A reminder that health insurance is defined eligibility while the NHS is universal equality. Every UK citizen, all of us NHS patients, should watch the short H of Lords debate tomorrow on Physician Associates. Barriers are rapidly increasing to end our assumed equity of access to a qualified Dr.
I hear too many stories of people waking up during surgery anyhow and not being able to say they’re awake - this is just a horrifying thought that might increase that rare occurrence. 😵💫
How can this even work, do they just stop working on you half way through heart surgery, or just say “okay the next 3-4 hours are going to be very shouty/screamy”.
Likely the real danger for patients here aside from the financial impact of a surgery over running is surgeons/anesthesia providers lowering the bar for complexity they are willing to work on. ASA3-4 patients most likely to be impacted. Or patients with extensive surgical history.
Right? Just slam that epidural in my neck so everything below that is dead and I'll watch TV or listen to Tom Petty while they're swapping out my heart for a new one.
"Good news, we found you a heart! Bad news, the surgery is 5 hours longer than your allocated anesthesia time, so I hope you got a good pain threshold and don't mind being awake."
Wow, just goin' in raw huh? Why don't you operate on me with a rusty spatula too, while you're at it? Y'know, just to really prove you care about my health? ~exasperated sigh~
This is really dangerous policy set by BCBS. I broke both bones in my wrist in '17. Surgery took an hour longer than expected due to findings during the initial repair procedure. There are millions of stories like mine.
People profiting from self-serving random rules don't belong in medicine. Since Margaret Meade's statement on the first sign of civilization is being a healed femur bone, then rich insurance profiteers must be a sign we're becoming uncivilized & the working majority should restructure society.
If only America had some kind of citizens’ association chosen from among us and granted legal authority to act on our behalf. Perhaps such a group of overseers might consider issuing some kind of edict stopping BCBS from behaving this way.
I can’t get over how insane this is. Almost as insane as my naive a** finding out that Medicare will not cover diabetes screenings or osteoporosis screenings… they really actively do NOT want us to be able to do our literal jobs.
(Don’t worry I already am circumventing this) it’s just wtf.
There is something wrong with the way your country does healthcare. Earlier I was reading that an insurance company decided on the dose of chemotherapy for a person and they had to fight to have it increased. Are they just trying to kill everyone?
As a private company, their sole goal is to increase profits. One could argue the board of the company has a fiduciary responsibility for its most expensive customers to die
For profit nursing homes here often use bed turnover as a metric of “success” .. the faster that person vacates the bed, the better it is. Method is irrelevant
Insurance trying to dictate dose of expensive meds is very normal here & there's a whole other thing which is "have you tried very cheap alternative (which doesn't really work)" and then the very scary "we're denying everything incl the meds you need cause we denied expensive med"
Don’t understand healthcare in the US. In the US, “healthcare” is a misnomer. It appears no one cares about health in the US. Mostly the health insurance industry and the gov’t that allows shit like this to happen.
Wai—HUH?!?😨 M’Kay. What on the earth is goin’ on with y’all Downstairs?! As a Canadian, I feel like I’m livin’ above a meth lab that’s about ready to explode! What the hell?! This would be a violation of human dignity and rights! Has America just simply gone barking mad? 😱
Apparently yes. And also thanks for making me laugh out loud. Some of us feel like we’re living in a meth lab that’s about ready to explode (deleted original to edit)
I once had my anaesthesia wear off in the middle of arthroscopic knee surgery
I can confidently say some people may try to save money by only getting the anaesthesia that's covered, and I really really don't recommend that approach
Mercury Insurance (who covered the person who rear ended me) refused to pay for more than 14 days for a rental despite my car being in the shop 9 weeks - “because it took too long to repair.” I’ll stop bitching, at least I wasn’t on an operating table with the clock running out on anesthesia.
"Delay, deny, defend" will be words they will be made to eat. I think the exorbitant salaries of ceo's will be coming to an end or they will. The pain this has caused American's has reached the tipping point.
this is absolutely ridiculous. Are people expected to bring their own anesthesia from home? How do you only cover part of a surgery’s anesthesia? I’m baffled
Provider liability if they are contracted with the insurance company. If they are not contracted then it is customer liability. There has always been specific time associated with any anesthesia charges. A specific # of units per procedure.
There are two villains here. Anesthesiologists and their professional org are notorious rent-seekers. They play hardball to demand ever higher rates knowing they can blame the insurers for the fallout. They often just refuse to join the network so they can bill patients directly
In the UK there’s a set fee for any particular procedure for the anæsthetist - not time constrained. But the thought of being woken up halfway through is a little disquieting.
You won't be woken up. When they bill the insurance company, the insurer will simply say, "We'll cover this much, but not the rest." And you'll be charged for the rest. Which would likely bankrupt or cause severe financial hardship for a good half of the country.
I've got BCBS, though, thankfully, not in those states. My mastectomy for breast cancer was considered an "elective surgery." (As opposed to, say, and emergency appendectomy.)
Any surgery that is *scheduled,* even if to save your life, is considered elective, because you are choosing *when* to have it. Whereas if they are operating on you after a car accident, or you have a burst appendix, it's emergency surgery.
So, my brain tumor removal surgery was elective. Honestly, I can see how it would be considered elective. I can elect to most likely die sooner if I just left it there. (It took 30 minutes, btw. The whole surgery. I was sitting up and talking to people in under an hour.)
It's a heinous way to force patients to pay more money
Imagine the dread of being wheeled in for a major surgery- a cabg, a hip replacement-and worrying during induction about whether you'll be financially destitute when you wake up on top of worrying about the surgery's success, pain, recovery etc
They wonder why so many people delay or forego medical care altogether. People can't trust that they won't be financially ruined, even if they are insured. OTOH, it's a win/win for the insurance companies. We're cheaper if we just go ahead and die and get it over with.
You could try cut-rate anesthesia from a facility without all that pesky FDA nonsense, but that may only be kosher when you're trying to kill people with it.
Just seems like an unnecessary incentive for OR teams to rush, which is really not great for patient safety/outcomes. Terrible policy that will increase burnout and kill people.
Or for people to delay elective surgeries, like mastectomies, hip replacements, etc.
As someone who's *not* a medical professional, every surgeon, anesthesiologist, OR nurses, etc, that I've met have been 1) kind, and 2) BUSY. They're not drawing out surgery for longer than necessary for funsies.
Well, that's interesting. 🤔
"Initially, the policy update went unnoticed, but that changed Wed, following the shooting of UnitedHealthcare CEO Brian Thompson in NYC. The killing sparked a wave of online vitriol about the U.S. health care system & Anthem BCBS’s decision roared into the conversation."
Aren’t anesthesia charges in the tens of thousands of dollars? One surgery could wipe a family out. This is horrifying. Greed will be the downfall of the USA.
Comments
sorry
https://bsky.app/profile/aaronblackshear.bsky.social/post/3lcjm4ok3yk2w
please correct this
(Don’t worry I already am circumventing this) it’s just wtf.
We can thank the two party system, lack of education and everybody's retirement being dependent on corporate greed via the stock market
But in all seriousness, doesn’t this create motivation to slow down some surgeries to make extra money?
I can confidently say some people may try to save money by only getting the anaesthesia that's covered, and I really really don't recommend that approach
@glaucomflecken.bsky.social
America, are you okay?
I mean why stop now.
I know, it's ridiculous.
Imagine the dread of being wheeled in for a major surgery- a cabg, a hip replacement-and worrying during induction about whether you'll be financially destitute when you wake up on top of worrying about the surgery's success, pain, recovery etc
Which element of healthcare coverage will the Insurance Corporations cancel tomorrow?
Transfusions? Catheters? Oxygen?
Gotta keep those investors happy because profits, right?
https://www.fishersci.com/shop/products/chloroform-hplc-fisher-chemical-4/C6074#?keyword=chloroform
https://open.substack.com/pub/medicineandjustice/p/lethal-injection-hates-sunlight?utm_source=share&utm_medium=android&r=cfnam
As someone who's *not* a medical professional, every surgeon, anesthesiologist, OR nurses, etc, that I've met have been 1) kind, and 2) BUSY. They're not drawing out surgery for longer than necessary for funsies.
"So we are all agreed on this plan to not pay for anesthesia"
"Yes, yes brilliant work"
"Just think of our bonuses"
*Someone checks phone
"Guys, someone shot the CEO of United Health"
*Room goes eerily silent
👀
https://www.nbcnews.com/health/health-care/anthem-blue-cross-blue-shield-time-limits-anesthesia-surgery-rcna183035
"Initially, the policy update went unnoticed, but that changed Wed, following the shooting of UnitedHealthcare CEO Brian Thompson in NYC. The killing sparked a wave of online vitriol about the U.S. health care system & Anthem BCBS’s decision roared into the conversation."
All jokes aside - what the actual fuck…