• .Donuts@lemmy.world
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    3 hours ago

    You know, at face value he’s absolutely right. We shouldn’t claim care that is unnecessary or maybe even harmful. But where we disagree is that I think that decision should be left to our medical professionals

    • Modern_medicine_isnt@lemmy.world
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      2 hours ago

      Really what it should be is that if a doctor prescribes unnecessary care, they should go after the doctor, not the patient. Doctors have malpractice insurance. If the health insurance can’t win a case of malpractice, then they should pay the bill. Why are patients in the midfle here at all.

      • SmoothLiquidation@lemmy.world
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        37 minutes ago

        It’s the same trick as rebranding bank robberies to identity theft. It puts the blame on the consumer who can’t afford to defend themselves.

      • Kichae@lemmy.ca
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        2 hours ago

        This is still validating the profit incentive of private health insurance.

        If the doctor prescribes unnecessary care, it should be none of these peoples’ business, because they shouldn’t be allowed any stake in the decision whatsoever.

    • TheAlbatross@lemmy.blahaj.zone
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      2 hours ago

      Insurance claims are approved or denied by medical professionals. In the state of NY it’s even required for a specialist to approve or deny specialist care.

      Some doctors are just absolute scum.

      • Tinidril@midwest.social
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        2 hours ago

        They are done by medical professionals who have no obligation or incentive to serve the best interests of the patient. If your doctor fucks up, he can be found liable. If the insurance doctor fucks up, there is no liability whatsoever. Cases have been brought to court and then immediately thrown out because there is no legal basis for holding them accountable.

        • AwkwardLookMonkeyPuppet@lemmy.world
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          1 hour ago

          My insurance’s tactic to this sort of demand is to just completely ignore my requests/demands. They log an acknowledgement of my action, and then never do anything with it, ever.

      • .Donuts@lemmy.world
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        2 hours ago

        Except in this case, they used AI to help them make decisions. The lawsuit is still ongoing so I shouldn’t speak in definitive terms, but considering the circumstances and evidence I think it’s pretty clear than they have tried to automate some processes and didn’t audit them properly.

      • Jesus@lemmy.world
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        2 hours ago

        There is a lot of crap that they’re able to instantly deny through your plan’s terms and conditions.

        It’s worth reading the plan summary of what won’t be covered, even if it’s prescribed treatment. Some of the shit that’s hidden in there is fucked up.

        This year someone in my family started to have to pay out of pocket for their GLP1s because their diseases didn’t progress far enough for the treatment to be covered. They’d rather you hurry up and die than pay for expensive drugs that keep you alive for longer.

        • medgremlin@midwest.social
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          7 minutes ago

          If they have cardiovascular disease or kidney disease, those are getting added as indications for the GLP-1’s so they might be able to resubmit the authorization/claim with those diagnosis codes added to get it covered.

      • nul9o9@lemmy.world
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        2 hours ago

        I don’t have a source. But i’ve read they are incentivized to go through as many claims as they can, and not to approve too many.

  • motor_spirit@lemmy.world
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    49 minutes ago

    gonna put this dumb mother fucker on an airbrushed tee like he’s already dead

    chalk yourself out ya big dumb bastard, show the sharks where that menstrual leak is bitch-made mf

  • rc__buggy
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    2 hours ago

    I miss Anonymous. Those fuckers would be figuratively burning down UHC right now.

      • spankinspinach
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        2 hours ago

        I don’t have sources, but I seem to recall reading somewhere that the OGs aged out or got caught, and the new gen that replaced them weren’t as ideologically driven or competent or something. I think they still technically exist but aren’t nearly as influential as they once were

        • Tinidril@midwest.social
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          2 hours ago

          It’s also not as easy to hack electronic systems anymore. It’s not that they are invulnerable, but the vulnerabilities are generally more complicated and difficult to exploit. Setting aside people still running Windows XP or something, vulnerabilities get patched pretty quickly today. State actors have the time and resources to still do straight up electronic hacking, but opportunities for individuals are sparse.

          Of course there is still the human element. Most data breaches done by individuals nowadays rely, at least in part, on social engineering.

        • CuddlyCassowary@lemmy.world
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          2 hours ago

          Another thought this just popped into my head is that the next generation may not have been brought up with the same fundamental hacking skills that were somewhat inherent in being technical in the late 70s-mid 90s. Could you still learn them?…Of course, but having grown up with BBSs and LoD (Legion of Doom, and the like) and pre-WWW, some things were just more prevalent when it came to learning about the guts of systems and “cybersecurity” (that word didn’t really exist back then).

        • CuddlyCassowary@lemmy.world
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          2 hours ago

          In this economy?!?! /s…kinda

          Actually that makes sense, and saddens me a bit there wasn’t a contingent to pass the torch to.

  • Gork@lemm.ee
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    2 hours ago

    Did he not have a PR person tell him that video was a bad idea? Or more likely, did he not listen to their advice?

  • foggy@lemmy.world
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    2 hours ago

    Can we gamble on how long they have left?

    That’d be some good old fashioned capitalism.

    • GreenKnight23@lemmy.worldOP
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      39 minutes ago

      I think that would be hilarious but no gambling site would allow it.

      the odds are too much in favor of the winners.