Comments | syncopated_time: I Do Not Need This Today

syncopated_time

I Do Not Need This Today

Oct 22, 2009 10:19

So first rape is a pre-existing condition. Like most people I am speechless. I am outraged. But I am NOT surprised. Anything to save a buck, right guys? I think a lot of people are missing the point that insurance companies don't discriminate because they are -ist. They are only looking at the financial bottom line and how to save the most ( Read more... )

rage, health care, nursing, wtf

Comments 8

is_thisdesire October 22 2009, 15:11:28 UTC

I just read that article and wow, that's absolutely astounding. I'm totally sharing your rage on this one.

akina16 October 22 2009, 16:59:53 UTC

That is absolutely infuriating! That makes me wonder now if I'll be able to get coverage and I didn't even have a claim like that... I have been put in a hospital and have taken medication... Now that just makes me worry. I feel so horrible for those women!

gomer21xx October 23 2009, 01:21:33 UTC

Oh, and let's not forget those that call pregnancy a "pre-existing condition". I had a friend who lost her babies because she wasn't able to get the care she needed because her insurance company kept trying to get out of helping her when she needed it!

I raged for days after learning of that.

missashleyjean October 23 2009, 03:57:18 UTC

It's not just a fat prejudice. They'll refuse you for not weighing ENOUGH, even if you don't have any disorders and are otherwise perfectly healthy. (See the story about the little girl that was smaller than average children, weight-wise, and was denied coverage.) Depression also will count you out. Because nothing says "CHEER UP!" like being denied affordable (and I use that lightly) health care.

snow_kitty November 12 2009, 18:30:08 UTC

I'm just NOW catching up with LJ, but I'm really glad you posted that. I'm one of those providers who has to call insurance to make sure my clients have coverage. I'm especially familiar with Magellan.

You wouldn't believe some of the things they've said to deny benefits. Things like, "well, this patient's chronic suicidal thoughts is their baseline, so it's not medically necessary" or "their past bouts of cutting was only superficial, so that's not a risk factor."

It really sucks to be caught in the middle...and providers lose a lot of money in the process. Even if an insurance company denies continued coverage, we are ethically (and I would think, legally) obligated to continue treating them. Because, of course, WE would be responsible if that client were to actually act on those suicidal thoughts.

It's infuriating that managed care gets away with a huge profit, while both the providers and those under their care have to suffer.

syncopated_time November 12 2009, 19:43:15 UTC

Ugh, I know! They play so dirty at insurance companies. I don't know how people can morally justify working there. :(

We've become so complacent with just letting companies dictate their terms to us that all of a sudden we've lost all power to stand up for ourselves as consumers, it seems. And unbelievable bullshit like this is the result.

snow_kitty November 12 2009, 20:07:46 UTC

In order to become a "care manager" for behavioral health you need to have a master's or better in counseling/psych/etc. Many of them also require licensure.

There have been a few times where I asked about the reviewer's credentials and threatened to report them to their licensing board for an ethics violation. It usually scares them enough to give me extra time to stabilize them for outpatient.

Of course I would do anything in my power to help a client get adequate care, but it's sad that many of us need to resort to such tactics just to get them covered.

syncopated_time November 12 2009, 20:18:15 UTC

See, I didn't know that tidbit about Masters/licensure. It seems like having someone credentialed in that position would be helpful for the patient but instead it seems like one more weapon insurance companies can use to bully patients and providers. Though next time I have insurance and have to deal with the behavioral health folks I'm going to keep that in mind.

Unfortunately such scare tactics seem to be the only way to really get through to the big insurance companies (or at least the people that you work with inside of them). They have all the money and they have a million reasons not to give it to you, so if you want treatment your sort of at their mercy. For this I (used to) pay a premium? If I pay for a service I expect that service to work for me.

I have no illusions that a public healthcare option or this new healthcare bill is going to solve all the problems in the system but geeze louise it could hardly make it worse (I hope).