'It's a death sentence': US health insurance system is failing, say doctors

[erronis]

https://www.theguardian.com/us-news/2025/jan/26/us-health-insurance-system-doctors

Firms including United Healthcare have denied basic scans and taken months to reconsider, physicians say

American doctors are accusing US health insurance giants of causing deadly delays to vital medical procedures and care – and putting profits ahead of their patients’ health.

Firms including United Healthcare have denied basic scans, and taken months to reconsider, according to physicians who spoke to the Guardian.

“There’s good evidence that these kinds of delays literally kill people,” said Dr Ed Weisbart, former chief medical officer for Express Scripts, one of the largest prescription benefits managers in the US. “For some people, this isn’t just an inconvenience and an annoyance and an aggravation.

“It’s a death sentence, and the only reason the insurance companies do that is to maximize their profits. The fact that they might be killing you is not in the equation of what they care about.”

...

One of many stories cited where the delay in getting approval for a PET scan came after six months, but the patient had died. United Health Doesn't Care.

[Irish_Dem]

1. The billionaires get rich overcharging for health insurance which does not deliver services.

This is called a scam.
One that kills people.

All totally legal.

[Lovie777]

2. Do the present administration care?...............

hell no.

[The Madcap]

7. It is called

Passive genocide.

[dickthegrouch]

32. It's called complicity in manslaughter

If a decent attorney is involved.

[The Madcap]

34. It seems to me like a coordinated effort

to do away with the poor, the unhealthy, the old, and the outsider...more deliberate than manslaughter in my eyes. I hope I'm wrong about that, but so far, that's what it looks like to me. Otherwise, they would be doing something to help and wouldn't be so danged secretive about why they are doing this.

[dickthegrouch]

35. I don't disagree but manslaughter is much easier to charge and convict than genocide /nt

[Skittles]

37. THEY PIMP FOR THE INSURANCE COMPANIES

THEY WANT ALL SENIORS ON "ADVANTAGE" SCAMS

[dutch777]

3. Medical schools are also part of the problem. Limiting the number of new docs produced raises costs/delays

One of the analyses during the pandemic was number of docs available and it was way behind many countries with better medical care outcomes on a per capita of patients basis. This has been a long standing issue where the AMA and others wanted to keep the "club" more exclusive to assure physician profitability back when single shingle docs were the rule not the exception. Now of course that profit goes to larger physician medical groups usually associated with hospital chains. While everyone says they are patient focused but really their metrics are about RVUs, which is basically how many patients can we jam into a doc's daily schedule to maximize $$$ not improve patient care.

[erronis]

5. Good additional analysis about hospitals, hospitalists, and RVUs.

[IbogaProject]

8. That has been an problem for 80 years now

The two big Dr associations haven't let the amount of medical school, internship and residency spaces grow much at all for 80 years while our country more than doubled in size. Yet another negative effect of not having a single payer health insurance system.

[LittleGirl]

9. If we can get free medical school

For students, this problem would disappear. Only rich students can go to Med school. And a 100k balance on student loans will keep potential students from ever considering going to med school. This is how it works in Western Europe.

[liberalgunwilltravel]

10. In most cases ...

The primary care givers are either Nurse Practitioners or physician assistants. In good hospitals, this has worked well and alleviated the pressure on physicians. But in many cases, it’s just a way to have fewer high paid physicians. Having been on the admissions committee of a top US medical school, and the Director of Admissions for one of the largest graduate programs in that school, what I have seen is that the selection process for years has been based on grades, standardized tests, boxes checked, and not on an applicant’s desire or real ability to do what they are being trained for. As Director of Admissions for the graduate program, I was able to change that such that we were selecting people based on real research experience and potential, rather than meaningless test scores. And the result of those changes was the average time to graduation decreased from almost 8 years to a little over 4 years. Unfortunately, similar changes have yet to be made in the selection process for most medical schools.

[RockCreek]

26. Many of the midlevels are horrible, many are wonderful

The lack of a true internship and residency for these folks makes the true outcome extremely variable.
I don't understand what you mean by going fro 8 years to 4 years for graduation in the graduate program you oversee. I could see it in a research PhD program

[liberalgunwilltravel]

33. I was talking about a PhD program

Sorry, I wasn’t clear on that. I was on the Med school admissions committee but I was the director of a PhD program admissions committee. Sorry for the confusion.

[RockCreek]

36. Which PhD programs produce practitioners?

Psychologists, of course, although many are phds but other doctoral level degrees.

[liberalgunwilltravel]

38. I'm not talking about practitioners

I am talking about training research scientists, not clinicians or clinical practitioners. I was just comparing one system that puts greatest emphasis on grades and test scores, rather than other more useful metrics.

[buzzycrumbhunger]

28. True

I did acute care transcription for years. During that time, I saw fewer and fewer docs in the ER until most had ONE on duty and interns, PAs, or ARPNs do most of the work and report back to the overworked guy in charge. I’m sure they figured why pay a veteran MD when you can utilize cheaper staff to do the same thing...

Slap dash healthcare by overworked, underprepared people—and those interns on a 48-hour shift were the worst! I had one Indian guy one night who kept falling asleep and starting over. A three-minute dictation turned into 45 minutes (we got paid pennies BY THE LINE transcribed, not the time it took!) and the patient kept coming into the ER, vitals were done, tests ordered, he was taken to the OR, he came into the ER, was taken to the OR, they lost vital signs and he expired, he came into the ER, tests were ordered, a code was called, he was taken to his room, family was called, he came into the ER…. on and on and on. It was infuriating.

The ER is the LAST place I want to go, especially at night or on the weekend, and NEVER at a teaching hospital! Scary shit.

[yardwork]

11. We have the same problem with the dental associations.

One way to increase access to healthcare, including dental care, is to allow dental hygienists to provide the care they're trained to provide. A lot of dentists don't want that. As a result, many communities have no access to affordable dental care. And removing fluoride from the water is going to make things worse.

[KPN]

14. More fillings for dentists!

[yardwork]

15. The sad thing is that a lot of children don't get those fillings.

I've seen images and information on the mouths of children that will make you cry. They're in constant pain from decaying, untreated teeth. It's one of the drivers of the opioid epidemic in rural areas.

Cities put fluoride in the water, but many rural children get water from wells. The disparity is striking. It's heartbreaking.

[KPN]

25. Yes, there's that too.

[sop]

4. Replace the word "care" with "profit": our healthprofit system, healthprofit insurance, United Health Profit, etc.

[BattleRow]

17. Or perhaps replace it with wealthcare.

[Joinfortmill]

6. Yup. Had my own battle. Doc won. It's gonna get worse.

[KPN]

12. Let me oversimplify, simplified capitalism kills.

[erronis]

18. Bane Capital - the root of evil

I know, Romney's company was Bain Capital - just a slight misspelling.

[Ilsa]

21. I used to spell it the same way. I don't

know why he gave it such an easily disparagible name.

[sop]

24. Yep, the increasingly unregulated, profits-over-people form of capitalism practiced in this country is deadly.

[BoRaGard]

13. "Ha ha. Suckers." - Republicon Insurance Execs (R)

[MontanaMama]

16. As someone who has been self insured

my whole adult life….DUH! I’ve always know this. Insurance corporations have one goal: To make as much money as possible for CEO’s and shareholders. There is no patient care in the mission statement.

[flashman13]

19. Just a note: By the time you need a PET scan they already know you have cancer.

The PET scan just tells them how bad it is and how far it has spread. Delay is your enemy.

[melm00se]

20. I know of one

doctor who worked for an insurance company.

Her license had been suspended for a series of failures so she could not practice medicine but she was perfectly fine to be able to review case files and determine if tests and procedures were medically necessary.

She was called "peer reviewer".

[homegirl]

22. Six weeks ago

I had an exam and ekg at my cardiologists office. I never saw the doctor, the exam was administered by a tech. First surprise was in the reception room. MY co pay has always been $15.00, it was $45.00. Last week I received a bill for $15.89, here's the breakdown:
TOTAL BILLED $487.00
INSURANCE ADJUSTED $332.06
INSURANCE PAID $94.00
TOTAL POST INSURANCE $60.89
CO PAY $60.89


*So, the copay of $45.00 I paid at the time has been increased by $15.89 for a total of out of pocket for me of $60.89.

PAST TIME FOR A CLASS ACTION CASE AGAINST THE HEALTH CARE INSURERS!!!

PS: My heart is in perfect condition!

[Evolve Dammit]

23. "We already have death panels. They're called insurance companies."

Alan Grayson, FL

[sakabatou]

27. No shit.

I mean, it's not like insurers have let people die because the needed treatment was too expensive even with insurance, or insurance wouldn't cover x-amount.

[valleyrogue]

29. Doctors inflicted a lot of that on themselves because of greed.

They loved, absolutely LOVED, fee for service. There was no real accountability back in the day, so they could charge whatever the "market will bear," and the insurance companies wouldn't question it. Then along came the HMOs and PPOs, which put a restraint on their greed, or, rather, shifted the greed onto the insurance companies.

The AMA was one of the original opponents of Medicare and that was because of GREED.

[erronis]

31. Back in my good-old-days, we paid the doctor directly. All transparent between patient and doctor.

Of course some patients couldn't pay as much (or bartered with chickens/eggs/labor/etc.). But the doctor was usually a long-term part of the community and didn't hide behind corporate practices with hidden owners and side hustles (labs, kickbacks)

[Clouds Passing]

30. It has been a death sentence for a looooong time