UHC CEO Gunned Down in Midtown Manhattan

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

So you’re saying we should shoot him in the back?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

Usually yes, some chronically ill individual year after year or end—of-life Hail Mary procedures and meds.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You always go to an ER with a broken bone. They set it and refer you to an ortho. My kids seem to always break things on weekends, so that’s been my experience.

Oh brother.

The very fact that we are having a conversation about whether one should go to an ER with a literal broken bone is a sign of how broken our system is.

We don’t have to live this way. Healthcare can exist FOR us.

I think the “you should wait for two weeks to get your broken bone set by an orthopedist” is just a troll. It is of course wholly irrational.

Does t take two weeks. Just walk into the correct dept of the hospital. Not triage and ER

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

But as a civilized society, it has to work this way. The healthy, working people support their elders because when they start to age or get cancer, they want to be supported.

It is moral to care for those who cared for us.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

“Free” Ozempic and Wepbound for all indefinitely via Medicaid and Medicare should really be a hot and a half.

Need to juice my BMI so I qualify. Can’t wait.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

This is only going to get worse as science advances. We now have 80 something yr olds getting dialysis multiple times per week and 90 something yr olds in nursing homes that are regularly sent to trauma center hospitals for full work ups because they “fell” or are confused and sent for a head CT. Then there’s the subset of very expensive people that are constantly going to the doctor demanding something and the doctor usually agrees or orders whatever they want because they don’t want a bad review, they get paid, and they are better off from a litigation standpoint point of they over-treat vs tell the patient no.

This times a billion

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You always go to an ER with a broken bone. They set it and refer you to an ortho. My kids seem to always break things on weekends, so that’s been my experience.

Oh brother.

The very fact that we are having a conversation about whether one should go to an ER with a literal broken bone is a sign of how broken our system is.

We don’t have to live this way. Healthcare can exist FOR us.

I think the “you should wait for two weeks to get your broken bone set by an orthopedist” is just a troll. It is of course wholly irrational.

Does t take two weeks. Just walk into the correct dept of the hospital. Not triage and ER

But they can't walk, remember their leg is broken. FFS start your own weird thread on this and stop hijacking.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Excellent equation. And one I think we know the answer too.

End of life
Chronically ill and disabled
Illegal immigrants

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I suspect the apologist for the insurance industry who's been posting in this thread all day in fact is an employed wonk with the insurance industry. LOL.

Yeah, that poster seems to be worshipping soundbites.

workshopping

Well they aren’t working.

Honestly, healthcare IS a basic human right. As a society we’ve developed the science to treat disease and ease suffering. Why a big fat insurance CEO needs to get a big cash bonus before humans are treated is simply bizarre.

I think most people agree that healthcare is a human right but the rub is deciding how much healthcare and what kind of healthcare that is?

The question is, how do we make sure those decisions are made by people for whom health care is care, rather than those for whom it is first and foremost a financial investment whose value must by definition grow?

Really, it's already far beyond this stage. It's that denying claims randomly benefits the insurance company. Forget about eyeballs on the claim. If their software, or their humans, or whatever is making mistakes, that's profit. There is zero incentive for them to improve, in fact they select for incompetence. Every denied claim is a claim that may never come back.

This. I have BCBS and I’m required to submit any out of network claim to BCBS via mail. There’s no way to submit it electronically on my current plan. There’s no way to check if it has been received. About a third of the time, I get no response for months and resubmit because it was apparently lost.

That’s weird. I have BCBS Carefirdt and it’s all in the online portal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

So you’re saying we should shoot him in the back?

No, you treat pain and discomfort. But we shouldn’t be subjecting those over 80 to colonoscopies, mammograms, dialysis, adv cancer treatment, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

So you’re saying we should shoot him in the back?

No, you treat pain and discomfort. But we shouldn’t be subjecting those over 80 to colonoscopies, mammograms, dialysis, adv cancer treatment, etc.

What about premature infants in NUCU for months on end costing hundreds of thousands or even millions of dollars? Or, infants with severe brain damage kept alive for years?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.

You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.

I doubt it is extending life. It's making life easier as time winds down. Is your plan to let the elderly just lay in beds with some Advil, water, and a bed pan until they waste away?

Like in most of Asia, europe and LatAm?
And for centuries and even this most of this one?

Yes.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.

You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.

Old people are covered by Medicare. Their care isn't the reason why the United or BCBS plan you get through your employer is expensive.

It's part of their business, isn't it? If you have a line that isn't overly profitable, you seek higher profits from the other lines.

Medicare Advantage is where the real juice is!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You always go to an ER with a broken bone. They set it and refer you to an ortho. My kids seem to always break things on weekends, so that’s been my experience.

Oh brother.

The very fact that we are having a conversation about whether one should go to an ER with a literal broken bone is a sign of how broken our system is.

We don’t have to live this way. Healthcare can exist FOR us.

I think the “you should wait for two weeks to get your broken bone set by an orthopedist” is just a troll. It is of course wholly irrational.

Does t take two weeks. Just walk into the correct dept of the hospital. Not triage and ER

Oh, stop trolling. You sound dumber with every post.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

So you’re saying we should shoot him in the back?

No, you treat pain and discomfort. But we shouldn’t be subjecting those over 80 to colonoscopies, mammograms, dialysis, adv cancer treatment, etc.

First of all, general colonoscopies are not recommended for patients over age 75 so you don't even know what you're ranting about. As for mammograms, dialysis, any cancer treatment if they are paying for Medicare and secondary insurance every month then they are entitled to treatment. I have an 83 yr old relative who is still sharp as a tack, still drives, and has only two prescription pills a day. She has never smoked or taken a illegal drug. Frankly, I would say smokers, drug addicts,and alcoholics should not be covered.