Wednesday, December 18, 2024

United Healthcare Wants Feedback: No Prior Authorization Needed!


<What they don't say is important
than what they admit. Right?
Courtesy: Reckoner's inbox>

<i.>
Of all the oddities that wash up in my inbox, this image (above) ranks among the oddest
-- in light of what's happened, with the Brian Thompson shooting, and outpouring of support for his killer, Luigi Mangione. Judging by the latest twists in the case -- $94,000 raised on his behalf, and his enlistment of a high-powered attorney -- a plea bargain seems out of the question, presumably.

What all this uproar will actually produce, once the courts deal with the defendant, is anybody's guess. Any high-profile killing typically results in a major ramp up of the security state, one that already needs little excuse to impose itself in our lives -- making executive murder a less than ideal solution, for those seeking meaningful changes to our freeze-dried status quo.

Anyhow, United Healthcare (UHC) allegedly wants my feedback. They're even willing to give me a toothbrush for my time, though -- as someone whose sidelines include surveys for cash -- a little incentive payment might work a bit better.

Still, the wording and the timing are particularly unfortunate, since United hasn't exactly earned a reputation for generosity towards its (captive) customer base -- to put it most tactfully -- nor a particular willingness to go the last mile, in giving them what they need.

Quite the opposite, in fact. Media reports suggest that United denies claims at rates -- up to one-third, according to the Forbes link archive below -- that exceed the norm, even for its industry, leading to tensions with customers, hospitals, and physicians. 

At the same time, United ranks first among insurers, with an estimated market share of $215 million, fueled by the most expensive premiums nationwide ($631 per month). Are these developments related? United executives and PR flacks will likely deflect blame, or plead ignorance. As for me, I'll go with the word from my good TV friend, Saul Goodman: "I'm gonna out on a limb here, and say that it's been known to happen."


<A sampling of the response to the Thompson shooting:
https://www.downwithtyranny.com/>

<ii.>
Given how miserable the system is designed to make people, is it surprising that a high-profile CEO finally tastes the tip of a bullet? Not particularly. The real surprise is that it didn't happen long ago, since -- the Obama era's signature health law aside -- much of the reek underlying the whole rotten structure remains untouched.

Hence, the same endless arguments -- who should pay, how much, for what, and so on -- rage on, as freely as they ever dud. Decades of well-intentioned platitudes have barely made a dent in them. This includes the unfortunate Mr. Thompson, incidentally, who solemnly agreed, at an investors meeting: "Healthcare should be easier for people."

The bigger surprise is that -- amid the politicians, trotting out all their usual boilerplate condolences -- some people are still struggling to understand the depth of anger directed at the likes of Mr. Thompson, and the industry whose interests he served so loyally, and for so long. 

And just who was Mr. Thompson, exactly? So far, the handful of stories that have trickled out paint a mixed picture. Small town Iowa boy, fierce protectionist made good, yet one apparently riven by the stresses of life that plague the excessively advantaged. He had racked up an impaired driving conviction in 2017, for which he was placed on probation (naturally); he'd also bought a home in 2018, and had begun living apart from his wife, and two boys (predictably).

Such are the stresses of the overprivileged. Yet the handful of quotes I've seen attributed to him (
He understood that the public was frustrated with what they perceived the company’s actions to be") suggest someone who seemed less bothered about the inequities baked into the system, than the potential for public resentment to cramp his style -- and, that of his colleagues -- at the box office.

For all the angst attributed to him posthumously, Thompson had been dogged by accusations of insider trading, and United's practices had been the focus of negative reports by the Department of Health and Human Services, and the U.S.Senate. Whatever concerned Thompson privately -- and we only have his colleagues' word for that, frankly -- continued to happen publicly. As Saul Goodman would have say -- "It's been known to happen."

The graphic below is only a mild sampling of what I've seen, from deep diving the Internet; I'm sure you've seen plenty of your own examples, ranging from the merely black ("Prior authorization required, before thoughts and prayers"), to the truly scabrous, like this dark nugget, served up by "The Daily Show"'s Ronny Chieng: 

“But now, the cops just need to narrow down their list of suspects to anyone in America who hates their health-care plan and has access to guns. Should be solved in no time.”



<More popular rage, served sunny side down:
https://www.downwithtyranny.com/>

<iii.>
I, too, have experienced the frustration of "deny, depose, defend," only from a different direction -- when I took a job with a federal agency, only to discover that bills demanding full payment, typically in triple-digit sums, kept landing on my door mat. Almost $1,700, in fact, once I totaled them up -- eight claims, in all.

When I gently inquired as to why, I discovered that this particular agency chose to self-fund its particular insurance plan. Unfortunately, such plans aren't considered insurance, according to the Affordable Care Act, one of many "get out" clauses that the industry carved out for itself, as part of its eternal crusade to futureproof against the few reforms our political class seems willing to allow us.

This, despite a cover page phrased along these lines: "Want to better understand your healthcare program?" This, despite a dizzying two-page list of exclusions -- nearly three dozen of them, ranging from abortion and drug treatment, to dental, hospice and hospital care, physicals, skilled nursing care, transportation, and vision. All of which begs the obvious question, "Well, then, what do you cover, exactly?" Not much, apparently.

In the end, I wound up enlisting my state representative, plus the Attorney General, and state insurance office, to press the faux insurer for action, having heard nothing about my appeal. Eventually, they suggested that more documentation was needed to fully evaluate my case, though they did refund $247 on one claim, and reduced another from $475, to zero. 

So, in that sense, some justice has been done, though I have yet to hear what's happened with the other half dozen claims -- whether we're talking about the original appeal, or further complaints and follow-ups that I filed. There have been no other developments on that score, since last summer; maybe that's just as well.

My "Insurance Pie Fight" folder, as I've labeled it, is already a quarter-inch think; at this point, I'm not looking for anymore additions. Of course, as someone who remains uninsured, stress is likely to come from other directions. This week, I'll have to visit my doctor at the community health clinic -- for the fourth time, I believe -- for a viral infection that's taken its time to fade, since it first flared up in June.

I currently owe $100, which is a bargain, even on the sliding scale system that determines the amount. However, due to all the other unwelcome financial surprises I've weathered, I have yet to pay on it; last time around, the receptionist got fairly aggressive about the matter, to which I had to grit my teeth, and assure her, "I just sent a check out. I'm sure they haven't gotten it yet."

I doubt if the gatekeeper at the desk bought my excuse; I honestly didn't care either way. 
At a certain level, it's all a giant game of, "Don't ask, don't tell." All that's left is for both parties to play their roles, mouth the words they don't believe, and move on.

In other words, for those still wondering why so few are grieving Mr. Thompson's demise -- and the rage against the machine he represented is boiling and bubbling, at volcanic levels -- they might do well remember another well-worn saying: "Walk a mile in my shoes." And, while we're at it, this one: "There, but for the grace of God, go you and I."

Alas, Andrew Witty, the CEO who took the knocks publicly -- and to whom Thompson was grateful for the shield it afforded him, privately -- doesn't get the memo, as this quote from his recent New York Times op-ed piece suggests: "“Together with employers, governments and others who pay for care, we need to improve how we explain what insurance covers and how decisions are made."

In other words? Stay calm, folks. Nothing to see here. There's nothing wrong with the system that's driving a screw through the middle of your spinal column. It's just a matter of some technical adjustments, and all will be good again.

He's off to a flying start, eh? I don't think so. And neither, I suspect, will the millions whose anger remains set on boil, not stun.

Until we can somehow force the insurance industry and its enablers to start from this premise, as the first step toward seriously reforming the system -- instead of papering the cracks, or tinkering around the edges -- it's doubtful that the popular rage will cool off, any time soon. 

Oh, and just for the record? I'm giving the survey a miss. Besides, I already have two toothbrushes, and don't need anymore. --The Reckoner




Links To Go (Hurry, Hurry,
Before They Deny Your Claim -- Again):

Down With Tyranny: The Bizarre Media Treatment
Of The Mangione Case:

https://www.downwithtyranny.com/post/the-bizarre-media-treatment-of-the-mangione-case  
[Included for good song by Jesse Wells -- scroll to the end to hear it!]

Forbes: The Rage And Glee
That Followed A CEO's Killing Should Ring All Alarms:

https://archive.ph/DsVqZ

The Independent:
The Daily Show Divides Viewers...:

https://www.the-independent.com/arts-entertainment/tv/news/the-daily-show-united-healthcare-ceo-murder-b2660091.html

Yahoo News/Washington Post:
Before Shooting, Brian Thompson
Worried About UnitedHealth's Negative Image:

https://www.yahoo.com/news/shooting-brian-thompson-worried-unitedhealth-205448649.html?.tsrc=daily_mail&segment_id=DY_VTO_ADS_T1&ncid=crm_19908-1475736-20241216-0&bt_user_id=GcF%2B9E2au5JSjvHLHE7dhab%2F0Jf2USx61LWvC3r6Lgy6FwK7bGSUO8MbCi%2FEGzea&bt_ts=1734367256416

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