Reply to UHC CEO Gunned Down in Midtown Manhattan

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I’m amazed at the number of people who think health insurance is the main problem, as if the hospitals just honest businessmen submitting bills for their services and the docs as well. The whole system is a sh&t show. Cardiologist in the US make like a half a million, in the Uk it’s like £150K.

People should be mad at their legislators for allowing it to get this way. This is not to say that insurers don’t have their problems but they are but one cog in the wheel of grift and dysfunction. [/quote]

Cardiologists actually provide an extremely valuable service.  Insurance companies suck money out of the system.  Do you really not see the difference?[/quote]

In many cases they keep the system from ripping people off and in many cases make sure that people don’t get the wrong med or unnecessary procedures. I know you think your doctor is the bees knees and would never do anything unethical or wrong but you would be wrong. Consider the fact that so many physician groups have sold out to PE who are managing care by the way in which they manage the practice. The docs didn’t sell because they are concerned about the good of the patients - they wanted a paycheck. There are no innocents in this game. [/quote]

Yep. Private equity is all over specialized surgical and medical groups …. these doctors are money machines. Cha Ching! $$ Smart doctors know how to game the system. Spend 15 minutes with a patient, quick exam, order scans. Done. Next!

Even large hospital groups order needless scans, ultrasounds, blood work, procedures, unnecessary surgeries…it’s insane.

[/quote]

Yes—I’m generally pro doctor but anyone who thinks that doctors don’t need checks on spending is naive.  The nursing homes are notorious for ordering useless tests and therapies to pad their profits.  And lots of doctors will just write whatever test or script their patient wants because it’s easier than arguing or because they are making a profit (remember the opioid epidemic?).  Everyone would like to have great doctors who only prescribe medically necessary stuff and only do so in their best interest, and have affordable health care that covers all medically necessary treatments, even if those treatments cost millions of dollars a year for a single condition.  But it’s not reality.  Yes, let’s crack down on the bad actors, but this generalized hate for health insurance providers is just so naive and dangerous. Does anyone remember the world before health insurance?  Working class people just died if they got anything that needed more than a doctors visit.  Pooling of risk is a good thing—that’s what insurance is. But insurance companies have to follow their written policies.[/quote]

There are monsters at every level of the system. This hospital allowed this doctor to misdiagnose and kill patients because he made money for them.

The opioid epidemic is due in part to physicians being courted by pharma sales people and the fact that no one was watching what was going on so the pill mills were allowed to dispense like crazy and Medicaid just paid. I’m not saying health insurance companies are angels by any means but there are plenty of bad actors out there.

https://www.propublica.org/article/thomas-weiner-montana-st-peters-hospital-oncology[/quote]

Also look at the stories about patients being kept in psych wards so that the monstrous doctors could keep billing insurance. It's sickening. The whole system from insurance to hospital to medical staff, is corrupt.

And Americans need to stop thinking this country has the most envied medical system in the world, because anyone who has actually traveled and needed medical care in other countries, knows it's BS. I have friends currently traveling to a couple of other countries for advanced medical treatments that the US doesn't offer.[/quote]

You are delusional. I am a doctor we are being forced by insurance companies to release patients before they are ready and /or before we think they are stabilized enough  to stay out of the hospital. Sure- there may be some exceptions, but trust me, docs get no pay outs from this. Our reimbursements and pay are declining, but we keep working. We see NPs and PAs constantly  ordering unnecessary tests and prescribing controlled stimulants because that’s what patients want and they don’t have the background and education to know better , and we’re constantly having to fix it. You all know nothing about health care and it’s so evident. These for profit entities are killing us and you. And you just take it and try to lay blame on the very people (and the only people) working to keep you alive. [/quote]

DP. Not a doctor but you are absolutely right, doc and I'm sorry you have to deal with people like the PP. Are there bad doctors out there? Sure--once in a blue moon. If memory serves, Atul Gawande wrote a long story about one a couple of decades ago in the New Yorker. Do doctors make mistakes or are they sometimes not up to date on the latest science? Sure--they're human, like everyone else.

[b]But we are all victims of this dollar-thirsty for-profit system where publicly listed healthcare companies chase shareholder returns, and whose flaws are now exacerbated by the private equity takeover of hospitals and private practices[/b].[/quote]

+100

The reality is that providing medical care that is best for a patient and increasing shareholder value are 2 completely opposing goals. Not like just sort of in conflict. But absolutely in opposition to one another (aside from maybe covering routine checkups or birth control, which can prevent larger expenses down the line).

Obviously this is true for other insurance like car and home insurance. But the costs to fix a house or dry out a wet basement are a little more straight forward, so there’s less wiggle room to argue something doesn’t need to be fixed. I’ve only needed to file 1 auto and 1 homeowner’s claim and both times I was surprised by how smooth it went (shout out to State Farm).

But health insurance has all sorts of confusing billing codes, financial people deciding what medications to cover, etc. And medicine can be so specific to an individual (e.g. not all meds work for the same person, some people have underlying conditions that affect XYZ, people have varying comorbid conditions that could affect recommend treatment, sometimes medicines are used off label, etc.) It’s not like fixing a fender bender.

Also there is a whole system out there of attorneys who will sue and help you get full coverage out of a car accident. But not really a good system for getting the health coverage you need (not to mention patients often don’t have the luxury of time). [/quote]

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