“Pay a monthly premium for a service we’ll then refuse to provide!” If any other business ran like this, it would be illegal and heavily sued to oblivion, but for some reason healthcare is allowed to operate like this in the US.
Home insurance, car insurance, all insurance at as a whole. Their goal is to not pay. That’s what CEO’s are paid for - to make the biggest profit for the company. Insurance is a scam business and they can’t stay afloat if they pay
Us healthcare workers and doctors have been frustrated at insurance companies and what they’ve done to the field and our patients! While there is a lot of anger out there against healthcare please don’t take it out on us. We have been screaming “it’s the insurance companies” forever
Its more complicated than insurance companies. My dentis used to cost $52. They did not take insurance. One year they started to. The bill went to $120 with insurance or $150 without. In 6 months after a contract was signed. Then providers milk the stuffing out of charges to the point nobody has any idea what will actually be billed. Coupled with if your life is in danger you really aren't in a position to negotiate. Its not JUST the insurance companies. But yes. Its a lot of them.
@@pdxmusl1510all I can say is I’m only making 3% more over the past 5 years. The surgeons I work with a 2.9% paycut. I understand private equity and non-compete agreements have givin some companies monopoly powers. Less options for workers and less options for hospitals to contract with companies so those few companies drive up the price artificially. It’s terrible
Oh course you all have been but as per usual the public thinks they figure everything out first and online no less. Just ridiculous how stupid and susceptible society has become simply by relying on the damn internet to “teach” them about “reality”. I saw how hard the medical profession fought on every kind of frontline in order to JUST be able to do your jobs during COVID!? I appreciate you all for that too so much to this day! True patriots! Js
@@pdxmusl1510I keep trying to comment about private equity, non- competes, and conglomerates on here but my comment keeps getting deleted by the powers that be. Why is my voice being silenced over true and non-violent statements???
@@pdxmusl1510you realize the example you gave is proving that insurance *is* the problem right? Your dentist charged a good price before accepting insurance, then realized they could charge way more to insurance companies and raised their costs, which then left uninsured or denied people paying what the insurance company would pay. The problem is that private health insurance opens the door for providers, mainly hospitals, to charge exorbitant prices. Bills to insurance are going to be 10x higher if insurance only cover 1/10 bills
I agree. Either doctors should be able to negotiate pricing at every level to give their patients access to the best treatments available or everyone's salaries should come from a collective pool of funding and be based on outcomes and performance of services/skills, not who makes the most money for their overlords to extract without having anything at all to do with the actual healing process. You honestly couldn't pay me five billion a year to takea job within the healthcare billing/insurance industry. Same with telemarketing.
They can't. They can just deny to pay for the service, They don't actually stop you from getting the service if you pay for it yourself. What they need to do is put penalties on negligently wrongful claim denials. This would solve the issue overnight.
@@lupea8079 The reason they charge so much is because only a fraction of medical bills get paid (so they end up multiplying the amount billed by like 10x so they get the payment they should've in the first place.) Government messed up healthcare by using tax law to incentivize tying it to insurance and then employment, then when it got bad a result their answer was to double down on more government interference with Obamacare. Of course now it's even worse and their bright idea is yet even more government interference... It's like the statists have only one lever to pull for 'solutions' and its always to use government coercion... Its really pretty gross.
Someone in earlier comments mentioned 2 things that set me off. 1. A.I. doesn't behave by accident, you have to optimize a language model to get that result. 2. This is arguably a crime against humanity. I find myself nodding with both 1 and 2.
Exactly this. They're using AI as an extra buffer to distance themselves from accountability, to dehumanize the process, while profiting off of suffering. But AI is programmed and needs human oversight. Even Deep Learning needs to have a programmed starting point.
1. Isn't entirely true. You can inadvertently introduce bias into the results that could give this negative outcome. #1 is either incompetence, incomplete data, or intentional.
And they get away with it because neither party wants to go after business and risk losing support of the billionaire class -- no matter how egregious their behavior. For five decades we've moved away from the FDR era policies that every president from FDR to LBJ supported and that included Eisenhower. But, in the early/mid 70's, while the nation was focused on Nixon and Watergate, behind the scenes we began to unravel the FDR era and replace it with a form of Capitalism that explicitly takes from the working class and gives to the leisure class. For five decades the nation and indeed much of the western world has embraced an idea that we need to eliminate the middle class so that there is just the wealthy and the poor.
The answer is outlaw health insurance, watch the price crash to that of a veterinarian clinic. It’s like 1/50th the cost when insurance isn’t brought into healthcare
I’m 19 and disabled, I’m on a medication that without insurance, will cost me $3k a month for 30 pills. This medication is a pacemaker med, it keeps my heart pumping correctly. If my insurance decides randomly to stop covering it, I will have to stop taking it. I get $400 a month from disability benefits, and that’s my only income, yet insurance still fights me *every month* about paying 70% out of pocket. I wish I was exaggerating or joking, but I’m not. Health insurance is a monopoly that is actively holding millions like me in a state of fear, fear of losing the thing that keeps us alive. I am 19. I shouldn’t have to be afraid of dying because I can’t afford my medication. I should be going to college, but instead of saving for that, I’m saving for the possibly of losing coverage
Leaving a comment in hopes your story gets pushed upwards more Wishing the best for ya, I'm 22 rn and have no income, just admitted into a crisis residential center for psychiatric help (it's where the ER sent me, currently only approved for 4-5 days but really I need like 1-3 months in a psychiatric center, my first and last trip back when I was 18, the center I went to struggled to get my insurance to approve a few more days, I'd admitted that time due to catchinf myself planning out and about to act on said 💀 plan, my stay was about a week and a half total. No I was not ready to leave, but the hospital literally couldn't keep me because my insurance wouldn't keep covering me)
I hope that you vote the right way when it comes to it because it’s republicans who voted against making medication for people like you affordable. But people seem to be more driven by hate towards immigrants and gay people.
I'm hoping that me and the rest of us get the courage to do what it takes to change the system, so that you don't live in fear like this. I wish you the best.
Recently I started seeing a cardiologist . I noticed a sign that read " we will no longer accept United Insurance" . I thought that was a little strange, now I know why.
Yeah, I had a policy from UHC for a few years. The network was spotty; for example, a worker at my local hospital told me UHC was the only major insurer they didn’t accept. From what I heard it’s because many providers found UHC too difficult to work with.
Not surprised. On a different video about UHC someone said one of their providers didn't take UHC because they didn't pay "because you're a small practice so you don't have the resources to sue us". Aka "we won't pay for valid claims because we can get away with it".
Cash is the way. Insurance needs to go away. Nobody should be forced to pay for another person's bad lifestyle, which is what insurance basically is. Healthy people get to foot the bill of unhealthy people.
@@Redditor6079 If only it were that simple. Unfortunately, most medical conditions are due to injury, illness, genetics, or other factors beyond people’s control. Also, the treatments are often too complex to expect them to be affordable to the average person.
Ever notice how nobody can agree on when America was 'last great'? 🤔 Well, here’s a thought: maybe it was when the rich actually paid their fair share in taxes. 🎯 During WWII, the top tax rate on the wealthiest Americans hit 94%. Yes, NINETY-FOUR percent. After the war? It stayed at 91% throughout the 1950s-aka the 'good old days.' With that money, we built highways, sent kids to college, and reached for the stars (literally, NASA was founded). 🎯 In the 1960s, the top rate was still over 70%. The Civil Rights movement thrived, we landed on the moon, and the middle class was booming. Fast forward to now: the richest man alive is reaching the stars while paying a fraction of that in taxes-and we’re subsidizing him. Meanwhile, regular Americans are drowning in debt just trying to stay afloat 🇺🇸🫡
The overwhelming majority of taxes are STILL paid by rich. 75-85%. Our contribution is practically nothing. Your post is a common misrepresentation of reality. Non rich like us could basically stop paying taxes and there would virtually be very little difference in government services.
@@pdxmusl1510That’s the point, if we assume the rich pay all the tax, then if they paid the correct proportion we’d actually have the money for these great things. From paying 90% to paying 10%, you’d have nearly ten times the tax revenue. You’d be able to afford basic human rights _as well_ as the overly expensive, inefficient military
This is fraud. The insurance company offered a product, then refuses to uphold their end of the bargain in 90% of cases for the sick, elderly, and dying? That is fraud.
@@mikeyman1974 Fraud SHOULD be criminal law, prosecuted by DOJ. Not contract law, nor a civil complaint. If other fraudsters can escape the law by offering 10% of their marks some compensation, they will be happy to take that deal.
@@tevrenendrigan1838 like I said it’s ultimately at it’s core this is a situation of United health violating the terms of it’s contracts and as a result their clients are suing. If you can prove intent maybe it could become criminal but until then this is how the laws and systems work.
We've 🇬🇧 still got National Insurance and the NHS though they took a bit of hammering from the previous Tory Government. We don't submit claims, medical costs are simply covered directly.
Watch for privitisation by stealth. Government underfunds said industry, points to it and says it's failing at current funding level, advocates for private money injection. National is busy doing it all over the place in NZ, and the muppets here are welcoming it with open arms.
That sounds like communism! Here in 'murica we have freedom to choose between medical bankruptcy or premature death from a treatable illness. Ronald Ragan told me to be afraid of the government when he was president, and I haven't stopped being afraid of it since. Now I don't see a doctor every year and I can't afford my medication all the time, but that's ok because one day I'll be a billionare and get to step on everyone else.
In NJ we have a state agency known as DOBI, division of banking and insurance. I once spoke to a rep concerning a case I had against BCBS of NJ, and the rep agreed, I had a legitimate case and I should file a complaint. She also warned they were backed up with cases against Blue Cross and it would "take a while." I filed the case, then called Blue Cross and told them as a courtesy I was informing them of a complaint filed with NJDOBI and the case has already been assigned a case number of which I am not obligated to give you. After more than four months of futility, paperwork, faxes, and phone calls my claim was paid in seven days. If you state has such an agency USE IT. If not, try to get one by calling you state representatives. Never mind Drud, of whatever Musk and his idiot friends want to do, there should be a federal agency that works on behalf of patient benefits. After all, we spend BILLIONS on federal health agencies that pretty work on behalf of big pharma and big insurance, and then make then lobby proof.
Profitcare And the most frustrating part is the debate is about getting everyone insurance which is a no value added for profit middleman va getting everyone healthcare In the US insurance and healthcare are synonymous despite being opposed forces
If he's guilty of the crime... no. No I'm not. Murder is deplorable and amoal. So.. you can sit in your mom's basement and be crazy. Leave me and every rational person out of your delusional world.
I just had an $800 claim denied (for lab work 😮). I called UHC and asked for the reason for the denial. "Um, looks like an incorrect code was used." "So," I said, "No bill will be arriving from the hospital?" " Oh, well we don't know if the server will bill you, but if they do, have them call us so we can correct the error in code. " They weren't going to correct it when I called in, so I don't imagine they'll correct it later. Such a crooked business they're in.
@TheFiercepixie Suddenly (yesterday), the bill has been 'covered.' Looks like UHC corrected the code in the meantime 🤪. I'm gonna make note of your solution tho, in the event it happens next year again. Thank you ❤️
If any other system “failed” 90% of the time it would immediately be taken offline. If that’s the “error” rate and they choose to leave it in service it’s not an error rate anymore. It’s now acting as desired.
If you didn't know, 'insurance' is a gambling game incorporated as a necessity (by the mafia style gubment we have) in U.S. living. It is the poorest people, looking to get health ASSURANCE (NOT a gambling scheme) for when they fall ill, but only paying for the health care of the rich families that are on the board of insurance company that are fleecing the poor. It's usury hidden under the premise of 'business', which is a huge sin by any that have that kind of 'power'.
The physician has to challenge the denial and this costs huge amounts of money for the physician to do. So unless your doctor is willing to do the appeal the patient can do nothing about the denial.
Because everyone knows and talks about “deny”, I think just how disgusting the “delay” and “defend” are get overlooked. The insurance companies delay the decision and defend their choices in court because of the possibility of the other party giving up or dying. Let that sink in. They deliberately try to wait out their clients’ deaths, just so they don’t have to pay the amount they said they would.
They outright encourage that death bc sick people aren't profitable. Sick clients use their healthcare making them a liability on insurance balance sheets that the company wants "deleted"
I'm a now-retired RN. Navihealth is a nightmare!! Before I retired in 2023, I was working in a rehab/longterm care facility. During my last year, we started having to deal with Navihealth, which was the arm of insurance handling authorization for rehab stays. They use algorithms to determine how much treatment a patient should get based on their diagnosis. They were getting tighter and tighter, denying inpatient rehab a week into the patients' treatment when they normally would have been there 2 to 4 weeks. Every insurance company will look for the cheapest way for you to get what you need.
Yep. It's taking me three months from initiation to get my first therapy appt through state insurance. And first they had to freak me OUT and ruin a Sunday by denying the payment of a physical I went to get as a prerequisite.
I came here from Mexico 35 yrs ago. Some say that it's a shithole country. However it has college education for all that pass an entrance exam. Everyone that works and their families has medical insurance. Everyone that works can buy a house subsidized by unions and the government. It's horrible that here the government doesn't help it's citizens much unless they belong to the 1%🤮
When I used to work as a pharmacy technician, I had a saying, “I pay the consequences for other people’s poor decisions”. I saw a patient who had broken several ribs. She was prescribed oxycodone and guess what her insurance did, they required a prior authorization for it. Guess who had to deal with the patient’s angry husband. I’ll give you a hint it wasn’t the frigging insurance company. I had to explain to the husband why the medication wasn’t covered unless the doctor filled out the prior authorization. I really detest insurance companies that do this. As someone who has been both sides of the shit sandwich that is the health insurance industry I don’t condone the violence but I sure as hell find it hard to have sympathy for the CEO when he had a hand in crap like this.
It’s also sad that the murderer has less blood on his hands than the guy he murdered. That healthcare CEO is most likely responsible for more deaths than all of the mass shooters and terrorists combined. But nobody in power holds these companies responsible for their literally fraudulent business practices because their all awash in their blood money.
@septanine5936 Until a drone hysteria took over the newscycle. And distracted all the MAGAs who'd just woken up and realised they were being played by the Culture Wars to fight against their own classes so they wouldn't notice it was the ones at the top that were responsible for their problems. Now, the RW pundits can drop the subject and not be crucified by their own audience. The classic strategy of "Look ..squirrel."
We have dangerous trees near our cabin that need to come down. I inquired with our property insurance company about them working with us to remove them. They told me that's not how it works. So, I said ok, then tell me how it works. They said if a storm takes them down, I would have to file an insurance claim, then they would remove them for us. Logically to me, I said wouldn't that cost the insurance company more because there would be more damage. In fact there could even be loss of life and property. They could care less. In short, it made sense to me for a company to pay a lower fee in order to remove a potential high cost or expense. Don't wait for it to break, before you fix it, if you see a potential for it to break. Sure enough, Hurricane Helene hit and took down numerous trees. Fortunately two years prior to this hurricane, we personally paid thousands of dollars to have these huge white pines cut down. Had we not done so, we would have lost our cabin and perhaps our lives. The system is broken!!! I was going to use cursive words, to express my anger but it's not necessary. You get my point. I don't want to offend anyone or get banned by TH-cam. We are no longer living in a free society. 🙏🇺🇲
Today, UHC and my MD had a meeting to discuss my MDs MRI request that was delayed, and then DENIED! I wonder what UHCs final decision will be after thst meeting. Another period of time I have to WAIT for their answer. 😐 😒
Yep. The united health care denied me an MRI couple of years ago. I had to pay $800 out of pocket for it because I was just desperate for answers at that point. Later my surgeon found 6 abdominal and pelvic hernias, some of them he told me were the size of his fists. Did I appeal with the insurance? Hell no. I’m disabled and barely functioning. They’d use it and they’d find a way to delay and deny again.
That’s not the guy. They know they will never find him so they picked up an actor (which is him) that will play the part of a shooter to show the public how competent the regime is. Just think about it how idiotic the story is: they found him sitting at a McDonald’s eating fast food, with the gun and manifesto of why he did the killing… It’s either a complete set up or he has to be the most idiotic assassin in human history! 😂 😂
1st off I wouldn't believe anybody in sweats videoing from their bathroom. And yes the regulations that allow one company to be involved in A-Z of Healthcare is not right when you manage all govt provided care, own the nursing home, the Drs & nursing staff, the distribution of drugs, all under different entities it's just not kosher, & hospitals send you to a nursing home asap for your rehabilitation. Just too much potential for abuse & lots of kickback to Drs, Surgeons, & Hospital Administrators. This needs to be investigated but She's blowing hot air to insinuate its AIs
I worked at a massage clinic 30 years ago and a client came in with whiplash and was helped greatly by Massage. She then told us she was an insurance adjuster and was taught to delay payment to us because we were a “sham” treatment, and she had believed it. She quit her job shortly after…
Happened to me. I 100% believe this is why I had issues. After being on wegovy for my diabetes, UHC denied it one day. Workers had zero idea why. Took 3 months to appeal and suddenly it worked and then took months to get back to therapeutic levels. I have asked serval times for someone to explain my diabetes med as denied. Every time worker said “it shouldn’t have been denied” and say someone will send me the reason by mail. That was a year ago. Never happens.
It's because an in patent highly cost-ineffective medicine that should only be paid for for by the plan for patients who truly need it for their illness and for whom more cost effective treatments don't work, but instead millions of people are getting it for weight loss and basically fudging the paperwork (in effect committing fraud.)
That's what you get when politicians have to appeal to companies instead of people. An easy fix for this would be that healthcare coverage always needs to cover a basic set and they always need to pay first and can only later try to get the money back. Also lawyer fees should be covered as part of your insurance so they and not you have to decide if it's worth suing.
The automatic denial has been that way for years. I worked for a medical facility that did a lot of cataract surgeries and the insurances almost always denied five times. That was back in the 1990s.
The reason that only 0.2% of policy holders appeal their denied claims isn’t because we don’t want to “call their bluff,” but because we can’t afford a lawyer. The system is broken at every level, or rather, it’s working exactly as designed.
This is exactly what I've been telling everybody I know as well. I am a tech nerd who constantly studies this stuff, and trust me, I know this was not made for you and me.
Practicing medicine without a license is illegal. Why do we let insurance claims adjusters practice medicine? Why are insurance companies allowed to have doctors operate well outside the scope of their practice like having an ob-gyn deny a claim for a head injury? Why can a podiatrist deny your claim for chemotherapy?
Last week, twice, i was told at an appointment my insurance was invalid. Company paid insurance. I call the insurance and both times they said it was not invalid that i had coverage nothing wrong with my policy. What they didnt know, was the second time i was with the Dr and the nurse trying to bill insurance. They read them the numbers from the policy and tried again...invalid. Even though the insurance just said it was and told them what numbers to use. I also have had insurance refuse to send me a prescription card because my regular card should cover it, it doesnt have an rx number on it and doesn't work but they refuse to fix the issue or even offer any solution that actually works
It’s not merely a “headache” to fight a denial. When we are extremely ill, the extreme anxiety and stress of a denial, and the losing battle via hours and hours on the phone damages our health significantly. Also delays result in more damage and even death for millions. ☠️
This is why we need universal healthcare/single payer healthcare, it would literally be much cheaper than the current system because no middlman who is price gouging literally. For example, insurance companies force pharamcies to up the prices of their medications just to have a contract and independent ones get fucked over because the insurance companies make it too expensive for them to sell certain medication. We already see how easy medica is so programs such as medicaid or medi-cal in CA which shows universal healthcare is possible even financially.
I have come to believe in expansion of HSA accounts. The money in the account is ours and the health care industry would at least have to compete for our money and we would keep it if we die or could withdraw it taxed if we needed it for something else. Time has shown both private insurance and government healthcare is extremely problematic and controversial, we do not even agree on the difference between healthcare and infanticide...
I got an AI phone call trying to sell me life insurance. It asked my age. I said 97. It hung up. Tried to call the number back but it was clearly a spoofed number.
While AI can be coded to evaluate a bunch of factors to approve a claim, this one does NOT run on that sort of reasoning. We know this because if it was actually following detection guidlines it would approve all of these claims, as they were already made by a trained and experienced professionals, and the AI would see the same things they do. Instead this one has a gigiantic disapproval rate, which means it was is built specifically to find excuses to deny claims. AKA: It was programed to LIE. Using AI for this sort of thing legally is fraud, and suing them based on this would be good case law, that would shut down a LOT of AI nonsense.
I just set my boundaries very sternly! I won’t talk to systems, I will only talk to humans and I only use health care for simple things. The rest I take care of myself!
Sorry, clarify the simple things bit. To me a “simple thing” is flu rest liquids time “The rest” is a broken arm which I’m definitely not taking care of myself
@ I go to the VA and I have set my boundaries with my Dr, they don’t even ask me if I want a flu shot anymore, they know I don’t do big pharma, blood transfusion and before any procedure I clarify with everyone of what you can put in my body and what you can’t. I went for a procedure and everyone assured me no antibiotic or steroids and I asked the anesthesiologist and he was going to give me steroids and I was like no your not. I make sure I am very clear. I do not want to be saved at all cost especially a blood transfusion with Covid contaminated blood! Very simple if I had a broken arm, you can treat that, but I don’t need to be given a bunch of preventative big pharma along with it. So I am very clear and I have my advanced detectives written up. I usually just have them do my blood work a couple of other tests I like to do. That is it. I have not taken an antibiotic since 1991 and I know how to heal myself. I got a second degree burn from boiling water and I had it healed within a month and you can hardly see any redness. I used bag balm! Great stuff! I worked in health care for 30yrs, I know the evils of big pharma!
@ haven’t you ever looked in to natural healing? Do you know you have the ability to heal yourself? You were given an amazing immune system! You are missing out on a whole new world! Break free from the chains that bind you called big pharma!! I have not taken an antibiotic since 1991, I have healed a second degree burn in 30 days with no scar, I am almost 60 and don’t take any RX. Energy healing is wonderful! Grounding, what you put into your body, how you treat yourself. All health care wants to do is give you a pill for every complaint. If you want to build muscle, exercises, want a strong immune system, allow your body to work through many of the minor things.
@@drewidlifestyle7883 they must have taken down my reply. Do some research, so many natural healing modalities! Big pharma just gives you more side effects so they can give you more pills! They are keeping you sick so they can make money and the food corporations are helping your illness along. Taking steroids breaks down your bone density, it’s one RX they always want to give you. You could not pay me enough to take that shit! Look outside the box!!!
So, what happens if we all stop paying for any insurances? Will these corrupted corporations go out of business? Homeowners are denied claims, auto ins claims are denied.... They are all corrupted. 😢
Back in my day, if we got hurt after working a 26hr shift at the plant, the doc would give us a vile of methamphetamine and morphine and send us on our way. Yep. Worked that plant for 4yrs but got laid off when I turned 14 😔
this is the stuff that makes me embarrassed to say I work on AI. it has some great use cases, especially computer vision stuff, but using it to deny people healthcare is disgusting
Computer Vision is one of the few beneficial uses of machine learning technologies. Generative AI however amounts to a toy most often, and is much more quickly used to harm than to help.
Of course they deny claims. People always shop for the cheapest coverage. The only way to have lower premiums is to not pay claims. When people start sorting providers by "pays the most claims" and not "lowest premiums first", things will change.
Surely you can't be serious. If car manufacturers could sell you a cheaper car that didn't have seat belts, air bags and explode like a Ford Pinto, they would. The reason we don't have to worry about our cars being more of a death trap than they already are is because we've regulated the industry to provide some basic level of safety to protect the consumer. Health insurance is currently broken and the solution isn't blaming the consumer, its to tighten regulation to make that industry work in the people's favor more. That's one of the core functions of government otherwise we'd be in some neo-feudalist hellscape where we have wealthy kings who are above the law and might makes right.
@@andrewn7365 That's a great analogy. All those standard features have made a new car about 20% more expensive, adjusted for inflation, since the 1980s. The amount of claims paid is tied by law to the amount of premiums collected. If people want more claims paid, they should sign up for higher premiums. No one does that.
@@DJ_Force Yes it has made cars more expensive, but the reason there's not a cheaper option isn't because of consumer preference it's because of regulation. Would you be blaming people buying dangerous cars had there not have been regulations in place to protect consumers from buying them?
Idk this AI thing and high rate of insurance coverage denial is giving IBM’s involvement in the Holocaust. Too many people perished because advance technology was removing humans from having to care about the people they were hurting. In this case - going after the sick in masses. Where are private insurance going with this if each year they’re supposed to out do the last?
“Pay a monthly premium for a service we’ll then refuse to provide!” If any other business ran like this, it would be illegal and heavily sued to oblivion, but for some reason healthcare is allowed to operate like this in the US.
Hmmm maybe we could start a class action
Some reason is Citizens United.
"Healthcare"
Lobbyists…
Home insurance, car insurance, all insurance at as a whole. Their goal is to not pay. That’s what CEO’s are paid for - to make the biggest profit for the company. Insurance is a scam business and they can’t stay afloat if they pay
Nothing will change unless they are FORCED to change.
Yes the tree of liberty is really damn thirsty
Who's next on the board of directors of United healthcare? 🤔🤔🤔😁😁😁😉😉😉
How? Lobbyists line the pockets of Politicians...the only guy that isn't on the take is Bernie
>3 seconds in....
And what did they use before AI? Stop trying desperately to apply AI to everything you don't like
@@pixelpotato4874bernie is a zionist shill
All they want to do is deny. The more money they save, the better in their minds.. it's insane. People need to figure out a solution.
The peaceful solution is universal healthcare and the insurance companies accept dissolution. The alternative, well, we've already seen it.
Obama should be ashamed of himself.
Getting PACS and private financing out of the government
@luisapaza317 Tell that to Bill Gates and George Soros.
Similar to what credit unions did for the banking system maybe?
Us healthcare workers and doctors have been frustrated at insurance companies and what they’ve done to the field and our patients! While there is a lot of anger out there against healthcare please don’t take it out on us. We have been screaming “it’s the insurance companies” forever
Its more complicated than insurance companies. My dentis used to cost $52. They did not take insurance. One year they started to. The bill went to $120 with insurance or $150 without. In 6 months after a contract was signed.
Then providers milk the stuffing out of charges to the point nobody has any idea what will actually be billed. Coupled with if your life is in danger you really aren't in a position to negotiate.
Its not JUST the insurance companies. But yes. Its a lot of them.
@@pdxmusl1510all I can say is I’m only making 3% more over the past 5 years. The surgeons I work with a 2.9% paycut. I understand private equity and non-compete agreements have givin some companies monopoly powers. Less options for workers and less options for hospitals to contract with companies so those few companies drive up the price artificially. It’s terrible
Oh course you all have been but as per usual the public thinks they figure everything out first and online no less. Just ridiculous how stupid and susceptible society has become simply by relying on the damn internet to “teach” them about “reality”. I saw how hard the medical profession fought on every kind of frontline in order to JUST be able to do your jobs during COVID!?
I appreciate you all for that too so much to this day! True patriots! Js
@@pdxmusl1510I keep trying to comment about private equity, non- competes, and conglomerates on here but my comment keeps getting deleted by the powers that be. Why is my voice being silenced over true and non-violent statements???
@@pdxmusl1510you realize the example you gave is proving that insurance *is* the problem right? Your dentist charged a good price before accepting insurance, then realized they could charge way more to insurance companies and raised their costs, which then left uninsured or denied people paying what the insurance company would pay.
The problem is that private health insurance opens the door for providers, mainly hospitals, to charge exorbitant prices. Bills to insurance are going to be 10x higher if insurance only cover 1/10 bills
90% error rate is insane! Can you imagine if the military tried to implement some new weapon that had a 90% error rate?! No one would have it!
Its not an error. Its working as designed.
Zero regulations to help citizens
Well they have a 100% failure rate on the last 7 budget audits...the military funding is rampant without any accountability.
You’d be surprised.
That's when you know it's all about the greed and when has govt approval in lack of regulation is all about the eugenics.
The fact that insurance can arbitrarily decide your doctor is asking for unnecessary or fraudulent care is lethal and criminal.
I agree. Either doctors should be able to negotiate pricing at every level to give their patients access to the best treatments available or everyone's salaries should come from a collective pool of funding and be based on outcomes and performance of services/skills, not who makes the most money for their overlords to extract without having anything at all to do with the actual healing process.
You honestly couldn't pay me five billion a year to takea job within the healthcare billing/insurance industry.
Same with telemarketing.
They can't. They can just deny to pay for the service, They don't actually stop you from getting the service if you pay for it yourself. What they need to do is put penalties on negligently wrongful claim denials. This would solve the issue overnight.
Lets do nothing about it!
We wouldn't need insurance if the doctors didn't charge so much for basic services. Blame the doctors and hospitals too!
@@lupea8079 The reason they charge so much is because only a fraction of medical bills get paid (so they end up multiplying the amount billed by like 10x so they get the payment they should've in the first place.) Government messed up healthcare by using tax law to incentivize tying it to insurance and then employment, then when it got bad a result their answer was to double down on more government interference with Obamacare. Of course now it's even worse and their bright idea is yet even more government interference... It's like the statists have only one lever to pull for 'solutions' and its always to use government coercion... Its really pretty gross.
Someone in earlier comments mentioned 2 things that set me off.
1. A.I. doesn't behave by accident, you have to optimize a language model to get that result.
2. This is arguably a crime against humanity.
I find myself nodding with both 1 and 2.
Exactly this. They're using AI as an extra buffer to distance themselves from accountability, to dehumanize the process, while profiting off of suffering. But AI is programmed and needs human oversight. Even Deep Learning needs to have a programmed starting point.
Ran here to say this …some people are saying “I’m ready for the future “ well this is it we were warned , they didn’t listen🤷🏿♂️
@@753studios6it sounds like a cliché but the Skynet needs to be shut off. These technologies dont bring any good to development or to the future
1. Isn't entirely true. You can inadvertently introduce bias into the results that could give this negative outcome.
#1 is either incompetence, incomplete data, or intentional.
Well the US never respected the International criminal court and other international courts so don't expect them to save you.
And they get away with it because neither party wants to go after business and risk losing support of the billionaire class -- no matter how egregious their behavior. For five decades we've moved away from the FDR era policies that every president from FDR to LBJ supported and that included Eisenhower. But, in the early/mid 70's, while the nation was focused on Nixon and Watergate, behind the scenes we began to unravel the FDR era and replace it with a form of Capitalism that explicitly takes from the working class and gives to the leisure class. For five decades the nation and indeed much of the western world has embraced an idea that we need to eliminate the middle class so that there is just the wealthy and the poor.
The answer is outlaw health insurance, watch the price crash to that of a veterinarian clinic. It’s like 1/50th the cost when insurance isn’t brought into healthcare
There is no middle class, only working class (us) and capitalist class (billionaires and owners of corporations)
The elites want to get rid of the middle class.
Guess what, your governments did that because they destroyed the USSR and now there is no alternative to capitalism.
Guess what, your governments did that because they destroyed the USSR and now there is no alternative to cаpitalism.
I’m 19 and disabled, I’m on a medication that without insurance, will cost me $3k a month for 30 pills. This medication is a pacemaker med, it keeps my heart pumping correctly. If my insurance decides randomly to stop covering it, I will have to stop taking it.
I get $400 a month from disability benefits, and that’s my only income, yet insurance still fights me *every month* about paying 70% out of pocket.
I wish I was exaggerating or joking, but I’m not. Health insurance is a monopoly that is actively holding millions like me in a state of fear, fear of losing the thing that keeps us alive.
I am 19. I shouldn’t have to be afraid of dying because I can’t afford my medication. I should be going to college, but instead of saving for that, I’m saving for the possibly of losing coverage
Leaving a comment in hopes your story gets pushed upwards more
Wishing the best for ya, I'm 22 rn and have no income, just admitted into a crisis residential center for psychiatric help (it's where the ER sent me, currently only approved for 4-5 days but really I need like 1-3 months in a psychiatric center, my first and last trip back when I was 18, the center I went to struggled to get my insurance to approve a few more days, I'd admitted that time due to catchinf myself planning out and about to act on said 💀 plan, my stay was about a week and a half total. No I was not ready to leave, but the hospital literally couldn't keep me because my insurance wouldn't keep covering me)
I hope that you vote the right way when it comes to it because it’s republicans who voted against making medication for people like you affordable. But people seem to be more driven by hate towards immigrants and gay people.
I'm hoping that me and the rest of us get the courage to do what it takes to change the system, so that you don't live in fear like this. I wish you the best.
Recently I started seeing a cardiologist . I noticed a sign that read " we will no longer accept United Insurance" . I thought that was a little strange, now I know why.
Yeah, I had a policy from UHC for a few years. The network was spotty; for example, a worker at my local hospital told me UHC was the only major insurer they didn’t accept. From what I heard it’s because many providers found UHC too difficult to work with.
Not surprised. On a different video about UHC someone said one of their providers didn't take UHC because they didn't pay "because you're a small practice so you don't have the resources to sue us". Aka "we won't pay for valid claims because we can get away with it".
Cash is the way. Insurance needs to go away. Nobody should be forced to pay for another person's bad lifestyle, which is what insurance basically is. Healthy people get to foot the bill of unhealthy people.
Plus, they started denying to cover the cost of anesthesia should a surgical procedure last more than some arbitrary time limit.
@@Redditor6079 If only it were that simple. Unfortunately, most medical conditions are due to injury, illness, genetics, or other factors beyond people’s control. Also, the treatments are often too complex to expect them to be affordable to the average person.
Ever notice how nobody can agree on when America was 'last great'? 🤔 Well, here’s a thought: maybe it was when the rich actually paid their fair share in taxes.
🎯 During WWII, the top tax rate on the wealthiest Americans hit 94%. Yes, NINETY-FOUR percent. After the war? It stayed at 91% throughout the 1950s-aka the 'good old days.' With that money, we built highways, sent kids to college, and reached for the stars (literally, NASA was founded).
🎯 In the 1960s, the top rate was still over 70%. The Civil Rights movement thrived, we landed on the moon, and the middle class was booming.
Fast forward to now: the richest man alive is reaching the stars while paying a fraction of that in taxes-and we’re subsidizing him. Meanwhile, regular Americans are drowning in debt just trying to stay afloat 🇺🇸🫡
Ding ding! You are exactly on point. The IRS needs to get after them instead of arguing over a couple hundred dollars that Joe worker might owe them.
The overwhelming majority of taxes are STILL paid by rich. 75-85%. Our contribution is practically nothing. Your post is a common misrepresentation of reality.
Non rich like us could basically stop paying taxes and there would virtually be very little difference in government services.
@@pdxmusl1510That’s the point, if we assume the rich pay all the tax, then if they paid the correct proportion we’d actually have the money for these great things.
From paying 90% to paying 10%, you’d have nearly ten times the tax revenue. You’d be able to afford basic human rights _as well_ as the overly expensive, inefficient military
How that boot tasting
@@pdxmusl1510: and this is supposed to change our opinion how? The rich SHOULD pay most of the taxes
This is fraud.
The insurance company offered a product,
then refuses to uphold their end of the bargain in 90% of cases for the sick, elderly, and dying?
That is fraud.
Yes but the lawsuit is months old and is ongoing. It’s basic contract law.
@@mikeyman1974 Fraud SHOULD be criminal law, prosecuted by DOJ.
Not contract law, nor a civil complaint.
If other fraudsters can escape the law by offering 10% of their marks some compensation, they will be happy to take that deal.
@@tevrenendrigan1838 like I said it’s ultimately at it’s core this is a situation of United health violating the terms of it’s contracts and as a result their clients are suing. If you can prove intent maybe it could become criminal but until then this is how the laws and systems work.
Exactly. In other countries, the consumer protection agencies protect people from corporations that scam people.
@@tevrenendrigan1838 again it’s not fraud because it’s not a misrepresentation of a product. It’s breach of contract.
We've 🇬🇧 still got National Insurance and the NHS though they took a bit of hammering from the previous Tory Government. We don't submit claims, medical costs are simply covered directly.
terrible
Watch for privitisation by stealth. Government underfunds said industry, points to it and says it's failing at current funding level, advocates for private money injection. National is busy doing it all over the place in NZ, and the muppets here are welcoming it with open arms.
Privitisation by stealth will soon happen. It's happening here in NZ.
@@23pinkpearyou enjoy begging for someone not to call an ambulance, or having no insurance because you were injured at work?
That sounds like communism! Here in 'murica we have freedom to choose between medical bankruptcy or premature death from a treatable illness. Ronald Ragan told me to be afraid of the government when he was president, and I haven't stopped being afraid of it since. Now I don't see a doctor every year and I can't afford my medication all the time, but that's ok because one day I'll be a billionare and get to step on everyone else.
In NJ we have a state agency known as DOBI, division of banking and insurance. I once spoke to a rep concerning a case I had against BCBS of NJ, and the rep agreed, I had a legitimate case and I should file a complaint. She also warned they were backed up with cases against Blue Cross and it would "take a while." I filed the case, then called Blue Cross and told them as a courtesy I was informing them of a complaint filed with NJDOBI and the case has already been assigned a case number of which I am not obligated to give you.
After more than four months of futility, paperwork, faxes, and phone calls my claim was paid in seven days. If you state has such an agency USE IT. If not, try to get one by calling you state representatives.
Never mind Drud, of whatever Musk and his idiot friends want to do, there should be a federal agency that works on behalf of patient benefits. After all, we spend BILLIONS on federal health agencies that pretty work on behalf of big pharma and big insurance, and then make then lobby proof.
Depose more CEOs.
You mean dispose 😂
Padre God be Praised for this young lady speaking out for us. Please continue to do so! You're so appreciated. Paz be with us all 🙏. "Sra Isa"
They need to be punished for their crimes
Healthcare as it is in the U.S. currently is NOT health care. It is shareholder care and C-suite care.
💯
Profitcare
And the most frustrating part is the debate is about getting everyone insurance which is a no value added for profit middleman va getting everyone healthcare
In the US insurance and healthcare are synonymous despite being opposed forces
I've heard people say it's not a Healthcare system, it's a torture system
And it is
@@drewidlifestyle7883 this is an excellent point. Insurance is profit driven and healthcare *should* be patient care driven - opposite goals indeed
Luigi represents the vigilante we ALL wish we were !!!
TRUTH BE TOLD
If he's guilty of the crime... no. No I'm not. Murder is deplorable and amoal. So.. you can sit in your mom's basement and be crazy. Leave me and every rational person out of your delusional world.
I just had an $800 claim denied (for lab work 😮). I called UHC and asked for the reason for the denial. "Um, looks like an incorrect code was used."
"So," I said, "No bill will be arriving from the hospital?"
" Oh, well we don't know if the server will bill you, but if they do, have them call us so we can correct the error in code. "
They weren't going to correct it when I called in, so I don't imagine they'll correct it later. Such a crooked business they're in.
Why couldn't they just call them and correct it if they were made aware of it? Ridiculous.
You need to call the doctor that coded the diagnosis for the labs. The coder/biller can review and if possible fix the diag and resubmit.
@TheFiercepixie Suddenly (yesterday), the bill has been 'covered.' Looks like UHC corrected the code in the meantime 🤪. I'm gonna make note of your solution tho, in the event it happens next year again. Thank you ❤️
And they paid AARP to use their name in their ads. Boycott AARP too.
AARP started as an insurance scam and hasn’t changed at all, IMHO.
"It was an error rate", one that resulted in heaps of extra profits. The purpose of a system is what it does.
Banks always err in their own favor chap
If any other system “failed” 90% of the time it would immediately be taken offline. If that’s the “error” rate and they choose to leave it in service it’s not an error rate anymore. It’s now acting as desired.
*WWLD* - _"What would Luigi do?"_
I swear this comment is a honey pot 😂
Indeed.
@@candyluna2929 who cares it's not like they can oust the majority of the population
Lol holy sh*t! 🤣🤣🤣
He would rescue princess peach and Mario.
If you didn't know, 'insurance' is a gambling game incorporated as a necessity (by the mafia style gubment we have) in U.S. living. It is the poorest people, looking to get health ASSURANCE (NOT a gambling scheme) for when they fall ill, but only paying for the health care of the rich families that are on the board of insurance company that are fleecing the poor.
It's usury hidden under the premise of 'business', which is a huge sin by any that have that kind of 'power'.
I appreciate your dedication to being truthful and transparent.
This is not new. This has been happening for over 20 years even before AI, AI just makes it faster
Exactly right and more efficient… another cost saving option for them.
@@Luka23567And that makes it a good thing???
@ absolutely not
Deny, delay, defend, deflect
meanwhile they are trying to get me to care about some mickey mouse drones
Exactly
The irony 😂
Love the user name
They are called GHOULS.
Pay attention at who’s trying to distract, the republicans are the ones losing their mind over drones.
The physician has to challenge the denial and this costs huge amounts of money for the physician to do. So unless your doctor is willing to do the appeal the patient can do nothing about the denial.
And this is why your medical costs rise.
Because everyone knows and talks about “deny”, I think just how disgusting the “delay” and “defend” are get overlooked.
The insurance companies delay the decision and defend their choices in court because of the possibility of the other party giving up or dying. Let that sink in. They deliberately try to wait out their clients’ deaths, just so they don’t have to pay the amount they said they would.
There's an old saying where this comes from, 'deny, deny until you die.'
Correct me if I’m wrong but… shouldn’t that be considered manslaughter? It feels like it at least.
They outright encourage that death bc sick people aren't profitable. Sick clients use their healthcare making them a liability on insurance balance sheets that the company wants "deleted"
That's murder. The government doesn't persecute it because they use the same method for disability claims.
I'm a now-retired RN. Navihealth is a nightmare!! Before I retired in 2023, I was working in a rehab/longterm care facility. During my last year, we started having to deal with Navihealth, which was the arm of insurance handling authorization for rehab stays. They use algorithms to determine how much treatment a patient should get based on their diagnosis. They were getting tighter and tighter, denying inpatient rehab a week into the patients' treatment when they normally would have been there 2 to 4 weeks. Every insurance company will look for the cheapest way for you to get what you need.
Yep. It's taking me three months from initiation to get my first therapy appt through state insurance. And first they had to freak me OUT and ruin a Sunday by denying the payment of a physical I went to get as a prerequisite.
I came here from Mexico 35 yrs ago. Some say that it's a shithole country. However it has college education for all that pass an entrance exam. Everyone that works and their families has medical insurance. Everyone that works can buy a house subsidized by unions and the government. It's horrible that here the government doesn't help it's citizens much unless they belong to the 1%🤮
Do you ever think of going back? USA feels like the shithole country these days to me...
The AI was made to deny over 1 in 3 cases.
Despicable 😢
When I used to work as a pharmacy technician, I had a saying, “I pay the consequences for other people’s poor decisions”. I saw a patient who had broken several ribs. She was prescribed oxycodone and guess what her insurance did, they required a prior authorization for it. Guess who had to deal with the patient’s angry husband. I’ll give you a hint it wasn’t the frigging insurance company. I had to explain to the husband why the medication wasn’t covered unless the doctor filled out the prior authorization. I really detest insurance companies that do this. As someone who has been both sides of the shit sandwich that is the health insurance industry I don’t condone the violence but I sure as hell find it hard to have sympathy for the CEO when he had a hand in crap like this.
It’s sad that it took a murder to bring light to this subject.
It didn't. Its been out in the open the entire time
It’s also sad that the murderer has less blood on his hands than the guy he murdered. That healthcare CEO is most likely responsible for more deaths than all of the mass shooters and terrorists combined. But nobody in power holds these companies responsible for their literally fraudulent business practices because their all awash in their blood money.
@@pdxmusl1510 true, but now a lot of people are actually talking about it
@septanine5936 Until a drone hysteria took over the newscycle.
And distracted all the MAGAs who'd just woken up and realised they were being played by the Culture Wars to fight against their own classes so they wouldn't notice it was the ones at the top that were responsible for their problems.
Now, the RW pundits can drop the subject and not be crucified by their own audience.
The classic strategy of "Look ..squirrel."
The murder of a rich person. The thousands dying from denied coverage or avoiding doctors due to cost all together didn’t count for some rrason
We have dangerous trees near our cabin that need to come down. I inquired with our property insurance company about them working with us to remove them. They told me that's not how it works. So, I said ok, then tell me how it works. They said if a storm takes them down, I would have to file an insurance claim, then they would remove them for us. Logically to me, I said wouldn't that cost the insurance company more because there would be more damage. In fact there could even be loss of life and property. They could care less. In short, it made sense to me for a company to pay a lower fee in order to remove a potential high cost or expense. Don't wait for it to break, before you fix it, if you see a potential for it to break. Sure enough, Hurricane Helene hit and took down numerous trees. Fortunately two years prior to this hurricane, we personally paid thousands of dollars to have these huge white pines cut down. Had we not done so, we would have lost our cabin and perhaps our lives. The system is broken!!! I was going to use cursive words, to express my anger but it's not necessary. You get my point. I don't want to offend anyone or get banned by TH-cam. We are no longer living in a free society. 🙏🇺🇲
Today, UHC and my MD had a meeting to discuss my MDs MRI request that was delayed, and then DENIED! I wonder what UHCs final decision will be after thst meeting. Another period of time I have to WAIT for their answer. 😐 😒
Thank God for the NHS.
SOMETHING ANY CIVILISED COUNTRY WOULD PROVIDE.
Doctors cant be doctors and treat anymore. Now they have to he admins too.
Yep. The united health care denied me an MRI couple of years ago. I had to pay $800 out of pocket for it because I was just desperate for answers at that point. Later my surgeon found 6 abdominal and pelvic hernias, some of them he told me were the size of his fists. Did I appeal with the insurance? Hell no. I’m disabled and barely functioning. They’d use it and they’d find a way to delay and deny again.
Disabled folk suffer severely and abled folk don’t care enough cause they can’t relate, yet.
If you are denied contact the Care over Cost campaign.
Here's hoping Luigi comes back for round 2.
That’s not the guy. They know they will never find him so they picked up an actor (which is him) that will play the part of a shooter to show the public how competent the regime is.
Just think about it how idiotic the story is: they found him sitting at a McDonald’s eating fast food, with the gun and manifesto of why he did the killing…
It’s either a complete set up or he has to be the most idiotic assassin in human history! 😂 😂
1st off I wouldn't believe anybody in sweats videoing from their bathroom. And yes the regulations that allow one company to be involved in A-Z of Healthcare is not right when you manage all govt provided care, own the nursing home, the Drs & nursing staff, the distribution of drugs, all under different entities it's just not kosher, & hospitals send you to a nursing home asap for your rehabilitation. Just too much potential for abuse & lots of kickback to Drs, Surgeons, & Hospital Administrators. This needs to be investigated but She's blowing hot air to insinuate its AIs
More promoting terrorism. Lot of that going around in these comments. Have fun on the watch list lol.
I worked at a massage clinic 30 years ago and a client came in with whiplash and was helped greatly by Massage. She then told us she was an insurance adjuster and was taught to delay payment to us because we were a “sham” treatment, and she had believed it. She quit her job shortly after…
...and then their CEO was "allegedly" murdered.
Happened to me. I 100% believe this is why I had issues. After being on wegovy for my diabetes, UHC denied it one day. Workers had zero idea why. Took 3 months to appeal and suddenly it worked and then took months to get back to therapeutic levels. I have asked serval times for someone to explain my diabetes med as denied. Every time worker said “it shouldn’t have been denied” and say someone will send me the reason by mail. That was a year ago. Never happens.
It's because an in patent highly cost-ineffective medicine that should only be paid for for by the plan for patients who truly need it for their illness and for whom more cost effective treatments don't work, but instead millions of people are getting it for weight loss and basically fudging the paperwork (in effect committing fraud.)
Since 2023, every single prescription I have been given has been denied.
That's what you get when politicians have to appeal to companies instead of people. An easy fix for this would be that healthcare coverage always needs to cover a basic set and they always need to pay first and can only later try to get the money back. Also lawyer fees should be covered as part of your insurance so they and not you have to decide if it's worth suing.
The automatic denial has been that way for years. I worked for a medical facility that did a lot of cataract surgeries and the insurances almost always denied five times. That was back in the 1990s.
United Health Org. is the 11th largest company ON EARTH 🌎
Thank you for keeping the discussion going and keeping this topic in the spotlight
Luigi time.
Unequivocally no.
@@pdxmusl1510Clearly you are rich and healthy. Step aside while real Americans solve the problem.
The reason that only 0.2% of policy holders appeal their denied claims isn’t because we don’t want to “call their bluff,” but because we can’t afford a lawyer. The system is broken at every level, or rather, it’s working exactly as designed.
AND they know we are too sick to fight them.
Although I have other reasons for my decision, this is primarily why I don't have insurance. It's a scam!
I keep telling people ai was NOT created to help the public.
AI, like any type of capital, was created to benefit the people who own it.
AI as any tool, can be weaponized. Now that it has been created, trying to limit it is as good as letting the government take your guns.
This is exactly what I've been telling everybody I know as well. I am a tech nerd who constantly studies this stuff, and trust me, I know this was not made for you and me.
The gaslighting is unbelievable. Like it's a normal behavior these days. Profit$$
Auto insurance companies have been doing this for years. Also State disability.
"don't cry for me argentina"..
The Truth is there will be a next CEO.
They've never left YOU.
90% error rate, depends on who thinks its an error…
Insurance that denies a patients claim that was received from a doctor’s council is malpractice.
Practicing medicine without a license is illegal. Why do we let insurance claims adjusters practice medicine? Why are insurance companies allowed to have doctors operate well outside the scope of their practice like having an ob-gyn deny a claim for a head injury? Why can a podiatrist deny your claim for chemotherapy?
Last week, twice, i was told at an appointment my insurance was invalid. Company paid insurance. I call the insurance and both times they said it was not invalid that i had coverage nothing wrong with my policy. What they didnt know, was the second time i was with the Dr and the nurse trying to bill insurance. They read them the numbers from the policy and tried again...invalid. Even though the insurance just said it was and told them what numbers to use. I also have had insurance refuse to send me a prescription card because my regular card should cover it, it doesnt have an rx number on it and doesn't work but they refuse to fix the issue or even offer any solution that actually works
At 90%, that’s not an error.
United Health Care at its finest
This is thoroughly illegal in most real first-world countries.
It’s deny, defend, depose
It’s not merely a “headache” to fight a denial. When we are extremely ill, the extreme anxiety and stress of a denial, and the losing battle via hours and hours on the phone damages our health significantly. Also delays result in more damage and even death for millions. ☠️
FREE LUIGI!!!
We need universal health care
The gubmint is 100trillion in debt... let it run health care 😅😅😅😅
This is why we need universal healthcare/single payer healthcare, it would literally be much cheaper than the current system because no middlman who is price gouging literally. For example, insurance companies force pharamcies to up the prices of their medications just to have a contract and independent ones get fucked over because the insurance companies make it too expensive for them to sell certain medication. We already see how easy medica is so programs such as medicaid or medi-cal in CA which shows universal healthcare is possible even financially.
An AI model with a 90% error rate is actually a model with a 10% error rate and mislabeled outputs
“This will change things” i was told. I had a suspicion it was going to be worse than before and I was correct.
This has been a common tactic in the auto insurance industry for years.
In the E.U we don't have this problem.
At all.
I not surprise they using AI to deny claims even though defective as they don’t care about harm they done.
Its not defective. Its working exactly as design.
I have come to believe in expansion of HSA accounts. The money in the account is ours and the health care industry would at least have to compete for our money and we would keep it if we die or could withdraw it taxed if we needed it for something else. Time has shown both private insurance and government healthcare is extremely problematic and controversial, we do not even agree on the difference between healthcare and infanticide...
I got an AI phone call trying to sell me life insurance. It asked my age. I said 97. It hung up. Tried to call the number back but it was clearly a spoofed number.
While AI can be coded to evaluate a bunch of factors to approve a claim, this one does NOT run on that sort of reasoning.
We know this because if it was actually following detection guidlines it would approve all of these claims, as they were already made by a trained and experienced professionals, and the AI would see the same things they do.
Instead this one has a gigiantic disapproval rate, which means it was is built specifically to find excuses to deny claims.
AKA: It was programed to LIE.
Using AI for this sort of thing legally is fraud, and suing them based on this would be good case law, that would shut down a LOT of AI nonsense.
Valedictorian got the top CEO. Salutatorians, consider this your marching orders to get number two.
It's happening to me right now!
Ridiculous! Pay so much money just to have insurance and then be denied for something I need. I saw they need to line up all those CEO’s!
Excellent delivery, easy & pleasing speaking voice, evan better your a hero for telling the truth when few have the courage.
Thank you. ❤ ❤ ❤ ❤ ❤ ❤
ItSA MEEeeeEeee!.. MaRiO!
I have nothing better to do than argue with them about a denial they realize that after a while.
we need change
Propose a better system. I don't disagree. But give that to your representatives. Not to youtube. Thats how you change things.
Insurance is a scam
I just set my boundaries very sternly! I won’t talk to systems, I will only talk to humans and I only use health care for simple things. The rest I take care of myself!
Sorry, clarify the simple things bit.
To me a “simple thing” is flu rest liquids time
“The rest” is a broken arm which I’m definitely not taking care of myself
@ I go to the VA and I have set my boundaries with my Dr, they don’t even ask me if I want a flu shot anymore, they know I don’t do big pharma, blood transfusion and before any procedure I clarify with everyone of what you can put in my body and what you can’t. I went for a procedure and everyone assured me no antibiotic or steroids and I asked the anesthesiologist and he was going to give me steroids and I was like no your not. I make sure I am very clear. I do not want to be saved at all cost especially a blood transfusion with Covid contaminated blood! Very simple if I had a broken arm, you can treat that, but I don’t need to be given a bunch of preventative big pharma along with it. So I am very clear and I have my advanced detectives written up. I usually just have them do my blood work a couple of other tests I like to do. That is it. I have not taken an antibiotic since 1991 and I know how to heal myself. I got a second degree burn from boiling water and I had it healed within a month and you can hardly see any redness. I used bag balm! Great stuff! I worked in health care for 30yrs, I know the evils of big pharma!
Sounds fine, until you end up with one or more chronic health conditions where you need a whole care team to help you.
@ haven’t you ever looked in to natural healing? Do you know you have the ability to heal yourself? You were given an amazing immune system! You are missing out on a whole new world! Break free from the chains that bind you called big pharma!! I have not taken an antibiotic since 1991, I have healed a second degree burn in 30 days with no scar, I am almost 60 and don’t take any RX. Energy healing is wonderful! Grounding, what you put into your body, how you treat yourself. All health care wants to do is give you a pill for every complaint. If you want to build muscle, exercises, want a strong immune system, allow your body to work through many of the minor things.
@@drewidlifestyle7883 they must have taken down my reply. Do some research, so many natural healing modalities! Big pharma just gives you more side effects so they can give you more pills! They are keeping you sick so they can make money and the food corporations are helping your illness along. Taking steroids breaks down your bone density, it’s one RX they always want to give you. You could not pay me enough to take that shit! Look outside the box!!!
Just another reason to praise Luigi.
something something luigi
So, what happens if we all stop paying for any insurances?
Will these corrupted corporations go out of business?
Homeowners are denied claims, auto ins claims are denied....
They are all corrupted. 😢
You'll have to pay "cash price" at doctors office.
Why are you always doing this in the toilet
Fellow TH-camrs, J.G.Wentworth69420 has woken up in the hospital with his legs broken.
Let's wish him a speedy recovery.
she has to poop a lot.
Cause most of the time this channel posts untrue or exaggerated s**t. Probably the real reason.
Free Luigi!
Back in my day, if we got hurt after working a 26hr shift at the plant, the doc would give us a vile of methamphetamine and morphine and send us on our way. Yep. Worked that plant for 4yrs but got laid off when I turned 14 😔
Geez! Meth and morphine are extremely strong. What kind of plant was that?
Looks like another CEO need an example
this is the stuff that makes me embarrassed to say I work on AI. it has some great use cases, especially computer vision stuff, but using it to deny people healthcare is disgusting
Computer Vision is one of the few beneficial uses of machine learning technologies. Generative AI however amounts to a toy most often, and is much more quickly used to harm than to help.
The American people need to rally together and fight this. This is just hands-down wrong.
If it had any error rate, that would mean that it had been approving claims.
😂
We need more people like luigi!
Of course they deny claims. People always shop for the cheapest coverage. The only way to have lower premiums is to not pay claims.
When people start sorting providers by "pays the most claims" and not "lowest premiums first", things will change.
So you can afford it? Well I'm proud of you😂
Surely you can't be serious. If car manufacturers could sell you a cheaper car that didn't have seat belts, air bags and explode like a Ford Pinto, they would. The reason we don't have to worry about our cars being more of a death trap than they already are is because we've regulated the industry to provide some basic level of safety to protect the consumer. Health insurance is currently broken and the solution isn't blaming the consumer, its to tighten regulation to make that industry work in the people's favor more. That's one of the core functions of government otherwise we'd be in some neo-feudalist hellscape where we have wealthy kings who are above the law and might makes right.
@@andrewn7365 That's a great analogy. All those standard features have made a new car about 20% more expensive, adjusted for inflation, since the 1980s.
The amount of claims paid is tied by law to the amount of premiums collected. If people want more claims paid, they should sign up for higher premiums.
No one does that.
@@DJ_Force Yes it has made cars more expensive, but the reason there's not a cheaper option isn't because of consumer preference it's because of regulation. Would you be blaming people buying dangerous cars had there not have been regulations in place to protect consumers from buying them?
@andrewn7365 Sorry, you've lost me. What do safety regulations have to do with insurance companies paying claims?
Idk this AI thing and high rate of insurance coverage denial is giving IBM’s involvement in the Holocaust. Too many people perished because advance technology was removing humans from having to care about the people they were hurting. In this case - going after the sick in masses. Where are private insurance going with this if each year they’re supposed to out do the last?