this post was submitted on 21 Dec 2024

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I Was a Health Insurance Executive. What I Saw Made Me Quit. (www.nytimes.com)

submitted 2 days ago by [email protected] to c/[email protected]

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One story that we couldn’t keep out of the press and that contributed most to my decision to walk away from my career in 2008 involved Nataline Sarkisyan, a 17-year-old leukemia patient in California whose scheduled liver transplant was postponed at the last minute when Cigna told her surgeons it wouldn’t pay. Cigna’s medical director, 2,500 miles away from Ms. Sarkisyan, said she was too sick for the procedure. Her family stirred up so much media attention that Cigna relented, but it was too late. She died a few hours after Cigna’s change of heart.

Ms. Sarkisyan’s death affected me personally and deeply. As a father, I couldn’t imagine the depth of despair her parents were facing. I turned in my notice a few weeks later. I could not in good conscience continue being a spokesman for an industry that was making it increasingly difficult for Americans to get often lifesaving care.

One of my last acts before resigning was helping to plan a meeting for investors and Wall Street financial analysts — similar to the one that UnitedHealthcare canceled after Mr. Thompson’s horrific killing. These annual investor days, like the consumerism idea I helped spread, reveal an uncomfortable truth about our health insurance system: that shareholders, not patient outcomes, tend to drive decisions at for-profit health insurance companies.

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[–] [email protected] 14 points 2 days ago (2 children)

You don’t HAVE to pay for health insurance if you feel it’s denying every fucking claim.

Don't they also go to great lengths to conceal information on their practices? And for most people what health insurance is available depends on their employer? There are a lot of obstacles to the public being sufficiently informed and able to exercise agency to solve this from a consumer level. Not to say you're wrong about murder not being a good solution to this though.

[–] [email protected] 8 points 1 day ago (1 children)

Indeed. It's a very privileged idea that "If you don't like someone's services, you're free to shop around until you find something you're comfortable with."

This only applies to the rich. Everyone else is fucked over by monopolies.

You think I like having Spectrum Internet? There's no other game in town that provides internet to this street. You think I like having health insurance that completely ignores my teeth? It's all I can afford.

[+] [email protected] -6 points 1 day ago (1 children)

You think I like having Spectrum Internet? There’s no other game in town that provides internet to this street.

Then have the balls to not have internet. How far are you willing to go to stand up for yourself?

But fucking murder is too far. Do you think someone should fucking murder the Spectrum CEO? Lots of Lemmy do think that. And it's fucking disgusting.

[–] [email protected] 1 points 19 hours ago (1 children)

I don't think they're saying to murder spectrum, but maybe you can see the parallel between people who can't choose the healthcare they can get and those who can? The vast majority of people get it through their employer and healthcare is expensive. "Switching company" is simply not an option for most people, so when their claims are denied, they might be being told to die. In contrast, I simply care little for the jackass that took advantage of everyone and ran into karma. Not saying we have to murder ceos, but I won't feel bad for them. As someone said previously, your "go somewhere else" speech just screams privilege.

[–] [email protected] 1 points 16 hours ago (1 children)

Not saying we have to murder ceos, but I won’t feel bad for them.

And that's fine in my eyes. But many on Lemmy are openly advocating for murder and some have even been saying that there needs to be a hitlist. That's my issue.

And how am I "privileged"? I work for minimum wage as a teacher's assistant at an elementary school. I make far, FAR less that the average Lemmy poster. And I'm older, so I get to face ageism too. And I grew up in poverty.

I've went without insurance most of my life, friend. And I've usually made too little to pay for private insurance, but too much for medicare.

My "go somewhere else" is based on if every claim was getting denied, I would just drop insurance. Because if every claim is getting denied, I'm not really having insurance am I?

What part of my life do you think is "privileged"? lmao

I make less than you. I have always made less than you do.

The vast majority of Lemmy is "privileged," and so much so, that they don't even have context for what that word means.

[–] [email protected] 1 points 4 hours ago

I suppose you're right- you are indeed not privileged; You are simply misguided in assuming living without insurance is either feasible or a wise decision. Just to be clear, I don't know where you get the idea that I'm making a lot of money right now. Likewise, I made an assumption based on how you presented yourself, because reasonable people, whether well off or not, don't think having zero insurance is the alternative to having bad insurance in the context of why healthcare execs are being offed- they would think that making healthcare options good for everyone is the way to go because the options are usually awful and they lack viable alternatives. Those same people may only see violence as the only means of achieving that goal and I'm probably more on their side of the fence on that-- based on history, violence almost always brings about change. This is not a new concept- as an example, the civil rights movement was not peaceful and I doubt much would have happened without forcing people's hand. That said, I don't consider healthcare a thing we should be "privileged" to have because it's a living necessity like food. You may survive for a while without it but when you run into a truly bad issue, you will realize you only got lucky and not everyone will be lucky; those same people may die in the current system. I hope you understand and I hope you understand why people won't share your vision. I wish you luck in your insuranceless life.

[+] [email protected] -7 points 1 day ago (1 children)

Don’t they also go to great lengths to conceal information on their practices?

Every time I have gotten denied, I get a letter. They list what gets paid for and what doesn't.

And for most people what health insurance is available depends on their employer?

No, you don't HAVE to take the health insurance that your employer offers. You can deny it. In most instances tho, it's worth it to keep it. Which is why the "revolution" that Lemmy thinks is going to happen, won't.

The only real revolutionary change on that will come by voting for politicians who don't worship the insurance companies money. And guess what? BOTH the Democrats and the Republicans worship insurance company money.

Which is why we need a third party. When I mentioned that and supported third parties before the election, the .world instance permabanned me! LMAO

Which is also part of the problem. People are too afraid to actually be uncomfortable for a bit in order to bring change.

But that doesn't mean people should fucking murder CEO's. WTF?!

[–] [email protected] 2 points 1 day ago (1 children)

Every time I have gotten denied, I get a letter. They list what gets paid for and what doesn’t.

Spending years putting up with a company is a pretty steep price to pay to learn the basics of how they do business. Consumer choices can't effect change very well if they are largely kept in the dark is my point, and they are.

From the book Delay, Deny, Defend:

Companies could report on how many claims are filed with them, how long it takes to process the claims, how many claims are denied, how many policyholders have to resort to suing the companies to have their claims satisfied, and how those suits turn out. They could report the information to state regulators or use it in their advertising. Then the scope of the problem nationally would be easy to determine, and consumers would know who the worst offenders are. In fact, some states require insurance companies to report these numbers, and the NAIC has begun to collect the data. But the reporting and collection are secret, at the insistence of the insurance companies. If they wanted to refute the existence of delay, deny, defend, they could do so. Their silence speaks louder than any numbers.

Which is why we need a third party. When I mentioned that and supported third parties before the election, the .world instance permabanned me! LMAO

Yeah I also voted third party, they don't really like it. Idk how much good it will do, or what the best solution would be, but the people calling for more murders I think are generally falling for the "something must be done, this is something, therefore this must be done" fallacy.

[–] [email protected] 2 points 1 day ago

Fair points.