New York hospital replaces 12 nurses with AI, prompting warnings over patient care dangers

[Endymio]

Fact, in the US, a single vial of insulin can go for upwards of $300 each, depending on variant. In most other countries, this vial would cost the equivalent of $5-10.

"...While list prices can exceed $300 per vial, most Americans now pay $35 or less per month for insulin. This is achieved through Medicare caps, manufacturer savings programs, and generic alternatives....."

Speaking to the more general question of which medicines are cheaper in many other nations, it's simply because many nations force producers to sell below cost (which total costs are considered, not simply production costs), requiring those producers to shift most of their R&D costs onto US consumers. It's an unfair system sure, but every 'solution' I've seen proposed is worse than the status quo.

 

[GhostLegion]

Let’s talk about price elasticity of demand. What would you pay for life saving treatment? What would you pay for car insurance that while illegal to not carry, won’t literally kill you.

Pricing power favors corporations and greed. To argue otherwise is foolish.

 

[axiomatic13]

Was this a joke, or do you not understand how subsidies work? "Subsidized" healthcare means others are paying that $18K. Money doesn't magical grow from Oregon trees, despite what others may have told you. And the mere fact you can purchase insurance at all with a pre-existing condition is a textbook case of cost-shifting -- like refusing to buy home insurance until your house burns down, then paying for a month's coverage to get your home rebuilt.

I get it now. You think those people have a choice in subsidizing my 18k? Hahahahahaha! Government taxes do not work that way, son. (crying laughing)

 

[Endymio]

Except medical debt weighs considerably on people

That doesn't excuse the chattel slavery of socialism: an evil responsible for more human suffering than any other of the last 100 years.

. Don’t pretend it doesn’t. I have friends suffering from medical debt burdens. I have suffered from surprise medical bills. I once had a bill sent to collections 2 years after the procedure

Appeal to emotion fallacy noted and discounted. I have a friend who died in a car crash. Does that mean we should ban automobiles?

I mentioned more than just the insurers as having a profit motive. Pharmacy benefit managers for one.

And now you've just outed yourself as a closet socialist. When you figure out a way to ban the law of gravity, then talk to us about how you can remove the profit motive from human interactions.

It was only last month that over 90% of denials for long term coverage under Medicare advantage were overturned, suggesting that many of the initial denials should not have occurred...

Your link doesn't support your claim. Do you not understand how statistics works? The set of "appealed claims" is a far different statistical universe than the set of "all denied claims".

But I’m not going to pretend that healthcare insurance makes any sense whatsoever. Because it doesn’t.

End of problem. Don't purchase any. No one is forcing you too ... thanks to a well-advised SCOTUS ruling.

 

[Endymio]

I get it now. You think those people have a choice in subsidizing my 18k? Hahahahahaha! Government taxes do not work that way, son. (crying laughing)

Why not read posts before replying to them? Of course they have no choice. That's the entire point. You are forcing others against their will to care for you. And instead of thanking them for that, you're giggling inanely over the injustice of it.

 

[axiomatic13]

Why not read posts before replying to them? Of course they have no choice. That's the entire point. You are forcing others against their will to care for you. And instead of thanking them for that, you're giggling inanely over it.

I'm giggling at your innocence. Healthcare should be free.

 

[GhostLegion]

That doesn't excuse the chattel slavery of socialism: an evil responsible for more human suffering than any other of the last 100 years.


Appeal to emotion fallacy noted and discounted. I have a friend who died in a car crash. Does that mean we should ban automobiles?


And now you've just outed yourself as a closet socialist. When you figure out a way to ban the law of gravity, then talk to us about how you can remove the profit motive from human interactions.


Your link doesn't support your claim. Do you not understand how statistics works? The set of "appealed claims" is a far different statistical universe than the set of "all denied claims".


End of problem. Don't purchase any. No one is forcing you too ... thanks to a well-advised SCOTUS ruling.

• Enrollees and their providers appealed 18 percent of SNF denials. When SNF denials were appealed, MAOs overturned 95 percent in favor of the enrollee. The extremely high overturn rate indicates that some enrollees were initially denied medically necessary care and raises concerns about denials that were not appealed.
• The contractor naviHealth processed half of all requests for SNF admission and denied 14 percent of them—a higher denial rate than MAOs that processed requests internally (11 percent) and other contractors (9 percent). MAOs later overturned 97 percent of SNF denials issued by naviHealth when enrollees appealed. This raises concerns about whether contractors are receiving appropriate training and oversight from MAOs. NaviHealth is a subsidiary of the MAO United Health Group, Inc.

14% denied claims, 18% of denials appealed, 95% of denials overturned. My apology for misstating or misrepresenting the results but even the first bullet mentions that the appeal rate is likely too low to accurately represent all claims that would likely be overturned. I understand statistics fine. I could also argue that many people lack the knowledge or resources to fight such a decision. Thus the implication that denial rates are too high at 14%.

Your sophistry does you few favors.

Do you think that governmental institutions are trying to turn a profit with taxes? Is your local school board trying to profit from property taxes that fund schools? Certainly vice will generally provide a better incentive than virtue for many, many things but humans are not Ferengi hahaha. Would you try to fleece your spouse for personal gain? Humans are well capable of employing other motivations in interacting with other humans.

 

[Endymio]

I'm giggling at your innocence. Healthcare should be free.

Learn economics. Healthcare can never be "free" until and unless magic angels start dispensing it from the heavens above. What you call "free" is demanding others support you -- and then accept horrifically substandard care as a result. Wouldn't it be simpler to simply get a decent job and be able to pay your own way?

 

[CaptLiberty]

Health insurance makes zero economic sense.

Health insurance should be a hedge against an unlikely or unforeseen event, same as a car wreck or house fire. But it has become payer of first resort for every ingrown toenail and head cold. This is what has driven up costs. For the insurance company and the service provider. Doctors would love to ditch dealing with the insurance companies. But patients expect an immediate return on their premiums.

 

[axiomatic13]

Learn economics. Healthcare can never be "free" until and unless magic angels start dispensing it from the heavens above. What you call "free" is demanding others support you -- and then accept horrifically substandard care as a result. Wouldn't it be simpler to simply get a decent job and be able to pay your own way?

You're a healthcare criticism superposition, criticizing my use of healthcare while also wanting to profit from it.

 

[torvuswalds]

• Enrollees and their providers appealed 18 percent of SNF denials. When SNF denials were appealed, MAOs overturned 95 percent in favor of the enrollee. The extremely high overturn rate indicates that some enrollees were initially denied medically necessary care and raises concerns about denials that were not appealed.
• The contractor naviHealth processed half of all requests for SNF admission and denied 14 percent of them—a higher denial rate than MAOs that processed requests internally (11 percent) and other contractors (9 percent). MAOs later overturned 97 percent of SNF denials issued by naviHealth when enrollees appealed. This raises concerns about whether contractors are receiving appropriate training and oversight from MAOs. NaviHealth is a subsidiary of the MAO United Health Group, Inc.

14% denied claims, 18% of denials appealed, 95% of denials overturned. My apology for misstating or misrepresenting the results but even the first bullet mentions that the appeal rate is likely too low to accurately represent all claims that would likely be overturned. I understand statistics fine. I could also argue that many people lack the knowledge or resources to fight such a decision. Thus the implication that denial rates are too high at 14%.

Your sophistry does you few favors

Can we just acknowledge this dude used "Chattel slavery of socialism"? What in the cringey edgelord shitake mushrooms was that?

 

[Endymio]

• Enrollees and their providers appealed 18 percent of SNF denials. When SNF denials were appealed, MAOs overturned 95 percent in favor of the enrollee. The extremely high overturn rate indicates that some enrollees were initially denied medically necessary care and raises concerns about denials that were not appealed.

As I said, the link doesn't support your claim. Quite obviously no approval process can be perfect -- that's the entire reason the appeal process exists. You're forgetting that the MAOs overturning these decisions are the same MAOs that initially denied them.

If a patient is convinced there is an error, they will appeal the decision. The mere fact that most appealed decisions are indeed overturned is proof the system works. For the same reason, the 80% of cases that aren't appealed are those in which the patient didn't really need the care, and thus didn't trouble to spend five minutes appealing to decision to get it anyway.

 

[axiomatic13]

As I said, the link doesn't support your claim. Quite obviously no approval process can be perfect -- that's the entire reason the appeal process exists. You're forgetting that the MAOs overturning these decisions are the same MAOs that initially denied them.

If a patient is convinced there is an error, they will appeal the decision. The mere fact that most appealed decisions are indeed overturned is proof the system works. For the same reason, the 80% of cases that aren't appealed are those in which the patient didn't really need the care, and thus didn't trouble to spend five minutes appealing to decision to get it anyway.

Schrödinger's Healthcare provider, everyone! (please clap?)

 

[torvuswalds]

Schrödinger's Healthcare provider, everyone! (please clap?)

lol I am really starting to think that this is a bot account.

 

[Endymio]

Can we just acknowledge this dude used "Chattel slavery of socialism"? What in the cringey edgelord shitake mushrooms was that?

I can't quite decode the Gen Z slang, but I was born in the USSR, fled before its dissolution, and experienced full-blown socialism first hand. Those who spend their lives eating Cheetos and playing Counterstrike should probably keep quiet on subjects with which they have little understanding.

 

[axiomatic13]

lol I am really starting to think that this is a bot account.

I assure you I am not a bot. I just don't think Endymio is a serious person. Sometimes you just have to poke the bear.

 

[torvuswalds]

I assure you I am not a bot. I just don't think Endymio is a serious person. Sometimes you just have to poke the bear.

lol I appreciate you so much, its been endless whiplash style comedy at this point. Sorry you have been dealing with your insurance problems though, its a real flaming a-hole of a problem.

 

[GhostLegion]

I can't quite decode the Gen Z slang, but I was born in the USSR, fled before its dissolution, and experienced full-blown socialism first hand. Those who spend their lives eating Cheetos and playing Counterstrike should probably keep quiet on subjects with which they have little understanding.

I don’t pretend to know otherwise. Nor do I make claims that communism is the bees knees. I will claim that chattel slavery (the treatment of humans as though they are livestock to be bought and sold) would be accurately depicted in the Antebellum South. Who exactly wants to argue that the slaves had seized the means of production there? That was capitalism at its finest my friend. Capitalism lends itself to exploitation and must be restrained from its excesses to drive society forward. That is not an endorsement of Communism, far from it. I read Animal Farm, but Orwell wasn’t right wing af either.

It sounds like you have much in common with Ayn Rand, I can understand your animosity but I don’t agree with it, nor do I think America is on the way to Soviet style control economies.

 

[Endymio]

Schrödinger's Healthcare provider, everyone! (please clap?)

Once again, I'll try to walk you through the logic here. Even a murderer with a signed confession and a dozen eyewitnesses testifying against him will appeal his conviction. So what does that say about a person who "desperately needed a health procedure" -- but refused to spend five minutes appealing a denied claim?

Reading into your link, it gets even worse:

"... high denial rates were driven by contractors that denied prior authorization requests, many of which were later overturned on appeal by the MAO. This raises concerns about whether contractors are receiving appropriate training and oversight from MAOs."

So instead of malfeasance by the MAOs, it turns out to be largely driven by incompentent employees, who themselves had zero "profit motive" for denying claims, but simply didn't understand the policies well enough. And -- once reviewed by the company who actually DID have a profit motive -- those mistakes were corrected.

 

[axiomatic13]

lol I appreciate you so much, its been endless whiplash style comedy at this point. Sorry you have been dealing with your insurance problems though, its a real flaming a-hole of a problem.

It was very jarring. It spilt my marriage too. My ex-wife would not leave her friends in Texas so we could save money on healthcare. My kids are both out of college and the youngest is coming to live with me, he's so upset with his mom for not supporting me.

 

[axiomatic13]

Once again, I'll try to walk you through the logic here. Even a murderer with a signed confession and a dozen eyewitnesses testifying against him will appeal his conviction. So what does that say about a person who "desperately needed a health procedure" -- but refused to spend five minutes appealing a denied claim?

Reading into your link, it gets even worse:

"... high denial rates were driven by contractors that denied prior authorization requests, many of which were later overturned on appeal by the MAO. This raises concerns about whether contractors are receiving appropriate training and oversight from MAOs."

So instead of malfeasance by the MAOs, it turns out to be largely driven by incompentent employees, who themselves had zero "profit motive" for denying claims, but simply didn't understand the policies well enough. And -- once reviewed by the company who actually DID have a profit motive -- those mistakes were corrected.

Why can't you just accept that the problem in my case is Texas, specifically its Governor making decisions for whole classes of people with medical conditions?

 

[Endymio]

I don’t pretend to know otherwise. Nor do I make claims that communism is the bees knees. I will claim that chattel slavery (the treatment of humans as though they are livestock to be bought and sold) would be accurately depicted in the Antebellum South.

Sure. And in the former USSR, the modern-day DPRK, and large swathes of CCP China.

Who exactly wants to argue that the slaves had seized the means of production there? That was capitalism at its finest my friend

This is so literally absurd I laughed aloud on reading it. By your logic, a group of smash-and-grab thieves are "capitalism at its finest" because they're motivated by profiting in the fastest, easiest manner possible. Please, stop embarrassing yourself and us like this.

 

[torvuswalds]

It was very jarring. It spilt my marriage too. My ex-wife would not leave her friends in Texas so we could save money on healthcare. My kids are both out of college and the youngest is coming to live with me, he's so upset with his mom for not supporting me.

If you ever want to vent, my inbox is open send me a DM! Always willing to help others out, even if its just an ear.

 

[Theinsanegamer]

"...While list prices can exceed $300 per vial, most Americans now pay $35 or less per month for insulin. This is achieved through Medicare caps, manufacturer savings programs, and generic alternatives....."

Speaking to the more general question of which medicines are cheaper in many other nations, it's simply because many nations force producers to sell below cost (which total costs are considered, not simply production costs), requiring those producers to shift most of their R&D costs onto US consumers. It's an unfair system sure, but every 'solution' I've seen proposed is worse than the status quo.

That $35 is what consumers pay after insurance pays their share. That is heavily bloated over what other countries pay.

These prices are enforced by copyright/trademark/patent laws. There are generic insulins that are much cheaper and 99.5percent as effective, but good luck getting them in the US, since US endos won't prescribe them. They will only prescribe the newest most effective stuff (that gives them financial kickbacks, but surely that doesn't matter....) this helping to sustain insane prices.

Solution: eliminate patents on medication. A company should not be able to patent and restrict medicine production to increase their profits.

Can we just acknowledge this dude used "Chattel slavery of socialism"? What in the cringey edgelord shitake mushrooms was that?

There are people who view any form of collective action via taxation as no different to slavery, as they had no choice in the matter. I get their viewpoint, but it's contradicted by everything they benefit from in society, like roads or education.

Healthcare, unlike houses or cars, is something everyone will get hit by eventually. The laws of supply and demand get heavily twisted because you can't train doctors and nurses on a whim, you need the right people, the right temperament, and years of training. The most responsible people can still get catastrophically sick, or get infections, and so on. Most of these diseases are also very time sensitive, which is the last place you should be thinking of profit motives.

Where he is right is the care. So long as you have money, the us system beats the living another out of everyone else. We wait days for what can take months or years otherwise. There are horror stories of people in Europe and Canada having to wait years only to find out their issue is now terminal.

There's also the indirect effects to consider, a healthier population can work harder and make more. They can take more risks since if their business goes under they don't lose medical coverage. It frees people from the corporate yoke, and more centralized systems can realize huge cost savings on paperwork alone.

 

[Endymio]

Why can't you just accept that the problem in my case is Texas, specifically its Governor making decisions for whole classes of people with medical conditions?

Why do you fail to understand the problem here is Oregon's politicians: greedily lapping up funds provided by other states (including Texas) in exchange for votes from self-interested freeloaders unable to pay their own bills.