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The sneaky thing to do is have your attorney send a letter to the insurance carrier's liability insurance provider, detailing everything you uncover and that they will be on the hook for the malpractice claim. That will get you an highly aggressive advocate with teeth.


This is excellent advice, and isn't restricted to the medical arena.

Corporate counsel for insurance companies comprise one of the very few spots on the brontosaurus with low-latency innervation from the brain. Poke it, you'll usually get a response that will arrive faster than the usual appeals processes.


Lawyers, the best way to get reasonable healthcare in USA.

What can be done?


Elect people, starting at the local level, who want to change the system?

That change doesn't have to be 100% or perfect. The ACA ensured that a lot more people got covered, even if it was not perfect.


Is "not perfect" strong enough criticism if people are being covered by services that do nothing? Today's article is saying that that large insurers might just be rejecting claims without reading them. Without the ACA, presumably money wouldn't be being spent on companies that literally just take the money for compliance reasons then don't provide a service.

This is one of the more annoying failure modes of socialised medicine; when things go wrong the consumer has no control over the waste because they aren't in control of the money being spent.


> Is "not perfect" strong enough criticism...

Absolutely pick a different phrase, but it'll still have applied before the ACA and it'll apply after except for people with preexisting conditions, eliminating lifetime caps, and maximum out of pocket limits.


Like Bernie Sanders? Who was then placed in a debate in an “insurance town” where every audience question was some insurance leech complaint that his plan would destroy their jobs? Yeah dude. That’s the point, your job is bullshit and you shouldn’t be doing it.

The media also loved to bring on people who “adored their current insurance plan and would hate to lose it”. I’ve never met someone like that in real life, but the MSM would have you believing you were the only one in all of America who had any ill thoughts about their insurance company.

If voting could change anything it’d be illegal.


> If voting could change anything it’d be illegal.

The absolute best way to ensure that nothing changes is to get cynical and try and demotivate anyone else from trying.


The only path to substantial change is and has always been violent revolution. I welcome anyone to try that.


I doubt that will ever happen when the Western world is so conditioned to view overthrowing the government as treason


Is there a part of the world that doesn’t view overthrowing the government as treason?


There’s nonviolent revolution, too. But it’s still likely to yield violence in response because these systems are inherently violent and ultimately enforced with violence.


What would you consider the most substantial change to come about via nonviolent revolution?


Maybe you're both right.


The mainstream media also doesn't mention that Americans already spend, on a per capita basis, the most on socialized medicine on the planet. I wonder if it has anything to do with those drug commercials that they play constantly?


By my understanding, that's the most on health care. This includes private insurance premiums, which is why the "we like private because it's cheaper" argument doesn't hold water.


Nope, the US government spends the most on socialized medicine.

The "We need to raise taxes to have universal coverage" argument doesn't hold water.

https://data.oecd.org/healthres/health-spending.htm


Interesting. In the summary, it's not clear what qualifies as "compulsory health insurance":

> Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”)

Digging into the source report[0], we see the following footnote exclusive to the US:

> All spending by private health insurance companies reported under compulsory health insurance. Category “Other” refers to financing by NGOs, employers, non-resident schemes and unknown schemes.

[0]: https://www.oecd-ilibrary.org/sites/ae3016b9-en/1/3/7/4/inde...


> If voting could change anything it’d be illegal.

Yet things do change, dramatically.


And I do wonder what the root of that is.


The root is you. The root is people believing they can change things. The far right believed it and has (unforunately) achieved inconceivable successes based only on utter bullshit and madness.


That’s one way of looking at it certainly. However I’ve never in all my life voted in any election where my vote had any capacity to have any bearing whatsoever on the outcome of the election. This is by design: America is about clumping people together into voting blocks so large that first past the post dynamics prohibit any but the most conventional of viewpoints rising to the surface.

What have the “far right” changed? And was it through voting or other means? In a sibling I admit violent revolution as a plausible change causer, and claim it is unique in that regard.


The ACA just gave more power and money to these same scummy insurance companies.


So, no, definitely not perfect. Also, some people are alive today because of it, and many are healthier. I'll take that over a better reform that doesn't get passed, and keep working to elect the people necessary for better reforms in the future. This stuff just doesn't happen overnight, sadly.


It got rid of pre existing conditions and the lifetime pay cap. That saved people, including me.


Yeah, we should have done some single payer system, medicare for all or whatever, but unfortunately we don’t have a very strong left wing in the US.


Blaming someone else is pathetic. It's not a system, it's you.


I’m a U.S. voter, so yes I’m part of this collective failure to vote well/convince my countrymen to vote well. I’m not sure why you think I’m blaming somebody else?


You talk about a 'system'. The system is in the mirrors, yours and mine. We are it. American tradition is that one person makes a difference, which seems pushed aside now by the fetishization of despair and doom.

Also, it's about far more than voting. Voting is done every once in awhile. Citizenship is every day. Powers-that-be are watching and investing enormous energy in manipulating public opinion - for a reason. It's powerful. Today is the day to act.


I’m not sure that our comments are really all that connected, I used “single payer healthcare system,” as in the term-of-art for a way of distributing funds for healthcare. You seem to have gotten latched onto the word “system” and seem to be using it in a sort of broad “fight the system” way.

There definitely aren’t any healthcare systems inside of my mirror, not even the bathroom one with a cabinet behind it.


It's a useful way to not address the merits of what I'm saying. That's too bad; we could have talked about something important.


Gunna take something a lot more radical than that.


guillotine.


I was thinking more Napolean than French Revolution.


I mean, I don't want to say "start shooting them until they get the message that we won't put up with their bullshit", but I honestly can't think of a better plan given that people will find all sorts of excuses to keep voting for the kinds of assholes who prefer it this way.

I'd really like to hear one, cause the violence option isn't really very appealing.


This. So, so, so many flavors of the "abuse of the public to make a few bucks" that is codified in the business models and job duties and KPIs of all sorts of organizations is only viable because people bend over and take it. If there was real risk that came with abusing the public employees would either a) not do that part of their jobs b) demand compensation, likely making the abuse not economically worthwhile c) seek other jobs. Any of these cases would force entities who are abusing the public as part of regular business to change their business or bleed out and die.

Or we could just bring back bribing....


"Or we could just bring back bribing.... "

Oh you sweet summer child...


What kind of "real risk" are you talking about? Risk of what?


Who are you to impose your opinion on the rest of us? Who are you to shoot me or my neighbor?


We're talking about people who sell insurance and then do their damnedest never to pay out.

You don't want to get shot? Don't try to cheat people out of their money, especially when it is about their healthcare. It isn't complicated.


Who decides that it's wrong, that I in particular am guilty, and that the punishment is murder? You?


To the extent there is anything that can be called "objective" morality, betraying social contract and causing other people to suffer for your own profit is going to be on the "wrong" side of that.

Going all philosophical here is, what, you making excuses for being a monster? Because what you're saying is that ruining other people's lives for your own profit is fine.

And yeah, violence is an extreme and distasteful solution, as I said. But if the only other option is to suck it up and let the exploiters win, then that's on them. You don't get to have a hypocritical morality system where it is ok for you to inflict harm on others for your own profit and not ok for them to inflict harm back in self defense.


Seriously consider a universal healthcare. Accept that it will be imperfect, but more balanced and will offer a chance to everyone. Another way to look at it: everyone pays for a healthcare insurance --> everyone gets covered.


Universal healthcare falls victim to the "I'm an above average driver" brainworm.

"I'm a healthy 22-year old male with no family history to worry about, go ahead and ravage the program to save me a nickel on taxes."

or, from the other side,

"I might need an ingrown toenail treated and how dare that go into a triage list and I have to come back in six months because there are more seriously ill people-- don't they know I'm rich and important?"


How does one discover what is the insurance carrier's liability insurance provider. Is that public information?


What is a liability insurance provider? Are you saying Cigna and other medical insurance companies have insurance themselves?


Every business has insurance, including insurance companies. This is because they specialize in their own business and outsource non-core business.

An insurance provider for a specific industry has teams of skilled attorneys that are expert in that specific domain. Cigna might self insure if they consider medical malpractice a core part of their business. In that case, your attorney sends the letter to their corporate counsel.

Often times, day to day business people just ignore liability risks because it's not in their core mandate. But the corporate counsel is in charge of managing legal risk, and they will see such a situation as unacceptable. Corporate counsels also hold a lot of sway within a businesses structure.


Yes, it's called reinsurance: https://en.wikipedia.org/wiki/Reinsurance


Yes, they typically will buy insurance to deal with risks outside their core business (like the health insurer having liability coverage).




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