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Brian Thompson’s killing sparks outrage over state of US healthcare


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Posted
2 minutes ago, impulse said:

Beginning in the 1990s, many major insurance companies reconsidered this understanding of the claims process. The insight was simple. An insurance company's greatest expense is what it pays out in claims. If it pays out less in claims, it keeps more in profits. Therefore, the claims department became a profit center rather than the place that kept the company's promise.

 

A major step in this shift occurred when Allstate and other companies hired the megaconsulting firm McKinsey & Company to develop new strategies for handling claims. McKinsey saw claims as a "zero-sum game," with the policyholder and the company competing for the same dollars. No longer would each claim be treated on its merits. Instead, computer systems would be put in place to set the amounts policyholders would be offered, claimants would be deterred from hiring lawyers to help with their claims, and settlements would be offered on a take-it-or- litigate basis. If Allstate moved from "Good Hands" to "Boxing Gloves," as McKinsey described it, policyholders would either take a lowball offer from the good hands people or face the boxing gloves of extended litigation.

 

They took out the wrong guy.  McKinsey is also the consultant behind the Boeing tragedies and fiasco.

 

https://delaydenydefend.com/excerpt/

 

It may have been the newly employed AI that caused the problem. Or people just feel that they no longer have control over their lives because of expenses.

 

Quote

Just over a year before United Healthcare CEO Brian Thompson was murdered this week in Midtown Manhattan, a lawsuit filed against the insurance giant he helmed revealed just how draconian its claims-denying process had become. Last November, the estates of two former UHC patients filed suit in Minnesota alleging that the insurer used an AI algorithm to deny and override claims to elderly patients that had been approved by their doctors. The algorithm in question, known as nH Predict, allegedly had a 90 percent error rate — and according to the families of the two deceased men who filed the suit, UHC knew it.

 https://www.yahoo.com/news/murdered-insurance-ceo-had-deployed-175638581.html

 

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Posted
12 minutes ago, impulse said:

The AI could have been programmed to pay out any percentage of claims they decided.  Someone decided on 90% rejection.

In the denial of coverage class-action lawsuit against United it says that 90% of denied claims that were appealed internally or through Federal proceedings were reversed

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Posted
20 hours ago, NickyLouie said:

 

 

Very little remorse for this guy, his salary was 10 million US per year and he indirectly caused more suffering than in Gaza.

   

yeah and I agree totally - my family health insurance is going up at a record rate for next year.  I get a COLA too and that is lower this year, plus the health insurance increase will take up 1/3 of the COLA amount.  I have had no claims at all for more than 10 years and no where near the costs of the increases over the years.  I do believe that it is a ripoff business but just afraid to forego it!

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Posted
18 hours ago, jerrymahoney said:

That is the 90% figure as in the lawsuit. That 90% of denials are reversed is the basis for the plaintiffs claiming the model is flawed.

 

Good catch.  There's an "unapproved source" that indicates their initial denial rate was 32%. 

 

Which isn't as many pissed off customers as 90%, but more than the 17% for Blue Cross.  And if 90% of those are overturned eventually, that's a lot of suspects with an axe to grind.

 

The guy left so many breadcrumbs (again, from an "unapproved source") that they'll probably catch him soon.    Looks like the power of the poon may be his ultimate undoing, but I'll leave it to you to chase that tidbit down with Google.  Assuming, of course, that they're after the right guy.  

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Posted
2 minutes ago, john donson said:

maybe the dead dude denied an insurance claim for his dying wife/kid ...  

One thing for sure at $10 million a year he didn't need to deny himself much

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Posted
1 minute ago, impulse said:

 

Not true.  I hated health insurance companies long before I ever heard of Bernie.

 

I should have included sarcasm ⚠️ alert ?

Posted

Apparently medical costs in the USA is the number 1 reason many American families go bankrupt everyone knows along with health issues add money problems great for relationships 

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