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Naked_Whale_Tamer's avatar

Are medical insurance companies totally dysfunctional or absurd?

Asked by Naked_Whale_Tamer (390points) February 8th, 2014

A simple personal anecdote: I filled a prescription and the co-pay was over $75. but if I paid cash and used the pharmacies “loyalty” card, the price was only $15.

In summary:

$75 co-pay using insurance
$15 cash price (no insurance)

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7 Answers

hearkat's avatar

The are for-profit corporations in the service of their shareholders and CEOs, not their ‘members’. This is the primary problem with the US Healthcare system, in my opinion (based on 20+ years working within the industry).

snowberry's avatar

Pretty much, yes. They can and will under certain circumstances micromanage you to the point of death, literally.

This was years ago, but it still applies. Hubby got extremely ill, and was hospitalized, then sent home. After hubby lost 5 months of income and had multiple lab tests, he never got a diagnosis, but we were also doing lots of research on our own.

We determined that he probably had been bitten by a tick and had Rocky Mountain Spotted Fever (the symptoms and the history all matched). But his doctor refused, and the insurance company declined to authorize testing him in time, even though we asked- begged them repeatedly, but they refused. I found myself on the phone with the insurance company an average of 2 hours a day for a long long time. Of course it didn’t help that our doctor was a total dunce, and hubby refused to change docs, but that’s another story.

He did recover, but it was not due to the help of his doctors or the insurance company. Many nights I remember holding him while he slept, wondering if he’d wake up in the morning. Those were painful days for us.

Naked_Whale_Tamer's avatar

Regarding @snowberry answer right above:

I throw a coronary thrombosis when people say that there’s no difference between the rich and not so rich.

If ‘snowberry’ had tons of money, she could have received whatever medical solutions that is available without having to beg. Of course, begging still will not change an insurance company’s mind since paying out will affect their bottom dollar.

I wish I was rich simply so that I could walk into any doctor’s office and get great medical care without ever having to think if I could afford it or if the “death panel” insurance companies will pay.

And I’d like to receive non-generic medications because despite all the crap you’ve heard, there is a difference between generic and brand name medications due the binders and fillers in the generics that greatly alter the efficacy of the medication. One generic medication made in India was much less expensive but was utterly worthless. The brand name worked perfectly but was incredibly more expensive.

Thank you @snowberry for your great answer.

Coloma's avatar

Our entire society is dysfunctional and absurd, insurance companies are just one of many fucked up cogs in the wheel of insanity.

ETpro's avatar

Vote Republican so we can make sure corporate profits always come before people’s lives. A few more votes, and we can repeal the Affordable Care Act and make sure insurance companies can refuse to cover preexisting conditions, set lifetime limits, and cancel policies any time they wish (Which means when you are diagnosed with a long-term illness that’s going to cost them a bunch, even if you have paid your premiums for decades and never submitted a single claim.).

Seaofclouds's avatar

It’s all a matter of the deals made between the insurance companies and the health care providers/pharmacies/labs/etc. Once those deals are made, it holds the people that use that insurance to those deals. People that self-pay aren’t held to those deals, and have more power for negotiating their costs.

stanleybmanly's avatar

The rigamarole involved in keeping the insurance and drug companies fat in defiance of single payer universal health care is shameful in its waste and expense. There should be a special place in hell for the politicians and the corporations that own them.

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