#But even MORE SO at UHC
Explore tagged Tumblr posts
Text
Fun fact! As well as all of this, United Healthcare is ALSO one of the largest contributors towards anti-abortion lobby organizations, including ones that impacted the Dobbs decision to allow states to fully ban abortion rights. They're using that money that they stole from taxpayers to directly fuck people over even more! 🥰
Here's an article!
“It seems like almost all of those people don’t have HIV,” said Jennifer Kates, HIV policy director at KFF, a health-research nonprofit. “If they did, that would be substandard care at a pretty severe level,” she said.
Ya’ll. United Health just got accused of $17 billion in medicare fraud.
Basically they made up diagnosis which are improbable or impossible, “forgot” to remove ones which had been cured, and overall allegedly stole billions from taxpayers.
The government pays insurers a base rate for each Medicare Advantage member. The insurers are entitled to extra money when their patients are diagnosed with certain conditions that are costly to treat.
… About 18,000 Medicare Advantage recipients had insurer-driven diagnoses of HIV, the virus that causes AIDS, but weren’t receiving treatment for the virus from doctors, between 2018 and 2021, the data showed. Each HIV diagnosis generates about $3,000 a year in added payments to insurers.
… He said internal company data for 2022 showed a treatment rate for patients UnitedHealth diagnosed with HIV of more than triple what the Journal found. He said the pandemic disrupted care, lowering treatment rates during the period analyzed by the Journal, and that the analysis failed to account for patients who started treatments in future years.
The Medicare data, however, show UnitedHealth’s patients with insurer-driven HIV diagnoses were on the antiretrovirals at low rates even before the pandemic, and hardly any started the drugs in the years after UnitedHealth diagnosed them.

Source: https://www.wsj.com/health/healthcare/medicare-health-insurance-diagnosis-payments-b4d99a5d
I bet United Health really wishes it was a different week right now.
#This was discovered by my coworkers at a certain large reproductive healthcare organization#when about 2 years ago our employer switched our insurance provider from Cigna to United#They never gave a reason why they decided to financially support an organization that directly impacted our patients' access to abortion#which we were providing EVERY DAY!!#I'm still so pissed at them for that#But even MORE SO at UHC#FUCK THEM for real#abortion#united healthcare
18K notes
·
View notes
Quote
One medical doctor, whose identity the Daily Beast confirmed, commented with sympathy for Thompson’s family and said the killer should be charged with murder, but then wondered about the damage the CEO had done. “I cannot even guess how many person-years UHC has taken from patients and their families through denials,” they wrote. “It has to be on the order of millions. His death won’t make that better, but it’s hard for me to sympathize when so many people have suffered because of his company.” “What has bothered me the most is people that put «fiduciary responsibility» (eg profits) above human lives, none more so than this company as run by him," wrote another medical doctor, who also spoke to the Daily Beast to confirm their identity. “When other’s human lives are deemed worthless, it is not surprising to have others view your life of no value as well.”
Moderators Delete Reddit Thread as Doctors Torch Dead UnitedHealthcare CEO Brian Thompson
8K notes
·
View notes
Text
there is no ethical consumption under capitalism
Years ago now, I remember seeing the rape prevention advice so frequently given to young women - things like dressing sensibly, not going out late, never being alone, always watching your drink - reframed as meaning, essentially, "make sure he rapes the other girl." This struck a powerful chord with me, because it cuts right to the heart of the matter: that telling someone how to lower their own chances of victimhood doesn't stop perpetrators from existing. Instead, it treats the existence of perpetrators as a foregone conclusion, such that the only thing anyone can do is try, by their own actions, to be a less appealing or more difficult victim.
And the thing is, ever since the assassination of United Healthcare CEO Brian Thompson, I've kept on thinking about how, in this day and age, CEOs of big companies often have an equal or greater impact on the day to day lives of regular people than our elected officials, and yet we have almost no legal way to redress any grievances against them - even when their actions, as in the case of Thompson's stewardship of UHC, arguably see them perpetrating manslaughter at scale through tactics like claims denial. That this is a real, recurring thing that happens makes the American healthcare insurance industry a particularly pernicious example, but it's far from being the only one. Because the original premise of the free market - the idea that we effectively "vote" for or against businesses with our dollars, thereby causing them to sink or swim on their individual merits - is utterly broken, and has been for decades, assuming it was ever true at all. In this age of megacorporations and global supply chains, the vast majority of people are dependent on corporations for necessities such as gas, electricity, internet access, water, food, housing and medical care, which means the consumer base is, to all intents and purposes, a captive market. We might not have to buy a specific brand, but we have to buy a brand, and as businesses are constantly competing with one another to bring in profits, not just for the company and its workers, but for C-suites and shareholders - profits that increasingly come at the expense of workers and consumers alike - the greediest, most inhumane corporations set the financial yardstick against which all others are then, of necessity, measured. Which means that, while businesses are not obliged to be greedy and inhumane in order to exist, overwhelmingly, they become greedy and humane in order to compete, because capitalism encourages it, and because there are precious few legal restrictions to stop them from doing so. At the same time, a handful of megacorporations own so many market-dominating brands that, without both significant personal wealth and the time and resources to find viable alternatives, it's all but impossible to avoid them, while the ubiquity of the global supply chain means that, even if you can keep track of which company owns which brand, it's much, much harder to establish which suppliers provide the components that are used in the products bearing their labels. Consider, for instance, how many mainstream American brands are functionally run on sweatshop labour in other parts of the world: places where these big corporations have outsourced their workforce to skirt the already minimal labour and wage protections they'd be obliged to adhere to in the US, all to produce (say) electronics whose elevated sticker price passes a profit on to the company, but without resulting in higher wages for either the sweatshop workers overseas or the American employees selling the products in branded US stores.
When basically every major electronics corporation is engaged in similar business practices, there is no "vote" our money can bring that causes the industry itself to be better regulated - and as wealthy, powerful lobbyists from these industries continue to pay exorbitant sums of money to politicians to keep government regulation at a minimum, even our actual votes can do little to effect any sort of change. But even in those rare instances where new regulations are passed, for multinational corporations, laws passed in one country overwhelmingly don't prevent them from acting abusively overseas, exploiting more desperate populations and cash-poor governments to the same greedy, inhumane ends. And where the ultimate legal penalty for proven transgressions is, more often than not, a fine - which is to say, a fee; which is to say, an amount which, while astronomical by the standards of regular people, still frequently costs the company less than the profits earned through their unethical practices, and which is paid from corporate coffers rather than the bank accounts of the CEOs who made the decisions - big corporations are, in essence, free to act as badly as they can afford to; which is to say, very. Contrary to the promise of the free market, therefore, we as consumers cannot meaningfully "vote" with our dollars in a way that causes "good" businesses to rise to the top, because everything is too interconnected. Our choices under global capitalism are meaningless, because there is no other system we can financially support that stands in opposition to it, and while there are still small businesses and companies who try to operate ethically, both their comparative smallness and their interdependent reliance on the global supply chain means that, even if we feel better about our choices, we're not exerting any meaningful pressure on the system we're trying to change. Which means that, under the free market, trying to be an ethical consumer is functionally equivalent to a young woman dressing modestly, not going out alone and minding her drink at parties in order to avoid being raped. We're not preventing corporate predation or sending a message to corporate predators: we're just making sure they screw other worker, the other consumer, the other guy.
All of which is to say: while I'd prefer not to live in a world where shooting someone dead in the street is considered a valid means of redressing grievances, what the murder of Brian Thompson has shown is that, if you provide no meaningful recourse for justice against abusive, exploitative members of the 1%, then violence done to those people will have the feel of justice, because it fills the void left by the lack of consequences for their actions. It's the same reason why people had little sympathy for the jackass OceanGate CEO who killed himself in his imploding sub, or anyone whose yacht has been attacked by orcas - it's just intensified here, because where the OceanGate CEO was felled by hubris and the yachts were random casualties, whoever killed Thomspon did so deliberately, because of what he did. It was direct action against a man whose policies very arguably constituted manslaughter at scale; a crime which ought to be a crime, but which has, to date, been permitted under the law. And if the law wouldn't stop him, can anyone be surprised that someone might act outside the law in retaliation - or that regular people would cheer for them when they did?
3K notes
·
View notes
Text
That's Right: It's Another Hot Take About That Dead Healthcare CEO
The websites are abuzz with debate on the utilitarian calculus of whether some guy getting shot was a good thing. What are the odds that the assassination will scare the horrible greedy health insurance companies into changing their ways and fixing the system? Is it worth killing someone over? Will the fear of being blasted by some guy with stylishly-engraved bullets put the fat cats in line? Or will their greed win out over their fear, leaving the nightmarish system unchanged?
Well, what if that was totally irrelevant?
You may have seen a graph that looks like this:

I've seen a few of these going around. These are the rates at which various health insurance companies say "no, you don't get the money" when someone says "hey I need money for this medical thing". UHC, the one whose CEO got shot, is notably really bad in this respect. They've got algorithmic claims denials and all kinds of nasty things that people don't like. All that money they're saving on paying out on claims must be making them rich, right? Let's look at their own financial reports:
Whoa! Big numbers! Six percent looks like a small number, but multiply and they make like thirty billion dollars doing this! That's a lot, right?
Well hang on. They're an insurance company. We can roughly model their profit as the amount people pay them for insurance, minus the amount they have to pay out for claims. Let's look at 2023: simple subtraction, their expenses are $339.2 billion. We simplify other overhead and assume that's all claims. So... that represents those 67% of claims they don't reject. What happens if they approve all the claims?
Multiply: $506.3 billion. They don't have that kind of money. They have $371.6 billion in revenue. So okay- they have to deny some claims. That's pretty normal. But let's pretend they're extremely afraid of assassins now and want to be completely non-greedy: they're okay making zero profit. They make $32.4 billion in profit- how many otherwise-rejected claims can they now afford to approve?
...uh. Well, they can afford to pay out, at most, 73.4% of claims. Still a denial rate of 26.6%, higher than most of their competitors. Not a huge improvement. And in reality, they can't afford to make 0 profit- a company that's making 0 profit is a company investors pull out of immediately, leaving it to collapse, because they can make more money investing in the ones that aren't as afraid of assassins. They've got to at least hover around the same profit margin as their competitors. Which is...
That's average profit margins for the whole US healthcare industry. So, okay, if we match those other companies' profit margins and try to hover around 3-4%... uh. Wait. Hang on. Here's another graph with more recent data on UHC specifically:
Wait, they're still just making that little 3-4% profit margin, even with all these shady automated denials- so how are those other companies doing better on claims? They're obviously not less greedy. They must be making more money somehow, right?
(My guess, sight-unseen, would be that they charge more for their plans, or offer less comprehensive coverage, or use a network of less expensive providers, or other things that make the amount they have to pay out smaller and the amount they're taking in larger. I don't feel like doing a comprehensive consumer review of what every insurance provider's healthcare plans are, but there's always these tradeoffs to make. UHC seems to be offering the tradeoff of "better or cheaper care, on paper" for "but there's a higher risk of getting denied", which is one annoying tradeoff among many.)
Okay But That's Enough Graphs
"Yeah yeah yeah shut up about profit margins and coverage tradeoffs. Is it a good thing that the CEO got shot or not?"
Well, their profit margin at the time he was shot was 3.63%. A company can't survive making 0 or less, so whatever effect fear of assassination has on UHC's greediness, it is going to be no larger than 3.63%.
They may learn the lesson that having their denial rates too high will get them assassinated. Accordingly, they may decrease that metric- by charging higher premiums, kicking expensive doctors out of their network, or reducing their stated coverage. They will not (because they cannot, without ceasing to exist as a company) simply start approving more claims without squeezing their customers elsewhere. They legally cannot do that. No matter how afraid you make the CEOs, you cannot make them afraid to a degree larger than their profit margin.
Well What The Fuck, Then
Like, what, are we supposed to accept that things will literally never get better and that this horrorshow is the best we can hope for? That's some bullshit! If we can't scare the CEOs, who can we scare?
Man I dunno.
Like, for some reason healthcare is stupid expensive! People can't afford to pay for healthcare without insurance- it's like thousands of dollars for basic procedures! Why? Maybe...
Doctors inflate their prices 10x because they know insurance companies will use complicated legal tricks to only pay 10% of the asking price, and this is a constantly escalating price war that serves mainly to fuck over the uninsured
Drug manufacturers and health technology companies fight tooth and nail to maintain monopolies over treatment, so they can charge gazillions to make back the gazillions they had to spend on FDA approval trials
(Trials those same companies lobby to keep necessary because the more money you have to pay for FDA approval, the harder it is for competitors to enter the market since they don't already have the gazillions)
Doctors operate as a cartel and lobby to gatekeep access to medical training so that they can keep doctoring a prestigious and exclusive position, and keep their own salaries high enough to pay their medical school debt and make them rich afterwards- leading to a (profitable) shortage of medical professionals
There is no limit to how expensive things can get but how much people are physically capable of paying, because frequently the alternative to "pay a ridiculous amount for healthcare" is "die", and so healthcare is subject to near-infinitely inelastic demand
Also like a thousand other equally annoying and complicated perverse incentives and stupid situations
This is the human condition: Shit is annoying and complicated and difficult to fix, pretty much 100% of the time forever. A few bullets in some fucko's back isn't really going to make a dent.
(But like, sure, fuck that guy. He probably sucked, as do the hundred other identical suits in line to replace him. Just... don't expect this to help.)
587 notes
·
View notes
Note
The way I screamed when I saw you write something for kess, ugh I love you for that. Can I request one for kess where reader surprises him at a game after saying she couldn't make it (like they've been apart for a bit) and he gets all excited during the game🩷
michael sulks through the phone, bottom lip pouty and his voice sad. he frowns at you, face taking up the entirety of your phone screen as the two of you facetime before his game—a little tradition that he’d started doing on roadies after the two of you started dating and he’d won an away game after you’d wished him luck via facetime.
it’s been a while since you’ve been to one of his games. your schedule never seemed to match up with his; you were always on work meetings or too busy to make it to a game whether it was in or out of town. but this time, you had enough time.
you’d used the several sick days you’d acquired from your job to call out for a few days, just enough to fly to missouri for their last game in the season. but you’d kept it a secret from michael, letting logan in on the secret to keep him preoccupied.
“i’m sorry, baby,” you say softly, leaning in closely so michael can’t see the airport behind you. you talk to him through earbuds, fingers crossed that the mic doesn’t pick up any weird background noise. “i’ll be there, in spirit,” you lie easily, glancing upward to see that your gate is boarding.
michael let’s put a dramatic groan, “it’s not the same,” he insists. “i just wish your boss wasn’t an asshole. you work too hard and he doesn’t ever reward or notice you!”
you chuckle, “i know, mikey. it really sucks, but i’ll be at home watching the tv and cheering you on. okay?”
michael sighs and runs a hand down his face, long fingers rubbing at his jaw. “okay,” he finally relents. he sighs again, “i better get going. i’m sorry, babe.” he frowns and the sight makes you frown.
“it’s okay, mikey, duty calls.” you reassure him softly, getting ready to board the moment you hang up. “i love you, okay? i’ll be watching.”
he nods and lets you know he loves you too before the call dies. you’re up in an instant and board your flight, prepared to see him in the evening.
when you land, you shoot off a text to logan letting him know you’re in st. louis. he’s quick to respond, telling you to go to baggage claim and that someone’s already there to pick you up.
sure enough, one of the assistants is there and grins and waves at you from where they stands. they wear a light blue uhc polo, the team’s logo hidden under a dark vest.
they help you with your bags and the folded poster you carry and drive you to the enterprise arena, letting you drop your bags off with the team’s things inside the bus for you to grab later. they hand you your ticket, a seat up against the glass so michael has a good look at you during warm ups, and then run off.
you get to your seat and unfold the poster that you’ve tucked under your arm. you hold it up to the glass, showing the two teams and everyone around you the words you’ve written on them.
‘i’ve come a long way—puck or stick?’
you watch as multiple players skate past you, smiling wide when clayton does a double take and waves at you and when logan winks. it takes a few more players to skate by until michael sees you, sign held high above your head and a large smile on your face.
he skates up to where you stand, giddy and smiling widely. he bangs on the glass, even though your attention is already on him, and turns around to receive a puck shot in his direction. he smiles as he scoops it off the ice. you bring your sign down and watch as michael brings the puck to the player bench and grabs a sharpie. when he returns, he takes the time to write something down quickly, glancing at you with a soft smile and flushed cheeks.
he knows you’re going to scold him later, but he brings the puck to his lips and presses a kiss to the cool rubber before tossing it over the glass. you catch it immediately, ignoring the other fans and children screeching beside you.
michael points at the puck and mouths, “read it!” when you catch it. when you look down, you smile at michael’s scratchy writing, the words i love you written on the puck.
you look at him and smile, pressing a palm to the glass. he reciprocates and presses a gloved hand to yours before the timer runs off.
“this game is for you,” he says, and you can barely hear it but you can tell what he says regardless.
#val’s reqs 🧃#nhl x reader#nhl imagine#nhl blurb#nhl x you#nhl fic#nhl fanfiction#nhl#michael kesselring blurb#michael kesselring imagine#michael kesselring#michael kesselring x reader#utah hockey club
171 notes
·
View notes
Text
youtube
A lot of people came together for this episode and it turned out great!
I talked with UHC about the two a few times during the development of this video and even proofread the script, mostly because cephalopods are one of my three favorite animal groups so I was pretty excited for this video.
Nu Udra has become one of my favorite monsters and as soon as a figure for it hits the shelves I’m buying it. It’s such a pleasant giant octopus and I find it and the babies cute and I want them as pets.
Xu Wu is definitely an interesting one, and I brought up the possible brittlestar behavior comparison. Overall it’s such a fascinating creature with a lot of personality, and I love toothy nightmare mouths. I also think its weapons being named after famous assassins is super cool, although I for one think it was a bit cowardly of Capcom to not name a Xu Large Bow Gun after JFK’s assassin (and a bit disappointing we don’t live in a timeline where assassination of an orange happened and we got a weapon named after that).
I’ve talked about how Xu Wu might not actually be a cephalopod, and now that we have access to some of the model we now know for certain it doesn’t have a beak or a siphon, so definitely lends more credence to that idea.
I suggested the thumbnail title just be SQUID GAMES in bold letters
#Youtube#monster hunter#speculative biology#speculative evolution#monsterhunter#monhun#monster hunter wilds#monster hunter biology#speculative ecology#unnatural history channel#UHC#nu udra#xu wu
70 notes
·
View notes
Text
So I've seen a few of my mutuals clutching their pearls over the UHC shooter being praised, others cheering him on, and some cheering him on reluctantly. While nobody asked for it, I'm going to give my input as a forensic specialist and consultant.
We have a multi tiered judicial system that splits things into "price points". If you're in certain tax brackets you get tried a certain way. If you're a corporation, CEO of a big corporation, or a board member / officer then you also get special treatment as well.
(In fact, one of the best recent representations of this is the trial scene from the new season of Helluva Boss where Solas is not executed when taking responsibility for the crime Blitz is accused of when Blitz was going to be executed for it.)
We then split all of this into what we call "blue collar" and "white collar" crime. White collar crime does more damage to people than what we classify as blue collar crime.
The latter is what we make television shows and podcasts out of, the former is maybe touched upon in a legal or financial drama.
The latter involves people who fall in the realm of Ed Gein who maybe kill into the double digits, the former involves people who make decisions that harm and/or kill into the hundreds if not thousands.
The latter involves robberies and assaults, the latter involves people going into debt because of a corporate decision and maybe committing suicide because they can't pay it off.
The latter involves vandalism of a building, the former involves a company being slapped with a fine because they polluted an entire area and now the residents have to deal with life altering and damaging health issues.
In my time as a forensic consultant I have worked cases that would fit into Hannibal very easily. So have my colleagues. It's not uncommon for us to encounter something at a crime scene that we would call ontologically evil because it is absolutely horrific to witness. I've been on a few cases where I would definitely classify the perpetrator of the crime as such.
But considering all of that... I would still say the worst crimes are committed by corporations and their leadership because they do so much more damage. They harm so many more people and our legal system is not set up for that.
It's set up to handle the murder, the robbery, and so on. It's set up so that people can receive justice for very immediate and visceral crimes. It's punitive and handles the individual.
It was barely set up to handle something like Love Canal.
It's definitely not set up to measure and act upon the scale of harm that corporations and their leadership impart upon the average citizen through exploiting loopholes in regulations, committing actual criminal behavior, and other unethical acts that simply result in a fine. It doesn't know how to prosecute a company and its leadership for causing lifelong harm to people.
We are still using criminological theory from the 18th century as the basis for a lot of our criminal justice system. So you can understand why it's not set up to handle white collar crime that would impact whole populations.
I personally can't recall any conversation with a colleague where we discussed a CEO or board members actually being charged with something that encapsulated the harm they did to people. It's always some form of fraud or embezzlement, because money matters more.
That's the issue. Those charges usually result in a fine which can easily be paid off and then they're back to it. Maybe they get fired, maybe the company is dissolved, but rarely do we get a Bernie Madoff like ending. Even then, the charge against Madoff was for the ponzi scheme he was running. A financial crime.
And that's the crux of it all. We are all witness to the privileges given to certain tax brackets here in the USA. The blatant corruption, bending of ethics and morals, and exploitation of legal and regulatory loopholes with no real recourse. I'm not surprised something like this happened. I'm shocked that it didn't happen sooner to be honest. Yes, we can change the system in some instances. But in others? You're naive. Completely and utterly. Remember my post about the ghost gun and how the NRA controls firearm research in this country and threatens careers? That's been since the 90s. That's 30ish years. You sound just like the grad student who comes in with big ideas who thinks they can change the system and we all look at you and go "good luck kid, but here's all our attempts, our continuing attempts, and the threats we've gotten." It's a been there, done that situation that only changes when the powers that be actually feel that they're no longer untouchable and under threat. It's the way it has always been (I even have some examples in entomology like this I can throw out there as well).
Now, I'm not saying we should go full Robespierre and drag every CEO out to the guillotine. I'm not an accelerationist or maximalist by any account. But I'm not crying over this at all, nor am I shaming anyone who is cheerfully celebrating. Hell, many of us recently celebrated the death of leaders whose crimes would fall into the blue collar category (and you should be able to understand the impact of both and how bad both things are).
But our legal system needs a complete and utter overhaul to handle white collar crime that happens in the modern era and address the very real harm that these companies and leadership do. I would love to see actual legal repercussions for these companies and have them held accountable for the harm they've done. But I realistically don't think that will happen in my life time, and neither do a lot of others. Hence why something like this did happen, and will likely happen again.
#uhc ceo#uhc assassin#Forensic consultant#forensic specialist#forensic specialist speaks#Our CJ system is outdated#There are a bunch of new and modern criminology theories out there that are not implemented because it would undermine so much#But implementing them would improve so many things and systems
106 notes
·
View notes
Text
So the thing about the UHC killer I would like everyone to internalize is that, in terms of the importance and impact of what he did, his identity literally does not fucking matter.
If he had done this in the dark, if the act had been hidden, if the CEO's death had been reported as a quiet tragedy, then the killing wouldn't be even close to the same event that it has been.
In my opinion, it's the response by the ENTIRE non-owning-class world that makes this moment a potential historical crossroads. The glee, the relief, the rage exposed by this one act of violence—the fact that it's been unifying, and the way it's carved open the surface of our for-profit systems to reveal the very real suffering caused by people who are flesh and blood and human and mortal.
If you've pivoted from that realization to the identity of the man who was arrested, to whether he did it or not, to what his politics are, to how privileged he has been, to whether he's a genius or a fool—then you are being distracted from the very important fact that the world's pulse has been exposed and more people than you might have thought are angry about the same things, could be talked to, organized with, could join community efforts out of a realization that we are not powerless and they have shared grievences.
I don't care who did it and I don't think you should either. I'm angry that the guy they've caught has had his life ruined whether or not he did it by a cruel system that would put out a $10,000 bounty on the killer of a mass murderer while responding to protests of police violence by giving more money to these gangs of killers and huffing about how they do it in self-defense and he was a scary homeless guy so he really didn't matter anyway.
Don't start eyeballing the hand that pulled the trigger when you can look around at the supporting crowd you've found yourself in and take note of the power we could have together.
#uhc ceo#uhc shooter#brian thompson#healthcare#united healthcare#collective action#identity politics
96 notes
·
View notes
Text
If it isn't already obvious, I work in utilization management. For those that don't know, it's a department that exists in most hospitals with the single minded purpose of getting health insurance companies to pay their due.
It's usually staffed by a lot of overworked nurses and one or two physicians, usually doing UM alongside actual clinical practice.
The nurses use whats in the patient's chart to justify the diagnostic code. They then upload those clinicals to the insurance company's portal, or fax them over.
Then, if we're lucky, a human being compares the clinicals with the MCG or other clinical standard guidelines and decides whether or not the chart justifies the diagnosis and treatment.
If we're not lucky, it's UHC which uses an automated system with a 90% error rate that denies 1/3 of the claims they receive.
In that case our nurses, who have to do this and so much more for about 90 patients a day *each*, have to go back in and highlight the criteria and hope it escalates to a human being.
The denial will usually be upheld.
So the case is forwarded to a contracted consultant company that staffs physician advisors. Their job is to narrow down exactly what needs to be done to beat the insurance company at their own game. The hospital pays for this service. Sometimes it works.
Often it doesn't, and the denial is still upheld.
So it goes to peer to peer. This means one of our doctors will have a phone call with a doctor on staff at the insurance company. There is no guarantee their doc will know anything about the specialty involved. I've seen OBGYNs make final calls on psych cases. This is the last chance.
Sometimes the physician on staff at the insurance company has a heart, and remembers what they got into medical school for. But often they have only a few minutes to make a judgement before the next peer to peer, and they have a quota of denials to maintain to keep their jobs.
So usually it's denied, and that's it. There's nothing else to do. The insurance company smugly gloats about protecting consumers from overuse of healthcare resources, the hospital bills the patient directly hoping to recoup something from it (even giving the patient services to help reduce their bill) and the patient is fucked at best, forgoes life saving care at worst.
All of that for such a shit ending. All of that money, time, administrative resources, look at it. Look at how many people are employed in the attempt to get insurance companies to pay and how many are employed to prevent it. There is so much bloat in the industry around this one thing, this one process, and it all goes back into the already inflated bill.
I go through insurance communications, I open the medical record with a photo of a child undergoing chemo. She's so small and so brave, smiling for the camera. Weeks of fighting back and forth to guarantee her care until one day I open it to forward yet another denial, and see the big gray 'deceased' tag under her now black and white photo. And I take a minute, I cry, I forward the fax, and I continue on. And this exact scenario repeats at least twice month.
We don't have to live this way. We don't have to.
#And I know I'm biased towards the hospital because I work for them but the hospital is not innocent in this either#Overworked physicians miss charting important vitals and communication in the medical record that fucks this process up
95 notes
·
View notes
Text
The thing about the UHC shooting is Brian Thompson was killed for being arguably the purest embodiment of the private health insurance system that has caused unfathomable amounts of suffering and death for normal US citizens. He lived that. He encouraged that. He did not give a fuck no matter how many people attest "he was a nice guy." His tenure as CEO was marked by ramping up denials in increasingly shady ways and bringing in lots of blood money to make that profit line go up. And just to really drive home the evil exploitation aspect, we can't ignore the fact that abusive health insurance practices are something that you can't combat on an individual level.
The average American cannot opt out of health insurance, because companies like UHC have made being uninsured into a cruel and unusual punishment. Being insured (especially under UHC) still results in ridiculous medical expenses and lack of care. Most people have basically no say over who their coverage comes from or what kind of plan it is, since it's through their employer. Finding a good doctor who will say "you need this treatment" does not guarantee treatment. Government representatives have broadly abdicated responsibility to try and fix this situation, and half of them in fact would like to make it worse as quickly as possible. You can't vote for a better system, or boycott, or try to find a better option to deny the bad ones your money, or even challenge a blatantly flawed denial without a huge obfuscating headache that you probably lose anyway.
No fucking wonder the general public is responding to the killing with general apathy or discussing how little sympathy they have for a victim who did so much evil.
No fucking wonder someone shot him.
And then almost the entire government and media response to this very valid anger has been tripping over themselves to make it very clear that this is NOT how we deal with these kinds of problems in a civilized society. Murder is bad. He had a family. Which given the way they've gone about it - sparing no expense on their manhunt, balking from discussing how the system has eliminated the "civilized" means of dissent, misquoting people in headlines to pretend no one else is discussing it, overcharging Luigi with terrorism while treating him like the worst criminal to ever exist, treating Briana Boston as a copycat for being angry on a phone call - actually just really efficiently conveys a different but far more honest message:
The lives of people like Brian Thompson are worth infinitely more than the lives of you and me. Get fucked, I guess.
88 notes
·
View notes
Text
#it's okay x I don't know what's going on either
I know you didn't actually ask and I have no idea if you even meant this situation specifically or just like life in general...
but for anyone who's confused; the context for this clip is that Badgerspanner is a longtime Xisuma viewer who has been part of his community for like at least five years now, probably more, and they also happen to be engaged to Joe Hills
(I know some people were confused (including Cleo) but X does in fact know who Badgerspanner is, as you can tell from the fact that he was surprised to hear they were moving to America, because he knows they're British. He just didn't know that they're engaged to Joe. Even though Joe had definitely told him and the other hermits.)
For extra context, realPhali who made this video is also a longtime Xisuma viewer and a longtime friend of Badger's (Badger is actually still a mod on Phali's own Minecraft server, Shamblecraft)
youtube
oh my god
#im also technically on shamblecraft#im just very inactive there bc i have another server that im an admin on so it takes priority#but ive been there since before it was even called shamblecraft#in fact ive been there since the launch day of season 0#which i guess is the secret third piece of context; i also know badger and phali (and to a lesser extent joe too i guess (sort of))#altho we rarely hang out anymore sadly#mostly my fault#i should hang out more tbh#sadly phali also streams less now#i miss their streams rip#and i miss badger's streams too but they haven't streamed in YEARS afaik#btw shamblecraft is both public and free#if anyone wants to join#it's not a big server but it's not really a small one either#and it's very friendly towards casual players#mostly vanilla but with some plugins and other extra features#there's an smp and a creative mode plotworld and also fairly regular events like uhc tournaments and building competitions#but it's all very chill#also queer friendly as well#(sorry this accidentally turned into an ad for shamblecraft)#(i promise im not paid by phali or anyone on the shamblecraft team)
2K notes
·
View notes
Note
Luigi’s wife!reader who has been constantly looking for him after he suddenly left. The media digging into her past, while she’s literally on the verge of a mental breakdown after finding out that her missing husband allegedly assassinated a ceo and is now in custody :(
this just made my heart squeeze omg :( before i get into wife!reader i can’t help but think of his parents, sisters but also best friends and how devastated and scared they must’ve felt when lu went missing. he obviously had his reasons and whatever they were they’re valid imo, i wish i didn’t relate to his actions but i do… anyways. i hope seeing lu again lifted some of their fears and worry even if the circumstances are horrible and hard to handle.
now as for wife reader, you’d obviously feel beyond devastated waking up one day to his side of the bed empty, some of his belongings gone, no trace left behind that could give you an idea of where he went; only thing he left you was a note saying he loved you more than anything and that he needed time away by himself and that you shouldn’t worry.
everytime you’d try to call him it would go directly to voicemail or even worse, you’d hear that robotic voice telling you the phone number you’re trying to contact doesn’t exist. his family, yours, your friends would try to comfort you but nothing they were saying would make you feel any better. you’d drive yourself crazy looking everywhere for him for months, it was draining the life out of you and your loved ones were beyond worried for your mental and physical state.
the day lu got arrested, you thought you were going to die. seeing his face plastered all over the news, social media, headlines calling him the shooter, claiming he unalived the ceo of uhc had you feeling like your entire world came crashing down in the snap of a finger. you were urged to make all your social media accounts private but it was too late, people had found your instagram and facebook through lu’s accounts before they got deleted and your mentions were blowing up like crazy. suddenly your photos were all over the internet, people were analyzing your relationship etc. you felt like you were living a nightmare but in that moment your sole wish was to see your husband as soon as possible and you made it your life’s mission to be by his side and fight for his freedom no matter what. lu would be a mess upon seeing you again after months of being separated, he’d hate himself for making you go through so much pain but he would vow to making it up to you for the rest of his life
#luigi mangione imagine#luigi mangione x reader#luigi thoughts#sorry i got way too invested into this aksjsjd
81 notes
·
View notes
Note
I just had a long convo with someone about the UHC ceo being shot and how he felt it's wrong in the long time term to celebrate the shooting of Anyone in broad daylight. Claims vigilanteism is not the answer bc bad actors can justify violence against minorities and something about this argument feels off to me? Even if he agrees that billionaires/corporations are responsible for untold amounts of systemic violence
There's a bunch here I could get into about trying to determine the morality of past events but it might come across as quite up my own ass so I'll save it for now
Look, fascists don't need a justification to do violence to minorities and if they do the justification is in a guy they like being in power saying they should do it, not in anti-millionaire political violence.
If we're asking a practical question about what effects this will have politically, there are a few reasonable assertions we could make and some whacky conjecture
It would be reasonable to say that this will not have a chilling or marginalizing effect on political struggle against private healthcare, because if being shot dead in the street is the new most radical option facing healthcare CEOs, the previous most radical options are more moderate by comparison. They would rather cede ground to single payer healthcare than literally die
It's reasonable to assume that this will inspire more political violence against the rich, as political violence tends to beget political violence of the same kind. There have for example been a whole spate of self immolations in the wake of Aaron Bushnell's, which itself came after someone in Atlanta did it a few months prior.
I could conjecture that the ruling class might push for tighter gun control, as they have done in response to working class armed resistance in the past. I think it's an often repeated fact that gun control only really gained any ground in American politics after the black Panthers started arming themselves
But no, I don't think it's reasonable to say or even to conjecture that this creates a higher temperature for violence in general, and while I agree with the assertion that "vigilantism is not THE answer", it simply will put the fear of God into some of these murderous fucking scumbags in a way that we are already seeing is making them walk back some of their worst impulses, as with the reversal of a cap on surgical anesthesia
68 notes
·
View notes
Text
authors note. + tw for mentions of rape.
i wanted to share my overall thoughts on fanfictions about/relating to Luigi Mangione.
in no way am i targeting any specific writers (i really don’t want to start any drama, this is just an analysis of my own findings.) but i am fully aware of how impactful words can be. not a person alive is immune to propaganda, and, that’s simply what words are.
with the writing i’ve done about him, i have been mindful to portray him in a way that is not at all abusive, toxic or even simply rape-y. i’m not trying to place myself at a higher moral ground for doing so or directly shaming anyone else in particular, i just think it’s disingenuous to view him in such a way and honestly? i don’t really think it helps his case in anyway.
also another thing that bothers me is that fics will often be tagged with things related to “uhc shooter” or “brian thompson”. this directly links luigi as the shooter, which isn’t something that should be done if you believe that he’s innocent/framed.
regardless of your personal views on the case, most can agree on the fact that luigi has been terribly treated in the press. i have made the decision to no longer apply myself to any further misinterpretations of who luigi is as a human being, and as a victim of public humiliation and abuse.
i do not think that it is inherently cruel to write fics of him but there are boundaries, boundaries that haven’t even been set because he’s quite literally incarcerated and silenced.
again, i am not trying to garner any sympathy from anyone, because it’s really just not the time and place but i have been subjected to multiple anon asks that have been unnecessarily rude and mean. i initially thought that it was some type of constructive criticism but the more asks that were sent showed that it was not the case. the anon was pretty clear in how much they disliked my depiction of luigi, and had some not so nice words about me and my writing. i’m not going to lie, it definitely has made me reflect on my actions.
i’m not going to respond to any of the asks on my blog, as it will only add more gas to the fire (or whatever that idiom is 🙄) i’m only human, words do get to me, so, i don’t really know what to do now, i will still be supporting luigi but, i don’t really know if writing fics for him is a good idea. his name needs to be voiced aloud, if writing fanfictions is loud enough then i will continue but right now i’m at a loss tbh
if anyone has similar feelings/thoughts and would like to share, my inbox is always open and safe + feel free to dm me :)
#luigi mangione#luigi is innocent#luigi mangione fanfiction#luigi mangione fic#luigi mangione x reader#yap central#my timbers were shivering when i pressed post
50 notes
·
View notes
Text
E!False vs HC!False is actually really interesting if we look at it through creation VS creator perspective
E!False is a reflection of HC!False‘s flaws and strengths. She acts the way False would in her situation, but she lacks the identity that comes from living experience of which she remembers none. E!False is in constant fear because she’s not in control of her life, she has no knowledge to understand this world, she’s been just thrown into, there are no previous achievements, events, people which would help her identify herself so she has to find these herself, but she’s unable to due to her debilitating paranoia, which ones again is a flaw we can in HC!False. E!False tells us of her faint steampunk memories and evil plans of revenge, but the return of full memory doesn’t do anything for her. She‘s already lost in identity that is not hers but of someone that is the reason for her suffering, and the saddest part is that she doesn’t really have time to explore herself beyond that. She’s broken by HC!False leaving, because that’s the only person who can see her, but she cannot get that closure.
HC!False on the other hand can identify herself and others, she is the 4X times MCC champion, 10+UHCs, one of the earliest Hermits, Queen of Heads Hearts and Bodyparts and also the main narrator of E!False‘s story. She knows everything and the moment she realises that, her paranoia that she had in her first crossover episode decreases by like a hundred. She’s unsure but knows enough that she understands how to deal with things surrounding her, although still with unnecessary caution. HC!False deliberately tries to hide her flaws from the viewer veiling the story to be more about how it was a necessary, not even evil, deed, to exile E!False, supposedly violent, without memories into The Rift, something she knows nothing about. False built her own reflection but the moment it started reflecting her own faults she disregards it as something to be afraid of, and she doesn’t understand (or accept) that she’s part of the problem. HC!False doesn’t see herself in this mirror, she sees something more twisted, out of her control and so she throws the mirror out as if she won’t see it again in the glass window of her castle.
HC!False tells us everything, E!False doesn’t acknowledge the viewer half as much as HC!False does. Instead we‘re shown what she‘s going through but it’s the HC!False that tells the reason for these events, many times contradicting them. Because HC!False would say that E!False is doing good:) and then the next episode E!False is showing us her head collection. And we don’t know why False contradicts the events, it could be lack of knowledge, lack of integrity, good faith and on and on.
The point is — E!False is HC!False, but HC!False isn’t E!False. E!False’s attempts to find that identity beyond are faulty because things outside it require experience she simply never had, but there’s recognition of herself as not a good guy, HC!False either doesn’t have or denies that she has.
I am the shape you made me. Filth teaches flith.
… or whatever
#tldr: Frankenstein’s Monster#I think#I haven’t read it#falsesymmetry#is this comprehensible#do you understand
97 notes
·
View notes
Note
It's scary that all the prosecution had to do was release a few snippets of his writings (not even new information we knew all of this already) and now everyone is 100% convinced that he's the shooter. I'm not saying it isn't him but the way some people suddenly did a complete 180 and are now saying everyone who believes in his innocence is delusional when most of them did the same until a day ago.
I mean that was their whole intention in leaking this, to poison the jury pool. No matter what my personal opinion is about his involvement, the public shouldn't be having access to "evidence" and why I used quotes is because the validity of it legally can't be determined until it makes it to the court room, and if it doesn't make it then there's a piece of information being instilled in the jury's mind that the court has deemed not reliable that shouldn't be known to the jury.
But a lot of people lack any kind of nuances in tackling situations and that's what we're seeing here.
But you're right this is dangerous for him especially because no one wants to afford him a fair trial, and people over reacting over things they already knew are playing right into the prosecutor's hands.
I don't think people who think he is innocent still are delusional even though I lean towards he probably did it. Doing all that name calling over writings of all things, which are usually thrown out as unreliable if they don't have a 3rd person apart from defence and LE claiming them as valid is simply foolish. I can see why people want more apart from things that would technically most probably still not make it to the actual trial even if the illegal search and seizure wasn't there.
you make several good points here than ive seen other people make as well. i think it was way too early for any member of the public (and the jury pool) to see any of this evidence. but now that is has been released, there's all these secondary questions that we have to ask ourselves. was this legally obtained? was this written to be a manifesto? or was it just notes/thoughts on a piece of paper?
note, it never said brian thompson's name and never referenced UHC (not to my knowledge, if im mistaken please correct me), so how is the prosecution going to prove that those notes pertained to that alleged crime
i agree that's futile to name call. everyone will have their epiphany about this case sooner or later. some people thought it was him all along, other like myself gradually began to think about it more and more
phrases like "fair trial", "alleged", "jury nullification", "illegally obtained evidence" still must be present when discussing luigi in a serious sense. that's something we can all agree on despite whatever opinions we might hold.
27 notes
·
View notes