Insurance companies

[Lewis the Pike]

http://www.youtube.com/watch?v=3yOtKWipG-o

What the hell do you do if people get rich, because they do not pay for the treatments to save your child's life?

This could be any one of us on this board.

Insurance companies kill people and get rich while doing it.

[Inspoke]

Do you have a solution for this problem?

[Lewis the Pike]

truthfully, it took a while for it to get this bad, it will take a long road to get better.

I believe a criminal negligence case could be made against the insurance companies (the CEO, the salesmen, the CFO, and the Adjustor who denied these claims and their supervisors). I hate lawyers and courts, but when a someone profits of the death of others, I feel our legal system should have some recourse.

If the police let serial killers go free, then likely they will keep killing.

[bleedorange]

Hard to know all the facts from a 4-minute youtube. Maybe they were covered for a transplant, maybe not. Really Lewis, you don't know if there is negligence not.

If your stance is that they should eat the uncovered cost just because a life may be at stake, where's your blame for the doctors, nurses, hospital, labs, everyone else who could simply "donate" their time and skills?

I really don't know the answer, but it may not be as simple as head hunting the insurance company CEO.

[Lewis the Pike]

The story was big news out here, it was an Armenian family from Glendale, and I work with a bunch of Armos.

I def. see you're point too bleed about Drs., nurses, etc.

As long as there enough people involved, people can spread the blame. It's not just one person.

It took a while to get this bad, but we need a change. Not nessecarily, Obamacare. But there has to be accountability somewhere down the line.

I was reminded of this because an Armo commic I know has thrown his support into their cause.

[BigBadBen]

There is absolutely no doubt we need reform and regulations in health care, including pharmaceuticals, but the government controlled socialist medicine is way too extreme.

[Lewis the Pike]

If your stance is that they should eat the uncovered cost just because a life may be at stake, where's your blame for the doctors, nurses, hospital, labs, everyone else who could simply "donate" their time and skills?


A second thought I had, was the insurance company took the obligation to provide funding for healthcare, when they take an individual's premiums.

If I pay for a service and don't recieve it. That is fraud.

[jakeman]

If I pay for a service and don't recieve it. That is fraud.

And if you pay for a loaf of bread, do you get to leave the store with a loaf of bread, a frozen pizza, and a 12 pack of Bud Light just because you are hungry? Can you pay for a tire rotate and balance and then demand a new set of tires?

I don't know anyone that has said some type of reform isn't necessary, but the fire, ready, aim approach isn't the way to go about instituting the type of reform we really need. And we do need reform. Worse than we need anything else in this country, we need health reform.

This administration said all along they were going to reunite the country, and they have done nothing that is bi-partisan in any fashion. Nothing. They have attempted to cram incredibly partisan politics down the throats of the opposition "because we won". Even though many thought it wasn't possible, the country is more divided now than it has been since 1862. Hows that for reunification?

They have not only alienated every republican/conservative (edit) citizen and member of Congress, but have even driven a wedge between themselves and a large portion of Democrats in Congress and democratic voters. We are not going to get the reform we so desperately need because they refuse to reach across the aisle in good faith. When health reform goes down in a tight spiral, trailing flames, and we are left with the jacked up mess that caused the above situation this country will have mostly the partisan ultra liberal politicians to thank. Of course, they will blame GW Bush and Fox news.

[wood911]

It depends on the contract you and the insurance company agree on as to what is covered. Most companies will have a clause about experimental or unproven procedures not being covered. As was said earlier, without knowing all the facts, it's hard to make any judgment about this particular incident. It's always sad when people die but it is especially sad when they are so young.

[ARPoke]

Could someone point out to me where any of the current healthcare reform plans would have covered this procedure? I haven't seen anything coming out of congress saying they would cover experimental, investigative or unproven procedures. Universal healthcare in other countries certainly wouldn't have covered this procedure. I just haven't seen any reform measures that would have helped in this situation.

[jakeman]

Could someone point out to me where any of the current healthcare reform plans would have covered this procedure? I haven't seen anything coming out of congress saying they would cover experimental, investigative or unproven procedures. Universal healthcare in other countries certainly wouldn't have covered this procedure. I just haven't seen any reform measures that would have helped in this situation.

No, they can't. Because it wouldn't. Not only will the experimental and unproven type of procedures not be covered, some well proven and successful procedures won't be covered, depending on the patient.

It's just a bunch of indignation for the sake of being indignant.

[wood911]

Both sides of the healthcare argument are finding the most egregious examples they can to try to sway public opinion. The government healthcare proponents have targeted insurance companies to vilify, and due to the companies own actions they are easy targets sometimes.
There are going to be "death panels" regardless of which way we go, the fight is over who gets to make those decisions, not whether those types of decisions will be made. There is just no way we can afford total, unrestricted healthcare for everybody.

[Lewis the Pike]

65% success rates with a terminal patient is 65% better than doing nothing.

[ARPoke]

65% success rates with a terminal patient is 65% better than doing nothing.

That does nothing to change the fact that the procedure was considered experimental/unproven.

Something to think about...The average 1 year BILLED cost of a liver transplant is ~$530K, they would have likely only had to pay 50% of that overall with 10% up front...I would happily work 2 full time jobs and have 3 mortgages on my house if it meant saving my family member's life.

[Inspoke]

That does nothing to change the fact that the procedure was considered experimental/unproven.

Something to think about...The average 1 year BILLED cost of a liver transplant is ~$530K, they would have likely only had to pay 50% of that overall with 10% up front...I would happily work 2 full time jobs and have 3 mortgages on my house if it meant saving my family member's life.

But, don't you realize that the government should make everything better for everyone and relieve families of having to do anything to take care of their own?

[MisterE-NYC]

There is absolutely no doubt we need reform and regulations in health care, including pharmaceuticals, but the government controlled socialist medicine is way too extreme.

Yup, we need to stop Medicare and VA Health plans immediately.

[MisterE-NYC]

There are going to be "death panels" regardless of which way we go, the fight is over who gets to make those decisions, not whether those types of decisions will be made.

GOD... the Ultimate "Death Panel"

[MisterE-NYC]

This administration said all along they were going to reunite the country, and they have done nothing that is bi-partisan in any fashion. Nothing. They have attempted to cram incredibly partisan politics down the throats of the opposition "because we won". Even though many thought it wasn't possible, the country is more divided now than it has been since 1862. Hows that for reunification?

They have not only alienated every republican/conservative (edit) citizen and member of Congress, but have even driven a wedge between themselves and a large portion of Democrats in Congress and democratic voters. We are not going to get the reform we so desperately need because they refuse to reach across the aisle in good faith. When health reform goes down in a tight spiral, trailing flames, and we are left with the jacked up mess that caused the above situation this country will have mostly the partisan ultra liberal politicians to thank. Of course, they will blame GW Bush and Fox news.

There will never be unity in the country again. The reason... party politics. Both parties are guilty. The elected officials want to be re-elected, and to do that, they need the funding and backing of their party. Instead of lefties taking on some rightey ideas, or righties taking on lefty ones, they hold their parties ground ignoring the facts and working together. The politicians have prices to pay. So, as long as there is the party, congress will do what the party wants, instead of what the people want.

And the country being more divided then it has been since 1862... I fully disagree. I remember thinking the same thing in 2004, and reading about the 80s, the 60's, the 20's. Now, it probably just seems like that to you because you are now on the oppressed side, not the oppressors.

[GoPokes83]

I've actually never heard of an insurance policy that would cover this transplant. Maybe they're out there, just not in any policy I could afford.

But after how many decades of liver / kidney / lung transplants are they still experimental? That always confused me.

It absolutely sucks about this kid, and I'd be lying if i said I can understand the parent's pain. But the truth is that Cigna did nothing wrong here. They didn't deny her a transplant, they just said they couldn't pay for it with the policy these people had. If so many Dr.'s said it would save her life did they offer to donate their work? Why isn't the hospital evil for not doing the surgery for free? Why aren't these parents going after them?

They're easy targets but insurance companies aren't evil, and yes the CEO makes a huge amount of money. He does this by managing the incredibly complex and vast resources of the company for the stockholders. It's not a job just any college graduate could handle.

Bottom line... If I need a transplant I'm probably screwed, or in debt for life to pay it off. But I understand my insurance policy and will do my best not to be too pissed at the insurer for not going beyond what I'm paying for.

[wood911]

Yup, we need to stop Medicare and VA Health plans immediately.
Medicare will be broke in 2017 according to estimates I read. At around 65 insurance gets to be very expensive but because they were taking taxes from all to pay they made it a universal program. Some doctors will not take patients that are on Medicare because Medicare does not pay enought o cover costs. Medicare was added to provide for seniors who could not afford insurance. Most people carry a supplemental policy that costs them about what their regular policy cost prior to turning 65. It isn't necessarily good, but it is the best most older people can get since insurance companies raise premiums as people get older. About 1 in 20 procedures are rejected by Medicare, more than any insurance company.
Having been to a VA hospital a few times over the last few decades due to exposure to Agent Orange and Napalm, shutting them down would be the most humane thing they could do for veterans. I have never gotten anything close to good service or treatment there.

[wood911]

GOD... the Ultimate "Death Panel"
Call it what you want, a young girl died because somebody made the decision her condition was not covered by her insurance. I guess you could call it the "medical procedure evaluation and treatment approval or disapproval specialist/team/group". MPEATAODSTG for short;)