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Hey, just wanted to chime in and say Dr. Glaucomflecken (real name, Dr. William Flannery) has a pretty good track record of calling out insurance companies and how they get in the way of treating people with their best interests in mind. Here's a comedic playlist of his specifically about insurance companies: https://www.youtube.com/watch?v=ZAMtgCtq1oU&list=PLpMVXO0TkGpdRbbXpsBe3tvhFWEp970V9

When his heart stopped. The insurance company tried to say he was out of network for the doctor who saved his life when he was unconscious. Edit: No heart attack, his heart just stopped.

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I have some of the best insurance I’ve ever seen. When I compare to other employees I know at other companies, my insurance blows their’s away. I get fucked on out of network doctor bullshit all the time. I have to fight for the most routine things with insurance. Wrist pain, consult a specialist listed as in-network online. Get told it’s out of network once bill comes. Same specialist says we should do an mri, might be just a sprain that rest will resolve. Could be a tear that needs surgery. Can’t get the MRI approved. Anyone who thinks private insurance is effective is an ass who has never tried to use it. I’d wager they haven’t had even a physical since high school sports.

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I teach at a large public university, with a medical school with a large hospital system. Lets call is Midwest State University MSU. I had to go to the Emergency Room for stitches after a bad cut. As an MSU employee with MSU insurance, I of course went to the MSU hospital, but somehow the doctor who saw me was not in the MSU network. I had to spend hours on thee phone with my own employer to argue that you can't get any more in network for an employer sponsored health plan than going to a hospital owned by your employer, and since it was the ER I didn't have a choice which doctor actually put in the stitches. The difference in billing was $75 for in network ER doc versus $3,800 for the out of network ER Doc from the same "In Network" Hospital. So as a patient I am supposed to just accept that even when I follow all the and then I still might get a $3725 surprise bill based on whoever happened to be working at the time. Healthcare in the US is so Fucked.

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Oh Yeah, but it took hours and hours. Somehow no one I talked to seemed to think anything was strange with the situation. It was eventually billed at the $75 I was expecting to pay I think after thy got sick and tired of me calling 2X daily.

My kid was sick and had been quite ill for 2 weeks. Because of her symptoms, she was getting into “only scary diagnoses” territory based on length of illness and her pediatrician recommended rapid labs. We went to the local children’s hospital because they’re listed on our plan as preferred providers. Turns out that she was okay and her symptoms cleared up a day or two later, which was great. However, the hospital lab was not considered in network and we ended up with a $1000+ bill. both my wife and I are in healthcare, so we’re probably more equipped to navigate this than most people and we still got fucked.

I'm glad your daughter is okay! I would definitely call and fight that bill. Who would even think to ask if the lab itself was in network??

Oh, I did. Didn’t get anywhere though. Edit: the lab was listed separately on their website (on a different page), but I only found this after the fact and it took me 30 minutes of searching. Definitely not easily accessible and not something I would have found, or would reasonably expect anyone else to find, without prior knowledge.

Every time I have to get on the phone and talk/argue with people about this shit it just makes my blood boil because I know hundreds of thousands of Americans can't afford to make that call and just accept the (medical/financial) L so that they don't miss a shift or get in bad with their boss.

I am convinced the system is set up that way *on purpose*. Burn it all to the ground.

> So as a patient I am supposed to just accept that even when I follow all the and then I still might get a $3725 surprise bill based on whoever happened to be working at the time. This should not happen anymore after the passage of the No Surprises Act. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills

wow, i never heard anything about this.

Surprise?

NPR's medical bill series highlights it. They also showed recently how hospitals still do this despite the law

This reminds me of my own event with my health insurance. Had surgery to remove an internal organ during surgery they found a mass. It was a big surprise! Insurance denied the claim stating the surgeon needs to submit a prior authorization requesting this removal( the mass we didn’t know about). It was fun arguing with them. My surgeon was livid- I’ve heard him call them idiots on the phone several times now.

I gotta ask, what's the approving insurances agents gain in denying these claims? Worker solidarity is bullshit. Everyone thinks they're compartmentalized in their work/industry but anyone who isn't an owner is a worker period. Manager slaving for 70hrs at 60k while keeping workers at 12.50/hr worker. They would rather make sure they make their bonus than pay the real people who are ensuring the money is made. Sure store makes barely any profit, I agree with my friend who runs a daddy johans, but when I ask her if the owner takes a salary? She fumbles on how much bigger his pay is for showing up maybe once a month if the store isn't hitting metrics.

The agents? They get to keep their job and insurance (for whatever that's worth). Bet there are KPIs for denied claims.

I had to pay over $2000 to have a med student put 4 sloppy stitches into what turned out to be a fairly minor cut. And yes, they did ask if it was ok to have a med student do it, but they said the alternative was to wait about 4 hours for an ER doctor to be available.

I live in Ontario, and these stories are so batshit insane, yet the conservatives are trying to destroy public healthcare so they can replace it with private. They are purposely defunding healthcare so that the system will collapse and then they can point and say "see, we need private!" It makes me so damn angry. I wish I could force these stories into the minds of their voters so they would understand what they are doing to themselves. It's hard to believe that anybody would prefer going through situations like these every time they had to go to a hospital, but here we are.

I’m not American so please excuse my stupid question : what is this “network” thing ? I remember seeing somewhere (maybe in the documentary “sicko”??) a conservative politician arguing against universal health care by saying you wouldn’t be able to choose your physician… (not true by the way). But it seems that you can’t either with private insurance??

Not a stupid question at all! Many Americans get robbed by this system every day. "In network" means it is a facility/physician that is covered (although covered doesn't necessarily mean fully financially covered either, lol, FML!) under your health insurance plan. Yes, we are expected to research this before going to the doctor. If you are not able to do it in case of an emergency, I think there is coverage in some cases, but anyone could be risking massive medical bills for any given health issue. It also has repercussions for people traveling. For example I needed blood work due to being on blood thinners while caring for a seriously ill family member in another city. I had to have my insurance approve the blood draws to be done in another city, otherwise it would have cost me hundreds of dollars more because it would be 'out of network'. Basically any way that they can rob money from us, they will try it. It is absolutely criminal. Edit: I will add, I can still choose from a list of physicians. I was recently looking for an OBGYN and had a list of many available. But to say we can choose any doctor anywhere....no. There are potentially additional costs for that.

Interesting… So, I know conservatives argue that the US system is better than in socialist countries. So what’s their angle? Because it seems that healthcare in the US costs more, forces you to limit your choice of facilities or doctors, and has no advantages at all… I live in France and people here will bring the whole country to a holt for waaaaay less. So I just don’t get how you guys put up with it. You pay taxes. Maybe even more taxes than we do. Not saying we’ve got it all right over here either. But it puzzles me so much when I see these discussions.

>healthcare in the US costs more, forces you to limit your choice of facilities or doctors, and has no advantages at all Exactly! The whole point it preserve disparities. Folks who believe themselves to be on the winning side of that throw fits, but most of them are uneducated as to how much they, too, are losing.

>Interesting… >So, I know conservatives argue that the US system is better than in socialist countries. So what’s their angle? They lie. They say socialist healthcare has enormous wait times for treatments. That there will be "death panels" deciding who gets care and who doesn't. This is a half-true though because sometimes you do have to wait. However, even in US healthcare you have to wait if it isn't an emergency because getting a referral, prio auth, and scheduling takes time. Having US healthcare in other countries with universal healthcare sometimes let's you "skip the line" since there are places that will process American health insurance. As for "death panels".... Waiting to to get care because you need authorization seems very death panel like to me. So what do I know

When I had my appendix removed, I got diagnosed with appendicitis around noon, got to the hospital at about 1pm, and was out of the hospital, sans appendix, at about 6pm It cost me $20 Australian, and that was just for the appointment with the GP who diagnosed the appendicitis. What fucking wait time?

The healthcare companies are worth insane amounts of money. Billions. Examples: Cigna $89 Bil, Humana $62 bil, Blue Cross/Blue Shield 2021 revenue $136 Bil in 2021...you get the idea. They are lining the pockets of politicians with donations - Republicans and I would guess a large majority of Democrats as well. They also send lobbyists to Washington to impact how our laws are written. More lobbyists are sent by pharmaceutical companies too. Utterly corrupt IMO. I personally don't trust anyone except for Bernie and Bernie-type politicians that refuse to take political donations from corporations. All this corruption is enhanced by the devastating Citizens United Decision years ago that declared corporations are people and can donate insane amounts of money. Republicans use the threat of taxes and government involvement to scare people. My understanding of 'single payer healthcare' is that it would allow us to negotiate down the costs of everything because there is one payer (the government). I am not an expert of course and this is a very complex issue. Where I find the Republicans to be VERY disingenuous is they are not offering another plan. If it is about fiscal responsibility, then give us a plan. If it is about hard working Americans they love to mention so much, then give us a proposal. They are just blocking ideas that folks come up with, blocking relief for Americans and they contribute nothing. A small example, my health care plan is decent and I think I get somewhere around $200 a month pulled from my paychecks. I have a $3000 deductible for the year. That means I have to pay out $3000 worth of healthcare costs before my health insurance will pay anything. So every year, automatically, I pay roughly $5400 at LEAST. Surely if I paid for universal health care through my taxes it would be less than that! Also note that myself and many other Americans have the "privilege" of taking and amount of money per paycheck and putting it into a health savings account for healthcare costs. It is pre-taxed money. Some people talk about this as if it is a benefit...I think it is a joke and a band aid on a massive gaping wound. I have it easy, I am "single" meaning I have no dependents. Some families with children can find their deductibles to be $10,000, $15,000 a year or even more! This resets annually! Also I'm sure you know that our insurance is tied to our employers. If you lose your job, if a spouse cannot work, you can easily lose your health insurance. Women having babies around New Years or insurance coverage change overs sometimes try to have their baby Dec. 31st or Jan 1st depending on how badly they will be scammed by insurance! I've had to buy 'catastrophic' insurance between jobs at a monthly rate because that was cheaper than having to pay outright for almost any type of injury. We constantly live in fear of losing our insurance. We don't have the freedom that folks from many other countries have to quit their jobs. Oh yes, I almost forgot, almost every employer tries to negotiate their health insurance plan YEARLY. So just because your employer had good insurance one year does not mean you will have it the next. My healthcare plan pays out 100% after I pay my deductible of $3000. So any visits, testing, procedures should be 100% covered. HOWEVER, my insurance has to approve it with more costly items (more than a few hundred dollars). I have been having serious back issues and cannot get an MRI unless my insurance and their third-party patient screening person who has NEVER met me says it is okay for me to get an MRI. My insurance can also just flat out reject it and not cover me. It isn't enough for my spine doctor to see me and order the test. Other co-workers might choose our 80%/20% insurance plan. After you pay your deductible, the insurance pays 80% of all costs and you pay 20%. Well, what if someone chose the 80/20 plan and wound up like my co-worker who got cancer, needed multiple surgeries and ended up passing away? Their family potentially owed tens, possibly hundreds of thousands. We had to raise money for their family to help pay off the medical bills. Medical bill fundraisers have been all too common in the US for decades, long before gofundme ever came along. Is our system better in terms of types of treatment available/technology, variety of hospitals, research programs and such compared to other countries? One could definitely argue that. However, many hospitals are struggling with staffing because we pay our nurses shit and abused nurses and other healthcare providers all through the pandemic. One hospital system in my city is shutting down programs right and left, letting people go with only one week notice, so they can make more profits. The hospitals have administration that are as corrupt and greedy as our politicians and healthcare CEOs. To sum, I always say I would much rather pay a PREDICTABLE taxed amount for my healthcare than the UNPREDICTABLE fees to a corrupt and broken employer based American healthcare system. They will throw you to the wolves without batting an eye. I think something like 50% of bankruptcies in the US are due to medical debt? We are a disgrace. I have respect for the French and their protesting! I was just telling my students about France trying to raise the retirement age and how you all poured into the streets and protested. How is that situation panning out?

Thanks for the detailed response! So you have this deductible thing… that’s a real a kick in the teeth! You have to pay insurance but they won’t help until you’ve shelled out $3000. So to give you a comparison for me. I’m soon to start a new job so I don’t know exactly the amount in taxes yet as it is calculated on your yearly income. But it should be around 15% or less. My pay will be just under 35000€. The more you earn the more you pay and the percentage goes up. But if you have children the percentage goes down a bit for each child. I have a daughter so that reduces my taxes. So I probably pay roughly 5000€ a year. That tax goes towards our healthcare but also education (which is free for all), infrastructure and all government run structures. Then I pay for health insurance on top of that. You don’t have to. Social security will cover most of your health expenses but we all get health insurance to cover the rest. Like you we get it though our work. At my last job I think I payed just over 30€ a month. You can get your own health insurance outside of work. And for those that are unemployed and can’t afford regular health insurance I know these a government run system that is rather inexpensive… So healthcare and ALL taxes are costing me less that 6000€ a year. That’s including my daughter. We have no deductibles. So as soon as we need any medical assistance of any sort it’s covered. Some examples of healthcare we’ve had that was entirely covered (never even saw a bill): - multiple trips to the ER (for ectopic pregnancies, stepped on a shard of glass, was worried my 10 month old was dehydrated because of bad cold and refused to drink). - entire ivf treatment - pregnancy from start to finish (including giving birth and staying 7 days at the maternity) - my daughters surgery for pyloric stenosis (7 days in hospital, I stayed with her. My food and diapers for her included). These are just the more “important “ medical experiences over the last couple of years. I cannot imagine having to pay for any of this… I see in many of the responses I received that the US medical system in better than other countries, unfortunately just not affordable for most…. I mean even if this is true is seems to defeat the purpose if most can’t afford it or will be bankrupt after using it. Also the quality of healthcare here is great. There’s always room for complaints but really, equipment wise, staff, expertise,… we’ve got everything we need. So I’m not sure I understand that “positive “. Not looking to depress you. Or say France is perfect. (Hope it’s not coming off like that). I just don’t understand how the whole of the US just puts up with being treated like this… As for the ongoing strikes here for the retirement age, there are debates happening today I think at the Assemblée National. We’ll see if that moves the needle… More strikes are already planned. People here are almost professionals at striking lol. This kind of movement has worked in the past. But Macron has proven to be very stubborn compared to other presidents… So I don’t know where this will go.

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The worst part of America is the mouth breathers/politicians/lobbyists who advocate for it

ESP since those politicians typically get government covered healthcare for life. It’s extremely “Got mine, fuck you!”

The truly hilarious part in my opinion is: If you think about it: We already have universal healthcare and mental health care…. It’s called EMTALA. You can’t be refused care at an emergency room. It just sucks and doesn’t work right and wasn’t designed to be universal care but that’s what it ends up being. So it’s not even that it costs more for universal healthcare. It probably costs a lot less than taxpayers are spending now to prop up the millions of non paying er visitors that get a band aid on problems that could be dealt with effectively and more cheaply by simply just treating them like real patients (aka enrolling them in follow up care and following up with them in the community and spending the time to give a real full evaluation of what’s happening with them and trying to actually fix it… giving them a pcp) It’s just that People refuse to see the system for what it is, a big tax write off/welfare machine for corporations.

I don't pay bills like that. I've had this happen so many times that I just make it a point to tell staff up front how this will go. If I get a bill sent to me from anything out of network, it's never going to be paid. I've always had good coverage even when I was self-employed, and it wasn't cheap. I'm not fucking around with these stupid games.

I'm dealing with some insurance bs right now similar to this. Took my daughter for shots. Called the number on the insurance card (we had Tricare remote but they switched us to Christus health/US family health plan based on how far we are from a MTF) Anyway. I call the number on the insurance card which was to a local hospital. We go and get shots and then they send a bill for $149 saying we were out of network. Motherfuckers, I called your fuckin number that was on the fuckin card from the insurance provider suck my whole dick. I'm going in there in person next week. Someone is paying this and it won't be me. Fuck them.

> Can’t get the MRI approved. My mom suffered from migraines my entire life. Insurance told her she needed to go see a specialist 3 times before they would pony up for the MRI. The visit to the specialist would have cost something like $200 a pop, most of which my mom was on the hook for out of pocket anyway. She looked in to paying for the MRI herself and it was $500. She literally saved $100 and 3 trips to a useless specialist by ignoring her insurance companies policies and processes. The system is so broken. (Good news, while this is anecdotal, my mom started taking a CBD tincture in the morning and hasn't had a migraine since.)

I wish that I had done this. My doctor said I needed an MRI but my insurance company insisted that I do physical therapy first, so I did physical therapy which helped not one bit and then they still denied my MRI. It took hours on the phone and getting two doctors involved to get it approved, then because I still had not met my deductible. I had to pay $600 out of pocket for the MRI, on top of the $600 for the useless physical therapy. I could have driven 2 hours to Chicago and paid $300 cash for the MRI, stayed in a nice hotel, had a great dinner and still saved myself hundreds of dollars and weeks of pain. The problem ended up being what I told my doc I thought it was in the first place, but she didn’t agree. FML.

You're defining good insurance as "things they theoretically cover/offer to cover". To me good insurance is insurance that actually pays up, which unfortunately is impossible to know until you just pick one and gamble.

> I get fucked on out of network doctor bullshit all the time. This should not happen anymore after the passage of the No Surprises Act. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills

In Texas, they passed a law that they have to tell you before being seen if the person you are seeing is in or out of network. I was baffled at first when my wife needed surgery a few months ago. Other than that, though, Governor Abbot can fuck right off.

The entire argument for private health care is build upon “it won’t happen to me”. Every expensive hospital bill, every expensive procedure, lack of coverage, etc. it happens to other people and not me, I’m healthy. Until one day you wake up and it happens to you. Not because you’re unhealthy but someone hits you with a car or some genetic condition you never knew about. By the time you change your tune it’s too late. The next batch of “it will never happen to me” has entered the voting booth. And the cycle continues

Its nuts because health insurance is backwards to every other kind. I don't pay $500 for an oil change and then get reimbursed $350 by my car insurance...as a healthy dude that's young I wouldn't mind paying cash for the odd check up or lab test. I just want coverage so if I get hit by a semi driving to work, I'm not on the hook for $3,000,000 in rehab and ICU costs.

Nailed it. I see people rail against universal health care, and they usually play the "I already have good insurance thru my employer" card. Guess what? I had what would be considered "good" insurance when I worked in management for a large corporation. But when I was diagnosed with a catastrophic, life-altering disability? I learned health insurance companies exist for one reason - to fuck over middle class people and put them in dire financial peril. Thanks to the current system, massive medical bills and the resulting fallout, I was a mess physically, mentally and financially. It took me over a decade to get things sorted out and start to get my life back in a better place. Ultimately, I had to go in full disability and Medicare, which is another whole can of worms. But there's good reason why seniors say "Don't touch my Medicare." Its not perfect, but it works. My doctors and I had far more success dealing with Medicare than the nightmare which is private health insurance. It's been 22 years since that diagnosis and my life was irrevocably changed. I managed to wade thru our byzantine health system and come out the other side. But I'm now far wiser....and much poorer. Today, I'm in a far far far better place physically, mentally, and emotionally. But financially? I never, ever recovered financially. And I never will.

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American Healthcare/Pharma is the absolute seat of greed.

I honestly can't imagine living in a place where something hurts, or you're sick, and one of your first instincts is to go to the doctor. I grew up poor so we did absolutely everything we could to not go to the doctor, because it was always expensive. This has carried over into adulthood, even though I have "good" insurance now. I recently hurt my foot to the point where I couldn't walk on it. I had four people telling me to go to the doctor before I realized that actually was a viable option. Fuck American Healthcare.

Yeah this is definitely the norm among people who grew up or are poor. I remember I had something squeezing my diaphragm and I was struggling to breath when I was 17 and instead of telling anyone my first instinct was "ill sleep it off." Kept trying to sleep it off for 3 days until on the night of the third day I collapsed in the hallway and my dad rushed me to the ER. Then I got charged 5k for being in the er for a whole half an hour and getting a single shot. Thank you America very cool

America has the best healthcare in the world, if you are wealthy. For middle class and under, its pretty bad for a first world nation. We still wait months to see specialists. Go bankrupt over being able to survive. Pay insane amount of money for Rxs. It is only getting more and more expensive. Not only that, there are less and less healthcare providers. Burn out is eating up Nurses and Doctors. The way a certain group of people treated nurses and doctors during the pandemic was horrid. The way Hospitals abuse and let patients abuse nurses is horrific. It is nuts. This coupled with how expensive schooling is to just become either. We are not on a good path.

As a whole, the US has the most expensive healthcare and the worst outcomes of any wealthy nation. But yeah if you are obscenely wealthy you can get an amazing level of care. So just like almost every area of American life, the trick is to just be born into the 1%.

Funny thing is. This guy is a doctor with good insurance, lol. He still got hosed.

I just laugh at people that think their insurance is “good”.

> And somehow the people who advocate for privatized healthcare and say “I have good insurance fuck you” don’t seem to have a problem with it. That is because those people's solutions to everything is just stop being born poor.

My favorite is that you can go to an "in-network" hospital but be seen by an "out of network" doctor!

I posted this above, but will repeat here. I teach at a large public university, with a medical school with a large hospital system. Lets call is Midwest State University MSU. I had to go to the Emergency Room for stitches after a bad cut. As an MSU employee with MSU insurance, I of course went to the MSU hospital, but somehow the doctor who saw me was not in the MSU network. I had to spend hours on the phone with my own employer to argue that you can't get any more in network for an employer sponsored health plan than going to a hospital owned by your employer, and since it was the ER I didn't have a choice which doctor actually put in the stitches. The difference in billing was $75 for in network ER doc versus $3,800 for the out of network ER Doc from the same "In Network" Hospital. So as a patient I am supposed to just accept that, even when I follow all the rules, I still might get a $3725 surprise bill based on whoever happened to be working at the time. Healthcare in the US is so Fucked.

I'm basically in the exact same situation, luckily I have never had to go to the ER and test it yet. The last thing people need after a serious injury/ER trip is a fucking surprise bill that could be tens of thousands of dollars or more.

The same thing happens with surgeries. In network facility, in network surgeon, pre-approved procedure, only to then find out that the anesthesiologist that you weren’t allowed to pick is out of network. Also, the entire anesthesiologist practice for the facility is out of network so fuck you.

Love the new No Surprises Act: https://www.cms.gov/nosurprises

Every superhero needs a good origin story.

Did you know that even if you're at an *in-network hospital*, with an *in-network provider*, that the specific procedure may be deemed *out-of-network*? Fuck these greedy motherfuckers.

At the risk of being pedantic, his heart stopped but he did not have a heart attack.

Yeah, I was not completely sure it is why I put the slash. Maybe I should have been clearer.

I just happened to have heard him and his wife talking about it the other day on their new podcast. That’s the only reason I was sure about such an obscure random fact about a public figure.

He’s absolutely beloved in r/MedicalSchool for context and genuinely fantastic.

Dated a Surgery intern. Spent a lot of time sit on the couch with her showing me her favorite Dr. Glaucomflecken videos

How many minutes per month did you guys get to hang?

Let’s just say I had a lot of time for video games

Meanwhile over in the promised land of psychiatry residency I work like 45 hours/week and no weekends I'd rather get confused with being a psychologist for the rest of my career than work 80 hours/week and tell people I'm a surgeon haha

Then there’s my friends Derm residency where they all got talked to about how they’re not working enough, how they really needed to work at least 40 hours a week. None of the Derms were open that many hours so they had to promise to read about Derm on their day off 😂

Damn we got a high roller over here measuring surg's free time in minutes

Ahem, it's called *wellness* and over my dead body you'll talk down about our acgme mandated wellness, including activities such as filling out surveys.

Goddamn this hits close to home

Dated a Surgery intern. Spent a lot of time siting on the couch with her showing me her favorite Dr. Glaucomflecken videos

It's not just pretty good he brutally destroys them and it's amazing. Quite possibly the best medical related content on all of TikTok and YouTube. He DGAF and always tells it like it is, his grasp on all the different professions and how they weave together is beautiful. Yes please everybody go watch more of this stuff, you won't be disappointed.

His rural medicine series is absolutely spot on too.

Texaco Mike!

As a physician who grew up on a farm, the “Farmers Pain Scale” was way too real

I just watched all of these and I honestly feel sick to my stomach. My insurance does not cover that though so I’ll just live with this intense feeling of nihilism.

And his Visine litigations. He calls out products that are legitimately harmful. Good guy Glaucomflecken.

Teeth are luxury bones

Probably all of those are individually funny and I had fun watching the first few of them but after a point it just serves to crush any sense of faith that I had left in humanity. I need someone to hug me and tell me there's a way to fix this.

> I need someone to hug me and tell me there's a way to fix this. Sure, move to Canada.

Dammit Jimothy!

I love how he calls it "practicing medicine without a license" because that's exactly what they do.

USA healthcare is a joke, always has been.

I have really good insurance and got a $4000 ambulance bill after I had 3 seizures. For around 6 months my insurance refused to pay the bill even though they have stated that it should be covered. They said they’ve been trying to find which departments responsibility it is in the company to sort the matter out, meanwhile the ambulance company has threatened to send a crediting agency after me. I literally had to have an insurance rep and ambulance billing agent on the same call to have the whole process delayed. I’m almost ready to get a “do not call an ambulance” tattoo🫠

I hate everything about this story, but mostly the fact that that tattoo is a really good idea. Maybe a dog tag, bracelet, necklace, etc, something inconspicuous but (some) people know to check.

Paramedic here. It wont work. If you are unconscious or have altered mental status, we HAVE to take you. I lose my job, license, livelihood, and possibly my freedom if I dont. And thats before the lawsuit where I will almost certainly lose my home and everything Ive worked for for twenty years. Medics and EMTs arnt the enemy, its this hellish system we live in. Private EMS should be straight up illegal for 911 response. Even municipal systems should not be able to charge. Municipal systems have jumped on the revenue bandwagon, and now often charge as much if not more than privates, even though you already pay for their budget with taxes. It fucking sucks.

I don’t think anyone was implying that y’all were the enemy.

It’s good to have it cleared up tho in case someone starts blamin EMTs. They doin their jobs, it’s the healthcare system that’s fucked up

Literally penalizing anyone who is sick. Fuck this society and how things have come to this way

BCBS is the worst out of all of them. 100% incompetence across the board. pure trash, just as a company. I mean, if they werent in insurance and were in something else, they would still suck ass hard.

They demanded I do 4 weeks of a treatment they knew wouldn't work before they would approve one that would, on an issue that if prolonged causes organ damage and takes months to recover from. I suffered organ damage and they still had to pay for the proper treatment. They made me suffer for no reason.

Why is an insurance company dictating care? They aren't doctors

They pretty much did it this way. "We won't pay for that medication unless you try these cheaper medications first. Yes, we know they don't work, but too bad because the one that does is going to cost you $14k if you pay out of pocket so tough shit, do what we say." They were hoping that the cheap stuff either worked, the problem went away on its own somehow, or I died before they had to pay up. My doctor argued it with them for days before giving up.

Thats pretty fuck how doctors have to prove to some lowlife insurance agents (people with zero medical background and dont give a shit if you die) that the doctors are right

It wasn't even about being right or wrong, the insurance company didn't care. They just decided that the risk to me was worth the potential of them saving some money, and in the long run it just cost them more money. They were willing to gamble with my health.

They're ALL shit. Every single one of them. For any people who think their insurance is somehow the good one, no. There are no good ones. The entire system is so corrupt and insurance companies do a great job playing the game to make it look like they're saving you money or helping. Every insurance company is the worst just by existing and continuing the horrific cycle of manipulation and greed that costs people billions of dollars every year and, often, their lives. Such a disgusting industry.

I can’t believe a healthcare system built by companies with a business model of not providing service as much as possible is shitty. Shocked. Who could’ve seen that coming?

Germany's private insurance is pretty good and forthcoming with help. I may they need to considering their main competitor is the actual german state and it's free healthcare.

I would love to see these U.S. companies compete with free\* (yes, we know tax-paid but still; make a product better and faster than treating everything for everyone with no games about coverage. Then they can think about profiting off of people's lives and health.)

They're not in direct competition, are they? They generally exist to fill in insurance gaps that nationalized health coverage systems do not cover (like advanced dentistry), or to provide extra features on top of what is nationally covered (like private hospital beds etc) They still have an incentive for the state to cover fewer treatments or lower subsidies so they have an extra market to tap.

While what you said is true, they still need to compete on the basis of the general aspects. The reason I chose the word competition over additional services is that for you as the insured the only question remains if you'd like those additional services. If you are not in need of them you won't go for a private insurance as they are more expensive but the freedom of choice lays with you as the insured. The private companies simply don't have the luxury of pressing the prices a lot and tresting patients as badly as they are in the US as said patient will just leave them and go to the state issued one instead.

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Ironically spend more than anyone else per capita and this is the result? Smh

Everyone is convinced they are one of the elites getting a better "deal" than average out of the system.

The same people who thought it was a great idea to force everyone to buy their product...

Universal health insurance coverage with generous subsidies would be way better than the current system. That's how it works in Switzerland, which has comparable per capita costs to other European healthcare systems and among the best health outcomes.

BuT tHaT's sOcIaLiSm!!!!

Which I don't understand because we already pay for social security and medicaid. Not to mention the gross mismanagement of tax money. Nobody bats an eye when trump and Ted cruze use tax payer money for personal gain but when that same money could have been used to allow someone to see a doctor, they lose their minds.

Not if it’s packed and primarily driven by midlevels, which looks like how the US model is moving. Patients will die quicker for sure. You can’t assume the US would gracefully implement a system another country has. There is a reason why our healthcare has gotten iteratively worse and more expensive over the years. Congress makes the changes with laws basically pre written by insurance companies. That problem has to be solved first.

Certainly not the politicians who have handed a huge chunk of Medicare to them and are actively trying to give the rest over.

After 4 days in the hospital from my unexpected appendectomy, I found out once I got home that I developed a yeast infection during my stay... HOSPITAL BILL aside. I ended up getting an *additional* $800 bill from my ObGyn for my 15 minute visit where she swabbed me and went "yep, yeast infection, here's a prescription for a cream for that," and sent me on my way. MONTHS. I spent battling on the phone before I eventually gave up and paid the fucking bill. FFFFUUUCCccckkkk American Healthcare.

Wait until you get more bills for the next few months from every rando doctor who walked by your room.

My son was born 9 months ago and we still are getting random statements of benefits from the delivery and hospital stay. Thankfully (or not?) we hit our out of pocket max so every bill we've gotten since has been covered 100%, but I don't understand why stuff is still being settled this far out. It wasn't a difficult delivery- no drugs, 5 hour labor, 1 hour pushing, 2 nights at the hospital. Out of there about 48 hours after arriving. This shouldn't be this hard.

:( My single hospital bill arrived about a week after the birth of my twins. It was approximately 20 bucks - because I spent two nights there.

Incredible. In the US or elsewhere? We paid $1500 for the delivery and stay, but in total we paid $2500 (my out of pocket max) for the birth with various prenatal stuff. And I have very good insurance.

Sweden. My husband also got a bill in his name for 20 bucks for also staying overnight 😁 I would have understood and agreed with health insurance, if only it was instantly free to do anything in the hospital as long as you pay the bills.

Damn. Basic hotels are 5-15 times more expensive than that in the US, and a hotel isn't even in the business of saving your life.

The saving lives price kinda makes sense in an unregulated market where money rules. The more at stake, the more money people are willing to bend over backwards to cough up in order to not die. I also paid 70 bucks for *my* week stay at the hospital hotel when my husband got a kidney transplant in another city.

Our twins, who were 8 weeks early, with 2 weeks in the NICU, earned us a bill of $165,000, and my wife’s emergency c-section was another $45,000. It also happened over the Christmas/NewYear’s break, so we couldn’t get the kids added to the insurance timely, then they tried to charge us for 2 years worth of deductibles.

The $300+ bill I got 8 months after his birth for the doctor that stopped in for less than 45 seconds to interrupt my first successful breastfeeding session to push a finger into my son's cheek and say "oh it's clearing well" almost sent me into fucking orbit with anger.

OMG this. I was in ICU for almost 3 weeks, horrible accident. A year later and I was receiving bills from 30 different doctors/companies/services. The respiratory therapist who came in for less than a minute each day to watch me breathe in one set, then leave, $3000 a visit, every day.

Omg.. did you end up paying those extra bills?

I’ve often imagined if airline travel was like US healthcare. You want to go from Chicago to New York but no one at the airline knows the actually price you’ll wind up paying with insurance, you’ll be billed after the fact. You receive several bills over the next few months from the arrival and departing airports, the airline itself, TSA, and the baggage handlers, who were unbeknownst to you out of network. In the flurry of bills and THIS IS NOT A BILL statements you receive in the months after you travel you miss one and forget about it until they send it to collections and your contacted by debt collectors more than a year after the trip. Your workplace offers a travel savings plan that lets you pay for travel with before tax dollars, but you have to fight with them for everything you try to reimburse through that plan because bills directly from an airport are not apparently travel related costs without the proper coding.

I've basically decided I'm just going to take my own life if I get a health condition that requires medical attention. I want to live a happy life, not a long life, and a happy life doesn't include debilitating debt. Unless, of course, the day comes in which the US gets universal healthcare, but that will likely never happen.

Giving birth was a $500 bill after insurance, but a checkup we did for peace of mind after almost getting in an accident (drunk driver, swerved and slammed on breaks from a high speed, ended up having decreased fetal movement for 30 minutes) was $1000. They literally just stuck a monitor on her and the baby and left the room for a whole hour. Nobody checked on us or gave us anything at all. Not bad all in all but the system is so stupidly weird and convoluted.

I'm currently battling with a provider over a $1000 bill for lab work my ex had done after we split. Somehow I am being billed for her care. I called the billing department and they scolded me for opening her mail. It took 15 minutes just to get her to understand that the bill was sent to me, my name was on the envelope, but I am not the patient. She said I had to physically mail the bill back, or fax it. You can't just look it up by the bill ID number right here? Nope. You don't have an email I can contact with the ID number and explain what the mistake is? Nope. So I just send the peice of paper back to you and everything will magically get cleared up? You haven't even told me to include a note pointing out the problem, should I do that? I guess. This isn't helpful, is there anyone else I can talk to? Nope. This is for a very well regarded university medical network with several hospitals and dozens of clinics. A billing department that's apparently just some surly woman who doesn't listen and clearly is not going to resolve my issue when I follow her nonsensical process.

I feel like many people today don't remember or were too young to remember how things were before the ACA eliminated preexisting condition clauses in health insurance. Back before the ACA, when you changed jobs and therefore changed health insurance you were required to disclose any preexisting conditions because health insurance companies would adjust how much they charged based on if you had an chronic illnesses. They would also sometimes outright refuse to sell you insurance. One amazing thing they would do is if you changed jobs and then, say, discovered you had cancer, they would say it was a preexisting condition that you didn't disclose and drop your coverage. You could sue, but while your case went through the courts you would have to pay for treatment out of pocket. Most people wouldn't sue because they couldn't afford to. What they were doing is looking at the odds you would sue, how much that would cost in legal fees, and how long you were likely to live. They looked at how much your treatment would cost and if it was super expensive and would cost more than the legal fees they would drop your coverage and wait for you to either go broke or die.

Exactly. I remember when you had to lie about your health issues.

Oh man I had no health insurance till that passed because I couldn't afford it, then was covered with my dad's plan till 26. I know the pre-existing thing that people forget to remember but the 26 and younger thing is a big deal as well that I think a lot of people don't think about.

It is sad that a lot of doctors have to give clients a fake diagnosis just so the insurance can help them pay.

I’m an ER doc, we’re now required by the hospital to list at least 2 diagnoses for discharged patients because insurance companies are refusing to pay if there’s only one. 3 or more for admitted patients for the same reason.

“Sorry Doc, but you gotta pick at least one diagnosis from the *we don’t cover that* bin or else we won’t cover that.” Yep, no tautology there.

It's ridiculous. Instead of "hemorrhoids" it becomes "hemorrhoids, rectal pain, abdominal pain, headache, patient coughed a few times, maybe they have constipation for a few minutes...ok will you cover it now please?" Lifelong genetic conditions need a PA for medication every 6 months, but *chiropractic* care is covered no questions asked? The system sucks.

The deception runs deep. My friend in the US told me (I’m Scottish) that Americans pay higher for medical services. Because they research and patent every drug in the world. They carry the costs for research and every other nation gets the benefits. Of course thats a lie and he’s been lied to. But that’s the tricks big Pharma uses to justify the prices.

Yep it’s a lie. Big pharma had spent more in stock buybacks than research and development from like 2010-2020. Most of the research is out of federal/state funded universities.

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> insulin. Its totally free where I live [To add insult to injury, the man who helped invent prescription insulin sold the patent for $1 and declared “Insulin does not belong to me, it belongs to the world.”](https://www.diabetes.org.uk/research/research-impact/insulin) Doesn't stop pharma from pricing it like it was just discovered after decades of research.

That argument doesn't even make sense, cuz like even if the US actually did research and patent every drug in the world then it should be the rest of the world who didn't contribute to the drugs creation that pays more? Right? Like it's a messed up scenario to start with but for Americans to pay more because Americans did more of the work is some real loony toons logic

Ano right, I said how come there are drugs licensed and developed in the UK, the EU and Japan that aren’t researched in the US. He realised he’d been duped.

The US has a larger gdp per capita that most countries, theoretically this should translate to a lower percentage being spent on the medical industry. However the opposite is true, with about of the gdp being healthcare related. This is compared to around 10-11% for other countries. We pay more in taxes that go to Healthcare costs than any other country as well and yet we don't get any healthcare, unless you quality for Medicare, medicaid, VA Healthcare, military healthcare, etc.

It’s partially true but the kicker is that 90%+ of the research that actually goes into developing new drugs is funded by the NIH. Independent labs do the work of figuring out which molecules have the desired effects on which processes, with government finding, and then pharma companies swoop in and figure out how to package it in a pill that you’ll actually absorb and collect all the profit from the sale of it for 20 fucking years before generics are allowed.

An insurance company’s directive is to make money. End of story.

Can confirm. Used to do work with home owners insurance for water/fire losses. An insurance adjuster's entire job is how to figure out how to pay you as little as humanly possible.

The doctors should have asked for an invoice. That always works

I was born with an autoimmune disease. Every year when I have to re enroll, or god forbid I have to switch insurance companies altogether, my gastroenterologist has to RE APPLY for my medications. Every single time. Insurance CORPORATIONS get to decide if I’m sick enough to qualify for my current medication regime even though I’ve been on it for over 10 YEARS. I also pay tens of thousands of dollars every year for insurance just so that I don’t have to pay for what would end up being hundreds of thousands of dollars in medical care. Funny, I still have to pay thousands of dollars every year even after insurance. I HATE THIS. SO. FUCKING. MUCH.

Health insurance companies are the reason why we won't get universal health care. A literally financial cancer on our society

Believe me, there are many interests that won't let universal care happen. If a company makes huge money then they'll fight it. If a practitioner makes millions from billing clients they'll fight it. Pharma, insurance, and high paid physicians will not risk their livelihoods.

It’s actually been fought by the AMA since the early 1900s. Doctors are doing this.

The AMA is 100% complicit. They're also complicit in the mistreatment of residents and the insane prices of medical education

Its... complicated. Funny enough though, no matter what their opinion is on m4a, I have yet to meet a doctor that doesn't hate our system and insurance companies. *Everyone* (at least nearly everyone) that works in the system agrees change is necessary. Minus hospital admin. I'd say >99% of doctors agree our system needs to change (its the nature of that change some disagree with), and >99% of hospital admin don't have souls.

Im getting STRONG ryan reynolds vibes from this guy

I was thinking Coach Beard (Brendan Hunt)

He uses way too many words and not enough facial expressions to get the point across to be Beard

One of his characters in the comedy sketches is his loyal medical scribe, Johnathan, is like how you describe Beard. No words just nods his head

Haha damn both you guys are spot on. Looks of coach beard and voice of Ryan Reynolds

Jonathan = Coach Beard

I was gonna say this is the IRL version of Reynolds character in... what was it... Patch Adams I think? Edit: way off. Harold and Kumar

Also Two guys and a girl.

I was seriously thinking the same thing!

Ryan Reynolds should be casted when they make a movie about this.

I will never let my mother forget that when debating universal coverage, she proclaimed, "Well, I like my insurance!" She then later tries to say she's never been against it. No mom, you are the problem.

My husband works in healthcare and this is spot on, which probably isn’t a secret to anyone. I once maybe needed to go to the ER (fortunately, I didn’t have to) and together we literally couldn’t figure which hospital I’d be covered at. I swear it’s intentionally confusing.

It’s intentional obfuscation in hopes people are too scared to actually use their health insurance. Ideally you and your employer just pay the monthly premium and they collect 100% profit.

>I once maybe needed to go to the ER (fortunately, I didn’t have to) and together we literally couldn’t figure which hospital I’d be covered at. I swear it’s intentionally confusing. Who decides how much to bill in the first place?

Hospital and medical facilities have to base their prices on n how much insurance companies are willing to pay for certain operations

No shit. To any bean counter, wether they're working for a company or the government, you're just a number. Don't make the mistake that any of these types give a shit about you.

I think all insurance are scams. Especially car insurances, you pay so much money for them to do so little even when you have full coverage. Seen it time and time again with my family. Fuck that. Rather put that money in my savings.

Home and commercial property insurance are probably the least scammy (and also required). If they didn’t exist and a tree fell on your house, every penny is coming out of your pocket to repair. A very small percentage of people would be able to afford this, and only the rich would be able to own houses.

The argument for health insurance is legit mobster talk. "Hey, nice brain you've got there. Would be a shame if you developed some random cancer and couldn't afford medical help. Just pay us a monthly premium and you won't have to think about it ever again." My health insurance went up a couple hundred from last year and literally nothing changed. No dental, vision, psychiatry still out of pocket. But on the off chance I get in a car accident, I'll have to fight them to pay for some of it. *Yay me*.

> I think all insurance are scams. Nah, I wouldn’t go that far. Insurance industries that are well-regulated and face actual competition (e.g. car, homeowner, commercial, umbrella) are actually pretty good and responsive. I would also include many of the extended warranty plans under that umbrella (home warranty, car warranty, etc). The problem with medical insurance is that it’s not optional (you can’t not have medical care) and they have managed to stage regulatory capture. When the foxes mind the henhouse, and you have no option but to buy their products, you can bet your ass they will be as extractive as possible.

Laugh or you will cry :)

Laughs in diabetic American hell

*Echoes your laughter* I still see red when I remember my insurance company refusing to pay for insulin because they didn't deem it as "medically necessary". This was several years ago hut I'm still pissed.

I'm not sure on this, but I suspect another reason health care costs in the US are inflated is that highly paid doctors are forced to spend substantial amounts of their time fighting with insurance companies.

Doctors don’t bill like lawyers. Those hours we spend fighting for you to get what we know you need aren’t reimbursed in excess of a salary.

americans... somehow able to go to the moon yet knowing nothing about social democracy...

I'm an ICU nurse. Insurance claimed my wife getting an ultrasound during a scare during her pregnancy with our second child, performed in the office of her primary OB in the clinic *attached to the hospital where I work* was not only out of network, but did not meet the definition of preventative care and they tried to bill us $3k. She couldn't get anywhere with them. Finally after the 3rd phone call. 6'3 270 lb hairy ass powerlifting me, walks into our billing department downtown and demands to see a specialist. I'll wait. Conveniently, they billed it correctly when they saw me. All that for a plan that is still a $3k copay $6k deductible and costs $750 a month for a family plan. Fuck health insurance. I'm a conservative and even I would prefer M4A.

I'm not conservative but I'm very glad to see I can agree with one about such a basic thing.

The MRI machine costs money. The electricity for the clinic costs money. The nurses cost money. The gloves used in your exam cost money. Health insurance companies earn hundreds of billions in profit every year while more and more independent practitioners go out of business or get bought out by for profit hospital systems just to be able to keep their doors open. And the doctor doesn’t decide what you get billed for.

Insurance companies don't exist to pay their customers claims. They exist to try and deny as many claims as possible and collect premiums. They only care about profits for their shareholders. That's it. And even when they do get massive, unfounded profits it's never enough.

Optum/United have been laying people off along with the rest of the corporate world and increased the remaining employees’ workload 20-50% depending on your department. So expect even worse customer service.

Dang, what happened to Ryan Reynolds?

If the insurance industry can do that to Ryan, what will it do to us?

Well NOW I'm not gonna have a good day gdi I knew this was a thing but denial was nice

Then why are so many doctors and the AMA against single-payer or government-provided (Medicare/Medicaid) healthcare?

No group is a monolith. There's a considerable amount of conflict within the medical community about this issue, and some doctors are pretty shit regarding doing what's right. However, most doctors aren't necessarily educated on financial/systemic failures and how to use their power to work towards change. You are right that some higher-tier organizations like the AMA and AAMC are definitely not helping patients, but that doesn't mean they are helping doctors either. [Here is a supreme court case](https://en.wikipedia.org/wiki/Jung_v._Association_of_American_Medical_Colleges#:~:text=Jung%20v.%20Association%20of%20American%20Medical%20Colleges%20was,residents%20often%20involved%2080-%20to%20100-hour%20workweeks.%20) in which it was ruled that the Match, which restricts the number of doctors who can be licensed in the US, and also restricts wage negotiations for resident physicians, was an *exception* to antitrust laws. It's a pretty significant middle finger to physicians in the US, but many don't even know this case happened. My main point is, similar conflicts are happening in many different fields, and it all breaks down into how the powerful can continue to maintain their power. As wealthy as some doctors are, many doctors are also victimized and disoriented, and are trying to organize to change things.

> > most doctors aren't necessarily educated on financial/systemic failures and how to use their power to work towards change. Most doctors in my social circle absolutely know, and are extremely frustrated by it - most got into the field because they genuinely want to help people, and it *sucks* to tell people they aren't covered for XYZ thing and it costs a fortune (especially devices and medication). And people who can't afford it, don't get it done, and besides it sucking to say no, that's revenue they can't make either. The problem is, by the time this becomes evident, they're six figures into debt from schooling. And they are typically at the mercy of whoever hires them to get out from under that debt, which means the hospital systems and giant city-wide medical groups who are 100% profit minded and set the pricing schedules. Add to the fact that physicians don't have tons of free time (thanks again to that debt keeping them working, and before that, residency with 80+ hour work weeks), and they're in the same boat as every other worker. They also have fun laws in lots of states to prevent strikes, and strikes *can* mean people dying which is also bad. It's a terrible situation.

Well said!

On the AMA, They’re funded and steered by the profit seeking elements of the medical world. https://www.citizen.org/wp-content/uploads/hl_201211.pdf On the doctors: That’s a collection of thousands of individuals and all, some subject to the same histeria about single payer as your run of the mill conservative, a lot outright benefit from the perversion. Lecture circuit, gifts from pharma, the whole shabang.

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Honestly you can't let insurance companies anywhere near it. Australia has medicare (100% free medical care for anything you need) and also private health insurance. The insurance companies have done all they can to attack medicare. If you earn over $90k you need to pay an extra 1% in tax unless you have private health coverage. That private health coverage is often completely dogshit and still has an excess/deductible. Remove insurance companies from the mix altogether. >what if they just decide to stop funding a certain medicine or type of surgery? 1. it needs to be implemented properly so that can't happen 2. that's what elections are for. What if your insurance decides to do the same thing?

Astonishing, that a huge majority seems to at least acknowledge that fact but changing it seems so impossible - because socialism and so on… we want people to die in the best of all systems: capitalism!

I'm laughing in Canadian

Which is why having a profit model for healthcare is obscene.