"I’m crouching as hard as I can!”

Buoyant!

It’s a more complicated version of that feature where Gmail offers suggested responses like “let me look into that” and “thank you.”

Then fair enough, I apologize for assuming she works in private insurance. Your initial framing and argument made it seem otherwise. I still think you and I disagree on the need for widespread chart reviews for medical necessity.

When you said doctors are not infallible, you said it in response to my claim that, in essence, the treating doctor should always get deference. It is natural to assume that you did not believe the same standard applied to reviewing doctors at Medicare since you’ve been arguing the same.

As you note, treating doctors frequently appeal Medicare denials. That’s a lot of wasted time and money. I see no evidence that these denials are saving more money than is being wasted fighting them. I’m having trouble finding data for traditional Medicare, but for Medicare Advantage, appeals routinely get overturned to such a degree that Congress investigated it.

You stated earlier that doctors are required to take notes and your wife relies on these notes when making a recommendation. Doctors are notoriously bad at documentation. It’s why relying on their notes to make a judgment as to medical necessity is a terrible idea. I firmly believe no one should be denied coverage because their doctor sucks at writing a report.

Medicare or Medicare Advantage? Because Advantage is private. Medicare has like 5 levels of appeal, including to a federal court, most of which is free. There are systems in place to allow challenges to the reviewing doctor’s denial. Private insurance typically forces arbitration.

I have problems with Medicare’s system too, especially when it comes to claims denials. If it is a covered item or procedure, the claim is not fraudulent, and the insurance provider has not met the patient to perform any exam, then going off of notes and comparing with best practices is insufficient to deny a claim. This may surprise you, but the doctors hired by insurance are not magically better than the ones treating the patient.

Yes, of course you’re right. That’s why my surgeon friend who works in oncology has to frequently waste his time calling insurance over denied claims regarding fucking treatments for cancer patients. Truly medically unnecessary, which is why they’re pretty much always reversed and when they’re not, he gets to tell the patient they are going to die because someone who has never met them denied their claim as medically unnecessary. Same goes for my friend in the PICU, except she gets the added bonus of telling a little kid’s parents.

And my guess is it would have literally been cheaper for everyone involved for insurance to just pay for the $200 seat cover. Modern American insurance companies are capitalist enterprises providing a socialist benefit. And the doctors denying claims on behalf of the insurance companies are not seeing the patients in question so are basing their decision on questionable documentation and “industry standards” that are based on heavy insurance influence. All to maximize value for the company rather than ensure patient welfare, which is the fucking point of insurance.

There is plenty of abuse of the system through over billing, but somehow fucking Medicare is the most efficient health insurance system in America. If private insurance is so great, why are they more inefficient with worse outcomes?

If your wife has not seen or treated the patient, she has no basis to deny the claim as medically unnecessary. She has no idea what conditions the patient may have that would necessitate having a different seat cover. I get that you love your wife, but her job leads to significantly more pain than benefit.

She was a journalist who used the Panama Papers to expose high level corruption in Malta. Galizia did not break the Panama Papers story, she’s impressive enough without people making stuff up about her.

Well you have to deep fry it first.

Didn’t he tour with Mastodon?

I don’t see anywhere that you can’t also just buy a battery and charge it yourself if you’d prefer that over a subscription.

Sort of like how you pay over and over for gas, without which your car doesn’t work?

Everyone I’ve spoken to about it has noted that it’s become a very different place. I’ll still use it for reviews and getting tips for serious things like privacy and some basic DIY. But a lot of that advice will be obsolete in a couple years and very few people are replenishing it. Who’s going to give a shit about the best home theater setups of 2023 in two years?

It’s a fairly routine argument by the defense (we’re being singled out/the regulations are unclear). And regarding federal enforcement, there’s a lot of hamstringing by Congress.

All that to say, this is arguably a good sign of the FTC properly enforcing, not a reason for pessimism.

I’m not sure how that’s indicative of the FTC not being serious? You’re quoting a defense argument, of course they’re going to argue the agency is wrong.

It’s medical ethics, not the Hippocratic Oath. Most doctors swear to an ethical standard. Besides, “first, do no harm” is a bit unhelpful if you’re a surgeon.

Otherwise you’re right, the risks of pregnancy outweigh the side effects of birth control, which is why birth control for women doesn’t have as high a standard for mitigating other consequences.

From what I can tell talking to teachers, the public bullying among Gen Z has ebbed (excluding anything gang-related) but the private stuff is way worse. My guess is it’s related, given how performative social media is and how much of an influence it has on Gen Z. Not saying Millenials are immune, but we came up in a society that actively cautioned against putting too much of yourself online whereas Gen Z grew up in a post-Facebook society that encouraged it.

Also, behaviors generally across the board are worse post-pandemic. It’s apparently like no one knows how to be nice to each other anymore.

I was very similar, heavy Reddit user that quit over thr 3PA shitshow last year. Not sure if you’ve noticed the same effect, but my attention span has gone way up.

So your argument is if the regulation isn’t perfectly applied to every possible instance of a potential violation simultaneously, then it should never be applied? How does that make any sense?

Monopolies for modern necessities (the internet and phone) don’t have to worry about customer retention.