The insurance company would respond that they do in fact employ doctors and nurses. These people however are unlikely to be licensed in the patients state and include doctors who may have found difficulty with the practice of medicine whether for capability, competence, ethical or other issues. The insurance company may require a "denials per hour" and "appeals denied per hour" metric from its employees with termination the reward for human kindness. These are profit centers with minimal acknowledgement of medical reality and no concern for patient care. They almost certainly increase patient costs and decrease quality of care. But hey! a million here a million there and its all good fun in the stands at the Masters.
I am in Australia, so not affected by US healthcare. However, I have a degenerative upper back problem which meant I had to go through the whole suing the companies insurer to get compensation. It took five years and many visits to all manner of doctors, especially doctors that the insurer wanted to examine me. What I learned from that experience is that doctors will literally say anything, even if it's completely invented, to get the insurer off the hook. Doctors lie through their teeth, and I'll never trust a doctor again. I was fortunate, I went to court, and the judge was able to see through their lies and I won compensation. But you have to ask, how can a medical professional lie for his or her own personal gain? They are scum.
Happens ALL THE TIME! And it’s nurses ( or less) working for the insurance companies make the initial denials prior to the ‘doctor’ denying on appeal or through request for peer review. As if ……
A lot of times it happens for good reason. It's like going to a mechanic and the mechanic saying "YOU NEED A NEW ENGINE. It will be 12,000 dollars". Then a plan coming in and saying "why don't you try changing out the head gasket first.... that's the proven route".
@@flexor212000for good reason ... I mean I guess if you consider lining their pockets good reason then yeah. However, myself and the majority of citizens don't consider that for good reason 🤷
United Healthcare (UHC) even rips off physicians and hospitals. - Last year, I needed a surgery. I got the required pre-approval for the surgery via the ore health insurance company Premera. Then, without my knowledge at the time, the hospital switched payment processors to a subsidiary of UHC called Optum. The hospital administration apparently didn't realize they needed to get a new pre-authorization via the new UHC subsidiary payment processor. I received the excellent surgery. Afterward, the insurance company, Premera (not part of UHC), denied payment because the original pre-authorization was deemed invalid because of the hospital's change of processing company. Premera told me the payment denial was not my problem and that I was not liable for any of the costs, not even a small co-pay. Meanwhile, both the hospital and the surgeon were stiffed by Premera and the UHC subsidiary payment processor. The hospital had billed $33,000.00 for the surgery. Premera calculated it would pay the hospital about $10,000.00 for the surgery, and then denied the claim and paid nothing at all to the hospital and the hospital employee surgeon. - The insight here is that the system not only endangers patients, it engages in snafu ripoff schemes that also stiff the hospital and the physicians. Everyone blamed the hospital administration for not realizing all the additional hoops they needed to jump through because they switch billing / payment processors to a UHC subsidiary called Optum. After discussions with the hospital, surgeon staff, and so on, it appears the hospital may have lost millions of dollars in revenue because of this administrative snafu. - These are the ugly truths of the "healthcare" in America.
Are there, or have there been any bills in Congress to remove this LOOPHOLE so companies like United Healthcare must be held responsible for their actions? I honestly did not know they had been granted this benefit. They have appeared to make themselves untouchable as they do harm to millions of Americans.
Physician here. It’s usurpation of the physician-patient relationship in the name of profits. I think checks need to be in place for appropriateness, but the pendulum needs to come back to the patient.
Exactly, and therein lies the root of the problem. If Brian Thompson had chosen to allow most or all of those denied claims to go through, he would have been acting against the interests of their stockholders. The company would have fired him and replaced him with someone who would do it. However, heath insurance is supposed to be to protect people's health. That makes it a systemic issue. This system has remained in tact after Mr. Thompson's death. In other words: The system must change!
Corporatocracy, like cancer, requires perpetual growth or it dies. Curing people of illness is not a sustainable business model. Making people sick is. Enter the evil twins: the food industry and govt regulators.
@@homespuncovers89, yeah, he said that, all right. The part he left out was that they'll keep putting the ultra-rich people first and keep crapping on the working class ones.
In the UK and in many countries in the West there was a tendency to privatise sectors that were formerly financed and run by nation states. I did not feel unease about this until the prison system in the UK for remand prisoners was privatised and handed over to private security companies. I did not see this as a good thing. Similar for care of the elderly and childcare which can have problems when the profit motive overrides the humanitarian duty to actually provide care to the people in question.
Those sectors are typically called 'Inflexible Demand', which include food, water, housing, & utilities on top of what you already mentioned. These are areas that every person should have reasonable access to in order to maintain a standard of living consistent with our advanced economy. Flexible demand commodities are things that are by choice, luxuries, or products/services where there is ample competition but you can also live without and not have it negatively impact your life. So, some people think its nuts to pay $1400 for the latest cell phone, but you have the right to pay that price if you really want a high demand item and companies have the right to sell it at a price/profit margin that the market will bear... but you won't DIE if you don't get that cell phone, and there are many, many much lower priced alternatives on the market for your communication needs.
Luigi Mangione actually served a purpose bringing this up to the forefront of public. Lets see how it gets pushed aside after. As politicians are paid for as we all know. Then they wonder why we are cynical.
I think the fire is lit. A large segment of the population has had their consciousness united around the topic. Many people needed a hero and associate strongly with both Luigi and Brian as they can now put a face on the problem and associate with one side. But we need to shift away from the person I sacrificed two lives to point to the topic and deal with the overarching issue of predatory corporate control over the citizenry. It's not just health insurance. It's residential property owning. An essential precursor to citizens having personal power. It's wages vs stock market profits. Luigi made himself a martyr for the cause. Focus on the cause.
UHC send over $100M in lobbying and over $35M in advertising last year. Health insurance companies are actily trying to stop us from getting universal healthcare in US.
Hey, Doc -- Former 3rd Party Dispute tech, here.....My job was to assist in disputing insurance denials, working for a 3rd party company that performed those jobs so hospitals didn't have to. UHC was always the absolute worst company to deal with, and they disputed virtually every charge, every time - our legal and medical teams dealt with them more than any other insurance company.
Somehow it doesn't surprise me this was your experience with the company that managed to become the biggest and most profitable in this sector 👀 To me as an European these things are something straight out of a dystopian fiction, how can you find what's wrong and not provide care if it's available in the hospital due to some CEOs and clerks, like whoa 💀
I'm half American and half Costa Rican. In little ol 3rd world country Costa Rica, I pay $50 a month for the whole family. It isn't perfect, but it's levels better than being denied care. All child births are free to anyone, citizen or not, paying into the system or not, as well as for young children and their mothers. And Private care, where you pay out of pocket, is waaaay cheaper than in the states. I just got 5 fillings, paid private cuz I didn't want to wait. $300 total. In the states, I got bit by a copperhead (Kansas 2006) and was billed $30,000 for going to the emergency room, antivenom, and spending a night at the hospital. At least I wasn't denied care. That's just satanic. Wake up people. United Health donated to both parties. The system is broken. Healthcare and education and prisons and policing should never be for profit.
Yes, "Corporate Speak"...or as everybody else calls it...lying. For profit health insurance should not exist, it is anathema to the whole point of medical care. Cheers!
@@michaelschaefer1904 I live in a "third world country" with universal healthcare, my country may have problems, but when i was born, i had to be hospitalized for several weeks due to an infection, my family was poor, if i was born in america in the same conditions, i probably would've died
I feel like there is a small distinction, all though the effects are still the same. Corporate speak is also a way of living; having made so many cold, profit-first decisions, makes these people emotionally blunt, and in some cases, truly believing the things they are doing is the right thing. So while they might be telling a lie objectively speaking, they might not perceive it as such, which shows how corrupt systems, corrupt people.
Why are the Non-medical people making decisions for my healthcare? Doctor, you are so correct. They want to practice medicine without license, they should be held accountable for their ignorant decisions when it comes to medicine.
We have parents now being held accountable for their children's crimes. It's time to hold these people accountable for denying people's claims and allowing them to die. Shame on them no wonder American's are fed up with this corporate greed. Sad to think how many lives they have ruined, families also.
@@PB-ho6dm Insurance companies are scams. They sell you an idea that you'll get medical expenses paid. Then they deny your claim. This is called a scam. What if you paid me $100,000 for a Porsche and then I told you it would be delivered next week... Then next week came and you didn't receive your car? Well, same thing - a scam. This is exactly what insurance companies do.
Keep in mind that United Healthcare (UHC) even rips off doctors and hospitals. - Last year, I needed a surgery. I got the required pre-approval for the surgery via the ore health insurance company Premera. Then, without my knowledge at the time, the hospital switched payment processors to a subsidiary of UHC called Optum. The hospital administration apparently didn't realize they needed to get a new pre-authorization via the new UHC subsidiary payment processor. I received the excellent surgery. Afterward, the insurance company, Premera (not part of UHC), denied payment because the original pre-authorization was deemed invalid because of the hospital's change of processing company. Premera told me the payment denial was not my problem and that I was not liable for any of the costs, not even a small co-pay. Meanwhile, both the hospital and the surgeon were stiffed by Premera and the UHC subsidiary payment processor. The hospital had billed $33,000.00 for the surgery. Premera calculated it would pay the hospital about $10,000.00 for the surgery, and then denied the claim and paid nothing at all to the hospital and the hospital employee surgeon. - The insight here is that the system not only endangers patients, it engages in snafu ripoff schemes that also stiff the hospital and the physicians. Everyone blamed the hospital administration for not realizing all the additional hoops they needed to jump through because they switch billing / payment processors to a UHC subsidiary called Optum. After discussions with the hospital, surgeon staff, and so on, it appears the hospital may have lost millions of dollars in revenue because of this administrative snafu. - These are the ugly truths of the "healthcare" in America.
As a patient living w prog ms i'm disgusted w the entire system- including docs in it for the lifestyle w no interest in health, medicine, or dealing w patients w health issues rather than a bunch of test referrals. I've gone w/out a gp or any physical doc since feb 2020. I've been getting drugs however i can. W an atrophied thyroid i'm looking online for synthroid 175mcg w no rx. Its beyond me that so many docs think i cant possibly be interested in my own health & be able to read more than: the divine comedy
United Healthcare is responsible for my mother's death. I have no sympathy for the devil. I celebrated last week, as did many people who have lost loved ones because of these greedy insurance companies. There's not been any accountability... until last week.
United Healthcare (UHC) even rips off doctors and hospitals. - Last year, I needed a surgery. I got the required pre-approval for the surgery via the ore health insurance company Premera. Then, without my knowledge at the time, the hospital switched payment processors to a subsidiary of UHC called Optum. The hospital administration apparently didn't realize they needed to get a new pre-authorization via the new UHC subsidiary payment processor. I received the excellent surgery. Afterward, the insurance company, Premera (not part of UHC), denied payment because the original pre-authorization was deemed invalid because of the hospital's change of processing company. Premera told me the payment denial was not my problem and that I was not liable for any of the costs, not even a small co-pay. Meanwhile, both the hospital and the surgeon were stiffed by Premera and the UHC subsidiary payment processor. The hospital had billed $33,000.00 for the surgery. Premera calculated it would pay the hospital about $10,000.00 for the surgery, and then denied the claim and paid nothing at all to the hospital and the hospital employee surgeon. - The insight here is that the system not only endangers patients, it engages in snafu ripoff schemes that also stiff the hospital and the physicians. Everyone blamed the hospital administration for not realizing all the additional hoops they needed to jump through because they switch billing / payment processors to a UHC subsidiary called Optum. After discussions with the hospital, surgeon staff, and so on, it appears the hospital may have lost millions of dollars in revenue because of this administrative snafu. - These are the ugly truths of the "healthcare" in America.
This is exactly the way I see it, the Shareholders come first the management are responsible to them. This 100% why the system is broken, the commercial sector overrides the health sector; profit is the priority!
I hate to break it to you, but charities beg for donations to run and profitable businesses are designed to offer services for a fair price. If a company is too profitable,it will attract competitors who want access to the profits. This is how an efficient free capital market works.
Agreed, however, note that Thompson had fucked over only the shareholders! He knew UNH was being investigated for fraud before it was announced, and sold all his shares to the tune of millions, screwing the shareholders along with the atrocious harm he has caused to medical patients. Sort of funny that they stepped over his corpse to hold the shareholder's meeting on time, lol.
@@theliftexpert Well, then the free market clearly isn't equipped to handle health care. Services at a fair price? Everyone from patients to physicians to former insurance company employees are speaking out loud and and clear right now. The profit-focused insurance model doesn't benefit anyone except senior executives and shareholders.
@@jaytc3218 the free capital market is perfectly equipped to handle any industry, it doesn’t matter if you are renting a car,buying a house, require health care or are buying commodities at Walmart . The market is efficient.
@@jaytc3218 "Well, then the free market clearly isn't equipped to handle health care." Correct. Most businesses, despite some unethical practices, mostly make money by providing more/higher quality/cheaper products. Insurance companies primarily make money by denying coverage--the product you paid for.
I agree with everything the doctor said. But, I also want to add that there's no room for corporate America in the administration of healthcare. Corporations have but one goal: Profit. Healthcare is a human right that is not compatible with profiteering by greedy individuals. Single-payer, Medicare for all is the only way forward.
Hate to break it to you, but healthcare is not a human right. Rights are things that can't be taken from you. They are not a service you are entitled to.
@@zorkman111 You poor soul. You've obviously been shortchanged by Fox News. You have a right to life and a right to thrive in life. Both of these things can be taken away from you by a shooter. How does that jibe with your definition of rights?
@@zorkman111According to the Universal Declaration of Human Rights from 10 Dec 1948, proudly presented by Eleonor Roosevelt, healthcare is. Check Article 25.1.
Leaked audio shows these corporate execs are positively gleeful when discussing things like limiting anesthesia during surgeries, etc. They are rubbing their hands, cackling, and counting their billions in profits. So, yeah, maybe expecting compassion from all of us is a stretch.
Anthem is my insurance. I’ve recently had multiple surgeries under them and got REALLY scared when they talked about limiting anesthesia. I’m a unique case where I generally require more. I’ve woken up in the middle of a procedure, heard the Drs go “she’s awake,” and was put back under. It’s something nobody should have to live with. They’re absolute vipers in the grass.
Excellent 👉point !!! Under what authority?? Insurance company's allowed to practice medicine ??? They are not qualified to do that " even Nurses or Nurse practitioners , have limited power " so these 💰 money hungry Insurance providers offers nothing more than half empty promises? so Why do they exist???? Government needs to step in !!! To 🛑 Stop the corruption " Audit them every year,, yes the government can set-up a System " European countries France 🇫🇷, Germany 🇩🇪, Britain & Canada 🇨🇦 have government sponsored Healthcare systems and all the European countries !!! Including China 🇨🇳 and Russia 🇷🇺 " So America 🇺🇸 the Richest country still rely on corrupt Self serving profits based Insurance companies??? This needs to be changed Urgently !!! Put the people first !! Deal 🤝 with the Profit later "😊
The CEO's will say that they put patients first, but their actions reveal their true priority, which is to make as much money as possible. "No matter what anyone says, no matter the excuse or explanation, whatever a person does in the end is what he intended to do all along" - Cus D'Amato
This and 1000 other things about the insurance industry need to change. Getting ready to graduate medschool in the Spring and it's just so nice seeing providers giving voice to this. Thank you.
Scapegoating doctors, zero accountability, and dead patients. And we see this Luigi kid as a villain? How long will Americans allow themselves to be exploited by these monsters
Several times in my life, these delays and denials came close to ending my life. I’ve been shouting from the rooftops for these reforms for decades, voting for national candidates who support universal healthcare. It’s time for change.
if a parent doesn't take a child to get medical attention and the child dies the parent goes to prison for that crime. Health insurance companies do the exact same thing IT IS a crime a well documented crime both legally and morally.
@@melaniedahl1572 It's very legal. If you think it's illegal, just try bringing a suit with a contingency lawyer. You won't win, and you likely won't even get a lawyer to agree to do it on contingency because the insurance companies are doing this all within the bounds of the law.
It doesn't get discussed enough how adversely all of this affects doctors too. The best doctor I ever had came out of the Navy. Our very first visit lasted 45 minutes because he wanted to know all about me. After a couple of years of grinding in this system, he closed his practice and re-enlisted in the Navy.
This is just crazy to me. I'm in one of EU countries and while disputes happen - they exist even betwen the national insurance and the public hospitals - the treatment always goes first, disputes later. For things like wheelchairs, pensions etc they can go beforehand, but then still - there is always medical personnel involved in the insurance decisions, if not a doctor then a nurse, but never just a clerk or a CEO. What a crazy system 😮 A murder is always a sad and bad thing, but how qrotesque is the surprised Pikachu face that the media and CEOs are putting on right now as if it wasn't just hanging in the air for quite some time due to the situation they created...
Thank you for this posting💜 I'm an independent person living a simple life under the poverty level, and when I needed surgury, insurance denied it💙The doctor approved it, and fought for me, but guess who won? You know who. Eventually, I had to get the surgery and pay for it. My case is a small one, but I'm sure there are millions like me in the USA where money rules . I appreciate your speaking up for us "little people"🧡
Of course it's a complete lie when they say they put patients first. Not only is it a lie (in these instances), but taking into account the severity of issues that arise from these lies, it's criminal.
What the lady Dr. said exactly happened to a physician who told me his insurance company made him take a generic drug first. After he almost died and had to have a heart operation he now has to take two medications for the rest of his life. He sued the insurance company and they have to provide those medications for free.
You are by far one of the more intelligent people talking about this. Most smart doctors say nothing. But those like you who can point and say hey this is wrong loudly are real heros
He mentioned later that they will continue Thompson’s legacy by denying care that’s “unnecessary.” You mean the care that the patient’s physician determined is necessary? Wow, thank you so much.
Really sad to say not many people think Thompson has much of a legacy. I also feel for Mangione. He must have been really upset and it worked on his mind to do what he did. He seemed like a compassionate nice kid.
@ No, if anything Thompson left a dark trail for these scumbags to continue. I feel for Mangione too. The fact that he had things to look forward to in his life and it takes one medical emergency to derail it. A story that so many of us have faced in dealing with this evil system.
When insurance companies over ride the recommended treatment of a doctor or deny care they are essentially practising medicine w out a license and that is illegal
In America? In the Make America Great Again movement -- this is fine. Let white men, middle management decide your fate. but ALL POLITICIANS IN DC GET PREMIUM CARE. THEY DON'T HAVE ANY OF THIS SCRUMERY.
Until Congress does something, nothing will change just talk. It should be outlawed to give kickbacks or more polite lobbying of politicians. We all have to get United on changing Healthcare.
If insurance companies are given latitude to override a health care provider then they should also be held responsible fo the malpractice repercussions $$ should the patent suffer harm from their imposed decision.
All the hate seems to be directed at the CEOs of these health companies, but very little on the shareholders of these companies. They must have been aware of the antics that were going on. I guess greed will overcome anything.
In many cases shareholders are pension pots managed by a set of finance directors who are competing with rival investment groups to provide the greatest return for their investors regardless as to how this is achieved. An example of this was the Vatican Bank which some journalists discovered had shares in a condom factory in spite of the RC church prohibition on artificial contraception. These investments were quickly got rid of. What is needed in this scenario is the setting up of not for profit organisations with strict medical and scientific oversight so that the profit motive is not the primary driver of financial performance in such organisations.
@@vincentho6840 Brian Thompson (along with other leaders in the company) was doing inside trading and sold millions of dollars worth of their shares illegally. So regardless how they obtain their shares, they still commit fraud.
Sounds like we need a law that says insurance companies have to listen to a doctor's request as long as the partient is covered for it in the insurance agreement.
The problem is that hospitals also benefit from the expense of healthcare, so doctors could be pressured to give unnecessary care for profit to the hospital owners. The only real solution is to remove private ownership of hospitals and private insurance completely from the system. Then doctors are only motivated by giving proper care. There can not be a profit incentive to give or withold care; it leads to problems that negatively impact the patient.
Sue United Healthcare and Any Other Health Insurance CEO for Medical Malpractice and Not the Doctor if Coverage was Delayed or Denied and it Harmed the Patient!
@ I agree with you but it’s gotta be against the drug companies and the insurance companies and we see how far that went with Covid mass murder only huge scale and it did come from China and the food and drug admin administration put out a report that ivermectin was a good protocol but it only cost five cents a tablet to make it so there was no way to make billions but we don’t need to be shooting people
This video didn't help that you are sadly misinformed. There are licensed doctors who review information from doctors. Sometimes, unfortunately, the patient plan that they chose does not include the care or prescription. This is what a peer to peer is for. It is a dedicated line for doctors to speak. This video is terribly misleading. Half the true is a whole lie.
@@ThemDevons I'm reassured. If my doctor's therapy is rejected, there are licensed doctors who have never seen me review information from my doctor without involving me. It's like the era of house calls has been revived by insurance companies! Or, maybe not. On a related note, have you ever looked at durable medical equipment purchased through insurance plans? My wife's wheelchair was about $800, and at that I didn't notice the payment I made wasn't a purchase, it was the first month of a rent-to-own plan. The $800 wheelchair can't be found for more than about $250 at free market prices. Equipment, services, and supplies paid for with insurance coverage should be competitive free market pricing. That doesn't happen. It's interesting how insurance companies assure customers a health care "network" watches out to make sure we're not overcharged. In the cases I've researched, the network actually owns the insurance company. High prices justify high premiums.
Agree with this physician. As a Mentla Health doc I have also experienced this nonsense. I also blame the government because I feel they should hold the insurance companies to the fire. I cannot tell you how many times they shafted my patients and even myself. They always go for the least expensive option which is not a safeguard for my patients. They put money and greed first over Healthcare of patients. Don't get me started.
I agree, and I have a potential fix for this. If a health insurance company denies or refuses authorization, then the patient should file a notice of negative impact. A link must be included on every denial that the doctor can click. That goes to a Department of Health and Human Services system. The doctor enters their ID Number (DEA Number?) and clicks a button saying the patient's health was negatively impacted by this decision. The doctor then gets back to helping patients. The insurance company must then follow up with the patient and have them provide the symptoms they are experiencing and a summary of the impact of those symptoms. The health insurance company must then decide within 24 hours to either keep the denial or pay for the car the doctor prescribed to the patient. If the health insurance company keeps the denial and the patient dies or suffers permanent harm, the patient or their estate can sue the company. The company is held liable for its decision. This also allows HHS to provide statistics in real-time. The law required to implement this could also direct HHS to publish quarterly reports showing the denial rate and the number of lawsuits brought against each health insurance company.
The root of the problem, here, is that in the wake of the "Citizens United" Supreme Court ruling of 2011 (which took the INSANE position that when a person or company gives a politician money, it's constitutionally protected "free speech"), we basically don't have campaign finance laws anymore. So what we're left with is a political landscape in which only a handful of ultra-wealthy actors (including health insurance companies) are able to truly influence politicians and they get whatever they want...and that, right there, is the ONLY reason why these for-profit health insurance companies continue to exist: they bribe the politicians who, in turn, won't stand up to them for fear of losing re-election and that's where we're all held hostage.
@@bobaldo2339 Yes, at present, we have a government that exclusively serves the socioeconomic elite, not the nation as a whole. This is nothing new in human history and it never bodes well for the masses of any nation.
Actually how rich people do it. They have their own doctors who don't even need to mess with insurance companies because their clients can pay cash no matter the rates
I remember when Columbia HCA tried to take over the health industry in the early 90's Physicians left the profession and hospitals closed down. This conglomerate refused patienst to be hospitalized because their CEO's and executives need to make their bonuses. Hospitals soon went out of business and then the Columbia did to.
We have free universal Health care in Canada . I’m proud of this , the unfortunate part with over immigration our resources are totally stretched now .
Plenty of dual citizenship people living abroad coming back to Canada only for free treatment then leave again. This has been going on for decades by hundreds of thousands of fake canadians.
This is why i love you so much. Your rigorous honesty is what every person should look to and achieve. The insurance companies are NOT physicians; they are vastly different jobs so they should not have the legal right to over throw a decision that he/she makes on the patients care or any other job for that matter. They are "not" qualified to make that judgment no more than a physician is to override any other job they are not academically qualified to do either. These are peoples lives we're talking about for Gods sake. Unless the law is changed this will continue and hundreds, if not thosands of lives are at risk of suffering and of death.
Another misinformed person. Insurance companies have doctors.. REALLY good doctors with patients. It would be illegal for a customer service representative to deny anything. This review is not honest, it is misinformation. Doctors do not overthrow anything. Unfortunately, some people are only offered a certain package of insurance FROM their employer. Most of the time, employers would rather save money, than to save their employees. Insurance is like a debit card..not everyone with a debit card will decline, but some will decline if they have no money in the bank. Unfortunately, because of the wide spread of misinformation and misinformed doctors, they place everyone in the same category as benefits. In Insurance, we meet to make things easier for our members. Contrary to popular belief we actually love to help. It breaks our heart to discover someone elected a bad package or someone's jobs elected plans with high deductibles to save their money. I mean, we actuallt have cried once we disconnected the line with a member. The only way something is denied in Insurance is if it is not covered or someone has gone out of network. Even with that, if a doctor is out of network and that is the only doctor that can save your life. We actually help you by completing paperwork to process your claim as if the doctor is IN your network, but because the doctor is out of network he or she can add additional charges to your care. Also, not everyone with medical insurance has the same insurance for pharmacy. People are upset at United Healthcare for something they have nothing to do with. It is layers to this. Unfortunately, people are taking advantage of the ignorance of the general public. This is misinformation. Very very bad misinformation. I am a previous claims specialist and escalation representative for United Healthcare . I know more about the behind the scene than anyone who doesn't work for insurance.
Agreed ! I think it would be better to get rid of assurance companies alltogether and make it a "public service", no ? Why mix profit and health care ? (sorry if my english is not good)
If someone puts profits of people, it's going to anger some people. If someone puts profits over people they are contractually obligated to help, that's going to cause a lot more anger. I'll offer the same amount of sympathy that they offer: Very little.
This is the best, most concise and easy to understand explanation as to why our healthcare system is so egregiously fkd up. Thank you for this! It should be shouted from the mountain tops.
Exceptionally well stated. I do think it is interesting that United Health Care, as provided by employers and paid for in part by employees is by all accounts miserable. Yet, United Health Care's administration of a Medicare supplement has been exceptional. I think the difference is that in the latter, UHC is held accountable by a government agency. I also have found that doctors and surgeons associated with large hospitals tend to be exceptional. Those working for smaller, private for-profit groups actions are often inexcusable to the point it can be described as medical malpractice without consequences.
Here’s my proposal to combat unwarranted insurance denials: every denial must be approved by a physician. If that physician works for the insurance company, his or her decisions would be reviewed by an independent panel empowered to determine if the denials were legitimate. If a doctor struck out too many times with an excessive rate of unwarranted denials, his or her medical license would be revoked.
It sounds like a lot of extra bureacracy if you need to get a panel of doctors together. Particularly if the matter is time sensitive and it adds additional costs from the addition of the panel of doctors time costs.
@@jknox2: You misunderstood. It is better to review denials than meekly accept them. Moreover, the process I proposed would quickly weed out reviewers prioritizing profits over patients and immediately incentivize reviewers to make appropriate decisions as opposed to those focused more on the insurance company’s profitability than patient welfare.
There should be nothing that comes between a doctor and a patient. Not to mention that Healthcare should be non-for-profit. If a doctor says a patient needs something then the healthcare insurance provider pays for it. They should have no ability to say what is necessary and what is not necessary. It should be only in cases of fraud that Healthcare is denied.
it has been like this for 25yrs at least. No matter how many CEOs and Patients are dead, they do not care as long as they make 10 millions a year salary, and millions of stock options upon retirement😢
Insurance company decides what test we can do and what medication we may take, they override the doctor's decisions nowadays. It was not like this 20 years ago.
Common sense!!! Thanks Doctor!!! 🤞🤞🤞👍👍👍 The insurance costs are raising because of that "line of denials" strategy of insurances!!! & They have "experts" deciding what to do & when to do anything they want to. Why? To make the shareholders happy & to get bonuses at the end of the year or more. 🤷
I saw a comment the other day that stuck with me: Overriding a M.D.'s decision is practicing medicine without a license.
Yes, accountability, please.
I would go further, interfering with someone's ability to get medical care is harmful, murderous intentions.
The insurance company would respond that they do in fact employ doctors and nurses. These people however are unlikely to be licensed in the patients state and include doctors who may have found difficulty with the practice of medicine whether for capability, competence, ethical or other issues. The insurance company may require a "denials per hour" and "appeals denied per hour" metric from its employees with termination the reward for human kindness. These are profit centers with minimal acknowledgement of medical reality and no concern for patient care. They almost certainly increase patient costs and decrease quality of care. But hey! a million here a million there and its all good fun in the stands at the Masters.
That's the first thing that came to my mind as well!
I am in Australia, so not affected by US healthcare. However, I have a degenerative upper back problem which meant I had to go through the whole suing the companies insurer to get compensation. It took five years and many visits to all manner of doctors, especially doctors that the insurer wanted to examine me. What I learned from that experience is that doctors will literally say anything, even if it's completely invented, to get the insurer off the hook. Doctors lie through their teeth, and I'll never trust a doctor again.
I was fortunate, I went to court, and the judge was able to see through their lies and I won compensation. But you have to ask, how can a medical professional lie for his or her own personal gain? They are scum.
That makes perfect sense. I’m seeing a lot of pushback on this issue. Way overdue.
How an insurance company can override a MD is MIND BLOWING!!!!!! It is absolutely unacceptable!!!!
Happens ALL THE TIME! And it’s nurses ( or less) working for the insurance companies make the initial denials prior to the ‘doctor’ denying on appeal or through request for peer review. As if ……
A lot of times it happens for good reason. It's like going to a mechanic and the mechanic saying "YOU NEED A NEW ENGINE. It will be 12,000 dollars". Then a plan coming in and saying "why don't you try changing out the head gasket first.... that's the proven route".
@@flexor212000for good reason ... I mean I guess if you consider lining their pockets good reason then yeah. However, myself and the majority of citizens don't consider that for good reason 🤷
Unbelievable 🎉
Right!!!
As a physician…..I 100% agree. 30 years of corporate speak and it’s always the same bla, bla, bla..
It’s not “corporate speak” when medical insurance companies do it. It’s health gaslighting.
United Healthcare (UHC) even rips off physicians and hospitals.
-
Last year, I needed a surgery. I got the required pre-approval for the surgery via the ore health insurance company Premera. Then, without my knowledge at the time, the hospital switched payment processors to a subsidiary of UHC called Optum. The hospital administration apparently didn't realize they needed to get a new pre-authorization via the new UHC subsidiary payment processor. I received the excellent surgery. Afterward, the insurance company, Premera (not part of UHC), denied payment because the original pre-authorization was deemed invalid because of the hospital's change of processing company. Premera told me the payment denial was not my problem and that I was not liable for any of the costs, not even a small co-pay. Meanwhile, both the hospital and the surgeon were stiffed by Premera and the UHC subsidiary payment processor. The hospital had billed $33,000.00 for the surgery. Premera calculated it would pay the hospital about $10,000.00 for the surgery, and then denied the claim and paid nothing at all to the hospital and the hospital employee surgeon.
-
The insight here is that the system not only endangers patients, it engages in snafu ripoff schemes that also stiff the hospital and the physicians. Everyone blamed the hospital administration for not realizing all the additional hoops they needed to jump through because they switch billing / payment processors to a UHC subsidiary called Optum. After discussions with the hospital, surgeon staff, and so on, it appears the hospital may have lost millions of dollars in revenue because of this administrative snafu.
-
These are the ugly truths of the "healthcare" in America.
Are there, or have there been any bills in Congress to remove this LOOPHOLE so companies like United Healthcare must be held responsible for their actions? I honestly did not know they had been granted this benefit. They have appeared to make themselves untouchable as they do harm to millions of Americans.
Physician here. It’s usurpation of the physician-patient relationship in the name of profits. I think checks need to be in place for appropriateness, but the pendulum needs to come back to the patient.
@@JackBirdbath it’s “I don’t give two f**ks whether you L*** or D**!! I want my bonus so I can buy that yacht I’ve had my eye on.
The system is by definition a conflict of interest.
100%
Exactly, and therein lies the root of the problem. If Brian Thompson had chosen to allow most or all of those denied claims to go through, he would have been acting against the interests of their stockholders. The company would have fired him and replaced him with someone who would do it. However, heath insurance is supposed to be to protect people's health. That makes it a systemic issue. This system has remained in tact after Mr. Thompson's death.
In other words: The system must change!
@@lukedrillbrain9850but but the guy said they would continue to put people first. Weren’t you listening?!?
Corporatocracy, like cancer, requires perpetual growth or it dies. Curing people of illness is not a sustainable business model. Making people sick is. Enter the evil twins: the food industry and govt regulators.
@@homespuncovers89, yeah, he said that, all right. The part he left out was that they'll keep putting the ultra-rich people first and keep crapping on the working class ones.
Certain sectors shouldn't be for profit: Healthcare, education, and criminal justice.
In the UK and in many countries in the West there was a tendency to privatise sectors that were formerly financed and run by nation states. I did not feel unease about this until the prison system in the UK for remand prisoners was privatised and handed over to private security companies. I did not see this as a good thing. Similar for care of the elderly and childcare which can have problems when the profit motive overrides the humanitarian duty to actually provide care to the people in question.
Those sectors are typically called 'Inflexible Demand', which include food, water, housing, & utilities on top of what you already mentioned. These are areas that every person should have reasonable access to in order to maintain a standard of living consistent with our advanced economy. Flexible demand commodities are things that are by choice, luxuries, or products/services where there is ample competition but you can also live without and not have it negatively impact your life. So, some people think its nuts to pay $1400 for the latest cell phone, but you have the right to pay that price if you really want a high demand item and companies have the right to sell it at a price/profit margin that the market will bear... but you won't DIE if you don't get that cell phone, and there are many, many much lower priced alternatives on the market for your communication needs.
And the postal service!
Food, housing, high speed internet and utilities should be added.
...and housing.
Luigi Mangione actually served a purpose bringing this up to the forefront of public. Lets see how it gets pushed aside after. As politicians are paid for as we all know. Then they wonder why we are cynical.
correction they dont wonder they know and pretend to care while receiving lofty donations? all organized crime!
But we’re not going to let them. Plus, the media is drawing so much attention to it themselves they’re defeating the purpose of pushing it aside
Not a peep crying out for gun control.
I think the fire is lit. A large segment of the population has had their consciousness united around the topic. Many people needed a hero and associate strongly with both Luigi and Brian as they can now put a face on the problem and associate with one side. But we need to shift away from the person I sacrificed two lives to point to the topic and deal with the overarching issue of predatory corporate control over the citizenry. It's not just health insurance. It's residential property owning. An essential precursor to citizens having personal power. It's wages vs stock market profits.
Luigi made himself a martyr for the cause.
Focus on the cause.
ESPECIALLY PEOPLE ASSOCIATED WITH TRUMP.
UHC send over $100M in lobbying and over $35M in advertising last year. Health insurance companies are actily trying to stop us from getting universal healthcare in US.
And the politicians are helping them
Hey, Doc -- Former 3rd Party Dispute tech, here.....My job was to assist in disputing insurance denials, working for a 3rd party company that performed those jobs so hospitals didn't have to. UHC was always the absolute worst company to deal with, and they disputed virtually every charge, every time - our legal and medical teams dealt with them more than any other insurance company.
Somehow it doesn't surprise me this was your experience with the company that managed to become the biggest and most profitable in this sector 👀
To me as an European these things are something straight out of a dystopian fiction, how can you find what's wrong and not provide care if it's available in the hospital due to some CEOs and clerks, like whoa 💀
I received those calls, even I don't know why it is denied and i am expected to resolve it.
As an RN, I hated that co….
@@haineko1989 the shareholder is more important than the patient. Our politicians have convinced enough people to vote against their own interests.
@@OberynTheRedViper Yep. And that’s on Republicans, not Democrats or Independents.
ABSOLUTELY BRILLIANT DOCTOR...100% SPOT ON.
They are disgusting. Must be consequences for them over riding a doctor's orders.
We all need to speak up now. Thank you for voicing what we are all thinking. Keep it up.
People have been speaking up but it took a bullet to get attention.
As a physician, I thank-you for expressing the truth of what is endured in our profession.
I for one am sorry you professional physicians must deal with this corruption.
I'm half American and half Costa Rican. In little ol 3rd world country Costa Rica, I pay $50 a month for the whole family. It isn't perfect, but it's levels better than being denied care. All child births are free to anyone, citizen or not, paying into the system or not, as well as for young children and their mothers. And Private care, where you pay out of pocket, is waaaay cheaper than in the states. I just got 5 fillings, paid private cuz I didn't want to wait. $300 total. In the states, I got bit by a copperhead (Kansas 2006) and was billed $30,000 for going to the emergency room, antivenom, and spending a night at the hospital. At least I wasn't denied care. That's just satanic. Wake up people. United Health donated to both parties. The system is broken. Healthcare and education and prisons and policing should never be for profit.
Amen
Well said.
Thank you for this! This needs shared 1,000,000,000 times!
Yes, "Corporate Speak"...or as everybody else calls it...lying. For profit health insurance should not exist, it is anathema to the whole point of medical care. Cheers!
Medical care or you mean, lying care.
The so-called nonprofits aren't much better.
@@michaelschaefer1904 I live in a "third world country" with universal healthcare, my country may have problems, but when i was born, i had to be hospitalized for several weeks due to an infection, my family was poor, if i was born in america in the same conditions, i probably would've died
I feel like there is a small distinction, all though the effects are still the same. Corporate speak is also a way of living; having made so many cold, profit-first decisions, makes these people emotionally blunt, and in some cases, truly believing the things they are doing is the right thing. So while they might be telling a lie objectively speaking, they might not perceive it as such, which shows how corrupt systems, corrupt people.
Why are the Non-medical people making decisions for my healthcare? Doctor, you are so correct. They want to practice medicine without license, they should be held accountable for their ignorant decisions when it comes to medicine.
That never happens. They are doctors who make decisions according to your plan. If it is in your plan. It will be covered.
We have parents now being held accountable for their children's crimes. It's time to hold these people accountable for denying people's claims and allowing them to die. Shame on them no wonder American's are fed up with this corporate greed. Sad to think how many lives they have ruined, families also.
Yes, persident need to approve this stuff... citizens have someone to blame and to pay for damages
@@PB-ho6dm Insurance companies are scams. They sell you an idea that you'll get medical expenses paid. Then they deny your claim. This is called a scam.
What if you paid me $100,000 for a Porsche and then I told you it would be delivered next week... Then next week came and you didn't receive your car? Well, same thing - a scam. This is exactly what insurance companies do.
As a doctor: so true. Good analysis.
Keep in mind that United Healthcare (UHC) even rips off doctors and hospitals.
-
Last year, I needed a surgery. I got the required pre-approval for the surgery via the ore health insurance company Premera. Then, without my knowledge at the time, the hospital switched payment processors to a subsidiary of UHC called Optum. The hospital administration apparently didn't realize they needed to get a new pre-authorization via the new UHC subsidiary payment processor. I received the excellent surgery. Afterward, the insurance company, Premera (not part of UHC), denied payment because the original pre-authorization was deemed invalid because of the hospital's change of processing company. Premera told me the payment denial was not my problem and that I was not liable for any of the costs, not even a small co-pay. Meanwhile, both the hospital and the surgeon were stiffed by Premera and the UHC subsidiary payment processor. The hospital had billed $33,000.00 for the surgery. Premera calculated it would pay the hospital about $10,000.00 for the surgery, and then denied the claim and paid nothing at all to the hospital and the hospital employee surgeon.
-
The insight here is that the system not only endangers patients, it engages in snafu ripoff schemes that also stiff the hospital and the physicians. Everyone blamed the hospital administration for not realizing all the additional hoops they needed to jump through because they switch billing / payment processors to a UHC subsidiary called Optum. After discussions with the hospital, surgeon staff, and so on, it appears the hospital may have lost millions of dollars in revenue because of this administrative snafu.
-
These are the ugly truths of the "healthcare" in America.
As a patient living w prog ms i'm disgusted w the entire system- including docs in it for the lifestyle w no interest in health, medicine, or dealing w patients w health issues rather than a bunch of test referrals.
I've gone w/out a gp or any physical doc since feb 2020. I've been getting drugs however i can. W an atrophied thyroid i'm looking online for synthroid 175mcg w no rx. Its beyond me that so many docs think i cant possibly be interested in my own health & be able to read more than: the divine comedy
Thank you for speaking out very obvious facts which mainstream media ignore!
Media decides to ignore. Luigi is a Saint!!!
United Healthcare is responsible for my mother's death. I have no sympathy for the devil. I celebrated last week, as did many people who have lost loved ones because of these greedy insurance companies. There's not been any accountability... until last week.
United Healthcare (UHC) even rips off doctors and hospitals.
-
Last year, I needed a surgery. I got the required pre-approval for the surgery via the ore health insurance company Premera. Then, without my knowledge at the time, the hospital switched payment processors to a subsidiary of UHC called Optum. The hospital administration apparently didn't realize they needed to get a new pre-authorization via the new UHC subsidiary payment processor. I received the excellent surgery. Afterward, the insurance company, Premera (not part of UHC), denied payment because the original pre-authorization was deemed invalid because of the hospital's change of processing company. Premera told me the payment denial was not my problem and that I was not liable for any of the costs, not even a small co-pay. Meanwhile, both the hospital and the surgeon were stiffed by Premera and the UHC subsidiary payment processor. The hospital had billed $33,000.00 for the surgery. Premera calculated it would pay the hospital about $10,000.00 for the surgery, and then denied the claim and paid nothing at all to the hospital and the hospital employee surgeon.
-
The insight here is that the system not only endangers patients, it engages in snafu ripoff schemes that also stiff the hospital and the physicians. Everyone blamed the hospital administration for not realizing all the additional hoops they needed to jump through because they switch billing / payment processors to a UHC subsidiary called Optum. After discussions with the hospital, surgeon staff, and so on, it appears the hospital may have lost millions of dollars in revenue because of this administrative snafu.
-
These are the ugly truths of the "healthcare" in America.
Sorry for the loss of your mother, stay strong
Sorry for your loss, but how? I've worked at United Healthcare, and we try our hardest to get claims approved, but providers come short of appeals.
That man did not deserve to be shot in the back by a coward😢😢,u feel sorry for the victim and the shooters family 😢😢😢😢😢
@@maryrunyon7 bot alert
Amen! Corporate greed is so shameful and has reached obscene levels. Keep making these videos, people need to hear this.
EVERSOURCE CEO IN NEW ENGLAND EARSM OVER 25 MILLION PER YEAR.
I NOW PAY 50 % DELIVERY CHARGE FOR EVERY NANOSECOND OF ELECTRICITY I USE IN MY HOME!
Corporate greed did not start with this CEO, and it won't end with him
Excellent commentary. Let's keep the momentum going. Insurance is a fleecing.
This is exactly the way I see it, the Shareholders come first the management are responsible to them. This 100% why the system is broken, the commercial sector overrides the health sector; profit is the priority!
I hate to break it to you, but charities beg for donations to run and profitable businesses are designed to offer services for a fair price.
If a company is too profitable,it will attract competitors who want access to the profits.
This is how an efficient free capital market works.
Agreed, however, note that Thompson had fucked over only the shareholders! He knew UNH was being investigated for fraud before it was announced, and sold all his shares to the tune of millions, screwing the shareholders along with the atrocious harm he has caused to medical patients. Sort of funny that they stepped over his corpse to hold the shareholder's meeting on time, lol.
@@theliftexpert Well, then the free market clearly isn't equipped to handle health care. Services at a fair price? Everyone from patients to physicians to former insurance company employees are speaking out loud and and clear right now. The profit-focused insurance model doesn't benefit anyone except senior executives and shareholders.
@@jaytc3218 the free capital market is perfectly equipped to handle any industry, it doesn’t matter if you are renting a car,buying a house, require health care or are buying commodities at Walmart .
The market is efficient.
@@jaytc3218 "Well, then the free market clearly isn't equipped to handle health care."
Correct. Most businesses, despite some unethical practices, mostly make money by providing more/higher quality/cheaper products. Insurance companies primarily make money by denying coverage--the product you paid for.
I agree with everything the doctor said. But, I also want to add that there's no room for corporate America in the administration of healthcare. Corporations have but one goal: Profit. Healthcare is a human right that is not compatible with profiteering by greedy individuals. Single-payer, Medicare for all is the only way forward.
Hate to break it to you, but healthcare is not a human right.
Rights are things that can't be taken from you.
They are not a service you are entitled to.
@@zorkman111Way to let everyone know how clueless you truly are. Maybe go educate yourself and then come back to speak with the adults.
@@zorkman111 You poor soul. You've obviously been shortchanged by Fox News. You have a right to life and a right to thrive in life. Both of these things can be taken away from you by a shooter. How does that jibe with your definition of rights?
@@zorkman111According to the Universal Declaration of Human Rights from 10 Dec 1948, proudly presented by Eleonor Roosevelt, healthcare is. Check Article 25.1.
Leaked audio shows these corporate execs are positively gleeful when discussing things like limiting anesthesia during surgeries, etc. They are rubbing their hands, cackling, and counting their billions in profits. So, yeah, maybe expecting compassion from all of us is a stretch.
Anthem is my insurance. I’ve recently had multiple surgeries under them and got REALLY scared when they talked about limiting anesthesia.
I’m a unique case where I generally require more. I’ve woken up in the middle of a procedure, heard the Drs go “she’s awake,” and was put back under.
It’s something nobody should have to live with.
They’re absolute vipers in the grass.
Very good point! These insurance companies are practicing medicine. Even a nurse is not allowed to prescribe medicine or approve/deny a treatment.
Excellent 👉point !!! Under what authority?? Insurance company's allowed to practice medicine ??? They are not qualified to do that " even Nurses or Nurse practitioners , have limited power " so these 💰 money hungry Insurance providers offers nothing more than half empty promises? so Why do they exist???? Government needs to step in !!! To 🛑 Stop the corruption " Audit them every year,, yes the government can set-up a System " European countries France 🇫🇷, Germany 🇩🇪, Britain & Canada 🇨🇦 have government sponsored Healthcare systems and all the European countries !!! Including China 🇨🇳 and Russia 🇷🇺 " So America 🇺🇸 the Richest country still rely on corrupt Self serving profits based Insurance companies??? This needs to be changed Urgently !!! Put the people first !! Deal 🤝 with the Profit later "😊
🥂the American Hero, the adjuster. My shock and horror comes at the idea that people don’t understand the OUTRAGE.
The CEO's will say that they put patients first, but their actions reveal their true priority, which is to make as much money as possible.
"No matter what anyone says, no matter the excuse or explanation, whatever a person does in the end is what he intended to do all along" - Cus D'Amato
This and 1000 other things about the insurance industry need to change. Getting ready to graduate medschool in the Spring and it's just so nice seeing providers giving voice to this. Thank you.
Well school scammed you too. College is another scam in the USA.
It's what I call outright lies. 100% agreed they need to be help liable for negative results
Scapegoating doctors, zero accountability, and dead patients. And we see this Luigi kid as a villain? How long will Americans allow themselves to be exploited by these monsters
You are 100% correct.
Uh, since the advent of any sort of ruling class? History is littered with this exact example.
Americans are pretty dumb so….
Excellent rebuttal to the corporate obfuscation and misrepresentation.
YOU MEAN LIES, MONEY GRUBBING, SLEAZINESS?
Several times in my life, these delays and denials came close to ending my life. I’ve been shouting from the rooftops for these reforms for decades, voting for national candidates who support universal healthcare. It’s time for change.
Denial of life is the same as murder. Not legally, but morally.
if a parent doesn't take a child to get medical attention and the child dies the parent goes to prison for that crime. Health insurance companies do the exact same thing IT IS a crime a well documented crime both legally and morally.
I think it is actually illegal, it's one of those things that people think is legal but is actually just gotten away with
Just wait til after the revolution. I guaruntee, that law will be the first article of the new constitution.
@@melaniedahl1572 It's very legal. If you think it's illegal, just try bringing a suit with a contingency lawyer. You won't win, and you likely won't even get a lawyer to agree to do it on contingency because the insurance companies are doing this all within the bounds of the law.
Not yet. But maybe in the future, these deplorable so-called people will be indicted for murder.
It doesn't get discussed enough how adversely all of this affects doctors too. The best doctor I ever had came out of the Navy. Our very first visit lasted 45 minutes because he wanted to know all about me. After a couple of years of grinding in this system, he closed his practice and re-enlisted in the Navy.
Sad
Corporate word salad will only enrage people more.
So many corporate idiots talk that way because they're lying.
That sounds very sensible. Insurance companies have no liability for the decisions they make to cut costs and every incentive to do so.
As a physician, I agree….
As a physician, you are nothing more than the other side of the coin, the coin of exploitation of the unwell!
This is just crazy to me. I'm in one of EU countries and while disputes happen - they exist even betwen the national insurance and the public hospitals - the treatment always goes first, disputes later. For things like wheelchairs, pensions etc they can go beforehand, but then still - there is always medical personnel involved in the insurance decisions, if not a doctor then a nurse, but never just a clerk or a CEO.
What a crazy system 😮
A murder is always a sad and bad thing, but how qrotesque is the surprised Pikachu face that the media and CEOs are putting on right now as if it wasn't just hanging in the air for quite some time due to the situation they created...
Thank you for this posting💜 I'm an independent person living a simple life under the poverty level, and when I needed surgury, insurance denied it💙The doctor approved it, and fought for me, but guess who won? You know who. Eventually, I had to get the surgery and pay for it. My case is a small one, but I'm sure there are millions like me in the USA where money rules . I appreciate your speaking up for us "little people"🧡
They have a fiduciary responsibility to maximise profits for their shareholders. It's so obviously a straight-up _lie_ to say they put patients first.
Not really. If you're going to say a bs case, it's state law, not federal.
@bobfg3130 What
@@bobfg3130 Look up fiduciary. I don't think that word means what you think it means.
Of course it's a complete lie when they say they put patients first. Not only is it a lie (in these instances), but taking into account the severity of issues that arise from these lies, it's criminal.
What the lady Dr. said exactly happened to a physician who told me his insurance company made him take a generic drug first. After he almost died and had to have a heart operation he now has to take two medications for the rest of his life. He sued the insurance company and they have to provide those medications for free.
You are by far one of the more intelligent people talking about this. Most smart doctors say nothing. But those like you who can point and say hey this is wrong loudly are real heros
Agree and also thank all the other physicians that have expressed their feeling by commenting.
At 0:35 the mission of this company is to increase profits to make the stockholders happy.
@@vincentho6840 Nothing left for the patients, the first two groups took all of it.
He mentioned later that they will continue Thompson’s legacy by denying care that’s “unnecessary.” You mean the care that the patient’s physician determined is necessary? Wow, thank you so much.
Really sad to say not many people think Thompson has much of a legacy. I also feel for Mangione. He must have been really upset and it worked on his mind to do what he did. He seemed like a compassionate nice kid.
@ No, if anything Thompson left a dark trail for these scumbags to continue. I feel for Mangione too. The fact that he had things to look forward to in his life and it takes one medical emergency to derail it. A story that so many of us have faced in dealing with this evil system.
When insurance companies over ride the recommended treatment of a doctor or deny care they are essentially practising medicine w out a license and that is illegal
In America? In the Make America Great Again movement -- this is fine. Let white men, middle management decide your fate. but ALL POLITICIANS IN DC GET PREMIUM CARE. THEY DON'T HAVE ANY OF THIS SCRUMERY.
Until Congress does something, nothing will change just talk. It should be outlawed to give kickbacks or more polite lobbying of politicians. We all have to get United on changing Healthcare.
Congress talks, and talks, and talks.. mostly to the lobbyists for the insurance company.
How about we cut out the middle man altogether!!!!! Health insurance companies do NOT need to exist!
If insurance companies are given latitude to override a health care provider then they should also be held responsible fo the malpractice repercussions $$ should the patent suffer harm from their imposed decision.
Sad to see this new guy is a fellow Brit. He should know how disgusting and corrupt this practice is.
He's not new. I think he's the chief CEO. The one who was killed was actually CEO of only part of the larger company
All the hate seems to be directed at the CEOs of these health companies, but very little on the shareholders of these companies. They must have been aware of the antics that were going on. I guess greed will overcome anything.
In many cases shareholders are pension pots managed by a set of finance directors who are competing with rival investment groups to provide the greatest return for their investors regardless as to how this is achieved. An example of this was the Vatican Bank which some journalists discovered had shares in a condom factory in spite of the RC church prohibition on artificial contraception. These investments were quickly got rid of.
What is needed in this scenario is the setting up of not for profit organisations with strict medical and scientific oversight so that the profit motive is not the primary driver of financial performance in such organisations.
ceos are also big shareholders
@@payasoinfeliz CEOs are the biggest shareholders in a company. They tend to own the most shares, which is why they're CEO.
@@vincentho6840 Brian Thompson (along with other leaders in the company) was doing inside trading and sold millions of dollars worth of their shares illegally. So regardless how they obtain their shares, they still commit fraud.
UNITED (WEALTH) CARE.
Sounds like we need a law that says insurance companies have to listen to a doctor's request as long as the partient is covered for it in the insurance agreement.
Who's going to pass that law? Nobody currently.
Correct. All of those potential people are puppets of Corporate America.@@Robert_Douglass
The problem is that hospitals also benefit from the expense of healthcare, so doctors could be pressured to give unnecessary care for profit to the hospital owners. The only real solution is to remove private ownership of hospitals and private insurance completely from the system. Then doctors are only motivated by giving proper care. There can not be a profit incentive to give or withold care; it leads to problems that negatively impact the patient.
I live in the Netherlands and by law private insurers cannot reject a claim if a doctor deems it medically necessary.
@@matteorebosolan2409 You're there. We're here in the United Oligarchy of America.
Sue United Healthcare and Any Other Health Insurance CEO for Medical Malpractice and Not the Doctor if Coverage was Delayed or Denied and it Harmed the Patient!
ABSOLUTELY!!
🤔hard to they got all the money and time an individual can’t put millions in lawsuits 😢😢 they know it too .
@@haroldgilbert6707 Do you know what class action lawsuits are? There's our answer to this problem.
@ Asbestos was awarded $160 billion in a class action lawsuit and the attorneys got 110, billion of it
@ I agree with you but it’s gotta be against the drug companies and the insurance companies and we see how far that went with Covid mass murder only huge scale and it did come from China and the food and drug admin administration put out a report that ivermectin was a good protocol but it only cost five cents a tablet to make it so there was no way to make billions but we don’t need to be shooting people
This is also a similar "Speak" that we hear to justify actions of war...
How about make it illegal for insurance companies to practice medicine without a doctor’s license?
This video didn't help that you are sadly misinformed. There are licensed doctors who review information from doctors. Sometimes, unfortunately, the patient plan that they chose does not include the care or prescription. This is what a peer to peer is for. It is a dedicated line for doctors to speak. This video is terribly misleading. Half the true is a whole lie.
@@ThemDevons I'm reassured. If my doctor's therapy is rejected, there are licensed doctors who have never seen me review information from my doctor without involving me.
It's like the era of house calls has been revived by insurance companies!
Or, maybe not.
On a related note, have you ever looked at durable medical equipment purchased through insurance plans? My wife's wheelchair was about $800, and at that I didn't notice the payment I made wasn't a purchase, it was the first month of a rent-to-own plan.
The $800 wheelchair can't be found for more than about $250 at free market prices. Equipment, services, and supplies paid for with insurance coverage should be competitive free market pricing.
That doesn't happen.
It's interesting how insurance companies assure customers a health care "network" watches out to make sure we're not overcharged.
In the cases I've researched, the network actually owns the insurance company.
High prices justify high premiums.
Agree with this physician. As a Mentla Health doc I have also experienced this nonsense. I also blame the government because I feel they should hold the insurance companies to the fire. I cannot tell you how many times they shafted my patients and even myself. They always go for the least expensive option which is not a safeguard for my patients. They put money and greed first over Healthcare of patients. Don't get me started.
True words! From someone who worked in hospitals for 30 years.
I agree, and I have a potential fix for this.
If a health insurance company denies or refuses authorization, then the patient should file a notice of negative impact. A link must be included on every denial that the doctor can click. That goes to a Department of Health and Human Services system. The doctor enters their ID Number (DEA Number?) and clicks a button saying the patient's health was negatively impacted by this decision. The doctor then gets back to helping patients. The insurance company must then follow up with the patient and have them provide the symptoms they are experiencing and a summary of the impact of those symptoms. The health insurance company must then decide within 24 hours to either keep the denial or pay for the car the doctor prescribed to the patient.
If the health insurance company keeps the denial and the patient dies or suffers permanent harm, the patient or their estate can sue the company. The company is held liable for its decision.
This also allows HHS to provide statistics in real-time. The law required to implement this could also direct HHS to publish quarterly reports showing the denial rate and the number of lawsuits brought against each health insurance company.
The actual level of gall to come out to the public and say this crap.
The root of the problem, here, is that in the wake of the "Citizens United" Supreme Court ruling of 2011 (which took the INSANE position that when a person or company gives a politician money, it's constitutionally protected "free speech"), we basically don't have campaign finance laws anymore. So what we're left with is a political landscape in which only a handful of ultra-wealthy actors (including health insurance companies) are able to truly influence politicians and they get whatever they want...and that, right there, is the ONLY reason why these for-profit health insurance companies continue to exist: they bribe the politicians who, in turn, won't stand up to them for fear of losing re-election and that's where we're all held hostage.
"The best government money can buy".
@@bobaldo2339 Yes, at present, we have a government that exclusively serves the socioeconomic elite, not the nation as a whole. This is nothing new in human history and it never bodes well for the masses of any nation.
That CEO is really shouting "ME NEXT"! lol 😂
I`ve said for years that if I win the lottery my doctors will work for me not an insurance company
Actually how rich people do it. They have their own doctors who don't even need to mess with insurance companies because their clients can pay cash no matter the rates
I remember when Columbia HCA tried to take over the health industry in the early 90's Physicians left the profession and hospitals closed down. This conglomerate refused patienst to be hospitalized because their CEO's and executives need to make their bonuses. Hospitals soon went out of business and then the Columbia did to.
Health care should not be for-profit. It just should not.
Dr. Anna's lioness side... wonderful!!!!
We have free universal Health care in Canada . I’m proud of this , the unfortunate part with over immigration our resources are totally stretched now .
Plenty of dual citizenship people living abroad coming back to Canada only for free treatment then leave again. This has been going on for decades by hundreds of thousands of fake canadians.
I’m glad this is being brought to light. Now let’s talk about how they OVER charge! Insane!! $50 for a damn aspirin. They’re not innocent EITHER!
This is why i love you so much. Your rigorous honesty is what every person should look to and achieve.
The insurance companies are NOT physicians; they are vastly different jobs so they should not have the legal right to over throw a decision that he/she makes on the patients care or any other job for that matter. They are "not" qualified to make that judgment no more than a physician is to override any other job they are not academically qualified to do either. These are peoples lives we're talking about for Gods sake. Unless the law is changed this will continue and hundreds, if not thosands of lives are at risk of suffering and of death.
Another misinformed person. Insurance companies have doctors.. REALLY good doctors with patients. It would be illegal for a customer service representative to deny anything. This review is not honest, it is misinformation. Doctors do not overthrow anything. Unfortunately, some people are only offered a certain package of insurance FROM their employer. Most of the time, employers would rather save money, than to save their employees. Insurance is like a debit card..not everyone with a debit card will decline, but some will decline if they have no money in the bank. Unfortunately, because of the wide spread of misinformation and misinformed doctors, they place everyone in the same category as benefits. In Insurance, we meet to make things easier for our members. Contrary to popular belief we actually love to help. It breaks our heart to discover someone elected a bad package or someone's jobs elected plans with high deductibles to save their money. I mean, we actuallt have cried once we disconnected the line with a member. The only way something is denied in Insurance is if it is not covered or someone has gone out of network. Even with that, if a doctor is out of network and that is the only doctor that can save your life. We actually help you by completing paperwork to process your claim as if the doctor is IN your network, but because the doctor is out of network he or she can add additional charges to your care. Also, not everyone with medical insurance has the same insurance for pharmacy. People are upset at United Healthcare for something they have nothing to do with. It is layers to this. Unfortunately, people are taking advantage of the ignorance of the general public. This is misinformation. Very very bad misinformation. I am a previous claims specialist and escalation representative for United Healthcare . I know more about the behind the scene than anyone who doesn't work for insurance.
This is actually the best, simple-to-implement, solution I have heard so far. Elegant and simple!
If only the country could endorse Bernie Sanders, sigh.
Thank you for Speaking the TRUTH and standing up Doc...The world needs more people like you in it!
Thank you for your channel. You turned me on to Cerave and Ren. Shine on!
That doctor is exactly right. Insurance companies NEVER face any consequences.
Agreed ! I think it would be better to get rid of assurance companies alltogether and make it a "public service", no ? Why mix profit and health care ? (sorry if my english is not good)
Spot on. They need to be help accountable. Ideally by the rule of law...
If someone puts profits of people, it's going to anger some people. If someone puts profits over people they are contractually obligated to help, that's going to cause a lot more anger.
I'll offer the same amount of sympathy that they offer: Very little.
As someone who worked for a major insurance company for far too long, I believe this doctor is speaking the absolute truth.
If COVID did not teach you that profit must be removed from public health then are just plain dumb
Thank you for speaking up. Absolutely "no skin in the game....prioritizing profits over patient well-being."
Darth Andrew the Witty: UNLIMITED DENIALLL!
*THANK YOU LUIGI MANGIONI....248 million people that were denied claims for health care in ONE year....thank you.*
Thank you.
This is the best, most concise and easy to understand explanation as to why our healthcare system is so egregiously fkd up. Thank you for this! It should be shouted from the mountain tops.
Excellent video, thank you!
That CEO'S " message" is a perfect example of Corporate Gaslighting
and remember, we care...
about our profits!
Being scared is what they are finally feeling. Something their patients are all to aware of.
YOu sir are 100% accountable for this !
Exceptionally well stated. I do think it is interesting that United Health Care, as provided by employers and paid for in part by employees is by all accounts miserable. Yet, United Health Care's administration of a Medicare supplement has been exceptional. I think the difference is that in the latter, UHC is held accountable by a government agency. I also have found that doctors and surgeons associated with large hospitals tend to be exceptional. Those working for smaller, private for-profit groups actions are often inexcusable to the point it can be described as medical malpractice without consequences.
Here’s my proposal to combat unwarranted insurance denials: every denial must be approved by a physician. If that physician works for the insurance company, his or her decisions would be reviewed by an independent panel empowered to determine if the denials were legitimate. If a doctor struck out too many times with an excessive rate of unwarranted denials, his or her medical license would be revoked.
It sounds like a lot of extra bureacracy if you need to get a panel of doctors together. Particularly if the matter is time sensitive and it adds additional costs from the addition of the panel of doctors time costs.
@@jknox2: You misunderstood. It is better to review denials than meekly accept them. Moreover, the process I proposed would quickly weed out reviewers prioritizing profits over patients and immediately incentivize reviewers to make appropriate decisions as opposed to those focused more on the insurance company’s profitability than patient welfare.
There should be nothing that comes between a doctor and a patient. Not to mention that Healthcare should be non-for-profit. If a doctor says a patient needs something then the healthcare insurance provider pays for it. They should have no ability to say what is necessary and what is not necessary. It should be only in cases of fraud that Healthcare is denied.
There were videos of healthcare employees laughing about clients getting turned DOWN for coverage. It was disturbing and disgusting.
There was a time when medical insurance companies could only operate as non-profit. That needs to return.
“They are not held liable” 💯
“Do not face any consequences”
💯
it has been like this for 25yrs at least. No matter how many CEOs and Patients are dead, they do not care as long as they make 10 millions a year salary, and millions of stock options upon retirement😢
i nominate this lady for Surgeon General
Thank you. I learned something. I hadn't heard this perspective before.
To say united put patients first is a slap in the face to us.. the company literally earned $22 billion last year by denying payments to patients…
Absolutely brilliant. Many channels have diagnosed the problem. Only you have provided an actionable solution.
Insurance company decides what test we can do and what medication we may take, they override the doctor's decisions nowadays. It was not like this 20 years ago.
Common sense!!! Thanks Doctor!!! 🤞🤞🤞👍👍👍 The insurance costs are raising because of that "line of denials" strategy of insurances!!! & They have "experts" deciding what to do & when to do anything they want to. Why? To make the shareholders happy & to get bonuses at the end of the year or more. 🤷