this post was submitted on 05 Dec 2024
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TLDR: The insurance company has a new policy, set to take effect in February 2025, where they decide how much anesthesia is needed for surgeries. They won’t pay for any anesthesia over that, with exemptions for maternity and pediatric cases and for Connecticut providers.

The article also notes the insurance company reported a $2.3 billion net income increase in June 2024.

Edit to update: Anthem now says they won’t put this policy into effect

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[–] [email protected] 41 points 3 weeks ago (1 children)

The fact that there aren't riots in the US demanding universal care simply baffles me.

[–] [email protected] 11 points 3 weeks ago (1 children)

Who needs roots when killing CEOs is more effective?

[–] [email protected] 13 points 3 weeks ago (2 children)

Is it effective though? I mean, it's fun, but I don't see it actually improving the situation.

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

Well, this decision just got reversed, so I'd say it does at least a bit

[–] [email protected] 6 points 3 weeks ago

It's not a one time solution, it's a lifestyle change. You have to keep doing it.

[–] [email protected] 30 points 3 weeks ago

Anthem Blue Cross Blue Shield said in a statement that its decision to backpedal resulted from “significant widespread misinformation” about the policy.

Ah, yes, if people complain about being mistreated, it is always "Our plan was misunderstood", or "The critique is based on misinformation"...

[–] [email protected] 17 points 3 weeks ago (1 children)

I would find it darkly hilarious if this killing sparks a war

[–] [email protected] 17 points 3 weeks ago (1 children)

I would find it hilarious if it sparks class solidarity, personally

[–] [email protected] 28 points 3 weeks ago

That's right. Rush the surgeons. That will end well.

[–] [email protected] 79 points 3 weeks ago (3 children)

It was already reversed.

We got them scared

[–] [email protected] 9 points 3 weeks ago* (last edited 3 weeks ago)

usually when a thing is reversed due to outrage, the entity will simply wait a few months to quietly put said thing into effect again

[–] [email protected] 14 points 3 weeks ago

Didn't verify, but someone said it was only reversed in like one out of the five proposed states. Figures

[–] [email protected] 13 points 3 weeks ago (1 children)
[–] [email protected] 4 points 3 weeks ago (1 children)

I propose a guillotine emoji.

[–] [email protected] 1 points 3 weeks ago

🧑‍🌾

[–] [email protected] 21 points 3 weeks ago

This is fucking insane

[–] [email protected] 90 points 3 weeks ago (1 children)

That's a nice CEO you got there. Be a shame if something happened to them.

[–] [email protected] 10 points 3 weeks ago

Or would it

[–] [email protected] 7 points 3 weeks ago

Insurance pays out until outcome and not treatment. Meaning of they don't cure you, insurance will have to cover until you die.

And if they kill you while trying to cure you, every care provider in the chain pays 10-times the cost (total insurance paid by patient over all the years) based on liability to the family else insurance pays 20-times total insurance cost to family.

[–] [email protected] 11 points 3 weeks ago (2 children)

and for Connecticut providers

Anybody from Connecticut care to respond. Why is your state so special?

[–] [email protected] 6 points 3 weeks ago

From a more recent article where Anthem now says they won’t implement this policy:

Connecticut comptroller Sean Scanlon said the “concerning” policy wouldn’t affect the state after conversations with the insurance company. And New York Gov. Kathy Hochul said in an emailed statement Thursday that her office had also successfully intervened.

[–] [email protected] 4 points 3 weeks ago

Don’t they have the closest thing to universal healthcare in the US?

[–] [email protected] 30 points 3 weeks ago (1 children)

Of course, because in the USA, insurance companies think they understand medicine better than doctors.

[–] [email protected] 6 points 3 weeks ago

And so do Politicians and Parents..

[–] [email protected] 28 points 3 weeks ago (1 children)

How did they figure out the amount because the different people have different tolerances. My brother had a surgery that had not started and they were like. Your still awake. When meeting with the anethsiaologist before surgery he has to mention he may need a bit more than normal plus I believe there is a weight thing. Is the amount allowed assuming a worst case longest surgery with person who requires the most anesthia to six sigma of the population.

[–] [email protected] 33 points 3 weeks ago (1 children)

Exactly, like how redheads need more anesthesia

Real answer? Who knows

Cynical answer? However low their lawyers told them they could get away with without being liable

[–] [email protected] 2 points 3 weeks ago

I remember some jokes around it being about cell receptiveness. Like their receptors don't react to taking pigment the same way they don't react to the anesthesia as well. If so, it would likely be a genetic trait, so the more natural red heads that have extremely low pigment may require more anesthesia to keep them under. But I'm no doctor, and most of those jokes had to do with their soul not being around to pick up the call 🤷.

[–] [email protected] 33 points 3 weeks ago* (last edited 3 weeks ago) (1 children)

So, at the absolute most charitable interpretation, this punishes patients for having a slow surgical staff or for a surgery having complications. Like most insurance things, punishing the patient for shit completely outside of their control.

On top of this, best outcome of this (for doctors to try and ensure their patients don't need to decide between potential financial ruin or surgery) would be for all surgical departments to wildly inflate their surgery times so they can't ever be over estimate. This will significantly reduce the amount of surgeries able to be completed per day, and hike up the price even more as they have to bill for more time.

The only possible justification for this is attempting to find another place to lower financial costs to the insurance company at any "cost". I miss when these people had enough shame to not go this mask off.

[–] [email protected] 28 points 3 weeks ago

This actually sets a time limit for anesthesia regardless of procedure or estimated time from the doctors.
It's entirely up to the insurance company to set an arbitrary time with which they think medical care should be provided within and deny past.

It's nothing but appalling cruelness for the sake of it, and a few extra dollars for a CEO and board of Directors that deserve the opposite of health care.

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