Death Panels - Aetna to pay $25.5M for denying coverage

CanadianJudo · 2018-11-11T08:17:09.498Z

I don’t get how healthcare is more complicated then the criminal justice system.

CanadianJudo · 2018-11-11T08:18:46.013Z

The only reason why healthcare is so expensive is because you make it.
there is no rational reason why a single use pair of rubber gloves should cost a patient 30$.

Dissident_Aggressor · 2018-11-11T08:31:03.900Z

CanadianJudo:

I don’t get how healthcare is more complicated then the criminal justice system.

Sorry, you lost me here. Is this some kind of comparison you’re making?

Dissident_Aggressor · 2018-11-11T08:40:55.338Z

CanadianJudo:

The only reason why healthcare is so expensive is because you make it.
there is no rational reason why a single use pair of rubber gloves should cost a patient 30$.

I’m really glad you brought that up, to be honest. Those gloves cost that much because we actually do have health coverage for everyone in this country. Those gloves are that expensive because they pay for the people who can’t pay, like the alcoholic, homeless guy I saw get demolished by a Honda Civic close to where I work. If I were to believe some people, I should have seen the authorities pick up his bloody body and fling it in a dumpster. That didn’t happen, though. County Rescue showed up and took him to the hospital. After what had to be a hundred plus thousand dollar hospital stay, my boy is back doing his usual stuff.

And make no mistake, this isn’t the only reason for the high cost, but a significant one.

Janet_Miller · 2018-11-11T09:35:54.007Z

I’m confused.

I’m very sorry about the loss of this lady.

But about 2/3 of the way through the article, it states her tumor was shrinking, the treatment was working.

Which treatment? Did she get the standard therapy? Or the recommendation of proton based therapy with a patient billing?

Also the article notes the patient was in Stage IV with the tumor by her brain stem. Possibly with the cancer was this far along, standard or proton based radiation, she may not have survived.

Janet_Miller · 2018-11-11T09:39:06.204Z

May I assume that in Canada, universal health care or not, one needs private medical insurance?

CanadianJudo · 2018-11-11T09:59:45.696Z

You don’t need it but most full times job if not all offer it.

universal healthcare only covers the basics.

private insurance covers the rest stuff like dental, glasses, minor prescriptions, mobility scooters, etc.
most provinces will covers percent of the cost of these thing with tax credit and subsides as well.

CanadianJudo · 2018-11-11T10:00:49.211Z

sometimes private insurance can get you some nice perk like mine comes decent amount of money for Massage therapy.

CanadianJudo · 2018-11-11T10:03:30.446Z

I wouldn’t say you need private insurance, but it is a huge plus to have for dental coverage alone.

Janet_Miller · 2018-11-11T10:25:52.017Z

Massage therapy, oo, that sounds nice! May try it for hip with osteoarthritis.

Janet_Miller · 2018-11-11T10:28:43.588Z

I’ve always said I understand the rationale behind universal health insurance if and only if it’s provided with private insurance in tandem or even as an alternative.

Sounds like you guys need it for dental care. I’m having the opposite problem.

Obamacare messed up many employee health plans. However I can honestly say it hasn’t impacted our low cost dental plan at all.

BlueTex · 2018-11-11T12:26:32.927Z

Janet_Miller:

I’m confused.

I’m very sorry about the loss of this lady.

But about 2/3 of the way through the article, it states her tumor was shrinking, the treatment was working.

She and her husband took out a mortgage and set up a GoFundMe to pay for the treatment out of pocket.

Which treatment? Did she get the standard therapy? Or the recommendation of proton based therapy with a patient billing?

She received proton therapy with funds from a mortgage on their home and a GoFundMe fundraiser. The GoFundme raised $17,790.

Also the article notes the patient was in Stage IV with the tumor by her brain stem. Possibly with the cancer was this far along, standard or proton based radiation, she may not have survived.

Of course nobody would be able to predict how a patient will do on any therapy but that is irrelevant to Aetna’s obligation to cover medical treatments under a health insurance policy for which they gladly accept premium payments.

CaughtInTheMiddle · 2018-11-11T12:44:14.267Z

Dissident_Aggressor:

reflechissez:

Are you under the impression that doctors would be employees of the government? That’s now how single payor works

Whether doctors are the employees, or money is taken from others to pay those doctors, somebody still has a responsibility to bestow that right, no?

Under our old and current systems money was taken from others to pay them.

CaughtInTheMiddle · 2018-11-11T12:50:37.842Z

7ranz:

Dissident_Aggressor:

7ranz:

LOL

Freedom to die because you are poor.

Because the poor are incapable of helping themselves, you call for others to help them through force of government. And hey, that’s fine. But it still is a part of the morality discussion even thought you really don’t want it be. At least you conceded that doctors aren’t in just to help people.

I don’t want a GoFundMe nation for healthcare. As we have now.

I’m cool with you and others talking about the morality of free universal healthcare being wrong because for some reason that will make doctors slaves. No one buys that ■■■■■

For the older folks…

Remember when you’d walk into a gas station and they’d be a glass jar by the cash register with a picture of a kid with some type of cancer and the family (many times farmers) would be begging for money so they could save their child. We’d all throw change in them.

We still have that. It’s just more sophisticated and called GoFundMe.

CaughtInTheMiddle · 2018-11-11T13:11:30.834Z

Jezcoe:

Dissident_Aggressor:

Jezcoe:

Do you know the difference between an elastic and an inelastic demand?

Nope. I’ll look it up later, I suddenly became busy, so I’ll pick this up later.

Look it up and you will see that however Capitalism is great for a lot of things… there are some things where profit motive serve to increase human misery.

Exactly true.

Almost everything about our society is capitalistic. Even many of our churches.

But there are some things that should not be. For example, no one should make money off of our best and bravest soldiers dying.

Heck, even our most profitable sports league (NFL) saw that they had to get away from pure capitalism/freedom (like MLB was) to be massively successful/profitable. They won’t even let their potential new employees work where they want to work.

mobulis · 2018-11-11T13:29:00.537Z

Dissident_Aggressor:

7ranz:

Healthcare for everyone is a moral position.

I curious about this statement. So you view health care as a right, then?

Yep…

mobulis · 2018-11-11T13:29:54.583Z

Dissident_Aggressor:

7ranz:

Well, I think rights are ■■■■■■■■ philosophically speaking. But, basically, yeah. Everyone should get healthcare. Full stop.

So, if a person has a right to health care, who then has the responsibility to provide it? Essentially, the provider is now in servitude to the recipient by virtue of the recipient’s existence. That certainly has to be considered when discussing the morality of the issue, no?

No…

moonshine · 2018-11-11T13:49:00.620Z

Hitting the company with a 25m judgement is all well and good but what needs to happen is the individuals need to be hit with judgements. Maybe multi million dollar judgements against the doctors working fircaetba that denied the claim and the top Aetna execs would change things

CaughtInTheMiddle · 2018-11-11T13:52:45.420Z

moonshine:

Hitting the company with a 25m judgement is all well and good but what needs to happen is the individuals need to be hit with judgements. Maybe multi million dollar judgements against the doctors working fircaetba that denied the claim and the top Aetna execs would change things

Correct. That’s all that can stop this type of crime.

Otherwise, it’s just an accounting write off (which most instances companies plan for).

Isn’t that cool? They plan on killing some people because they can afford it.

Janet_Miller · 2018-11-11T13:53:09.859Z

“Aetna’s obligation to cover medical treatments”

This wouldn’t be the first time I’ve seen an insurance company refuse to cover services not that necessarily are experimental, jut that they consider new & experimental.

And are insurance companies required to cover all medical treatments? For example, relatively few insurers cover LASIK as glasses have been around since antiquity, & contacts are available.

There was an instance in your state, I believe, where a child covered by Tri Care was denied a gastric bypass (age 12). Child was obese due to a pituitary tumor that, even when removed, her body didn’t respond to diet & exercise & she was openly ridiculed in public.

Tri Care refused to cover citing safety concerns for a child still growing (it isn’t commonly performed on growing children). Parents appealed & got the procedure covered.

Once again, is insurance, even under the ACA, required to cover all medical treatments? It appears the lady in the original article received the proton based therapy & died. Would insurance coverage or payments made otherwise have made a difference?