A Boring Dystopia

Deny coverage, delay and argue. Even if you eventually do have to pay for coverage some of the patients will die before then, saving money statistically.

The oncologists described the serious adverse event as “delay of treatment” 96% of the time, “denial of treatment” 87% of the time, “disease progression” 80% of the time, and “loss of life” 36% of the time.

Just a financial perverse incentive. Once someone demonstrates a expensive chronic condition you save money by exiting them from coverage as fast as possible. Either through rejections, denials, or waiting out their deaths... Not to mention sick people are usually not in a good position to fight a Kafkaesque nightmare of bureaucracy

I imagine the internal conversation plays out a little like this:

"generally speaking, there's very slim chances of surviving cancer, so we should deny it."

Ok but there's many forms and locations for it, this particular case is treatable and has a high success rate.

"Are there really? Oh well, we only have a slip here says Diagnosis- Cancer and survival chances of 'cancer' listed as 10%. It doesn't seem worth the money to gamble on a 10% chance for anything!"

You realize this is a human...right? Like we're talking about prolonging the life of another human for a few years, hopefully another 20+ by giving them care?

"Oh I've never met them, shame about them passing but don't't we all eventually? 10% is 10% and that's what we go by. Anyway so....denied"

Saint Luigi hear my prayer...

I got scans denied after I hit my head and got a concussion, they didn't even give a reason but the doctor said I might have a brain bleed.

Fuck these companies.

D³

The night before the first procedure, Pike’s surgeon called to let the family know Blue Cross and Blue Shield of Illinois, Pike’s health insurer through his employer, had declined to cover the roughly $40,000 treatment.