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]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

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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.[/quote]

Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America. [/quote]
Should this apply to babies in ICU with a diagnosis of three to nine months to live as well. [/quote]

Or even back it up earlier to the super preemies. The reality is nobody wants to tell anyone else no, their care is not necessary or worth it. People want other people to make the hard decisions they would never make themselves. [/quote]

People are able to make the hard decisions if they are given full information. But there is little training in the medical community for sharing hard cold facts with the parents of terminally ill children and/or dying elders. There was a great op-ed about this in the NYT recently, by the mother of a girl who died, lamenting that she spent the last months with her daughter focused on treatments instead of enjoying the remaining time they had together. Here are some letters to the editor that followed.
https://www.nytimes.com/2024/12/07/opinion/orli-wildman-halpern-death.html[/quote]

+1. When my mom was diagnosed with advanced cancer at 61, she straight up told the oncologist she only wanted treatment if it had a good chance of meaningfully extending her life. She was dead in 6 months, most of which she spent in treatment that maybe, MAYBE, extended her life a month or two. She would MUCH rather have had 4 months to spend with us than spending it at chemo and radiation. And she knew this in advance, wanted to be told, and the doctors still wouldn't tell her. A couple of days before my mom was released to hospice (and two weeks before she died) some AWFUL oncologist at the hospital looked at a beach town t-shirt I happened to be wearing and said, "Oh, you should take your mom there!" My mom at that point couldn't walk, or use the toilet alone, and barely knew who I was." I was I had the balls to have said, "ARE YOU EFFING SERIOUS RIGHT NOW?"[/quote]

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