https://www.valuepenguin.com/health-insurance-claim-denials-...
https://www.valuepenguin.com/health-insurance-claim-denials-...
November 14, 2024 - In an unprecedented move, Anthem Blue Cross Blue Shield plans representing Connecticut, New York and Missouri have unilaterally declared it will no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes. The American Society of Anesthesiologists calls on Anthem to reverse this proposal immediately.
https://www.asahq.org/about-asa/newsroom/news-releases/2024/...
Their profit margins are higher than average but not exceptional.
https://www.financecharts.com/compare/UNH,CI,ELV,CVS,MOH/sum...
But even that doesn't mean anything.
I worked for a company that used ML to fight health insurance fraud ("mistakes") in the German market - where doctors/administrators would require payment for extra procedures that they never actually performed. So "denial rate" or even "profit margin" would go up with better AI that discovers more fraud!
Maybe a good metric would be something like "expected lifespan"? But even that can be misleading (e.g. maybe different insurers serve different populations...)
I have. We have. So many more people than apparently you think. He deserved a lot worse that a gunshot.
When the systems are so kafkaesque, so labyrinthine, the processes are intentionally gordian knots of unknown requirements, silently attacking your very need to survive as a human being. When the systems can't be fixed by the people most drastically effected, what recourse do we have? Nothing. So I'll cheer his death, at least someone did something for once.