CEO Shot -a thread

Snowdoggie (Forum Supporter) said:. I later found out that the doctor had a sweethart deal to send all of his patents to the expensive place and was probably getting a kickback

 

That's a crime, at the least can result in loss of license.

In reply to Appleseed :

I think the point he is trying to get to is that healthcare insurance, is insurance, not healthcare.  As in, it's primary purpose is to smooth out risks (costs).  It is a generally sort of "misunderstanding" in the US, that healthcare insurance is the healthcare system, at least the way they approach it, and of course it's generally obligatory nature, though the way it's used can also make it confusing.

Insurance can only work if they charge the average person more than the average person will use (a lot more really). In this case it gets weird because it is in the interest of the insurance company to favor (reward) certain behaviors (e.g. not smoking, checkups etc), so it takes on a weird sort of caretaker roll, and I think that is where the confusing starts. The insurance company is "looking out for you" not because it truly cares (its not your parents) it's because healthier behavior means lower medical costs, for them.  Which is not unreasonable (admittedly, their commercials will never admit that of course!)

Boost_Crazy said:

In reply to Snowdoggie (Forum Supporter) :

 A few months ago Mrs. Snowdoggie needed an MRI and her doctor sent her to the most expensive place in town where they quoted her one price then after it was done, billed her another price that was twice as much. Then her insurance company paid only a part of it and the MRI place demanded she pay the rest or get her credit rating trashed and get sued for payment and so on. There is a cheap MRI place in town that advertises a low price and promises to take Medicare, all private insurance and even cash. I asked if I could drive here there next time and the admin at her doctor's office said that just isn't done. I later found out that the doctor had a sweethart deal to send all of his patents to the expensive place and was probably getting a kickback. The worst of it is that the amount she paid after the insurance paid a part was still more than the advertised total for the cheaper place.

 

You just gave a great example of why an insurance company should deny or short pay a claim. Your doctor and/or MRI provider ripped you off. You found that out for yourself, after you agreed to and used the service. Why is that the fault of the insurance? If you don't want to overpay for the same service, why do you expect that they should? I think you are pointing your finger at the wrong party. 
 

 

 

I didn't say that this particular incident is the fault of an insurance company. You are putting words in my mouth. I said the whole system is corrupt, and it is. If somebody gives you an estimate to fix your car for $200 and then hands you a bill for $1,000 without any explanation, that has more to do with what happened to her. She agreed to $200. Not $1,000. I told her to go to a different doctor but she won't. I looked at his bills and estimates and they are never anywhere near what he charges in the end. The insurance paid what what they wanted to and left the rest for her. It had nothing to do with a deductible. Medicare will do the same thing to a doctor and doctors hate that. I don't know why the insurance company did what they did. I guess they only pay so much for a procedure. That actually makes sense. They didn't really explain it. They paid what they thought was fair which was a different amount from both the estimate and the entire bill. The doctor didn't even want to negotiate with the insurance company. He went right to the patient who was more easily intimidated. 

Floating Doc (Forum Supporter) said:

Snowdoggie (Forum Supporter) said:. I later found out that the doctor had a sweethart deal to send all of his patents to the expensive place and was probably getting a kickback

 

That's a crime, at the least can result in loss of license.

Only if you can prove it. I suspect there were some kickbacks involved in what assisted living home the hospital wanted to send my mother to. They wanted to ship her off to a real hell hole and insisted there was a shortage of medicaid beds in town. I found several brand new facilities that were well run and also took medicaid and made arrangements with one of them. Even after that the nurses there argued with me and wanted me to send her to the first place. One of them actually wrote down the address of the first place on the chalkboard. I erased it and put the address where I wanted her to go. I then waited for the transport driver, gave him instructions and followed him in my car the entire way. 

Illegal? Probably. I just wanted my mother to be properly taken care of.

You know Blue Cross/Blue Shield used to be non-profit and some of it was actually run by the hospitals.

In reply to aircooled :

I agree to that. Boost can navigate the insane maze of insurance. How many cannot? How many don't realize there are appeals, other problems, etc..? He alluded to the many misconceptions in this thread. That should be an indicator as to how confusing insurance really is .

In reply to Appleseed :

In reply to aircooled :

I agree to that. Boost can navigate the insane maze of insurance. How many cannot? How many don't realize there are appeals, other problems, etc..? He alluded to the many misconceptions in this thread. That should be an indicator as to how confusing insurance really is .
 

It is confusing. And it's far from fair. And it can't be, because we don't want it fair, there is no mathematical way to make it fair and provide what we as a people expect. Plus everyone has their own definition of what fair means anyway. We are largely getting what we asked for, we just never bothered to understand what we were asking for. We want everyone to have healthcare. We want everyone to have the same level of care. We want people to have access to that care whether they can pay for it or not. The math says that those that are paying must pay more. That MRI that Snowdoggie was taking about? He wasn't just paying for his wife's MRI. He was subsidizing someone else's as well. They likely do X number of Medicare MRI's, which are capped in what they can charge, need to charge extra on the insurance MRI's. The cheaper place likely didn't do Medicare MRI's, and charges less even though the average is the same. None of that is reason to execute someone on the sidewalk. 
 

Aircooled explained it exactly. No, you don't get free healthcare, they will bill you. But they won't refuse care. You won't die. The problem is that for most people, they won't blink at a huge car payment because they get a shiny hunk of metal to show for it. All they get with healthcare is, you know, life. And people believe you shouldn't have to pay for that because they are entitled to it. I get that. But they fail to see that the care that they think they are entitled to must be provided for by others, and there are limits. And again, even the most convoluted reasoning should never lead to shooting someone dead because you don't like how the system works. 
 

In reply to Snowdoggie (Forum Supporter) :

I didn't say that this particular incident is the fault of an insurance company. You are putting words in my mouth. I said the whole system is corrupt, and it is. If somebody gives you an estimate to fix your car for $200 and then hands you a bill for $1,000 without any explanation, that has more to do with what happened to her. She agreed to $200. Not $1,000. I told her to go to a different doctor but she won't. I looked at his bills and estimates and they are never anywhere near what he charges in the end. The insurance paid what what they wanted to and left the rest for her. It had nothing to do with a deductible. Medicare will do the same thing to a doctor and doctors hate that. I don't know why the insurance company did what they did. I guess they only pay so much for a procedure. That actually makes sense. They didn't really explain it. They paid what they thought was fair which was a different amount from both the estimate and the entire bill. The doctor didn't even want to negotiate with the insurance company. He went right to the patient who was more easily intimidated. 
 

I'm sorry, what was point of your example then? I thought we were talking about the insurance industry screwing people over and whether or not that justified murdering their CEO's. You complain that your insurance didn't cover a procedure- because the provider was overcharging. Are we supposed to shoot the providers now too? That's not going to help the supply and demand situation long term. 

aircooled said:

In reply to Appleseed :

I think the point he is trying to get to is that healthcare insurance, is insurance, not healthcare.  As in, it's primary purpose is to smooth out risks (costs).  It is a generally sort of "misunderstanding" in the US, that healthcare insurance is the healthcare system, at least the way they approach it, and of course it's generally obligatory nature, though the way it's used can also make it confusing.

Yup. And a transmission doesn't propel your car down the road. It is effectively just an intermediate step in between the motor and the tires. It's just a part of the car, not the car itself.

But if your transmission is busted, your car is busted.

The total vehicle that is our healthcare system has a lot of problems that need to be fixed. But as much as the shocks are dead, the tires are worn out, and the engine seems to be down compression on one cylinder - it's that insurance industry transmission that grinds if you try to put it in gear and will pop loose if you try to accelerate that is arguably the biggest problem.

Boost_Crazy said:

In reply to Snowdoggie (Forum Supporter) :

I didn't say that this particular incident is the fault of an insurance company. You are putting words in my mouth. I said the whole system is corrupt, and it is. If somebody gives you an estimate to fix your car for $200 and then hands you a bill for $1,000 without any explanation, that has more to do with what happened to her. She agreed to $200. Not $1,000. I told her to go to a different doctor but she won't. I looked at his bills and estimates and they are never anywhere near what he charges in the end. The insurance paid what what they wanted to and left the rest for her. It had nothing to do with a deductible. Medicare will do the same thing to a doctor and doctors hate that. I don't know why the insurance company did what they did. I guess they only pay so much for a procedure. That actually makes sense. They didn't really explain it. They paid what they thought was fair which was a different amount from both the estimate and the entire bill. The doctor didn't even want to negotiate with the insurance company. He went right to the patient who was more easily intimidated. 
 

I'm sorry, what was point of your example then? I thought we were talking about the insurance industry screwing people over and whether or not that justified murdering their CEO's. You complain that your insurance didn't cover a procedure- because the provider was overcharging. Are we supposed to shoot the providers now too? That's not going to help the supply and demand situation long term. 

Again, you put words in my mouth. I wasn't complaining that an insurance company did not cover a procedure. They actually did pay for part of it. I was just showing an example of how corrupt the system is. Are you now accusing me of advocating the shooting of providers. That's kind of a wild accusation considering I haven't advocated the shooting of anybody. 

Quite honestly, after this and other interactions with you, I think you have a personal problem with me, even though we have never met. We could go around and around, but that would not be productive, and I really don't want to be a part of locking this thread. So I'm stepping out for a while. Keep trying to start a fight with me if you must, but I won't respond anymore, and maybe that will be enough to save this thread.

Have a nice day.

Captdownshift (Forum Supporter) said:

Physicians have the hypocritic oath.

That's politicians. Doctors take the Hippocratic Oath.

Sorry, couldn't resist.

The thing I've been wondering about this guy:  he's apparently pretty smart (valedictorian of his high school class, an advanced college degree) yet he's caught with the gun, fake ID and some sort of manifesto.  Apparently he's never read any crime novels, in them the first thing a criminal does is throw the gun in a river and destroy any incriminating documents.

Boost_Crazy said:

The CEO was murdered over money. So who thinks that is okay? And at what dollar amount is it okay to murder a person?

Time is money, and money is time. At what level is it OK to take years of someone's life to increase your pay package? At what point is it OK to take years off of millions of people's lives to increase your pay package? People who can not pay for medical care do not get that medical care. People who do not get urgent medical care get sicker and die. Refusing to pay for reasonable medical costs is not "just money." It's pain and, eventually, death.

My father died in 1969, at 56, from a heart attack.

I had a quadruple bypass in 2019, at 58.

Who cost the health care system more?  Who will continue to cost the health care system?

It is a real issue.  We can fix way more people now than we could before, which means basically, mo money, mo money, mo money.  It puts insurance companies, government agencies, or your own Visa card, in a difficult position. Solution, then...Doctors work for free?  We go back to 1969 levels of health care and  expensive jobs don't get done?  I really don't have an answer, and I'm not sure there is one...

Insurance companies are evil, I have no doubt.  Kind of a tough financial situation, though.

Detached retina diagnosed at 11:00 AM on a Monday.  Temporary treatment completed to minimize damage by 1:30 PM that same day.  Surgical repair completed on Thursday of that week.  All in Canada.  All at zero cost to me.  It does help that I live in a city with a university/hospital network, with one of the specialities being eyes.

But without doubt there are other areas where non-emergent care is long.  It took me 8 weeks to see a specialist about some kidney stones.  And that specialist is in a city an hour away from me.

stuart in mn said:

The thing I've been wondering about this guy:  he's apparently pretty smart (valedictorian of his high school class, an advanced college degree) yet he's caught with the gun, fake ID and some sort of manifesto.  Apparently he's never read any crime novels, in them the first thing a criminal does is throw the gun in a river and destroy any incriminating documents.

Considering how smart he was leading up to it and the level of planning evidenced, the only thing that makes sense* is that he wanted to be caught.

* yes, I know that none of it makes sense.

In reply to Mr_Asa :

My suspicion is that he proud of what he did and really did want the recognition, which again speaks more to a social-political motivation than personal.

Certainly some bad info out there, but "the internet" pegged his motivation as a back surgery that ended up being super expensive and lack of coverage.  I don't know if he actually had a surgery, but he seemed very much from a wealthy and power connected family, so it seems unlikely the financial strain was a prime motivator (certainly possible still though)

I hate to say it, but he might have a lot to do with the type of "education" (as in the unofficial part) many people are getting in Universities, in that he thought this was a good plan. Not terribly different from what was going on in the 60's, and that certainly resulted in some very violent actors (e.g. the weather underground, SLA, heck maybe even Manson)

I guess you could ask: "did those violent actors from the 60's-70's motivate any actual change?"

I would have to say no.  It's generally a very bad idea to change thing based on these types of violent action.  Clearly it sends the message it works, so more will likely do the same.

His actions may have potentially set back the change he was looking for.  And that is the definition of ironic btw.

Boost_Crazy said:

No, you don't get free healthcare, they will bill you. But they won't refuse care. You won't die.

Have you ever actually tried to use the health insurance you paid for or are you being intentionally obtuse for the sake of engagement?  

I mean, literally this has happened to nearly every single person I know at one point:

I, and again, almost every person I know whom I've discussed this with, has had the experience of the doctor recommending something, us understanding and agreeing on it, and then some AI/phone-worker-with-a-script/whatever in Omaha says, "ummm, no.  We know better than your doctor.  You don't need this." Then, sure, I guess technically you can invest hours of your time to navigate the intentionally labyrinthine system to maybe try to get it approved, or, pay $2-6000 for the procedure out of pocket, on top of the $16,000 per year you're paying to the insurance company to deny stuff anyway.   Or roll the dice and hope that it really wasn't a problem, I guess?

This was with a "good" health insurance plan.  I know the HR person spent at least 20 or 30 hours of their time dealing with this in addition to the 20-40 hours we spent over the course of one of my wifes' pregancies. 

I'm all in on burning the entire system to the ground and going to a German-style one. 

Insurance and health care are a funny thing. Does your car insurance cover oil changes, or clutch replacements? Does your homeowners insurance cover if you want to upgrade the old parts down below? Health care providers actually do let you shop around and negotiate. Having a baby is one of the best examples, because it's pretty much the only time people are excited to go to hospital. You can prepay and save thousands, or you can just go with your insurance and keep getting bills for months afterwards when you are too sleep deprived to figure out what is happening.

ZOO (Forum Supporter) said:

Detached retina diagnosed at 11:00 AM on a Monday.  Temporary treatment completed to minimize damage by 1:30 PM that same day.  Surgical repair completed on Thursday of that week.  All in Canada.  All at zero cost to me.  It does help that I live in a city with a university/hospital network, with one of the specialities being eyes.

But without doubt there are other areas where non-emergent care is long.  It took me 8 weeks to see a specialist about some kidney stones.  And that specialist is in a city an hour away from me.

 

Which is how it typically works, and has been my experience through many years and many medical episodes.

There's always a lot of misinformation and just pure nonsense coming from people who don't live here, but think they know how it works. And they can usually find all the evidence they need with a quick google search.

What a lot of Americans don't understand is that there are wait times and there are wait times.

If I have a medical issue that's stable and not endangering me, but you have one that is endangering you, you go to the front of the line. That's how it works, and I'm OK with that.

bbbbRASS said:

Insurance and health care are a funny thing. Does your car insurance cover oil changes, or clutch replacements? Does your homeowners insurance cover if you want to upgrade the old parts down below? Health care providers actually do let you shop around and negotiate. Having a baby is one of the best examples, because it's pretty much the only time people are excited to go to hospital. You can prepay and save thousands, or you can just go with your insurance and keep getting bills for months afterwards when you are too sleep deprived to figure out what is happening.

Sure, perhaps you can for the predicted.  All of your shopping around and negotiating goes out the window when something goes wrong and you need immediate care from the closest provider. Or, if in the case of a lot of America, there's only one provider within a reasonable source that your insurance deems to cover/work with (in network). 

Your analogy breaks down because you're talking about the equivalent of visiting your GP doc every year for a checkup.  I don't think anyone really wants to burn down the insurance industry because of that.    People can and do get insurance to cover when a transmission breaks or the engine dies, it's just called an extended warranty.

In reply to WonkoTheSane :

When looking at getting new insurance plans for my employees, they absolutely are asking about the cost of co-pays for annual visits, prescriptions, and predictable items.

I agree with what you are saying, but don't think I've ever heard someone call extended warranties good deals for the consumer. Yes you are paying for piece of mind. No, you are not saving funds vs just taking that money and actually saving it consistently. We don't teach our society (either in most families, pop culture, or our schools) how to be actually healthy physically or fiscally. The consumer-driven mindset leads to fat, dumb, sick, and broke.

I'm not sure I'm willing to find more fault with one of the pieces of the three-way clusterberkeley that is our healthcare system.  Both of my elderly parents have been maimed by incompetent doctors.  And there's no question that many doctors recommend procedures that are not indicated or likely to help the patient.  And don't even get me started on Big Pharma, which uses its influence in the bureaucracy to peddle chemical creations that undoubtedly do more harm than good.

Boost_Crazy said:

I think this whole discussion is framed incorrectly. Let's fix it. The CEO wasn't murdered for denying health care. Health insurance is not healthcare. It's a means for paying for health care. Health care cannot be withheld, the patient can get whatever care they need. Paying for that healthcare is a separate issue, but in the end, it's just money. The CEO was murdered over money. So who thinks that is okay? And at what dollar amount is it okay to murder a person? 
 

Separate issue- healthcare is materials, knowledge, and labor. Like pretty much every other product or form of labor, it's usually exchanged for money. Is it okay to murder the providers of said labor when you don't want to pay? Are there other goods and services where we should consider murdering the providers to bring costs down? 

It's not just money. It's about capitalism being applied to a service which has an inelastic demand if you want to live decent life.

I have no issues with paying taxes to educate and pay providers. They should be compensated for the work and knowledge they have accumulated and apply to make life better for their communities.

I have a problem with the mediator between the provider and I being the 9th largest company in the world by revenue. One that denies 32% of it's claims and built an entire AI agent, that rejected 90% of the claims fed to it, simply so they can shirk responsibility.

That said let me tell you about my long term care plan.

As soon as I hear I need long term care I'm walking out into a field and offing myself. The end.

As morbid as this sounds my family, not some health insurer or hospital system, gets to keep the assets and wealth I've accumulated over my lifetime. This ensures that they are as upwardly mobile as I can possibly make them. I refuse to let a system bankrupt me slowly and take everything I've ever worked for to make their bottom line look better like they did to my grandparents.

I recognize that this is pretty berkeleyed up, but I simply don't have the power to change a system that sees my life as a revenue stream. Health insurance should be for catastrophes not a prerequisite to care.

So yea, you'll have to forgive me if I feel no sympathy for the face of the problem.

I think the argument some are making is the bankruptcy isn't death. You can always go bankrupt. And it can happen EXTREMELY easily in our healthcare system.

There are many of us that almost correlate it with death though. 

And there are ways that the flow of care stops of you don't have the money. There are medications you can't get. Medications needed to survive. 

Or the pharma-bro thing of buy the rights to a medication and jack the price 1000%+ because regardless of price they need to pay it or die. 

Being able to hold a gun to someone's head that way is wrong. I doubt many would disagree. 

If the system allows it, the system is broken. It's not really getting fixed. At some point, it's not unexpected that thing will get ugly on it. I'm not saying its right, or that it should, or that I'm excusing the guy who did it. I'm saying it's a natural consequence of a broken system, whether the guys just nuts, or was in what he felt like and impossible situation from the system.