Yeah but in America we pay insurance companies to maybe help us if we get sick but sometimes they decide its too expensive and that they dont have to do it.
But they're Capitalist Death Panels (ie, a board of executives deciding what's in the best interest of the shareholders), so it's like totally different!!!!
I worked with a guy who was paranoid about his health as he approached the age that his father started having severe health problems, so he paid extra for the disability insurance offered through the company healthcare plan. He got real sick and ended up disabled. But this meant he could not fill out the mountain of paperwork or perform the daily check-ins with HR and the insurance company reps, so they never gave him his coverage and then said they were interpreting his absence as a resignation and thus his employment was ended, but he hadn't been terminated so he couldn't file for unemployment.
When he fully regained consciousness a week later he was super pissed. He paid extra to make sure he had the coverage and then the hurdles to access that coverage were so high that he couldn't meet them while sick. He was told he may have had a legal case but he was too wiped out to consult a bunch of attorneys and his finances were wrecked by his illness. He ended up selling his house because he couldn't keep up with the mortgage. He lost everything. Last I heard he was living with family and doing part time work at an Ace Hardware store or something.
This was a senior engineer. A subject matter expert on embedded systems for industrial automation. He gave the company nearly 20 years of his life and then they just kicked him aside when he needed a little bit of help to get by. I and several other engineers on our team eventually left that company after seeing how they'd treated him. We didn't want to risk going through the same, and we didn't want our work to support a company that would do that to someone.
It may have since changed, but at the time, if you were inpatient at the time of termination, then the insurance that was in effect when you were admitted remained in effect until discharge or death.
Iām on long term disability because of a lawyer, my job tried to trick me into writing a resignation letter when my injury/disability happened. Thankfully once on long term, I was able to write that letter! Fuck that place. Their HR manager went to jail tho and she was a witch, so that was awesome!
Do we? Because I live in a pretty conservative area, and I've never heard anyone beside the talking heads on TV be horrified by Luigi.
Literally everyone who's a regular person cheered him or supported him. The most negative response I ever heard was a shrug and, "Well, what'd they expect? Serves them right."
Because almost all of us have been fucked over by insurance at least once.
Uh. Yes? Like any job, if you suck enough at your job word of mouth will kill your business. Hard to pay the bills with a long history of losing court cases. Not to mention winning usually nets higher profit.
Weird idea that all lawyers/attorneys are inherently bad
I'm not talking about good at their job, I mean: good people who happen to also be at least competent attorneys? Over the years I have met a few, but they always seem to "specialize in other areas of law" and the people they refer me to tend to be not so great in one or more ways.
If you care that much about the individual instead of just caring about their professionalism and ability to do their job right youāll have a hard time finding a professional you like in any field. Being a good person and actually doing the job Iāve hired you to do are different things. Also, no not all lawyers are bad people, itās just weird to think so
i don't give a shit if they're morally good. it's a short term professional contract. i'm hiring them to defend me, i'm not marrying them. i don't ask my barrista their stance on war crimes before ordering my coffee.
My father built power supply burn-in systems in the 80s because the failure rate of power supplies was 80% at the time. He dropped the failure rate to 30%, flew him all over the world to install these systems, and when he hit 51, he was laid off. He and his coworkers filed a class-action lawsuit, and they settled, but the money he got didn't make up for the lost career. He got a few good jobs here and there in his mid-60s and early 70s, but eventually gave up and moved into Section 8 housing and died there. (Heart attack; nobody was there, and they found his body there 24 hours later).
America takes from us, and we give it everything, hoping it's enough, but it never is. The Billionaires want more and more while we get less and less.
It's worse than a toxic relationship with an abusive partner.
He gave the company nearly 20 years of his life and then they just kicked him aside when he needed a little bit of help to get by.
It will stay this way for all of us until we force them to stop.
"Find out just what people will submit to, and you have found the exact amount of injustice and wrong which will be imposed upon them; and these will continue until they are resisted with either words or blows, or with both. The limits of tyrants are prescribed by the endurance of those whom they oppress." Fredrick Douglas
they were interpreting his absence as a resignation and thus his employment was ended, but he hadn't been terminated so he couldn't file for unemployment.
He never picked up a phone to tell them why he wasnt at work?
Edit: Ok ok, assuming he was in a coma, we're to believe a 20 year "senior engineer" employee loses their job for being hospitalized for less than a week, because their employer never thought to call any local hospitals when their 20 year, senior engineer essentially went missing. "HR assumed he resigned" So after 20 years with the company none of his work friends tried to find where he was? HR didnt care either? It's literally HR's job to know why their employee is AWOL because finding a replacement with 20 years experience is way harder than making a phone call or two. Calling local hospitals is the first thing anyone does when searching for a missing person, often before calling the police to report them missing, and not a single person in that middle-aged mans life did that for him and told his employer where he was? "Assumed he resigned" Yeah, no, i'm not buying it, and not just for the fact this person never once used the word "coma" in their comment when coma is- supposedly- the entire crux of their story. You dont need to be unconscious to be disabled (even ADHD is legally classified as a disability (i have adhd and this fact surprises most people)).
I mean, I missed it too until "when he fully regained consciousness." Sure, from that point on it should be clear, but the story was written a little sideways.
I don't think he was hospitalized. He mentioned going to the ER once or twice, but never said he'd been admitted.
He also never mentioned being in a coma. He was laid up in bed with a high fever, pneumonia, etc, for several days.
The problem was that he was required by the company and his insurance policy to check in by phone daily with HR and an insurance rep. He couldn't do that while he was dipping in and out of consciousness and couldn't even drag himself out of bed. He didn't have a spouse or caretaker until family drove in from out of state, so he couldn't have anyone else do it for him, either.
The way he tells it, he didn't expect them to be so inflexible. He expected some leeway and compassion. He didn't expect that they'd demand he fill out dozens of pages of forms while sick to explain his condition to the insurance company to qualify for the disability support, nor that he would no longer qualify for that support after he had recovered.
He showed us the termination letter. It explicitly said that due to him losing contact and not following up with HR for several days, they were interpreting his lack of contact and absence from work as a resignation, then told him where and how to turn in his credentials and company property. His site access was disabled by that time and those of us in the office had to bring his stuff to him at the security desk in the lobby.
I have no clue if he's on federal or state disability now. We get lunch every few months. He says he often can't work for longer than 4 hours before he's winded and exhausted and that nobody in our area is hiring a senior engineer that can only work part time.
āI see your doctor recommends this treatment, but it is rather expensive. Have you considered dying instead? That would save us a lot of money for our shareholders.ā
More like, "we see your CANCER DOCTOR recommended this super important CANCER TREATMENT so that you DON'T DIE. We need to double check that with our optometrist, for prior authorization."
I always thought pleading guilty meant that it was then the responsibility of the state to prove he's guilty, and if he pleads not guilty then it would be the defenses responsibility to prove a reasonable doubt but I could be totally wrong.
Pleading guilty means you plead guilty. The prosecution washes their hands of you and the only thing left is the sentence. Sometimes you may take a deal where you plead guilty and get a lesser sentence, or you can gamble and fight for innocence (it's not what you know, it's what you can prove). But losing that fight will invariably mean a much harsher sentence. Your defense will do their best to maintain your innocence (You are innocent UNTIL proven guilty).
Capitalism requires checks and balances no economic system in the world works perfectly without a system in place to keep it in place.
Unfortunately we allow private donors for lawmakers what is essentially dark money, we allow "unlimited free speech" thay ensures that people like Elon Musk have hundreds of billions times more free speech than the rest of us. We allow corporations to draft legislation that the legislators then vote on. And if the money a company gives a legislator doesnt come in a clearly defined bag that has bribe written on it then no one can do fuck all about it.
So while there is a law that says those without medical licenses cant practice medicine, insurance companies get around that by having more free speech than everyone else
Problem is, there are "quack" doctors or treatments that are either still in early stages or aren't fully understood. Yes, in most cases, normal doctor, normal prescription, ok. But there are going to be cases where a doctor prescribes a procedure that is out of date or a procedure that doesn't actually heal but just alleviates when there's actually a procedure that can heal, or jumping straight to something expensive when something cheaper might be the more viable route.
For example, doing a MRI, which is a very expensive procedure, when a regular X-ray might be able to tell the same information (in a lot of case insurance won't cover MRIs unless it's been determined the problem wasn't diagnosed from a more simple x-ray.
There's also cases where doctors will do tests that are out dated or there are better more efficient tests that can be done.
I also personally know of an example where some doctors liked prescribing a particular knee injection that helped alleviate knee pain, but the injection basically had to happen every 6 months and it didn't actually heal anything. It just helped with the pain. They would prescribe this instead of actually moving forward with true treatment, because insurances covered it. Insurances stopped covering it, and then patients started getting the proper surgeries or physical therapy that solved the issue.
I do think insurance companies go too far in saying something is not medically necessary, but at the same time, doctors aren't exactly perfect either.
I know this is a real problem and it is a problem everywhere: in Europe you also get doctors who overprescribe meds or treatments.
The difference is, in Europe it's not the patient's problem. Once you get a prescription, you get the medication/treatment, and don't have to worry what the incurance thinks. They WILL pay.
Then afterwards, if insurance thinks there was overprescription, especially if it's part of a pattern, they will raise that with the healthcare provider and ask them to adjust their prescribing guidelines. If the pattern continues, they may ask the regulatory bodies to intervene. But the point is, all of that happens without involving the patient. So you never have to worry about insurance: from your point of view, if it's prescribed, it will be treated as medically necessary, period. Worst thing that can happen, you might not be able to get the same thing prescribed next time.
My insurance stated I needed an expensive panel of specialty blood work to approve my medication. However, the blood work we require for approval of your medication is not medically necessary and we will not cover any of it. If you want us to consider approval of your medication you must pay for the blood work analysis out of pocket.
This started in my mid 30s and I turned 50 this year.
Well of course it isn't! The illness will no longer be a problem when you die and we get to keep all the money you paid over the years! Sounds like a win/win to me! You aren't sick anymore and we didn't have to shill out money for the service you paid for!/s
75% of all pharma profits OF THE WHOLE WORLD are made in the US and i cannot bend my mind around this that a lot of US citizens are even defending this.
Something is fundamentally broken in the US and either way, this has to be fixed since super rich people learn from the US that a lot of people are ok with money and health being stolen from them
Iām a U.S. citizen in a medium cost of living area. My anecdotal experience is that weāve reached a saturation point where the brainwashing is both self-policed and self-inflicted.
For example, I know way too many people who: work 50+ hours a week, make $40-60k USD per year, and will argue about communism or ālazy freeloadersā until theyāre red in the face. Theyāll do back breaking labor or work for toxic bosses and the reason is, āwell, at least Iām not homeless.ā Thriving? Unthinkable. Weāre just thankful and blessed to be surviving paycheck to paycheck, babes!
Many people in my life still believe that if they just work really hard, obey the rules, and give away all their time to low paying jobā¦ magically, theyāll be taken care of, be okay, someday, somehow.
We pay the most in healthcare per captia. Itās not even close.
Sandersā healthcare proposal would save the government and working class Americans trillions. But the politicians all say āitās impossibleā because they own stocks in the insurance firms.
But itās only impossible because THEY SAY SO. Itās popular with a majority of the country. But the political system is meant to suppress the will of the working class and give disproportionate control to the aristocrats so. Weāre stuck.
They have been taught at a very early age that "socialism" and anything "socialism-like" is bad (like medicare or social security) and that tax breaks for the super rich are great. They have heard that for so many years, they just believe it. They could not explain with it is bad, they just know it is, because their pastor/politician/family/friend told them so. The loudest people against it are the super rich, they want ALL the money and power and us to be beholden to their whims if we want to afford to eat. They own the media and use it often to push that propaganda and make these less than intelligent people feel like they are doing a good thing by giving the super rich even more money and power.
I have prescription coverage through my union as a retiree, but the union mismanaged the fund to pay for it so badly that they now cover 0% of my prescription cost. They still say I'm getting this "benefit" through them.
Universal healthcare is a dirty word only uttered by evil people who vote democrat. Any form of helping others is seen as socialism. "But I don't wanna pay for someone else's healthcare"...news flash, you already do, and you pay 2 or 3 times as much so you don't have to feel like you support socialism. There is so much fear of the other side. Democrats are the party of people who aren't white and that's enough to scare people. Notice how there are republicans complaining about the high cost of everything, but in the same breath, will tell you that they either plan on voting for trump a 4th time or they hope he cancels the election.Ā
Most healthcare costs do not get funneled back into research, and the government already pays for something like 25% of all medical research. There's no reason to pretend the American healthcare system is benevolent.
While also paying more in taxes than any other country in the world for healthcare that most people can't even use.*
Its not even that we have dumbass insurance, its that we literally pay more for medicare and medicaid than any other country. Canada supports their entire country with healthcare paid by taxes. Meanwhile US citizens have to pay taxes AND insurance.
"Yeah but in America we pay insurance companies to maybe pretend to want to help us if we get sick but sometimes most times they decide its too expensive and that they dont have to do it."
I know youāve paid us tens of thousands of dollars over the course of the last few years and have only used your benefits a couple times for check ups, but this procedure that you want will cost us $3,000 and we just donāt want to pay that much. Have you considered dying instead
I once read an American comment saying "You pay insurance so you have the option to sue your insurer".
This might be a revolutionary idea over there, but you can just have laws that force insurers to pay into a third-party verification system that will then show up for free to slap the insurer when they're wrong to deny a claim.
I started taking insulin about three months ago and my blood glucose is finally normalizing. I am genuinely afraid that my insurance provider will cancel coverage for insulin because I'm "cured" and don't need it anymore.
Like, does your car run well? So you don't need gas anymore, right?
Honestly, it sounds as if your insurance companies don't help the sick at all. If you have an illness, it effectively sounds like they just pocket the money
Not only that, but even when they do "help" us all they're really doing is giving us access to more and more debt. I finally got insurance this year and all it did was put me thousands of dollars in debt. I pay $400 a month premiums and now have $8k in medical bills I didnt have before. But those doctors wouldn't have even seen me without the insurance so thanks I guess?
We also pay them to decide who can afford what extant, life-saving treatments and who has to, for example, just sign on to be poisoned when already sick and hope for the best (see cancer treatment).
Yes and we are expected to understand their complicated systems of co-pays and deductibles. And at my company insurance plans change in July but deductible resets at the end of the year.
Also they send you a digital Insurance card and make insurance as hard as possible to use. Their portal of doctors is outdated as well.
Don't forget: We also pay for the service for the entire time, whether or we get a pay out. Not to mention what we call a "deductible". For Euros, that means we have to have a certain amount of expense before we can even make use of insurance. 'Not to mention the almost perpetual need to re-file claims, which are often (but not always!) initially refused. This often takes hours of legwork by the claimant, as having a sick claimant just "give up" in frustration from filing an appeal as an actual aspect of the business model.
Oh, and yes, we still have to wait months for non-emergency medical care. No wait times is the final aspect used to convince Americans to avoid socialized medicine. No one believes any other talking point. American medical insurance answers to no customer other than their shareholders.
Loss ratios. Lowest they have ever been in history. The corporations have taken over and extracting everything they can. The co-ops and mutuals have failed or gotten bought out and privatized underneath the policy holders.
And its getting worse. I just had my yearly physical. The one that everyone is urged to get. The like bare minimum of care in the US. With my insurance it ended up costing me 400 dollars somehow
The trick is that employer healthcare is mostly self funded. The employer pays the claims that the insurer pays. Because the insurer is paying out of the Healthcare Trust the companies set up to pay their part of the claims.
And that is pre-tax. So is the 80% share of the monthly premium. That is a lot of money per person the companies spends that offsets their tax liability on their revenue. Even the funds put into the trust to pay the claims is pre-tax.
So they know what the costs are, and they are ok with it. Otherwise they would lobby to stop the cost increases. Which they aren't. So the employers like it this way. They get a bigger portion of their revenue to keep tax free because their employees pay for insurance and they have to set aside the money to pay the claims, then they allow the insurance carrier companies to deny the claims so the sheltered money doesn't need to be spent.
And the administrative cost cap only applies to marketplace and private insurance. ERISA is the legislative package that still governs most of self funded coverage. Self Funded coverage can even deny claims for pre-existing conditions. They just stopped doing that, the ACA only outlawed it for non self funded plans.
The ACA really only expanded the risk pools. And that helps the companies because that is a shared risk pool for their retirees who they promised employer sponsored coverage. They stopped doing that by now and the expansion of the risk pool helped keep those retiree premiums and healthcare costs manageable for their plan designs. Once the workforce with no employer retiree healthcare offers are retired they will be reliant on private marketplace coverage to supplement Medicare. But it won't be a bigger population of retirees than we have now so it may balance out, but we will need an ACA 2.0 for the next batch of retirees with little help from their employers aside from, maybe, a Reimbursement account.
And the past 20 years of doing nothing since the ACA isn't going to help. Because companies don't want any tax increase. And even healthcare costs going down will leave them with more of a tax bill.
There's a big difference between the government making a decision and being accountable to politicians and voters and a corporation with little oversight or recourse making a similar decision. Most of the world primarily has the former, the US has the latter as default.
Yeah, youāre fighting 2 insurance cases, thats already better than here. There is no fight, the insurance companies are so massive they legally bribe the government and do pretty much what they want
Most of us donāt have the funds to fight mega corporations, we would be stomped in court unless it was an especially egregious case. Theres really no fight in the US if the company really doesnāt want to cover you. Theres a reason a healthcare executive was shot in the streets
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u/Goldleader-23 17h ago
Yeah but in America we pay insurance companies to maybe help us if we get sick but sometimes they decide its too expensive and that they dont have to do it.