petal53
This event has been reported for a couple of days now. The CEO of United Healthcare in America was killed in New York a couple of days ago. This has sparked a discussion about the state of healthcare in America, where it is said that people are frequently denied the healthcare they have paid for by the insurance companies. If reports are true, such as one where it was claimed that people are denied anaesthesia for essential surgery so they are forced to pay for it themselves or forego the surgery, then healthcare is in a dire position in America. Killing can never be condoned, but how angry must people be for this to have happened?
Respectfully, this why disinformation is dangerous. I happen to be on an unplanned visit to the US at this moment.
1. The actual motives behind the murder have not been officially established. The suspect has only just been arrested. Media speculation is all that currently exists regarding the ideological theory behind the killing.
2. Denied care and denied claims aren’t the same thing. A denied claim, which is what the rumours about the motive are currently centering around, is NOT the same thing as being denied care. You cannot submit claims, nor be paid for services they have not been rendered. All claim forms need a date of service. US medical documentation and laws are strict and complex. Every payer has a fraud unit. Providers who commit such fraud eventually get caught. It’s too risky for most. If a claim was submitted, the care was already rendered. Now, whether or not the patient is stuck with the bill post service is another issue entirely. Words matter, so please be careful with describing the situation.
3. As someone who spent 15 years in the US in their healthcare industry, it is far too complex for us here to scratch the surface of understanding. There is private insurance and there are public health plans such as Medicaid and Medicare. Most people have some sort of private insurance. 65 plus’ are covered under Medicare and supplemental plans if necessary. Medicaid is for low incomes, partially federally-funded, administered individually by the individual states. Many people are uncovered and are self-pay.
4. Healthcare facilities and providers are usually stuck with unpaid claims, not patients. Credit agencies can come after patients who aren’t on Medicaid, but it’s a futile effort if the patient cannot afford to pay.
4. Elective anaesthesia “surprise bills” are quite specifically the big fuss in US healthcare. This is much to do with the contracts of payers and anaesthesiologists , who often contract separately with specific payers than their institutions. Because of this, some patients get separate bills, which are expensive because those are the highest paid doctors in the US, which pays doctors far more than the UK can imagine. An “essential surgery” being forgone by the patient because they cannot afford the aneasthesia is misleading. Patients in the US can move more freely between providers. If you know your provider is not contracted ahead of time, you can find another provider who is by going through your payers list of contracted providers. All insurance companies have a provider search tool patients can use themselves, or call the insurance for. Surgery deemed ‘medically necessary’ doesn’t need to be scrapped all together. Not all patients are aware of how to navigate such situations, much to the delight of the insurance companies. It’s not a matter of no options, it’s a matter of intentionally not giving people the knowledge of their rights. Imo you have more options in the US if you’re not in the middle of nowhere and have a faint idea of how to find in-network doctors.
5. US healthcare, while completely inequitable and horrifically expensive imo is superior in the sense that even without money patients wait less in non-rural areas, and the care in the higher quality facilities is better than the UK. US Healthcare is less delegated. People receive more care from actual physicians. For example, pregnant women see OB’s there, not midwives. Their healthcare system is very capitalistic and poorer people and those in rural areas are forgotten. The best care is always where the wealthier people are. The system itself is so profit-driven than enough providers do abuse it and bill up a storm for unnecessary services. Physicians in the US are typically well off after a few years. So, the concept of utilization management has driven the bottom line for people like this murdered CEO. It has gone too far.
In summation, I don’t know what the answers are for US healthcare. I don’t like how undervalued trained physicians are in the UK, and I certainly do not love the wait times for basic services. But I do know that the profit-driven nature of US healthcare makes public health systems far more attractive. There wouldn’t be so much easy speculation on murders like this if not for the seedy, money hungry nature of their system.
