Sitirmineri
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Sep 2, 2026 6:21 PM
Sitirmineri
13760
1167
96
TyrCarter
as per usual american logic, extremes. Unusable fucking stupid extremes. How about I dunno... you pay a bit of your income to a public insurance systems that can be supplemented by private if you want to get faster service, like you know ALL THE NON THIRD WORLD SHITHOLES DO IT!
PutItInNeutral
*an independent board of physicians
JaceCameron
They'd just pay off the board of physicians.
5knotcans
All these posts and still no progress what gives?
CaldariBob
Gonna need a few more posts, is all.
5knotcans
This is the wind of change!
Pistolstar86
Tie the denial to Russian roulette style rules.
Ceo: I am going to deny this.
Rules: pick up the 45 and give it spin. Put it to your temple. Pull the trigger. By the way, these are real bullets.
hushpuppyextraordinaire
The people doing the denying are probably a bunch of retired PE teachers calling themselves the board of physiquecians
BlackHoleSon01
Doctors and hospitals routinely order tests and treatments that provide no benefit to the patient. In 2000, the Institude of Medicine estimated that about a third of overall health spending fell into that category.
Health care is complicated, isn't it?
zechor
This is a strange problem with so many fixes. If you want stark capitalism, let us sue and prosecute the companies and the people who deny coverage. I personally prefer the universal healthcare option, but then I also think that things like basic water, food, housing, and education should be universal.
unkreativ
This is Germany. And I an proud about our system once more. Can‘t understand why the Us is still without universal healthcare….
ForceAwakenWasLame
It should be called the Luigi Act of 2026
GrimleyGraves
SHHhh, you'll make the billionaires mad.
UserMad42
And if that happens, doctors will be told "If you prescribe something ONE TIME that costs us more than we want to pay, you will be dropped from our insurance." So no doctor will dare prescribe what's needed: Only to keep their cash flow going.
The whole system has to be rebuilt from scratch. The "insurance companies" need to be taken out of basic heath care and it needs to be single payer, universal healthcare.
emu314159127001
Side note, has anyone seen the United Healthcare video where they show the actual workers who "take care of us?" Total shit hole office space-like working areas.
CDRMiik
I personally like, it should be illegal for insurance companies to deny any care if you accept any money from the government.
KuldFyt
Specifically, anyone in the decision chain that is not a licensed physician should be considered to be practicing without a license for both criminal and civil purposes, and physicians in the decision chain should have the same negligence (criminal) and malpractice (civil) exposure as if they were actually treating the patient.
williamshakesbeer
In some aspects this is still a global issue when it comes to prescriptions. In Canada certain medications aren't covered and my anxiety medication that was prescribed from my doctor wasn't covered at my old job, but the common one with a shit ton of side effects was, and I had to fight to get an exception... Thankfully that's not an issue for me now
trouble4you
I see the sense of it. But I have also known doctors who prescribe anything and everything to make money out of insurance companies without any regard to patients health. Example, CT scans shouldn’t be used frivolously, once in a life, if required sorts. But I know a doc who asks this from every other patient. I know a doc who replaces expensive injections with water. I know someone who necessarily asks all females to get ultrasound. I mean, no one is ethical any longer.
ThisDeservesMoreUpvotes
XXXSpork
Ya see the thing is insurance companies make money by NOT paying claims.
tyner156
Confused European noises...
Spoonland
it should be illegal to not have a publich health service and still call it a democracy
funone77
Or hey... maybe we should just eliminate the worst middle man in history for one with a history of low administrative cost like..... MEDICARE!
Toqom
My mom is a retired physician and every time she prescribed something it was automatically denied by insurance, the reason: reason needed for approval. She would call and read the reason she sent with the prescription/referral verbatim off the sheet sent. Whole system is corrupt. Having to call for every fucking patient is insane and should I cure a financial penalty for insurance simply delaying care. If a doctor didn't have the time or left early, they could easily forget and boom, delayed.
AnythingMuchShorter
Reminds of the time I had damage where I couldn't breathe through my nose, and my insurance tried to deny the surgery as elective and cosmetic. Because technically I could breathe through my mouth for the rest of my life and not suffocate. I have pretty expensive insurance by the way, from a fortune 500 employer.
Skuggen
Which is why the insurance company brings in their own "the doctor".
RetrogradeLlama
Yeah, but the insurance company has doctors review every claim... at the rate of 60 per minute and with a recommendation they click "Select All" on every screen full and then click the "Deny" button.
IndependenceHallPhiladelphiaPA
great. now insurance companies will employ a board of physicians who havent treated a patient in twenty years and are paid based on how many claims they deny.
YoungCore
The insurance company would just have a "board of physicians" on payroll. It's ironic, and deeply sad, the amount of money an insurance company will spend to not pay out claims.
PointlessBarking
Well, under universal healthcare, there are no insurance companies... But replace 'insurance' with 'pharmaceutical' and you're dead right.
jimmythehat1
Yeah, a board of physicians that graduated last in their class and just need a check. Student loans are expensive
TheJuiceLoosener
I think they already typically do. They give them 45 seconds to review the case and make a decision.
PointlessBarking
Whoops, misread your comment, sorry.
irisewithredeyes
But hey, hey, hey! Think of all of the abuse these doctors would do by recommending treatment that's not needed... /s
YuckFuMaga
Unpopular response but please read this….
Work in insurance, had a doctor review an MRI as totally normal and unremarkable… then suggested an exploratory surgery to figure out what they couldn’t see on MRI.
An independent physician is the opinion I obtained to prevent that unnecessary exploratory surgery on someone with no objective symptoms of an injury. We are not always the bad guys here. That doctor just wanted his 50-100k to cut someone up and was known for unnecessary surgery.
Sylfeya
But if the OP proposed stance were the law, then you would have had to appeal to a board of physicians... and if said exploratory surgery truly were unnecessary, then the board presumably would agree and deny the surgery. What you've posted is like a 'good cop' story - possibly true, doesn't change the vast majority of the opposite being true.
YuckFuMaga
Which is actually what happened in my case. Which was a true case.
Their doctor wanted to explore and cut someone open, an independent doctor refuted and said it was unnecessary and that is the educated decision my decision was based on.
And no reason to lie here. It does not benefit me in any way
MeowWoof
I mean it's not like that doesn't happen https://www.justice.gov/archives/opa/pr/doctor-convicted-illegally-distributing-over-18m-doses-opioids-and-5m-health-care-fraud
irisewithredeyes
Pfft, insurers should be liable too or not reviewing this, then...
davebarton315101
That actually does happen but only because some unscrupulous doctors can profit from it. Universal healthcare will have to be regulated and supervised.
InsertTabA
Which is what all the other countries do but doesn't rely on a profit margin call.
Helixninja333
Simpler solution, remove the insurance middle man entirely and have universal healthcare like every other developed nation on this planet.
tinyfootprints
The insurance industry makes profits in the billions, yet provides neither a product nor a service. All they do is move money from one account to another. That right there tells me that they can be done without.
kingersgambit
Like every developed nation you mean. You can’t be a developed nation without universal healthcare.
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HarryDresdenIsMySpiritAnimal
Do you know what universal healthcare doesn't involve? Crippling medical debt. This negates any counter arguments
Dawgsarethebestpeople
This is wrong.
There are LOTS of countries with universal health care, if I would break my spine and both my legs tomorrow I would pay maybe 60 dollars in total for the ambulance ride, health care and hospital stay and maybe 60 more in total if I need rehabilitation and medicine every day for a year.
The only personal insurance I have is life insurance so my family gets extra cash if I drop dead or something. This is true for all Nordic countries and many more countries.
BeaverOnFire
NeverDownvoteMelBrooks
AtmaDarkwolf
*DING DING* CHICKEN DINNER FOR THE WINNER. But can't have that, that is SO UNAMERICAN!
ElbowDeepInAPoliceState
A lot of them actually use a two tiered public-private insurance system, though much more heavily and effectively regulated than the US. Actual single payer health insurance (like in Canada) or direct government provisioning of healthcare (as in the UK) together accounts for less than half of all universal healthcare systems.
TanithRosenbaum
Yes, but that is just outsourcing the administration of it. We have such a system here in Germany, and there's very little difference to the UK NHS in terms of quality and scope of service. There's a list of treatments they need to cover, mandated by law. Which includes pretty much everything except for things like breast implants or nose jobs (and even those are covered if you have an actual reason to need them, and don't just want them). At no point does the insurance decide the treatment.
NKato
Basically, "luxury" procedures aren't covered. Procedures that are designed to improve your "quality of life" further, when you're already above the standard.
Stuff like breast implants, penis enhancement surgery, etc.
armswoldier
Teeth aren't covered unless its major, glasses aren't covered unless you are almost blind. Our system sucks ass and needs an overhaul. Private healthcare should not exist and tbh our doctors are pretty bad, sending you home to drink some tea and "destress" when you have chronic problems.
TanithRosenbaum
Well, compared to the US, I'd say it's pretty good. But I fully agree, the private insurance parallel system has no business existing. Everyone should be in the same basic insurance, and instead of entirely different systems, people can buy add-on insurance for non-standard things, but the standard treatments all run through the same common insurance. That would solve a lot of problems.
somethingnotyettaken
"which includes pretty much everything" is certainly not true in the NHS. There's lots of things (procedures and drugs) which aren't covered but are available privately. There's also horrific waits for lots of things. Certainly not saying that the US system is better, but people keep holding up the NHS as a shining example and it's a shitshow in many ways.
TanithRosenbaum
genuinely interested, could you give me an example for a drug or procedure that's not covered? Here in Germany, it's usually teeth and glasses that aren't covered, I assume it's similar in the NHS? Or is the list of excluded things larger there? And yes, waiting times aren't anything to write home about here in Germany either.
freezingpilot
Canada is flirting with the private health insurance enough in our provinces that we effectively have two tiered healthcare. Rich people can see a doctor quickly, everyone else gets to wait.
TrainsDeluxe
you have to blame Paul and Stephen for that, when I was a kid we never had long wait times even in the small local hospitals, also we had small local hospitals.
ElbowDeepInAPoliceState
Wow really? That's news to me, because I certainly ain't rich amd I've mever never needed to wait more than a couple days for an appointment with my GP
NKato
The key element is that some specialties are booked out months in advance, while others have plenty of staffing. GP's tend to be pretty easy to schedule for in general even in the United States, but try to get an Opthalmologist and you're stuck waiting months for the first available appointment. I can't imagine it's really that much different in Canada.
Marsupialmessiah
Yeah your gp! Specialists are a bit of a different story, i have to book my rwcurrent folliw up appointments 6 months in advance and it took me about 3 months to get an oncology specialist to even see me, obviusly there less of those so bookings are a bit more difficult.