New healthcare thread...

[CrimsonNagus]

I’d like to see some evidence of this waste that’s pervasive in the scientific research community. If these accusations are valid, then certainly adjustments need to be made.

It’s Trump and the MAGAs. They don’t have proof, we are just suppose to “trust them”. They’ve been attacking science for years and now they have the means to take it down. You’d think MAGAs would read PJ2025 so they understand what is at stake but they don’t care, everything Trump does is a okay in their minds. Screw whoever it might harm.


Now on to my next rant…

I hate our current healthcare system, especially the corrupt insurance companies. I don’t know what the answer is and I’m not saying we need free healthcare. But if a doctor thinks you need a procedure, a test or a prescription then it should not be up to insurance whether you actually get it or not. At the very least it should be 100% illegal for these billion dollar company’s to deny care. They are not the medical professionals, they are scummy paper pushing bean counters.

My wife has had 2 runins with insurance this week. They denied a prescription because it needs prior authorization. How the hell are we suppose to know we need it before the doctor prescribes it? My wife suffers from really bad acid reflux, has for many years. She’s tried every over the counter option and they don’t help. She had an endoscopy done this week and nothing major was found but some inflammation. Doctor wants to try a stronger Rx that also helps heal the inflammation. Stupid insurance want her to use over the counter options. They are not the medical professionals! Just approve it already you greedy billionaires!

The other run-in pertains to her yearly OB visit and a cancer test they do each year. Suddenly BCBS only wants to pay for it every 3 years. So she might get cancer one day and not know it for 3 years because the greedy billionaires don’t give a damn about people’s health.

I hate our healthcare system and I hate this country’s wealthy class. They have held us down for long enough just to squeeze out more profit.

 

[arthurdawg]

I’d like to see some evidence of this waste that’s pervasive in the scientific research community. If these accusations are valid, then certainly adjustments need to be made.

The funny thing is that this will hammer red state universities over blue state universities who have funding from their states and larger endowments. UAB, as a good example, simply can't make up the funds that will be cut.

There is no evidence that universities are "quadruple" dipping. I mean, I don't know much other than being and oncologist and having been involved in clinical research for a number of years. And yes, the indirect costs are critical to most large state universities. The idea that you can magically cut them to 15% and "send more money to research" is fine Republican math. No lights, no bricks, no research.

There is also no way around the fact that a huge number of medical and scientific advances have come from the basic studies that don't have a clear cut commercial application. Private industry has no interest in doing this work or training the next generations of PhDs, engineers, and other workers that are critical to its functioning. I hope changes will settle and be more realistic, but this could seriously impair our STEM base in the country. Once again, we seem to be willing to cede our lead to the Reds of the CCP in order to make a political point. We've already done so with renewable energy tech and electric cars, which will be a huge market globally going forward, whether or not Present Trump wants it that way.

I think the major aspect of letting Elon Musk rip everything apart is that he simplistically views the Federal Government as another Twitter, when it is a very different and much more complicated beastie that needs revamping, but not destruction. The downstream effects have to be considered and I don't see anyone from President Trump and the Administration giving this issue much thought.

 

[Huckleberry]

Thank for that post. I agree completely.

 

[Huckleberry]

https://www.smithsonianmag.com/smart-news/the-human-brain-may-contain-as-much-as-a-spoons-worth-of-microplastics-new-research-suggests-180985995/

The Human Brain May Contain as Much as a Spoon’s Worth of Microplastics, New Research Suggests
The amount of microplastics in the human brain appears to be increasing over time: Concentrations rose by roughly 50 percent between 2016 and 2024, according to a new study

 

[Huckleberry]

Family says Cincinnati Children's won't put unvaccinated daughter on heart transplant list

A family related to Vice President JD Vance says Cincinnati Children's won't put their daughter on its transplant list because she is unvaccinated.

www.cincinnati.com

Family says Cincinnati Children's won't put unvaccinated daughter on heart transplant list

An Indiana family says Cincinnati Children's won't put their 12-year-old daughter on its heart transplant waiting list because of her vaccination status.

Janeen Deal, who is related by marriage to Vice President JD Vance's half-siblings, said the hospital requires her daughter to receive COVID-19 and flu vaccinations, which Janeen and her husband are unwilling to do.

The couple adopted Adaline from China when she was 4 years old. Adaline was born with two heart conditions, Janeen said, and they adopted Adaline knowing she would one day need a heart transplant. Janeen said Adaline has been receiving treatment at Cincinnati Children's for almost 10 years, and they hoped she would receive a heart transplant there because they consider it the best hospital in the area.

But earlier this month, Adaline's doctor said she would need to have the two vaccinations to be put on the transplant list, according to Janeen. The couple told the doctor the vaccines conflict with their religious and medical beliefs (the family is nondenominational Christian), but the hospital would not honor a religious exemption.

"I thought, wow. So, it's not about the kid. It's not about saving her life," Janeen told The Enquirer.

Vaccines are recommended for transplant recipients because those patients have a much higher risk for infections.

A Cincinnati Children's spokesperson did not answer The Enquirer's question about whether the hospital withheld Adaline from the transplant list.

Janeen believes the vaccines are unsafe, and also said they came to their decision after "the Holy Spirit put it on our hearts." The couple is now considering taking Adaline to a different transplant center – one that won't require her to be vaccinated.



Willing to risk the child's life because "the Holy Spirit put it on our hearts." Madness.

 

[CrimsonJazz]

$UNH Added diagnoses to patients’ records for conditions that no doctor treated, which triggered an extra $8.7 billion in federal payments. Untreated diagnoses from in-home visits by nurses cost an avg of $2,735 in additional federal payments per visit.

https://twitter.com/i/web/status/1892914878433620180

Holy crap on a carousel! If these accusations are proven......just wow. And I highly doubt only United is doing this.

 

[arthurdawg]

$UNH Added diagnoses to patients’ records for conditions that no doctor treated, which triggered an extra $8.7 billion in federal payments. Untreated diagnoses from in-home visits by nurses cost an avg of $2,735 in additional federal payments per visit.

https://twitter.com/i/web/status/1892914878433620180

Holy crap on a carousel! If these accusations are proven......just wow. And I highly doubt only United is doing this.

United has been accused of doing this for a while... They are probably better at doing it than most of the other commercial insurers too. They have started utilizing AI to deny your care ever more effectively.

 

[JDCrimson]

Remember UNH is likely part of a group of companies lobbying for a permanent tax cut from Republicans. And they are likely going to get it...

$UNH Added diagnoses to patients’ records for conditions that no doctor treated, which triggered an extra $8.7 billion in federal payments. Untreated diagnoses from in-home visits by nurses cost an avg of $2,735 in additional federal payments per visit.

https://twitter.com/i/web/status/1892914878433620180

Holy crap on a carousel! If these accusations are proven......just wow. And I highly doubt only United is doing this.

 

[jthomas666]

 

[DzynKingRTR]

apparently my visit to the CVS Minute Clinic was not covered by my insurance. The "office visit" and flu test ended up costing $140 with insurance.

 

[crimsonaudio]

apparently my visit to the CVS Minute Clinic was not covered by my insurance. The "office visit" and flu test ended up costing $140 with insurance.

Apparently there are 'doc in the boxes' popping up now that bill as 'urgent care' (or similar) meaning they tag your insurance as an ER visit. One opened near me and I've had a couple of friends go in for quick flu shots, etc. only to get billed later for upwards of $1K.

I wish I knew what the answer is.

 

[arthurdawg]

Apparently there are 'doc in the boxes' popping up now that bill as 'urgent care' (or similar) meaning they tag your insurance as an ER visit. One opened near me and I've had a couple of friends go in for quick flu shots, etc. only to get billed later for upwards of $1K.

I wish I knew what the answer is.

The extraction of money from insurance plans with all manner of schemes, and the dumping of those extracted funds on the patient for them to pay, is something I see every single day. It is a disaster.

 

[crimsonaudio]

The extraction of money from insurance plans with all manner of schemes, and the dumping of those extracted funds on the patient for them to pay, is something I see every single day. It is a disaster.

It should be criminal.

I'm sure there are ways we can fix the system we have (the money is clearly there), it's just so convoluted I've no idea where to begin...

 

[DzynKingRTR]

Apparently there are 'doc in the boxes' popping up now that bill as 'urgent care' (or similar) meaning they tag your insurance as an ER visit. One opened near me and I've had a couple of friends go in for quick flu shots, etc. only to get billed later for upwards of $1K.

I wish I knew what the answer is.

Well after having a very frank discussion with my boss, he said the company will cover the difference after my copay.

 

[CrimsonNagus]

It should be criminal.

I'm sure there are ways we can fix the system we have (the money is clearly there), it's just so convoluted I've no idea where to begin...

My wife was in tears this morning because we just can't get our insurance to approve the Rx her doctor wants her to try for her severe acid reflux. All over the counter medicine fails to work, she has tried them all over the years. Insurance wants her to try those same over the counter meds instead of approving the Rx.

I asked the pharmacist how much it would be without insurance and even with a discount card it is $145 for a 30 day supply. We can't afford a new $145 monthly bill. So, she's back to just having to deal with the constant, all day, pain and soreness because of greedy billionaires who control the system. Insurance companies should not be allowed to make medical decisions which is essentially what they have done to my wife. They should not be allowed to say no to a doctor's request. This is the medicine they say she needs; it should be out of the insurance's hands. If they don't like covering the customer's costs, then maybe they should exit the insurance business.

The "system" doesn't need to be fixed, it needs to be blown apart. The medical insurance industry has way too much power and control. That control should be in the hands of the doctors.

 

[crimsonaudio]

Really sorry to hear that, @CrimsonNagus - truly feel for your wife.

That Insurers are allowed to override doctors is criminal, imo.

 

[75thru79]

My wife was in tears this morning because we just can't get our insurance to approve the Rx her doctor wants her to try for her severe acid reflux. All over the counter medicine fails to work, she has tried them all over the years. Insurance wants her to try those same over the counter meds instead of approving the Rx.

I asked the pharmacist how much it would be without insurance and even with a discount card it is $145 for a 30 day supply. We can't afford a new $145 monthly bill. So, she's back to just having to deal with the constant, all day, pain and soreness because of greedy billionaires who control the system. Insurance companies should not be allowed to make medical decisions which is essentially what they have done to my wife. They should not be allowed to say no to a doctor's request. This is the medicine they say she needs; it should be out of the insurance's hands. If they don't like covering the customer's costs, then maybe they should exit the insurance business.

The "system" doesn't need to be fixed, it needs to be blown apart. The medical insurance industry has way too much power and control. That control should be in the hands of the doctors.

I have acid reflux as well and have been taking prescription strength omaprezole for about 10 years. It works pretty good and costs me a $10/month copay. $145 sounds incredibly high. It must be either an experimental drug or a new one still under patent. If it were me I would be more angry at the drug company. The insurance company shares in the blame but that amount of money for acid reflux treatment is crazy.

 

[DzynKingRTR]

I have acid reflux as well and have been taking prescription strength omaprezole for about 10 years. It works pretty good and costs me a $10/month copay. $145 sounds incredibly high. It must be either an experimental drug or a new one still under patent. If it were me I would be more angry at the drug company. The insurance company shares in the blame but that amount of money for acid reflux treatment is crazy.

Yeah, that is what I take as well. I had to get approved to take. My doctor had to write a letter to the insurance stating this was "medically necessary."

 

[CrimsonJazz]

I have acid reflux as well and have been taking prescription strength omaprezole for about 10 years. It works pretty good and costs me a $10/month copay. $145 sounds incredibly high. It must be either an experimental drug or a new one still under patent. If it were me I would be more angry at the drug company. The insurance company shares in the blame but that amount of money for acid reflux treatment is crazy.

Yeah, my insurance is good when it comes to paying for generics (most of which are dirt-cheap anyway.) When my doctor wants to try a name-brand drug with no generic alternative, it's a solemn guarantee that BC/BS won't pay it, end of story. It's a never-ending battle between the medical industry/pharmaceutical industry and the insurance companies who are routinely getting soaked by high prices for meds and/or treatments. Last time I was hospitalized, I actually paid attention this time to the itemization report which showed what everything cost. Just the cost for a bag of saline nearly knocked me off my feet. With both sides continually trying to screw each other, it feels like a war of attrition, but the real victims in all this continues to be us.

 

[CrimsonNagus]

I have acid reflux as well and have been taking prescription strength omaprezole for about 10 years. It works pretty good and costs me a $10/month copay. $145 sounds incredibly high. It must be either an experimental drug or a new one still under patent. If it were me I would be more angry at the drug company. The insurance company shares in the blame but that amount of money for acid reflux treatment is crazy.

For all I know that is what it would cost us as well if the insurance would cover it. The $145 was without insurance and some discount card the pharmacist said they used. The doctor has tried 3 times but, I don't know if they have written a letter.