The absolute JOKE that is American Health Care

[Grrr...]

I've posted a number of times about healthcare. I happen to be in a unique position - my sister is a Tech, my sister in law is a physical therapist, my wife is a nurse, her best friend is a nurse administrator. So, we know quite a bit about the system.

Nov, 2019, my wife was in a serious car accident. Her back had been broken previously, and while it was not rebroken, she was in a lot of pain.
October, 2021, the pain became debilitating. She entered physical therapy.
November 2021 her therapy ended. She had 31 appointments total.
June 2022 we were contacted and told it wasn't covered.

Today I got a call from my ATV insurance (4 wheelers) saying that someone was trying to make a claim against our Polaris ATV for healthcare. This instigated a flood of phone calls that ended up with us finding out some stunning information.

In July of 2021 the state of Michigan instituted guidlines saying you got 3 appointments, standard, for physical therapy. Then a bunch of guidelines needed to be met for the care to continue.

The physical therapy office continued scheduling appointments without verifying that they were covered.
They billed the auto-insurance company. The auto insurance company DID NOT DENY THE CLAIM until January of 22. Well after the appointments were complete. We were not notified.
The physical therapy office now claims we own over $14,000.
We did not find ANY of this information out until today. June, 2022.

The story of how Meemic (car insurance I've had for 30+ years), who had been purchased by AAA, told the physical therapy office to contact Progressive (ATV insurance I've had for 2 years) to bill it is whole different joke.

In short. Medical facility shedules dozens of appointments. Doesn't verify insurance coverage. Tells us we're good. Insurance company doesn't deny claim until a month after the 30 appointments are complete. We don't find out until 6 months later. Both parties claim they 'tried' to contact us. Which is bullshit, because they could have talked to my wife while she was still going, and I have personally had dozens of interactions with my insurance company insuring / uninsuring various vehicles.

In NO other industry would you receive services without knowing they were paid for.
In NO other industry would you not know all this until 6 months after.
In NO other industry would people continue to do work without being paid.
In NO other industry would they expect YOU to know how their systems work better than they do.

FUCK American health care.

 

[kent_island_sailor]

My local chiropractor told me I was covered by insurance for treatments. I had a weekly session going for a long time and then one day they told me they were wrong and I owed them several thousand dollars. I advised them they were committing fraud and if I ever heard one word from them about this I was calling the local prosecutor. I asked them *several times* about the billing and it was always "No Problem". It seemed an obvious scam to run up a big bill and then see what they could get

 

[Grrr...]

My local chiropractor told me I was covered by insurance for treatments. I had a weekly session going for a long time and then one day they told me they were wrong and I owed them several thousand dollars. I advised them they were committing fraud and if I ever heard one word from them about this I was calling the local prosecutor. I asked them *several times* about the billing and it was always "No Problem". It seemed an obvious scam to run up a big bill and then see what they could get

That sounds very much like what this physical therapy place is doing. My wife repeatedly asked if we were covered. I'd never heard of physical therapy going on that many appointments.

 

[Gouvernail]

Rich people get all the healthcare they want. Their system is working perfectly

 

[kent_island_sailor]

That sounds very much like what this physical therapy place is doing. My wife repeatedly asked if we were covered. I'd never heard of physical therapy going on that many appointments.

I never paid and never heard from them again.

 

[giegs]

So they bungled your coverage, tried to subrogate to another unrelated policy, and finally informed you once that fell through? Was there any attempt by them to wrap your medical carrier in on this?

I had similar happen with a worker who had to get helivaced back in 2019. Earlier this year the former employee contacted me asking wtf about a 30k bill for the chopper ride they got. The company had never bothered to try billing my company or processing through the WC claim.

 

[d'ranger]

There are I believe 33 countries considered 1st world. 32 have some form of universal healthcare. The USA is Exceptional. It's really that simple. At least everyone has plenty of guns. And the best government that money can buy. If you aren't wealthy then you suck and are lazy and stupid. That should about cover it.

 

[basketcase]

ya, socialized universal healthcare sucks. its way too expensive when you pay for it through your taxes. In Canada, I buy a six pack of Waterloo Dark tallboys and it costs me about $16cdn, but I get health care with it (and a really good beer). When I am at my house in Santa Fe, I can pick up a delicious 6 pack of Santa Fe Nut Brown in 12oz cans for an average of $10usd. No health care, but I do get Space Force. we all know Space Force is more important.
When you go through the math and conversions, the Canadian beer (and health care it pays for) is actually cheaper. But fuck me, who doesn't want Space Force.......

 

[basketcase]

There are I believe 33 countries considered 1st world. 32 have some form of universal healthcare. The USA is Exceptional. It's really that simple. At least everyone has plenty of guns. And the best government that money can buy. If you aren't wealthy then you suck and are lazy and stupid. That should about cover it.

is America, by the modern definition, still considered a first world country?

 

[Ishmael]

is America, by the modern definition, still considered a first world country?

If it still is, it's stepping on the Down escalator.

 

[giegs]

is America, by the modern definition, still considered a first world country?

Only if you deliberately exclude large swathes of the population.

The Navajo Nation for instance. Or Camden, NJ. Or Steubensville, OH, and so on.

 

[130lights]

I never paid and never heard from them again.

That sounds very much like what this physical therapy place is doing. My wife repeatedly asked if we were covered. I'd never heard of physical therapy going on that many appointments.

Was this PT a private clinic?

 

[Not for nothing]

I had a friend who need hip, or something replaced, she went to a doctor here in Florida, they want something like 80K + follow ups,
The doctor say he had practice in the capital of some Latin American country, so he few her down put her up in a great hotel, had a full time Associate, recoup on the beach all for around 10K. with as good or better job than in the US.
Had another friend heeded knee replaced in Fl. had go back 3 times to get it right wtf
It seems in Florida, if the doctors want a new car or vacation, they find something wrong to operate on???

 

[jerseyguy]

is America, by the modern definition, still considered a first world country?

Barely. And if the ‘22 and ‘24 elections go as predicted first world status and democracy will be gone

 

[Meat Wad]

There are I believe 33 countries considered 1st world. 32 have some form of universal healthcare. The USA is Exceptional. It's really that simple. At least everyone has plenty of guns. And the best government that money can buy. If you aren't wealthy then you suck and are lazy and stupid. That should about cover it.

Health Insurance is the problem, not health care.
Once a company is traded on the stock marked, the CEO and Board are responsible to the Stock Holders...........NOT the Customers or the Policy Holders.
This creates an inherent conflict of interest which congress should address. They wont do anything about it though, just like they wont fix the Tax code.
You are right about one thing We have the best Government money can buy, especially in Kalifornia where we are dying of thirst because the Govt wont do anything to deal with the water issues.

 

[Ishmael]

Health Insurance is the problem, not health care.
Once a company is traded on the stock marked, the CEO and Board are responsible to the Stock Holders...........NOT the Customers or the Policy Holders.
This creates an inherent conflict of interest which congress should address. They wont do anything about it though, just like they wont fix the Tax code.
You are right about one thing We have the best Government money can buy, especially in Kalifornia where we are dying of thirst because the Govt wont do anything to deal with the water issues.

What do you expect government to do about California water? Legislate the drought over?

 

[Olsonist]

..., especially in Kalifornia where we are dying of thirst because the Govt wont do anything to deal with the water issues.

That is stupid.

 

[Olsonist]

How are people's experience with traditional (A+B+D+G not C) Medicare?

 

[jerseyguy]

How are people's experience with traditional (A+B+D+G not C) Medicare?

No complaints about A&B

 

[d'ranger]

Health Insurance is the problem, not health care.
Once a company is traded on the stock marked, the CEO and Board are responsible to the Stock Holders...........NOT the Customers or the Policy Holders.
This creates an inherent conflict of interest which congress should address. They wont do anything about it though, just like they wont fix the Tax code.
You are right about one thing We have the best Government money can buy, especially in Kalifornia where we are dying of thirst because the Govt wont do anything to deal with the water issues.

You were doing so well until your last sentence - the water problems are due to climate change and no restrictions on development and water use. This was predicted many years ago and everyone just ignored it or passed the buck. I agree about the health insurance industry so lets add in the pharmaceutical one as well - it's free markets and fucked people. Thanks to St. Ronnie people believe government is the problem when it's unregulated capitalism which funds bad government.