A breast cancer surgeon had to "scrub out mid-surgery" to call a UnitedHealthcare representative because the insurance giant questioned whether the procedure she was in the middle of performing was really necessary.Dr. Elisabeth Potter posted her story to Instagram this week, and the post has gotten...
A breast cancer surgeon had to "scrub out mid-surgery" to call a UnitedHealthcare representative because the insurance giant questioned whether the procedure she was in the middle of performing was really necessary.
Dr. Elisabeth Potter posted her story to Instagram this week, and the post has gotten more than 221,000 likes.
Still wearing her scrub cap, Dr. Potter began her video saying, "It’s 2025, and navigating insurance has somehow just gotten worse."
Sad to say, my company was bought by another, and i am forced to change to these dirt bags. I currently have a malady that will require surgery. Not that it matters, the old company declined my last surgery anyway and i paid out of pocket
Push back when it's auto-declined. You can often get them to pay up even if they decline at first. They're trying to make as much profit as possible, so they decline and hope you don't fight back.
I sure wish someone would do something about this.
We need a hero. Someone who will do whatever it takes even sacrifice themselves if necessary to proclaim, "this is not okay. You will not get away with this."
Mass movements always exist, you just have to join them.
But mass movements also demand a lot of your time and energy, which you may not have if you're staring down the barrel of multiple major medical procedures. What's more, they demand a political system receptive to their demands.
The appeal of stocastic violence is that it doesn't require an enormous long term collaborative good faith effort. It just requires a few vigilantes with more rage than sense.
After decades of campaigning on health care reform (literally straight back to the 1940s) and posting a ton of Ls (particularly since Carter and the neoliberal turn), Luigi might not be transformative but he's cathartic.
I've been hearing for decades that the 2nd amendment is fundamental to the American identity, because it's supposed to be an insurance against this type of tyranny against the American people. There you have your mass movement, making claims on that insurance, using what's purported to be fundamental to the national identity of the country. What tyranny is the 2nd amendment protecting against if this doesn't make the cut?
It's really hard to disagree with Luigi when he wrote "evidently, I am the first to face it with such brutal honesty". Brutal honesty is what this state of affairs calls for. It's time to water Jefferson's proverbial tree of liberty.
Nope, y'all don't need (or deserve tbh, speaking as someone not from the US) a hero. You should try to hold your own government accountable for once; the last time that happened was the Civil Rights Movement I think?
How about using the wonderful internet and social media to sync calendars so you can all take out the quarter of a toilet break you americans call "paid holiday" and gather up, pool resources in order to make the federal government non functional until things improve. Rather than talking big about grabbing for the literal gun and doing drive-bys.
The damn french go for the jugular for as little as government implementing points system for driving liscences.
My partner had this same thing happen. She needed a neurosurgery to install a nerve stimulator in her neck. Her insurance approved a surgery to implant a test device, but then when it was determined it did solve her issues, denied the surgery for the permanent stimulator, forcing her neurosurgeon to write to them to get it approved. Then, during the surgery, they sent another denial. Fortunately, U of M is fantastic, and their hospital just covered the cost of the surgery due to the level of bullshit the insurance company pulled. Otherwise she would have ended up with multiple scars on her head and neck, and nothing to show for it, other than continuing nerve pain.
There was one single doctor in a fifty mile radius who would deliver my youngest because UHC. Had there been zero, we could've gone to anyone and they'd have had to cover it, but because there was one provider, we had to use him.
It reminds me of enshittification, in that the end product involves both regular people and businesses customers being fucked over (but the regular people are fucked over worse/for long). In this analogy, the doctors are the business customers. Enshittification doesn't apply here though, because this system has always been shitty for everyone, even if it's getting worse. If this scenario "rhymes" with enshittification, it's just because they both are based on capitalism being toxic
UHC has an enormous client pool, though. Their business model involves lots of kickbacks to HR/Execs and tons of money on marketing, as well as regulatory capture and consolidation/cartelization of competitors.
"Well, I simply won't do business with you" isn't a practical option for most hospitals, particularly in the ER or other time sensitive setting.
I could be wrong, but I believe ER visits are handled differently?
It only speaks to how bad UHC is that even though their business model is marketing and kickbacks, there are still providers who don't want to have anything to do with them.
Looking at Canada and Sweden as models, they absolutely do. Getting an actual specialist appointment takes a long long time, but they do get there eventually. And they def do a better job at getting you the meds you need in a timely fashion.
No, no, they should only be required to provide life insurance for deaths related to refused treatments, but the amount should be massive and punitive. Whoops, you died because we denied your treatment, your next of kin gets several times more than we could have hypothetically saved by denying the treatment.
You can't make it a massive punitive amount of it's general life insurance because everyone dies eventually. But you can if it's for deaths related to a denied treatment, and you can make it high enough that the financial incentive is always in favor of approving necessary treatments.
Cigna has this cool new thing they do where, after they deny a medication for our son, they have a nurse call us and tell us why our doctor was wrong to prescribe it in the first place. You know, because a nurse who has never been in the same room as my son knows more than the fucking doctor who examined him.
I have Cigna. Did you catch the email they sent before the new year? In 2025 you need to centralize your prescriptions between either CVS or Walgreens (with exceptions for small pharmacies I didn't look into). They didn't even send a physical letter, just an email they hoped would be ignored or missed.
I'm sure there are so many people already getting surprise huge bills at the pharmacy in 2025. Luckily I saw the email and put all my prescriptions at a CVS all the way across town instead of the Walgreens two minutes away. Because that CVS has one of my prescriptions that Walgreens seems permanently out of. Absolute fucking bullshit.
No, I didn't hear about that. I normally send my prescriptions to CVS anyway, since they're down the street, but sometimes I send it to my local doctors office's pharmacy when they can't fill it. I'm gonna be pisse if they give me shit for that.
We need to make it a crime to deny claims on necessary healthcare. 10x penalty (paid to the victim directly) for denial. 30x if they were denied using AI or an automated system.
Just make it not up to the insurance company. If the healthcare provider believes it's necessary care, then the insurance company pays. Full stop. They get no say in the matter, and denial is not an option.
"But health insurance would become unprofitable!", they'll cry? Good. Necessity shouldn't be exploited.
This would incentivize abuse of the system by quacks and malicious profiteers trying to overbill, but Medicare/Medicaid seem to manage that problem just fine through fraud laws/policies.
If the insurance company believes it's actually unnecessary care, they can take up a complaint with the medical board and only get to claw back money if an independent panel of doctors in the same specialty agrees that it was unnecessary or unethical. A bonus from this is that insurance companies would have incentive to make sure doctors are well-trained to know what testing/treatment is actually warranted. Btw, "necessary" doesn't only get to mean you get the minimum required to keep you from dying today; quality of life and long-term prognosis must be required considerations.
If the insurance company believes it's fraud, they can take it up with law enforcement too.
Another thing that could help would be to make the medical/nursing/etc boards better equipped for investigation/enforcement of ethics complaints and to make disciplinary records follow those who would move to another state to get a new license, and also make those disciplinary records readily accessible by the public on a centralized national database. Bad actors will not be able to continue being bad actors if they lose their license, can't get a new one, or wind up in jail.
Even better, let's just have a national healthcare system.
I hope the surgeon said, at least, "Even if you conclude against my advice that it wasn't necessary based on your data before this call, it is most definitely necessary now, as the patient is open on my operating table at this moment." <slam>.
Police recovered bullets at the scene that read, "delay, deny, defend
Depose. Say it, DEPOSE.
I can understand this one instance being an editorial slip-up, but I’ve seen way too many news articles that reference the bullets while omitting that one particular word - depose.
It’s the word that scares the oligarchs the most. Which is all the more reason for us to repeat it, even if journalists won’t. DELAY, DENY, DEPOSE.
(EDIT: The parent comment now has the correct words!)
In your defense, the cops initially reported the words from the bullet casings incorrectly before later making a correction. And half the media has been confused about it ever since.
This is one of the reasons I want to be a night shift emergency medicine physician. No one is calling me at 2 in the morning to argue with me running a code for insurance reasons.
Only when they start costing more than they're expected to produce in future profits. So less like a parasite and more like a soulless corporate leech, because actual parasites at least want the host to survive until they can reproduce.
At this point if I ever switched jobs and the new employer had United Health Care I would politely thank them for their time and get up and walk out of the interview.
Unfortunately most people can't be so picky as to walk out of an interview, but yeah we should normalize asking who the company insurance is through, and if it's UHC, out.
I mean, maybe an interviewer will tell you what they have if you ask, but HR and the recruiters will not, and the company policy is going to be "you will get your employee handbook and benefits selection guide after starting."
At the very least there should be a law, forcing any health insurance to at least cover all costs needed to insure survival and long term health. And what is needed for survival and long term health is defined by the Doctor and not by the insurance company!!!
Honestly, no idea why this is not law in any rich country in 2025!
I mean that's basically all medicine besides some very specific aesthetic services. Even plastic surgeons do some amazing work sewing people's faces back on after animal attacks and industrial accidents and whatnot. This is a medical journal article of an amazing facial reconstruction after a car crash but fair warning that in the initial images his face is basically... gone (Scary Link). I've also heard stories of general and trauma surgeons trying to find a plastics doctor at 2am to sew a toddler's face back on after various accidents because while part of stitching anything up is minimizing scarring the delicate skin of a tiny face that has a lot more growing to do is just outside of their skillset once the injury is past a certain surface area.