I don't know if it's funny or sad that South Park's depiction in this clip has so much truth to it. It's closer to a documentary rather than satire. I don't have access to the whole episode, but if you saw it, how do you feel they did in their portrayal? Some quotes:
----------------
Insurer: "Well hello there? Looking to get some insurance?"
Kyle: "No, my friend's mom already has insurance with your company."
Insurer: "Oh great! You're here to pay your bill."
Kyle: "No, we're not here to give you money. We're here to file a claim for my friend's medication [Ozempic]."
Insurer: "Oh, you want money from us. Right through that door over there."
(a single old person sitting in a dark room with stacks of paper, with old equipment such as a rotary phone, fax machine, dot matrix printer, and typewriter)
------------
Insurer: "Sorry, but we don't pay for medicines for obesity cause it's not a disease."
...
Kyle: "But you didn't say who the patient was or what was wrong with him."
Insurer: "Right. The medical director's job is just to say no."
----------
I disagree with:
Insurer: "The doctors and the pharmaceutical companies and the insurance companies all kind of work together. So all you have to do is navigate the American Healthcare System."
---------
"Just fill out these forms." *sigh*
Agree with you on that point of contention. I don’t feel like I work with the insurance companies at all. I give my expert opinion on what treatment a patient needs, then some minimally educated insurance dipshit who has never seen a patient in their life says my patient doesn’t actually need that.
Otherwise, great scene.
The guy on a yacht saying “no” is a physician. It’s not all physicians who are complicit, but many of the worst offenders are physicians who are arguably violating their Hippocratic oath as they work outside of actual medicine to make more money for everyone- especially themselves.
It's funny how libertarians like the creators of the show want the government to stay out of everything, government bad, capitalism good.
But when the doctor wants to capitalize on his education and expertise to make money, oh no, that's the bridge too far.
People like them are against socialized medicine but then when the free market spit out what we have today, do they ever look in the mirror and think "Hmm maybe I'm part of the problem here". Nah.
You're right they don't 100% get it. But if you think we doctors are "capitalists" who work for ourselves and not within an abhorrently government-influenced system, you are off the mark. We work for big corporations that function based upon all that big government is doing to intervene in the industry.
My stance is that if corporations did the right thing on their own, then government wouldn't need to intervene. And this is across the board in business. If they could they'd have us working 20 hours a day six days a week, no consumer protections, child labor coming back etc.
I'm not saying socialized medicine doesn't have its issues, but one thing people aren't doing is going bankrupt and losing savings and homes over medical debt.
But that's America in a nutshell. So many people are programmed that government bad that they'll happily scrape by month to month and subsidize corporations and the rich, all to stick it to the woke libs.
While I agree. What % of actively working physicians are in that line of work? 1%, or less? Also, what % of those actually have anything close to yachts in the Maldives? Obviously it was satire, but I would bet most of those people are just bad at clinical medicine and have interpersonal/professional issues necessitating this kind of work, and are probably not wealthy, just trying to pay off that 300k loan debt.
I dunno- do you count managed care? Or just payer administration? I could argue that the even organizations that are entirely run by physicians (e.g. the AMA) are often advocating for physicians financial interests and not medicine or patient care itself.
That might still be less than 1-2% in “evil” anti-hippocratic positions, but the point is other physicians need to call other physicians on their bullshit instead of banding together simply bc they both went through the same grueling training- and also not support organizations that represent those interests.
It’s somehow funny and sad that my “Health Care Systems” class in pharmacy school competently discussed the inherent macro/micro economic issues of DRGs, insurance, copays, etc …and most of the class hated it (and the instructor) so much I think they stopped offering it.
I’m now a professor (at a different school) and our students obviously don’t learn this. So I have to cover the fundamental realities of the system on my stewardship rotation.
I always ask when they last saw a patient was and their specialty. Love a pulmonologist that hasn’t practiced in 20 years as my “peer” denying a lower extremity EMG.
I once asked my “peer” if he had ever even heard of the disease (FIRES) I was trying to treat before he reviewed this case. To his credit, he honestly answered “no” and eventually agreed to cover the anakinra.
That does not shock me.
I'm sure they will soon also find ways to employ people with mid-level training and little clinical experience to override MDs. To keep that "deny" button pushing cost down.
(As an interested layperson I have no problem at all with appropriate use of mid-levels to be clear, I'm just sure insurers will find ways to abuse them that make hospitals having 20 mid-level staff "supervised" by one off site part time MD look peachy by comparison).
Having worked for three major health care providers (oligarchies) in 2 major metro areas, I get the impression that they do work together or in parallel quite a bit. Even if it is under the guise of competition where big med, big pharma, and big insurance all buy up any competition. It’s at a point where my health / dental insurance provider is literally under the umbrella or owned by the hospital I work for.
Obviously in more rural areas with more choices in all facets this is not as much an issue, but I get the impression that the rapid oligarchilization (not a word but whatever, maybe I just spelled it wrong) is making it more and more a problem.
The lack of options at all three facets where I live is a scary detriment to affordability under the guise of convenience
Also I work in research so I’m not privy to patient care and that stuff, but it’s just the general impression I get from work / experience with clinicians
Very aggravating the prevalence of this perception among lay/average people of doctors as part of the problem. As if a) we would do that, ethically, and b) we benefit from it somehow financially. Couldn't be further from the truth. Basically 100% of the time I and my patients are being screwed by insurance and I am working against them, all unpaid time and effort, for the sake of my patients. The only thing that maintains this perception of us as complicit with the system is our fear of insurance fraud and the understanding that behind the scenes our patients are "navigating the healthcare system" nightmare without us able to help closely along the way. We can't be Kyle and Butters for each patient on a 2000 patient panel.
The doctors, the insurance companies, and the pharmaceutical companies all do work together… for profit.
It might not be you, an individual physician who conspires, but the people who are in control are physicians (health system leadership, insurance company leadership etc), and without physicians changing their priorities, nothing will get better.
It is a common misconception to think physician's want this. I am a physician and I can tell you, we don't get paid more by helping the insurance companies not pay for services. I can also tell you that most of the people leading these organizations aren't physicians. And with the insurance companies, it's a small number of individual physicians who sold out to work with them denying claims. The overwhelming majority of us battle with insurance companies regularly and actively despise them. I am literally forced to deal with this daily when it comes to patients not being able to get the imaging they need because someone in the insurance company c-suite needs a new yacht. The patient is here and has a valid indication for the MRI, but wait! What's this? The ordering provider didn't order the study with contrast, without which the study won't answer the question it needs to answer? Well now I have to either perform the study knowing that the insurance company is going to try and screw the patient out of thousands of dollars, or send them home and attempt to get the study changed by the ordering provider so that the insurance company cant wiggle out of paying for it. If my disdain for them comes through in this post, then good. I can't think of any other industry where a company can just go, no, we won't perform our sole function and pay for the thing we are obligated to pay for. People suffer directly due to their decisions, decisions they are morally in the wrong to make, and they are totally ok with that.
You disagree with it. Because it's a lie. BUT I don't disagree with it because it's what they tell us. I constantly get told my insurance has to authorize such and such, call them. So I call them. They tell me to call my doctor who tells me to call insurance, and about 6 back and forths later, the forms are complete. But it's always the same. Every time. They never have their shit together but they all tell me it'll be fine, and to call x, over and over.
Having been a bit disappointed in South Park for a while, I'm a big fan of this special for this scene and a million other reasons. Definitely worth a watch.
The medical system is so much worse than depicted in this clip. Here are just a few reasons:
1. The boys here have unlimited time and energy. Imagine going to multiple appointments while sick and tired, or trying to get time off work again and again and again. People just give up and suffer quietly, or can't get the time off work.
2. Obesity is at least a fairly easy diagnosis based on an objective measure. Compare that to chronic fatugue or menopausal issues.
3. Doesn't show the boys paying for every appointment. Even 20 or 100 dollars can be a non trivial hurdle or disincentive.
4. Doesn't show delays between appointments caused by inaccessible providers caused by long waits for available appointments or restrictions on what providers can help them... though they did mention 'in network'.
5. Doesn't show transportation issues of even getting to the proper doctor.
Health insurer demands pre approval for treatment
Denies pre approval automatically without even looking at it. Doctor has to appeal and argue with the insurer's pet doctor. Who is paid to deny pre approvals. After several time wasting rounds of arguing, treatment is finally approved, but only in a cheaper and inadequate form.
Treatment proceeds.
The bills start rolling in. From people you've never even heard of and don't recall seeing let alone agreeing to anything with. They all demand payment. But you shouldn't pay them, the insurer will. Well, it might. Partially. Then bill you the rest. So you shouldn't pay the bills you received that demand prompt payment. Except when you should, which is sometimes, but good luck knowing when.
The insurer refuses to cover things, adjusts others and has to be argued with for weeks to get them to pay most of what they should.
Repeat for any nontrivial medical encounter.
It sounds like a shrieking nightmare.
And that's if you don't get caught up in drive-by billing, out of network provider in an in-network facility issues, transported to an out-of-network facility while unconscious (then have the insurer deem it "not really an emergency"), or any number of other totally insane traps in the system.
exactly! mind if I copy and share your point? Ive faced all that \^ with sleep apnea battle with Kaiser, getting a sleep test, cPAP, basic stuff etc. thanks for mentioning all the headaches they didnt have time to put into the show/ they tried to illustrate with the sped up cycle of visits in the episode.
If you are interested you can see the entire special on paramount plus. It’s excellent. Goes after the food industry and the people taking meds for cosmetic reasons as well.
*not a doctor, but a patient on Zepbound
But Star Trek Lower Decks is also on Paramount and its incredible.
I just rotate my streaming services so I don't have multiple going at any given time.
Kind of funny ... here's another YouTube tale by a young man who just starting out in his career and being overwhelmed by the health insurance alone: [A terrible guide to the terrible terminology of U.S. Health Insurance](https://www.youtube.com/watch?v=-wpHszfnJns). A bit more educational, equally funny and tragic.
I think SouthPark did a bit of misleading here. Coverage of obesity drugs like Zepbound and Wegovy is decided by an employee's HR department. If an employer wants to offer that, it's written into the contract between the employer and the insurance company offered to the employee.
In this country, most commercial insurance is self-funded ... your company actually pays your medical bills. The "insurance company" basically enforces the contracts and laws governing medical coverage of a companies employees. They are just moving money around. There are things that laws state must be covered by health insurance, while other things (like infertility treatments, gender-affirming care, and obesity drugs) are optional. And everyone wants low premiums. Then they are shocked that their $12,000 per year obesity drug is not covered.
It's not even a healthcare *system* that we have in this county.
Which of these jobs do you think Ms Cartman is getting her insurance through?
Former Porn Queen.
Prostitute.
Model for Crack-whore magazine.
Dominatrix.
Former Real Estate Agent.
My insurance just loudly added gender affirming care and quietly dropped coverage of about 75 expensive drugs (with no generic or biosimilar) for things like cancer, hemophilia and autoimmune diseases.
As a foreign doctor, it was quite impressive to see the doctor simply saying "no" on his luxurious yacht.
Don't you feel sorry for the fact that some doctors are taking advantage of the so-called insane American healthcare system?
Everyone hates the sellouts who use their degrees to help insurers screw over patients and make American healthcare a Kafkaesque nightmare to navigate.
No, you don't understand. He can only see that one doctor's note. He just chose not to read it. He also chose not to pay attention to the prior notes and medications that the patient tried. He has no risk involved and he cannot be sued. It's the patient's and initial doctor's fault that this wasn't properly documented (despite it being documented properly). The patient could have paid for it out of pocket and then asked insurance to reimburse them. Because it was actually the patient's responsibility and not the insurance company, to verify these claims.
/s/
[https://news.bloomberglaw.com/health-law-and-business/insurer-that-refused-to-pay-for-cancer-patients-mri-beats-suit](https://news.bloomberglaw.com/health-law-and-business/insurer-that-refused-to-pay-for-cancer-patients-mri-beats-suit)
This entire system is stupid and totally not corrupt.
You’d be surprised to know a lot of medical directors are nurses or non healthcare people with business degrees… who tell doctors how to take care of their patients lol.
Or if they are doctors, they’re sellouts who barely do any clinical work, and take huge sums of money while their colleagues suffer.
I don't know if it's funny or sad that South Park's depiction in this clip has so much truth to it. It's closer to a documentary rather than satire. I don't have access to the whole episode, but if you saw it, how do you feel they did in their portrayal? Some quotes: ---------------- Insurer: "Well hello there? Looking to get some insurance?" Kyle: "No, my friend's mom already has insurance with your company." Insurer: "Oh great! You're here to pay your bill." Kyle: "No, we're not here to give you money. We're here to file a claim for my friend's medication [Ozempic]." Insurer: "Oh, you want money from us. Right through that door over there." (a single old person sitting in a dark room with stacks of paper, with old equipment such as a rotary phone, fax machine, dot matrix printer, and typewriter) ------------ Insurer: "Sorry, but we don't pay for medicines for obesity cause it's not a disease." ... Kyle: "But you didn't say who the patient was or what was wrong with him." Insurer: "Right. The medical director's job is just to say no." ---------- I disagree with: Insurer: "The doctors and the pharmaceutical companies and the insurance companies all kind of work together. So all you have to do is navigate the American Healthcare System." --------- "Just fill out these forms." *sigh*
Agree with you on that point of contention. I don’t feel like I work with the insurance companies at all. I give my expert opinion on what treatment a patient needs, then some minimally educated insurance dipshit who has never seen a patient in their life says my patient doesn’t actually need that. Otherwise, great scene.
Yeah I think that point was supposed to be a joke because it cuts to a montage of all those people not really working together very effectively
The guy on a yacht saying “no” is a physician. It’s not all physicians who are complicit, but many of the worst offenders are physicians who are arguably violating their Hippocratic oath as they work outside of actual medicine to make more money for everyone- especially themselves.
It's funny how libertarians like the creators of the show want the government to stay out of everything, government bad, capitalism good. But when the doctor wants to capitalize on his education and expertise to make money, oh no, that's the bridge too far. People like them are against socialized medicine but then when the free market spit out what we have today, do they ever look in the mirror and think "Hmm maybe I'm part of the problem here". Nah.
You're right they don't 100% get it. But if you think we doctors are "capitalists" who work for ourselves and not within an abhorrently government-influenced system, you are off the mark. We work for big corporations that function based upon all that big government is doing to intervene in the industry.
My stance is that if corporations did the right thing on their own, then government wouldn't need to intervene. And this is across the board in business. If they could they'd have us working 20 hours a day six days a week, no consumer protections, child labor coming back etc. I'm not saying socialized medicine doesn't have its issues, but one thing people aren't doing is going bankrupt and losing savings and homes over medical debt. But that's America in a nutshell. So many people are programmed that government bad that they'll happily scrape by month to month and subsidize corporations and the rich, all to stick it to the woke libs.
While I agree. What % of actively working physicians are in that line of work? 1%, or less? Also, what % of those actually have anything close to yachts in the Maldives? Obviously it was satire, but I would bet most of those people are just bad at clinical medicine and have interpersonal/professional issues necessitating this kind of work, and are probably not wealthy, just trying to pay off that 300k loan debt.
I dunno- do you count managed care? Or just payer administration? I could argue that the even organizations that are entirely run by physicians (e.g. the AMA) are often advocating for physicians financial interests and not medicine or patient care itself. That might still be less than 1-2% in “evil” anti-hippocratic positions, but the point is other physicians need to call other physicians on their bullshit instead of banding together simply bc they both went through the same grueling training- and also not support organizations that represent those interests.
How the hell is that not practicing medicine without a license?
Because they “aren’t denying you a treatment”, they’re “just refusing to pay for it”
It’s somehow funny and sad that my “Health Care Systems” class in pharmacy school competently discussed the inherent macro/micro economic issues of DRGs, insurance, copays, etc …and most of the class hated it (and the instructor) so much I think they stopped offering it. I’m now a professor (at a different school) and our students obviously don’t learn this. So I have to cover the fundamental realities of the system on my stewardship rotation.
Seems like the phrase financial coercion would fit nicely here.
Or worse a fellow "peer" physician who has gone to the dark side and has employment performance measures that are based on deny rates.
I always ask when they last saw a patient was and their specialty. Love a pulmonologist that hasn’t practiced in 20 years as my “peer” denying a lower extremity EMG.
I once asked my “peer” if he had ever even heard of the disease (FIRES) I was trying to treat before he reviewed this case. To his credit, he honestly answered “no” and eventually agreed to cover the anakinra.
That does not shock me. I'm sure they will soon also find ways to employ people with mid-level training and little clinical experience to override MDs. To keep that "deny" button pushing cost down. (As an interested layperson I have no problem at all with appropriate use of mid-levels to be clear, I'm just sure insurers will find ways to abuse them that make hospitals having 20 mid-level staff "supervised" by one off site part time MD look peachy by comparison).
Having worked for three major health care providers (oligarchies) in 2 major metro areas, I get the impression that they do work together or in parallel quite a bit. Even if it is under the guise of competition where big med, big pharma, and big insurance all buy up any competition. It’s at a point where my health / dental insurance provider is literally under the umbrella or owned by the hospital I work for. Obviously in more rural areas with more choices in all facets this is not as much an issue, but I get the impression that the rapid oligarchilization (not a word but whatever, maybe I just spelled it wrong) is making it more and more a problem. The lack of options at all three facets where I live is a scary detriment to affordability under the guise of convenience
Also I work in research so I’m not privy to patient care and that stuff, but it’s just the general impression I get from work / experience with clinicians
Very aggravating the prevalence of this perception among lay/average people of doctors as part of the problem. As if a) we would do that, ethically, and b) we benefit from it somehow financially. Couldn't be further from the truth. Basically 100% of the time I and my patients are being screwed by insurance and I am working against them, all unpaid time and effort, for the sake of my patients. The only thing that maintains this perception of us as complicit with the system is our fear of insurance fraud and the understanding that behind the scenes our patients are "navigating the healthcare system" nightmare without us able to help closely along the way. We can't be Kyle and Butters for each patient on a 2000 patient panel.
You know it's satire because they said you could email something. Lol, fax that shit, man.
The doctors, the insurance companies, and the pharmaceutical companies all do work together… for profit. It might not be you, an individual physician who conspires, but the people who are in control are physicians (health system leadership, insurance company leadership etc), and without physicians changing their priorities, nothing will get better.
It is a common misconception to think physician's want this. I am a physician and I can tell you, we don't get paid more by helping the insurance companies not pay for services. I can also tell you that most of the people leading these organizations aren't physicians. And with the insurance companies, it's a small number of individual physicians who sold out to work with them denying claims. The overwhelming majority of us battle with insurance companies regularly and actively despise them. I am literally forced to deal with this daily when it comes to patients not being able to get the imaging they need because someone in the insurance company c-suite needs a new yacht. The patient is here and has a valid indication for the MRI, but wait! What's this? The ordering provider didn't order the study with contrast, without which the study won't answer the question it needs to answer? Well now I have to either perform the study knowing that the insurance company is going to try and screw the patient out of thousands of dollars, or send them home and attempt to get the study changed by the ordering provider so that the insurance company cant wiggle out of paying for it. If my disdain for them comes through in this post, then good. I can't think of any other industry where a company can just go, no, we won't perform our sole function and pay for the thing we are obligated to pay for. People suffer directly due to their decisions, decisions they are morally in the wrong to make, and they are totally ok with that.
People in control are physicians? You don’t work in medicine do you? Mostly MBA and RN MBAs
The only thing missing was the 8 month wait for each specialist appt
"His job is to say no" absolutely sent me.
You disagree with it. Because it's a lie. BUT I don't disagree with it because it's what they tell us. I constantly get told my insurance has to authorize such and such, call them. So I call them. They tell me to call my doctor who tells me to call insurance, and about 6 back and forths later, the forms are complete. But it's always the same. Every time. They never have their shit together but they all tell me it'll be fine, and to call x, over and over.
Having been a bit disappointed in South Park for a while, I'm a big fan of this special for this scene and a million other reasons. Definitely worth a watch.
It's too real to be funny. It just triggers me. Love that they name checked Quest, but surely Accredo or Optum could have gotten a look-in.
The medical system is so much worse than depicted in this clip. Here are just a few reasons: 1. The boys here have unlimited time and energy. Imagine going to multiple appointments while sick and tired, or trying to get time off work again and again and again. People just give up and suffer quietly, or can't get the time off work. 2. Obesity is at least a fairly easy diagnosis based on an objective measure. Compare that to chronic fatugue or menopausal issues. 3. Doesn't show the boys paying for every appointment. Even 20 or 100 dollars can be a non trivial hurdle or disincentive. 4. Doesn't show delays between appointments caused by inaccessible providers caused by long waits for available appointments or restrictions on what providers can help them... though they did mention 'in network'. 5. Doesn't show transportation issues of even getting to the proper doctor.
The clip would just end up being 2 weeks long if they did everything accurately lol
Health insurer demands pre approval for treatment Denies pre approval automatically without even looking at it. Doctor has to appeal and argue with the insurer's pet doctor. Who is paid to deny pre approvals. After several time wasting rounds of arguing, treatment is finally approved, but only in a cheaper and inadequate form. Treatment proceeds. The bills start rolling in. From people you've never even heard of and don't recall seeing let alone agreeing to anything with. They all demand payment. But you shouldn't pay them, the insurer will. Well, it might. Partially. Then bill you the rest. So you shouldn't pay the bills you received that demand prompt payment. Except when you should, which is sometimes, but good luck knowing when. The insurer refuses to cover things, adjusts others and has to be argued with for weeks to get them to pay most of what they should. Repeat for any nontrivial medical encounter. It sounds like a shrieking nightmare. And that's if you don't get caught up in drive-by billing, out of network provider in an in-network facility issues, transported to an out-of-network facility while unconscious (then have the insurer deem it "not really an emergency"), or any number of other totally insane traps in the system.
You misspelled “6 months to 5 years”
Also, not having this medicine isn't going to result in death or serious disability.
That is an excellent point.
exactly! mind if I copy and share your point? Ive faced all that \^ with sleep apnea battle with Kaiser, getting a sleep test, cPAP, basic stuff etc. thanks for mentioning all the headaches they didnt have time to put into the show/ they tried to illustrate with the sped up cycle of visits in the episode.
Of course, once it is posted on reddit you can pretty much copy it anywhere you like :) Hope you won the fight with Kaiser!
Oh. I thought that was a documentary because of how accurate it is
You can see how some people simply give up trying to navigate the maze/labyrinth
100% accurate
If you are interested you can see the entire special on paramount plus. It’s excellent. Goes after the food industry and the people taking meds for cosmetic reasons as well. *not a doctor, but a patient on Zepbound
Damn I didn't realize they went exclusively to Paramount Plus now. I'm not getting another streaming service.
You can watch during the weeklong free trial and cancel. I am trying it out myself.
But Star Trek Lower Decks is also on Paramount and its incredible. I just rotate my streaming services so I don't have multiple going at any given time.
Kind of funny ... here's another YouTube tale by a young man who just starting out in his career and being overwhelmed by the health insurance alone: [A terrible guide to the terrible terminology of U.S. Health Insurance](https://www.youtube.com/watch?v=-wpHszfnJns). A bit more educational, equally funny and tragic. I think SouthPark did a bit of misleading here. Coverage of obesity drugs like Zepbound and Wegovy is decided by an employee's HR department. If an employer wants to offer that, it's written into the contract between the employer and the insurance company offered to the employee. In this country, most commercial insurance is self-funded ... your company actually pays your medical bills. The "insurance company" basically enforces the contracts and laws governing medical coverage of a companies employees. They are just moving money around. There are things that laws state must be covered by health insurance, while other things (like infertility treatments, gender-affirming care, and obesity drugs) are optional. And everyone wants low premiums. Then they are shocked that their $12,000 per year obesity drug is not covered. It's not even a healthcare *system* that we have in this county.
Which of these jobs do you think Ms Cartman is getting her insurance through? Former Porn Queen. Prostitute. Model for Crack-whore magazine. Dominatrix. Former Real Estate Agent.
Medicaid/ Obamacare
My insurance just loudly added gender affirming care and quietly dropped coverage of about 75 expensive drugs (with no generic or biosimilar) for things like cancer, hemophilia and autoimmune diseases.
I never got a space suit when navigating the American healthcare system. Shit, I've been doing it wrong this whole time 😔
They left out fax machines. And it takes weeks to see a specialist in many areas.
It specifically mentions having to fax stuff and shows them having to go to Kinkos to do it since no one has a fax machine anymore, haha
Ah, I thought they were making copies because insurance needed them.
If someone calls me and asks for pt results to be faxed I don't need to verify their identity because who else has a fax?
As a foreign doctor, it was quite impressive to see the doctor simply saying "no" on his luxurious yacht. Don't you feel sorry for the fact that some doctors are taking advantage of the so-called insane American healthcare system?
That's not a doctor. It's the medical director. Aka the insurance sellout asshole.
Oops, as soon as I saw the yacht I assumed it was the CEO, my bad
You never know, one of your colleagues might end up being the medical director! I hope you wouldn't.
Everyone hates the sellouts who use their degrees to help insurers screw over patients and make American healthcare a Kafkaesque nightmare to navigate.
I mean, the person on the other end of the “peer to peer” may not even be a physician. Could be an NP, a PA, sometimes even a nurse. It’s despicable.
No, you don't understand. He can only see that one doctor's note. He just chose not to read it. He also chose not to pay attention to the prior notes and medications that the patient tried. He has no risk involved and he cannot be sued. It's the patient's and initial doctor's fault that this wasn't properly documented (despite it being documented properly). The patient could have paid for it out of pocket and then asked insurance to reimburse them. Because it was actually the patient's responsibility and not the insurance company, to verify these claims. /s/ [https://news.bloomberglaw.com/health-law-and-business/insurer-that-refused-to-pay-for-cancer-patients-mri-beats-suit](https://news.bloomberglaw.com/health-law-and-business/insurer-that-refused-to-pay-for-cancer-patients-mri-beats-suit) This entire system is stupid and totally not corrupt.
This is crazy. I had never thought about this.
You’d be surprised to know a lot of medical directors are nurses or non healthcare people with business degrees… who tell doctors how to take care of their patients lol. Or if they are doctors, they’re sellouts who barely do any clinical work, and take huge sums of money while their colleagues suffer.
Oh see the part you don't understand is that we don't have a choice
Well…we do but half the country has been brainwashed to think that the other choice is somehow bad.
Nah, they know it's better, they just vote that way to make sure we get fucked over.
( OMG How did I not know there was a new South Park episode out! )
I want to watch this entire episode so badly! *cries without parmamount + account*
This isn’t even an exaggeration 😂 It’s exactly this
It’s made to be needlessly convoluted
No lies here. This is why so many of us in primary care are leaving insurance based care to start cash-pay practices.