In 2022, UnitedHealth Group made over $20 billion in profit. Cigna made $6.7 billion, Elevance Health made $6 billion and CVS Health made $4.2 billion. All told, America’s largest health insurers raked in more than $41 billion of profits in 2022.

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Even if you can afford health insurance, that is not a guarantee of affordable, accessible health care. Health insurers make money by not paying for health care. Their bottom line depends on refusing to pay for care and they are ruthless when it comes to protecting their profits.

Anthem Blue Cross Blue Shield has been consistently underpaying reimbursements and inappropriately denying coverages. In 2021, 53% of Anthem’s medical bills for the second quarter were unpaid, amounting to $2.5 billion.

Another way health insurers try to get out of paying for care that patients need is by requiring pre-authorization for routine and even lifesaving care. UnitedHealth announced earlier this year that it was going to require prior authorization for colonoscopies, a critical way for doctors to detect colorectal cancer.

An American Medical Association survey found 94% of physicians surveyed said that prior authorizations lead to delays in receiving care and 80% said that prior authorizations can lead to treatment abandonment. UnitedHealth was forced to alter its policy due to public outrage, but they are still requiring “advance notification” for the procedure, which doctors fear could lead to bureaucratic delays and delayed care.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

There are millions of healthcare interactions a day. The numeric small minority that have decided the US healthcare system is a disaster making a few threads is statistically so far into the insignificant territory it’s like the head of a microscopic pin.

Right. There are millions of these interactions, and if every patient who asked a question or was reasonably trying to sort out a problem was "fired," there would be no system.

And yet some people experience nothing but obstruction and what they see as power-mad demigods providing healthcare, nothing but ogres as far as they can see -- and they keep experiencing this wherever they go, every clinic and every office.

One person can start six threads, or sixteen, or sixty. Or a group of a half-dozen people of the kind most likely to open a thread called "Drs firing patients" might be more likely to post in it and follow up with alacrity.

And then there are those millions of interactions that keep going on and on, and those people somehow, oddly, don't seem to have the same perspective. Quite inexplicable.

Many just accept there is nothing they can do and just roll with it. There comes a point when it's not worth the hassles to argue back. It's too stressful because the bureaucracy does have the power, not you, and there's nothing they can do about it.

I'll give you an example of an ongoing situation. I am filing for reimbursement for certain services and have to go through an entity called Naviguard, who handles these reimbursements including negotiating with the provider, if they deem it necessary. I've received three messages from Naviguard assuring me they're going through the process and attempting to negotiate with the provider but it's taking longer than expected. After the third message today (third since early January) I called the provider only to be told they have no record of Naviguard trying to reach out to them.

What am I to believe of any of the healthcare bureaucracies? It doesn't mean I don't think I'm not getting good care, but the system is definitely not what most people would find pleasant to deal with. We just accept that it'll be difficult.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

There are millions of healthcare interactions a day. The numeric small minority that have decided the US healthcare system is a disaster making a few threads is statistically so far into the insignificant territory it’s like the head of a microscopic pin.

Right. There are millions of these interactions, and if every patient who asked a question or was reasonably trying to sort out a problem was "fired," there would be no system.

And yet some people experience nothing but obstruction and what they see as power-mad demigods providing healthcare, nothing but ogres as far as they can see -- and they keep experiencing this wherever they go, every clinic and every office.

One person can start six threads, or sixteen, or sixty. Or a group of a half-dozen people of the kind most likely to open a thread called "Drs firing patients" might be more likely to post in it and follow up with alacrity.

And then there are those millions of interactions that keep going on and on, and those people somehow, oddly, don't seem to have the same perspective. Quite inexplicable.

Anonymous wrote:Drs shouldn't have to put up with the abuse some patients seem entitled to throw at them.

I say, good for them.

Anonymous wrote:I've seen people accused of being aggressive who were just frustrated. They weren't being aggressive at all - their child was literally turning blue and no one was coming to help them.

There should be bodycams.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

There are millions of healthcare interactions a day. The numeric small minority that have decided the US healthcare system is a disaster making a few threads is statistically so far into the insignificant territory it’s like the head of a microscopic pin.

Right. There are millions of these interactions, and if every patient who asked a question or was reasonably trying to sort out a problem was "fired," there would be no system.

And yet some people experience nothing but obstruction and what they see as power-mad demigods providing healthcare, nothing but ogres as far as they can see -- and they keep experiencing this wherever they go, every clinic and every office.

One person can start six threads, or sixteen, or sixty. Or a group of a half-dozen people of the kind most likely to open a thread called "Drs firing patients" might be more likely to post in it and follow up with alacrity.

And then there are those millions of interactions that keep going on and on, and those people somehow, oddly, don't seem to have the same perspective. Quite inexplicable.

Keep showing up to these threads to dump on them/their authors. On a long enough timeline, you'll encounter the problems we're trying to discuss.

And no, I don't experience "nothing but obstruction" wherever I go. It just doesn't take many bad experiences to lose faith in a system that wasn't structurally sound to begin with. I had my last PCP for a decade and a half before they switched to a patient management program that made me an nameless file number and dehumanized my care for profit. It wasn't always this way, it is this way a lot more often now, and it's not likely to get any better because anytime someone says anything, they get denied and dismissed by both providers and some other patients who've yet to experience the same treatment and would rather victim blame than consider the possibility.

It'll happen to you someday, despite how you seem to see yourself as a perfect patient (which you shouldn't have to be to receive high-quality care when you're sick/struggling/suffering). Hopefully soon, because you're becoming somewhat insufferable arguing other people's reality just because you haven't had their experiences (yet). Maybe see a psydoc about that?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

There are millions of healthcare interactions a day. The numeric small minority that have decided the US healthcare system is a disaster making a few threads is statistically so far into the insignificant territory it’s like the head of a microscopic pin.

I would never argue US healthcare is a disaster because as things go, it's pretty good to outright impressive in delivering high quality care. But it's also exploded in complexity in the last 20-30 years and now comes with an enormous bureaucracy that makes dealing with healthcare, once you have an issue, frustrating and byzantine. All bureaucracies are automatically defensive, protecting themselves and their entities rather than the people they ostensibly serve. Like all bureaucracies, it's staffed by generally not the brightest in society. Then add the dimension that you're dealing with people's own health and frailness. No wonder tempers can be high.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

There are millions of healthcare interactions a day. The numeric small minority that have decided the US healthcare system is a disaster making a few threads is statistically so far into the insignificant territory it’s like the head of a microscopic pin.

Right. There are millions of these interactions, and if every patient who asked a question or was reasonably trying to sort out a problem was "fired," there would be no system.

And yet some people experience nothing but obstruction and what they see as power-mad demigods providing healthcare, nothing but ogres as far as they can see -- and they keep experiencing this wherever they go, every clinic and every office.

One person can start six threads, or sixteen, or sixty. Or a group of a half-dozen people of the kind most likely to open a thread called "Drs firing patients" might be more likely to post in it and follow up with alacrity.

And then there are those millions of interactions that keep going on and on, and those people somehow, oddly, don't seem to have the same perspective. Quite inexplicable.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

There are millions of healthcare interactions a day. The numeric small minority that have decided the US healthcare system is a disaster making a few threads is statistically so far into the insignificant territory it’s like the head of a microscopic pin.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

There are millions of healthcare interactions a day. The numeric small minority that have decided the US healthcare system is a disaster making a few threads is statistically so far into the insignificant territory it’s like the head of a microscopic pin.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.

Correct: that the US healthcare system sucks, and that some clinicians would rather blame their ill patients than look at their own involvement.

If it were just me, as you seem to be implying, there wouldn't be multiple threads on the subject. But go off.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Covid has changed healthcare dramatically. Healthcare workers concerns are front and center and patient concerns are far down on the list. In the real world people work more than 40 hours a week, deal with unpleasant people and take their jobs seriously. If they don’t care about their career and, in most cases, exceed expectations they will be forced out and certainly not progress in their field. Healthcare workers hold your life in their hands and they know it and there’s a good chance they don’t care. Did you ever notice that when you have a problem (you’re in pain, a billing issue, you need to schedule an appointment, etc) you walk away knowing all their problems and don’t get resolution for what you came for (even though that’s what their job is).
When a savvy person is in need of medical care they learn early on that no one cares about them. If you’re smart you feed their egos and even bring treats if you’re in the system with a chronic illness.
And you pray, a lot, and hope you are not harmed physically or emotionally.

YES! I've learned more ingratiating behaviors (compliments, active listening as they trauma-dump, remembering their trauma-dump stories from visit to visit, bringing treats/sweets) dealing with whitecoats than I did in my abusive marriage. I divorced that guy; I can't divorce the entire US healthcare machine.

There is only one constant in your interactions.