UnitedHealth Is Strategically Limiting Access to Treatment for Kids with Autism

https://www.propublica.org/article/unitedhealthcare-insurance-autism-denials-applied-behavior-analysis-medicaid

by stefankuehnel • 2 years ago

48 23 2 years ago

propublica.org

cluckindan• 2 years ago

Wow, these companies are evil.

atmavatar• 2 years ago

Reminder: don't anthropomorphize corporations.

This policy was recommended by Alice to her boss Bob, and it was then signed-off by Christine above him, Dave above her, Evelyn above him, and so on... until it reached the desk of Nathan Orville Percival III in the C-suite, who happily collected a fat yearly bonus for the savings. People made this decision, and in a large organization like UnitedHealth, likely a lot of people did so.

Unfortunately, the laws surrounding corporations make it largely impossible to hold such people accountable - piercing the corporate veil, so to speak, is rather difficult even in the few cases where it's allowed. The most you can do is fine the corporation a little and hope it shocks the business enough to make its own internal changes. In practice, it's usually just a small slap on the wrist that can be written off as a cost of doing business.

I would argue that for the long-term health of society, we ultimately need to start poking more holes in this corporate veil protection so individual people can no longer get away with the equivalent of "just following orders" which is the profit-above-all-else excuse.

vacuity• 2 years ago

I agree with your view, but to refine it: on the flip side, we could change our culture so that normative statements about "this company" refers to everyone in it, starting with the highest responsibility for top positions and trickling down. Corporations are indeed not individuals, but they are very much hierarchies of individuals. If a corporation is a body capable of agency, however diluted from individual human agency, we can hold it accountable. And that indeed starts with the upper brass.

Y_Y• 2 years ago

Sounds like a failure of regulation to me. I can't imagine how it would be possible to just rely on the moral compass of whoever ends up setting policy at a huge insurance company. It's one thing to try to live a good life, but you can't fight incentives, and it's far more likely that each cog in the machine doesn't have a particularly hard time justifying their own contribution.

I'd ideally like to see decisions about medical necessity made by a third party who isn't financially tied to the outcome of a payout decision, but failing that the insurance companies should be held to a high standard which is obviously not happening.

(This may be because many consumers have their insurer chosen for them by their employer, and will change insurer only when changing job.)

grecy2• 2 years ago

Sounds like a failure of regulation to me

Which is a direct result of corporations lobbying with billions of dollars.

Every other country calls it bribery for a reason

sgammon3• 2 years ago

Lobbying exists in many countries and in many forms does not constitute bribery. Lobbying is already regulated in countless ways. Without lobbying, elected officials would have a much harder time understanding the real impacts of policy. While, yes, Big Tobacco has lobbyists, so does the Cancer Society. Complicating the morality of the equation, a good lobbyist specializing in that industry might work (at different times) for both sides, just like many types of attorneys or other professionals.

dqv• 2 years ago

It is a failure of regulation, but that regulation was promulgated by the regulated through lobbying. They come out and say "no, we want to fix healthcare too, we get your frustration and anger!" (only after a CEO was shot and killed) while they slip money and a wish list into the politicians' pockets. It's not a "can't" fight incentives situation; they won't fight them because they created them!

Then through their PR departments, they sow discord by trying to persuade everyone to think it's everyone else's fault. It's the pharmaceutical companies (it is). It's the providers (true, but they are also the providers). It's the politicians (yes, the one's they lobbied). What they don't want people to think is that they are all working together to fuck us over. So the pharmaceutical companies and the providers and the politicians likewise, through their PR departments, blame everyone else.

THEN, in this entirely unworkable system, the one they have control of, where they get to decide what is and isn't considered murder, the ruling class has the audacity to chastise the public for cheering on the death of an avatar that represents the system.

figassis• 2 years ago

Lobbying, like for example every big tech now donating $1m to Trump’s inauguration. That’s just the start. What do you think is the motivation for that?

sgammon3• 2 years ago

Donations are not the same as lobbying, especially within the context of a campaign or inaugural committee. Obviously the motivation is to curry favor / build influence.

renewiltord• 2 years ago

Interesting. I was curious what a single-payer healthcare system like the NHS has in comparison. The NHS is good for this because it has generally good data availability.

Here’s the summary for autism: https://digital.nhs.uk/data-and-information/publications/sta...

Based on this, I think the truth is that most societies are going to struggle to care for these people. We face a problem with a workforce expanding too slowly and increasing rates of these mental conditions. We’re going to have to either ration care or let something else go.

At this point, we have 1% of the federal budget dedicated to dialysis. Over time, I expect that we will allocate similar quantities of money to other chronic conditions that we have no means of escape from. Certainly some of the tools we use incentivize bad behavior (like the flat payment structure described in the article) but the fact that healthcare in another country is facing the squeeze indicates this isn’t the broad trend motivator.

If we do not accept the reality of rationing care, we must accept the reality of letting go of something else: pensions, our ability to patrol foreign waters, incentivize businesses or so on.

It’s an interesting thing. I would not have expected one of these things to have been a Precipice for our society.

orf• 2 years ago

At this point, we have 1% of the federal budget dedicated to dialysis

That’s insane, it can’t possibly be correct.

bediger40002• 2 years ago

The NHS is good for this because it has generally good data availability.

I predict that the USA will collect less and less data, and allow access to less and less of what is collected.

drewcoo2• 2 years ago

predict that the USA will collect less and less data

Then you're betting against insurance industry and their legion statisticians. The odds favor the house.

retskrad• 2 years ago

When dictators like the Assam regime opresess their people, everybody can see it. When corporations and laws like ObamaCare do the same it’s much harder to pinpoint it because the oppression is diffuse and everyone can see it when the CEO gets taken down.

JohnTHaller• 2 years ago

The 'death panels' you're thinking aren't a result of the Affordable Care Act. Without the ACA, my kidney donation to my Dad would be a pre-existing condition and preclude me getting care for my remaining kidney. Fun fact: When I've mentioned this in social media online, Republicans love to tell me that it's my 'fault' for donating it so I have to suffer the consequences despite the fact that it saved the government money overall between Medicare and the VA.

kthejoker2• 2 years ago

I know it's a myth, but this is just the late stage capitalism equivalent of the Spartans casting away weak children and every eugenics program ever.

Either Benji (the kid in the article) gets the help they need to be part of our society or they don't.

Who are we?

antisthenes• 2 years ago

You know there's a middle ground between killing unhealthy babies and unlimited lifetime help and therapy for everyone.

There isn't an unlimited supply of mental health professionals either.

Who are we? Hopefully someone who can have a reasonable discussion without resorting to reductionist rhetoric of the extremes.

drewcoo2• 2 years ago

And there are always people standing in the middle ground deciding "objectively" who lives or dies. Sometimes that middle is the problem.

jayski• 2 years ago

I'm all for capitalism, but still don't understand how people can work in that cost-cutting department.

If I was working there, Id quit the moment I realized what my job was about. Id honestly rather be homeless that get a paycheck from that kind of work.

jareklupinski• 2 years ago

Id quit the moment I realized what my job was about

there's a scene in Arrested Development where Buster believes he's playing a airplane simulator video game, when in reality he was piloting drones for the Air Force the whole time

https://www.youtube.com/watch?v=IWKjZzm9VnU

UnitedHealth Is Strategically Limiting Access to Treatment for Kids with Autism

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