Deny and delay: The practices fueling anger at U.S. health insurers

https://www.washingtonpost.com/business/2024/12/16/deny-delay-health-insurance-anger/

by pseudolus • 2 years ago

50 30 2 years ago

pseudolus• 2 years ago

c222• 2 years ago

I recently had a procedure denied (after the fact) because the price charged was apparently "excessively above the average" price for that procedure, leaving me on the hook for the full amount. It felt like the opposite of being insured.

I also couldn't wrap my head around why they didn't just pay whatever they thought it was worth and let me cover the rest.

xena• 2 years ago

Doing that would make sense, and we can't have that now, can we?

cogman10• 2 years ago

I also couldn't wrap my head around why they didn't just pay whatever they thought it was worth and let me cover the rest.

Because insurance would then just lowball the cost of everything.

Insurance needs to either do what they say they do, cover x% of procedure cost with a maximum yearly deductible or we need to be talking about why we have insurance in the first place.

We need new regulations around health and insurance. Ideally, public insurance.

evoke4908• 2 years ago

Because insurance would then just lowball the cost of everything.

They do. Many, many billable items are priced to the limit that insurance will pay. Insurance and providers have agreements on the prices they can charge for certain procedures or supplies.

It used to be the norm that insurance would pay their maximum and leave the rest to you. Sometimes the provider would waive the difference, sometimes it was billed to you.

The cost of healthcare is 100% an artefact of insurance price fixing and absolutely nothing else.

bfrog2• 2 years ago

Insurance is a terrible name for what we have, its not insurance, its blackmail.

You dying and zero being paid out by the insurance company is the best profit margin they can ask for, that's the entire goal of an insurance company at this point.

s1artibartfast4• 2 years ago

If there are no payouts, then they have to return all premiums. They only get paid a percentage of covered care.

This presents it's own set of tradeoffs, namely between decreasing premiums to attract subscribers, and what is covered, to keep subscribers happy.

lovich2• 2 years ago

I also couldn't wrap my head around why they didn't just pay whatever they thought it was worth and let me cover the rest.

Because nothing is forcing them to do so. If you don’t like it, what are you going to do about it? Shoot their CEO or something? They have all the leverage.

vjulian2• 2 years ago

I resent that the Pentagon decides who the bad guys are and that the population large accepts what it’s told.

nradov2• 2 years ago

Was the provider in or out of your health plan's network? If the procedure was performed by a network provider then it's likely they made a billing error and submitted a claim in excess of the negotiated rate. But it does suck that patients are caught in the middle.

c222• 2 years ago

In network! I considered challenging it, but the amount was small enough to not be worth my time.

ChrisArchitect2• 2 years ago

Feds help health insurers hide their dirty secret: denials on the rise

https://news.ycombinator.com/item?id=42408925

ChrisArchitect2• 2 years ago

Doctors Say Dealing with Health Insurers Is Only Getting Worse

https://news.ycombinator.com/item?id=42398069

kelseyfrog• 2 years ago

Calling IncreasePosts to determine whether or not this is just an Internet bubble.

mrangle• 2 years ago

It's no surprise that the Washington Post is capitalizing on domestic terrorism for issues that it approves of.

The single reason that it is able to do this is that these outlets were not held to legal account for doing the same thing surrounding George Floyd.

At least they aren't allowing their January 6th rhetoric to cloud their journalistic vision.

There is no "anger at US Health insurers" that is new. Or is otherwise beyond the anger at the way the system is forced to balance itself in any other arena in which fees, costs, and profit are always in relative flux and people can't get it all.

The only novelty in this anger is that someone was murdered and now the Washington Post has declared the murderers issue to be sanctified. Which is exactly what you aren't supposed to do, or at least when you aren't supposed to do it, when you don't want to be seen to be supporting domestic terrorism.

The insurance industry sucks, but it sucks by its nature. Its not "broken" nor widely exploited except in the notion that its existence is a corrupt economic act.

But its current detractors wouldn't dare be rid of it. Oh no, it isn't that bad. And yet, we are in another period of being harangued with direct and indirect sympathies for murder.

Deny and delay: The practices fueling anger at U.S. health insurers

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