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[–] 191 points 1 year ago (1 child)

Well that's the worst headline I have read in a while

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  • [–] 56 points 1 year ago*

    The fact that there's shares to be had for denying care is crazy. They know denying care is their business! Meaning that the money they didn't spend on your care doesn't go back into the pot for everyone in your group, they are pocketing some of the money whenever they deny someone. That's it. They don't help anyone but themselves. There should be a requirement that insurance companies publicly announce how much money they made from denying care

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  • [–] 164 points 1 year ago (10 children)

    Literally and with no exaggeration, death panels. You know, the ones Republicans were yelling about a few years ago. Those exact fucking ones.

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  • [–] 55 points 1 year ago (2 children)

    Those same ones who screamed about fema prisons... At some point, we'll catch on that these conspiracy theories are actual plans...

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  • [–] 24 points 1 year ago (1 child)

    The question is: which came first? The conspiracy theory, or the plan? It could go either way with the party of family values.

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  • [–] 12 points 1 year ago*

    Ah, see, there's your problem: you're using a slight mistranslation. A common mistake. They were never the party of "Family Values". They're the party of "Family Valuations". They exist to find a way to put a number on every family, either "amount of money we can squeeze out of them" or "amount of money we can make by destroying them", and they get bonuses from their corpocratic upstream if they can manage both at the same time.

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  • [–] 19 points 1 year ago (3 children)

    Every accusation is a confession, right? That's how conservatives work. They're unimaginative people with poor empathy. They think about what they would do and assume that's what everyone else would do, too. They are trash. Failures. Disappointments.

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  • [–] 2 points 1 year ago (2 children)

    Failures in every way except for gaining power and wealth. A few of them anyway. The sad reality is that throughout history being ruthless always paid off to a large extent.

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  • [–] 2 points 1 year ago (1 child)

    Some of the leadership is getting a lot of wealth, true. The majority seem to be losing more. Loss of government programs (eg: Medicare). Return of preventable diseases (eg: measles). Pollution and climate change.

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    [–] 60 points 1 year ago
    [–] 56 points 1 year ago (1 child)

    AI companies going to start generating fake claims and denying them for rewards, I guarantee it.

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    [+] 95 points 1 year ago* (last edited 1 year ago) (6 children)
  • [–] 36 points 1 year ago* (last edited 1 year ago)

    The goal of the healthcare system should be to treat people.

    The goal of a good healthcare system is to treat people. The goal of ours is to treat the rich to another yacht. Healthcare providers bill far above cost for profit, knowing that either the insurance or the patient will have no choice but to eat the cost. Insurance providers use high healthcare costs to justify high policy prices and then do unethical shit to avoid paying out.

    The hospitals make money. The insurance company makes money. The shareholders and corporate owners make money. The people needing healthcare get screwed.

    The system is, unfortunately, working as intended for those who benefit from it being the way it is.

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  • [–] 2 points 1 year ago

    Rejecting claims does have some legitimate purposes.

    Invalid ID numbers, people aren’t actually a customer of the insurance company, unreadable data, and actual medical fraud to name a few.

    Denials should trigger a government review that the insurance company must justify to a neutral 3rd party that has a medical degree

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  • [+] -7 points 1 year ago (1 child)

    Cystic acne treatment is frequently covered by insurance and the same treatment is desirable to those that suffer from normal acne. Emotional support animals required doctors notes and were desirable for free admittance on planes. Ozempic as a weight loss drug. Topical steroid treatments for treating inflammation. Glasses to see better than 20/20.

    There are all kinds of medical treatments (relatively) healthy people would want if they were affordable and knew they existed.

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  • [–] 3 points 1 year ago*

    Perhaps so, but it should be up to a medical professional (doctor) whether or not those treatments are appropriate for the patient. Not for-profit companies run by sociopathic executives. (Although in this case we are talking about state-run Medicare using private companies’ AI to make the determination.)

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  • [–] 78 points 1 year ago (15 children)

    Well I'm sure it'll be all fair and definitely not
    DENIED
    DENIED
    DENIED
    DENIED
    DENIED CHACHING
    DENIED CHACHING
    CHACHING
    CHACHING
    CHACHING

    Oh no, that'll deffo not happen. No way!!!

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  • [–] 30 points 1 year ago (12 children)

    Going to be weird when they let Luigi Mangione out and the head of CMS immediately unalives.

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  • [–] 27 points 1 year ago (11 children)
  • [–] 13 points 1 year ago* (8 children)

    We can, but it's getting deeper than that. Algorithmic censorship is leading to changes in the real world English language.

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  • [–] 32 points 1 year ago (4 children)

    Is there a name for the next step beyond perverse incentives?

    Because that's where we are now.

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  • [–] 17 points 1 year ago (2 children)

    Kleptocracy. They just aren't bothering to hide the fact that they're selling off the government for parts anymore

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  • [–] 1 point 1 year ago (1 child)

    They are ethically clensing America

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  • [–] 3 points 1 year ago

    They're trying... But it's almost performative. I calmed down a lot when they complied with the orders to shut down alligator Auschwitz, now we've got ICE whining about how no one likes them, people aren't coming to their hearings to get picked up, and all that bullshit about denaturalization seems to have been dropped

    Don't get me wrong, it's still horrible, we need to fight it, and we need to disband ICE and have trials when this is all over... But it's not the defining aspect of this administration

    Those tents and cages in the Everglades cost hundreds of millions to set up, and probably a comparable amount to tear down. Money that was set aside for disaster recovery. The majority of that money went in someone's pocket

    And that's the real defining aspect of the administration. They're fascist enough to do fascism, but they're too busy looting the government for profit to commit to it

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  • [–] 32 points 1 year ago (4 children)

    Here's your head of Medicare.

    Good Ol' Doctor Oz.

    Big profile you should be able to track him down easy in the wee hours of the morning to ask some questions as any good citizen of someone representing their interests.

    https://www.hhs.gov/about/leadership/mehmet-oz.html

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  • [–] 31 points 1 year ago (3 children)

    I fucking hate the future, man.

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  • [–] 4 points 1 year ago (2 children)

    This is why I'm so thankful for mortality and chose not to have children. Please, universe, let reincarnation not be a thing.

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  • [–] 30 points 1 year ago (2 children)

    Officials assert that the AI tools will only be used to judge claims for about a dozen different types of procedures it deems to be wasteful and providing little benefit, including steroid shots to relieve pain, per the NYT.

    Yeah cause people on medicare aren't likely to need steroid shots for things like joint pain or anything. Anyone 65 and older should start saving their money now to pay for their steroid shots that are going to start costing them a couple hundred bucks a pop.

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  • [–] 3 points 1 year ago

    If payments out of pocket were reasonable maybe we are charged like a hundred times what everybody elsein the world pays.

    Investors like private equity have taken over Health Care and are extracting the life savings of baby boomers for medical care that used to cost a reasonable amount of money.

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  • [–] 28 points 1 year ago

    You don’t need AI for that….

    
    #!/usr/bin/env python3
    
    def main():
        try:
            _ = input("Enter reasoning for claim: ")  # read but ignore the input
            print("denied")                # always respond "denied"
        except (EOFError, KeyboardInterrupt):
            # Even if input is interrupted, still respond "denied"
            print("denied")
    
    if __name__ == "__main__":
        main()
    
    
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  • [–] 27 points 1 year ago (1 child)
  • [–] 27 points 1 year ago (2 children)

    So they will approve more claims to avoid paying, right... Right?

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  • [–] 26 points 1 year ago

    In the radio business they call that "payola", and it is very much illegal.

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  • [–] 25 points 1 year ago (3 children)

    So, reject everything and let appeals sort it out.

    We got you fam.

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  • [–] 24 points 1 year ago (1 child)

    So bribe the private sector to deny all claims routed through them first for government healthcare and then claim 'gUbmEnT dEAtH pANEls!' are the problem.

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  • [–] 22 points 1 year ago (2 children)

    something something video game character from a nintendo game who's colors are from mixing blue+yellow... 😏

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  • [–] 19 points 1 year ago (2 children)

    I've wondered this for a while: Insurance is a contractual obligation on the insurer's part, right? What's stopping me from just suing them for breach of contract rather than going through their appeals process if they illegally deny my claim?

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  • [–] 12 points 1 year ago* (last edited 1 year ago)

    What’s stopping me from just suing them for breach of contract rather than going through their appeals process if they illegally deny my claim?

    Medicaid is a government provision that has no contract that underpins it. With something like United Healthcare, there is a bargained for exchange of mutual consideration (you give $ and UHC provides insurance subject to all the terms and conditions in the contract).

    That is not something in Medicaid because Medicaid isn't getting anything in exchange for its health coverage. The government can put whatever restrictions on it that it wants. The benefit comes from the government having one more contribution to the ecconomic system. However, that is too attenuated of a benefit to say that there was a bargained-for exchange.

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  • [–] 18 points 1 year ago (3 children)

    If it makes anyone feel better, they denied everything when it was humans running the show too

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  • [–] 18 points 1 year ago

    Ah! Americans need to be willing to dig deep—really tough it out—to cut costs and save as much money as AI makes possible so that the government can give just 1 more penny to the billionaires. Won't someone please think of the billionaires?

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  • [–] 18 points 1 year ago (2 children)

    I guess "death panels" are fine if they are machines?

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  • [+] 17 points 1 year ago (1 child)
  • [–] 14 points 1 year ago (1 child)

    what the fuck kind of country looks to save billions of dollars spent on healthcare for their own citizens instead of waste fraud & abuse by the uber wealthy, or the military?

    you can have an insanely strong military without the waste & fraud that exists in the US

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  • [–] 14 points 1 year ago (2 children)

    It should be illegal for anyone but a doctor to deny a claim. This isn't even going to be AI, its just going to be a program that denies everything.

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  • [–] 13 points 1 year ago

    This is FUCKING enraging.

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  • [–] 12 points 1 year ago

    I didn't know I still had any faith to lose in the insurance industry. At this point anyone in a management position is undeniably evil, in all senses of the word. I wish nothing but the worst for them.

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  • [–] 11 points 1 year ago

    I’m so tired of living under capitalism. Can you all please get some fucking class consciousness so we can get out of this hellscape?

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  • [–] 11 points 1 year ago (1 child)

    That's a fucking idiotic idea.

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    [–] 10 points 1 year ago
    [–] 10 points 1 year ago (1 child)

    So what's the point of having insurance if you can't claim what you need?

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  • [–] 6 points 1 year ago

    The point is fraud. They give you just enough to think they will cover you when you really need it. And by then, they've already extracted the optimum amount they were gonna get from you.

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  • [–] 10 points 1 year ago

    Garbage humans in, garbage AI out

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  • [–] 8 points 1 year ago (1 child)

    The term 'perverse incentive' springs to mind, except there'll be nothing unexpected about the consequences.

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  • [–] 15 points 1 year ago

    What’s the fucking point of paying for it anymore? Might as well not even have it at this point…

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  • [–] 7 points 1 year ago

    Wasnt incentivising robots to kill humans supoosed to be prevented by those Azimov laws?

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  • [–] 5 points 1 year ago

    Fucking bots, they started disallowing us from browsing the web. Sure they'll be more careful with our lives.

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  • [–] 3 points 1 year ago

    Will it then be fined when it gets it wrong after manual review? Will the person be compensated too?

    Of course what they forget is other AI companies will game it on the other end to add new codes to claim that won't be denied.

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