Shitty physical therapist twice raised what I owed per visit because of their clerk’s incompetence. Not just for future visits but retroactively for visits I already had. (Edit: I should say this was possibly fraud and if I had a lawyer it may have been worth pursuing).
I knew I was screwed when the clerk pronounced tier as tire. Oh well, lesson also learned for me: Always conduct a three-way, recorded conference call with provider and your insurer before provided service.
Another fun fact; Per KFF, 50% of Americans forego medical attention for free of medical debt. Naturally, this snowballs leading to them inevitably going anyway for a more costly, complex procedure. Our system is top-heavy with specialists for this reason, lacking adequate preventative care and rapid accessibility.
They want essentially 200 bucks fee to give a script for antibiotics
And you can’t them with oit a script. Now just for a basic medicine you need a provider, prolly make you go to urgent care, then receptionest needs to file your insurance, they do some reviee or bullshit.
Anyway or you could go pharmacy, check with them and get what you need. This ain’t rock science cast majority of time.
Wasn’t tele medicine supposed to save money? Does it?
Insurance companies make money on gross revenue as base rate. So they have every incentive to increase revenue then demand higher premium justified by higher payouts.
Then they will maximize this profit by deny claims to “expensive losers”
This is their core business…
A friend of mine was feeling ill, but didn’t go to the hospital because he couldn’t afford it. Once the leukemia started advancing though he only lasted a week.
I’ve got cluster headache. Only medication that had any noticeable effect was Prednisone. Not even that expensive of a drug, but more than I could afford out of pocket. Insurance wouldn’t cover it because they considered an oxygen mask to be a more appropriate treatment, even though I’d been using them for months with no improvement, and O2 only works for a small percent of people with cluster headache, anyway.
Couldn’t afford to get the meds. Not legally, at least. A coworker was taking Prednisone for a different condition, and managed to convince his doctor to double his dosage, and I paid him for the difference, until he stopped taking it altogether. Ended up having attacks again, and missed enough work because of them to get fired. Between the pain and losing my job, that was easily one of the lowest points in my life.
I wouldn’t wish our healthcare system on my worst enemies.
The worst thing about that are the prices in the US. Not only that the insurance system is shit,you are also getting cheated there.
I actually looked up Prednisone in Germany (third most expensive pharma market in the world): 5mg, 100x, 16 bucks. Basically around that price for all halfway normal doses.
In other words, for 60 bucks you could easily cover a year.
If you have a pet, you may be able to convince the vet to prescribe them Prednisone
Hadn’t considered that! Sad that that’s probably the most viable option if I needed to get it again.
My dog has anxiety and is taking Xanax and Prozac (I forget which exactly, and they’re the generic of course) prescribed by a vet and filled at a human pharmacy.
And usually way cheaper too
On a road trip, got food poisoning so bad that I couldn’t eat for 5 days, barely kept fluids down and was so weak that walking into an appointment, the doctor told me to go to urgent care.
They gave me an IV, did an ultrasound, and gave me some anti-nausea and anti-diarrhea meds, which barely helped. It still took 3 or 4 days before I started feeling better.
Insurance comes back with a 5K bill. They claimed that even though I had my regular prescriptions go through both before and after the trip, the trip claim itself was denied because it was “during a time when I did not have coverage”.
Took several months and phone calls of pointing out the before/after is approved without questions so there’s no way to claim I wasn’t covered during this one week. Every human I spoke to agreed with me, but it still took months.
Once upon a time there was a man who was very, very, very, very, very glad he never had to deal with the American healthcare system. He lived happily ever after.
Cigna dropped my medicine coverage. I had to to drop two name brands simultaneously to generic else i would be out 4k every 30 days.
The switch was not pretty.
Like, mental breakdown, life changing, never-will-be-the-same not pretty.
That was…8 years ago. I imagine if it was something maintaining my physical health I certainly would have died. I mean, shit, I nearly did. Don’t get me started on the arm i broke as a kid, that didn’t heal correctly because a narcissist parent(RN) wanted to skip the er wait and had hospital buddies patch me up on the dl instead. A bionic arm sounds more feasible than actually getting it to where I could play strings again without pain.‘group bargaining’ is a giant lie in the united states. the idea that groups of insured people can bargain for cheaper healthcare. a complete fabrication.
my monthly insurance costs were cut by 75% when i dumped my corporate health insurance program and signed on to my wifes plan, where she makes far less than i do but the benefits are amazing. because its a government job.
and i work in the healthcare industry!
its all a giant fucking scam designed to rape the american people of money.
private insurance companies only profit when human beings suffer. how many other industries get to do that?!
Group bargaining works, it’s just that people heard “we’re going to use our position to lower consumer costs”, but what they said was “we’re going to use our position to lower costs”. They have no motivation to pass those savings on, considering you probably get a plan partially subsidized by your employer so it’s cheaper than what you can get alone, and you’re legally obligated to buy insurance.
Look at what the government can essentially dictate as the procedure costs because they’re big enough that their “accept our terms or don’t see our patients” is a compelling threat, particularly when backed by the tax ramifications of saying no. They’ve got leverage and no particular profit motive, so they can tell a hospital “a surgery suite costs you $250 an hour, the surgeon $150, staff another $500, and material $100, with recovery costing another $250. We’ll pay 80% and you can bill the patient the remaining $250. If they have gap insurance they’ll pay and they can’t dispute because we payed”. And the hospitals invariably just accept it, rather than lose tax status and ~60% of their patients.
only profit when human beings suffer. how many other industries get to do that?!
Defense contractors, daytime talk shows, and reality TV. 😛
A pediatric neurologist told me definitively that my oldest son did not have autism. After a year of no improvement and assuming he was a particularly hard to diagnose, I got on the wait-list at the local university medical hospital. They were able to diagnose him quickly (apparently he’s pretty text book, but the pediatric neurologist didn’t ask the right questions). But he had been without supporting therapies and help in school for years as a result of the misdiagnosis.
My other kid (also autistic) had an ear ache. The urgent care doc was unfamiliar with how to deal with an autistic kid and assumed he didn’t have an ear infection. The next day his ear drum burst and we ended up at the big children’s hospital.
In both cases we had huge delays in appropriate care and had to pay twice.
Jesus christ I am so sorry.
We are getting better at navigating the system! Horrible skill unlocked. 😉
I went to the ER once because my heart was acting weird. Turns out it was a benign issue, but they kept me over night to be safe. $10k copay. Insurance covered almost nothing. I paid $10 a month for 5 years and eventually they called me and said they would take $2000 if I paid it all right then.
I went in for a $10,000 surgery. Told them to bill my insurance and I came out with a bill for almost $30,000! Insurance barely paid $7,000 left me with the rest
Just paying good money all these years and now I am concerned that I might be fucked over.
They appear to be targeting more complex and high cost patients with these tactics while mandane shit just get push through without too much drama.
But there still issues like residual billing which are technically illegal but some how still happen.
Point being, if you have not been fucked over like these horror stories, do you trust these people when you will need them?
I don’t.
I work in healthcare, and the response from the workers in my hospital to the UHC CEO assassination has been… pretty much the same as the response here on Lemmy!
Couple morale-high-horse folks pearl clutching about no one deserves to die or some shit; but 99% of us are on team Luigi.
We fucking hate parts of this industry, with a strong emphasis on insurance bullshit.
My two cents from the inside.
My spouse had their lung collapse. Insurance denied it because we didn’t get advance approval for their lung to collapse.
This is scary, as an European. I had my left lung collapse too. Two years later my right one. After that I had to have surgery on my right lung (Pleural Abrasion) and a few months of physiotherapy after that. I also had a yearly appointment with a Pneumology MD for 5 years to follow the development of the lung until it was all fine.
How much did I pay? You guessed it…zero. Now I wonder how much would that set me back in the US with or without insurance.
I’m glad you’ve recovered! They did say it was more likely for my spouse to have a lung collapse again, which is scary.
Luckily my spouse’s employer has someone whose whole job is to fight with insurance. She got insurance to admit that in an emergency we didn’t need pre-approval which brought our bill down some.
Had something similar, failed to get pre-approval for a CT scan to diagnose a pleural effusion. Yes, I was supposed to wait 24-36h for someone unfamiliar with my case and likely not even a doctor to determine if a diagnostic test was nessasary.
Edit DDD
Went to a clinic to get birth control, had to convince them I wasn’t interested in using it to control whether or not I gave birth, when I finally got a prescription it turned out it would cost over $100 for the medication.
Between my wife and I we make 200K a year. We have a roommate to help pay bills because between her chrones disease and our kids health issues we can’t afford to live. She has been without her chrones medication for 6 months because the hummers was causing problems and the new prescription has been in limbo between pharmacies not wanting to deal with it or her insurance and her insurance continually sending her to pharmacies that don’t accept her insurance. Medication that is easily affordable and available in other countries is dangled just out of reach while she suffers.
