My spouse struggled with a medical condition for years and was lucky to finally get a prescription for something that actually resolved the problem. The medication was expensive ($1000+ a month), but since we literally tried everything else, insurance would “let” it be covered.
Then I lost my job and had to move over to a new company’s insurance plan. And they won’t cover it.
The fact that your employment in the US determines what medical care you can get is absolutely bonkers.
A medication being more expensive usually indicates rarity. This means the instance of required coverage by insurance companies is also rare. The fact any medication, needed to mitigate the risk of simply being born, might not be covered by “insurance” is bonkers.
I think we need to start a new industry to take it to insurance companies every time they deny coverage. Bury them in complaints and legal actions. Go so hard on every case that they give in immediately upon seeing the letterhead.
I think insurance companies are useless parasites that should all have been outmoded by single payer decades ago.
I knew a guy with AIDS that had some pills to take like once a month I think that were around that price and also struggled with coverage. I didn’t think AIDS was considered rare.
I don’t know what time period you knew this guy, but back in the 90s when the first retrovirals came out it was not a friendly place for gay people, especially gay men.
I actively covered for at least two in workplace situations where bosses were hinting/asking around about questionable sexual orientation, and made up brief scenarios where I’d seen them out with some beautiful woman just to throw these assholes off the track, if only because I knew how it would be for them at work if anyone found out: the prelude hell of whispers and glances, then open harassment, then complete loss of employment.
One of them, who ended up being a good friend, was also HIV+ and stared this exact scenario in the face on multiple occasions, but got his retrovirals through one of the first studies so at least that specific healthcare access wasn’t threatened.
And remember the statement at the top of this thread:
The fact that your employment in the US determines what medical care you can get is absolutely bonkers.
AIDS was not rare at all. It is still not rare in many parts of the world. But you could not get a better group of people to marginalize, deny, and treat criminally than gay men in the 80s and 90s – especially ones who had to keep their sexuality completely hidden from employers just to have jobs and health insurance in the first place.
My medicine is $1,500 a month without insurance. It’s a bipolar medication. It doesn’t indicate rarity, it indicates greed. They could easily sell it for half the price and still make money.
It’s important to keep in mind that this rarity is often artificial scarcity by the pharmaceutical companies. There are some conditions which are rare, but have treatments that have been available for decades now with generics on the market for years. They simply don’t produce much of those meds, even though it’s cheap to do so, in order to artificially inflate the market price.
Insurers are complicit in this scheme because they don’t push back on this practice at all. Without single payer, we have no negotiating force to get pharmaceuticals to produce drugs in an affordable way, so they can manipulate the market however they please. It’s absolutely depraved.
Most meds take dollars to make. It ain’t rarity.
That’s their point. If I need to setup a production facility but there’s only demand for a thousand doses a year, then the long term capital costs are going to drive the unit price up.
But there’s also greed. Stuff that’s a dollar to make and a thousand dollars to use.
They did that to prevent people from being able to shop for insurance. They promote capitalism, but they suppress competition which is, in theory, supposed to be part of a “healthy” capitalist economy.
The ACA helped a tiny bit, but it didn’t go nearly far enough. And then they tried a zillion times to revoke even that.
It’s never been about healthcare, it’s always been about making a small number of people very wealthy.
We do stings in restaurants (for servering underagers) all the time. The fines are significant for the server and the restaurant. I wish they would do stings on mechanics, dentists, and most importantly health care. Wrongfully denied claims should be devastating to the company.
Oh yeah dentists for sure. The dentist who removed my wisdom teeth was a total quack. He did it in two sessions, used novocaine even though I told him it didn’t work well on me, and actually crushed a tooth to get it out. And yes, I felt the pain of him crushing a tooth. We should have sued him.
This was when I was 19. I’m 46 now. A few months ago, I had a terrible pain back where my wisdom teeth were and it got worse and worse. I have some nerve issues, so scheduling a dentist is a big deal right now because I need to be totally out. So we scheduled it, but a few days later, a little sliver of tooth from the space where he crushed the wisdom tooth worked its way out and the pain stopped.
Oof I feel for you friend. When I was in my early 20s I had to get all four wisdoms out as they came in crooked, all four had to be crushed and removed, but at least they knocked me out for it and gave me percocets afterwards…
That’s a twofold issue. Original dentist for sure, but also, that sliver of tooth should have been picked up over the years in routine x-rays you should have had during routine exams, as well.
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The fact that whether or not I get medical care is almost completely determined by whatever insurance company I have at any given time is so depressing.
I have thankfully been pretty healthy in my life but the few times I’ve actually needed help I have been told to go fuck myself pretty much every time by my insurance and since I’m not a millionaire I can’t afford anything that’s not covered. Don’t even get me started on the Russian roulette at the doctor’s office where anything can cost seemingly any amount at any time and no one has any damn clue until the bill’s arrived.
So whether or not I need the help really doesn’t matter at the end of the day most times. All that matters is if the insurance company is feeling nice or not.
My doctor diagnosed me with a b-12 deficiency. Something easily fixed with a shot she prescribed.
The pharmacist looked at me like I was a drug addict when I asked where the needle for the injection was when I picked up the scrip. “Just have the doctor do it”.
Fee for randomly showing up to my doctor to get the shot? $0
Fee for getting the shot done when I was actively at a scheduled check up? $130
I take an oral supplement instead now that’s not quite as effective.
Go to your local co-op or tractor supply, or order online. We always have hundreds stocked here on the farm for the animals, and they’re cheaper and literally the same thing as the stuff used for humans, usually from the same companies and factories.
Inb4 someone makes a joke about Horse Dewormer, or Fish antibiotics because they’re “better than that”.
I can make that joke… because we had almost a whole fucking 2 years where it was constantly out of stock, we have horses and cows we couldn’t regularly deworm per our vet because of those fucking idiots. Our tractor supply, had signs that said it was not to be used as a COVID cure, yet you still had dumbass people coming in from all over the place trying to buy cases of it.
Someone let me know if the article has any value beyond what is already heavily studied and known — that the profit motive and racketeering between all middlemen (insurers, big pharma, banking/finance sector, and health care providers) is a calculated effort to dramatically inflate the profits of each at the expense of the most vulnerable. Insurers don’t make money by paying claims. They make money deny them, so do everything in their power to deny as many claims as possible.
The insurance companies use computer algorithms to deny claims and most people won’t fight it.
Most people can’t fight it. Fighting a claim, depending on insurance, requires multiple different Doctors recommending the same thing. Sometimes the insurance requires prior steps taken that are unavailable to individuals (I was required to take antibiotic that I’m allergic to before a surgery). Getting into a specialist can take months, and the costs of seeing a specialist are not often covered at all (goes towards deductible), and unless you live in or near a city you may not be able to find specialists you don’t need to get a hotel to see (travel expenses and time off work are not covered). Not to mention, if fighting a denied claim rolls over to the next year, everything starts over, even if you have the same insurance it’s considered a new policy because it’s a new year.
Unless you have unlimited time and money, fighting a denied claim is pretty difficult and goes nowhere fast. That’s how the system was designed.
Remember all the hysteria over “death panels” during the ACA debates? Fooled you, they were already here, invented by insurance companies.
They paired that with a ton of bullshit about “corporate efficiency” vs " government corruption". It was one of the biggest Anarcho-Capitalist PR coups in my life.
This isn’t news, but I’ll accept that there are people who still haven’t learned this and suppose that it’s still worth publishing.
What is the point of this comment then?
Of course there are people that haven’t heard of this or don’t understand this. The world didn’t freeze and people didn’t stop being born, new humans growing up and becoming adults and just learning about various parts of the world everyday don’t know about these sorts of things.
Education and information is a perpetual struggle and a perpetual effort.
Does anyone have a non-paywalled version of this
Paywall removed: https://archive.is/CXm5f
Here’s the corresponding video: https://youtu.be/9s3CN5EafNs
