About 1000 people have pointed out that funerals are not cheap. Well they are to health insurance companies. In fact, they’re free! As cheap as it gets! That’s the joke!
@@rahmed5701 I'm sorry.. good luck. US healthcare is a fucking nightmare. I know people stuck living below the federal poverty line because they can't live without healthcare and if they eke out a dollar too much, they will lose that healthcare. Remember, killing a tory isn't murder, it's self defense.
@@puddincakes1005 And EVERY. SINGLE. CLAIM. requires a handwritten manuscript outlining every little detail of it's medical necessity. Ya' know, for the prior auth...
Sorry ! (Not!!)) That line is busy Please try back In 10 to 20 business years Or press the we are big business and We give a damn For anyone else Button
@@isntthatsomething8928 And if it's looked over (Hmmm 🤔 overlooked) It's not by a medical professional But a cost cutting Bottom Line is bonuses for those who already are Real financially COMFORTABLE
I'm a paramedic, during orientation we were taught to never put in our narrative what the patient is sitting in, just in case. Once someone wrote that the patient was sitting in a wheelchair and insurance denied to pay for the ambulance ride because she "could have just called a wheelchair van company," she had to be intubated during transport, wheelchair van companies don't do that. It took months of fighting to get insurance to accept it, so anyway, now we say "patient found in a sitting position."
I feel so bad for healthcare professionals in the US who have to do things like this and make medical decisions based on what a patient can pay. It's dehumanizing. Not just to the patients but people like you. Insurance companies are trying to make you a cog in their profit machine.
As an EMT in the 80s who worked for Medicare as a day job, they have only changed incarcerations. As I have changed my own degrees and titles, I have kept that early “education” close, knowing full well through it all, evil rises to the top.
Do it. Many photos will be taken over the years. Many grieving people visiting their own wronged loved ones will see it, and it will fill their bellies with fire.
I work in costumer service. Tell him to ask for it to be escalated, the further up it goes, the more pressed to authorize they get, tell him to insist on him having call multiple times so a grievance may get submitted.
If your father died because Prior Authorization someday, grant your dad wishes, hopefully his grandchildren can learn about how horrible his life / healthcare system and can do something about it in the future.
Many years ago my mom was in mediation with her insurance. Their attorney had the gall to say, "Okay, worse case scenario, Mrs. S lives." He was serious. There was no moment of realization where he verbally stumbled and reworded his statement to make it less disgusting.
That's so genuinely disgusting. It's mind boggling to me how people can have so little empathy for other humans. Society puts serial killers on this pedestal of evilness, but then you have these people high up in these insurance companies that have absolutely caused more deaths than people like Bundy and Dahmer ever could - and they get paid TONS of money to do it too. I hope your mother was able to get through whatever she was dealing with and is doing better now!
Seriously. I was denied for not trying 2 different medications. Thing is, I had tried them. It was right there on page 2 out of 7. The nurse circled the page in the copy she sent with the appeal.
The only unrealistic part of this is that Jimothy stays this long in claims; in real life he would be “reassigned” to the mail room by the first 10 sec of the clip
He'd be fired and file a lawsuit with an NDA settlement... Then release a tell-all book revealing nothing we don't already know because the rest was part of the NDA.
@@cameronno6039 he most likely signed an employment contract stating his employment could be terminated at any time for any reason. Can’t sue for wrongful termination with that sort of clause in the contract
Ironically, if insurance companies were to approve more people on a reasonable timeline/more often, theyd ultimately profit MORE in the long run for less effort. Reason being, by actually allowing people to access their insurance when they need it, they can, in the longrun, prevent more hospitalizations which will, on average, cost them a lot more money than just paying for medications, or medical devices etc. by just approving in the short term they stand to gain a lot more by having healthy people pay into the insurances and not actually using it. but when theyre only motivated by the short term profits, then theyll do whatever they can to hold onto it rather than thinking about a long term investment.
One flaw in your argument. Most people have HMO insurance. Health Maintenance Organization. Know what a HMO will cover? Annual checkups and routine visits to your primary care physician. Maybe some generic medications. Broken leg? Stroke? Diverticulitis flares up to the point you require hospitalization? Perforated colon requiring emergency surgery? After coughing up thousands of dollars for the deductible, and most likely having to borrow from family to pay for it, you’re still gonna be on the hook for tens of thousands of dollars in hospital bills. That’s why medical emergencies are the number one reason for personal bankruptcies in this country. The solution to that is a PPO or Preferred Provider Organization. Will your premiums be a bit higher? Most likely but not to the extent they’re not affordable. Will your deductible be higher? Not in my experience. My last PPO provider, as a single male, had a deductible of $150. I think family plans were around $600-700. PPOs cover basically the same doctors, hospitals, clinics, etc. But your copays will be a lot lower, prescriptions a lot cheaper, and overall out of pocket costs for healthcare are much lower. I was out with a heel spur 3 years ago that was nearly 4cm long. The only reason it didn’t puncture my Achilles’ tendon was because it was growing almost vertically. Between the trip to urgent care ($100), X-ray, MRI, several appointments with my primary, multiple appointments with my podiatrist, and nearly 3 months of physical therapy, my out of pocket expenses were under $300. All in I think my insurance paid a little over $3000. But HMOs are a lot cheaper for employers so that’s why most people have it because they get their insurance through work. And because heart attacks, strokes, and aneurysms aren’t part of maintaining health, treatments for them under HMOs are astronomically high.
@@dr.floridamanphd I have always had a PPO and grudgingly switched to an HMO this year because my employer selection system kept insisting it was a better plan for me. I should have listened to my gut instinct. I have been to the ER 3 times this year so far, continue to get mystery bills months later, I am enraged by the co-pays and my specialty medications, which somehow can only be filled for 30 days at a time, constantly cost me $50. Huge mistake. I am counting the days until re-enrollment this fall so I can go back.
Years ago, a friend of mine worked for an insurance company and said that their policy was to deny things that they knew they would eventually have to pay just to keep the money in the bank longer. He would have people calling him in tears because they were being sued and he still had to deny them - KNOWING THEY WOULD EVENTUALLY PAY. I have no doubt it is even worse now.
Given that this man has literally had a cardiac arrest, I think they should listen to him about getting some more AEDs... not everyone has a super wife to save their life!
Where I live the law is being changed to allow any enterprise to have it, and allow anyone with or without training to usem them without liability. It's more harmful not to use when needed than use when not
@@dr.floridamanphd and from what I’ve read the machine won’t even do anything unless it detects that the heart needs defibrillation. So you can’t shock someone who doesn’t need it.
@@Sashazur that’s true. The worst you can intentionally inflict on someone while using an AED properly is ripping out a guy’s chest hair with the sticky pads to get them in contact with the skin.
A friend of mine “lost” both hard contact lenses on top of her eyeballs just before going on stage for a theater performance. She did the first half of the show that way. Then the manager came on stage and literally said “Is there an ophthalmologist in the house?” There was. He went backstage and extracted them.
@@pilkoso Lies, Johnathan wouldn't make any noise. It's imperative in his line of work to be as non-threatening and accommodating as possible. **Brief affirmative nod**
I feel like I’ve been fighting insurance companies since my first positive pregnancy test. I’m so tired of 26 years of uphill battles with these idiots. I once knew a Canadian who complained about their healthcare system because people were always using it so it was difficult to get an appointment or a hospital bed where she lived. I told her it was easy here to get a hospital bed because we all stay home and die. It’s too expensive to live once you are sick.
And you can't get appoinments any quicker here anyway. Two-three months for a routine visit to my primary care physician, 4 to 6 for a specialist, even with a referral. And that's assuming you can find one who isn't at least a two-hour drive away.
Literally yesterday, I ordered a CT for a patient with acute abdomen (urgent care). United Healthcare denied the outpatient STAT CT order. Had to send him to the ER. This was about a 2 hr delay in care. His appendix perforated during the CT in the ER. Hate this for the patient, but now he will have an extended hospital stay for IV antibiotics. UHC shot themselves in the foot on this one!
From what I know, funerals ain't cheap either. It's expensive all round. Expensive living and Expensive dying, unless you get fed to the crows or something.
The fun part is that funerals are definitely not cheap 😭 A lot of funeral homes guilt trip and manipulate people in mourning into over paying for stuff. For example, saying that the body HAS to be embalmed even if they’re just getting cremated, making cremation out to be a worse option than burial, or upselling caskets by doing stuff like making the cheapest casket moderate to high priced because they know the family won’t question it, and will buy the next one up the price list. If you call around to different funeral homes, you’ll find that the casket prices are pretty much arbitrary and have no rhyme or reason. I’ve even heard stories of funeral home owners trying to make customers pay for extra shit right after the family member has died when the customer has arranged the funeral years in advance, and implying that they didn’t love the dead family member if they don’t pay. The idea is that they’re not thinking clearly because they’re sad, so they’re easy to manipulate. Obviously that’s just the worst, most profit driven funeral homes though. Not all are like that. That’s why it’s so important to compare prices between funeral homes when you’re trying to arrange a funeral- the bad ones count on you not doing that.
@@saintofall3653 A funeral is a one time fee, treating elderly or sick patients is a recurring expense. So yeah, in the financial long term - funerals are cheaper.
@@saintofall3653, funerals are cheap for them, though, because they're paid for with life insurance and not health insurance. So why would the health insurance care?
The point of an insurance company is to limit access to healthcare. Once healthcare access has been cutoff to most people, they then charge for access to healthcare. They are purely middlemen. The reason healthcare is so expensive is because insurance corporations collude with hospitals to set prices, and have successfully lobbied the government to make it illegalfor the government to negotiate prices when it buys healthcare as well. Ensuring there will be no effectove market forces in favor of the consumer (you and me)
As someone who just had a prior authorization denied for routine treatment for migraines being “investigational” in pretty sure the mystery grab back is exactly what happens
I get migraines as well, and they make me COMPLETELY nonfunctional. The Healthcare system in this country is SO fucked up. Healthcare isn't even about patient care, it's about what your insurance company will cover and what you can afford. It's so fucked up, it truly makes me really sad.....there are tens of thousands of people (maybe more) that can't afford a medication they need! One example of many is insulin. The insurance company either doesn't cover it or they do cover it and the patient can't afford the co pay.
I've actually never gotten a clear reason for why my insurance no longer covers my _ostomy supplies._ They just stick to "We only cover durable medical supplies, and those are non-durable.". Well yes, I am aware that they are non-durable, because that means that they need replaced/changed every few days, which means that, unlike durable supplies, I need to buy them every month or so. The wafers are $65 for _10 OF THEM,_ plus $60 more for 30 bags. And we're talking about the medical necessary supplies that literally cover the part of my _freaking intestine_ that is outside of my goddamn body. It's not like I can just put a fucking sock over it
Okay, well I just checked Amazon now to double check the prices I wrote and apparently the wafers have gone up in price, and now it's _$75_ instead, so it's gone up $10 since I bought them last. I can't fucking afford that, this is just _so wrong_ -_-
This is just so messed up. You obviously have a permanent medical condition. If they question it you could send them a g-- damn picture. Maybe the supplies aren't durable but the ostomy sure is.
@@pmc2999 Right? Seems pretty straightforward that if you put inside body parts on the outside, they need to be covered. I'd like to find out when the next board meeting is for the insurance big-wigs so that I can just show up completely bagless and freak everybody out enough that they realize how insane it is to not cover medical supplies like that. I just had to buy the paste for it earlier tonight and that's even gone up to $20 for a 4oz tube. The other day I got a quote from a dentist for _$40,000_ to fix my teeth that my health problems destroyed. Insurance only covers the actual pulling of the teeth really because now they mostly cover "preventative dental". It's just getting way too expensive to be disabled nowadays and it's awful how many people get screwed over every single day, so many so much worse than anything I deal with too
So glad we live in Wisconsin, where my medically complex daughter got state insurance that pays 100% of her medical expenses (and there are programs that pay for equipment that insurance doesn't cover). We would have been financially ruined by the time she was a week old otherwise, and she would be getting poor care for life. Good care doesn't have to be expensive. A handful of execs with dollar signs in their eyes have made it that way.
I'm on state insurance in WI as well. I even got a good co-op HMO that covered my addiction treatment and continues to cover all my mental healthcare in addition to physical stuff. Back when I was a child/dependent on my parents, the only insurance I could get charged my family over $2k a month due to my pre-existing conditions. No exaggeration.
@@jfm14 I am also on state insurance in Wisconsin. It pays for my addiction treatment as well. I wouldn't be in treatment without it as it would cost over 500$ per month.
Are you all referring to Badgercare? Yeah it’s good but you have to stay poor enough to have it which in turns makes paying bills super hard and not being able to save at all or have any money spent on a hobby for example.
I got to say, I like how most doctors really hate health insurance and most doctors I worked with in the Navy were very pro nationalized Healthcare, or a combination system like the English have.
People like to blame doctors and hospitals as being the greedy bastards, while we all know the real villains are the insurance companies. The first HMO started the slide. It’s akin to having a Car Maintenance Organization. They could deny transmission flushes, brake pads, even new tires. Mechanics would have to haggle with the middleman (CMO) to get paid, and prices would go up. No more 10 min oil changes for you! That’s what happened to healthcare in America.
I laughed, as I agreed this is how it's done. I sometimes ask why I pay renters insurance, hopefully I'll never use it. I've been doing it 35 years,,,,,the insurance rejoices!!! Health insurance,,,my personal nightmare. At this point I'm a liability no longer an asset. It's a matter of time,,,, will I live or die based on a denial or approval? A dear friend died waiting for a heart device. It was approved ,,, the day after.
I have literally been told this in a pharmaceutical call center that pushes ED pills. "If it helps, just think of our patients as bags of money." - Trained Medical Professional to us call center reps whenever we were pushing back on new policies that would do nothing but price gouge for the CEO that already took out $500k in PPP loans that got forgiven without repayment. /rant sorry.
That is so wild. I don't know what makes me angrier, them literally telling you think of people as bags of money or the fact that the CEO got his loans forgiven when so many people are struggling with crippling debt.
I.... 😳 So in my country (Netherlands) a lot of public spaces have AED's. I guess people, organisations or cities buy them out of pocket but when the AED gets used they can claim the costs of servicing the machine from a government fund. The goal is to get nationwide coverage of AED's so there's always one available within 500 meters.
@@powers1217 The USA is requiring them in all assembly occupancies, education buildings, healthcare, and some other instances by code now (since 2018 code, but not necessarily adopted in your state) for new builds and renos of specific scale... TLDR we'll get there eventually but it's slow.
I've been browsing open positions in my field and some at United Healthcare have come up. I have not applied thanks to these videos. I can't be a part of that. Nope.
As someone who works in a health insurance facility.. I get so aggravated on behalf of providers who are just trying to get help for their patients. I keep saying if they need it just approve it dang.
As a European I'm speachless everytime I see those skits. Holly sh*t how aren't y'all revolting for this!!?? I know european countries don't have the best healthcare out there but at least we get care when we need it, and without having to go bankrupt!
Most European countries have a way higher tax rates than the US. So you are forced to pay a lot for everyone's healthcare whether you personally need it or not. We just haven't moved as far into socialism as you have. And I for one, hope we don't. As the saying goes, "A government that is powerful enough to give you everything you want is powerful enough to take everything you have."
Don't forget, not only are you taxed for that healthcare, but the US is footing your defense bill. If European countries had to pay for the cost of what the US provides, you couldn't afford healthcare. I'm not attempting to be snarky....rather just bringing attention to something rarely talked about.
Because somehow a lot of people are convinced that paying absurd prices for healthcare is superior to having an increase in taxes. So instead of everyone paying a little more in taxes and getting Medicare for all, people would rather medically bankrupt themselves and their fellow citizens. It's the American attitude of f*ck you, I've got mine, and it's very sad.
As a pharmacy technician, an AHA BLS Instructor, and a patient this makes me want to cry. God bless you for shining a bright light on the problems our patients and some of us go through each day. PURE E•V•I•L. God help us all! 🇺🇸
My mom, an American citizen, tried to defend American insurance companies because "At least we don't have high taxes like those European countries and Canada." She lives in California and couldn't quit her job because she'll lose her insurance if she did so. SIGH...
I live in Australia and about a third of my wage goes to income taxes. I also did not have to pay a cent for my treatment after a stroke last year. Nor did I have to pay a cent with three pregnancies and deliveries. Or for my son's appendectomy, my other son's tonsillectomy, my sinus surgery, and on and on.
I’m so sad about the healthcare problems in the USA. US politics and governance is scary. As an outsider it looks like you have systems that fail large parts of the population but those people don’t get their problems solved by representation and democratic voting. Instead it’s just a war between the red team and the blue team and nothing ever gets fixed, and profiteering corporations like insurance companies carry on getting away with murder.
Living in Germany, self-employed and taxes / insurance stuff comes at around 40% of my income. Guess what - had surgery two years ago and the most expensive thing was the damn parking garage at the hospital for some pre-exam stuff. Took about 20 bucks those bastards! Those parking garages are robbery in bright daylight!
As an American, I would gladly pay more in taxes if it meant getting universal healthcare. Heck, I'd personally be saving money on that deal, to say nothing of everyone who can't afford it.
This reminds me of assisted living corporations. My grandpa was abused for 6 months and my mom asked the facility to check on all the other residents there, but they refused to do it. Since then, we've learned that they cut all kinds of corners. They told the CNAs not to feed people who were bedridden or in wheelchairs. The only food the memory care got was what was left over from the Assisted living because families don't believe memory care patients when they say they didn't eat. They never had staffing even halfway adequate. And the scariest thing is that they LOOKED like a nice facility. What about all the ones that are obviously terrible?
I got denied a new ADHD med which has much less of a chance for addiction and side-effects than Adderall. But nooooooooooo....Blue Cross would rather prescribe low-dose meth instead. 😑🤔
Alberta’s government has begun the slippery slope to privatization.. recently they made the decision to deinsure insulin pumps and there was public outcry. Perhaps I should post the flesh coloured bags of money on the premier’s social media page. Thanks for saying what we feel we can’t say!!
I had to see my OBGYN recently. Everything was fine, but when he inquired about why he couldn't do a full "well woman exam" to double-check my last Doctor's findings, I told him that my insurance wouldn't cover two full exams within a year. His mirthless chuckle and accompanying smirk was prime Doc Glauc stuff, lol.😂
The kicker is that his employer will only pay him more if he meets RVU goals based on routine items like your exam. So not only are you getting less healthcare than you should, your doctor is also getting fucked by not getting paid like he should
Isn't that the same as saying you won't pay him for that particular service because you don't think it's worthwhile? Nothing wrong with that, but let's at least admit that using insurance to pay for predictable events has perverted our sense of what is actually necessary. Why not ask your car insurance company to pay for gasoline, oil change, and tires?
"Preach it," my dear brother!!! Your words are way too true, unfortunately in healthcare. Money should never drive healthcare in any hospital or healthcare system. Besides being an R.N., I'm also a Pastor. I so often think about Christ's words when He told people how God will judge us. Matthew 25:44-45 has some heavy words for us as healthcare providers: “Then they will reply, ‘Lord, when did we ever see you hungry or thirsty or a stranger or naked or sick or in prison, and not help you?’ And he will answer, ‘I tell you the truth, when you refused to help the least of these my brothers and sisters, you were refusing to help me.’"
It’s sort of funny how he just convinced jimothy that it is necessary towards the end to have an AED by saying heart attacks and aneurysms going to Cabo… But then again it’s Friday
In less then a month i was dropped by both my eye doctor and my dentist because and i quote "it was too hard to get approval from my insurance company. "
Sadly, funerals are also not cheap (which is pretty evil too). Large corporations like SCI and Stewart Enterprises have bought up a ginormous percentage of the mom and pop type funeral homes, and they kept the local names so no one noticed. It’s suspiciously difficult to track various subsidiaries and holding companies to find out if your local funeral home is a more expensive, corporate, onion-layered monstrosity feeding off of grieving families. And most places realize that families only very rarely call different places to compare prices (uhhh because they’re grieving…), so they can do all kinds of crazy up charge shenanigans. There’s also the “third” rule that’s part of the corporate policies. Most families don’t go with the cheapest casket or the second cheapest casket, so they focus on price-gouging the third cheapest casket. Sounds pretty evil to me. This fun quick look at the corporate funeral industry was brought to you by my latest obsession: the Ask A Mortician channel. Lots of good info.
I have severe, intractable migraines. There are times the neurologist needs to put me in a hospital bed for IVs three days in a row before I can get relief. The insurance used to approve it the same day the authorization was requested, but this last time it took 11 days (7 business days and 4 bonus weekend days of pain) before they finally made the decision to deny it. The reason? They had no way of knowing if I still had a migraine after that many days. The neurologist’s office argued that they had been contacting insurance daily with requests marked URGENT due to how much pain I was in, so yes, they should know I still had a migraine. Ah, but was it the SAME migraine that entire time?? They had no way of knowing, so still denied. The nurse said the insurance companies have been doing this to many of their patients lately.
@@msscoutshadow After it was denied, the neurologist sent me to the Emergency Room because it wouldn’t fall under the denial and they wouldn’t have to get approval before treatment. The insurance wasn’t amused, but they had to pay it at 100% coverage since my doctor told me to go. It probably would have been cheaper for them to have paid for the initially requested out-patient IVs. This neurologist isn’t afraid to play hardball. lol
ER doctor here ! So sad how this is true. If you are healthy you are good. Sick they don’t like and May have to charge you more or denied your insurance. Incredible. How dare they do what they are suppose to do which is pay up when needed. Oh well ! Stay safe my friends !!!
Outside of the US it's the opposite problem. Doctors with prime hell realestate overprescribing treatments to get richer. Though it's still better. The cut that insurance providers take is less then the bad apple doctors and the one providing inadequate treatment is an actual medical professional.
Oh my god I feel this. I’m, um, “medically complicated”. Never in a million years did I think that the government (Medicare) would treat me more humanely than a PPO, but, here we are.
There was quite a scandal with my old insurance company many years ago, when it came to light that they denied 100% of initial claims because about 30% of the time people were so discouraged they either didn't appeal or didn't even realize they could to begin with.
I most recently got to "test" one of these AEDs on a stranger during a train ride and I might say, after I have only worked with "real" defibrillators in intensive care before, these AEDs work perfectly well and save direct Funeral costs for the family....
Prime real estate = the 8th level of Hell, the special place for health insurance CEOs. I don't know what happens there, but I suspect it's watching their gold get melted down and turned into streets for those they denied.
I am so enjoying all of these videos. I crack up over all of them, tears running down my checks from laughing so hard. Thing of it is, is that it is all so true!
Having been through 3 different insurance companies (a Medicaid administrator, and then two different employee plans because they've switched 3 times in the 3 years they've offered benefits) in the last 3 years with an insulin pump and various other things requiring prior auths... The reality of 0:20 is PAINFUL. Hours and hours on the phone with insurance and the doctors, and months of out of pocket expenses (that they won't reimburse once they finally approve it) every time. Let's not forget the "oh sorry that DME you already have isn't covered by us. You'll need to get another one. But we don't cover the intro sessions and kit that are required for the DME we do cover, so you can't even get that one." The "yeah but I'll be able to afford prime real estate" bit is great, too. The boss at the insurance company sure will. The employees... the ones who actually have the power to approve or deny these things... won't at all.
Either Jimothy's arc is going to be to save the world from insurance companies or to join them because he feels he can't change anything, so he might as well be evil to. I'd be happy with both outcomes
If it wouldn’t be too dark for his channel, I think Jimothy would ultimately end up committing suicide. But ultimately I think he’s going to live long enough to see himself become the villain.
Just had my left knee replaced one week ago. Between Aetna, Orthonet, CVS, AT&T and Xfinity, there’s little healing going on. Did I mention that my Ortho doc has not called either my PT or me in two day? Feeling low, thanks for listening!
Just a word of encouragement from someone who had both knees done - I hope you get good PT and keep on track - the eventual healing and mobility will be worth it - but it is indeed heavy surgery !
My mom dropped dead of cardiac arrest at 48 years old during the 15 minutes my dad was gone to run an errand for her. I’m going to be 47 this year and I tell the first responders at work that if I go down they get a chance to use the emergency defibrillators we have stashed on the walls. They don’t find it as funny as I do 🤷♀️
I’m absolutely sure that my insurance hates me! I have a very rare autoimmune disorder, that decided to bring cancer along for the party. Just one of my treatments is $650k a year. 😳. It’s sad what the hoops they make people jump through, just to get the live saving treatment needed. Oh and I was 35 when diagnosed with all of lovely conditions. 🤦🏼♀️🤦🏼♀️🤦🏼♀️
They say that they aren’t preventing from us doctors for prescribing it. You could still get it. Just you would have to pay the zillions of dollars rather than them.
@@erinbarnes8149 I was about to say the same thing with different wording. They technically don't decide what care you can and can't get, only what care they will and won't pay for. The fact that these are considered different in the eyes of the law is the evil part. Almost certainly the result of insurance lobbying too. Why rich corporations get to decide what the law says by throwing money at it, is also evil.
Well - everything in capitalism is a product you can buy and sell. Unfortunately this also goes for the rules governing fair play between participants.
My daughter has hydronephrosis and we have "good" healthcare still pay a ton after premiums due to hidden out of pocket costs...I can't imagine the financial ruin some families are in...
I have suffered two rounds of viral encephalitis the first time I had a picc line put in and 40,000.00 worth of medicine if the company that made the medicine didn't help me out I would have died because my insurance didn't cover any of this. I am disabled now because the second round of viral encephalitis was misdiagnosed with migraine for a year by the time they used the 5 dollar bottle of antiviral I already suffered brain damage and severe nerve damage. I love your skits! Do you have a scribe Jonathan in real life?
About 1000 people have pointed out that funerals are not cheap. Well they are to health insurance companies. In fact, they’re free! As cheap as it gets! That’s the joke!
Health insurance companies that are also in the life insurance business are doing it wrong.
Weeping as I watch the NHS in the UK be deliberately gutted into the ground in favour of the US system 😭
@@rahmed5701 I'm sorry.. good luck. US healthcare is a fucking nightmare. I know people stuck living below the federal poverty line because they can't live without healthcare and if they eke out a dollar too much, they will lose that healthcare. Remember, killing a tory isn't murder, it's self defense.
Exactly
@@rahmed5701 oh no, so sad to hear that.
Flesh covered bag of money here… I would like to file a complaint about my “flesh” to “bag of money” ratio.
Get in line. There’s a lot of claims waiting…
@@puddincakes1005 And EVERY. SINGLE. CLAIM. requires a handwritten manuscript outlining every little detail of it's medical necessity. Ya' know, for the prior auth...
Statistically significant. A bit in many a data set. Bag a bones.
Sorry ! (Not!!))
That line is busy
Please try back
In 10 to 20 business years
Or press the we are big business and
We give a damn
For anyone else
Button
@@isntthatsomething8928 And if it's looked over
(Hmmm 🤔 overlooked)
It's not by a medical professional
But a cost cutting
Bottom Line is bonuses for those who already are
Real financially COMFORTABLE
I'm a paramedic, during orientation we were taught to never put in our narrative what the patient is sitting in, just in case. Once someone wrote that the patient was sitting in a wheelchair and insurance denied to pay for the ambulance ride because she "could have just called a wheelchair van company," she had to be intubated during transport, wheelchair van companies don't do that. It took months of fighting to get insurance to accept it, so anyway, now we say "patient found in a sitting position."
That is horrible...
What the fresh hell
I feel so bad for healthcare professionals in the US who have to do things like this and make medical decisions based on what a patient can pay. It's dehumanizing. Not just to the patients but people like you. Insurance companies are trying to make you a cog in their profit machine.
As an EMT in the 80s who worked for Medicare as a day job, they have only changed incarcerations. As I have changed my own degrees and titles, I have kept that early “education” close, knowing full well through it all, evil rises to the top.
Is this your American dream. ? Dystopia more like.
My father, who's 81, said his tombstone should read " Still waiting for authorization!"... Lol... Sad but true
Grant his wish. And hope that in a future generation that is just understood as a terrible time during America's history.
Do it. Many photos will be taken over the years. Many grieving people visiting their own wronged loved ones will see it, and it will fill their bellies with fire.
I work in costumer service.
Tell him to ask for it to be escalated, the further up it goes, the more pressed to authorize they get, tell him to insist on him having call multiple times so a grievance may get submitted.
If your father died because Prior Authorization someday, grant your dad wishes, hopefully his grandchildren can learn about how horrible his life / healthcare system and can do something about it in the future.
Well he was 81, and there’s young, healthy people that are dying because they can’t afford their insulin.
Many years ago my mom was in mediation with her insurance. Their attorney had the gall to say, "Okay, worse case scenario, Mrs. S lives." He was serious. There was no moment of realization where he verbally stumbled and reworded his statement to make it less disgusting.
That's so genuinely disgusting. It's mind boggling to me how people can have so little empathy for other humans. Society puts serial killers on this pedestal of evilness, but then you have these people high up in these insurance companies that have absolutely caused more deaths than people like Bundy and Dahmer ever could - and they get paid TONS of money to do it too. I hope your mother was able to get through whatever she was dealing with and is doing better now!
I wish that attorney went to prison
@@beatrix1120 naive child, rich people don't go to jail. They only do after their attorneys have made them poor.
Evil pays well in the USA.
How… how is there no legal penalty for being this blatantly psychopathic?
"Healthcare is expensive"
Healthcare is only expensive BECAUSE of insurance companies
" claims denial mystery grab bag" i really think this is really what happens at insurance company. Lmao
This is a documentary
Seriously. I was denied for not trying 2 different medications.
Thing is, I had tried them. It was right there on page 2 out of 7.
The nurse circled the page in the copy she sent with the appeal.
We call it spinning the random claim denial wheel.
~ Nurse Practitioner and former owner/administrator of a medical practice
"Shouldn't we do things to help save people's lives?"
Who hired Jimothy in the insurance company? A used pen in the garbage?!
😂😂😂
Health Insurance company needs someone to provide authentic lip service about giving a shit while they quietly rake in the cash.
I feel he might be looking for a new job after this video...
Oh thank God we know that ophthamologists all work off of charity money for purely altruistic reasons and aren't rich at all *eyerolls*
The only unrealistic part of this is that Jimothy stays this long in claims; in real life he would be “reassigned” to the mail room by the first 10 sec of the clip
He'd be fired and file a lawsuit with an NDA settlement... Then release a tell-all book revealing nothing we don't already know because the rest was part of the NDA.
@@cameronno6039 he most likely signed an employment contract stating his employment could be terminated at any time for any reason.
Can’t sue for wrongful termination with that sort of clause in the contract
Plot twist: He stays for his own sub-par health insurance.
@@dr.floridamanphd except in cases of illegal discrimination or whistleblowing.
@@emiliabolsas sadly, probably.
He’s a victim, too.
Ironically, if insurance companies were to approve more people on a reasonable timeline/more often, theyd ultimately profit MORE in the long run for less effort. Reason being, by actually allowing people to access their insurance when they need it, they can, in the longrun, prevent more hospitalizations which will, on average, cost them a lot more money than just paying for medications, or medical devices etc. by just approving in the short term they stand to gain a lot more by having healthy people pay into the insurances and not actually using it. but when theyre only motivated by the short term profits, then theyll do whatever they can to hold onto it rather than thinking about a long term investment.
Please stop, you’re making too much sense
They’re just greedy and demonic. They want people to also suffer.
No one wants to profit in the long run, you sweet summer child. They booked Cabo for next month!
One flaw in your argument.
Most people have HMO insurance.
Health Maintenance Organization.
Know what a HMO will cover? Annual checkups and routine visits to your primary care physician. Maybe some generic medications.
Broken leg? Stroke? Diverticulitis flares up to the point you require hospitalization? Perforated colon requiring emergency surgery?
After coughing up thousands of dollars for the deductible, and most likely having to borrow from family to pay for it, you’re still gonna be on the hook for tens of thousands of dollars in hospital bills. That’s why medical emergencies are the number one reason for personal bankruptcies in this country.
The solution to that is a PPO or Preferred Provider Organization.
Will your premiums be a bit higher? Most likely but not to the extent they’re not affordable.
Will your deductible be higher? Not in my experience. My last PPO provider, as a single male, had a deductible of $150. I think family plans were around $600-700.
PPOs cover basically the same doctors, hospitals, clinics, etc. But your copays will be a lot lower, prescriptions a lot cheaper, and overall out of pocket costs for healthcare are much lower.
I was out with a heel spur 3 years ago that was nearly 4cm long. The only reason it didn’t puncture my Achilles’ tendon was because it was growing almost vertically.
Between the trip to urgent care ($100), X-ray, MRI, several appointments with my primary, multiple appointments with my podiatrist, and nearly 3 months of physical therapy, my out of pocket expenses were under $300.
All in I think my insurance paid a little over $3000.
But HMOs are a lot cheaper for employers so that’s why most people have it because they get their insurance through work.
And because heart attacks, strokes, and aneurysms aren’t part of maintaining health, treatments for them under HMOs are astronomically high.
@@dr.floridamanphd I have always had a PPO and grudgingly switched to an HMO this year because my employer selection system kept insisting it was a better plan for me. I should have listened to my gut instinct. I have been to the ER 3 times this year so far, continue to get mystery bills months later, I am enraged by the co-pays and my specialty medications, which somehow can only be filled for 30 days at a time, constantly cost me $50. Huge mistake. I am counting the days until re-enrollment this fall so I can go back.
Is that why the phrase “costs an arm and a leg” exists? Because there’s money in the arm and leg?
Lmao
Somebody call Ortho.
I suddenly understand why orthopedic procedures makes the hospital so much money...
Oh, someone didnt tell you that they sell your bones after you died?
Years ago, a friend of mine worked for an insurance company and said that their policy was to deny things that they knew they would eventually have to pay just to keep the money in the bank longer. He would have people calling him in tears because they were being sued and he still had to deny them - KNOWING THEY WOULD EVENTUALLY PAY. I have no doubt it is even worse now.
Given that this man has literally had a cardiac arrest, I think they should listen to him about getting some more AEDs... not everyone has a super wife to save their life!
Where I live the law is being changed to allow any enterprise to have it, and allow anyone with or without training to usem them without liability.
It's more harmful not to use when needed than use when not
@@rui518 you don’t need much training to use an AED. The machine tells you what to do so it’s not like you can do harm with it.
@@dr.floridamanphd and from what I’ve read the machine won’t even do anything unless it detects that the heart needs defibrillation. So you can’t shock someone who doesn’t need it.
@@Sashazur that’s true. The worst you can intentionally inflict on someone while using an AED properly is ripping out a guy’s chest hair with the sticky pads to get them in contact with the skin.
@@dr.floridamanphd I know, I had work injuries response training and we saw how to operate one, and perform basic life support.
One choice from the grab bag should be, “Approve claim today and deny it tomorrow because we changed our minds.”
I wish that were only a joke...that really happens
Kid you not, the post-video ad was for Blue Cross Blue Shield. Irony doesn’t get any better than that!
A friend of mine “lost” both hard contact lenses on top of her eyeballs just before going on stage for a theater performance. She did the first half of the show that way. Then the manager came on stage and literally said “Is there an ophthalmologist in the house?” There was. He went backstage and extracted them.
OW
And that is an intensive care opthalmologist!
**Happy Jonathan noises**
@@pilkoso Lies, Johnathan wouldn't make any noise. It's imperative in his line of work to be as non-threatening and accommodating as possible. **Brief affirmative nod**
Not all heroes wear capes!
I feel like I’ve been fighting insurance companies since my first positive pregnancy test. I’m so tired of 26 years of uphill battles with these idiots. I once knew a Canadian who complained about their healthcare system because people were always using it so it was difficult to get an appointment or a hospital bed where she lived. I told her it was easy here to get a hospital bed because we all stay home and die. It’s too expensive to live once you are sick.
And you can't get appoinments any quicker here anyway. Two-three months for a routine visit to my primary care physician, 4 to 6 for a specialist, even with a referral. And that's assuming you can find one who isn't at least a two-hour drive away.
Are you aware that they’re outright telling us to MAiD ourselves at this point?
Literally yesterday, I ordered a CT for a patient with acute abdomen (urgent care). United Healthcare denied the outpatient STAT CT order. Had to send him to the ER. This was about a 2 hr delay in care. His appendix perforated during the CT in the ER. Hate this for the patient, but now he will have an extended hospital stay for IV antibiotics. UHC shot themselves in the foot on this one!
"health care is expensive, but funerals are cheap" what a masterpiece of a line
From what I know, funerals ain't cheap either. It's expensive all round. Expensive living and Expensive dying, unless you get fed to the crows or something.
The fun part is that funerals are definitely not cheap 😭
A lot of funeral homes guilt trip and manipulate people in mourning into over paying for stuff. For example, saying that the body HAS to be embalmed even if they’re just getting cremated, making cremation out to be a worse option than burial, or upselling caskets by doing stuff like making the cheapest casket moderate to high priced because they know the family won’t question it, and will buy the next one up the price list. If you call around to different funeral homes, you’ll find that the casket prices are pretty much arbitrary and have no rhyme or reason. I’ve even heard stories of funeral home owners trying to make customers pay for extra shit right after the family member has died when the customer has arranged the funeral years in advance, and implying that they didn’t love the dead family member if they don’t pay. The idea is that they’re not thinking clearly because they’re sad, so they’re easy to manipulate.
Obviously that’s just the worst, most profit driven funeral homes though. Not all are like that. That’s why it’s so important to compare prices between funeral homes when you’re trying to arrange a funeral- the bad ones count on you not doing that.
@@saintofall3653 A funeral is a one time fee, treating elderly or sick patients is a recurring expense. So yeah, in the financial long term - funerals are cheaper.
@@saintofall3653, funerals are cheap for them, though, because they're paid for with life insurance and not health insurance. So why would the health insurance care?
@@saintofall3653 funerals are cheap, because they don't have to cover it. They don't care if your family has to pay for it, not their problem
These videos take very complex topics and makes it approachable to normal people as well as being hilarious for those in the medical field. Great job.
The point of an insurance company is to limit access to healthcare.
Once healthcare access has been cutoff to most people, they then charge for access to healthcare.
They are purely middlemen. The reason healthcare is so expensive is because insurance corporations collude with hospitals to set prices, and have successfully lobbied the government to make it illegalfor the government to negotiate prices when it buys healthcare as well. Ensuring there will be no effectove market forces in favor of the consumer (you and me)
When did you stop doing parody and just recreate actual conversations that insurance company executives have?
That's what satire should be. You don't laugh, because it's funny - you laugh, because otherwise you'd cry.
@@robertnett9793 it's a coping mechanism
It's why the opposite side of tragedy is called comedy
@@haruhisuzumiya6650 True.
As someone who just had a prior authorization denied for routine treatment for migraines being “investigational” in pretty sure the mystery grab back is exactly what happens
I get migraines as well, and they make me COMPLETELY nonfunctional. The Healthcare system in this country is SO fucked up. Healthcare isn't even about patient care, it's about what your insurance company will cover and what you can afford. It's so fucked up, it truly makes me really sad.....there are tens of thousands of people (maybe more) that can't afford a medication they need! One example of many is insulin. The insurance company either doesn't cover it or they do cover it and the patient can't afford the co pay.
I've actually never gotten a clear reason for why my insurance no longer covers my _ostomy supplies._ They just stick to "We only cover durable medical supplies, and those are non-durable.".
Well yes, I am aware that they are non-durable, because that means that they need replaced/changed every few days, which means that, unlike durable supplies, I need to buy them every month or so. The wafers are $65 for _10 OF THEM,_ plus $60 more for 30 bags. And we're talking about the medical necessary supplies that literally cover the part of my _freaking intestine_ that is outside of my goddamn body. It's not like I can just put a fucking sock over it
Okay, well I just checked Amazon now to double check the prices I wrote and apparently the wafers have gone up in price, and now it's _$75_ instead, so it's gone up $10 since I bought them last. I can't fucking afford that, this is just _so wrong_ -_-
This is just so messed up. You obviously have a permanent medical condition. If they question it you could send them a g-- damn picture. Maybe the supplies aren't durable but the ostomy sure is.
But... have you tried putting a sock over it?
@@pmc2999 Right? Seems pretty straightforward that if you put inside body parts on the outside, they need to be covered. I'd like to find out when the next board meeting is for the insurance big-wigs so that I can just show up completely bagless and freak everybody out enough that they realize how insane it is to not cover medical supplies like that. I just had to buy the paste for it earlier tonight and that's even gone up to $20 for a 4oz tube. The other day I got a quote from a dentist for _$40,000_ to fix my teeth that my health problems destroyed. Insurance only covers the actual pulling of the teeth really because now they mostly cover "preventative dental". It's just getting way too expensive to be disabled nowadays and it's awful how many people get screwed over every single day, so many so much worse than anything I deal with too
@@joko2882 You know, I actually hadn't considered that 😄 I could match it to my outfit lol
"I know I say this once a week, but that's pure evil."
Dr. Glaucomflecken should be our next HHS Secretary.
Sipping coffee…relaxing…and well you did it agin doc… I alternated between snorting my coffee and adding tears to the mug
So glad we live in Wisconsin, where my medically complex daughter got state insurance that pays 100% of her medical expenses (and there are programs that pay for equipment that insurance doesn't cover). We would have been financially ruined by the time she was a week old otherwise, and she would be getting poor care for life. Good care doesn't have to be expensive. A handful of execs with dollar signs in their eyes have made it that way.
I'm on state insurance in WI as well. I even got a good co-op HMO that covered my addiction treatment and continues to cover all my mental healthcare in addition to physical stuff.
Back when I was a child/dependent on my parents, the only insurance I could get charged my family over $2k a month due to my pre-existing conditions. No exaggeration.
@@jfm14 I am also on state insurance in Wisconsin. It pays for my addiction treatment as well. I wouldn't be in treatment without it as it would cost over 500$ per month.
Are you all referring to Badgercare? Yeah it’s good but you have to stay poor enough to have it which in turns makes paying bills super hard and not being able to save at all or have any money spent on a hobby for example.
The expression with “I’m sorry, what?” absolutely made my morning 😂
I scremed.
I got to say, I like how most doctors really hate health insurance and most doctors I worked with in the Navy were very pro nationalized Healthcare, or a combination system like the English have.
The NHS is th quintessential nationalised healthcare system, it is not a combination. Germany is a better example of that.
@@ShawFujikawa you can get privatized insurance in Englabd that's all I know. So maybe the Germans are better at that combination, I'm not sure.
People like to blame doctors and hospitals as being the greedy bastards, while we all know the real villains are the insurance companies. The first HMO started the slide. It’s akin to having a Car Maintenance Organization. They could deny transmission flushes, brake pads, even new tires. Mechanics would have to haggle with the middleman (CMO) to get paid, and prices would go up. No more 10 min oil changes for you! That’s what happened to healthcare in America.
I laughed, as I agreed this is how it's done. I sometimes ask why I pay renters insurance, hopefully I'll never use it. I've been doing it 35 years,,,,,the insurance rejoices!!! Health insurance,,,my personal nightmare. At this point I'm a liability no longer an asset. It's a matter of time,,,, will I live or die based on a denial or approval? A dear friend died waiting for a heart device. It was approved ,,, the day after.
Oh geez, so sorry to hear that 😞
I have literally been told this in a pharmaceutical call center that pushes ED pills. "If it helps, just think of our patients as bags of money." - Trained Medical Professional to us call center reps whenever we were pushing back on new policies that would do nothing but price gouge for the CEO that already took out $500k in PPP loans that got forgiven without repayment.
/rant sorry.
E for erectile or eating?
@@cozying_up erectile dysfunction
That is so wild. I don't know what makes me angrier, them literally telling you think of people as bags of money or the fact that the CEO got his loans forgiven when so many people are struggling with crippling debt.
I.... 😳 So in my country (Netherlands) a lot of public spaces have AED's. I guess people, organisations or cities buy them out of pocket but when the AED gets used they can claim the costs of servicing the machine from a government fund. The goal is to get nationwide coverage of AED's so there's always one available within 500 meters.
500 m? You guys have windmills that produce money or something?
@@jaxkal9596 The range is based on effectiveness. I'm guessing the government funding is coming out of our taxes.
That’s because your country is proactive, which is smart. The USA always has (wants) to wait until there’s a crisis of some sort before acting.
@@powers1217 The USA is requiring them in all assembly occupancies, education buildings, healthcare, and some other instances by code now (since 2018 code, but not necessarily adopted in your state) for new builds and renos of specific scale... TLDR we'll get there eventually but it's slow.
@@jaxkal9596 no but they also dont have the worlds highest military spending
Welcome to another episode of healthcare being a horror show
American Horror Story: Healthcare
No. That's not horror. That's just plain and simple criminal behaviour.
I've been browsing open positions in my field and some at United Healthcare have come up. I have not applied thanks to these videos. I can't be a part of that. Nope.
As someone who works in a health insurance facility.. I get so aggravated on behalf of providers who are just trying to get help for their patients. I keep saying if they need it just approve it dang.
You make a comedy out of this tragedy. Either you’ll expire waiting on insurance approval through the mail or from being on hold for for ever!!
You are fighting for all of us, and we see you. My love, gratitude, and respect are immense. One love, my brother.
As a European I'm speachless everytime I see those skits.
Holly sh*t how aren't y'all revolting for this!!?? I know european countries don't have the best healthcare out there but at least we get care when we need it, and without having to go bankrupt!
Most European countries have a way higher tax rates than the US. So you are forced to pay a lot for everyone's healthcare whether you personally need it or not. We just haven't moved as far into socialism as you have. And I for one, hope we don't. As the saying goes, "A government that is powerful enough to give you everything you want is powerful enough to take everything you have."
That’s what the insurance companies always brainwash us with: you rather pay us premium than the government tax!
Don't forget, not only are you taxed for that healthcare, but the US is footing your defense bill. If European countries had to pay for the cost of what the US provides, you couldn't afford healthcare. I'm not attempting to be snarky....rather just bringing attention to something rarely talked about.
Because somehow a lot of people are convinced that paying absurd prices for healthcare is superior to having an increase in taxes. So instead of everyone paying a little more in taxes and getting Medicare for all, people would rather medically bankrupt themselves and their fellow citizens. It's the American attitude of f*ck you, I've got mine, and it's very sad.
@@thirdactwarrior317 "socialism is when the government does thing" ok boomer
God bless you, Dr. G. I wish every politician in America would watch this video.
Jimothy and Tristopher are humanity’s last hope
I love it! Way to go Dr. Glauc raising awareness about the issues. I am so glad your super wife saved your life.
TY for what you do. I have no confidence we will see a positive change in our lifetimes, but you are fighting the good fight.
As a pharmacy technician, an AHA BLS Instructor, and a patient this makes me want to cry. God bless you for shining a bright light on the problems our patients and some of us go through each day.
PURE E•V•I•L. God help us all! 🇺🇸
I work Denials EVERYDAY and i SWEAR this is really happening……..😭🤷🏼♀️…😂😂😂
I'm just saying that gasoline isn't cheap but kerosene is probably still inexpensive. Not sure why I felt the need to bring that up.
like a concentration camp guard
😬
How do you sleep at night? I would kill myself.
My mom, an American citizen, tried to defend American insurance companies because "At least we don't have high taxes like those European countries and Canada."
She lives in California and couldn't quit her job because she'll lose her insurance if she did so. SIGH...
I live in Australia and about a third of my wage goes to income taxes. I also did not have to pay a cent for my treatment after a stroke last year. Nor did I have to pay a cent with three pregnancies and deliveries. Or for my son's appendectomy, my other son's tonsillectomy, my sinus surgery, and on and on.
I’m so sad about the healthcare problems in the USA.
US politics and governance is scary. As an outsider it looks like you have systems that fail large parts of the population but those people don’t get their problems solved by representation and democratic voting. Instead it’s just a war between the red team and the blue team and nothing ever gets fixed, and profiteering corporations like insurance companies carry on getting away with murder.
Living in Germany, self-employed and taxes / insurance stuff comes at around 40% of my income.
Guess what - had surgery two years ago and the most expensive thing was the damn parking garage at the hospital for some pre-exam stuff. Took about 20 bucks those bastards! Those parking garages are robbery in bright daylight!
As an American, I would gladly pay more in taxes if it meant getting universal healthcare. Heck, I'd personally be saving money on that deal, to say nothing of everyone who can't afford it.
@@scrumptious9673 Thats how you maintain the status quo. Let people fight over pointless stuff and collect money behind the scene .
Ah I just witnessed Jimothy's soul giving up hope. It was funny, but brutal. Well done.
So much truth in that lol...I bet they have a room right next to Hospital Administrators/upper management down there.
This reminds me of assisted living corporations. My grandpa was abused for 6 months and my mom asked the facility to check on all the other residents there, but they refused to do it. Since then, we've learned that they cut all kinds of corners. They told the CNAs not to feed people who were bedridden or in wheelchairs. The only food the memory care got was what was left over from the Assisted living because families don't believe memory care patients when they say they didn't eat. They never had staffing even halfway adequate. And the scariest thing is that they LOOKED like a nice facility. What about all the ones that are obviously terrible?
And all along I thought only lawyers go straight to hell...
Thank you, Timothy for being on our side- the " flesh money bags".
I got denied a new ADHD med which has much less of a chance for addiction and side-effects than Adderall. But nooooooooooo....Blue Cross would rather prescribe low-dose meth instead. 😑🤔
Alberta’s government has begun the slippery slope to privatization.. recently they made the decision to deinsure insulin pumps and there was public outcry. Perhaps I should post the flesh coloured bags of money on the premier’s social media page. Thanks for saying what we feel we can’t say!!
This plays like an insurance company documentary.
I had to see my OBGYN recently. Everything was fine, but when he inquired about why he couldn't do a full "well woman exam" to double-check my last Doctor's findings, I told him that my insurance wouldn't cover two full exams within a year. His mirthless chuckle and accompanying smirk was prime Doc Glauc stuff, lol.😂
The kicker is that his employer will only pay him more if he meets RVU goals based on routine items like your exam. So not only are you getting less healthcare than you should, your doctor is also getting fucked by not getting paid like he should
Isn't that the same as saying you won't pay him for that particular service because you don't think it's worthwhile? Nothing wrong with that, but let's at least admit that using insurance to pay for predictable events has perverted our sense of what is actually necessary.
Why not ask your car insurance company to pay for gasoline, oil change, and tires?
@@andefiance I found the insurance adjuster!
@@akijade27 MD
@@xZOOMARx
Idk what "RFU goals" means bc I watch this channel for the comedy. Please, feel free to explain!😃
Thank you for posting these videos. As an optimist, I believe they will change the world
"Preach it," my dear brother!!! Your words are way too true, unfortunately in healthcare. Money should never drive healthcare in any hospital or healthcare system. Besides being an R.N., I'm also a Pastor. I so often think about Christ's words when He told people how God will judge us. Matthew 25:44-45 has some heavy words for us as healthcare providers: “Then they will reply, ‘Lord, when did we ever see you hungry or thirsty or a stranger or naked or sick or in prison, and not help you?’ And he will answer, ‘I tell you the truth, when you refused to help the least of these my brothers and sisters, you were refusing to help me.’"
OMG!! I never dreamed that this is how insurance companies worked! Thank you for keeping us informed.
I'm glad to be introduced to the denial grab bag. It clears some things up for me. I was denied because "headaches don't sound serious."
I love seeing a doctor trolling insurance companies.
It’s sort of funny how he just convinced jimothy that it is necessary towards the end to have an AED by saying heart attacks and aneurysms going to Cabo…
But then again it’s Friday
In less then a month i was dropped by both my eye doctor and my dentist because and i quote "it was too hard to get approval from my insurance company. "
This is such shock humor lol I was smiling and laughed but I was just stunned at what he said!
Sadly, funerals are also not cheap (which is pretty evil too).
Large corporations like SCI and Stewart Enterprises have bought up a ginormous percentage of the mom and pop type funeral homes, and they kept the local names so no one noticed.
It’s suspiciously difficult to track various subsidiaries and holding companies to find out if your local funeral home is a more expensive, corporate, onion-layered monstrosity feeding off of grieving families.
And most places realize that families only very rarely call different places to compare prices (uhhh because they’re grieving…), so they can do all kinds of crazy up charge shenanigans.
There’s also the “third” rule that’s part of the corporate policies. Most families don’t go with the cheapest casket or the second cheapest casket, so they focus on price-gouging the third cheapest casket. Sounds pretty evil to me.
This fun quick look at the corporate funeral industry was brought to you by my latest obsession: the Ask A Mortician channel. Lots of good info.
The joke was that health insurance doesn't cover funerals
I’m not haha-ing this one. I’m actually crying over it.
I really help you are doing well after your unexpected cardiac arrest Doc!
Snickering out loud at this one! So many truisms lobed with just the right amount of sarcasm.
I have severe, intractable migraines. There are times the neurologist needs to put me in a hospital bed for IVs three days in a row before I can get relief. The insurance used to approve it the same day the authorization was requested, but this last time it took 11 days (7 business days and 4 bonus weekend days of pain) before they finally made the decision to deny it. The reason? They had no way of knowing if I still had a migraine after that many days. The neurologist’s office argued that they had been contacting insurance daily with requests marked URGENT due to how much pain I was in, so yes, they should know I still had a migraine. Ah, but was it the SAME migraine that entire time?? They had no way of knowing, so still denied. The nurse said the insurance companies have been doing this to many of their patients lately.
Despicable!!
@@msscoutshadow After it was denied, the neurologist sent me to the Emergency Room because it wouldn’t fall under the denial and they wouldn’t have to get approval before treatment. The insurance wasn’t amused, but they had to pay it at 100% coverage since my doctor told me to go. It probably would have been cheaper for them to have paid for the initially requested out-patient IVs. This neurologist isn’t afraid to play hardball. lol
I feel this bag definitely exists!
I work in "healthcare" for insurance and your videos are simply perfect.
I've had 44 surgeries for water on the brain and I always have to fight for much needed treatment. IT SUCKS!
Poor sweet Jimmothy... I hope he straight up connects his boss to gods wifi while actually approving the system by helping people.
"connects his boss to god's wifi" 😂 omd what a turn of phrase
The St. Jude ad after the skit really drove the message home
Chronically ill🙋♀️ and escaped multiple health insurance murder attempts
ER doctor here ! So sad how this is true. If you are healthy you are good. Sick they don’t like and May have to charge you more or denied your insurance. Incredible. How dare they do what they are suppose to do which is pay up when needed. Oh well ! Stay safe my friends !!!
Outside of the US it's the opposite problem. Doctors with prime hell realestate overprescribing treatments to get richer. Though it's still better. The cut that insurance providers take is less then the bad apple doctors and the one providing inadequate treatment is an actual medical professional.
“Stay safe” and hope you don’t need medical care…the American for-profit way 😖
Oh my god I feel this. I’m, um, “medically complicated”. Never in a million years did I think that the government (Medicare) would treat me more humanely than a PPO, but, here we are.
There was quite a scandal with my old insurance company many years ago, when it came to light that they denied 100% of initial claims because about 30% of the time people were so discouraged they either didn't appeal or didn't even realize they could to begin with.
I don't know how you managed to keep that evil face straight. I would've broken down... You're a truly great actor. 👏👏👏
I most recently got to "test" one of these AEDs on a stranger during a train ride and I might say, after I have only worked with "real" defibrillators in intensive care before, these AEDs work perfectly well and save direct Funeral costs for the family....
Haha.. Worked in a billing company for many years and "mystery bag of claim denials" sounds about right 🤣🤣
Prime real estate = the 8th level of Hell, the special place for health insurance CEOs. I don't know what happens there, but I suspect it's watching their gold get melted down and turned into streets for those they denied.
I feel like these are actual conversations being had at insurance companies all across the US. Sad and true!
I wish you have a life insurance company agent come in at the end and start a fight with the health insurance agent.
When I saw "flesh covered bags of money" in the description, I thought this was going to feature an urologist; this is worse.
I am so enjoying all of these videos. I crack up over all of them, tears running down my checks from laughing so hard. Thing of it is, is that it is all so true!
Having been through 3 different insurance companies (a Medicaid administrator, and then two different employee plans because they've switched 3 times in the 3 years they've offered benefits) in the last 3 years with an insulin pump and various other things requiring prior auths... The reality of 0:20 is PAINFUL. Hours and hours on the phone with insurance and the doctors, and months of out of pocket expenses (that they won't reimburse once they finally approve it) every time.
Let's not forget the "oh sorry that DME you already have isn't covered by us. You'll need to get another one. But we don't cover the intro sessions and kit that are required for the DME we do cover, so you can't even get that one."
The "yeah but I'll be able to afford prime real estate" bit is great, too. The boss at the insurance company sure will. The employees... the ones who actually have the power to approve or deny these things... won't at all.
So true. I’m lucky that I live in Canada
Same thing is happening here in Canada with any insurance company.
Don’t go the USA way…be warned!
Either Jimothy's arc is going to be to save the world from insurance companies or to join them because he feels he can't change anything, so he might as well be evil to. I'd be happy with both outcomes
If it wouldn’t be too dark for his channel, I think Jimothy would ultimately end up committing suicide.
But ultimately I think he’s going to live long enough to see himself become the villain.
Then Jimmothy discovers he has to train the new hire, Billiam.
This is why in my office we outright say in training insurance companies are the enemy.
Amen, glad you’re speaking out
Just had my left knee replaced one week ago. Between Aetna, Orthonet, CVS, AT&T and Xfinity, there’s little healing going on. Did I mention that my Ortho doc has not called either my PT or me in two day? Feeling low, thanks for listening!
Just a word of encouragement from someone who had both knees done - I hope you get good PT and keep on track - the eventual healing and mobility will be worth it - but it is indeed heavy surgery !
Hang in there gf 👍😊💓🙌
@@MsJENelson Many thanks!
@@msscoutshadow I appreciate it!!
My mom dropped dead of cardiac arrest at 48 years old during the 15 minutes my dad was gone to run an errand for her. I’m going to be 47 this year and I tell the first responders at work that if I go down they get a chance to use the emergency defibrillators we have stashed on the walls. They don’t find it as funny as I do 🤷♀️
I’m absolutely sure that my insurance hates me! I have a very rare autoimmune disorder, that decided to bring cancer along for the party. Just one of my treatments is $650k a year. 😳. It’s sad what the hoops they make people jump through, just to get the live saving treatment needed. Oh and I was 35 when diagnosed with all of lovely conditions. 🤦🏼♀️🤦🏼♀️🤦🏼♀️
I’d love for a “Health Insurance Provider Reacts” video to these…see if they have any valid counters to the point you beautifully put across!
The wifi on the beach in Cabo isn't good enough for RUclips.
Notice how it hasn't happened yet? There aren't any. XDDDSS
@@jcortese3300 that works too XD
@@jcortese3300 Cabo is where high school kids and 50 year old moms go to party.
These guys are in Tahiti, Bermuda, Jamaica, Philippines, etc.
They don't want to show their faces
In all seriousness, why don't insurance companies get sued for practicing medicine without a license?
They say that they aren’t preventing from us doctors for prescribing it. You could still get it. Just you would have to pay the zillions of dollars rather than them.
@@erinbarnes8149 I was about to say the same thing with different wording.
They technically don't decide what care you can and can't get, only what care they will and won't pay for.
The fact that these are considered different in the eyes of the law is the evil part. Almost certainly the result of insurance lobbying too.
Why rich corporations get to decide what the law says by throwing money at it, is also evil.
They should start fining them ten fold or more each case they deny completely unreasonably that they lose in court.
@@amazingkoolTRUTH
Well - everything in capitalism is a product you can buy and sell. Unfortunately this also goes for the rules governing fair play between participants.
This video gives context to the saying "A Pound of Flesh."
My daughter has hydronephrosis and we have "good" healthcare still pay a ton after premiums due to hidden out of pocket costs...I can't imagine the financial ruin some families are in...
Another great video from the doctor.
Surprised insurance companies haven’t come together to silence you 😂😂😂 I do appreciate you being honest with your opinion issuance industry
Was thinking the same thing
I have suffered two rounds of viral encephalitis the first time I had a picc line put in and 40,000.00 worth of medicine if the company that made the medicine didn't help me out I would have died because my insurance didn't cover any of this. I am disabled now because the second round of viral encephalitis was misdiagnosed with migraine for a year by the time they used the 5 dollar bottle of antiviral I already suffered brain damage and severe nerve damage. I love your skits! Do you have a scribe Jonathan in real life?
So so sad. I'm sending this video to my insurance company who are denying me yet again another diagnostic. I'm so over our health care system.
Thank you. And from a licensed doctor in the United States even!