#income insurance

[bitchesgetriches]

NEW POST!

Short-Term Disability Insurance Is a Waste of Money… With Two Very Specific Exceptions

Here's an excerpt:

"In preparation for this article, I read a lot of stories from people who filed short-term disability insurance claims. I was dismayed but not surprised to see just how many people experience claim rejections.

As this ProPublica report explains, the claims rejection process is so murky it could easily be mistaken for a Rainbow Brite villain. On average, 20% of claims are rejected. But it’s often wildly erratic. One company rejected 66% of claims in one year, and 7% the next. And the sole arbiter of the claim is, of course, the insurance company itself. You know: the entity that has vast resources and a compelling financial interest in denying those claims?

HI, I DON’T LIKE THIS."

Keep reading.

[dreaminginthedeepsouth]

LETTERS FROM AN AMERICAN

December 5, 2024

Heather Cox Richardson

Dec 06, 2024

Yesterday a gunman assassinated the chief executive officer of UnitedHealthcare, Brian Thompson, as he arrived at a meeting of investors in New York City. While authorities are still investigating, officials have released the information that the casings of the bullets that killed Thompson bore the words “deny,” “defend,” “depose,” all words associated with companies’ denial of health insurance, taken from the longer phrases “deny the claim,” “defend the lawsuit,” “depose the patient.”

While those clues could simply be a red herring, posters on social media have cheered what they seem to see as revenge against an abusive system in which people’s lives are at the mercy of executives who prioritize profits.

Health insurance companies have long been under scrutiny for their practices. For the past two years, ProPublica has run a long series exploring the different ways in which companies have developed systems to deny healthcare coverage to their policyholders.

UnitedHealthcare has been no exception either to such practices or to scrutiny. Its parent group UnitedHealth has a market valuation of $560 billion and was the eighth largest corporation in the world last year as measured by revenue. This year, UnitedHealthcare—Thompson’s unit—is expected to bring in $280 billion in revenue.

UnitedHealth is embroiled in a number of lawsuits. Andrew Stanton of Newsweek reported that on November 14, 2023, families of two now-deceased patients sued UnitedHealthcare over denial of coverage for Medicare Advantage patients for nursing home stays prescribed by their doctors. Medicare Advantage is the private insurance alternative to Medicare that receives a flat fee from the Centers for Medicare and Medicaid Services. It’s an enormously profitable industry, and UnitedHealth controls almost a third of it.

The lawsuit alleges that UnitedHealthcare uses artificial intelligence to deny claims from Medicare Advantage policyholders. The lawsuit claims that the company knowingly uses an algorithm that makes errors 90% of the time because it also knows that only about 0.2% of policy holders will appeal the decision to deny their claims. Last month the Senate Permanent Subcommittee on Investigations hammered UnitedHealth for dramatic increases in their denial rates for post-acute care between 2019 and 2022 as it switched to AI authorizations.

On the same day as the shooting, Anthem Blue Cross Blue Shield insurance covering Connecticut, New York, and Missouri announced it would cover anesthesia during surgery or procedures only for a specific time period in order to make insurance more affordable by reducing overbilling.

After an outcry both from anesthesiologists and the public, the company today retracted its policy change, saying it had never intended to avoid “medically necessary anesthesia,” but meant simply to “clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.” Their explanation might have calmed the news cycle, but its suggestion that the insurance officials rather than doctors should determine what anesthesia is appropriate for a patient during surgery echoed the argument in the UnitedHealthcare lawsuit.

Thompson’s murder seems to be a cultural moment in which popular fury over the power big business has over ordinary Americans’ lives exploded. Maureen Tkacik of The American Prospect noted, “Only about 50 million customers of America’s reigning medical monopoly might have a motive to exact revenge upon the UnitedHealthcare CEO.” The shooter, whose actual motive remains unknown, is fast becoming a folk hero.

Social media has exploded with users writing things like “[t]his claim for sympathy has been denied”; songs featuring the words “deny, “defend,” and “depose”; and recorded commentary condemning the healthcare insurance industry. UnitedHealth Group posted its sadness about Thompson’s death on Facebook yesterday about 1:00 p.m.; 36 hours later the post had 65,000 laughing emojis under it.

Security expert Charlie Carroll expressed surprise to Josh Fiallo of the Daily Beast that Thompson did not have a security detail. “We’re living in a world where people are extremely disgruntled,” Carroll said. “When people lose trust in the system, you start seeing more kidnappings and assassinations because they feel like they have to take matters into their own hands.”

In the wake of the shooting, UnitedHealthcare and several other insurance companies took down from their websites the names and photographs of their officials.

Billionaires Elon Musk and Vivek Ramaswamy were on Capitol Hill today where they met with lawmakers to explain their vision for the Department of Government Efficiency, the group designed to cut the U.S. budget. Neither they nor the lawmakers shared much with the press, although Fox Business played a video of Representative Ralph Norman (R-SC) saying that that “nothing is sacrosanct,” and that “they're going to put everything on the table,” including Social Security, Medicare, and Medicaid.

Representative Tom Tiffany (R-WI) told Just The News that cuts to the budget “don’t have to be just the discretionary spending. We can get at some of the mandatory spending also…food stamps, some of those things.” He continued: “There may be more bang for the buck in terms of growing our economy…making regulatory changes, get the impediments out of the way, let those job creators and entrepreneurs really be able to go to work.”

In view of today’s news about healthcare, it’s probably worth remembering that Musk has called for the elimination of the Consumer Financial Protection Bureau, and that Project 2025 has called for making Medicare Advantage—the privatized Medicare in which UnitedHealth specializes—the default enrollment option for Medicare. This would essentially privatize Medicare for the 66 million people who use it, but since Medicare Advantage costs taxpayers about 6% more than Medicare, this would not create the savings Musk is supposed to be finding.

Andrew Perez of RollingStone reported today that election financial disclosures filed yesterday revealed that Elon Musk was the secret funder of the “RBG PAC,” a Super PAC created just before the election that claimed Trump had the same position on abortion as the late Supreme Court justice Ruth Bader Ginsberg. Although Trump has bragged about overturning the 1973 Roe v. Wade decision recognizing the constitutional right to abortion and the 2024 Republican platform supported the far-right idea of “fetal personhood”—which would apply all the rights protected by the Fourteenth Amendment from the moment a human egg is fertilized—the RBG PAC ran ads promising that Trump would not support a national abortion ban.

Ginsburg’s granddaughter called the comparison of Trump and her grandmother “nothing short of appalling.”

The super PAC was created so late that it avoided disclosure before November 5. It was funded entirely by Musk with an injection of $20.5 million.

Bridget Bowman, Ben Kamisar, and Scott Bland of NBC News reported tonight that Musk spent at least $250 million to get Trump elected. In addition to the $20.5 million to the RBG PAC, he put $238 million into the America PAC. Musk also supported Trump through free advertising and commentary on his social media platform X.

Today provided a snapshot of American society that echoed a similar moment on January 6, 1872, when Edward D. Stokes shot railroad baron James Fisk Jr. as he descended the staircase of New York’s Grand Central Hotel. The quarrel was over Fisk’s mistress, Josie, who had taken up with the handsome Stokes, but the murder instantly provoked a popular condemnation of the ties between big business and government.

Fisk was a rich, flamboyant, and unscrupulous man-about-town, who was deeply entwined both with railroad barons like Jay Gould, Daniel Drew, and Cornelius Vanderbilt and with New York’s Tammany Hall political machine and its infamous leader, William Marcy Tweed. Tweed made sure the laws benefited the railroads and, the papers noted, snuck into the hotel to say goodbye to his friend in the hours it took for him to perish.

After the Civil War, most Americans applauded the nation’s businessmen for the support their growing industries had provided to the Union, but by 1872 the enormous fortunes the railroad men had amassed had tarnished their reputation. At the same time, big operators were starting to squeeze smaller enterprises out of business in order to control the markets, and popular anger simmered over their increasing control of the economy.

Stokes’s shooting was the event that sparked a popular rebellion. Newspapers covered every minute of the event and Fisk’s demise, while sensational books about the murder rolled off the presses.

Together, they redefined late nineteenth-century industrialists, with one painting Fisk as a representative businessman who with just “an hour’s effort,” could “gather into his clutches a score of millions of other people’s property, impoverish a thousand wealthy men, or derange the values and the traffic of a vast empire.”

Both those covering the murder and those reading about it rejoiced in Fisk’s misfortune.

LETTERS FROM AN AMERICAN

HEATHER COX RICHARDSON

[reegis]

possibly minor Crisis i was going to finish my current projects & maybe open commissions again afterwards but??? my apple pencil is dead and seemingly will Not charge??? iv tried a couple different things & im leaving it alone for now hoping it works 🤞🏻🤞🏻🤞🏻🤞🏻but if not idk what to doooo aaaaaa i cant afford a new one rn & doing art is everything to me 😭 pls i Just barely managed to not end up homeless less than a month ago i dont need this too

[its-a-beautful-day]

Updating my donation post as it's been a few months. I'm still struggling with being homeless and I recently lost my health insurance (yayy turning 26!)

I've applied for section 8 at a local large city but that can take time. I'm also in the months long process of applying for SNAP/medicaid. I've also applied for financial assistance through my work to help me as well but I'm unsure of the turn around time or how much they can assist me.

Currently with the cost of rent in my local area the best option might be for me to renovate a free mobile home. However I need to move it to a lot/mobile home park with hookups and that can cost alot of money. The current estimate I got is around $8,000.

This doesn't include the lot rent per month or the cost of fixing the mobile home. But I do get to own the trailer after and can sell it once I have my feet under me again and ready to move.

I've been looking into so many different options but I'm struggling with finding something in my budget. Current income restricted housing is at a 1 to 2 year wait list. Others require a $48 per person application before you get to even see the apartment (for a one bedroom no less)

I've already made so many sacrifices during this year including not perusing fighting to get my cat back. Unfortunately with the way I can't find housing there wasn't a hope I could find housing and have it allow pets.

I've anyone has suggestions for finding roomates (that's not Facebook) or housing please feel free to message me

I'm also doing donation doodles for any donation over $10, give me a suggestion or prompt when you donate otherwise you get a bug art lol

[justinspoliticalcorner]

Andrew Perez at Rolling Stone:

EARLIER THIS WEEK, two Democratic senators announced they have requested a criminal investigation into Supreme Court Justice Clarence Thomas — regarding, in part, a loan for a luxury RV provided by a longtime executive at UnitedHealth Group, one of America’s largest health insurers. Thomas apparently recused himself in at least two cases involving UnitedHealth when the loan was active, according to a Rolling Stone review. Yet, he separately chose to participate in another health insurance case and authored the court’s unanimous opinion in 2004. The ruling broadly benefited the industry — shielding employer-sponsored health insurers from damages if they refuse to cover certain services and patients are harmed. Thomas’ advice to patients facing such denials? Pull out your checkbook.

While UnitedHealth was not a party to the case, the company belonged to two trade associations that filed a brief urging the Supreme Court to side with the insurers.  “As we saw so starkly this term, Supreme Court decisions can have sweeping collateral implications: If the court rules in favor of one insurance giant, for instance, it tends to be a boon for all the other insurance giants, too,” says Alex Aronson, executive director at the judicial reform group Court Accountability. “That was the case here, and it’s a perfect example of why justices shouldn’t accept gifts — especially secret ones — from industry titans whose interests are implicated, whether directly or indirectly, by their rulings.” The public had no way of knowing about Thomas’ RV loan at the time of the decision: The loan was only exposed by The New York Times last year. Senate Democrats investigating Thomas believe that much or all of the loan, for a $267,230 motor coach, was ultimately forgiven. Sens. Sheldon Whitehouse (D-R.I.) and Ron Wyden (D-Ore.) recently requested the Justice Department investigate whether Thomas reported the forgiven portion of the loan on his tax filings, after he failed to disclose it in ethics forms.

Meanwhile, Thomas’ health insurance opinion has had wide-ranging, long-lasting ramifications, according to Mark DeBofsky, an employee benefits lawyer and former law professor.  “It hasn’t been rectified. The repercussions continue,” DeBofsky tells Rolling Stone. “People who are in dire need of specific medical care, and [their] insurance company turns around and says, ‘That care is not medically necessary,’ and there’s an adverse outcome as a result of the denial of the treatment, or hospitalization, or service — there’s no recompense for what could have been an unnecessary death or serious injury.” Since last year, the Supreme Court has faced an unprecedented ethics crisis, with much of the focus aimed squarely at Thomas. ProPublica reported that Thomas received and failed to disclose two decades worth of luxury gifts from a conservative billionaire, Harlan Crow, who allegedly provided free private jet and superyacht trips to Thomas and his wife; bought a house from Thomas and allowed the justice’s elderly mother to live there for free; and paid for at least two years of boarding school tuition for Thomas’ grandnephew.

[...] Federal law requires Supreme Court justices to recuse themselves in any case where their “impartiality might reasonably be questioned.” The justices decide for themselves when such a move is necessary — and when they do withdraw from a case, they rarely say why. Thomas does not appear to have explained his decision to withdraw from the two matters that directly involved UnitedHealth. Thomas did not take similar steps in Aetna Health Inc. v. Davila, a case that broadly affected the health insurance industry. He instead authored the court’s opinion, which expanded insurers’ favorite tool for limiting liability: ERISA. Congress passed the Employee Retirement Income Security Act, commonly known as ERISA, in 1974 to protect employee benefits. The law is relatively vague when it comes to “welfare benefits,” and contains a broad preemption clause. The courts have filled in the blanks — including in the Aetna Health case — with distressing results for patients. Half of Americans have employer-sponsored health insurance coverage; nearly all of these plans are governed by ERISA.

Rolling Stone exposes how SCOTUS Justice Clarence Thomas received a $267K RV from a health insurance executive.

[oscarpiastriwdc]

what the FUCK am i donig

[dr-archeville]

Disability Benefits: Last Week Tonight with John Oliver (HBO) [source]

"John Oliver discusses why disability benefits can be hard to get and easy to lose, how getting them can turn people’s lives upside down, and why John fucking hates mimes. Ya, you heard us. John Oliver fucking hates mimes. Spread the word." [24 min 5 sec]

[bitchesgetriches]

Short-Term Disability Insurance Is a Waste of Money… With Two Very Specific Exceptions

NEW POST! Short-Term Disability Insurance Is a Waste of Money… With Two Very Specific Exceptions

In honor of Disability Pride Month, we’re coming to you with our hot and sweaty take on short-term disability insurance. We’re going to explain what it is, how it works, and why you probably don’t need it… unless, of course, you’re in two very specific situations. Ooooh, look at me go, building that mystery! No disability-related topic can ever be simple. But we’ll do our best to make the pros…

[barnaclive]

someone should write a fic where Barnabas is a manager and Clive is an employee and Benedikta is a "Karen"* but not actually a bad one (that's reserved for anabella I'd say).

Anyway Clive gets her order wring and she demands the manager things happen there's a fight then Clive goes on a (smoke? Bathroom?) break and is scarred for life seeing Barnabas and Benedikta making out.

[squidsmeister]

I need to bitch here too my fucking car is in the shop for the 3rd time this year (6th time in the last 2 years) and it’s always something different and they always have to hold it overnight and it always costs like $650

[aduck8myshoes]

AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA

Don't get cancer folks

[quasistarjudgement]

I have GOT to get out of this country oh my GOD

[qazastra]

guys i have an interview tomorrow send get-a-job vibes

[queerlycarter]

i spent. 2 hours yesterday dealing with health insurance bullshit

and 2½hours today applying to medicaid. and apparently in florida if you're under 65 and have no children you have to be disabled to qualify for medicaid. so uh! i hope they decide im disabled enough!

ive been out of work for an entire year now so that may be in my favor. so there's that.

i have to wait for my medical records to be available to send them over.

[bitchesgetriches]

Short-Term Disability Insurance Is a Waste of Money… With Two Very Specific Exceptions

Short-term disability insurance is an income insurance benefit you might get from your employer, your state, or a private insurance company. If you become too ill or injured to work, and your condition is covered, the insurance company will pay you a portion of your paycheck while you’re laid up.

Each policy is different. To give you an idea of what’s normal, an okay short-term disability insurance plan might pay out 50-60% of your former paycheck for a maximum period of 3-6 months. The most generous policy I’ve seen reimburses a full 100% of paychecks for 12 months. Some have a hard upper limit across all policies; I’ve seen $750 and $1,000 per week.

The only thing short-term disability insurance protects is your current income. Not your job, nor your future earnings, nor the actual health of your body. Understanding this is crucial to evaluating its worth.

Keep reading.

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