[xp84]

Indeed, I didn't like the dishonesty there. There's probably many situations where you're absolutely right. It's just that my hatred for this industry is too strong to grant them any quarter even when they're technically in the right.

Because the fact is true that even though they probably didn't demand to speak to the surgeon immediately, there's a reason the staff deemed it worth pulling her from surgery, and it's because if she didn't get to talk to the caller right now when they were on the phone, it could be any number of days before the matter could be resolved, and the hospital may not be willing to proceed if the insurance company is going to deny the claim, since that could saddle the patient with an unexpected $10,000 bill. In this way, our shitty system, designed on purpose by companies like UHC, forced most of this to happen.

[gruez]

>Indeed, I didn't like the dishonesty there. There's probably many situations where you're absolutely right. It's just that my hatred for this industry is too strong to grant them any quarter even when they're technically in the right.

You know what's arguably worse than insurance companies? Racists. So when there's a mysterious flu coming out of China and racists are latching onto it as a way to hate on Chinese people (eg. "China flu"), we better downplay it[1] so we don't give them any rhetorical ammo.

[1] https://www.cnn.com/asia/live-news/coronavirus-outbreak-01-2...

>there's a reason the staff deemed it worth pulling her from surgery [...]

Sounds like you're giving infinite charity to the doctor/staff and not allowing for any possibility that any sort of mistake on their end. Is this based off of any facts, or your "hatred for this industry is too strong to grant them any quarter even when they're technically in the right"?

[lovich]

You linked an article titled “No Clear Evidence Wuhan Coronavirus Can Spread Before People Show Symptoms” from _January 27 2020_.

The headline is accurate, at that point in time nothing about the virus was clear. The only portion of this article that even tries to downplay anything about China is this portion which as far as I know is still accurate.

> On the call with reporters, Messonnier also seemed to allay concerns that the virus could be transmitted via packages sent from China. Coronaviruses like SARS and MERS tend to have poor survivability, and there’s “very low, if any risk” that a product shipped at ambient temperatures over a period of days or weeks could spread such a virus.

> “We don’t know for sure if this virus will behave exactly the same way,” Messonnier said, but there’s no evidence to support transmission of the virus via imported goods.

Why are you trying to paint that as doctors lying?

[gruez]

>Why are you trying to paint that as doctors lying?

the exact wording I use was "downplay", not "lying".

>The headline is accurate, at that point in time nothing about the virus was clear. The only portion of this article that even tries to downplay anything about China is this portion which as far as I know is still accurate.

Even though the headline is technically accurate, the "downplay" part comes from the CDC trying to imply that the risk was low.

"Messonnier repeated her message that the immediate risk to the US public is low at this point."

[xp84]

I'm sure there was a technical mistake on the doc's end! But it's because UHC wants absolutely everyone to make 'mistakes' constantly, because every mistake delays or avoids a payment. Even a delayed payment moves an expense forward, maybe even into a new period, while the revenues are always captured promptly when your employer pays your premium. So, UHC's processes are purposely designed to add as much uncertainty and to be as easy as possible to derail.

The system insurance companies designed works something like this:

Provider: Enters patient ID, procedure code, date, etc. into the insurance billing system.

Insurance company: Applies an automated check to find reasons why this claim might be denied. For example: "Our records show that you amputated her right arm yesterday, so we can't pay for wrist surgery with a date of today" or "automatically deny all claims for XXXXXX as 'not medically necessary' and wait for them to appeal by following a separate process". If it finds any reasons, claim is denied. Some limited info is sent to the provider or patient, usually with a lot of latency.

Doctor or Patient: Must play a game with the insurance company to figure out (1) why insurance company thinks [insert wrong belief] (2) how to satisfactorily prove to them otherwise and (3) why despite after solving 1 and 2, the claim is still showing as denied. Providers are overwhelmed with hundreds of instances of this at all times, so they can't always handle doing this for you, and patients often lack the documentation, medical knowledge, and legal definitions in the policy, to be able to advocate for themselves.

If it were designed by anyone other than a bunch of ghouls looking to profit off killing people, there would be good ways to asynchronously but promptly enumerate and solve the problems that prevent claims from being paid. This would be tricky to build, but not impossible if the parties involved wanted to cure disease and save lives more than they wanted to be rich.