Comment by toss1 | Hacker News Reader

Comment by toss1 | Hacker News Reader

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THIS!!

Similar for a close family member with a strange heart and immune condition.

InsuranceCo BCBS had some bureaucrat without even a medical degree directly second-guessing the tests ordered by the literal Director of Cardiology at the world-renowned Mayo Clinic.

All I can think is: "Who the fck are you to even begin to question this expert, and deny his recommendation?". Now, IFF they had some actual peer reviewing it (e.g., the head of cardiology at Cleveland Clinic or Harvard Med School), that might be legit, but this is nothing of the sort. It's like the tech giant's arbitrary terminating accounts with support, except instead of cutting off your livelihood, they are killing you.

It is the death of expertise. It seems like practicing medicine without a license and without even seeing the patient (which is legally required before writing many prescriptions).

Why it is even close to legal is utterly baffling.

(I hope your dad continues to recover)

When Americans style healthcare promoters toss around arguments like “doctors in public healthcare are deciding if treating you is worth it”… I love replying with “at least in public healthcare the doctors get to decide, with only private health insurance paid for by insurance companies, it’s a faceless claims adjuster with zero medical experience who isn’t even deciding as much as they are just telling you that treating you properly would cost the company too much money… I’ll take my chances with a death panel of doctors over the death panel of accountants any day of my entire life”

I think American healthcare is insane… and the slow sliding in the American style healthcare direction I see in the UK and even slower slide here in Australia, this slide is largely borne out of American healthcare business having no more room to expand and trying to export their business model overseas to expand their addressable markets… it’s insane to allow non medical professionals… to allow armies of accountants and actuaries… to decide how to treat patients.

It should be criminal, but it won’t be because the healthcare industry in America is so broken it will lobby till it’s broke to continue to be allowed to remain broken otherwise it might not be as profitable.

> I love replying with “at least in public healthcare the doctors get to decide, with only private health insurance paid for by insurance companies, it’s a faceless claims adjuster with zero medical experience who isn’t even deciding as much as they are just telling you that treating you properly would cost the company too much money… I’ll take my chances with a death panel of doctors over the death panel of accountants any day of my entire life”

I think a licensed doctor/pharmacist employed by the insurance company has to make the decision, although, since they do not have liability exposure, I can imagine metrics can be imposed on them that make the quality of their work less than desirable.

Remember: the doctors working at insurance companies do not need to have a license to practice medicine to do so. In fact an orthopedic surgeon had to fight a denied authorization from a guy who lost his license for surgery for life because he installed a hip backwards!

Yes, that was an egregious example. I think they skirted that one through because that doctor still had a medical license, but not one for surgery? Which, whoever wrote the rules or even just hired him, should have prevented him from being able to be in that position.

And even if you are refused treatment you can always pay out of pocket if you really want to.

Exactly. Another one of the weirdest things in the “healthcare debate” is the idea that it’s public or nothing like a closed border dictatorship that will shoot you before they let you exercise any freedom of choice.

If I don’t want to pay I can have a GP appointment with a short trip and a little wait sometime in the next 1-3 days… if I’m happy paying $40 Australian … I’ve got a GP appointment within walking distance tomorrow, no issues no bullshit, and I’ll even get some of that back from the government if I can be bothered, because anything that urgent is probably worth the money lol.

If I want to pay I can get specialist treatment, I’ve got private healthcare to cover fancy shit like regular physiotherapist sessions due to having an office job which will slowly and stealthily destroy your body no matter how careful you are… and glasses if I eventually need them… and stupid levels of dental because that’s my personal preference, if someone ever smashed out all my teeth I’m just completely covered … and that’s all on top of basically being assured care for anything serious disease or critical injury related by public healthcare… it’s just obviously the better arrangement. The most general risks are shared by the biggest pool of people paying for it… everyone paying for that with their taxes. If you want more… your free to buy it, and a lot of people do! It works great.

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