Thank you for the opening, I have a very true story to tell about that very subject.
I met my wife on vacation in the 90’s, and after a few long distance months, she decided to move to where I lived. As a trained, experienced secretary from NYC, she used her own tried-and-true method of getting a job - she signed up with a good temp agency, and worked a series of temp jobs until she found a job where she fit in, hoping they would want to keep her.
She went through a series of bad employers, until she ended up working a temp job with the state’s biggest healthcare company. She sat outside the office of a corporate lawyer whose sole job was to look through the files of people with the most expensive treatments, and find some excuse, any excuse, to cancel them, no matter how flimsy. Usually it was some pre-existing condition, like allergies. For example, if someone was getting expensive cancer treatments, this lawyer would find some evidence that they knew they had allergies when they got their insurance, and the lawyer would cancel their insurance based on that small unrelated issue. People who had paid premiums for years, were cancelled at the very moment they needed their insurance the most. They also didn’t refund the thousands of dollars they’d paid in premiums, they kept it all, despite refusing to provid the service that had been paid for. Her refusal of treatment DEFINITELY led to the deaths of people, and this lawyer was nothing short of a Corporate Serial Killer.
My wife worked the job for three months, becoming increasingly uncomfortable and unhappy as she realized what she was assisting this Corporate Serial Killer in doing (and so did I), and was planning on having the temp agency find a a new position for her.
Before she was able to do that, she came home and told me “They offered me the job.” It was a good opportunity, with better pay and good benefits. Normally, it would be time to celebrate, but she was clearly heavily conflicted. I asked what wanted to do, and she reluctantly said she was going to take the job, because we needed the money.
I told her we didn’t need the money that bad, that it wasn’t worth destroying her soul over (we aren’t religious, I meant it in a more metaphorical way). I had already been concerned about the psychological toll the job had been taking, so I also told her that she was never going back there, and to call the temp agency tomorrow for a new position. Let them tell the company that she was never going back. We’d get by for a while longer, until something better came along.
I still remember her look of relief when I told her that I didn’t expect her to work that soul-sucking job any lomger. She got a new temp job that developed into a permanent position that she held for years.
Years later, when Sarah Palin started talking about “death panels” associated with Obabacare, my wife said “Death Panels already exist at healh care companies, I personally worked for that company’s one-woman death panel.”
I know personally how psychopathic these health care companies are, and they should be run out of business for their fraudulent practices. They are Serial Killer Corporations, murdering people for profit. We need to put health care in the hands of an entity without a profit motive, and the only thing like that is the government. I was already thinking along the lines of Universal Health Care before my wife’s experience cemented my firm belief in it.
My wife’s experience is why I support Luigi 100%, even though he is totally innocent of all charges.
I was listening to the Acquired episode on Epic and they touch on the severe cost overruns in our healthcare system. They make a point to share that hospitals aren’t the ones making a killing. It’s insurance companies.
They make a compelling argument that if you add up the total that you pay to insurance, taking into account what your employer pays, there’s no way you get that much value out of your health insurance annually.
I have a number of complex chronic health problems and I usually hit my out-of-pocket limit around April every year. I find spiteful glee in costing my health insurance tens of thousands of dollars every year. (And every penny of it is actually medically necessary.)
insurance is always a gamble, and the house always wins
don’t insure anything you can afford to lose, and save up money you’d put into insurance in a HISA
that said, things you can’t afford to lose probably include your house, someone else’s lamborghini, your health
buuuuuuut US health care is set up for bargaining: hospitals overcharge, pharmacies overcharge, drug companies overcharge because they all know insurance companies aren’t gonna pay what they actually charge because they have bargaining power… which, if you don’t have insurance, leaves you holding the fucking ball with no bargaining power
… all of this is said as an aussie, with universal healthcare and only a passing (but real life) experience of the US healthcare system (and in general a system that will protect me from fucking up so hard i can’t even imagine being completely destitute), so grain of salt n all that
Oh man, epic is such complicated garbage that even with a company brought in to set it up, the center I worked at during the rollout was a fucking mess. I left 14-18 months after initial deployment and they were still ironing bugs out, and I heard they rolled back within a year or so of leaving. Also, it’s almost hilarious how often I hear nurses bitching about using epic just when I have to go in for anything, and none of them are related to the place I worked.
I respectfully disagree after you try other EHRs like Cerner lol
I also haven’t heard complaints about Epic with bugs at least in my org. They are pretty user friendly especially when we have some staff that can barely type. The only complaint was documentation. Nursing documentation was tedious with like over 250 options for “adult assessment” but they’ve slimed it down to like 50 earlier this year for my healthcare system. Lastly, I think things work better the more money hospitals put in the EHR. I was per diem for another healthcare system. It was pretty cool how many other features they had than ours.
Must just be one of those “yeah my product is awful but have you seen the other guy?” sort of situations. I never had to use the EMR directly outside of troubleshooting, but both epic and the previous EMR were pretty garbage so I don’t really have a good baseline to go off of.
The Acquired episode made it clear that the customer isn’t the people who use the software. Their customer is the CEO and the CIOs of hospital systems.
yeah my product is awful but have you seen the other guy
Yeah, it’s this. I worked at Epic somewhat recently, and I’ve since worked with former Cerner/Oracle folks too. To Epic’s credit, they’ve never been acquired, and are better for it.
There’s a lot of vocational awe across the board, people genuinely trying their best to make the product good. But healthcare is inherently complicated, because people are complicated. Each individual health system needs it customized to their specific needs, and over time this can get hairy to support. Add on to that that regulations and guidelines literally change every year, and it can become really hard to make headway on more meaningful changes when you’re just trying to stay compliant.
This leads to burnout on the software support side, Epic churns through new hires like crazy - average tenure has been way down since COVID-19 (you can Google their response to that), so it’s a revolving door of 21-25 year olds keeping that ship afloat.
Also, yes, insurance companies are the ones making the big money, by a mile.
That’s kind of interesting because I used to work in health insurance (mental health specifically, so it has its own quirks), and it felt like things were always in financially dicey territory. It must be different in medical.
The costs are inflated for sure, but compared to to cost of paying for cancer treatment entirely out of pocket, it’s still cheaper. That’s the whole point of insurance, to cover the event of a catastrophic cost.
I’m not as sure about that. If you paid your premiums, etc. into a low yield savings account, especially when you start when you’re young, I think the value proposition would be more than insurance where you have no way to control payment decisions.
Please do not read this as me saying don’t get insurance. Read it as our insurance is failing to provide the value that we pay into it and need something better.
The Acquired episode goes into detail how we ended up with a private payer system and it’s so infuriating. Our health system was being set up around the same time as the UKs and they show how different incentives lead to where we are.
Why do you think the cost of paying out of pocket is so high? Private insurance bears a significant part of the responsibility for causing that problem.
Structurally, yes, you need a system that amounts to healthy people saving, and sick people being taken care of from those savings, whether it’s individual or social. But our current system of private for-profit insurance is about as bad as such a system could be while still technically sorta working.
Abstraction. They don’t even see individual numbers of denied claims, they see a percentage, a percentage of chance and other KPI. For they, there’s no people being affected by the denials, only indicators.
I don’t know man, I ended a friendship with someone when I realised they couldn’t figure out that the insurance company they worked for was abusive to them and everyone else. I realised we lived in completely different realities and it was affecting my mood too. It’s also what made me realise that marketing should be borderline illegal. These companies are so utterly toxic to their own employees I don’t know why there haven’t been more Luigis from the inside. Ironically, I think it was UC too!! She and her colleagues had to reapply for their jobs 3x+ in one year.
Healthcare is the number one reason I won’t return. It is also the reason America will continue to crumble. If you nationalise healthcare, you have to regulate business to not burden the healthcare system and this affects all sectors. America loves bombing brown people more than it loves it’s own children. Despicable.
I don’t know how you can work for these companies and sleep at night, especially at the executive levels. Utter psychopathy.
Thank you for the opening, I have a very true story to tell about that very subject.
I met my wife on vacation in the 90’s, and after a few long distance months, she decided to move to where I lived. As a trained, experienced secretary from NYC, she used her own tried-and-true method of getting a job - she signed up with a good temp agency, and worked a series of temp jobs until she found a job where she fit in, hoping they would want to keep her.
She went through a series of bad employers, until she ended up working a temp job with the state’s biggest healthcare company. She sat outside the office of a corporate lawyer whose sole job was to look through the files of people with the most expensive treatments, and find some excuse, any excuse, to cancel them, no matter how flimsy. Usually it was some pre-existing condition, like allergies. For example, if someone was getting expensive cancer treatments, this lawyer would find some evidence that they knew they had allergies when they got their insurance, and the lawyer would cancel their insurance based on that small unrelated issue. People who had paid premiums for years, were cancelled at the very moment they needed their insurance the most. They also didn’t refund the thousands of dollars they’d paid in premiums, they kept it all, despite refusing to provid the service that had been paid for. Her refusal of treatment DEFINITELY led to the deaths of people, and this lawyer was nothing short of a Corporate Serial Killer.
My wife worked the job for three months, becoming increasingly uncomfortable and unhappy as she realized what she was assisting this Corporate Serial Killer in doing (and so did I), and was planning on having the temp agency find a a new position for her.
Before she was able to do that, she came home and told me “They offered me the job.” It was a good opportunity, with better pay and good benefits. Normally, it would be time to celebrate, but she was clearly heavily conflicted. I asked what wanted to do, and she reluctantly said she was going to take the job, because we needed the money.
I told her we didn’t need the money that bad, that it wasn’t worth destroying her soul over (we aren’t religious, I meant it in a more metaphorical way). I had already been concerned about the psychological toll the job had been taking, so I also told her that she was never going back there, and to call the temp agency tomorrow for a new position. Let them tell the company that she was never going back. We’d get by for a while longer, until something better came along.
I still remember her look of relief when I told her that I didn’t expect her to work that soul-sucking job any lomger. She got a new temp job that developed into a permanent position that she held for years.
Years later, when Sarah Palin started talking about “death panels” associated with Obabacare, my wife said “Death Panels already exist at healh care companies, I personally worked for that company’s one-woman death panel.”
I know personally how psychopathic these health care companies are, and they should be run out of business for their fraudulent practices. They are Serial Killer Corporations, murdering people for profit. We need to put health care in the hands of an entity without a profit motive, and the only thing like that is the government. I was already thinking along the lines of Universal Health Care before my wife’s experience cemented my firm belief in it.
My wife’s experience is why I support Luigi 100%, even though he is totally innocent of all charges.
https://en.m.wikipedia.org/wiki/Sicko
This is a major part of this documentary. I’m glad she got out. I hope life is much better now.
deleted by creator
I was listening to the Acquired episode on Epic and they touch on the severe cost overruns in our healthcare system. They make a point to share that hospitals aren’t the ones making a killing. It’s insurance companies.
They make a compelling argument that if you add up the total that you pay to insurance, taking into account what your employer pays, there’s no way you get that much value out of your health insurance annually.
I have a number of complex chronic health problems and I usually hit my out-of-pocket limit around April every year. I find spiteful glee in costing my health insurance tens of thousands of dollars every year. (And every penny of it is actually medically necessary.)
insurance is always a gamble, and the house always wins
don’t insure anything you can afford to lose, and save up money you’d put into insurance in a HISA
that said, things you can’t afford to lose probably include your house, someone else’s lamborghini, your health
buuuuuuut US health care is set up for bargaining: hospitals overcharge, pharmacies overcharge, drug companies overcharge because they all know insurance companies aren’t gonna pay what they actually charge because they have bargaining power… which, if you don’t have insurance, leaves you holding the fucking ball with no bargaining power
… all of this is said as an aussie, with universal healthcare and only a passing (but real life) experience of the US healthcare system (and in general a system that will protect me from fucking up so hard i can’t even imagine being completely destitute), so grain of salt n all that
It’s a metaphorical gun to the head. It’s not designed to help. The purpose of the system is what it does.
Oh man, epic is such complicated garbage that even with a company brought in to set it up, the center I worked at during the rollout was a fucking mess. I left 14-18 months after initial deployment and they were still ironing bugs out, and I heard they rolled back within a year or so of leaving. Also, it’s almost hilarious how often I hear nurses bitching about using epic just when I have to go in for anything, and none of them are related to the place I worked.
I respectfully disagree after you try other EHRs like Cerner lol
I also haven’t heard complaints about Epic with bugs at least in my org. They are pretty user friendly especially when we have some staff that can barely type. The only complaint was documentation. Nursing documentation was tedious with like over 250 options for “adult assessment” but they’ve slimed it down to like 50 earlier this year for my healthcare system. Lastly, I think things work better the more money hospitals put in the EHR. I was per diem for another healthcare system. It was pretty cool how many other features they had than ours.
Must just be one of those “yeah my product is awful but have you seen the other guy?” sort of situations. I never had to use the EMR directly outside of troubleshooting, but both epic and the previous EMR were pretty garbage so I don’t really have a good baseline to go off of.
The Acquired episode made it clear that the customer isn’t the people who use the software. Their customer is the CEO and the CIOs of hospital systems.
That would explain a lot. I’m pretty sure the CEO/CFO (can’t remember which) got let go for embezzlement or something a year or so after I was gone.
Yeah, it’s this. I worked at Epic somewhat recently, and I’ve since worked with former Cerner/Oracle folks too. To Epic’s credit, they’ve never been acquired, and are better for it.
There’s a lot of vocational awe across the board, people genuinely trying their best to make the product good. But healthcare is inherently complicated, because people are complicated. Each individual health system needs it customized to their specific needs, and over time this can get hairy to support. Add on to that that regulations and guidelines literally change every year, and it can become really hard to make headway on more meaningful changes when you’re just trying to stay compliant.
This leads to burnout on the software support side, Epic churns through new hires like crazy - average tenure has been way down since COVID-19 (you can Google their response to that), so it’s a revolving door of 21-25 year olds keeping that ship afloat.
Also, yes, insurance companies are the ones making the big money, by a mile.
That’s kind of interesting because I used to work in health insurance (mental health specifically, so it has its own quirks), and it felt like things were always in financially dicey territory. It must be different in medical.
The costs are inflated for sure, but compared to to cost of paying for cancer treatment entirely out of pocket, it’s still cheaper. That’s the whole point of insurance, to cover the event of a catastrophic cost.
I’m not as sure about that. If you paid your premiums, etc. into a low yield savings account, especially when you start when you’re young, I think the value proposition would be more than insurance where you have no way to control payment decisions.
Please do not read this as me saying don’t get insurance. Read it as our insurance is failing to provide the value that we pay into it and need something better.
The Acquired episode goes into detail how we ended up with a private payer system and it’s so infuriating. Our health system was being set up around the same time as the UKs and they show how different incentives lead to where we are.
Why do you think the cost of paying out of pocket is so high? Private insurance bears a significant part of the responsibility for causing that problem.
Structurally, yes, you need a system that amounts to healthy people saving, and sick people being taken care of from those savings, whether it’s individual or social. But our current system of private for-profit insurance is about as bad as such a system could be while still technically sorta working.
I imagine it’s something like this that helps:
:(
Even with the amount of money they earn I don’t think I’d be able to sleep at night anyway.
sleeping is overrated anyways, I mean how are you supposed to spend money while doing it?
They have pills and alcohol for that. Or they don’t actually sleep and are on a coke binge instead.
Last I heard UnitedHealthcare was denying claims with an AI – https://arstechnica.com/health/2023/11/ai-with-90-error-rate-forces-elderly-out-of-rehab-nursing-homes-suit-claims/
Abstraction. They don’t even see individual numbers of denied claims, they see a percentage, a percentage of chance and other KPI. For they, there’s no people being affected by the denials, only indicators.
They behave like warlords.
Literally nobody in their social circles holds them accountable for what they’re a part of.
It’s like ignoring your friends are part of the Nazi Regime because they’re “just doing it for the money.”
One of them is taking a dirt nap
Only one, though.
So far…
Record profits help
Sorry, we can only afford another layoff.
You answer your own question.
I don’t know man, I ended a friendship with someone when I realised they couldn’t figure out that the insurance company they worked for was abusive to them and everyone else. I realised we lived in completely different realities and it was affecting my mood too. It’s also what made me realise that marketing should be borderline illegal. These companies are so utterly toxic to their own employees I don’t know why there haven’t been more Luigis from the inside. Ironically, I think it was UC too!! She and her colleagues had to reapply for their jobs 3x+ in one year.
Healthcare is the number one reason I won’t return. It is also the reason America will continue to crumble. If you nationalise healthcare, you have to regulate business to not burden the healthcare system and this affects all sectors. America loves bombing brown people more than it loves it’s own children. Despicable.
America occasionally bombs its own brown children. See: Philly
I wonder that a lot