I was stumbling upon the internet trying to commit to my new-year’s goal daily quota of cyber bullying when I chanced upon this comment;
“My insurance company decided I didn’t need the PET scan my oncologist said I needed. The hospital fought them for it for months and had no luck. But I need to worry about death panels if we enact M4A! Psh, we already have them [the death panels].”
I did a bit of searching and The Lame Media tells people that Death Panels are a myth. Which only retards with political backing would try to have you believe in that falsehood. All of this bullshit stems from politics jerking eachother off. So, Death Panels came about from some political circle jerking about ‘he said, she said’ for regards to some shitty bill about healthcare.
Most of the politics said Death Panels were about ‘individuals being judged to see if they were worthy of health care.’ Which is an oddly specific and obfuscated version of the actual truth. That means that definition is really shit, and it’s a straw-man for people to not address the issue that plagues -like- living breathing people instead of some political caricature that some political Jacktivist can shit on.
(A Jacktivist is a political charged journalist practicing Political Yellow Journalism. For some retarded reason, the internet has scrubbed this word. That makes me sad- anyways)
What I’m here to say is that a better definition for ‘Death Panels’ are ‘decisionmakers for whether someone should or shouldn’t die.’ It’s not specifically tied to their worth for health care or receiving health care. Instead it’s policies that make it so people have many roadblocks to actual health care.
Most of all, Death Panels actively exist in the current US healthcare industry.
Yes, there’s a board/panel of random fuckers deciding if you die or not based off of your insurance.
What’s worse, is most of this is systemic, so the panel that decides your death does it without emotion or feelings, like a robotic machine that follows ‘corporate policy’ of the insurance company or other shit takes like ‘industry standard best practices’ in denying people’s ability to get health care. You gotta understand, insurance is trying to literally make money from you, and they do so by either getting you to pay more for insurance or avoiding coverage and paying less to the medical providers for treatment of those insured. I mean, why did we gamify -Literal Health- this retardedly? I don’t fucking know.
And when I say denying people’s ability to get health care, I’m talking about,
How Insurance Companies Practice medicine without a license,
I’m talking about prior authorization.
Basically, your insurance company has to buy off on any future health treatments before you get em. Here’s a video from the guy that helped to spread the word on how fucked things are;
Here’s some of the comments in that TikTok video, just agreeing;
Yea, so that guy is a comedian and a Doctor AND also having shit problems with insurance;
Peer to Peer being a process in which an ordering physician discusses the need for a procedure or drug with another physician who works for the payer in order to obtain a Prior Authorization approval or appeal a previously denied Prior Authorization. So, Having two doctors talk to overturn the Insurance company also requires the insurance company to allow the Doctors to have a Peer to Peer. Isn’t that a scam?
And here’s a follow up conversation. Keep in mind the ‘Fail Transdermal First’ bit in the comment below. It’s important that you remember the words ‘Fail First’.
And he’s got some dank jokes;
Back to the topic at hand,
So get this, you have health insurance, you think you’re covered. Cute.
You get hurt or have some illness or injury, and inadvertently become hospitalized.
You get a doctor who actually gives a fuck (lucky) and tries to get you through some tests.
You get the tests done and the doctor reviews the results on your chart, and he/she has experience dealing with what is ailing you.
Doctor recommends these Procedures A, B, and/or C to be done to alleviate the issue. Doctor places an order for said procedures.
Your Insurance company reviews the Order (the upfront cost or bill) of procedures and reviews your test results and asks why they didn’t run Unrelated Test X or Y or try Therapy or some other procedure U or V?
Doctor says those tests won’t help. Something similar to “how would an X-ray help when this is a nerve issue?” or “why would I examine the feet when this is related to gastrointestinal problems?”.
Insurance company has some retarded person reading a script. “well have you tried X or Y”
Doctor Rebuttals each and everything, fighting.
It’s so bad, the back and forth, that Doctors hire entire staffed administrative agents to literally bounce back and forth this bill. I mean, the insurance company isn’t the one dying, why the fuck would they be in a rush?
This is over the span of weeks. Which can evolve into months.
So, like, you still haven’t gotten care nor scheduled anything of substance, basically wasting your time. And if you’re in pain, then you’re probably losing your health, mental health, ability to get money, and possibly your condition is worsening.
Your Doctor will fight back and forth with the insurance company, and who knows what will happen.
This is why Insurance companies should properly -Fuck off-.
Simply put, The practice of medicine is dictated by the Patron, the funder.
And if you have insurance, you basically signed yourself up to a scam where you pay insurance and the insurance company pays your doctor. So you paid a middle man to make medical decisions for you.
They hold the financial decision. In the case of a medical insurer, they decide what treatments they’ll accept or pay. But they want some sort of tiered step system of making sure it’s not insurance fraud, so they have patients undergo what sequence of events that the medical insurer will actually pay for.
Simply put,
The insurance company will go through a list of questions that are cookie cutter to try the most retarded way to get you the health care you need. Or rather, to delay you from the health care you need.
This idea of the insurance company denying the Doctor’s order and recommending or questioning other medical practices, tests, and procedure is called;
‘Fail First’ or ‘step therapy’.
Remember those words, “fail first” from Dr. G bitchin’ on Twitter? Yea, turns out, that’s what’s happening here.
Insurance Company; “Did you try X, Y, and Z? No? Well, when you do, then we can move on to the next thing regardless if those tests pass or fail at evaluating a solution. We at least need you to fail these procedures first before we move on to the next thing, even if this procedure is retarded and doesn’t apply to you”
All of this right before they schedule you for a mammogram and a prostate exam in the same day for this condition. They obviously want to make sure you’re getting properly fucked.
Here’s a rando video from people trying to make the world simpler or something;
Basically;
It’s totally great for everyone, you get to waste a doctor’s time arguing with insurance companies, insurance companies get to make you take weird tests and waste your time, all the while you don’t get treated and less patients get seen. Also, you might be lucky to get a Prior Authorization for a medical procedure that is actually bad for you! It’s like winning the Health Lottery in a Russian-Roulette style. Obviously a win-win situation for everyone, it’s a beautiful thing.
One of my partners refers to this as “cheap first,” because the payer almost invariably prefers a less-expensive and often-more toxic choice first.
. . .
The insurance company will require that I first give her [a patient] a drug that I know will not be effective before I can give one that may be.
–Some online Doctor
Which raises the question. How can this be an attenable Practice? Like, why would you want to add more procedures that also cost money? Isn’t Insurance supposed to not spend a bunch of money?
Why would insurance companies use Fail First/Step Therapy?
Fail First/Step Therapy policies are used by health insurers to control costs. However, they are time-consuming from a physician and patient standpoint and are more expensive from a direct and indirect out-of-pocket cost perspective. The practice denies patients the drugs they need when they need them, and allows insurance companies to practice medicine without a license. And, while fail first policies control costs, the savings do not result in lower premiums for you. Instead they produce higher profits for insurance companies.
-Source
So insurance companies can actually make more money off of you by;
- Denying you medical care,
- Delaying the medical care,
- and running costly tests to raise premiums on you.
That’s also not factoring the possibility that your ailment causes tertiary symptoms or complications in lifestyle resulting in more medical problems. You know, like the inability to work resulting in using all your sick days and then getting laid off or put on medical leave -unpaid- while you stress further and complicate things. Oh, also, you might exacerbate the problem to be worse causing indirect medical complications. If you got leg nerve issues, who says you might not slip and fall hurting your back too?
So, be ready for filing that, probably new and distinct, medical claim too.
I mean, best case (for the insurance company), is that you die and they blame the doctor and sue the doctor for malpractice while also not having to cover your death because apparently health insurance and life insurance ain’t the same thing.
Like, do we really need Insurance companies managing health care?
They don’t give a fuck about your health, they only want your money. If it was between your expensive medical treatment and your premiums that you pay to the Insurance Companies, then the insurance companies will give a mighty fine thought at Letting you die (through Corporate policy). Why the fuck would you pay someone like that?
Here’s some side comments from the internet;
“They [Insurance Companies] claim to be saving money, yet every time they deny a procedure, the physician must order extra tests to ‘prove’ that you need treatment [which costs more money]. It does not save money in the long run. It has also helped the opioid crisis along because if they keep denying people surgery and procedures, the patient’s only alternative is pain medication which is cheap.”
-rando person
Hey, It’s your hypothetical doctor in this scenario- I know you feel like you’re dying and stuff, but we’re fighting Your Insurance company that you paid for. So, uh, here’s these pain meds, try not to get addicted kid. By the way, your insurance said you have a deductible so I’m gonna need you to pay for those pain meds as we try to fight and win against your insurance company.
Doesn’t that sound evil? Isn’t that insurance companies? You pay them for the possibility of them fucking you over and making you pay more?
Especially if the decision is held by someone hired to work the phones and read a phone script without any knowledge of medicine;
I know someone who’s in claims, she regularly thinks she knows more than doctors. Like shut up, you’re dense as fuck.
-rando person
Here’s one doctor’s words,
“In medicine, it has become increasingly common for physicians to encounter patients who we know we could help but can’t — at least not right away — without jumping through hoops created by their insurers.
These hoops extend time to treatment, interfere with clinic workflow, add to patient inconvenience and lead to treatment abandonment and adverse outcomes. It’s these kinds of cases that are extraordinarily frustrating because, as a physician trained in cancer care, I know the right thing to do, but I am limited in my ability to do it.
Every day in medical practices around the country, more and more health care providers like me are finding ourselves hamstrung over what’s best for our patients —”
-clinical oncologist on Morning Consult,
Here’s some data from a Survey of Doctors;
This is all in some nifty brochure.
Also, Hospitals pay a fuck ton in administrative staff for paperwork and claims. Meaning that hospitals have to pay for all this admin specifically to fight insurance companies. So the bills are high because of insurance companies existing and asking Doctors and Physicians to ‘CoDe tHinGS PrOpErLy’
Here’s a side comment from the internet to address some of those admin claims;
I can think of no way in which health insurance companies benefit patients. Whether they acknowledge it or not, their business model depends on taking in as much as they can in premium payments and spending as little of that money as possible on the delivery of health care. This is true of all of them, even the so-called “not for profit” ones.
They have people whose job it is to deny approval for care when at all possible; hospitals and doctors have to jump through all sorts of unnecessary hoops in many cases to get approval. Even when insurers are willing to pay, they suck away around 30% of the dollars intended for care, by virtue of adding enormous overhead costs to docs and hospitals, filling out forms, etc, for dozens and dozens of companies. And more leaves the system in the form of outrageous CEO pay and profits distributed to investors.
In short, they provide no care, and they cost the system billions in money that ought to be spent on care.
-rando internet person
Here’s some more data because cool chart makes you think you’re learning;
These infographics are from a 2018 survey;
The doctors were also asked a loaded question;
It’s a loaded question because all of the answers are shit. However the doctors have weightedly picked the worst thing, so it kind of points to what the root of the problem is. (hint, all of the answers are problems).
However, Enough Doctors feel that the ‘Health insurers should not override the professional judgement of physicians’ implying that the Health Insurers have the ability to override medical practice. . .Which means they’re practicing medicine (even if indirectly).
There was more to the survey, it’s worth a look. But a good chunk of the questions are framed in a manner that may be conducive of preformulating an answer. So it’s a bit iffy. What is good is that there are issues and that among the issues, chief of them, is the ability for Health Insurance to be shit.
The available work around for ALL of this,
You could just pay for the medical procedures yourself.
If you have the money, then you have the power to decide financially what medical shit-ass you get with confirmation of your Doc. So then you can empower your doctor to provide you with healthcare. Because for whatever reason, you need money for healing in this shit-ciety.
So, You can easily cut out the Insurance company and get the treatment that you need by paying out of pocket. Wow, a good chunk of the problems and administrative hassles disappear when you don’t involve health insurance. Health care providers won’t have to rely on a surplus of admin staff playing ping-pong with letter mail and billing, while also saving money on potential legalities and overhead while being able to help more people. It’s almost like health insurance was the problem.
Almost like Health insurance isn’t insuring your health,
Almost like it’s insuring that you have bad health.
It’s Almost like, (Idk?) a scam.
And since we’re at it,
To go full circle,
It actually is political to some degree. You know, the whole ‘death panels thing’.
It’s not just Insurance Companies internal cost-model policies that apply here when deciding health care.
It’s also the Policies passed by Governments saying what Doctors can and can’t do, and what Insurers have to cover and How they have to cover it.
So, over all, everyone is to blame and it’s all shit.
But let’s circle back to the circle back by circling back. Because here’s a fun tidbit, insurers lobby a lot more than hospitals, individual, or private practices. So of course the government policies and bills that dictate health care are also influenced more in part by the insurers (and opioid pill mill pharmaceuticals). So it’s insurance companies’ fault, and they just listen to the government, which is influenced by insurance companies. What a feedback-loop Circle Jerk, another beautiful thing.
So everyone is to blame, especially insurance companies, and it’s all still shit.
The easiest way to not worry about any of the above
Is to be rich as fuck.
Money would literally solve a lot of people’s problems, their stress, their debts, and their ability to live a life and get help when they need it.
It would improve their standard of living, their livelihood, their agency, their mental health, their physical health, and a slew of other good things.
That’s, all of course, as long as they don’t blow it all on hookers and blow or somethin.
In Closing,
Welcome to the Death Panels of our American Sick Care System™.
(It’s not really trademarked you loon).
It’s all fucked.
But hey, cheer your little puppy eyes up.
Find solace in the universal truth that- we’re all going to die with or without medical treatment.
That also includes insurance companies.
Probably.
(There are no safe bets, some asshole could invent immortality. So -probably- some edge lord in the future will be depresso for the rest of eternity. Lmao).
Hey, if we were to gauge all of these ‘Best Industry’ Insurance practices, remember this other bit of truth. No Lives Matter (apparently, sheeesh).
*Not Valid Medical, Insurance, Financial, Legal, Life, or Any Advice
*Also not a valid voucher for Prior Authorization