The ultimate insurance company cost savings

I had a very disturbing conversation with a physician who is employed by an insurance company last week.

I admitted a patient in the hospital for very clear-cut reasons. She is one of my few non-compliant patients, doing none of the strategies I advocate–no fish oil, no vitamin D, no correction of her substantial lipoprotein abnormalities, not even medication. Much of this was because of difficult finances, some of it is because she is from the generation (she is in her late 70s) that tends to ignore preventive health, some of it is because she is a kind of happy-go-lucky personality. So her disease has been progressive and, now, life-threatening, including an abdominal aneurysm near-bursting in size (well above the 5.5 cm cutoff). The patient is also a sweet, cuddly grandmother. I have a hard time bullying nice little old ladies.

While she was in the hospital, the social worker told me that her case was being reviewed by her insurer and would likely be denied. Their medical officer wanted to speak to me.

So the medical officer called me and started asking pointed questions. “Why did you do that test? You know that she’s not been compliant. Are you sure you want to do that? I don’t think that’s a good idea.” In other words, this was not just a review of the case. This was an opportunity for the insurance company to intervene in the actual care of the patient.

Then the kicker: “Have you considered not doing anything and . . . just letting nature take its course?”

At first, I was stunned. “You mean let the patient die?”

Expressed in such blatant terms, while he was trying to be diplomatic, made him back down. “Well, uh, no, but she is a high-risk patient.”

Anyway, this was the first instance I’ve encountered in which the insurance company is not just in the business of reviewing a case, but actually trying to intervene during the hospital stay, to the point of making the ultimate healthcare cost savings: Letting the patient die.

Unfortunately, never having had an experience like this before, I did not think to record the conversation or take notes. I am wondering if this is an issue to be taken up by the Insurance Board . . . or is this a taste of things to come as the health insurers fall under increasing pressure with the legislative changes underway?



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48 Responses to The ultimate insurance company cost savings

  1. Anonymous says:

    It’s annoying how some people such as f0xpawz use an otherwise importantly informative
    web-site and discussion board as a bully pulpit for their unlettered views on subjects entirely
    irrelevant to what the site is all about. This kind of behavior is straight up unseemly and offensive.

  2. Anonymous says:

    I this happened to my mother last year.

    The hospital and then nursing home staff were clearly driving her into the ground with bad food and defective medicines. The doctor was a social climbing medical deity, the head nurse a borderline psychotic.

    I was able to find more knowledgeable, broad minded doctors, cut the meds, improved the food, aded supplements over the nursing home's many obstructions, and we eventually escaped without mortality. Mom got better, after eliminating a number of drugs and their horrid side effects (including nausea and vomiting, Parkinsonism).

    All the nursing homes in the locale exhibited the (sub)standard American diet syndrome. I have since come to view US nursing homes as death traps.

    Also my wife's cousin died in UK last year under NHS cost control. Her sister, an American MD, on the phone, recognized her sister had a systemic infection that needed IV antibiotic, stat. NHS guidelines delayed treatment. Dead in 48 hrs.

  3. Anonymous says:

    I this happened to my mother last year.

    The hospital and then nursing home staff were clearly driving her into the ground with bad food and defective medicines. The doctor was a social climbing medical deity, the head nurse a borderline psychotic.

    I was able to find more knowledgeable, broad minded doctors, cut the meds, improved the food, aded supplements over the nursing home's many obstructions, and we eventually escaped without mortality. Mom got better, after eliminating a number of drugs and their horrid side effects (including nausea and vomiting, Parkinsonism).

    All the nursing homes in the locale exhibited the (sub)standard American diet syndrome. I have since come to view US nursing homes as death traps.

    Also my wife's cousin died in UK last year under NHS cost control. Her sister, an American MD, on the phone, recognized her sister had a systemic infection that needed IV antibiotic, stat. NHS guidelines delayed treatment. Dead in 48 hrs.

  4. ash17 says:

    Well, it’s amazing. The miracle has been done. Hat’s off. Well done, as we know that “hard work always pays off”, after a long struggle with sincere effort it’s done.
    ———–
    marqgibs
    Savings

  5. zeeshan ali says:

    I found your blog very informative about insurance policies and plans.

  6. Dana Seilhan says:

    I get angry every time I hear a don't-wanna-be-a-socialist RED-stater griping and complaining about "Obamacare" and how they don't want to be forced to pay for other people's bad health choices. Then they bleat about death panels. Have these kind souls ever BEEN without insurance? Boy, I sure have. Nothing says "death panel" like "sorry, we require payment up front and by the way, you don't qualify for Medicaid."

    Paying for someone's dumb decision to leave their front door unlocked at night when they suffer a burglary and have to call the cops? No problem. Paying for someone's dumb decision when they fall asleep in bed with a lit cigarette and need the fire department? No problem. What's the difference then?

    I do not understand and I will never understand. Yet they go on about "death panels" and "un-American" and so on and so forth. What, are fat people and chronically ill people not alive or something? Or not American?

  7. commercial insurance quote says:

    I am really shocked to read the whole post. In my opinion the real cause is the increasing number of fraud that people are doing by showing false information so that they will get the claim. This just results into the poor people who are true, suffers a lot.

  8. Anonymous says:

    To: Dana Seilhan

    VERY WELL said!

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