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Drudge Retort: The Other Side of the News
Thursday, July 11, 2024

In its analysis, [The Wall Street] Journal says it found that some diagnoses were made that doctors were unaware of and patients received no care for, or that were apparently false.

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All of this because if white people got universal healthcare black people would get it, too.

In post-racial America, no less...

#1 | Posted by tres_flechas at 2024-07-10 07:07 PM | Reply

How many executives are going to go to prison over this?

#2 | Posted by tres_flechas at 2024-07-10 07:10 PM | Reply


Gloria Lee was diagnosed with diabetic cataracts after a nurse stopped by her Boston home for a quick checkup.

Nurses can do this? And Medicare accepts it?


Private insurance companies involved in Medicare Advantage " a government program in which private insurers oversee Medicare benefits " made hundreds of thousands of dubious diagnoses from 2018 to 2021 that triggered extra taxpayer-funded payments, according to an analysis by the Journal, and Medicare paid insurers around $50 billion for diagnoses added just by insurers to patient records.

TreFeces, I am not clear on the US health system, but isn't it "certified" doctors that diagnose patients? If there are dubious diagnoses isn't that the doctors fault?

Or is what they are doing legal?

Finally I find fault with the insurers, but the system has to be built/designed to allow this sort of thing.

How can an insurance company receive money from the government for a persons health care without receipts?

I imagine this is going on through out the governmental systems.

#3 | Posted by oneironaut at 2024-07-10 07:26 PM | Reply

Or is what they are doing legal?

#3 | POSTED BY ONEIRONAUT

In the end no one will be found at fault.

No one will go to trial.

No one will be found guilty..

Even if there is a law on the books that spells out the names of the people involved and says that they are not allowed to do X, and Y, and Z on the specific dates and times that they did it no one will be held to account.

So, yeah, it's legal.

#4 | Posted by tres_flechas at 2024-07-10 07:36 PM | Reply

I imagine this is going on through out the governmental systems.

#3 | POSTED BY ONEIRONAUT

And yes.

If a "mistake" is made and it puts billions in a capitalist's pockets you can count on that "mistake" being made time and time again.

#5 | Posted by tres_flechas at 2024-07-10 09:30 PM | Reply

Interesting... the DSM is written by the insurance industry. It makes me wonder if all the finger-pointing at those determined as the "undeserving poor" of being a burden on the "system" or of bilking the "system"... is just a projection.

#6 | Posted by RightisTrite at 2024-07-11 10:10 AM | Reply

-The Journal's analysis showed insurer-driven diagnoses by UnitedHealth for diseases that no doctor treated made a stunning $8.7 billion in payments to the company in 2021.

But the administration of Medicare is really efficient.

#7 | Posted by eberly at 2024-07-11 10:30 AM | Reply

Private insurance companies involved in Medicare Advantage " a government program in which private insurers oversee Medicare benefits " made hundreds of thousands of dubious diagnoses from 2018 to 2021 that triggered extra taxpayer-funded payments, according to an analysis by the Journal, and Medicare paid insurers around $50 billion for diagnoses added just by insurers to patient records.
In my opinion, privatized Medicare (Medicare Advantage) was designed specifically to undermine Medicare, and quash any idea that public/universal healthcare could work in America.

We will never have effective basic healthcare for everyone in the US until much of the profit motive is eliminated. Our healthcare system as it is, is specifically designed to separate average Americans from ALL of our life savings, before we die.

#8 | Posted by Whatsleft at 2024-07-11 10:56 AM | Reply | Newsworthy 2

8

www.commonwealthfund.org

#9 | Posted by eberly at 2024-07-11 11:04 AM | Reply

No one should ever trust anything UHC says. I have had my worst experiences with compliance trying to get them to give me answers to risks I've brought to them. They balk at providing evidence. They refuse to sign regulatory documents when risks warrant them, like a BAA because technically it doesn't apply to insurers in most contexts. Yet, any other insurer gladly does these things. And with the recent debacle regarding their subsidiary Change Healthcare which was a direct result of UHC executives getting their hands into things they should never have, anytime I see UHC commenting on anything I believe the opposite of what they say.

#10 | Posted by humtake at 2024-07-11 11:21 AM | Reply

"We will never have effective basic healthcare for everyone in the US until much of the profit motive is eliminated. Our healthcare system as it is, is specifically designed to separate average Americans from ALL of our life savings, before we die."

We will never have effective basic healthcare for everyone until everyone starts taking responsibility for their health, either. In socialized countries, it's almost a necessity to take care of yourself because the long wait times means you don't get the help you need in any good amount of time, and many ailments are exacerbated into worse ailments because of it. So people in those countries tend to take better care of their overall health to avoid this problem. While that is a positive result of socialized healthcare, it also causes many people to incur life-threatening or life-sustaining ailments they have to live with the rest of their life, when all they needed was quick care.

But, of course, liberals will never accept that there are any negatives to ANY of their ideologies, so I don't expect anyone on here to understand. Especially those who have never even spent any amount of time in those other countries.

#11 | Posted by humtake at 2024-07-11 11:24 AM | Reply

"In my opinion, privatized Medicare (Medicare Advantage) was designed specifically to undermine Medicare, and quash any idea that public/universal healthcare could work in America."

Private plans have been part of Medicare since the program's inception in 1966.

#12 | Posted by eberly at 2024-07-11 11:25 AM | Reply

"We will never have effective basic healthcare for everyone until everyone starts taking responsibility for their health..."

LOL you are talking about a group that includes people who google "vaccine" and think they are experts and refuse to get life saving shots.

Good luck with that

#13 | Posted by truthhurts at 2024-07-11 11:27 AM | Reply | Newsworthy 1

#6 Link? The DSM has been written by the APA for several decades. My first exposure was the DSM II. Now on DSM 5
Did you mean the CPT codes or ISD codes. Neither of which are 'written' by the insurance industry.

I get called every 3 months from my advantage plan for a N.P. to do a home visit and update my diagnosis. No care plan, no contact to my primary. I suspect a money grab as described in the article.

#14 | Posted by mattm at 2024-07-11 11:29 AM | Reply | Newsworthy 1

Sorry typo I meant written "for" insurance companies and my conclusion/question still stands.

#15 | Posted by RightisTrite at 2024-07-11 11:40 AM | Reply

In socialized countries, it's almost a necessity to take care of yourself because the long wait times means you don't get the help you need in any good amount of time, and many ailments are exacerbated into worse ailments because of it.

#11 | POSTED BY HUMTAKE

There's no wait time in the US if you can't afford to schedule the procedure in the first place.

But your argument is crap. There are huge wait times for many procedures in the US if you aren't super rich. A friend had a minor brain aneurysm and it was an 8 week wait for surgery. I don't even want to know the weight time if she was rural.

But yes, I'm sure "take care of your own health" will magically solve everything.

It definitely can't be the 25-30% profit the hospital takes and the 25-30% more profit the insurance company takes.

#16 | Posted by Sycophant at 2024-07-11 12:10 PM | Reply | Newsworthy 1

We will never have effective basic healthcare for everyone until everyone starts taking responsibility for their health, either.
#11 | Posted by humtake

Where do the unhealthiest americans live?

hint - it's the states that outlawed abortion and have the nations worst schools.

#17 | Posted by SpeakSoftly at 2024-07-11 12:39 PM | Reply

The Journal's analysis showed insurer-driven diagnoses by UnitedHealth for diseases that no doctor treated made a stunning $8.7 billion in payments to the company in 2021.

#7 | POSTED BY EBERLY AT

Why,,,,,,

It's almost like "for profit healthcare" isn't about healthcare at all, only profit..

#18 | Posted by tres_flechas at 2024-07-12 05:10 PM | Reply

That's advantage plans for ya.

they produce more money for the companies and have less oversight and regulation.

Is it any wonder they're preferred by insurers?

#19 | Posted by Tor at 2024-07-12 05:56 PM | Reply

18

I posted that because Medicare is touted as the best system we have and we need to replicate the whole system like it.

#20 | Posted by eberly at 2024-07-12 06:15 PM | Reply

I posted that because Medicare is touted as the best system we have and we need to replicate the whole system like it.
#20 | POSTED BY EBERLY

Of course.

And, hey:

UnitedHealth

#7 | POSTED BY EBERLY

Is UnitedHealth the US government agency that runs Medicare?

#21 | Posted by tres_flechas at 2024-07-12 06:21 PM | Reply

On the bright side America does have medicare which is better than anything found in most of the world.

#22 | Posted by Tor at 2024-07-12 06:29 PM | Reply

I guess #20 thinks the government has forced these benevolent corporations, that provide a valuable service to the public, to rob everyone.

#23 | Posted by tres_flechas at 2024-07-12 06:34 PM | Reply

You know when I read the dribble about wait time with other systems...and how in the US we don't have to wait... and how the "socialist countries" people have to wait... and yet our care is mediocre relative to the places where you have to wait to get better outcomes and quality of care.

Why are you in such a hurry for mediocre care? Why is fast mediocre care so desirable?

#24 | Posted by RightisTrite at 2024-07-12 11:29 PM | Reply

Because in America people on Medicare don't stand in line Outdoors to see their Primary Care physician.

#25 | Posted by Tor at 2024-07-12 11:30 PM | Reply

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