BCBS of Louisiana denied payments for preapproved reconstructive surgery for breat cancer patients...however they made exceptions for the wives of executives. But wait, it gets worse
#HealthInsurance #HealthEquity #HealthRights
https://pluralistic.net/2025/04/12/pre-authorization/

CNN amuses and confuses me.

They’re having a misinformation report coming out on Sunday that covers January 6th and what they call a “Luigi Mangione fan club”

Based on the interview with the reporter, he has made a few questionable assumptions:

1. Luigi support comes from the left exclusively
2. The sympathy for Luigi is equal to support for January 6 insurrection, and hypocritical.

I don’t think those are correct assumptions, frankly.

We have predicted for some time that if we don’t stop health insurance from bankrupting Americans when they’re most vulnerable, we will see vigilantism.

I think the desperation of the sick and poor supersedes the delusion of people who think our system of voting is bullshit just because they lost.

I cannot agree with the implied equal sign that reporter put between these two groups.

I think they’ve been told to do journalism in a certain way that is almost more abstractly mathematical than fact based. Kind of more “let’s cut that baby in half, cuz that’s fair.”

According to that school of journalism, It’s always balanced, it’s always half, and if it isn’t, then we shall make it so.

What a world.

When I called, I was shocked to learn that I was actually ineligible for coverage. My insurance had cut me off, leaving me without support for essential treatments.
https://buff.ly/Qk0jKej

Why I called Bob Herman a "master bluster-buster" a few weeks ago:

He doesn't mince words in reminding us where the money the government gives insurance companies comes from: Our pockets.

"Health insurers that sell Medicare Advantage plans are going to get billions more in taxpayer money next year."

via @STAT
https://www.statnews.com/2025/04/07/medicare-advantage-payment-rate-2026-cms-trump

I don't care what company you are contracted with for health insurance, keep a copy of every Explanation of Benefits (EOB) & get a receipt even when you use a credit card.

I'm "fighting" with another medical provider about how much I owe them. This time it's a radiology company.

I spent 20 years working in the med field, including med billing, which includes deciphering EOBs to determine who owes what. It drives me insane when companies hire ppl & don't train them properly

I'm sitting here trying to force myself to do my Medicaid paperwork for the year and finding it really hard to get going.

There is so much fucking paperwork involved with being poor, you have no idea.

The alleged UnitedHealthcare CEO killer faces the death penalty. Will a jury impose that punishment? https://www.theguardian.com/us-news/2025/apr/06/luigi-mangione-death-penalty-jury-unitedhealthcare-ceo #BrianThompsonshooting #Capitalpunishment #Healthinsurance #Guncrime #NewYork #UScrime #USnews

For people outside the US, here's a demonstration of American health insurance. Do not let your country adopt our stupid model. I'm currently in the process of getting signed up with an insurance company that can deny people with health conditions coverage (Tennessee Farm Bureau, it was grandfathered in when the ACA passed). I had to fill out a long form with my medical history and have to supply blood test results to prove I'm not diabetic and don't have sky high cholesterol. They don't pay for any existing health issues for one year, and charge higher premiums if you have existing health issues. Why am I applying for this instead of the Affordable Care Act? Because look at these prices for people in their 50s in a rural area. Monthly premiums AS LOW AS $782 a month! Wow! The last image shows the cheapest plan I can buy. $782 a month, with a $9200 deductible, which means my insurance would pay literally nothing until I paid $9200 for health care and medications, and that does not include premiums. The plan I'm applying for through my state is $330/month with a $3000 deductible . What a bargain. Our healthcare industry is a legal mafia. #Healthcare #Healthinsurance #LegalMafia

Un-fucking-believable

Senate confirmed #MehmetOz to oversee #HealthInsurance for millions of Americans

TV’s “#DrOz” & known quack has been confirmed to lead the Centers for #Medicare & #Medicaid Services, which has a massive $1 trillion+ budget & oversees health insurance for millions of Americans.

Thinking today about all my #patients who tell me they can’t take even one day off work after they’re diagnosed with #cancer

Reflecting on how often the treatment plan has to accommodate the patient’s need to continue to work (in the U.S.)

And this was before the intentional #dismantling of the minimal services available to help

Worried about what’s to come

This is what I got this morning when I tried to log into my (previous) #healthInsurance company's website (which uses #Optum's "Healthsafe ID" for authentication) after 9am to submit a claim from last month (before we switched to new insurance).
It's of course a -show that Optum can't keep a mission-critical website up during business hours, and a double -show when they've got a bogus "test" email address displayed in the error message.
Par for the course for Optum, eh?
#changeHealthcare

I just went to pick up a prescription at #CVS and I went to give them my new insurance info and they already have it. I am _certain_ no one in my family gave it to them. That is… disturbing.
Most people would probably be like, "Oh, how convenient," but I'm like, "Wow, there are all sorts of privacy issues here."
#privacy #healthInsurance

Via Reuters

U.S. Attorney General Pamela Bondi directed prosecutors to seek the death penalty for Luigi Mangione, the man accused of shooting and killing UnitedHealth Group chief executive Brian Thompson in New York last year.

"One week after the killing of UnitedHealthcare executive Brian Thompson, an intelligence report compiled by a regional intelligence center made an admission that’s shocking in its simplicity: Rising health care costs are correlated to threats against executives and civil unrest.

The two-page document obtained by the Prospect and compiled by the Connecticut regional intelligence center—one of dozens of fusion centers across the country that communicate intelligence between federal agencies and state law enforcement—is uncharacteristically forthright in its language and assessment that health care costs lead to instability, and that the reaction to suspect Luigi Mangione’s alleged action was largely positive.

According to the dossier, “Healthcare expenditure in the United States increased from $2.75Trillion (T) in 2004, to $4.09T in 2018, in inflation adjusted dollars. 2019 and 2020, saw expenditures of $4.2T and $4.6T respectfully, which represents a 10.6% increase year over year and was largely influenced by the COVID-19 pandemic. Historically, threats or actual acts of violence against those in the healthcare industry rose by more than 60% from 2011 to 2018.”

The dossier adds that the public “may view the ensuing manhunt and subsequent arrest of Mangione as NYPD, and largely policing as a whole, as a tool that is willing to expend massive resources to protect the wealthy, while the average citizen is left to their own means for personal security.”"

https://prospect.org/justice/2025-03-27-intelligence-dossier-compares-luigi-mangione-robin-hood/

Today's edition of AI Prognosis had a dud link for the "don't ever use this again" ambient AI scribe study. The web version below has the right one

Also in today's issue:

-CHAI's assurance labs are behind schedule
-AI tool for cancer clinical trials shows promise

https://www.statnews.com/2025/03/26/how-insurers-are-using-artificial-intelligence-ai-prognosis/

#23andMe is declaring bankruptcy, and your #genetic information will now go to the highest bidder. Yeah, that will probably be the (now ex-) CEO, but if I were, oh, say United Healthcare, that data would be worth a LOT to me. And then, boom, you can no longer get #healthinsurance because you carry a trait that results in death in 3 per 100,000 patients.

I know, I know: a long way from here to there. But the road's open.