Re:Cigna Saves Millions by Having Its Doctors Reject Claims ...
by CaliforniaKarl on Saturday March 25, 2023 @08:15PM
(#35309071)
That's why it's better to have everyone covered under insurance, so that the risk pool is larger, and the cost to the individual is lower.
That's why it's important to spend money on research; to develop new technologies and techniques, and improve existing technologies and techniques; that can make cost of care lower.
That's why it's important to have standards of care and treatment, for all medical providers to follow.
Re:Cigna Saves Millions by Having Its Doctors Reject Claims ...
by LBJsPNS on Saturday March 25, 2023 @08:18PM
(#35309085)
Cry me a river when paying claims keeps insurers from turning a profit. They brought all the contempt heaped on them upon themselves.
Re:Cigna Saves Millions by Having Its Doctors Reject Claims ...
by 1123581321 on Saturday March 25, 2023 @10:34PM
(#35310146)
I get your example is hyperbole, but just for fun: the space flight would be recognized as an experimental treatment since it’s known not to be a routine/established procedure. Expenses would be covered if a legitimate clinical trial of space flights were being conducted. Otherwise, costs would be out of pocket unless a special approval were granted. If space flight were being seriously studied for an extremely rare disease, it would likely be paid for by the research institution.
Re:Cigna Saves Millions by Having Its Doctors Reject Claims ...
by kjs3 on Monday March 27, 2023 @11:39AM
(#35328098)
You aren't wrong, per se, but until the incitive for the insurance company stops being "maximize profit", they shouldn't be allowed to make decisions about how health care dollars are allocated.
If a patient breaks a leg and a doctor recommends not experiencing gravity for a while, do we fly them to space?
I am using hyperbole to demonstrate a point: there are meaningful economic limits that must be created by some entity and enforced.
What is the value of a human life? The GDP of a nation is a hard upper limit. The total money a particular person in question has access to is the lower limit.
If you run an insurance company (or you run government run healthcare) you can't avoid answering that question with an actual real dollar amount.
At some point spending money on a person with a particular condition does mean that someone else with a different condition can't have money spent on them.