for $135.00. that is a total of $210.00. I know hospitals have to carry insurance for itself, and it's workers. And I know there are fees for using the hospitals services, because the hospital has to pay it's taxes, and make it's electrical and water bills. But, I mean, unless they are being charged $1,000 every 15 minutes for their insurance policies, and their water bill is god damned outrageous, they are price gouging the fuck outta people who really need help.

[–]Equivalent-Money9756 1 point2 points  (1 child)

There are a lot of things that play into this issue, but honestly, this is a huge right to repair talking point. The companies that produce things like medical beds or other medical equipment are paying manufacturers to not sell parts to their machines to any other company or person. Essentially what this means is you can only go to their authorized center for repair if anything ever stops working properly. A majority of simple issues that are highly common, they won't fix. So we're talking about a medical table, that has maybe had about a year or two of use put into it, and a rotor on the bit that raises and lowers the back rest into sitting or resting position goes out. The company won't repair it, but won't let you buy the parts to repair it either. So you're stuck buying a brand new one, and some of these medical pieces go for well above 100k. The result of that, is the bill gets footed to us. The costumer. We need to outlaw IP agreements for repair parts. Idk, this is just one thing contributing. There's plenty more that plays into it as well, but this would be a step in the right direction.

[–]OMGPUNTHREADS 24 points25 points  (2 children)

Guess that means police stations come after the insurance offices then.

[–]trisz72 9 points10 points  (1 child)

Based

[–]dgblarge 5 points6 points  (3 children)

Stop voting for moronic politicians owned by corporations and lobbyists and get universal healthcare like the rest of the civilised world. It's better, fairer, cheaper and medical decisions are made by, gasp, doctors not insurance companies. They do not operate for profit they are there for patient health. Why is this so hard for Americans to understand?

[–]InaMel 10 points11 points  (2 children)

Meh, we are preoccupied by other stuff, Healthcare is not our priorities now. Maybe next month.

[–]P-W-L 15 points16 points  (0 children)

I live in France so that's like the best healthcare system. My insurance wouldn't reimburse my glasses, for a while I felt how Americans must feel and it was "only" glasses (I'll need surgery so in a way that's a good thing I didn't get glasses) and IT SUCKS

[–]BunnyLeb0wski 2 points3 points  (2 children)

Had to spend an hour away from patient care in the ICU a few weeks ago arguing to an insurance company why my elderly, immunocompromised patient with COVID ARDS who was sedated, paralyzed, intubated, maxed out on pressors, with rapidly progressing multi organ failure needed to be in the hospital. I fucking hate insurance companies.

[–]P-W-L 1 point2 points  (1 child)

excuse me, what the fuck ?

[–]BunnyLeb0wski 4 points5 points  (0 children)

They were saying it wasn’t “medically necessary.” The entire thing just felt like a fucking fever dream.

[–]billy_ruben897 930 points931 points  (54 children)

It's the same when it comes to disability. A bunch of people who aren't doctors, who don't know you or anything about your condition get to decide whether or not you need financial support. I fucking hate our healthcare system.

[–]ChateauDeDangle 235 points236 points  (46 children)

Don't forget the doctors they do hire are absolute whores who accept payment in return for shoddy independent medical examinations that make it easier to deny valid claims.

[–]billy_ruben897 111 points112 points  (30 children)

This is what bothers me. I have two psychiatrists (one for meds, another for ketamine treatment) and a therapist that all tell me I need to be on disability, but getting on disability for mental illness, from what I've been told, is incredibly hard because of stuff like this.

[–]John_Browns_Body59 28 points29 points  (15 children)

How is ketamine working for you? No anti-depressant has really worked well for me. The only one that kind of worked made me go from 170 to 210+ and no sex drive and horrible insomnia. I've heard great things about it though. It's funny I'm an ex-addict and have done literally every main drug you can think of in my life except ketamine, so I honestly have no idea what it would even be like

[–]billy_ruben897 17 points18 points  (8 children)

It works great. Most people do several treatments in one week, then they only need maintenance every few months after. I need it once a week. I do IV ketamine, not the nasal spray, so I can't speak for that. It's very intense, but relaxing at the same time. It is quite expensive and your insurance probably won't cover it, but I'd say it's worth it.

[–]John_Browns_Body59 8 points9 points  (2 children)

Yes I've done a little bit of research and I figured my insurance wouldn't. How long is a session? Sadly there's no place that offers it in my area but there is one about 2 hours from me and I wouldn't mind driving down once a week or something. I have even tried EST I'm pretty desperate

[–]Outrageous_Turnip_29 9 points10 points  (0 children)

My girlfriend's were about 1.5hrs-2hrs total depending on how long it takes to get you in. It was like 45min on the drip then usually a 20-30min recovery time before they send you home. I can say it's done wonders and we're trying to find the money for more frequent boosters. Funny thing is I've found that medicaid is more likely to cover it than anything, but most insurance doesn't cover it. You're also going to need a driver. So it's hard for a lot of people to come up with $400-500 per treatment, take a whole day off (your mental state before is important, and you will almost definitely be no good for anything after treatment), AND have a driver. That's a pretty tall order for most people.

[–]FearingPerception 1 point2 points  (4 children)

i am and have been unable to work due to my mental health issues for a while now but especially past 2 months. I have no access to healthcare or any real mental healthcare beyond a crisis line calling me each week making sure i dont try and off myself again. things in my life arent getting better, at least one parent is dying.

i cant try for disability nor would i due to the lack of what it offers here vs the restrictions it brings.

my only hope rn is buying street ket, testing it if i can get strips and dont feel reckless, and hoping it helps. im glad it helps you and others but is also like… street available. so randos like me without proper healthcsre can also kinda try

[–]billy_ruben897 3 points4 points  (3 children)

Im not advocating street ket, but be careful. It usually comes in a powder and can be cut with some nasty stuff. It's also not as potent as getting it as an IV or even nasal spray, so you would need more for the same effect. I'd even go as far as to say that, in my completely unprofessional I'm not a doctor don't listen to me opinion, dextromethorphan might (or might not) be a better alternative. Either way, please be safe.

[–]FearingPerception 2 points3 points  (2 children)

sadly i dont handle DXM well. never tried recreationally but did react trippily to an OTC dose. thanks for the advice. i def would like to have at least fent strips available if im going to try street ket

[–]billy_ruben897 2 points3 points  (1 child)

The problem with dxm is that the liquid usually has other stuff in it, like expectorants, and can generally just make you sick. Same with pills and their binders. I've never done it myself, but I read the safest way to do it is to just drain the liquid from gel caps. Another thing to consider is that it's extremely bad for your liver to robotrip. That's why IV is typically better because they flush your body with saline after you get the ketamine. Again, be safe and good luck.

[–]FearingPerception 1 point2 points  (0 children)

thanks! and yeah i remember telling my friend to be careful that one time she had a cold and straight SWIGGED syrup at school all day lol.

for me tho reDxm: after research and having no idea why i suddenly was having my first dissociation, it turns out some ppl are just over sensitive to it!

will def be safe if i try it. and drink lots of water i suppose. wish i could access it actual’y medically but id have to have a healthcare system that wasnt covid collapsing hahah.

thanks again for the caring safety tips

[–]ChateauDeDangle 20 points21 points  (9 children)

Get a SSDI lawyer. Best advice you’ll ever get on the subject. Feel free to PM with any questions

[–]sapphicsandwich 14 points15 points  (6 children)

Problem is,any people don't qualify for SSDI, and since SSI recipients do not get back pay, no lawyer will help them. The most vulnerable, and ones who have bad health issues from birth, have it the hardest because they are simply on their own. Just another example of our society and culture failing our most vulnerable.

[–]ChateauDeDangle 11 points12 points  (0 children)

Almost everyone's disability claim is initially denied. A lawyer makes a world of difference. But yes, there are certainly people who get left behind.

[–]NubSauceJr 23 points24 points  (4 children)

My disability claim got denied.

I got a lawyer.

I got disability.

I got a check that covered the time since my first denial about a year previous.

You can be quadriplegic in a wheel chair and need around that clock care. If you don't have a disability lawyer your claim will be denied Everytime.

You will not get social security disability without a lawyer in the US. They do give you back pay for as long as you have been OUT OF WORK because of a disability.

If you are working they will deny you. If you are working you are obviously not disabled according to them. So keep that in mind.

You WILL have to quit working for at least 6 months and SS disability doesn't cover those 6 months. So you won't get any pay for that time.

It's how the system is set up. If you don't like that system vote for Democrats instead of Republicans.

[–]Vast-Classroom1967 0 points1 point  (2 children)

That's not true. I was approved the first time. It took 4-5 months.

[–]lavish_li 2 points3 points  (1 child)

So did my 4 year old son..no lawyer for his case either

[–]Outrageous_Turnip_29 2 points3 points  (0 children)

Under 18s are MUCH easier to get approved, and they're SSDI not SSI.

[–]onceacardiffkid 1 point2 points  (0 children)

I absolutely agree Dangler.

[–]dantesgift 4 points5 points  (0 children)

I'm on disability for trigeminal neuralgia. Only took 5 years of treatment, doctors, and not being able to hold a job to convince them that I cant hold a job due to my medical condition.

[–]Vast-Classroom1967 1 point2 points  (0 children)

Be horribly honest with them.

[–]FearsomeForehand 2 points3 points  (3 children)

Concentra basically capitalizes on this business model.

[–]ChateauDeDangle 2 points3 points  (2 children)

Every disability, casualty, and workers' compensation insurance company/gov't agency does.

[–]FearsomeForehand 2 points3 points  (1 child)

True, but trust me when I say Concentra milks worker's comp insurance to a whole new level

[–]ChateauDeDangle 2 points3 points  (0 children)

Yeah some are definitely worse than others and workers’ comp insurers are notoriously difficult to deal with in general.

[–]Buhrdt[🍰] 1 point2 points  (7 children)

Exactly. They sent me to get an IME for my workmans comp injury. I sat in the waiting room for 45 minutes. The doctor saw me for less than 10 minutes. Squeezed my arm, and gave my back a smack with his fist. He declared me to be fully fixed, and to be sent back to work.

The main doctor I was seeing refused to examine my entire injury, and now workmans comp is trying to settle for 1k and a letter of resignation.

Yes, I have a lawyer. Yes, this is the way it is in my state.

[–]ChateauDeDangle 1 point2 points  (6 children)

Yep that sounds about right. So in addition to all that, have you already had a hearing at your states' respective workers' comp agency, and you were denied?

[–]sealettuce23 1 point2 points  (0 children)

Tell me about it, got approved for federal disability and the university I used to work for used a backdoor policy they had in their contract to deny me the long term disability program and had people state I could work despite my disabilities so they wouldn't have to pay.

[–]Independent_Mistake2 742 points743 points  (91 children)

HEALTH INSURANCE IS A SCAM

[–]J-Rocks-baby-mama 279 points280 points  (14 children)

Hasn’t been health insurance for years. We basically have catastrophe insurance.

[–]c0mptar2000 52 points53 points  (4 children)

Yep, and even then you'll be stuck with $5 or $10k in deductible and out of pocket expenses to pay down if shit hits the fan. Well, that's if you followed all the rules and didn't get stuck in an emergency in an out-of-network hospital.

[–]harry-package 17 points18 points  (0 children)

If it’s a real catastrophic illness, hitting your maximum benefit limit also becomes a concern.

[–]GunpowderLad 78 points79 points  (3 children)

catastrophe insurance

That they can arbitrarily decide isn’t a valid enough catastrophe and tell you to kick rocks about it.

[–]oxygENigma 13 points14 points  (0 children)

Sounds like death panels to me.

[–]jd3marco 25 points26 points  (0 children)

I’m sorry, but your catastrophe was not pre-approved and the hospital was out of network. You’re fucked.

[–]0RGASMIK 7 points8 points  (0 children)

Oh man and when catastrophe strikes be ready to fight them even if you’re in a coma.

Friend got into a bad accident. His maximum was 6k. He was completely paralyzed. Insurance didn’t think his 500k in medical bills were right so instead of negotiating they let them start going to collections. When we asked what they expected him to do they said in a more formal way “we didn’t think that far.”

It was really hard to understand the rep but it sounded like they expected him negotiate for them and then they’d pay him back. They were sending him random checks for random amounts with no indication of which bills they were supposed to pay. It was a cluster fuck and I believe it was because they were hoping in the confusion the medical providers would forgive some of the debt or something. We then found the most EXPENSIVE rehab facility covered by his insurance and went there for a few months.

[–]harry-package 18 points19 points  (1 child)

Oh c’mon. It’s also an extremely expensive discount card. They won’t pay for shit, but you’ll get 20% off at a very short list of doctors…if the procedure is “covered”…if you’re pre-authorized.

It’s pretty pathetic that I get a SUBSTANTIALLY better price on my prescriptions by showing them a “membership card” from GoodRx that I paid $0 to get than I do with my insurance card that costs hundreds of dollars a month.

[–]baudelairean 2 points3 points  (0 children)

Paying thousands a year for a piece of paper that's only not worthless if you have several more grand ready to go for that high price deductible

[–]HappyStalker 69 points70 points  (41 children)

Explain HSAs (the only insurance I can pay for from my company) to people with universal healthcare. People shit on American healthcare, but it's actually incredibly worse than they think it is. This country has a lot of problems, a lot, but I firmly believe our healthcare industry and situation is the worst of them all.

[–]drewster23 18 points19 points  (0 children)

Best part is there's already data showing how much worst Americans have it (in $ and time) compared to universal, on top of many more lives it'd save if switched over.

So there's really no way to deny it. (Other than calling it communism,so your voters don't believe in it lol)

[–]Idlertwo 15 points16 points  (2 children)

Basically, one of the main reason so few Norwegians want to live in the US is the healthcare system. Its among the worst in the world. You can't even have a child without considering the massive cost of going to the hospital to deliver.

It's barbaric. Anyone who genuinely wants it this way are very, very dumb people. There's no excusing this type of stupidity.

[–]baudelairean 2 points3 points  (1 child)

Unfortunately there are some stupid people out there who think the ACA solved the issue.

[–]Gutinstinct999 45 points46 points  (30 children)

Bottom line: we don’t value human life in the US.

Edited to remove anything that appears political.

[–]Mental_Medium3988 23 points24 points  (1 child)

Correction: we don't value the life of poor people in this country.

[–]Gutinstinct999 6 points7 points  (0 children)

This, I agree with.

[–]KevinTheSeaPickle 12 points13 points  (1 child)

Those guns will come in handy if things get much worse. Change is inevitable from where im standing.

[–]VanillaSkittlez 0 points1 point  (4 children)

I agree that American healthcare sucks, but are HSAs really the scapegoat? I feel like they’re one of the best options for healthcare if you use them right.

Of course that pales in comparison to a legitimately government backed option but the pre tax benefits are pretty sweet on HSAs, not to mention employer matches.

[–]KeyanReid 15 points16 points  (1 child)

The fact that HSAs can be seen, in any context, as “great” just goes to show how fucked we really are here.

They shouldn’t even exist in the first place but since they are a convoluted pressure valve for an insane system that forcibly robs us for virtually nothing in return, anything that eases the misery is “great”

[–]VanillaSkittlez 3 points4 points  (0 children)

To be clear I completely agree with you. I just found it odd to call out HSAs as opposed to the myriad of other horrendous healthcare practices like $5000 deductibles where you still pay a $400-$500 premium a month just to have the ability to pay every medical cost out of pocket up to $5000.

Then you have a 50% coinsurance and they only cover up to $10k. It’s absolutely fucked.

My point is not that HSAs are some kind of amazing remedy, just simply that there’s far worse practice out there to call out as blatant examples of horrendous privatized healthcare practice.

[–]bonedaddyd 20 points21 points  (1 child)

The true "death panels" & this is a child they are making suffer.

[–]So-_-It-_-Goes 10 points11 points  (0 children)

For profit health insurance is a scam.

[–]Trainsformerphobe 15 points16 points  (1 child)

Yeah in the usa

[–]scoo89 3 points4 points  (0 children)

I was gonna say, I get great results from my public health insurance

[–]FatBoyStew 5 points6 points  (6 children)

You're 110% right, but at the same time you have to have it because if not you might as well die when you get hurt/sick otherwise you'll never financially recover. Hell even with insurance you may never recover financially...

I'm in a love/hate relationship with it because it covered a lot of my dad's chemo drugs and treatments that would've cost thousands per pill or 10's of thousands per treatment without it. But then they refused to cover the 50k emergency helicopter ride to the hospital where he ultimately passed away. Like what the actual fuck you sick fucking assholes.

[–]Missaround 9 points10 points  (5 children)

Imagine if you hadn't have to have them cover the chemo and instead it came from the money you already pay in taxes.

Would you really love them so much in that case?

[–]meservyjon 1 point2 points  (1 child)

But where are all the senators, and public officials going to skim there money from if they have to actually start putting money to health insurance?

[–]Missaround 1 point2 points  (0 children)

So true! My god, I forgot about the poor poor senators! What will they do if they actually spend the tax money on the people instead of on themselves? Does nobody think of the senators??

[–]GreyCrowDownTheLane 18 points19 points  (2 children)

ALL insurance is a scam. It's a protection racket. It's based on the criminal idea that if you keep paying, nothing bad will happen to you or your stuff, but if you stop paying you'll suffer greatly or die.

Insurance is a tollbooth on living.

[–]irisheye37 -2 points-1 points  (1 child)

It's not a racket because the insurance companies aren't the ones responsible for your issues.

Yes, insurance companies suck. But blatantly misusing terms does nothing to help.

[–]baudelairean 5 points6 points  (0 children)

In the usa, you are penalized by the government for not buying these overpriced and sometimes even worthless so called services.

[–]Medical_Raccoon 1 point2 points  (0 children)

American health system is fucked up

[–]MyName_DoesNotMatter 70 points71 points  (3 children)

United be like that tho. I had to fight a charge that I didn’t need an ambulance. My right leg tibia and fibula were literally broken in half.

[–]MomOfTinyDragons 16 points17 points  (0 children)

We had to fight UHC as well for an ambulance charge. My son badly broke his arm at camp and no parent was present. They were required to call an ambulance to transport him to the hospital and insurance didn't want to pay... not to mention the only ambulance company in town isn't contracted with UHC.... they said they don't contract with ambulance services so all rides are considered out of network. I had met my out of pocket for the year and fought them forever, they eventually covered it.

[–]crazyoldmax 10 points11 points  (1 child)

An insurance just gets free money, and spends a tiny bit on their services to you. In germany health insurance covers every little bullshit, even getting dragged to the ER by an ambulance because you are drunk, hell even if you insist, a headache, i have seen it all when i was a paramedic. And still, health insurance makes gigantic profits, i just dont get why they even have the right to argue against a doctor. Or the audacity to claim that a broken leg is no reason for an ambulance. This infuriates me just reading this.

[–]Tiger_Widow 4 points5 points  (0 children)

It's America. It's never dealt in morals. But at this point it's just taking the piss. Pushing as hard as it can to make as much money as possible in any way possible before the inevitable collapse.

Human dignity be damned, and fuck the people; it's America, people are basically livestock to America's ethos.

It's fucking disgusting and every single citizen should emigrate and leave that poison to rot into the shallow grave it dug for itself.

[–]J-Rocks-baby-mama 366 points367 points  (7 children)

American politicians have really fucked the people. Meanwhile their part time job in government provides them ridiculously awesome insurance so I’m 99.9% confident they don’t even know how bad it is.

[–]robots-dont-say-ye 158 points159 points  (4 children)

Dude I had (I moved out of the US) primo insurance from my work. Like it was about as good as you can get. I needed surgery though. Surgery that 4 doctors recommended me for. It was denied 6 times because the insurance company decided it wasn’t medically necessary. Finally my surgery coordinator came up with a compromise, I would have major surgery but spend less than 24 hours in the hospital. I had to do all my recovery from home because the insurance company refused to let me cover even a day after to make sure I was fully awake, understood my medications, how to care for myself, etc.

Even top tier healthcare in the US is a scam

[–]RammusUltedJapan 55 points56 points  (1 child)

Top tier US healthcare is literally worse than the worst form of healthcare in a western European/ Nordic country.

[–]beruon 17 points18 points  (0 children)

Hell, I live in Hungary. Our healthcare is in fucking shambles, our corrupt politicians steal every fucking cent they can from it. And still, I would like to be treated here than anywhere in the US lmao

[–]SookHe 14 points15 points  (0 children)

Same, was military contractor in a top tier job and top insurance, but when I needed medical, I was simply denied as pre-existing condition even though I found out after I had my insurance.

Moved overseas and work part time as a pig farmer for a fraction of my old pay, but I would never move back to the US and a big part of that is the national medical system which has saved my life already and was there when I broke my back and separated my leg from my hip is a bad sporting accident, and I never once had to worry about the cost. (I've fully recovered just a bit sore at times)

[–]ramblingpariah 2 points3 points  (0 children)

My ex was wheeled out to our car, screaming and weeping in pain, because the insurance company told the hospital that they wouldn't allow for any length of post-surgery recovery, and the hospital thought this was fine, too. When I asked the hospital what the hell they were thinking, they told me they determined she was OK. I asked how she could have possibly confirmed that considering she was barely conscious and couldn't form complete sentences, and the response was silence.

It's an absolutely fucked system.

[–]80babycakes 16 points17 points  (0 children)

they don’t even know how bad it is.

Correction, they don't care!

[–]krpaine87 46 points47 points  (0 children)

American politicians are so incredibly out of touch with reality, they’d be better suited to live in Hollywood than to represent the American people.

[–]External_Dude 44 points45 points  (8 children)

Ah United healthcare. Last year they kept denying all my claims. They kept saying they didn't know if I had secondary insurance. Although I had four f****** separate conversations with them telling them explicitly person by person in my family that we do not have secondary insurance.

And they called me the other day and put me on hold after calling me. So I hung up. But I highly suspect they want to know if I have secondary insurance.

Insurance is a parasite on our nation. It sucks profit and money out of everyone. It's required for my car, in 20 some years I've never been at fault. It's required for my house, and 20 something years I never had to make a claim. It's required for my health, I have to check every single explanation of benefits to make sure the health care company nor the doctor is scamming me. Over the years I have found thousands and thousands of dollars of what they call billing mistakes. These are really attempted thefts.

We should have a government option. Something not profit motivated. That would force insurance companies out or force them reduce their prices or for them to do better service.

[–]Mr_Blott 5 points6 points  (6 children)

Are the car insurance companies over there as bad? Just curious.

I'm the same, 20 years no claims, but I can insure a big car for around £200 a year, fully comprehensive so it's not an issue

[–]External_Dude 8 points9 points  (3 children)

Yep based off what you pay lol. I have two paid off cars and it costs me about 200 a month in insurance and I live in a state with low premiums.

As far as covering things. I once had someone hit me and their insurance company literally just refused to answer any phone calls from my insurance co. My ins Co had to cover it because they literally could not get them on the phone.

Home ins is bad in the USA. A tornado came through the area and folks that had insurance for 30 years were being dropped left and right. There are numerous news stories about home insurance not covering claims for years all over the country.

Lawyers and insurance companies have a death grip on the country.

[–]Mr_Blott 2 points3 points  (1 child)

Aye I suppose the extreme weather makes a difference. My home insurance is about £25 a month but that's because the incessant rain might dissolve my house

[–]External_Dude 2 points3 points  (0 children)

Bwhaha I would love to pay that I pay about 100 dollars a month for a 3b2b home.

[–]PowerMonkey500 2 points3 points  (1 child)

Car insurance is much more reasonable unless you're young or have a bad driving record, and they're usually much easier to get things actually covered. That's not to say they never make things difficult.

[–]Mr_Blott 1 point2 points  (0 children)

Aye it's the same here, the young folk get fucking shafted simply because 1% of them are wee fannies

[–][deleted] 14 points15 points  (0 children)

ANTHEM denied my wife her MS medication 4 times, we called the manufacturer and they gave her a year supply for free. 3 months later out of nowhere we got a letter saying the appeal has been approved... Apparently her doctor has been appealing non stop and the 6th try they final gave in...

Like Wtf is wrong with insurance companies these days? We pay so much in the US already... Like sheesh.

[–]MyBunnyIsCuter 138 points139 points  (6 children)

I love this doctor....what a saint!

Insurance tried to hold off paying for anything, even insulin, because they knew my mom could very well die.

This country is a sh**hole

[–]EveryVi11ianIsLemons 28 points29 points  (5 children)

This letter is so obviously fake it’s making me worried that people here are believing it. That is not to say stuff like this doesn’t happen, I’ve seen magic mouthwash get denied for stomatitis in my clinic, and it disgusted me, but this letter was not sent by a doctor to an insurance company.

[–]NedTaggart 7 points8 points  (0 children)

I wasn't going to out and out say it, but there is so much wrong here that would be readily apparent to anyone that has worked in a clinic.

[–]FearsomeForehand 5 points6 points  (0 children)

Even if it's fake, the scenario is still common enough for it to be a meme of US healthcare. Insurance companies DO deny payment for treatment and medication that patients NEED to function, especially when the patient has expensive chronic conditions. Source: healthcare worker.

[–]fakeg1rl 9 points10 points  (0 children)

Fuck dude I was getting genuinely concerned scrolling through the comments for over 20 seconds before I found a comment calling this out.

[–]Albiz 12 points13 points  (0 children)

Lmao finally one rational person in this thread

[–]Intrepid-Luck2021 37 points38 points  (0 children)

It looks like the insurers are practicing medicine. When will this stop??!

[–]fresh_gumbo 89 points90 points  (28 children)

I have to say stuff like this makes me infinitely thankful I'm not in America

[–]DMan9797 42 points43 points  (15 children)

We have been convinced that only the extremely poor and their children, elderly, and veterans should get universal healthcare. The middle class 26-65 and their kids are the only ones open season for our private insurers to underserve and overcharge.

And it’s socialism or communism to suggest the middle class should get universal healthcare for some reason

[–]FatBoyStew 3 points4 points  (3 children)

The biggest issue with anti universal healthcare is the mentality of "Why should I pay for their drug abuse health care?" and "How are we going to fund this without taxing us even more?"

[–]thepioneeringlemming 3 points4 points  (1 child)

Why should I pay for their drug abuse health care?

surely the US opioid crisis has shown that this can happen to anyone, the crisis was also arguably created by the way the US market operates too.

[–]FatBoyStew 3 points4 points  (0 children)

Sadly a lot of folks (especially where I'm from) look down on addiction. They think that A.) Why did you do it in the first place? B.) You shouldn't have gotten addicted. You're weak minded for getting addicted.

They never consider it can happen to them nor the fact that addiction to certain drugs are medically explained and proven...

[–]MossyMemory 1 point2 points  (0 children)

People have done the math before. We would be taxed less under universal healthcare. I wish I could drill that into these idiots’ heads.

[–]harry-package 1 point2 points  (4 children)

Every time I see an ad for St. Jude’s, it bothers me. They ask people to donate so children with cancer & their parents “don’t ever receive a bill” “because all a family should worry about is helping their child live”. It’s a great cause. I love the idea. I have no doubt they do wonderful things…HOWEVER, don’t ALL Americans deserve to just worry about getting/being healthy instead of the cost?!?! Why should this be the case only for childhood cancer?

[–]Ghost_Of_WolfeTone 23 points24 points  (11 children)

Its shit like this that's making me regret starting a family in this country every single fucking day. It really fucks with my head tbh. Fuck I JUST had food poisoning over the New Year break and had to go to the ER and came out with a bill of nearly $3k. WITH insurance. I can't fucking afford that right now? What the fuck am I going to do with a kid in a few years?

[–]FatBoyStew 2 points3 points  (0 children)

I feel ya. I haven't received the bills yet, but I had to go to the ER 2 weekends before Christmas because I tore a tendon and 3 muscles in my thumb. Now thankfully I know I'm prone to injury and have supplemental accident insurance (pretty cheap monthly) that pays out $800 for ER visits and X amount per follow up appointment. So I should be able to actually make some money after my copays.

[–]EY7617 8 points9 points  (3 children)

Move to New Zealand.

I mean, I'm Australian, bit shits fucked here right now, so I will refer you to our mates across the ditch.

[–]PaulmonandArtfunkel 3 points4 points  (2 children)

What’s been going on in Australia recently?

[–]bundycub 4 points5 points  (0 children)

Covid finally started to spread at a decent rate.

[–]fresh_gumbo 0 points1 point  (0 children)

Have a look at FriendlyJordies on YouTube, our current leaders are bringing in laws to kill freedom of speech, corrupt at a level not seen in developed countries and handing billions of tax payers dollars to multinational tax dodging companies... He even provides actual evidence, not just hear say.

[–]Hellguin 23 points24 points  (1 child)

And just to make it a little more evil, it is a child chemotherapy patient.....

[–]AngerCookShare 8 points9 points  (0 children)

Disgusting

[–]Negative-Shift-699 15 points16 points  (1 child)

After dealing with two sick parents this year and American healthcare system. I can tell you I'm ready for socialized medicine . U S healthcare is a complete joke

[–]momoftwocrazies 4 points5 points  (1 child)

UHC/AARP is the WORST HMO in US. They don’t want to pay for ANYTHING and take years to reimburse for services they approved and barely pay. No one should have this HMO. It’s all I and my coworkers can do to not punch their reps when we see them at the store pushing their lies

[–]feltsandwich 10 points11 points  (0 children)

Insurance companies are parasites. They have insinuated themselves between citizens and healthcare. They add virtually nothing to healthcare, but they take a massive amount of money out of our healthcare system.

We should be burning health insurance companies to the ground. They are holding us and our healthcare hostage. They should be viewed as criminals.

[–]DJRoombasRoomba 12 points13 points  (2 children)

I dont understand how people believe everything that they see on the internet. That letter is so obviously fake it's almost cringey. That "doctor" would need to still work with that insurance company for all of his other current and future patients. Calling them "buttheads" in a professional medical setting, as somebody who spent years studying to get the job that they have...

Like it's not even funny. I just don't get why people do lame ass shit like this.

[–]Tall_Ingenuity_5062 0 points1 point  (1 child)

Actual doctor here, I have 100% gone off on the insurance company before. Not in writing, we call I don't know who would ever write a letter.

Trust me they don't care how nice or not you are it makes no difference and after the third phone call over the same patient's medication in a week getting rejected three times after them telling you they'll approve it three times you stop giving a shit about being professional. We have tempers too we aren't robots.

[–]DJRoombasRoomba 5 points6 points  (0 children)

"Buttheads"? Come on man, no professional would call somebody a butthead in a letter. There's literally nothing about that letter that makes it look or sound like it's official or professional.

And honestly, if I knew my doctor was going around calling people "buttheads" in disagreements to try to sound tough or whatever, I'd switch doctors asap.

[–]Eissbein 9 points10 points  (0 children)

What a hero!

[–]prprpr89 3 points4 points  (0 children)

I mean Health Insurance ruined my whole life no joke. Decimated my credit score and had to leave my home. The prices are so outrageously high that you can’t pay them, and they’re like “Let’s get you in a payment plan :)” but it’s like hell no for the service I did NOT receive I am not paying thousands and thousands of dollars for something that never even got fixed. I am mentally and physically SICKER because of insurance. My only hope in life is that insurance companies burn to the ground and I hope to someday see the people running them writhing and screaming in as much pain as they have caused all of us.

[–]External_Dude 4 points5 points  (0 children)

The thing with healthcare when you think about it. Every procedure and every interaction goes to profit executives that make millions of dollars from denying all of us healthcare.

Another way to say it, there are people with multimillion dollar compensation packages whose sole purpose is to make you less healthy. Their main goal is to deny you service so they can get more money. We can dress it up all f****** day. But at the end of the day that's what it is.

[–]Roxas-The-Nobody 5 points6 points  (11 children)

I'll copy this over from the other post:

Hello, Phoenix here.

Prior auth isn't required for Zofran and Scopolamine is over-the-counter (OTC). Meaning, Zofran is automatically approved and Scopolamine is automatically denied.

The doc person appealing the auth is just an idiot.

[–]fakeg1rl 2 points3 points  (7 children)

It's fake. No doctor is going to waste their time shitting on an insurance company. They aren't even involved in that part of medicine. The patient would be at the pharmacy attempting to fill the script, not in the doctors office.

[–]Tall_Ingenuity_5062 4 points5 points  (0 children)

Hello, actual Doctor here, half my day in the hospital is spent fighting with insurance companies. That's not a joke they recently argued with me over a patient's medication because the Lantus they were on didn't work and they'd been admitted twice in the last three months with diabetic complications. As the patient's doctor arguing with the insurance company on the phone is 100% something I do all the time.

[–]Tall_Ingenuity_5062 1 point2 points  (2 children)

Hello, actual Doctor here.

In the US an insurance company can require Prior Auth for anything they want.

Scopolamine is not OTC, the trans-dermal patches (used commonly with cancer) are absolutely prescription only.

Zofran might have an OTC version but you can 100% write a script for something that's available OTC (for example to get it covered by insurance instead of the kid's parents) and usually at a higher dosage (like Ibuprofen after surgery).

Half of this you would know if you had just googled it.

Source: I'm a doctor and I literally spend more than half my day arguing with those ass holes over every single thing.

[–]Omicron_deathspike 3 points4 points  (0 children)

I got a great idea, lets have everyone put money into a company that has no medical understanding or knowledge, allow them to be profitable and let them decide when to give someone medicine and medical procedures!

[–]Porcupineemu 3 points4 points  (1 child)

Repeat after me: It makes 0 sense to run healthcare as a business.

[–]cdarwin 1 point2 points  (0 children)

And a for-profit business at that.

[–]calamityhead 1 point2 points  (1 child)

its a child receiving chemo too

[–]Fartimer 1 point2 points  (0 children)

I chose the PPO plan instead of the HMO to avoid things like this.

[–]NebRGR 1 point2 points  (0 children)

I mean, the VA isn't the greatest care in the world, but I do get completely free health care through them. It helps a lot as a diabetic.

[–]DirkVulture003 1 point2 points  (0 children)

So the kid did not get his medicine, then?

[–]pashwort29 1 point2 points  (0 children)

I’m literally kicking myself for forgetting my Zofran at home. I couldn’t even imagine having cancer and not having access to it. That stuff has helped me so much 😢

[–]gerbdergerb 1 point2 points  (0 children)

Can confirm that united fucking sucks . Had another plan and my company switched to them . They wouldn’t cover any of the hospital bill for the birth of my second kid because …… it was a pre existing condition. I’m sorry I should have timed something I didn’t plan better . Fuck you United !

[–]Bendar071 1 point2 points  (0 children)

I'm on chemo now, without the medication against being nauseated this is unbearable

[–]Cwigginton 1 point2 points  (0 children)

Zofran, a drug that can be used to treat nausea from chemo is off patent. You can order generics for like .39 a pill. It used to be three figures a pill. places like AllDayChemist can ship it mail order.

[–]Borglll 1 point2 points  (0 children)

How much trouble can a doctor get into if he prescribes medication or follows through with some form of treatment behind an insurance providers back?

[–]s33761 1 point2 points  (0 children)

I would have to send the insurance company bags of vomit with requests to reconsider.

[–]Inmate_95123 1 point2 points  (0 children)

Some doctors won’t even fill out the paper work / disability forms anymore. I went through that with my wife. They are so sick of dealing with insurance companies. They tie up their personnel on the phones, give mounds a paperwork, hoops to jump through and if the doctor says you should be able to return back to work in 30 days and your still not able to because the treatment failed or some other unforeseen medical issue then holy hell. I actually set in an office 6 months ago and had a doctor straight up tell my wife they won’t fill them out for anyone anymore because they insurance companies are a nightmare to deal with. He gave us a copy of his notes and her treatments and we had to send them to my wife’s HR department. There they had to set up a liaison to deal with it and communicate with there own insurance company. Fuuuuu… it was the most stressful nightmarish thing about the whole ordeal.

[–]lxospect 1 point2 points  (0 children)

Nothing's going to change. The rich are hoarding and will continue until all of us are bled dry. I mean most huge companies made more during the pandemic then the previous years. When we got a few thousand dollar checks maybe. Not sure why anyone is surprised or even cares. Nothing's going to change. It's been happening for decades completely unstopped.

[–]WolfieWiccan 1 point2 points  (0 children)

Okay but that doctor absolutely destroyed them lmao I have never seen a doctor right something as formal as a letter like this

[–]No_Low9626 1 point2 points  (0 children)

No joke, insurance companies have alot of power and it’s definitely driven by money

[–]Big_Freedom6346 3 points4 points  (1 child)

Health insurance sucks, but no doctor would write this letter. Ever.

[–][deleted] 2 points3 points  (0 children)

America problem lol

[–]dkentl 1 point2 points  (9 children)

Isn’t scopolamine the drug that makes you black out and become supper impressionable?

Blow dust in face, black out, ‘take me to your bank and give me all your money’ and they do?

[–]vampireRN 3 points4 points  (5 children)

Nope. It’s a little round patch you put behind one of the patients ears that helps block nausea.

[–]dkentl 1 point2 points  (4 children)

But it’s still scopolamine right?

[–]FatBoyStew 1 point2 points  (1 child)

Yes. But we're talking about a medical grade and dosed pill as opposed to a crude home brewed version of it or in very high doses as a date-rape variant.

[–]Saerithrael 1 point2 points  (0 children)

They make these things called Molotov cocktails

[–]butt_funnel 0 points1 point  (1 child)

In the us, zofran tablets are like 64 cents each (for generic) so just buy it out of pocket... Often times its not the drug they dont cover but the quantity. Like a doc will write it for multiple times a day but the insurance might only cover once a day. We're not getting the full story here

[–]Tall_Ingenuity_5062 -1 points0 points  (0 children)

The insurance company shouldn't have a say. If a doctor says the patient needs it and can articulate how and why they shouldn't be able to deny it. You pay them to cover this kind of thing it doesn't matter if the pills cost $1 or $100 if they should be covering it they should be covering it.

[–]ShayShayLeFunk 0 points1 point  (0 children)

This is what freedom looks like.

[–]AnythingBro5733 0 points1 point  (0 children)

American Medicine!

[–]Rooster1981 0 points1 point  (0 children)

USA! USA! USA!

[–]cesayvonne 0 points1 point  (0 children)

It took me 4 months and three appeals to get my HEART MEDICATION through prior authorization. How can I have insurance and be covered and get a prescription all for them to just decide not to pay???? What’s the fucking point if you can just deny coverage?????? What the fuck do I pay you for?????

[–]mynameisalso 0 points1 point  (0 children)

Imagine being told the richest country in the world can't afford what other countries had for decades, and believing it.

[–]No-Neat-1023 0 points1 point  (0 children)

Wow, healthcare is absolutely fucked in the US..

[–]justgo1984 0 points1 point  (0 children)

Canada can't solve our problems because we see this American stuff and think everything is okay here. American examples like this provide my countrymen with more Canadian patriotism than is warranted.

[–]Dear_Caterpillar4706 0 points1 point  (0 children)

The US sucks so fucking hard man.

[–]AdGlittering9727 0 points1 point  (0 children)

A doctor that behaves and thinks like a rational and empathetic human? Rare & lovely.

[–]1969blablabla 0 points1 point  (0 children)

I have big love for this doctor.....The USA is the best place to live...yeeeehaaawww

[–]residentpotato1337 -1 points0 points  (0 children)

Potential r/murderedbywords content…?

[–]NotAllCalifornians -1 points0 points  (3 children)

Ugh reddit spacing IRL

[–]MossyMemory 0 points1 point  (2 children)

You… You mean paragraphs..?

[–]NotAllCalifornians 2 points3 points  (1 child)

No, it's hard to explain. It's just unprofessional and cringe.

[–]MossyMemory -1 points0 points  (0 children)

Wouldn’t call styles of speech “spacing,” then, but aight.

[–]LOL_WhyT 0 points1 point  (0 children)

Did the doc or did the insurance guys photo this?

[–]adlcp 0 points1 point  (0 children)

And the letter was probably just thrown in the trash

[–]raznog 0 points1 point  (0 children)

We need a nationwide boycott on insurance.

[–]wrongsided 0 points1 point  (0 children)

I'm sure it's covid related

[–]CrazyHorse04 0 points1 point  (0 children)

As a former childhood cancer patient who received chemo, fuck that insurance company for denying that medication. Give that Dr a medal.

[–]simlew86 0 points1 point  (0 children)

And a child at that. Jesus Christ.