this post was submitted on 01 Jan 2025
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[–] AA5B@lemmy.world 8 points 1 week ago (1 children)

Y’all are making a lot of assumptions about this person’s life, as if you yourself were on the death panel. Maybe it’s, true, maybe it’s not, but the doctor knows more about the case and the patients prognosis than any of us

[–] Elextra 1 points 6 days ago (1 children)

I know in the 10 years ive worked in a hospital ive never had a patient denied care in ICU unless the reason listed above. I also know A LOT about insurance, much more than most healthcare professionals. I also connect my doctors to insurance when we do need to appeal decisions and ask for a peer to peer.

Im not saying insurance never denies care. They do. Anecdotally though, never had incorrect denial with ICU. Its too easy to prove insurance definition of "medical necessity' there. I am still very doubtful of this specific example. Downvote all you want but the scanario I gave above is almost 100% probably what happened. I'm just explaining the process and likely what happened. Its okay if I'm not believed. I know what's true and how healthcare works. Its bittersweet that I have my job because I know how to navigate the healthcare system and get my patients what they need for their healthcare goals.

[–] AA5B@lemmy.world 2 points 6 days ago (1 children)

The fact that you have to be there and know the tricks to getting care is part of the problem. We have people who paid a crap load for medical insurance and doctors taking care of their treatment: why does there also need to be someone to deal with getting paid?

[–] Elextra 1 points 6 days ago

100% agree. Our healthcare sucks and I won't deny that. It would be so much cheaper and more efficient to have single-payer/universal healthcare. Studies and data consistently show that Americans pay the most and have worse healthcare outcomes (especially comparing mortality rates: overall, maternal, infant, etc). People are paying into it with high premiums and still having copays, out of pocket costs, etc. Single payer is the way to go for sure.

My job still exists in other countries like Australia, Japan, etc. But yes they dont have to worry about the healthcare services patients get being paid for or covered as much.