How Corporations Raided Medicare
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- Опубликовано: 4 окт 2023
- Corporations have turned Medicare Advantage into a money-making scheme, denying patients care to generate profits. For Megan Bent, it may have cost her father his life.
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"They work to deny your care for profit" describes all private health insurance companies. It is insanity that they are allowed to exist.
It's evil embodied.
This system of health insurance through employment and private firms was literally created so that it would intentionally only work for white people and exclude black people. Literally it was the solution that was chosen because it avoided any sort of open health care or socialized health care that would have evenly benefitted black people.
This is criminal and these monsters belong in prison.
Many of the insurance agents that are denying care are not doctors. So insurance companies are practicing medicine without a medical license
They not alone. Doctor, hospital and pharmacy company over price treatment to profit also.
This everyone fault . Best thing right now is to find foreight treatment
Insurance companies are the only companies I can think of whose primary financial incentive is to deny the product its customers pay for.
@@HouseboundPerspectives Those regulations are also the only reason people with pre-existing conditions can have coverage today. When one party's telling you the government can't run anything, but wants to be elected anyway, maybe don't give them the chance to prove themselves right while making their buddies rich...
Some people call that fraud.
@@carycunningham9510 Of course it is fraud! Insurance companies need to be penalized for not insuring people when it goes against the definition of insurance! Against the definition of healthcare. We need to enforce new incentives to punish any business for this fraud of denying consumers what they paid for. When they do not do their job to help us and are never help accountable for it, they are as bad as Napoleon from Animal Farm.
@@Joesolo13 Do not worry. I will not give them the chance to prove themselves right and turn into the next Animal Farm Napoleon. When they tell us the government can't run anything, it is safe to assume that they only want to be elected just so they can run everything their way and bend the government to their self-serving will.
👍👍👍👍👍
This is murder. We need to put these monsters behind bars for life.
Unfortunately doctors/nurses/therapists/pharmacists are sued , not the insurance company .
Sad state of affairs for sure.
That would be Bush and the wealthy Republicans
@saliksayyar9793 Yup, pretty much. They lost the plot before I was old enough to realize what was happening, and by the time I was old enough to vote there wasn't anything I could have done.
Along with federal politicians
As a former ER nurse and then a home health nurse, I've seen this same basic scenario play out so many times. It just makes me sick! If this doesn't prove we need a different health care system, I don't know what does!😡
It won't happen until we get the money out of politics.
@@watamatafoyuso never
It can be proven all you want. These companies don't care until their hand is forced.
@clintonlunn7582 I'd argue its also not their job to care. It's thr job of profit makers to make profit. We've been thrown to the wolves they just wear wool.
It’s called universal healthcare! The only people that benefit in Americans healthcare are the rich! The 1%ers!
As a physical therapist with over 30 years of experience I can tell you this video is spot-on. I have had patients who would have had months of rehab only approved a few weeks of treatment. This is nothing but GREED pure and simple. Corporate criminals are taking over our country.
"Have" taken over
Government has made it possible. Greed has been around forever. Lying to people that there is a free lunch has made this possible.
There is no free lunch. There are things we can do to make medical care more affordable.
@@edarcuri182 nobody's saying it's free it's paid through tax dollars
@@danielstadden1149 Then say so. "Your taxes will pay government bureaucrats to make medical decisions rather than your Doctor and you will have no choice."
Single payer makes it sound simple and efficient. It is neither.
@@edarcuri182 It's better than a CEO making those decisions and living high denying claims. Countries with single payer spend less on medical care but have better outcomes. United States has the most expensive health Care and nowhere near the best outcomes. I have original Medicare, it's not perfect but I have never had a problem getting anything covered.
Medicare Advantage is turning into the best argument for government-run healthcare.
Actually Republicans are pointing to this, lying to the people and saying Medicare and government ran healthcare doesn't work.
People just see the name and not what's actually going on, republicans privatizing medicare and cutting funding to actual Medicare.
Republicans are very good at manipulating people, we need to push man and educate people what's actually going on.
Boomers gave themselves medicare.... and now they are doing everything they can to stop anyone younger from having healthcare also lol. Medicare advantage is just what everyone else deals with under the private health insurance system..... and it will never change in this country because of corruption and a populace too stupid to realize blue or red won't fix it.
If you think Medicare advantage is bad you should see what the VA does. It is 100% run by the government and it absolute garbage.
Give me a bureaucrat over a CEO any day
This is how government runs healthcare. Medicare Advantage is where the government avoids their responsibility and pushes the administration of medical care to cut rate middleman.
No other wealthy democracy has this problem. All healthy democracies have universal healthcare.
We're an unhealthy oligarchy. No one should consider the US a democracy.
We don't have a democracy anymore. It's closer to a oligarchy/plutocracy. That's why we're starting to see terrible business practices like this. Corporations will place greed over the health of the country.
If the biggest cohort group who is now in need, can't change the system to something better, we are all screwed. They changed the system to deny you care after taking your tax money for decades.
Whatboutism from GOP apologist in 3...2...
@Neil-iu2sq when it is, talking heads either 1. cry SOCIALISM!!! and then hope the red baiting was enough to get people to stop thinking about it, 2. Call any candidate who brings it up "unrealistic" for wanting things to be better than they are now, or 3. Bribe them to stop talking about it.
This is what class warfare looks like. We live in a corrupt oligarchy. We need ranked-choice voting, ballot access, and more parties.
More parties would probably mean they get to participate in capitalism but we could probably use a real socialist party
@@BleedForTheWorldmost likely you are quite soon going to need communists, at this pace of tefth and exploitation.
I am somehow glad this is becoming so raw so missinformed working people of America would understand why workers and communist revolution ever happened in other parts of the world, and why is socialism the only real treath to ultra rich and their fat guarding dogs.
None of those are possible without severe social upheavel and personal sacrifices. Americans always take the easiest immediate path, so it will never happen.
@@DistrustHumanz I live in a state with down ballot voting in a county where they are recalling 3 county commissioners all R on the ballot that did what they said they would but the down ballot voters did not read listen or care what they had to say in 2022 just that they had the R sadly this is the rigged system we live in.
@@DistrustHumanz It's starting to happen now but I don't see it happening before I die. I have hope for my kids.
This is what happens when you elect people hell-bent on dismantling Medicare.
This is what happens when you elect people who only care about money and power, Medicare is not being threatened with being dismantled, that is political marketing.
And then all the ones who voted for them will be screaming when premiums rise and benefits get reduced. Medicare and SS will be fixed by lifting the cap on taxes. But no - the wealthy bought their representatives and senators so they'd eliminate the programs altogether, and they got dumb voters to cheer along. But they're Mepublicans. Nothing matters until it impacts ME! @@rrmackay
It really pisses me that RUclips has hundreds of ads continuously pushing /hawking this crappy worthless insurance. It's total BS...needs to be addressed. It's false advertising.
One reason why it’s not questioned enough. Media companies make millions off advertising placements.
@@inthesun3884because capitalism.
Their constant ads can drive you nuts...droning on & on & on! Ironically the ad that usually follows the Medicare Advantage ads is the burial insurance ad...🤣...Now that could be a tip off!
I am 71 and get big post cards in the mail EVERY DAY pushing this thievery.
Our life is filled with ads. Broadcast TV shows you an ad every 10 minutes. RUclips shows you an ad every one to two minutes. No wonder people are going crazy and becoming mass shooters. Commercials are stripping people of their hard earned money and impoverishing them while fabulously enriching the leisure class. Yet the internet only got off the ground with government subsidies.
The healthcare system in the US is so incredibly predatory and shameful. We need universal healthcare.
Like the UK? If diagnosed with cancer in the US your chances of surviving a year or more are 7 times greater than in the UK.
Why? Cancer treatment is expensive so the UK doesn't pay for it.
It isn't better and you can call it "universal health care" until Hell freezes over and you'll change nothing. Study what is in place around the world, including the shameful mess of socialized medicine in the US - yes, we have it - and, then, start pontificating with some actual knwledge.
Exactly 💯 💯 💯
I'm born and bred in the tiny country of New Zealand, but have also lived many years in our friendly neighbour Australia.
Both countries have a form of Universal Health Care. Visits to normal doctors is subsidised (or free for some folks. My local charges $19), and prescriptions medications cost $5 per month per item, up to a yearly maximum, then free.
Treatment in normal hospitals, whether you, have a heart attack or stroke, break your arm falling out of a tree, or need treatment for cancer, will be entirely free. That includes Xrays, medicines in hospital, blood tests, and in hospital Physiotherapy.
A minority of people choose to pay for Private Health Insurance (subsidised by few employers), and that may give partial payouts on cosmetic surgeries like Boob Jobs etc as well as payments towards hearing aids and spectacles.
With limited budgets, there are waiting times for not immediately needed Public Hospital Treatments. (So sometimes a delay for cancer treatments to begin).
There are differences between the Welfare Payment systems of both countries, but they both have, generous by some countries' measures, welfare payment and unemployment payment schemes.
An Old Age Pension is payable universally upon reaching age 65 in NZ, or age 67 in Australia. (Australia's is "means tested" so folks with hundreds of thousands of dollars worth of assets, excluding their main home, get a smaller Old Age pension payment).
The pension is over and above any individual personal "Retirement Plan Savings" that folks may have (what in the USA might be called a "401k" or an "IRA"). . But such plans are in their infancy in NZ, having only commenced in 2007. Australia has had a Retirement Savings Plan scheme since the 1980's.
The Age Pension in NZ is currently about $500 per week, for a single person (a little under double that for a couple both of pensionable age).
The systems in Australia and New Zealand may not be perfect, but generally serve the population well. Universal Health Care is a large part of that equation.
Yes, some taxes need to go towards paying for that healthcare. Our Petrol/Gasoline and Diesel fuel costs more than in the US, with most of that difference in price being Taxes
Other countries make universal healthcare work.
It truly is that simple🤔
Socialize medicine 100%, outlaw health insurance and institute a 10% annual wealth tax on billionaires.
70 %
@@marpro765Wealth tax. Even at 10% they'd potentially go broke in a decade. Income, capital gains and inheritance could be much higher.
Comedy. Gov and your health. Rem. Plan-demic. Mandates.
I know a lot of dead people due to gov choices for your health.
@@beryllium1932not really. There would be some left. And dont forget their millions of dollars in so called business expenses. They dont need no stinking income because the tax rates are higher.
I say it should be a flat 10% tax all all. Period. That will allow the government to fund these programs.
It’s the corporations. They have to much power.
You americans have guns to revolt against your oppressors don't you? You have school shootings all the time doncha? You have the addresses of these corporations, doncha? Why dont you go to these corporations and write them a very angry letter. Or better still, pickett with signs. No even better, call your elected representative? Or hahahaha vote another political party!
No, it's called capitalism. It shouldn't exist.
It's corrupt private entities running the corporations that have the power. The majority of the world's workforce is employed by corporate entities of some sorts. Stop buying iPhones and going to Starbucks if you want the corporations to have less power. you dingle berry. In fact don't work at just I don't know figure out a different way to get food and resources. Are you can go down to your local food pantry and then you can pick up trash on Sundays like a like that Good Samaritan that I know you are. Take back the power, You Dingus!!!
They use us like TP.
They are the modern system for new aristocrats.
As a therapist working in a large hospital in a major city, I can say this happens en mass every day across the US. It's terrible how many procedures and treatments these companies deny the patients we see. They deliberately make it frustrating and difficult so you don't want to fight the appeals process, and they still reject treatments needed even when doctors do a peer to peer review with the Advantage company. Medicare Advantage needs to be outlawed and traditional Medicare expanded to include the things that cause people to choose Advantage to start with (dental, vision, hearing etc).
100% agree.
I used a broker after talking to a few and the one thing they had in common was EVERY single one told me go for original Medicare, NOT an Advantage plan.
A very wise decision. And I'm glad your broker told you the truth unlike what some others would do. Medicare Advantage is an unmitigated disaster and only works to deny the care you deserve after paying Medicare taxes your entire career.@@GrumpyOldFart2
Superbly well said!!! As a former court reporter and medical transcriptionist, I was privy to a lot of litigation related to treatment, procedural, and denial issues. I don't know why in the hell we have to have some additional "Advantage plan," besides Medicare, for dental, vision, hearing, etc. We're one complete human being. The body parts of teeth, eyes, and ears are not separate from us and floating around on their own. What a slick predatory racket!! I, too, feel that this Medicare Advantage plan for profit crap needs to be outlawed and our TOTAL HUMAN BODY should be included under just "Medicare" - PERIOD!!
I'm born and bred in the tiny country of New Zealand, but have also lived many years in our friendly neighbour Australia.
Both countries have a form of Universal Health Care. Visits to normal doctors is subsidised (or free for some folks. My local charges $19), and prescriptions medications cost $5 per month per item, up to a yearly maximum, then free.
Treatment in normal hospitals, whether you, have a heart attack or stroke, break your arm falling out of a tree, or need treatment for cancer, will be entirely free. That includes Xrays, medicines in hospital, blood tests, and in hospital Physiotherapy.
A minority of people choose to pay for Private Health Insurance (subsidised by few employers), and that may give partial payouts on cosmetic surgeries like Boob Jobs etc as well as payments towards hearing aids and spectacles.
With limited budgets, there are waiting times for not immediately needed Public Hospital Treatments. (So sometimes a delay for cancer treatments to begin).
There are differences between the Welfare Payment systems of both countries, but they both have, generous by some countries' measures, welfare payment and unemployment payment schemes.
An Old Age Pension is payable universally upon reaching age 65 in NZ, or age 67 in Australia. (Australia's is "means tested" so folks with hundreds of thousands of dollars worth of assets, excluding their main home, get a smaller Old Age pension payment).
The pension is over and above any individual personal "Retirement Plan Savings" that folks may have (what in the USA might be called a "401k" or an "IRA"). . But such plans are in their infancy in NZ, having only commenced in 2007. Australia has had a Retirement Savings Plan scheme since the 1980's.
The Age Pension in NZ is currently about $500 per week, for a single person (a little under double that for a couple both of pensionable age).
The systems in Australia and New Zealand may not be perfect, but generally serve the population well. Universal Health Care is a large part of that equation.
Yes, some taxes need to go towards paying for that healthcare. Our Petrol/Gasoline and Diesel fuel costs more than in the US, with most of that difference in price being Taxes
I'm a primary care physician in the rural south, and stories like this are all too common. There are no good insurance companies, there are only people lucky enough to not need their insurance to cover certain things.
1-They just want the patients to die quickly so that they do not have to give out money that they sucked from same taxpayers.
2-Same is happenig with housing rental- They want people to pay 100% or more what they earn to corporate landlords, or you are left to die on streets.
Same with Education- You are tied into a debt, which would take an entire lifetime to repay.
Same with Credit- if you are poor, It will take you a lifetime to recover from a small credit card chargeoff for the money bank created out of thin air. Means, the cost is all opportunities.
Same with legal record- If you have a slightest record (eviction, possesion etc) , which most people are most likely to have, since they cannot afford lawyers, they can never recover from it. Means, they would be blocked off far behind in the system, from where its impossible to come back.
Same with food- Healthy food is made scarce and poisonous food is at every corner.
I am just wondering. What is the tax money used for? Looks like it is just being hoarded by these off shore corporations. And the crazy part is, they have so much already that they do not know what to do with it. yet, they still keep collecting.
This is blatant human rights violations. Humans are denied basic dignity.
Humans are commodities just like pork bellies.
Social credit 😅😅😅😅😅
The US government spends most of our money on weapons & military. The figure from 3 years ago was 59 cents per tax dollar goes toward defense. It's absolutely insane. They take our money & use it to kill people. It's utterly shameful! 😡😢💔
This happens thousands of times per DAY.
As a nurse in Connecticut, I can tell you that insurance companies practice medicine every day to increase profits. They decide what is prescribed and at what doses, what treatments are, or aren't done ALL with NEVER meeting or seeing the patients. 😢
I have many patients with regular Medicare that this happens to all the time. Don't be fooled, the only patients I have had in the last 20 years who haven't been denied care are ones who are poor enough for Medicaid part A. Husky B and C are better than any Medicare plan available, but you still have people overriding prescribers every day.
Private insurance through employers is the worst! It doesn't matter what employer anymore. The days are long gone when people who had insurance through their jobs got the best care. They, in fact, have the highest out of pocket cost and denial rates by far.
But right behind them are the Medicare Advantage plans and then Standard Medicare.
For-profit companies are exactly that, they are profit before people, whether it's the insurance companies or hospitals and healthcare facilities and companies. Healthcare non-profits are no better. Don't be fooled by these massive conglomerates raking in money and paying CEOs millions per year. They are businesses, big businesses, they just don't pay taxes and rake in more government tax money.
If you want to be a patient and not a customer or client, the United States is not where you want to be to receive healthcare or treatment.
It's horrible and sad, but the only people to blame are the people in this country who insist that healthcare is not a human right and should not be Government funded in a Capitalist Free County.
😢 It is currently, in fact, a commodity in the US. Something to be sold and profited from.
So why do you think the AMA opposes a universal public health care system?
@@lizzy-wx4rx💵💵💵💸
Federal employees and congress people get the solid platinum medical care
That's what capitalism does it commoditizes everything including human beings.
I worked in a Medicare funded program in CA, a drug addiction rehab for low income and court mandate. For all of that programs' faults, we _never_ _once_ denied or shortened care for a patient based on money or coverage. If we felt someone needed to stay 9 months instead of 6, that was our prerogative. There was no approval process, no one to ask permission. We had to pass state quality reviews and audits, but we had our act together, so they'd typically ding you because you forgot to cross your t, not because you gave a parent the care you believed they needed (and the patent wanted).
The issue of money just never came up with us.
Our program also cost a pittance to run, compared to neighboring for profit programs... by a factor of 10. We were all severely underpaid, lol, but I also think huge swathes of private Healthcare are overpaid. No one in healthcare wants to change the system, because they're afraid they're not going to make 200k a year anymore. There are huge swathes of the industry- bill coding, prior authorization, sales and drug reps, pharmacy benefits managers- who shouldn't exist at all. They need to go get real jobs instead of extracting millions from the rest of us.
Look up the FTC complaint against US Anesthesia Partners in Texas. The FTC had them dead to rights for creating a monopoly- a private equity firm rolled up all the anesthesia firms in DFW, then the state. Then they quadrupled and quintoupled their prices (anesthesia practices tend to sell services to hospitals, in TX). They engaged in many other anticompetitive measures, including flat colluding and price fixing with potential competitors. They made so much money doing this, that they are in repeating this business strategy with other medical specialties.
Their defense, so far, is a version of "this can't be illegal, because everyone does it!" They can talk all they want about a patent center business model, the FTC has their emails where they engaged in price fixing.
IMO the whole industry is crammed with fraud and abuse. Or government has let this go on too long.
I'm grateful for the warning about Medicare Advantage, and sorry for this family's loss. What a horror to go through.
The devil loves deception, it's all in the name. It's deceptive you think you're covered until you find out you're not. Medicare advantage...the advantage is not on your side.
A warning does no good when you can't afford anything else.
Medicare advantage isn’t inherently bad. The govt literally set it up to get people off of Original Medicare.
I signed up for MAdvantage to get dental. I checked with dentist yesterday. Bills have not been paid. More than 3 months later, even though insurance companies are required to pay within 30 days. I was told that I would get 12 acupuncture and 12 DC visits annually. $180 per month for OTC and first aid and produce. Five places refused to accept card and all stores using the UHC card had so much difficulty that they don’t want it. Usually takes a lot of time and multiple clerks. pOS company who has now purchased major medical network in WA. So a choice of religious owned health care and/or even worse for profit AARP/UHC POS. Hey, Congress, give me a card to use wisely to get what I need. Will be a lot more cost effective. I assume that somebody is getting huge administrative fees. Is money going to lobbyists and campaign funds? Sure not going to my health care. I could go on but want to breathe and lower my BP
And no DC or acupuncture or gym cause nobody will accept UHC Advantage.
Bernie Sanders, shut up about Medicare for All and get a universal health care plan passed that covers you, federal employees, retirees, veterans and every American etc etc etc
Give me access to Walter Reed or it equivalent. Do I need to announce my candidacy for Congress?
@@bettyjones113 You need a new Medicare agent. Washington state right?
I work for one of the largest national insurers in the USA. It's a low level position because I cannot promote, in good conscience, to a position that does more harm. But in my position I have to read thousands of emails, denials, court filings, and the shady backroom discussions that are SICKENING when you realize that it's a network of untrained, compassionless drones turning pain and misery into profit.
This video does a great job of telling one such tale. I see variations of this story thousands of times a day, five days a week.
One day they’ll All answer to God!
I have never understood how someone who has never met me or worked with me in a medical setting supposedly knows what’s necessary for my care.
It has recently come out that United Healthcare used AI to issue denials. They are now being sued over it, so an actual human being may not even be involved.
Exactly 💯 they put they're on agenda on your diagnosis
I know, right? These insurance companies have no right being in the patient care.
I escalated an appeal all the way to the WA Office of the Insurance Commissioner. Had letters from many specialists saying i needed care. The insurance commissioner said that as long as the insurance company followed their internally documented procedures, no denial could be appealed.
Its such a cruel and hateful system.
I had a successful appeal in California to force Cigna to cover a prescription. I have a rare, but easily treatable condition. My case was different because state law was pretty clear: this prescription had to be covered.
When it was coming to arbitration time, and Cigna would have to explain themselves to me and the rep from the commissioner's office, they gave up and approved the medication.
Bunch of dickheads.
Wtf. Wa ins commissioner was my next step. MK was insurance prior to being a good in’s comm and now off the rails
#VoteBlue because the Republican party gave us this nightmare and it will never be fixed while Republicans have a majority.
@@Julz99907 The crazy thing to me is that, IMO, Medicare is the only insurance that actually _works_ .
America is the only country where you pay a fortune for coverage, and they still deny you. The average premium is far more expensive than what individuals pay in taxes in EU and developed nations in SE Asia.
At the same time, we pay an _incredible_ amount of money for healthcare via federal spending, between tax incentives to pharma, flat spending via medicare, and funding research. So US spending on healthcare has totally eclipsed "expensive" nationalized healthcare systems, when you add it up, it's like 3-4x the money. And they still deny you.
Who wants this? Who could possibly say this is a good way of doing things?
@@Julz99907 insurance companies gave just as much money to Democrats as they did to Republicans. The system is rigged and voting is little more than a busy box for the people
Americans are housebroken to the point where they would rather let a corporate bureaucrat decide their care for about 20% of their paycheck than spend 4-5% of their paycheck on a single-payer or national health care plan that covers everything.
This. Americans are domesticated. Corporate vampires don’t even have to hunt anymore.
Because that money goes to Other people. Capital "O" on that one.
@@Theomite Wrong. The insurance companies pocket the money as profits Fool!
They think poors and minorities will benefit
@@kirby-hm4mb Wrong money. I was referring to the hypothetical money that the Americans won't pay.
Not everyone can afford a Medicare supplement, but original Medicare + Supplement is the way to go. Your doctor decides on your treatment; not an insurance company.
My father has a Medicare advantage plan. He needed to get a stent put in. His cardiologist, who has a very prestigious practice and national profile, couldn't get the insurance to pay. The insurance denied the service- an office procedure- for six months. All the while, his symptoms are getting worse and worse.
He finally has bad chest pains one day, and he calls 911. He goes into the hospital, he's right on the edge of having a heart attack. The insurance finally approves the payment for the stent procedure, but now it has to be in a hospital under emergency conditions, which raises the costs 10 or 20 fold.
My dad is a longtime conservative, who thinks Obamacare is a communist plot. But he finally saw, private insurance sucks in America. You pay this incredible amount of money (far more than any healthcare tax would cost him in EU) and you don't get anything for it.
I guess, back in the day, before an oligopoly took over helarh insurance, wrote their own regulations, and crafted regulatoes who are unwilling to enforce the law. Back then, employer health insurance used to be good. You paid a little more than Europe, but you got great care. Older generations remember that time, that's how they think about private insurance. But those days are long gone.
Really???? In 60s , I had health ins thru my dad’s union job. When I aged out, my premiums were $40 for 3 mos.
When I needed ins in 80s as self-employed, $120 per quarter. Then they raised it to $480. They said it was a 10% increase. So I was uninsured till Medicare which is better than the alternative. But we need some properly trained medical personnel and then a national health universal health care program. I’ll be interested in seeing how Medicare advantage is profiting cos and killing patients and leaving bills unpaid.
Fortunately, you can change plan from now to Dec 7, but to what?
@@wolfumzwhen obummer care went into effect was the last time we could afford to see a dentist or go to the doctor and not be treated as if we are exaggerating etc…doctors don’t communicate and don’t read the charts any more….I had one doctor think I was lying about having thyroid disease and sent me to the specialist that diagnosed me with it a few years prior…as a new patient. The doctor who did this had the notes from the original specialist sitting in my chart! Needless to say, she no longer wanted to be my primary doctor after the specialist called and chewed her butt for embarrassing him! And me! It was a huge foot in mouth and oh crap! Find the chart! Run around and a huge waste of my time and gas to drive the two hours to the specialists office! Now the insurance companies don’t pay out and the dentists and doctors are refusing to accept ALOT if these plans ….it’s all just been a scam to take control over everything
@@wolfumzI worked for the same company for 35 years. Early in my career their insurance was considered the gold standard. The last decade of my employment I started getting denied by some doctors that refused to take our insurance.
Thank you for investigating. We NEED accountability and checks and balances against our corporations, ranked choice voting, regulations for truth in media, and single-payer healthcare. Yesterday.
Amen. Medicine is my profession. I thought I was going to be a CLINICIAN. I spend way too much of my time on the bureaucracy of the patient's insurance plans, something they RARELY bother to investigate or understand fully until forced to in times of medical crisis. The boomers still labor under the delusion that there's a complaints department that gives a damn found on the end of a telephone number printed on the back of their insurance card...and they routinely vote against their self interest, which further exacerbates their frustration that nobody is out there looking out for THEM.
Most Americans have zero clue how ANY of this works and I long resented that I had to become an expert in administrative hopscotch in addition to spending my entire adulthood on educating myself how to best save their lives AND preserve the QUALITY of that life.
Sigh.
America is desperate for institutional reform. Medical. Educational. In Corrections. Law enforcement.
Across EVERY field.
@@lf3541 thanks for posting this.
Never going to happen. The congressmen are given plenty of money, to keep the system running and supplying the insurance industry as much money as possible. Biden? He supported the plan back in 2009 to guarantee the insurance industry, a minimum profit margin. Yes, they are guaranteed to make a minimum amount of profit. The only industry which is GUARANTEED by law to make money. And YOU are paying for it. Trump's plan? He had none. He wanted to let the insurance companies to be completely unregulated, so they could rip you off even more. Both political parties are complicit in scamming the public, the voters, all the time, and if you think they are going to cut their own throats, you are crazy. This is one reason there aren't any term limits; so, once in office, they can continue to get all that political action committee's $$$$. It's the primary reason why all the congressmen and senators leave office as millionaires, even when they first got in, they were just ordinary workers scraping by. Just getting into congress is a guaranteed way to become rich.
@@lf3541 Yeah, boomers not only vote against their own best interest but everyone else's as well. Most of the MAGA conservatives too
@@lf3541 I do the same, from the HR employer side. It's such an obnoxious joke of a system. Thank you for advocating for your patients. 🙏
My heart breaks for all the families that have had to take this journey.
When will the citizens of the United States be worth more than the money these greedy companies can make off of us? When will people matter?
Never, the proletariat has always existed in our country to be overseen by the ruling class. It was actually designed that way, but now the ruling class is an oligarchy instead of the robber barons of yesteryear. We are but pods in the matrix, we exist to make money for others.
Unfortunately probably never. In the US you aren't a person but a commoditiy
@@Lando-kx6so I agree.
The Constitution of the United States state that the government was to protect the private property and interests of the wealthy elites. The Constitution was more of an economic document than a political document and they use politics to beat us down with.
When healthcare starts being paid for by your taxes and run on a strict non-profit basis.
My step-dad had a widow maker heart attack and managed to survive. When he kept getting fluid in his lungs, they put in drainage tubes. His doctors all agreed that he needed at LEAST a stint if not a transplant. Insurance wouldn't cover it because they didn't deem it necessary. They transferred him to the most appropriate hospital in the state and they agreed that yes, this surgery was necessary. Again, insurance didn't deem it necessary. He died the next day in hospice. He was 55.
I just don't understand why the doctors and hospitals bend to them. If it was me, I'm doing the procedure, I don't care about the paperwork after the fact. So fucking stupid and cruel.
God this gutted me. This family is incredibly strong to speak up about what they went through. Thank you for giving them this time and space to speak.
I turned 65 in January 2023; I was warned in advance about the dangers of Medicare so-called "Advantage." Fortunately, I made the right informed decision.
What did you choose?
@@cpoul I chose Original Medicare, not Medicare "Advantage." Nevertheless, I have received many offers from private insurers promoting "Advantage."
This is what privatization of public goods does and this is directly in line with Reaganomics. The republicans want to privatize everything, including public schools and fee based management of our retirement for profit, and often privatization is paid through public taxation. There is no market for some public goods the working poor can pay for through normal consumer demand for goods and services without government subsidies.
Reagan = Satan
Bold comment, I don't see MAGA morons commenting tho
What I don't understand is, isn't this also affecting the Republicans too? It all makes zero sense.
NEVER vote Republican! EVER! But it amazes me that so many people do and its usually against their own best interest.
@@marciamartins1992 Very good question. I'm not sure I know the answer why republican voters support such policies because they are affected the same way. I suppose it's exactly why it doesn't make sense to me (as an economist and former CEO and CFO of a small non profit company) that I have become more progressive since studying the 2008 financial crisis and the sluggish political recovery in real time. I began to see Reaganomics as a failure especially for our rural middle class (MAGA) and for the rise of populism.
If I had to guess, and I have a hypothesis that rural MAGA Trump supporters really don't understand it much beyond the simple "nationalist" rhetoric, I'd argue it wouldn't make sense to them either. (I'm a nationalist and former Trump supporter, too). It only makes sense to conservative lawmakers who don't like the deep state for ideological reasons and regulations for financial reasons. So, that becomes the narrative and conservative media talking points to bash democrats as evil "socialists" to win elections.
I need to take a dive into why it seems to make sense even to those affected equally. I will add, however, people often vote against policies that help low income folks, often like themselves, because they don't want their tax money paying benefits to others like welfare queens who are seen as abusing the system. That policy affects them, too, but of course they see themselves as not abusing the system because their need is very real to them. I believe this misunderstanding is the root cause of the division in our country.
We are beyond the point of simple justice. This calls for retribution. Every person who had made a penny off this needs to be stripped of double, triple, what they made. Jail time for loss of human life and crimes against humanity. Punish these monsters.
Need to be stripped of something much more than just their profits
Exactly! I dream of guillotines...
The question is who has the power to bring these Criminals to justice? They have billions which means if anyone tries to fight them they will just hire a bunch of lawyers plus I wouldn't be surprised if they already have lobbyists creating new shady rules and laws behind close doors to help make them max profit. The true cost of all of this are people lives.
They are placing profits over the country and the health of its people.
You haven't been paying attention, the US was built for these people
There are stories out here like this and people are still confident in corporate coverage and paranoid towards universal coverage
That is how propaganda works to manipulate ordinary people.
@@JohnT.4321We need to make stories like this poor man dying famous.
@@marciamartins1992 Stories to point out the disasters of for profit health care is a good idea.
Because it's being drilled into their heads that socialism is evil
You only find out how bad your insurance is until you are sick. That is why most are unaware. They are healthy.
I worked in medical billing for a radiology firm years ago, and it was just accepted then that _every_ insurance company will deny the first claim out of hand. No reasoning, not even really looking at the claim - if it's a new claim, it's automatically denied. The 2nd and 3rd claims also had a very high chance of being denied for no discernible reason. If there was a typo _anywhere_ on the form, it would be denied. If the printer was a little bit off (yes, some companies still _required_ paper claims as late as the 2010s) and the text was just outside the pre-printed field, denied. Literally anything they could find to deny the claim would be used, and if insurance denied the claim, then it was on the patient to pay...sometimes thousands or tens of thousands for necessary, life-saving care...but the insurance companies didn't care - don't have a pre-auth on that head CT for someone that was in a massive car crash and is comatose? DENIED.
There is nothing that will turn someone into a socialist faster than actually seeing what these companies do, and how many barriers they put up to paying for care that is absolutely needed...especially when that care is needed by a loved one. Practicing medicine without a license is the LEAST of the charges that should be leveled at every single insurance company in the US.
socialism doesn't work either.
The FTC should require providers to change the name from Advantage to HMO. Medicare Advantage is a scheme where the government saves money by outsourcing Medicare to providers who provide substandard medical care to unweary participants and pocket the difference.
It is likely to get worse, too. Humana is no longer writing private insurance. Just "advantage" plans.
What will they do to increase their income? Start lobbying Congress for more of your tax dollars.
Some Congress critters will happily oblige and claim this is to improve our health. Ha!
Yep, I’m choosing my Medicare plan now and I’m shocked at the fraudulent advertising and flat out lies. Seniors don’t realize they were lied to until it’s too late.
Not all Advantage plans are HMO, though. Many are PPO plans. Many employer group insurance plans for the last 40 years have either been HMO or PPO, but they are pre-Medicare plans. Only persons who are enrolled in Medicare Part A & B are eligible to get an Advantage plan.
I'll never sign up for Medicare advantage
This is the problem with exposing the healthcare sector to the profit motive. If you allow prior authorization insurance companies can legally cut corners on patient care. If you don’t allow it, the hospitals and drug manufacturers will push unnecessary or dangerous procedures/drugs on patients. On either side of this system is a greedy corpo that has only one priority, profit. The free market isn’t capable of providing quality healthcare to the masses. Either we socialize healthcare or we accept gradually worse care for higher prices over time.
Ok so be prepared to loose your money, health, and loved ones too unless we nationalize health care and do away with this current sham. Got it tell your friends.
This video NEEDS to be shared to the MAX.
I was waiting to see my sleep doctor and I heard the receptionist tell someone that they could no longer see their doctor because of their Medicare advantage plan, the doctor was now out of network, and they would have to see the doctor before the end of the month. After that they wouldn’t be able to see them anymore. Anyone I know I tell them not to get an advantage plan.
In our capitalist hellscape, profit will always come first. In every industry in every market in every sense. They won't stop, and its never enough for them.
capitalism is not the problem, it's wicked people who not only give capitalism a bad name, but ruin everything they touch.
I'm glad I never fell for this con. Other seniors haven't been that fortunate.
For low-income seniors, they don't have much choice. :(
@@stephm.3407 I'm definitely low income. I live in Oregon where there is a state program that takes up the slack, for free. I cannot speak to other states, though.
@@SpecialSP Ugh in my state of Texas you basically have to be in poverty to get help with your Medicare. I think you're not allowed to have more than $20,000 in assets outside of house and maybe one car.
Correct. My neighbor (RIP) who lived alone in a small house, had a brain tumor, 11 years ago, & held a title to a 30-yr-old broken down boat, that he had to pay someone to take it off his hands. @@homerthompson416
@@homerthompson416 I definitely don't have 20Gs in assets NOR a house and my car is DOA! I'm lucky if I make it through the month. I started working in junior high during vacations until I finished high school. After that I pretty much worked full time even as a single parent, Now, I live on less than $800 per month! I'm disabled and pay rent for one tiny room in my daughter's house. BUT - I'm still here, "hoping" to get my own place. So much for the middle class life …
Having worked in health care and also now having an "advantage" plan myself, I have no doubt this situation will only worsen. I have had routine maintenance medications denied prior authorization despite taking daily for years. They recently dropped their "preferred" status to the only private pharmacy in a rural area, leaving the only pharmacy available in a 'big box store'. That remaining pharmacy receives orders once a week. So if they're out of what you need, the response is simply "sorry." The dental insurance started as one lie after another, with 'some improvement. I know there are far worse plans, but the 'advantage' plans shouldn't be flat fee based as shown here. And imagine working in health care where your job is to routinely deny life saving services! Disgusting on so many levels.
❤
Heck, humans are no longer the ones denying your health care, artificial intelligence is now doing the dirty work. It is more cost effective and much more efficient. AI can deny thousands of prior authorizations in mere seconds.
About time this has been more focused on. It's a gigantic taxpayer giveaway. They overbill with minimal consequence. Cigna just paid a $173 million fine over 7 years of overbilling. They make over $1.2 billion a year with just Medicare Advantage. It's a nuisance tax. The same happens with Medicaid because most states have private insurers managing the enrollees.
I’m a nurse. Every elderly person I love and has asked I have encouraged them to get a medigap plan. Actually I tell everyone I know that is getting ready to go on Medicare to get a medigap plan. Thankfully they all have.
And they need to get the Part G supplement in the first year they're eligible for Medicare so they can't be denied nor charged a higher rate based on previous medical history. Let it go a year or more before buying into Part G and the private insurance companies are allowed to tell you to piss off if they think you won't be profitable for them. Also means you're stuck with the Part G plan you buy in that initial coverage window unless the company you buy from stops offering Part G. If that happens you get another window where you can't be denied and they can't subject you to underwriting when you get a new Part G plan.
What is that,and do you know any names i can look into
But medigap is not cheap and there are no controls over how much they can increase premiums on a yearly basis.
@@olegayguy It definitely is not cheap and whichever one you buy in your initial enrollment period you're stuck with since if you drop it or lose it now you can be subject to underwriting next time you apply for a Part G plan, unless the company you buy from stops selling Part G: then you get another initial enrollment period where you're guaranteed coverage and the company can't base your rate on your medical history but only age and zip code.
I’m picking my plan now, and it’s shocking how many lies seniors are being told. I can see why so many get duped into advantage plans.
America everyone. If you want an explanation of why Americans leave this country and never return, look no further.
but where else is there to go? the whole planet is going to hell.
I'm a medical student and my mom is a doctor. I've heard horror stories about MA. Best to just stay with original medicare. When you're young, HMO/PPO style employer based healthcare is fine but you don't want to be gambling on your health when you get old and likely to have more health problems.
As the insurance sharks and the government money changers well know. American health "insurance" is an actuarial game (call it "health scare life insurance"): calculating death/risk rates rather than providing adequate health care.
I’m picking my Medicare plan right now and it’s shocking how much bad advice and outright lies seniors are being told. The whole industry is designed to scam confused seniors so that brokers can make commissions and advantage plans can profit.
Problem is when you have too much $$$ to qualify for Medicaid, but not enough $$$ to pay for Medicare Part B, private drug plan, and then a Medigap policy. It's very expensive. I won't be able to afford it next year, will have to drop it, then I will die because of my health problems. All the while, politicians are funded by regular Americans and for-profit corporations, getting the best care for free. Dontcha just love it.
Agreed. My MiL got talked into based on getting a free gym membership.
I'd expand on this and say ALL health care basically works like this when there is even the slightest profit motivation.
My dad was a veteran and they sent him home to slowly die from internal bleeding rather than give him the care he needed. I only found out about his bleeding after his death... Always read the records and reports yourself, never trust what they say to your face! The price for me to learn that was too high.
I just went through the appeal process with my mom because she had a problem with her leg they refuse to treat and just wanted her out of the hospital ASAP.
You MUST work a full-time job or more of effort just to stop this broken system from killing you or your family.
It's horrible, it shouldn't be like this... But it is.
Elderly people are the ones who normally have the most expensive care, if I was on charge of determining who got hip and knee and other operations I would deny everybody over the age of 65
@@jonathanjones3126 So everyone over 65 that needs a hip or a knee replacement should just get melted into biofuel or something? Maybe we can sell that for a profit to go blow up more brown folks in another country too! I'm glad you aren't in charge of this stuff because you seem to need some serious alignment work on your moral compass. I hope you're first in line to volunteer as tribute when you hit 65 and need any major healthcare service.
@@jonathanjones3126elaborate?
Living with chronic diseases sucks because how hellish insurance and health institutions are. WE NEED TO CHANGE THE HEALTHCARE SYSTEM.
I’m approaching this age, alone, and I am terrified 😢
💜
Keep your original Medicare. Don't be suckered by false promises. I kept mine and I am doing fine.
@@JohnT.4321thank you so much for reminding us what we need to do.
@bcx1138
Look up medicare.gov>basics
The Medicare signup here it is from January 1st to the end of March.. yes you can change from Medicare Advantage to regular Medicare
@@I2AmUS You're welcome.
Fn pure evil 😡
Yep. They "love" us to death.
As a Registered Nurse for 45 years and Master’s Prepared Clinical Nurse Specialist and Certified Nurse Case Manager at a major East Coast University Teaching Hospital, I’ve spent the last 25 years fighting ( and having families fight) the circumstances in this video OVER and OVER again. For profit insurance companies say they are “Patient Centered”… but they still follow standardize “ criteria which are MEANT to be GUIDELINES for insurers ( and medical practitioners). However EVERY case is different, and (as presented in this video) for and insurance case manager to give a discharge date BEFORE an evaluation was complete is unconscionable! And yes, the denial and appeal process is devised to take inordinate amount of time for the family/hospital/doctors to appeal (sometimes years for the whole process) …it appears designed to wear you out and make you give up! It’s one of the reasons I finally retired. Despite having one of the lowest “Denial” rates in my department among the patients I covered ( my director referred to me as the “pit bull” of denial appeals)…it took me 10-12 hours (of an 8 hr work day) to fight insurance companies on cases you KNOW the insurance company had not READ the patient records, before denying the care/appeal. It finally affected my physical ( and emotional) health…
I wonder what insurance the people that work at Medicare Advantage companies have for themselves and what do they tell their families and friends to get.
In Michigan our governor Whitmer's father was the head of Blue Cross Blue Shield Michigan. They also held a private fundraiser for her and then she put the CEO of Blue Cross Blue Shield MI on her transition team. She gained roughly $145K in money from that fundraiser. Private insurance has infiltrated the system to the very highest levels and it'll take a huge movement of the people to fight it.
As have all corporations thanks to Citizens United circa 2010
Thanks, I had no idea. I used to think she was presidential material. You have educated me. We need someone not beholden to the Health Insurance Industry!
Every last politician is beholden to those who give them money and usually corporations give the most by far. They are the ones that have the power in our country.@@suzannecastello4380
Literally describes every insurer in the US. 🤡
Why the clown emoji
When I signed my mother for Medicare it was a complex process and I didn’t really know what I signed her up for. I later found out that I signed her up with a Medicare plan with Medigap supplement. Wow I dodged that bullet. My brother helped me sign her up; he was confused on the process too. I am eternally grateful to him.
I have medicare advantage plan (not old, just disabled) the amount of hoops i had to jump through just this month alone is insane. I have chronic pain and i was trying to go to a rehab center, but even though i had the appointment 3 months in advance i couldnt get the referral till a week out and my pcp didnt even know touch it till a day before the appointment. My pain doctor's receptionist had to go and call them to get the ball rolling. Im now waiting another 3 months. Thankfully i only had one denial and was able to appeal it. So so annoying. Thankfully my family is on my side and is able to do most of the paperwork and such. My dad usually has to call too since they just dont care if i call.
Edit: i didnt want advantage, but my main doctors were only on the advantage plan.
I lost my mom to the US broken healthcare system. She had a heart attack, they stabilized her the same day and kicked her to the curb. The next morning she has a massive heart attack and died before the ambulance arrived.
And then my dad had cancer for two years before the he was able to get any help. He almost died twice. During his surgery, they ended up having to do a emergency resection of his rectum and put in an emergency colostomy bag to keep him from dying. He ended up having to have another surgery two weeks later and almost died again. These doctors promised to help and none of them really did.
They are just as bad as these damn insurance companies.
I have so many stories about this countries healthcare system just from my own personal experience. This country is a crap hole.
Helps explain why health insurance agents are paid so much for just retaining people under these plans. Turns out the insurance companies are profiting from denying coverage. It might seem like a good thing to cut costs but not when it is such an important aspect of life. Health coverage should be universal and without cost to the people who already paid taxes to sustain the government that should provide these services.
Isn't that essentially the problem with for-profit health insurance companies to begin with? The profit motive is inherently at odds with the service the company claims to provide.
One more thing to stress about.
The American healthcare system needs to be gutted, and all the profit motives cut out of it entirely. I work in healthcare, and I'd have zero sympathy if every single healthcare insurance company was destroyed tomorrow. The workers displaced would be the real loss, but I say let it all burn so that we can build it back up.
The insurance companies cried job loss. It's already been tried. It's why we have the monstrosity we have now.
Nope. Goods and services move most efficiently and inexpensively in a market. We don't have a market.
Medical services, pharmaceuticals and durable medical equipment are goods and services.
Do you know what pharmacy benefit managers do? Find out to begin your journey toward understanding where the problems are.
Mind blowing how helpless US citizens are against corporate tyranny.
I'm a therapist at a skilled nursing facility. All of this is 100% accurate. I've had the same exact conversation about "you will probably win the first appeal, maybe the 2nd appeal but that's about it." Humana and UHC are the worst. We all can tell heartbreaking stories of people whom needed more services and the insurance co didn't care. The families are left bewildered and feeling hopeless.
There are strategies. Business office manager has converted many people to regular Medicare so they can continue services. The problem is when people that has a Medicare advantage plan as a part of their retirement.
The biggest flaw in Medicare is that it does not cover prescriptions and that's why this mess with the Advantage plan happens. It's lame that when we work we're taxed with the expectation we're going to get coverage but then we have to buy a supplement plan and if we don't an extra fee is imposed on the Medicare fee in perpetuity! This needs to get fixed!
When Medicare came into law things like penicillin where the most advanced medications available
And the creator of the Salk Vaccine for Polio refused to patent it, he wanted to prevent Polio not make money. Other early inventors of medicine has similar policies and remain the main medical philosophy till the 1970s. Since the 1970s, the trust has been to make profits. Many recent medications cost pennies to produce but due to patent protections are worth millions of dollars while costing people who need those medicines hundreds if not thousands of dollars.
@paulmentzer7658 the cost of bring one drug to market years ago was a billion dollars, that is probably closer to 5 to billion now and their is quite a few failed attempts on the way.
Who is going to pay the cost fir new drugs to be developed, go through the clinical trial phases etc.
I would have the government pay the people who develop the new medicines full cost plus up to a %50 bonus depending on how useful it is. New antibiotics and anti virals get the most bonus
@@jonathanjones3126do u know where that money comes from to discover new meds and treatments and then to study and then produce them? We the people pay for it through government grants funded by our tax dollars…we are the original share holders. We just aren’t allowed a return. On the investment like the politicians and corporations are
@w8what575 that is not true for all medications, I doubt any number of grants used to discover a useful compound would even start to pay for turning a new discover into medicine
I'm disabled and receive medicare. I am constantly getting phone calls and letters wanting me to either join one of these plans or one of the plans that you can get by combining my medicare and medicaid even a different plan just about my meds, the answer is always a big no. I saw how my grandma with just her supplemental insurance was treated. How much she had to pay each month and all the rest, it's not worth it. I would rather pay the 20% medicare dosent pay. At least the hospital has things they will do to help. So I'm lucky in that aspect I know many others aren't. This is why republicans keep pushing to defund social security and Medicare they are trying to scare and force people into having to do these other things. Ever wonder just how much of a steak any of them have in any form of the medical industry. At least where I live my Drs keep pushing for everyone to have health insurance as in Medicaid for all. Because in this country how our medical system is set up and there are next to no laws to protect us, the medical industry charges us out of control amounts and over price everything because most other countries one have medical coverage for all it's people, and two they have the ability to not only negotiate the prices but often set the prices, so until we can finally come into the 21st century we will continue to not only be overcharged, but overcharged by totally ridiculous amounts because we are the only western country they can make the amounts of money off of to buy their second, third, fourth, and even more homes from.
Exactly why we would NEVER choose a Medicare Advantage plan. Recently retired nurse. It’s a complete mess. I had to do prior authorizations for cardiology testing. Many denied. A complete waste of time and complete waste of trained staff.
This is why privatizing social security is a bad idea.
Thank you for making this video. I am a former mental health care provider (now retired). I saw a bunch of this millionaire / billionaire / corporate class welfare system in action with the people I tried to help after they were switched to a Medicare Advantage Plan. A significant percentage were transferred out of regular Medicare without their prior knowledge in an attempt. I guess for the State to save $$ (I have no other idea why they were switched). The literature to read was very confusing.
Also one aspect that your video did not cover was how difficult it can be for individuals to switch back from an Advantage Plan to a regular ( old-fashioned). Medicare. Health. Plan. Again, many thanks for your spotlight on these issues. Many folks do not realize how this PRIVATIZED version of health care plans dilutes their power as voters to bring costs down for working-class poor (the majority of U.S. health care consumers).
I lost one eye because my insurance delayed the surgery for 3 weeks before approving, but by then my eye was too damaged to safe, the doctor tried either way, then my insurance told me they do not cover this type of surgery so I had to pay out of pocket. Then why they made me wait?
The penalty for having a denial reversed should be all of the court costs, and then all of the court costs a second time to provide a general fund for the next denial case. Having a denial reversed should be very expensive, to the point where companies err on the side of not denying coverage.
Maybe all this needless beurcacy is what they consider job creation. It's sickening 🤢
When we finally eat the rich, does anyone have a good smoker recipe? Like a dry rub or brine perhaps?
You americans have guns to revolt against your oppressors don't you? You have school shootings all the time doncha? You have the addresses of these corporations, doncha? Why dont you go to these corporations and write them a very angry letter. Or better still, pickett with signs. No even better, call your elected representative? Or hahahaha vote another political party!
I don't know but I heard it pairs well with a nice Chianti
Start with Jeff Bezos!!!
@@stevechance150 And Elon Musk for desert.
I'm not sure introducing that kind of poison into our systems is a good idea... even for dog food.
I work in pharmacy insurance benefits, and it always shocks me just how different and honestly worse medical benefits are in comparison. At least on the pharmacy side (tho maybe this is just my company), when something is denied, there's always a reason listed. It might not be a good reason, but there is at least a listed reason that people can then fight back against. To find out that medical can just say 'we're denying your healthcare and not gonna even give you a reason why' is mind boggling.
But also for anyone who didn't know, pharmacy and medical insurance benefits are separate things even though the part of the same healthcare benefit package, and they have radically different processes. A lot of plans use entirely separate companies for pharmacy and medical, and even ones who do use the same company they're almost always entirely separated departments. So if you don't see pharmacy processing info on your health plan's ID card (that would be your RxBin, RxGrp, and RxPCN), then your plan probably has separate cards and you need to make sure to get yourself a pharmacy card since for some reason they don't automatically send those to people.
My father almost had me talked into buying Advantage. Glad I didn't.
I'm a bit gullible, but explosive when I discover I've been ripped off.
Two of my physicians quit taking Medicare Advantage within 6 months of each other and I was fortunate enough to be able to switch out of that plan into a supplemental plan. Even hospitals in my area are refusing to accept Medicare Advantage plans.
As a kid in Sunday school I didn't pay much attention to the clergy's warnings about evil. Now I sit in disbelief as evil ravages our world...
"unless they have family, patients have to navigate this process themselves." for a guy just out of brain surgery and can't tell what time it is, that would have been insane.
We need information about how to get our relatives on medicare advantage back to regular medicare
Medicare signup is coming up soon you can change every year Google it you can find more information asking questions on Google or your favorite search engine
It cannot be done unless they make policy changes in Washington. Once you sign into a private health care plan they got you by the gonads.
@@JohnT.4321 That's not true. You can switch during the open enrollment period every year. The only thing is that if you chose an Advantage plan and then switch to regular Medicare you pay a higher price than if you chose regular Medicare at age 65 and stayed with it. I know this because I helped my grandmother switch from a Medicare Advantage plan back to regular Medicare last year.
@@JohnT.4321
You can change insurance companies every single year you want when the Medicare sign up period starts.
But the insurance company you choose this year you can't change it until next year.
@@richardjacullo8312 Interesting to know but I have heard otherwise from those who are experts on Medicare. I will look into though. Paying higher prices after getting back on Original Medicare is downright criminal and disgusting.
Every object in every corporate headquarters is flammable.
It's called advantage..... Because they take advantage of you
😂
As an American i firmly believe that we are all entitled to life liberty and the pursit of happiness. In order to live you must have health. So it is in our rights to have healthcare. Unfortunately some greedy seek to prey upon the weak and deny them of their right to health. We live in a country where insurance dictates medical care and as a medical professional i am tired of watching my patients suffer for it.
This is madness. I don't get how the US public accepts this.
As a hospital based physician - thank you for your service. We are lost in red blue left right battles while American peoples wealth is stolen. 🇺🇸 first - more perfect union. Thank you and will share with my patients
😢medicare does not pay for nursing home care. Only medicaid pays for that and they drive you to poverty to get eligible. Its atrocious
Congress knows Medicaid is 50% Federally funded and 50% funded by your state. Your state can permit higher assets and income limits, but refuse to do so for Medicaid is the main cost of "Welfare" today. State Politicians love running on cutting welfare, NOT expanding "Welfare".
“Short term” (120 days max per “event”) SKILLED nursing home ( requires the daily intervention of a Registered Nurse, Physical Therapist or Occupational/Speech therapist is only paid for by Medicare.
You are covered for long term “custodial care” ( bathing, dressing, feeding) ONLY if your income is low enough to qualify for additional Medicaid, OR you can afford to pay out of pocket for $600-1000/DAY ( not a typo) the extended care facility charges ongoing after 120 days
I am a hospital case manager. We try to convince people to stay away from them. They are rip offs and make horrible denials of peoples needs they pretend to cover...
The same thing happened to me in June, 2023. My doctor said I needed to go into rehab after complicated knee surgery. Insurance said I didn't qualify. I tried to appeal United Healthcare's decision. Unfortunately they make the appeal process so complicated and the deck stacked against the patient. This is a real problem and it does happen to real people.
As a nurse in a long term care
I see this daily!
I no longer want to be a nurse as corporate greed has taken over
As a surgeon, the biggest annoyance is actually why did they make the name so similar. I only take traditional medicare but so many medicare advantage patients get it confused so they think they have medicare but they don't. Also I will never bother with prior auth, I'm a doctor, i dont need to ask anyone for permission on what I think is best for someones health. But uneducated ppl will continue to pay private health insurance so this problem will never go away because everyone is still paying their insurances.
Unfortunately, many non-Medicare employer group medical insurance plans require pre-authorizations, as well.
I know medicaid is an entirely different program, but my experiences trying to access care- namely, multiple necessary surgeries to remove unidentified masses, has been so similar. In the past 3 years since discovering my masses wall after wall goes up, even with doctors willing to write appeals for me. I often think how if my case were a quickly progressing cancer, I'd be dead by now and that's the whole point. Im only 32 and living in Maryland, by the way. Even being able bodied and in a "progressive" state, it's a battle to access care as a poor person.
I'm not on Medicaid, but I noticed a while back when I had to find a new PCP, that some private-practice doctors state: "We do not accept Medicaid".
My heart hurts for the people featured in this video, and for the untold numbers we don't know about. However, the NIH in Great Britain, once heralded as one of the best health-care systems in the world, is also changing radically. Who here thinks the Government is here to help us?
DESTROY THEN PRIVATIZE - Got to love the deregulated free market - this is one example of many where privatization destroys. Our pals use algorithms to prioritize profits while denying treatments including medications.
That money that the insurance companies are getting is our money we have paid though out our working life. They could fix medicare and save money.
Medicare Advantage is great for people who are lucid enough to game the system. But companies bank on the elderly failing to read their mail, and each year during the annual enrollment period high pressure sales tactics are used to get them to switch between the private insurers. This is because companies make 380$ per enrollment, which incentivizes private insurance companies to discontinue plans each year usually by renaming them and keeping the coverages the same. If you fail to notice your plan is being discontinued you can be left without insurance, which as we all know can lead to crippling debt. Especially with regard to drug coverage, and the donut hole. Source = Me, as a licensed rep. Also much of this video should be taken with a grain of salt, as they are mostly describing HMO type MA plans. Please note PPO's also exist, and the 20% Medicare doesn't cover, is also a crippling expense due to the average payout on social security hovering around 1800$, which is also too high to qualify for Medicaid. Another thing this video fails to mention is that you absolutely CAN go back to original Medicare.
"Medicare Advantage is great for people who are lucid enough to game the system"
Why is it great?
" If you fail to notice your plan is being discontinued you can be left without insurance,"
If this happens wouldn't they lose the $380 enrollment fee?
"bUt DeAtH pAnNeLs!!!"
DONT FORGET WHO SUPPORTS THESE WONDERFUL CORPORATIONS.
Story Idea: With regard to health insurance; I’d like to have a story on the way health insurance agents are incentivized and paid, by health insurance companies. From the little information I am aware of, it seems like a pyramid scheme. The agent hires “contract” workers, who then sign people up, and if I am correct, the agents then get a part of the profits from their employees. If this is the way this insurance business is run, how much money do the insurance companies reap off of this model? If the agents are being paid per “sale”, I believe the insurance industry is getting the biggest cut, and their rates are inflated to cover this model.
Think of all the money a small group of executives made, that they barely feel, off their patients unnecessarily dying and suffering. That's the whole point of maximizing profit, right?
The money only goes one way, to the already rich.
This was so goddamn disgusting. 😢
SHAME ON YOU, INSURERS!!!! 😤😤😭😭
As a health care social worker, I can affirm that so many of my patients have been denied care or had their care become even more out of reach because of Advantage plans. I absolutely hate the plans and it makes it nearly impossible to get my patients the help they need. An area can have a plan, but no doctors subscribed to it in the area. It shouldn't be allowed at all. They are literally preying on vulnerable people who see the commercials and hear they could have more benefits, when in truth they don't qualify for any of it and then end up having much of their essential care limited or denied entirely.
My Medicare Advantage plan hasn't even found me a PCP. I have been waiting all YEAR to see a doctor. I have Diabetes, Heart Disease and Hypertension. I probably will be dead before I can see a doctor. All I did was move to another State and I lost all my Medicare healthcare because I was forced to change Advantage plans.
All of your conditions are related to a poor diet consisting of processed food, sugar, and fluoridated water and then treated with synthetic bioengineered petroleum based chemical pharmaceuticals that are destroying your liver and kidneys.
It's intentional manslaughter.
Cover American Medical Association monopoly.
The AMA is a CARTEL.
"Do you want government death panels?"
We already have corporate death panels.
Excellent journalism! Advantage plans are as predatory as payday lenders and protection rackets! 😊
Good work on this. A detailed analysis illustrated with real examples of why the US system is corrupted by the shareholder class