Day 26 30 Days of US Healthcare • 30 Days of US Healthcare
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@DGlaucomflecken11 ай бұрын
By the way, the only thing I made up here is the joke about the PET scan. Everything else came from actual comments/anecdotes from followers
@jlfrandsen11 ай бұрын
horrifying..
@benyelrod11 ай бұрын
Even the one about the long scary name? 🥲
@ohgodno11 ай бұрын
@@benyelrod i was about to ask...
@felipercalvo11 ай бұрын
wait, what about the menstruation one? what the hell was that?
@DGlaucomflecken11 ай бұрын
@@felipercalvoyes, even that one. I added the bit about a man speaking confidently, but the conversation is real
@stearrow_324511 ай бұрын
I'm not even american and this makes me furious. How are the people who write these policies not being chased through the street by a torch wielding mob?
@raznaak11 ай бұрын
"Hurr durr communism."
@mandalynn138411 ай бұрын
Because the mob would be gunned down by the government
@bosstowndynamics548811 ай бұрын
Because widespread propaganda about America being the bestest nation means that a lot of Americans think this type of healthcare is somehow better than a public system where your doctor says you need tests or treatment so you just get to have it instead of all this nonsense, and the only cost is that sometimes you might have to wait a bit if it's not urgent.
@Roo-Smith11 ай бұрын
@@bosstowndynamics5488because America pays half the worlds bills is what you mean😊
@MyCleverHandle11 ай бұрын
Because the fuel for the torches was denied!
@prevalent117211 ай бұрын
I'm a pharmacy tech, and the amount of times I've heard a patient tell me "My insulin is HOW MUCH?!?!?!, well, guess I'll die" is... more than it should be
@itsraining644911 ай бұрын
Send them to pharmacies in Canada. They will two day ship in dry ice. These are not fly by night operators, but actual brick and mortar stores who have online pharmacies. Novolog or Humalog at $40 a vial is cheaper than the US at $350 a vial.
@johnkirk865011 ай бұрын
As a fellow Pharmacy tech we hear this a lot at our windows too
@BrianJRichards11 ай бұрын
@@itsraining6449my mother has been Type 1 since the early 70’s. During a particularly tough patch when she was out of work, the Canadian pharmacies literally kept her alive. She’s much better now, but this advice is sadly 100% needed for folks out there relying on the US healthcare system.
@garrybrown316511 ай бұрын
And as a retired pharmacist and physician I am old enough to remember when Keflex was introduced in the mid 1970's and it cost a DOLLAR a capsule!!! Original directions were one by mouth every 6 hours for 10 days. Patients would see the amount to be paid and say, "FORTY DOLLARS for a prescription! That is highway ROBBERY!!!" GJBrownDO 9/26/2023 11:39 Eastern
@lohphat11 ай бұрын
This is why the state of California is getting into the pharma business to offer common drugs as generics at cost. The Biden administration is doing something at the national level to bring down the cost of common meds and Big Pharma is having a stroke over it. GOOD.
@DrMama2411 ай бұрын
Can confirm that I’ve experienced at least 80% of these scenarios with patients. Hey, we may even hit 100% by Christmas. UHC is Santa’s coal in the stocking for all the bad doctors who try too hard to provide care without insurance overlords.
@adampope510711 ай бұрын
It ain't just UHC. It's pretty much all of them. Deny care to maximize profits to give them to shareholders.
@JeffGeerling11 ай бұрын
@@adampope5107Cigna, checking in.
@deepwater3646emt11 ай бұрын
The important thing is you know this.... Now, please make sure to fill out in triplicate using ancient Sumerian cuneiform prior authorization forms so they can be denied faster. Also giving the insurance companies the joy of not only telling you and the patient no, but also killing trees and having the satisfaction of shredding the forms while you are on the phone. It's good for all.
@jeannemacaluso16211 ай бұрын
😰😰😰😰
@patriciabajcer893011 ай бұрын
Bingo. . .and it’s paper wasteful partner-Humana. Some days I get 3 pieces of mail from them but there is always a minimum of 2/wk, innumerable texts . . .but this is the DIS-Advantage Plan. Next week I’m changing my prayers that we be permitted to put the CEO through a paper shredder.
@perilousrange11 ай бұрын
The truly awful part... these phone calls only happen AFTER it's been denied, then you've called, and been on hold for 45 minutes.
@safaiaryu1211 ай бұрын
This infuriates me. There are times where I've spent an entire work day on the phone trying to fix an insurance issue, sometimes even multiple days in a row. And I'm expected to manage a chronic illness and work a 40 hour week on top of that? It's bullshit. I get even angrier when the hold music is juuuusssst right to give me a horrendous headache in ten minutes.
@perilousrange11 ай бұрын
@@safaiaryu12 How about this one... I work for a medical billing business that works on behalf of the providers. The major insurers block our caller ID at their phone system, to try and avoid talking to us. We actually have fairly involved work-arounds; just so our calls aren't blocked.
@nyarparablepsis87211 ай бұрын
"Trust me, I'm a man speaking confidently." Perfection.
@Imzadi11 ай бұрын
Having to file an appeal for my daughter while she was in the NICU and I was postpartum from a traumatic birth was the lightbulb moment that acknowledging our healthcare system is completely messed up is a non-partisan issue.
@themidnightbanshee592711 ай бұрын
That was the lightbulb moment, no that should have been the last straw
@Julia_and_the_City11 ай бұрын
Or, well. _Should_ be a non-partisan issue.
@stansman546111 ай бұрын
@@Julia_and_the_Cityoh it is. I've asked republicans who think it should be private (which it isn't) or you think it should be public (which it also isn't) both agree the current system is broken to hell
@justsomenobody88911 ай бұрын
Yes, but the partisan part is opining on whether we fix the blatant crony capitalism using a government funded method a la most developed countries or with free market capitalism with an emphasis on encouraging competition. My opinion is that either is welcome since it's far better than what we have currently
@stansman546111 ай бұрын
@@justsomenobody889or put those together like Singapore. Where the gov pays part of the bill from a person's savings, but hospitals need to keep costs low and transparent since bill is still paid from my savings.
@KnightSlasher11 ай бұрын
I get that this is supposed to shed light on the situation but at the same time it makes me angry how messed up the US Healthcare system is
@robert-rv8lo11 ай бұрын
The best part is, if the insurance company decides it is most profitable, they will let the patient die. Then, they won't have to pay the claims, and they are immune from lawsuits from the family for their "medical decisions".
@PBMS12311 ай бұрын
yeah wow. I feel so lucky in Australia with these videos. We like to comeplain but in reality, wow we have it sogoodd.
@couldntthingofone26911 ай бұрын
@@PBMS123 Just don't let them start to defund your system so that you have to start using private insurance.
@Jack_Redview11 ай бұрын
Take that anger and do something about it.
@rogueviking926811 ай бұрын
@@Jack_Redviewputting insurance executives into Saw traps is frowned upon here. For now.
@JeffGeerling11 ай бұрын
You know how they say the best satire is funny because it's true? I was playing a bit of a bingo game with all the different denials I've personally experienced. The worst is having to prove-every single year-that I still have Crohn's disease and I still need treatment, to the EXACT SAME INSURANCE COMPANY going on 5 years now! Last year they wouldn't approve the treatment I was on until June, meanwhile my doctor ran out of free sample medication and I came out of remission and required a major surgery. Thanks, Cigna!
@curtthomas846511 ай бұрын
FREE MARKET EFFICIENCY🎉
@tamarinmangold141411 ай бұрын
ABSOLUTELY DISGUSTING! 😡🤬😡🤬😡🤬😭😭😭😭😭 I'm SO very sorry you had to go through that!
@jedinxf711 ай бұрын
these executives should not be able to sleep soundly. someone should dox the hell out of them, and someone else should use that information however they deem appropriate for incentivizing social parasites to change their behavior or change careers.
@sophiathore353811 ай бұрын
I am just so indescribably sorry
@teh-maxh11 ай бұрын
They know surgery is more expensive than medication, right? They're not even saving money; they get nothing out of it except being terrible.
@relic4611 ай бұрын
I had no clue that doctors in health care workers had to go through this just to make sure patients got the right to medications. I thought it was just the patience doing all the work. Thank you for your information and humor Dr
@ScubaFanatic6011 ай бұрын
We have a person in our office who spends half his time doing prior authorizations. And if we don't word this juuuust right in our charts it will be denied. It's infuriating.
@gamemeister2711 ай бұрын
Hell even my dentist office does stuff like this for me. The providers generally care about their patients and want them to get their treatments approved
@StefanoFierros11 ай бұрын
some offices even pay someone to do PAs, they're that shitty.
@jeanjaz11 ай бұрын
Dr Mike (youtube) talks about the time he spends arguing with insurance companies, also.
@nailsofinterest11 ай бұрын
Well typo but also very correct!! It was/ is the patience making it possible. Both physicians, medical workers, and patients! 😅
@NickTobi11 ай бұрын
As a Type 1 Diabetic that has had to work with my endo to assure my insurance that I still have the same T1D Ive had since I was 8 years many times over the past 20+ years, and had to explain to them that I will die within days without my insulin and their processing times are in fact a matter of life and death.... yeah this hit really close to home
@StefanoFierros11 ай бұрын
if you need a PA for that just tell them you NEED to file an urgent PA, given that the circumstances are life or death; most insurance companies have them but dont tell patients about them, some ask only drs to submit them and they're supposed to be solved in 3 natural days.
@lynnebucher653711 ай бұрын
The ignorance of someone who demands proof you still have a permanent autoimmune condition... is astounding.
@cpMetis11 ай бұрын
I was diagnosed with T1 at 14 months old. From 16 to almost 26, I've had to prove I was diabetic and couldn't just solve it with dietary changes or a pill to insurance on at least five separate occasions, sometimes paying over $100 in copays just for the luxury of getting the ol' "WELL MABY IF YOU LAYED OFF THE TWINKIES" by multiple irate insurance reps. Sidenote: I finally tried a Twinkie when I was about 15. Worst stuff I ever tried to eat. Why did that thing become the standard for "hehe diabetics r fat" jokes? Is it specifically because it's gross?
@safaiaryu1211 ай бұрын
@@cpMetisPure ignorance and stigma. I'm not diabetic, but I am overweight. I was severely UNDERWEIGHT most of my life, and then a bad medication side effect made me gain 50 pounds in three months. I eat better than anyone I know. I'm an excellent cook and I genuinely enjoy eating salads and snacking on vegetables, and yes, Twinkies are disgusting. In fact, I tracked my calorie intake for a couple months in excruciating detail, and I struggled to take in more than 1200 in any given day. And so, SO many people tell me that I just need to eat better, just need to eat less, and clearly I'm LYING to everyone about my diet. 🙄 What it comes down to, I have learned, is that people are scared of chronic illnesses. They're scared that anyone could come down with a devastating condition at any time for no reason at all. They would rather believe that we must have done something wrong and therefore we deserved this fate. So they say these things to reassure themselves that if they just do things right, they'll be safe. Too bad they're completely wrong and being genuinely shitty people while they're at it.
@NootalieWalf11 ай бұрын
@@safaiaryu12dude I think you hit the nail on the head with that one! I never thought about it that way but upon hearing it it makes so much more sense why people seem to have to blame the person who’s struggling.
@BeeWhere11 ай бұрын
Toddler takes the pill form, chokes and goes to ER. United Healthcare denies the visit. It's a pre-existing condition because he choked on a marble before.
@daniellebrackett490511 ай бұрын
What the... how dare your toddler be a toddler! This defies all logic. Related: I'm currently waiting on the bill from resetting "milkmaid's elbow"... here's hoping the preexisting elbows do not cause denial.
@awaredeshmukh320211 ай бұрын
Being a toddler is unsafe and is a pre-existing condition all by itself! Seriously, they should have made better choices!
@reggie102510 ай бұрын
Oh thank god for Obamacare making pre-existing illegal. I spent so much time calling people’s doctor’s to track down those letter’s with lists of dx history and then going though that shit with a fine tooth comb so I could pay people’s claims. But I damn well did it and documented the fuck out of it so the company couldn’t turn around and pull a take-backsies. At this point I’ve replaced the memories of the exact time restraints for what was and wasn’t a pre-existing condition with better things, but if it meant I could spend the company’s money, my timelines were on point.
@SoulKiller7Eternal7 ай бұрын
Actually they cant deny a medical emergency such as...choking to death. If they do, doctor or patient (if smart enough) can appeal, and if appeal is denied, request review by a state/federal board.
@amylynn382111 ай бұрын
You missed one of my favorites. “We can’t approve the medication the patient has been on for three years unless we have evidence that he has failed the preferred drug first. I know you say that he had a near fatal allergic reaction to the first line medication three years ago but we require him to have tried it and failed it in the past 180 days before we can approve the second line therapy”.
@ghillies4life11 ай бұрын
When I was pregnant with my first, United Healthcare denied my Group B strep test (completely standard routine pregnancycare which prevents newborns dying of meningitis), because they wanted it to be the rapid strep. Which isn't even the same strep species.
@akmalsy15911 ай бұрын
Doctors need to record these conversations they have with health insurance companies and put them on blast, on mass media, youtube, senate hearings, etc... let them justify denying life-saving procedures to the outrage mob.
@feedzuh11 ай бұрын
what stops United from lobbying literally anyone involved to be against those doctors?
@gamemeister2711 ай бұрын
@@feedzuhThey don't even have to do that. All they have to do is remove the doctors from their network, and now they can't see a bunch of their existing patients
@bonjourputas11 ай бұрын
Can't risk exposing patient information and some states won't allow recording with both parties consent. And a pleas of other excuses but health insurance deserves to be put on blast.
@nn12365411 ай бұрын
That would be a massive HIPPA violation and they could literally lose their license for that. Maybe if you got the patient's and insurance company's consent in writing and got it approved by separate attorneys representing each party, but otherwise no.
@rcslyman892911 ай бұрын
@@nn123654 heh, right. Cuz HIPAA was ever actually about protecting the patients.
@AL-pu7ux11 ай бұрын
“A PET scan? We barely cover human scans.” 😂😂😂
@andrew32247 ай бұрын
On some insurances, it is hard to even authorize x-rays because they require authorization from PCPs.
@sam747911 ай бұрын
I assume one of the many reasons the service of health care is so expensive is because of the amount of overhead a medical practitioner has to employ just to fight the insurance companies to insure he/she gets paid.
@Axel_Andersen11 ай бұрын
I believe some hospitals have more clerks/accounting staff than medical people ... in US that is. Here in Scandinavia IDK if they have any.
@unarei11 ай бұрын
and all of that time spent fighting the insurance companies ends up getting paid directly by the insurance companies. they're paying for the time of people denying claims and they're paying for the time of hospital staff fighting denied claims
@ArgzeroYT11 ай бұрын
You can't sue the company on behalf of your patient. Your pt may not have the money for it. Your hospital is happy if it gets paid. You're stuck holding a check with no purpose for its payment.
@elizabethm716311 ай бұрын
Yep. That's part of it.
@timdowney67219 ай бұрын
This perhaps says it all about US healthcare. If you are not comatose when you get to the ER,, you’ll be asked about you insurance before the reason you’re seeking care.
@Zoecasady333711 ай бұрын
My fiancé is a radiation oncology tech and yesterday he had to call UHC because they decided that she can do the cheaper treatment that comes with way more side effects than the more expensive one that has less side effects. They also said her treatment isn’t emergency even though it’s treatment for her windpipe and it’s getting worse everyday and she can’t breathe really. Insurance can either be super helpful or your worst enemy.
@robert-rv8lo11 ай бұрын
I've never had a good experience with health insurance in my life. I don't know what you are talking about there.
@rayzerot11 ай бұрын
... the only time I've found insurance to be helpful is... when they do what I pay them to do. I've never had one do any more than that
@justahugenerd127811 ай бұрын
Y’all are getting super helpful moments with insurance?
@safaiaryu1211 ай бұрын
American health insurance. Can't live with it, can't live without it.
@justinsummers878811 ай бұрын
The antisocial healthcare crowd really did a number on this country when they started calling insurance healthcare
@BrightAmbition11 ай бұрын
Hey, it's hard being social. We introverts are just trying to live life the best way we can.
@lolwtnick436210 ай бұрын
@@BrightAmbitionusing drugs and being online 24/7?? yeah, hows that working for ya
@Alex-xk9yd11 ай бұрын
The scariest thing is that there's a very high chance that all of those exact phrases were used at least once
@lizmalsam752811 ай бұрын
I’m sure you mean “once per hour!” 😏
@lilowhitney861411 ай бұрын
They were. He took them from anecdotes from followers.
@DianneGerrity11 ай бұрын
Every one is real- except the pet scan comment.
@waffles362911 ай бұрын
Oh, it's not just a very high chance, he got these stories from people (minus the pet scan). My insurance checks every year to make sure my incurable condition hasn't magically stopped.
@haruhisuzumiya665011 ай бұрын
Including the PET scan?
@margaretbear11 ай бұрын
God almighty this series needs to be seen by everyone in the United States 😩😩😩
@generaljellyroll873711 ай бұрын
Katie Porter should show it on the floor of congress
@SilverStarHeggisist11 ай бұрын
Could be worse, could be Canada "have you considered dying instead of healthcare?"
@tlpineapple111 ай бұрын
@@SilverStarHeggisistTry actually reading the law instead of falling for the propaganda. That is for terminal patients who frankly should have the choice to die. Religious activists and American healthcare activists have spun instead to be either purely monetarily forcused (which there is certainly a benefit in that regard) or as the shining failure of socialized healthcare. You could instead of course have U.S. healthcare where you pay so much you wish you could die.
@maggie615211 ай бұрын
@@SilverStarHeggisist I'm disabled and live in the states. I'm already openly and quietly told that every day of my life from every institution here. And I get treated like a criminal for needing state and federal assistance to live. So, yeah. Find a better talking point than "allowing people with terminal illnesses to choose euthanization to avoid extended suffering is bad."
@nailsofinterest11 ай бұрын
@@maggie6152heck they outlaw euthenization, too! 🤯 Sorry you're suffering from the system too.
@samkadel818511 ай бұрын
As a diabetic, yeah.... id recommend looking into New England Home medical to see some horror stories of medical suppliers. They repeatedly lie to you about sending medical supplies (taking over a MONTH to fix their own failure to ship despite me callinf nearly dailt) and will randomly stop covering supplies without telling you. Truly a nightmare. Also, double charging is... way too common in healthcare.
@fayej659111 ай бұрын
I love that my surgically proven endometriosis patient with antiphospholipid syndrome who has failed an attempt at bleeding suppression with a Mirena was told that she had to try ibuprofen before they would approve a GnRH agonist. 🤦♀️We are waiting for her to start her new job and the new health insurance to see if we will have better luck with them. 🤷♀️
@waffles362911 ай бұрын
My insurance tried to deny I needed a hysterectomy because "there's no evidence". Apparently narrowly avoiding iron/blood transfusions multiple times a year (I believe I was 1% above the levels at one test), and needing narcotics for my cramps so I wouldn't pass out aren't good reasons. They then tried to deny it stating I hadn't tried a med. That I had tried...after two appeals in which they stated it wasn't medically indicated for my condition. I don't know what magic my doc did, but she got it approved. I also wanted a hysterectomy so bonus. Bye bastard, don't miss ya.
@Sikkeskatona11 ай бұрын
With each day I get more depressed by this series . 😥 This is just so inhumane tactics... 🤬 Thank you for shining light on this practise so people can understand this misery...
@i-love-comountains385011 ай бұрын
We still know where the pitchforks are... but now they are ranged🎉😊
@RC311711 ай бұрын
Having ADHD my whole life. That line near the end about ADHD medications hit a bit hard. Nothing like talking to the Dr every 30 days to have a 90 second conversation about how the meds I've used for years are still working just fine and could I please have 30 days of my dose.
@MaryCumbersnatch11 ай бұрын
I go through that with my ADHD seven-year-old, except he's also autistic and has hyperactive catatonia. If he doesn't get his meds, he will slip into auditory and visual hallucinations, and also be rendered mute, requiring inpatient treatment. However, that doesn't mean the doctor will have availability before the scripts expire, nor does it mean CVS will actually have the Klonopin and other meds in stock when the scripts are finally renewed. The medication game sure is a barrel of laughs!
@backseatogre490210 ай бұрын
And then you get the bill for $125 for a 90 second conversation with the Dr. Every 30 days.
@jrmckim10 ай бұрын
I had to do that with my insulin. Thank God for telemed now.
@deamonmist10 ай бұрын
They tried to do that "try different formularies" route but underestimated my determination. Every time an appeal was denied I just sent in a new prior authorization request. It did take a few months but eventually they just gave up and started covering my medication. Butt munchers.
@lolwtnick436210 ай бұрын
@@MaryCumbersnatchdid he get vaccinated?
@TheLastEchelon11 ай бұрын
American healthcare system just breaks my heart
@alliecat834811 ай бұрын
The American health-care system broke my life 😢
@Crazymama8111 ай бұрын
I've been watching this series everyday and I'm always simultaneously interested and terrified to watch it.
@alabaster191311 ай бұрын
At the start of September: "Wow, Dr. G's going to upload daily for an whole month, lucky us!" At the end of September: "Noo, make it stop!"
@cpete297611 ай бұрын
I was waiting to see my ob/gyn and overheard the angry doc say to his assistant about another patient: "how can they deny diagnostic tests for a75 year old woman with vaginal bleeding and severe pelvic pain ???&*@!!"
@lynnebucher653711 ай бұрын
Apparently these are the death panels that Sarah Palin claimed would be part of Obamacare.
@marialegare395411 ай бұрын
I feel like I'm just walking on eggshells in my healthy body, hoping something doesn't go wrong and make me poor forever
@LexYeen11 ай бұрын
That's because you are. Everyone who is not currently considered disabled is one bad day or a long-lived life away from becoming disabled, and there’s no telling which applies to you.
@waffles362911 ай бұрын
@@LexYeen yep. 25% of people will become disabled. It's just a question of if you die before that.
@alliecat834811 ай бұрын
@@LexYeenSo true! In my case I was 100% fine 1 day and within 24 hours I was disabled. No job no savings no home no good health care either because when you're poor the only healthcare you get is completely bottom-of-the-barrel. Great country we live in.
@suemilkbone486811 ай бұрын
Dr. G, thank you so much for this series. It brings light to a very dark situation here in the United States. The more information gets out to the general public, then maybe, just maybe, we can change things for the better. Thank you!
@jeremybartlett239611 ай бұрын
I had an initial consultation with a psychiatrist about a possible ADHD diagnosis, then went back a couple of weeks later to actually get tested. United proceeded to deny the claim, and when the psychiatrist and I asked why, we were told : First, the wrong charge code was used/UHC doesn't have a contract with him to do the testing (he copy and pasted from the last person he did an ADHD diagnosis for with United, and that had been approved); second, that testing and consultation were done on the same day (they weren't, and United's bill said they weren't); third, that the psychiatrist hadn't gotten prior authorization (he had never had to before, and didn't get a notice of a policy change. Plus, it's prior authorization for a computer test?), and fourth, "no", as his appeal was denied and they didn't bother responding to the one I had to fax in. This was after I had to spend three months trying to get them to pay for an appointment to the nurse practitioner that had referred me to the psychiatrist, because UHC didn't have the correct tax ID numbers on file. If UHC doesn't know why the claim is being denied, how on Earth am I supposed to figure out if a claim is going to be paid for ahead of time?! During one of these calls where I was told the problem was prior authorization, the rep had the gall to say "you didn't do anything wrong, your doctor didn't follow the correct procedure", and it took everything in me to not yell at the minimum wage worker that my assumption was the neither of us did something wrong, and that United had either screwed up or made something so complicated that it would be impossible for anyone to get it completely right.
@gingersun53511 ай бұрын
Honestly, I just appreciate that you recognize that them saying your doc did it wrong was a lie. They do that crap all the time, "it's coded wrong," "your dr did it wrong," whatever they can say to get out of paying!
@waffles362911 ай бұрын
Ugh, my insurance blamed me for having my claim denied because I did something...the thing they told me I needed to do for my claim to be approved. I needed a sleep study, they said I had to do a home sleep study before the lab study. They denied my lab study because I did a home one.
@elizabethm716311 ай бұрын
They aren't getting paid minimum wage. Not that that invalidates any of your story and they definitely aren't paid enough.
@Haromour11 ай бұрын
I hate this so much because it's true, I have UHC and i've had these conversations with them trying to get them to cover anything or explain why I owe thousands more than their own website says I would have. I've been lied, misled, and denied by them more times than i've ever had anything covered.
@Kairamek11 ай бұрын
Last year my CPAP was dying and I needed a new one. Had to redo the sleep study to show that my chronic lifelong condition that can't be cured hadn't been cured. When I said this verbatim to the tech who set me up, he gave me a very resigned and definitive "Yep."
@timothypryor795211 ай бұрын
Violence, so much violence. Make united need it's own healthcare.
@daniellegammon96711 ай бұрын
issue is that the people who control public healthcare can afford not to use it and therefore never need to deal with the utter bullshit that they force upon everyone else
@lagomoof11 ай бұрын
I seem to remember that Dr G has already said that that the top brass of the health insurance companies - those who most need the swift and repeated kicking of their _glutei maximi_ - are covered for everything, all of the time.
@goodfortunetoyou11 ай бұрын
Justice is about harmony, revenge is about making yourself feel better. - Batman begins. Also, I'm going to guess that United already self funds their own insurance plan. Why wouldn't they? So I'm not sure how this would help.
@i-love-comountains385011 ай бұрын
@@goodfortunetoyou Yes, stacking insurance company c-suite like sandbags WOULD make us feel better. That's why we want that for them.
@goodfortunetoyou11 ай бұрын
@@i-love-comountains3850 Don't calm down. Just be aware that anger can be a poison that will redirect your attention from solving the problem.
@amylizbrarian11 ай бұрын
“Trust me, I’m a man speaking confidently” absolutely killed me 😂😭
@LaureanoFulco11 ай бұрын
“If the chemotherapy causes nausea then we’ll talk” had me laughing for an hour
@Tker197011 ай бұрын
UHC just denied Thyrogen for me yesterday-needs prior authorization. I'm living and loving these videos.
@EShum11 ай бұрын
"Trust me, I am a man speaking confidently" pretty much sums up health insurance and why we're still in this mess
@laukinath19411 ай бұрын
"Counterpoint... No." Well that's just insurance in a nutshell, isn't it?
@HikaruKatayamma11 ай бұрын
Note on insulin: Walmart sells vials of both short and long for $25 each.
@ChanceNP11 ай бұрын
Some pts need other insulins or will go through 5 vials of insulin monthly. $125 is a a lot of money to those on fixed incomes. This can help a few people, but is not a solution.
@socgrrrl11 ай бұрын
I’ll add a story. My dad has Parkinson’s and as you know, that’s a degenerative disease. One of the things that really helps him and improve his quality of life is speech therapy and loud therapy. My mom has to pester the insurance company for referrals. They only give him a small handful of sessions at a time. Then they have to wait and evaluate and then maybe they’ll authorize more sessions. But it’s never continuous (which it should be!) Just once I want to scream at their insurance company.
@OfficerRay10111 ай бұрын
This is painfully real. Just had a Code 3 Critical Care transport get cancelled by the ordering facility because apparently being vented and on full life support wasn’t good enough of an excuse for their insurance company. God bless the American EMS/Healthcare system.
@mcchoco266111 ай бұрын
Soon "To be alive will require prior authorization"
@goodfortunetoyou11 ай бұрын
A pre-auth on the delivery, nicu, or surgical interventions like a C-section? Or perhaps whatever they do beforehand? They connect this stuff to tables in their claim system, so I get the feeling this wouldn't even be hard if you precisely specify "being alive" to be a unique number in said system.
@maggie615211 ай бұрын
I'm chronically ill and disabled. I'm already there.
@jodil120911 ай бұрын
I have a large cyst growing on my ovary. I needed to have a CT scan for it. So, I scheduled the CT scan at the hospital where I was told by my doctor to go. A week after I had the scan, a guy from our insurance called and suggested that I go have the scan at an orthopedic office because it was cheaper. I said I'm pretty sure they don't do those there. He insisted on keeping talking. I just started laughing. I didn't know what else to say.
@vhs1090711 ай бұрын
I am blown away daily by the truthful, hard-hitting, and yet humorous videos that you produce. We must do something to get them out to the powers that be, so the system and hijinks can be altered.
@quoted_by11 ай бұрын
I always picture claims inspectors as the type of people to dream of using live people as household furniture.
@BrightAmbition11 ай бұрын
Or the type of people that would eat you or your dog like it's nothing.
@lauragonzalez-yr1kv11 ай бұрын
Soy española, tenemos un sistema sanitario que lo cubre prácticamente todo. No es perfecto, hay poco personal y listas de espera. No pagan demasiado bien y los profesionales se van a otros países. Por eso y por qué lo pagamos todas las personas q trabajamos con nuestros impuestos, hay gente que quiere q tengamos lo q hay en estados unidos, por q en la tele se ve q tienen muchas novedades, recursos y hospitales estupendos y aquí no lo parecen, sin darse cuenta que allí te puedes morir si no tienes dinero para pagar cosas que aquí se tratan sin problema. Ojalá todos los países tuvieran mínimo lo q tenemos, y ojalá no acabemos como vosotros Gracias por tus vídeos, soy enfermera y me encantan 😂
@StefanoFierros11 ай бұрын
igual en méxico, está creo un poco más peor que en otros países con medicina socializada, principalmente por que solo ponemos 3% de nuestro PIB en salud cuando la OMS recomienda 6% como mínimo; aún así a mi novia le van a hacer una cirugía de rodilla no urgente esperamos para diciembre sin que le cueste nada y pagándole 60% de su sueldo por los días que ella esté incapacitada; no cambiaría este sistema por la pesadilla gringa.
@AnOriginalYouTuber11 ай бұрын
Well, emergency rooms are supposed to treat you whether you can pay or not. However, they can only do so much.
@StefanoFierros11 ай бұрын
@@AnOriginalKZfaqr you can still die of things that an ER wouldn't treat tho, such as diabetes, cadiovascular disease, etc; plus you'll still get a bill and still get harassed if you cannot pay and do the whole lotta paperwork required to have your debt swiped away
@h3yw00d11 ай бұрын
All of those new things you see on tv? I'm American, I don't get to see those new things on TV either. The doctors offices and hospitals I've been to look a lot worse than that. Whole hospitals heald together by I swear to God the sheer willpower of the nurses and doctors alone. You don't get that TV treatment until you are a multimillionaire.
@LibraryAce11 ай бұрын
TV doesn't show you the many hospitals that have closed, the doctor's offices that can't afford enough staff to handle the endless insurance paperwork, the people who can't get a Covid test much less medication because it's just not available, regardless of cost. And we still have long wait times for anything not immediately life threatening. It is almost always months to see any specialist. Please show people these videos to help them understand the reality of the situation.
@Ro-ro-ro11 ай бұрын
Doc, I'm a huge fan and hv been following this series from the onset. But this one is the one that broke me. As a medical student who really just wants to make things better for people who are suffering, this was heartbreaking on so many levels Insulin, Pacemaker Batteries, Birth Control, Multiple Open Fractures?!?! Is there even a light at the end of this tunnel?
@longforgotten482311 ай бұрын
My depression and anger are through the roof. Our healthcare system is awful and needs to stop. Your life is forfeit, while the executives make record profit.
@sarahmason815411 ай бұрын
I hate hate hate United. I have no idea how they have gotten away with this for so long. They sent me a job link and asked me to apply. I told them you make my life a living hell everyday, why would I do that? Although it was tempting to go work there and approve as many rehabs as I could before I got fired.
@pc943411 ай бұрын
0:29 I had this exact thing happen to me. Working in an electrical shop, any kind of chest pain was an automatic 911 call. It should have been worker's comp, but I was on file with the hospital so they billed my insurance, who denied the claim because I hadn't actually had a heart attack.
@jimbelter211 ай бұрын
Oh the appeal process. They hate me when I appeal their decision. I go toe to toe with them and usually win because they try using nonsense to deny extending the treatment, just like he showed here.
@eacalvert11 ай бұрын
Blue Cross Blue Shield did the it wasn't a heart attack so it wasn't an emergency to my ex husband (this before I met him so more than 20 yrs ago). He had inflammatory costal condritius (inflammation of the rib muscles) and thought he was having a heart attack so called an ambulance. They tried to deny covering any of b/c it "wasn't a real emergency." He appealed under the thought of I'm not a medical doctor how was I supposed to know it wasn't a heart attack and actually won...but this was 20+ yrs ago
@floridamaninthewild11 ай бұрын
Everything my Dr requested for the last 6 months has been initially denied by insurance requiring him to resubmit it with additional information, causing delays and twice the amount of paperwork. The industry is killing itself and convincing more people we need universal healthcare.
@smh-smh-smh11 ай бұрын
This got published on YT as I was literally fighting that UHC denied prior auths twice for PrEP despite being on it for years and it being mandated under the ACA
@regularbloke439511 ай бұрын
I had a patient coming in last week with headaches with a bunch of red flags. UHC approved an MR the same day and her scan showed a 6 cm bleeding intracranial tumor that turned out to be a glioblastoma. In conclusion, your documentation is going to help your patient get the test they need.
@Jman116Films11 ай бұрын
Oddly enough, I’ve pretty much bounced from ADHD medication to ADHD medication without ever hearing anything from insurance. My mother’s stage 4 colon cancer? Oh man when my dad’s work switched healthcare providers (cigna/aetna?) they wanted to put her from what was working back onto something that not only didn’t work but also she was extremely allergic to because she needed to “fail” those treatments first. Well my dad’s bosses bosses boss, my dad, and the healthcare rep had a nice meeting and suddenly she didn’t need to switch treatments.
@ReallyBadJuJu11 ай бұрын
I'm not calling for anyone to be harmed, but there are people in our society deserving of harm.
@LexYeen11 ай бұрын
I don't need to touch grass. I need the people ruining the world to face genuine consequences for their actions and decisions.
@cindyhesson921311 ай бұрын
Yes, every insurance company employee should watch this. But they still wouldn't care. This country is full of greedy and corrupt people. But you're awesome ❤😂😅 Thanks!!
@Roo-Smith11 ай бұрын
Im just happy Ukraine is getting trillions of our $$$ to praise nazis
@juliedrouillard205311 ай бұрын
As an RN , reading this comment makes me cringe. With so much of our "Healthcare Industry " being controlled or mandated by insurance, most Healthcare workers end up working either indirectly or directly for one insurance company or another. We are not "greedy". We are simply trying to make a living like everyone else and are in the same health insurance boat as everyone else. Paying the same amount as everyone else while still trying to advocate for our patients.
@cindyhesson921311 ай бұрын
@@juliedrouillard2053 you work there where I would not. I'm sorry. Prayers for you 🙏
@forever887911 ай бұрын
@@juliedrouillard2053so many times a year you deny life saving meds? Just asking for fun lol
@Mx.RumpusParable11 ай бұрын
Not every employee... there are a lot of Jimothy's out there. Soul dying a little each day....
@Starvingmetheartist11 ай бұрын
The bit about not taking the placebo birth control pills killed me omg 😂😂😂 (i had a doctor straight up tell me it didn't matter that my endometriosis was only msnageable when they removed the period, I was to take them as prescribed and I should just walk off the pain and symptoms)
@msshellm815410 ай бұрын
🤬 As if you could _walk_ ! 🤐
@maxfieldstanton454111 ай бұрын
"aaaaand it's January!" Folks who don't work in healthcare don't really get this to the full... from January until...about May or June is what we call "Peak Season". That's when insurance changes. All of it, but mostly Medicare and Medicaid. Not just formularies (fuck you UHC and your non form of a drug that was form a fucking week prior) but also dispensing pharmacies and co-pays. That line about the "he has to fail two ADHD meds before we'll approve the one he's been stable on for a year" happens every fucking January. And not just with ADHD meds, with serious life-sustaining meds. The "we only cover pill form" happens on meds that don't even come in tablet form, and they won't approve capsules and require prior auth for any other form. WHY ARE WE NOT RIOTING!?
@ruairiodonohoe253311 ай бұрын
Day 6 of Asking when does US Healthcare become Eugenics against the poor
@sandytaylor815811 ай бұрын
Already there.
@waffles362911 ай бұрын
When? It is now.
@redteam663111 ай бұрын
Since I'm a physician I understand. But this makes me very furious and angry. It's like all the guidelines and research we put into diagnoses and treatment were simply thrown in the trash.
@Houster100011 ай бұрын
Medicine is just the cargo. Money is the boat. You can throw some cargo to save the boat.
@justahugenerd127811 ай бұрын
Be angry. That’s what any person with a normally functioning conscience and set of rational faculties would be when looking at this stuff. We can make this change, but only if we all get fucking angry and remind these people that we’re the majority here and we want change
@ishaansingh697311 ай бұрын
Having experienced this firsthand with patients it's incredibly funny but immensely sad at the same time.
@starrychan3311 ай бұрын
As a therapist, watching my ADHD patients go through all the shit they have to go through with my meds is endlessly frustrating
@jacobstory889511 ай бұрын
The 10mg tablets one got me! My behavioral therapist had to fight OptiumRX over that *exact* thing.
@fayej659111 ай бұрын
1:24 Thank you Dr. G for throwing this one in there for all the menstrual migraine, endometriosis, PCOS, etc. patients out there! It’s even worse when trying to prescribe birth control patch this way. The boxes only come with three patches. 😤
@waffles362911 ай бұрын
My insurance covered 12 boxes a year. A box was 4 weeks. Thankfully I have since evicted my uterus so it's not an issue anymore.
@garrybrown316511 ай бұрын
Thank you, thank you, THANK YOU! Personal AND professional with United Health Care captured precisely in this episode.
@tc224111 ай бұрын
I’ve tried to explain this to extended family members who blame their physicians for failing to approve treatments. I call it the congress effect. You blame the guy in front because it’s a lot harder to delve into the inner workings that allowed your system to rot in the first place
@AntarticTheFox11 ай бұрын
Former UHC Tier 2 Insurance Adjustor here: I got to see almost all of these. This brings me great pain and that job drove me to day drinking my way to an early grave! Thanks for shedding light on the Bullshittery they pull. It's fucking soulless.
@liviaclementoni519211 ай бұрын
My heart is breaking for all US citizens... How can a society function like this? How is it possible that so many people refuse to acknowledge where the common good is? I say this because I have read online of many Americans talking about how they think socialized Healthcare is bad and a waste of your money... I just don't get it...
@redblue514011 ай бұрын
what do you mean you dont get it? american media is owned by rich people and they are using it to further their own interests. you should be able extrapolate the rest
@BlackKnight289511 ай бұрын
I always wonder wouldn't they make more profit if they approve medication and preventative measures for the insured than deny the treatment? I mean they need to pay eventually and if they wait it gets just more expensive for them. My socialized healthcare likes to pay for stuff that keeps me healthy because then they don't need to pay that much.
@ejk630411 ай бұрын
@@BlackKnight2895 It would be a grave mistake to credit them with any interest in long term thought or planning, everything is calculated on a quarter to quarter basis, and predicated on the idea of chasing endless rising profit, which creates incentives to do all of the things highlighted in this series, even though it all runs completely contrary to good medicine and the well-being of society.
@waffles362911 ай бұрын
Brainwashing. Propaganda has told them everyone else has it worse. Of course their version of worse is very often better than the reality. I've had many people tell me "Socialized medicine would be so much worse cause then you'd have to wait *weeks* to see a specialist". Like cool, sign me up, where can I get that? I had to wait 3 *months* for an emergency priority appointment for a non-stop migraine. It's also a very individualistic mindset because they don't want to pay for other people's healthcare because tHeY might be getting something you don't agree with or "don't want to pay for someone's bad decisions*". Of course they don't realize that insurance does just that, but at a higher cost. *bad decisions can include- getting hit by a car, encountering an unknown allergen and ectopic pregnancies
@llofdarkwater915211 ай бұрын
I can't even afford insurance. I have fairly regular chest pains, I just have to muddle through. Emergency treatment can't help because they have to refer to a cardiologist for care. One day, I won't muddle through. So. Probably won't be around much longer. I'm getting my affairs in order now. Such is life (or soon not) in the good ol' U.S. of A.
@ScubaFanatic6011 ай бұрын
The preventative healthcare laugh was so scary. Don't they realize how much money they would save oyn the long run of e patients were healthier?
@Sceusell11 ай бұрын
Long run? No, you misunderstand. If it isn't immediate profit growth to impress the investors next quarter, then it's not worth doing for them
@marcoa.258511 ай бұрын
Well, they save costs now and have enough measures to not pay for the consequences later. It is a bit strange for us Germans, but i understand now that this seems to be the driving concept in US Healthcare.
@grmpEqweer11 ай бұрын
The longer they can use premiums to collect interest, the better they do.
@bosstowndynamics548811 ай бұрын
It is true that you save money by paying for preventative healthcare instead of waiting and paying to fix it. But you make even more money if you jack up everyone's premiums and just refuse to cover anything at all.
@curtthomas846511 ай бұрын
That's the problem with companies these days. The future doesn't really exist past the end of the quarter. It doesn't matter if it blows up in their face later (they can always just get a bailout lol), what matters is that it looks good right now.
@doomsdayaddams289411 ай бұрын
I love these so much. I imagine people from countries with civilized medical systems think these are ridiculous exaggerations, but they are not. Not at all.
@elaexplorer11 ай бұрын
I got one for you. NP sent in a request for a sleep study for sleep apnea. It was denied because all of the conditions suggested I DO have sleep apnea so no need for the sleep study. The NP was confused and didn't know where to go from there. So nothing was done and I had a heart attack a few years later. So now they're paying for my $600 in prescriptions every 3 months.
@marileem343411 ай бұрын
Pt denied glaucoma medication they’ve been on for 6 yrs and for which same insurance company approved last yr. Sent appeal with reason why needs meds (allergic to most others) and copy of their letter of approval which expired 3 months ago. Appeal denied! Give me strength. Signed PA coordinator for 10 yrs who is ready to give up
@Rabies-gx5hy11 ай бұрын
I’m a Peds practice manager and the stupid “step therapy” for ADHD and changing formularies for stable pts makes me SO mad I wanna break stuff 🤬 I tell parents EXACTLY what the issue is and to call and file a complaint with their insurance. Won’t work, but at least their voices get heard! I’m surprised all of us in healthcare don’t have wine habits yet 😅
@Just1Nora11 ай бұрын
I'm not sure whether to laugh or cry...I've been through so many of these as a chronically fabulous (ill) person. I get occipital nerve blocks, supposed to be every 3 months, and the last one was in December...as of April if diagnoses of "headache" or "migraine" are ANYWHERE in your records, denied! So my drs office dragged their feet on submitting the application, and in that time, my insurance company changed the formulary to keep me from getting these necessary treatments. It's like, "F you in particular!" 😮💨
@maryel539811 ай бұрын
Getting a PET scan for a 4 year old with suspected Ewing’s Sarcoma is ridiculously hard to get covered. At least they don’t think he’s a pet though.
@_Dwarkin11 ай бұрын
That was infuriating even for me, and I'm not even American. But at least I feel happy afterwards for having free universal healthcare here. Idk how do you still survive with such a mess
@erikkennedy872511 ай бұрын
Luck, mostly.
@curious105311 ай бұрын
Providers and physicians work for free where you live?
@_Dwarkin11 ай бұрын
@@curious1053 are you idiot? Just google how universal healthcare works in the normal countries
@aqlakejee691811 ай бұрын
Oof! Gut punched by how realistic some of these are from personal experience.
@shadebinder359911 ай бұрын
"we only cover 10mg tablets...ans if your patient even thinks about splitting them" My doctor litterally prescribed finasteride with 5mg and told me to split them 4 ways 😂
@LadyAnuB11 ай бұрын
This video was a timely release as my roommate's orthopedic doc was talking about insurance denials and this was the KZfaq video that was first when I opened up KZfaq to show her your series on US Healthcare. (Too much crap that my roommate has to go through to get a knee replacement due to a work injury 3 years ago.) Also, UHC has an ad out now (that I muted and didn't pay attention to) which I suspect is trying to head off this video series' roasting of them.
@Rg-hc6or11 ай бұрын
I work in health care. You are spot on with UHC but Aetna is a very close second.
@randolphmahoney11 ай бұрын
"Multiple open fractures" HEY, UHC Bro!!!!!
@Forriedude11 ай бұрын
As a type 1 diabetic, this is painfully accurate.
@eirianerisdare8011 ай бұрын
Laughed, then was hit with an overwhelming sense of grief. The unadulterated rage behind his eyes reflects the rage of all medical professionals who deal with this bull on a daily basis while their patients get denied lifesaving treatments and investigations.
@yourpalfred11 ай бұрын
Mom spent the last year of my dad's life arguing with insurance. They'd been together since high school. 💔
@Blazeddonuts424111 ай бұрын
As a family physician these videos give me a pit in my stomach with how accurate they are. Somehow I can’t help but watch them though. Thankfully where I practice we don’t have a ton of United Healthcare. Unfortunately we have Blue Cross instead.
@Dan-N2211 ай бұрын
"Okay but the chest pain didn't end up being an emergency" HOLY MOLY.
@ironyusedincorrectly11 ай бұрын
I think that last one is also how some news outlets decide if something is experimental.
@alissagoodwin11 ай бұрын
Thank you so much for making this series. It's so helpful in explaining to my family, friends and sometimes patients about why our job is so hard. Family Med here and I feel exactly how skewed glasses guy looks most days.
@KK-ef1ow11 ай бұрын
At least my Zofran didnt need prior authorization. Both my migraine meds did though because I didnt fail more than one drug. Failed triptans because they make my brain feel like it on fire.
@goobus_floobus11 ай бұрын
Its scary to me how much material he has for this
@lisasharf144211 ай бұрын
I think it’s scary to all of us…
@kaboom467911 ай бұрын
The only way this gets funnier would be to have Deadpool as a guest commentator , in a MST3K style " review " of insurance company commercials . If you haven't been hot with a blizzard of C and D letters yet , they probably aren't coming no matter what . But , if they do start coming , you can add a " fan mail " segment so we all know who everyone is working for , their names , addresses , etc .. You know , in case folks want their autograph . Or , appendages... I don't judge .
@capt3z4w3e4i11 ай бұрын
Cardiologist-attorney here. Been there, done that. Perhaps we should push to have the insurers’ absolute ERISA immunity statutorily converted to, at most, qualified immunity dependent upon the insurer’s review being: 1) conducted in good faith; 2) based on substantial medical evidence; and 3) with physicians being reimbursed for the cost of providing said patient data beyond that accessible in the electronic medical records. To tamp down unjustified lawsuits against the insurers, we could 1) establish specialized “medical necessity approval” courts; and 2) adopt the British rule on attorney’s fees and costs-loser pays.
@goodfortunetoyou11 ай бұрын
I'm neither a doctor nor a lawyer, but to throw a thought into the mix; If an insurer would prefer an alternative to the doctor's original treatment plan, the insurer must submit a request for treatment plan amendment document to the doctor. If this amendment request is denied, and the submitted claim is otherwise valid, then it must be paid as originally submitted. Any such claim shall be subject to review by "medical necessity approval" courts. This clause may not be waived by contract. Review by such court shall take precedence over, and may be invoked in addition to any arbitration proceedings.
@michaellorton80999 ай бұрын
Mr. Ziegler, excellent! I truly appreciate when someone makes a thoughtful suggestion in an attempt to improve potential solutions to a problem. I particularly like the general thrust of your idea that the Insurer be compelled to play an active role and make a substantive counter-proposal for quality care that the Insurer would promptly pay for. As it currently stands, Insurers know their ERISA tort liability immunity is absolute, and they often make these critical medical decisions with little or no consideration of the medical science applied to the patient’s particular facts-the Insurers’ disingenuous protestations notwithstanding. To clarify my earlier comment, “medical necessity approval” courts would only become involved when Insurers negligent denials resulted in serious harm to the patients. Those courts would mete out damages from and punishment to the Insurers if the Insurers’ denials proximately caused the patients’ injuries. These “courts” would have to contain adjudicators trained in medicine and law and would be far too slow to make the plethora of extremely time-sensitive diagnostic and treatment decisions required each day.
@Crymeariver22711 ай бұрын
This whole damn month has been scary!
@LakPak200011 ай бұрын
Love this series!
@mikerouch41611 ай бұрын
Keep up the message! Nobody knows until they've experienced it...
@rebeccakerr159311 ай бұрын
This happened to me when I had breast cancer and authorization of MRI..😢