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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.
Well advocate for assisted suicide/euthanasia
+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.
Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.
That’s funny because every time one of the older people in my family have entered the hospital, we have been pressured to “let them go”. Even when they were simply dehydrated and needed IV fluids. You aren’t the person to make the decision about whether someone has “quality of life”.
A nurse decided it was time to kill my dad, who had dementia, and gave a lethal dose of morphine.
The nurse didn’t inform anyone in advance that she planned to do this.
Pretty sick.
I don’t believe you. That would be a crime. The amount of morphine is tracked.
Okay. Don’t believe me.
I’m not sure why you think tracking morphine would prevent a nurse from administering morphine to a hospice patient and leaving them alone to die. She did call to say “it won’t be long now.”
But we were hours away.
After the ambulance arrived, narcan was administered.
I hope you never have to be on hospice and that no nurse tries to kill you because you seem unable to believe sick hospice nurses exist in the world.
DP. Because there has to be a doctor’s order for morphine and she has to document how much exactly was given at what time and that needs to match the order. When a patient is in the final stages of death and having aganol breathing, there may be an order to titrate the morphine to comfort. But again, that is to make the patient comfortable- it is not assisted suicide or killing them.
I will add same thing happened to my grandmother. Given morphine. Died morning after. She also had bruises all over body.
I’ve sat with three dying people. Two died very quickly after the morphine.
Morphine kills people. I don’t mind nurses giving it to actively dying people if they want it because it’s better than suffering but it’s not right to give it to people who are still up and moving around. But they can if they are on hospice—at least in Montgomery Country, Maryland because it happened.
So whatever you say about the rules and the law, nurses are giving it to patients and killing them. I doubt this was the nurse’s only kill.
If you read The Good Nurse, you will see how that nurse was able to kill so many people because colleagues would not or could not prove it.
The author told me he put that book, his book, on his mother’s side table at the hospital and kept a close watch.
Part of the reason nurses get away with it is people don’t want to believe it. Meanwhile, more people die.
Hope it doesn’t happen to you. It’s pretty awful.
After the narcan was administered, they were transferred to the hospital. At the hospital, I saw the difference in how the killer nurse administered a lethal dose versus the hospital nurses administering morphine correctly.
I know you don’t want to believe it happened. I sure wish it hadn’t.
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