And all you have to do is read United Healthcare's latest which is that they will be doing deep dives on all ER visits with an eye to denying payouts.
All insurance companies are bastards, and any policies to fix healthcare in the United State that involved them are doomed:
Doctors and hospitals are condemning plans by UnitedHealthcare—the country’s largest health insurance company—to retroactively deny emergency medical care coverage to members if UHC decides the reason for the emergency medical care wasn’t actually an emergency.
In the future, if one of UHC's 70 million members submits a claim for an emergency department visit, UHC will carefully review what health problems led to the visit, the “intensity of diagnostic services performed” at the emergency department (ED), and some context for the visit, like the member’s underlying health conditions and outside circumstances. If UHC decides the medical situation didn’t constitute an emergency, it will provide “no coverage or limited coverage,” depending on the member’s specific insurance plan.
Emergency medical doctors and hospitals were quick to rebuke the plan. They say it sets a dangerous precedent of requiring patients to assess their own medical problems before seeking emergency care, which could end up delaying or preventing critical and even lifesaving treatment.
The policy was initially set to take effect July 1. But in an email to Ars Thursday, UHC now says it is delaying the rollout amid the criticism—at least until the end of the pandemic.
They are implying that if you have symptoms that look like a heart attack, and it turns out that it's heart burn, you will be facing thousands of dollars that they won't cover, because they are evil bastards.
Doctors are having none of this:
………
The delay is unlikely to ease critics’ concerns. After the policy was first announced last week, doctors were quick to note that assessing the necessity of emergency care before it’s actually given is nearly impossible. Many serious conditions have symptoms that overlap with nonserious conditions. For instance, chest pain may simply be a symptom of acid reflux or a panic attack, but it could also be a sign of a life-threatening heart attack. A bad headache could just be a bad headache, or it could signal a dangerous brain bleed.
In a 2018 analysis published in JAMA Open Network, researchers found that up to 90 percent of the symptoms that prompted an adult to go to the emergency room overlapped with symptoms of nonurgent conditions, which may be denied coverage in the future. But those same symptoms could also be linked to life-threatening conditions.
That analysis was spurred when the second-largest insurance company, Anthem, instituted a similar policy to UHC’s and began denying ED coverage.
In an accompanying editorial, one of the authors of the analysis—Maria Raven, chief of emergency medicine at the University of California, San Francisco—noted how problematic it is to retroactively evaluate emergency medical care. “My colleagues and I examined whether a patient’s symptoms at presentation to the ED could be labeled reliably as a non-emergency based on the discharge diagnosis—the diagnosis that Anthem is currently using to determine medical necessity,” she wrote. “We found it was impossible.”
It's more than evil, it's a public health disaster.
A significant proportion of vaccination reticence in the United States is driven by people believing that the medical-insurance complex will f%$# them like a drunk sorority girl whatever promises are made by the US government.
Our system is beyond broken.
Not Enough Bullets.
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