#american medical system

[tuttle-did-it]

Leverage is an American tv show about a man who worked for an insurance company, but he was completely fucked over by said insurance company and his son died because of it. And he spends the next several years trying to fuck over the american insurance company as much as possible. And take down as many corrupt ceos as possible.

It's now available on UK Prime. But pretty sure it's not too hard to find wherever you are.

There's no reason for me telling you this at all. None.

[nathanleemustdie]

they learned nothing???

Insurance Companies and the gop after the luigi situation didnt learn shit and arent really “scared” bc prescription drugs are now more expensive, insurance companies can legally deny people solely based off sexuality, gender identity, and religion. and theyre also planning to axe medicare if they havent already.

after it originally they all faked being scared lmao

[batwynn]

Ok quick question before I go in to a new doctor in an hour.

How to I describe that I have felt really unwell like I’m actively dying every day for over a month now in terms that make sense. I’m constantly dizzy, faint, nauseated, entire body pain, feels feverish but no fever, headaches every day, blood pressure up and down, exhausted, heart feels weird, body feels weird??, etc. Like in general how do I explain this feeling other than just saying ‘I feel like I’m dying and I know what that feels like because I’ve been here before.’ 🥲 Any added ass-kissy lingo welcome because doctors are fucking ego monsters.

[coffee-counts-as-a-meal]

question frank for the community bc why not and i have no idea where else to turn re: medical debt in America

in May of last year (2024) I went to urgent care to get a basic sexual healthcare workup done because it had been a while and I had a new sexual partner and I wanted to make sure everything was all fine and dandy. At the time, I was under my workplace “insurance” (HoorayHealth which isn’t really insurance but whatever) which to my understanding meant that basically I could go to urgent care for a $25 copay and nothing else. Which, fine, its 2024, who even have primary care physicians anymore, right? and then later the bill for the $25 copay arrived and i paid it.

fast forward to now, January 2025 - I have a new job, no longer under that bullshit “health insurance”, but I don’t qualify for healthcare under my new job either just yet. Today I got a bill in the mail for the tests that were ran on my from MAY LAST YEAR that they now say equal around $800+. ?????

can anyone tell me what course of action I have here? how is this even allowed? and what would happen if I just pretended like i never got it in the first place? I know $800 might not seem like a lot compared to the hundreds of thousands of dollars some people have but to me it is

[napkinmouse]

This is a comic about my real actual life and experience this week. It’s been a few days and I never did hear back from the surgeon. It’s worse than waiting on my internet to be fixed. They say they will send someone to fix it between a certain time, but you don’t see them until 2 days later. Except instead of the consequences being no internet, it’s critical care.

I didn’t even get pain relief. Probably the biggest whiplash was going from “that looks like cancer” to “Motrin and Tylenol should probably be fine”.

Safe to say there probably won’t be any Sanderson updates for a while. I didn’t even have the energy to polish this

[definite-human]

Recently discovered that my health insurance not only excludes my teeth, it also excludes my eyes. Why do I need 3 different types of insurance for my 1 body. Whomst the fuck designed this system.

[lelu3]

I need to scream into a void.

I got some bad health news. I was born with a congenital heart defect called Tetralogy of Fallot. Well, technically I was born with 2, because I have pulmonary atresia to go along with it.

It requires open heart surgeries. My last one was almost 11 years ago. At the time, they said my new part would be good for 20-25 years. We'll, at my cardiology appointment, they discovered my right ventricle is enlarge and my heart has decreased pumping power. One of the causes of this could be that my part is leaking. Which would mean another surgery much sooner than I was expecting.

I'm scared. I'm disappointed. I resent the hell out of the fact that my primary concern is how I'm going to pay for this.

I want to move to Canada. I want to be concerned with my health, not with how much debt fixing my BIRTH DEFECT will cost me.

Anyway.

Shout out to everyone out there with ToF, ToF-PA, and any kind of CHD. Thoughts, prayers, or a kind word would be appreciated.

[nicheofmyown]

Barely Contained Rage: An Open Letter to Danaher and Cepheid. 

IF NOTHING ELSE, NOTE 3:55-4:20 (25 seconds total please). You can then skip to the description with all the links. 

I apologize in advance for tagging fandoms I am a part of, I just hope that word can get around. In his words “polite but impassioned” message.

“Lowering the price of these tests would save hundreds of thousands of lives over the next few years.”

Feel free to be pissed at me later for interrupting your page. People are currently dying, Kim.

Anyway. Much love. Breathe. Get rest. Drink water. Eat ice cream. Basic necessities and such.

[in-sufficientdata]

At the source, the thread continues: This does not mean all your medical care is then covered by insurance. Nope, not even close. Most doctors visits have a co-pay, meaning you pay this to even be seen. It's anywhere from $20 to $200 depending on emergencies. Insurance also requires you to pay a deductible before they kick in. So let's say your deductible is $1000. That means for each visit, you owe $1000 before they start covering. But they "negotiate" with hospitals, so an MRI out of pocket might cost $5000, but through insurance only costs $400, so you pay $400.

After awhile, there is a "max out of pocket" which means you pay $20,000 out of pocket for all these little visits and then insurance will cover anything further 100% for the year.

Oh, but insurance doesn't cover everything. They agree to certain exclusions... like maybe they don't cover an ambulance ride or only partially cover major dental. Oh and they typically don't cover regular dental or eye care at all (that's a different insurance you buy).

And the insurance only negotiates with certain doctors and clinics... so if you don't use them they only cover your care 50% instead of 80% and the deductibles are higher.

But, if you get hospitalized, the insurance might cover the facility and nurses, but the doctors can be out of network, so you have to pay more without any say in the matter. And medical facilties, even ERs, can just choose not to take any insurance. It isn't a requirement they take it.

Now for prescriptions and treatments. So, let's say you do everything right. You use all in-network doctors and facilities, pay your money, so you should be good?

Nope.

Insurance companies can step in and dictate your care.

So let's say you bang up your knee and need an MRI plus surgery. The doctor agrees and you agree, but the insurance company says "No, you need physical therapy first." So in order to have the MRI plus surgery covered, you now need to go through months of physical therapy before it will be approved. You could always just pay outside of insurance, but now you are paying $12k of your money instead of $3k and months of pain.

There are plenty of other caveats too that I didn't even cover.

So basically, you can have medical insurance, get into a major accident, and still go bankrupt because I don't know many people with $40k just lying around.

But politicians and insurance lobbyists keep telling us we should be grateful to only have to pay that $40k instead of hundreds of thousands of dollars!

And remember, even if you are perfectly healthy and need just a checkup, you are paying $10,400 every year anyway.

Medical insurance in the US is a billion dollar profit industry. It is also complete and utter garbage.

Oh and keep in mind.... NONE of this is taught in schools or anywhere. This is knowledge I've gained completely on my own. And this barely scratches the surface of how complicated this system is.

You think the majority of Americans understand how insurance works?

I like how there isn't any arguing in this giant thread. Just people coming together with angry and sad resignations that the US health insurance system is a giant trash fire.

Lots of people have asked why people living in the US just accept this system. It's pretty easy: classism, racism, ableism, and sexism.

You see, everyone pays the same for insurance at a company. You think the CEO making billions is going to experience that $400 per pay period the same as the junior employee making $30k per year?

On top of that, the Black and other minority communities are more likely to have claims denied or receive lesser care because insurance companies won't pay as much for their care. If they can even get insurance coverage to begin with (a whole other issue).

Disabled folk also receive lesser care. If you are disabled after an injury, insurance companies can even dictate what type of prosthetic you receive or at home care that's available (hint, practically nothing).

Women are also affected by insurance claim discrimination, but not as much as disabled or minority folk. If you are Trans, more and more states are blocking to even cover the care you need. This is all justified because of the risk you will need future care. If it is highly likely you are in a risk category to either 1) not be able to pay the adjusted bills or 2) need further/lifelong care, then you get treated as such with higher bills, different care, and/or denied claims.

So the current system benefits rich white men the most. And we all know how much most of them like to admit their privilege and work to change these systematic issues against a billion dollar industry.

[indominusregina]

It should be illegal for things to help me breathe to cost more than zero dollars.

[thebookewyrme]

So, I have finally realized, I think what's putting me in the hole every month is physical therapy. It's $25 a week, which amounts to a $100 a month. Like, there have been other things too, from being committed to too many things probably. But I think a big part is PT. Which has been helping so much! I can almost walk completely pain free now! But I think I'm gonna have to quit soon, and that's making me mad. Our medical system is so fucked.

[nathanleemustdie]

america’s medical system in one news article

american capitalism i think is worse than regular capitalism.

[freelyhauntedduck]

It feels so strange and so heartbreaking to know that we have essentially monetized the very system that allowed humanity to evolve in the first place.

I remember being in an anthropology class, and how a professor mentioned a skeleton that had been found from before the start of human civilization. The person had clearly been missing their teeth for awhile before they died, which meant that they had survived because they were cared for by other people. My professor mentioned this as what he considered the key stage in human evolution and complexity. The ability and willingness to care for people is what allowed us to evolve.

In the US at least (and in other places) we've managed too monetize care, taking something that has been a part of human nature for so long and putting it behind a paywall. And sometimes I wonder what else this denial of essential human activities might do to us in the future.

[fablefancy]

Going through this at this very moment. I have endometriosis and need a hysterectomy, but according to the surgeon I am too heavy to safely be put under anesthesia, so I was prescribed a glp1 medicine to help me lose weight reliably so I could get down to a safe weight for surgery. My insurance denied coverage at first and I had to go through a pre-authorization process only for it to be denied again, and then I had to appeal it with proof of support from THREE DOCTORS in order for it to be covered. Then, when my deductible reset at the beginning of January, my cost for this medication went from $24.99 a month to $1300 a month. Now I have to fight that battle.

I'm tired y'all.

[misspoken-mistaken]

01.31.2025

I’m sitting alone. In an emergency room hallway. Not the best place to be on a Friday afternoon. Not when I’d really rather be anywhere else. There are curtains separating patients. The woman beside me wished me well when I cobbled my body towards the bathroom to attempt my urine sample. When I came back out I gave her a thumbs up and she asked “take it you didn’t drop it in like I did…

[phasesofthelunareclipse]

probably an unpopular opinion but DBT/CBT is not the best treatment for depression.