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"And therefore, someone must decide what claims are reasonable."
Yes, that person is MY DOCTOR. There is no world in which it is reasonable that my health care team says I should have particular treatment, and insurance executives get to say no I don't. Sadly I understand this is not the case, and we value money more than human life, but I do not find that reasonable, no matter how common it might be.
I also understand that medical fraud happens, but I'm not sure the tradeoff to reducing it is worth the lives it's taking when we refuse claims.
> Do you think that there is some health care system in which all requests for care can be approved without limit?
I'm not going to wade into the murder tag, but is this the actual incentive? The health care execs don't have enough money to save everyone so they pick who they can help strategically, making sure to help as many as possible, or is the system incentivized to instead maximize finding who can be denied so that the company makes the most money?
Eichmann never directly murdered anybody either.
Shame? Where's the shame for these orphan crushing machine administrators? Just doing my job. Just following orders. Just designing and optimizing it
All of it is doing it both. The system is cracking and the ONLY REASON why its brought up is because 1 guy did a murder to an important guy. Otherwise business as usual.
Shame on society
If you think all denied claims are denied in good faith, I don't know what to do for you.
The insurers are hardly running up against hard resource limits, where there just isn't enough to go around and they have to triage. They are profit driven entities, and if they were legally allowed to deny all claims they would be required to do so by their shareholders.
No system is perfect, but patients shouldn't die to boost a stock price. And no patient should be required to fight for coverage at their most vulnerable.