r/PoursTea • u/McDowdy Oh the Human-a-TEA • Aug 26 '26
American Dream đşđ¸ Imagine forcing children to suffer on purpose becasue it will make the shareholders a little more money
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u/UnspeakablePudding Aug 26 '26
UHC would chum your children for fish food if the profits outweighed the legal fees.
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u/VaporTrail_000 Aug 26 '26
And somewhere, some unpaid intern just input the prompt "how much would it cost in legal fees to turn human offspring into aquatic fodder, on a per unit basis," into an AI.
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u/5318008ekiLi Aug 26 '26
Legal fees: whatever it costs to defend yourself against an absolutely enormous pile of criminal charges.
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u/Choice-Produce-7146 Aug 30 '26
Hell, even if the Profits DIDN'T outweigh the Legal Fees, they'd probably still do it for shits and giggles.
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u/Veers85 Aug 26 '26
I work in disabled services, a person I support who is confined to a wheelchair, build, non verbal and on a feeding tube has been denied after years of care by UHC. The family is scrambling to help their daughter who is in constant pain. We truly do not hate this enough. Let people suffer as long as shareholders get a few bucks We need a new system and fast
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u/AdministrativeLeg14 Aug 26 '26
The system, the infrastructure is busted.
Better call the right plumber.
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u/AdWeak183 Aug 28 '26
I hear that Mario has a brother that may specialize in health insurance corporate restructuring.
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u/Tdivarco Aug 26 '26
And people wonder why some people support that good looking man sitting in a court room every dayâŚ
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u/TheGrayGhost805 Aug 26 '26
The United States is always doing it wrong.
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u/EitherChannel4874 Aug 26 '26
They're incapable of being a normal country.
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u/Right_Ear_2230 Aug 26 '26
as someone who lives here, yep
help
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u/EitherChannel4874 Aug 26 '26
You guys gotta help yourselves and grow a pair unfortunately.
I know it's scary but this isn't gonna change unless you guys take your country back. Elections are done. They won't be fair again.
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u/ShillBot666 Aug 28 '26
They did it right about 250 year ago. Just need to tap into that revolutionary spirit again.
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u/vampyreprincess Aug 29 '26
Ehh, there were still class and race disparity among the Founding Fathers and in the documents. To say nothing of other issues.
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u/DJSAKURA Aug 26 '26
Yep. Don't have depression or anxiety. Do have chronic intractable migraine.
Can't get any of the newer targeted meds like aimovig or nurtec until I have trialed out antidepressants, anxiety meds, or seizure meds.
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u/Kittykg Aug 26 '26
I have an unknown gastrointestinal issue similar, yet far more severe than, IBS. It doesn't fit any of the known issues so my medical records are filled with labels for my symptoms but nothing definitive, and I've tried many medications and physical therapy trying to fix it.
My docter is certain a specific medication thats only prescribed for the most severe IBS cases would help me...but my insurance won't cover it because I don't actually have IBS. They also won't let me get the two drugs that are considered a step down from the one she wanted for me, again because I don't actually have IBS. I am excluded from any coverage for any drugs in this group, and they all cost over $1000.
I've dealt with this for about 7 years now, and I was only approved for a colonoscopy right after I turned 35, despite having these debilitating and life-altering issues since I was 29. They even bar the things that could help get a diagnosis to open up more avenues of treatment, like some of these drugs they need a specific label for.
We're running out of things to even try and the things that may help me are kept entirely out of my reach because of arbitrary labels and weird age metrics, as if its impossible to have issues prior to their designated age recommendations and those recommendations suddenly became hard rules.
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u/Capable_Deer5826 Aug 28 '26
Sorry, I looked at your profile a bit. (I have severe GI issues too and thought I might know the problem.)
Has your doctor checked for autonomic involvement? Abnormal heart rate, fainting/loss of muscular control, abnormal blood pressure, abnormal temperature changes/inappropriate sweating are all autonomic functions, and so is digestion.
Do you have back pain? Have you been checked for disorders/damage of the lumbosacral spine? That can cause GI issues.
You should probably look at r/ConstipationAdvice also, particularly the stickied threads.
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u/LizMoonstar Aug 28 '26
ooh, i just went through this, re-upping the prior authorization for my aimovig! i did trial out a few things, but my insurance has a procedure (and all the other insurances i've had also had this, so while i don't know that it's common, it appears to at least not be a rare oddity?) where you have to either trial OR have the doctor explain why you can't/shouldn't try the other ones. in my case, i was happy to trial the antidepressants because i needed an antidepressant for other conditions anyway so why not see if it would do both, but the beta blockers were unsafe because i already had abnormally low blood pressure and the seizure meds were a no go due to family history of horrible reactions. so i was able to jump from tricyclics (actually worked really well but the side effects were intolerable and dangerous for me) to gabapentin (which we only bothered to try because i also have fibromyalgia, that one wasn't required) to the CGRPs.
so if you happen to have a decent doctor who wants to work with you, and if your insurance has that process where the doctor can rule things out on medical grounds without trying them, they may be able to at least cut down on the list of things you have to try before getting the CGRPs. i really hope one way or the other you can get there - those meds (i've tried all of them, using aimovig at this point because they'll cover it and it's almost as good as ajovy) are basically a miracle for me.
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u/Hang10arts Aug 30 '26
Im not certain about aimovig, but if your insurance refuses to cover the meds look to see if there's a savings program. I have signed up for ones for ajovy, botox, and qulipta. I believe nurtec promotes a savings program on their packaging as well. I paid $50/month for my ajovy instead if ~$600 and am now paying $0 for my qulipta.
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u/Training_Sugar_2053 Aug 26 '26
There are third world countries that have a better health system than the USA. It's laughable and sad at the same time. But as long as your politicians can be bought by those big companies nothing will change. Your health system is not only broken it is also corrupted to the bone. Sorry for those who really need it but cant afford it.
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u/MassiveBuzzkill Aug 26 '26
My first job out of college was a drug and alcohol counselor, my âdream jobâ at that point. One day I got a 19 year old in my detox, her addiction was so advanced she was already having trouble with scarring in her arms and has begun shooting up using her neck. So dangerous.
Her insurance denied inpatient treatment, that she desperately wanted because she had not âfailed at a lower level of careâ and Iâm like thatâs insane, you want me to send this 19 year old back on the streets in an outpatient program? She could die? So I get in touch with her home county and they agree to pay.
The day she went to the inpatient womenâs building a supervisor came up to me and was like oh wait, the county agrees with insurance. They want her to fail at a lower level before theyâll pay for inpatient. They kicked that girl out and I never saw her again. I couldnât even do my groups that day, all I could do was cry.
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u/VaporTrail_000 Aug 26 '26
So... medical advice provided by a doctor unrelated to and/or unfamiliar with the case, or provided by a non-doctor?
"I am your financial consultant. I am not a lawyer, and definitely not your lawyer, and this is not legal advice, but you have to pay your lawyer to try the Chewbacca Defense before we can let you pay your lawyer to try anything that might help you better."
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u/Either_equipment_04 Aug 26 '26
I got denied a medication by my insurance because there was âno evidence I couldnât swallow pills.â Itâs not that I canât take pills. This particular medication just doesnât come in a pill form.
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u/crybabymuffins Aug 26 '26
The VA is great for this. I was getting an eczema drug from a doctor in the community because the VA didn't have a dermatologist. I didn't realize they only approved me to see that doc for 12 months, and they suddenly stopped sending it.
When I went back to get a new referral and see a different doctor, they made me try their "preferred" meds again. All of which I knew didn't work because I'd done this all before. Including a cream with a black box warning from the FDA saying it has been linked with causing cancer.
VA: Well sure, you have cancer now, but has your eczema stopped?
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u/AmericanCitizenry Aug 26 '26
When will the nurse uprising happen?
Stop using a system set up to fuck over your community in the ways it fucks over your community.
Instead use it to fuck over the insurance companies.
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u/Icy_Fish_2154 Aug 26 '26
The nurses are too busy saving lives to fix it. There aren't enough travelling nurses to cover if the rest march on Washington, each with a rolling IV stand with a pitchork shaped top. People would die if the nurses united. Feels like the system was designed that way.
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u/AmericanCitizenry Aug 26 '26
Nurses could refuse to charge patients. And overcharge insurance companies. Bend the system. Break the rules.
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u/VaporTrail_000 Aug 26 '26
Nurses aren't the ones billing patients or charging the insurance companies. Usually, those people have no real medical background.
Charges come from the computer systems tied to patient treatment. That $100 Tylenol capsule? Billed automatically because it was scanned as administered. Order it, administer it, and not scan it? That's the nurse's job, and their medical liability if something goes wrong.
Systematically overcharge the insurance company by using false charges? That's straight up fraud.
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u/Icy_Fish_2154 Aug 26 '26
Nurses aren't the ones billing patients or charging the insurance companies.
Oh yeah? Tell that to the charge nurse. /jk
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u/AmericanCitizenry Aug 26 '26
Burning the building down is arson too!
Until nurses get on board with ripping the profit out of healthcare, they just as bad as the insurance companies.
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u/VaporTrail_000 Aug 26 '26
I don't think I've ever met a nurse who would answer the question "Why do you do this job?" with "I enjoy watching people physically and financially suffer." Fairly sure the great majority of them are on board with removing extreme profit from healthcare.
But how do you propose they take action to do that? Literally commit crimes until things change? Do their jobs badly enough that potentially more people suffer and/or die before the nurse gets fired or arrested? Or just... leave?
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u/Hapless_Wizard Aug 26 '26
Trust me, basically everyone in healthcare has tried. Unfortunately, the system is set up in such a way that "fucking over the insurance companies" just isn't possible. They hold all the legal power - heck, when you pay for drugs at the pharmacy, paying the price the insurance company didn't just agree to but which they set, that isn't even the end of it; they frequently go back months and decide "actually, no, we'd rather not pay for that" and the pharmacy just.. doesn't get paid. There is, in a practical sense, no recourse for this, and I can only imagine they do the same shit to doctors, too.
I want to be clear that they don't just do this to small pharmacies, either, I saw it most when I was doing retail pharmacy for a billion-dollar corporation with a legal team to match. The power the insurance companies have over the entire process is insane.
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u/Chance-Deer-7995 Aug 26 '26
This is the way corporations work, and it is exactly why they shouldn't be making all the decisions like they are today.
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u/pupranger1147 Aug 26 '26
Seems like intentional torture of a child, for which the executives deserve to be executed under the law.
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u/EitherChannel4874 Aug 26 '26
Maybe doctors should be making decisions instead. Like normal countries do.
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u/Unfair-Alfalfa4916 Aug 26 '26
Freakin UHC, where's the feds and why they aren't storming their headquarters, outrageous
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u/Healthy_Cancel_2604 Aug 27 '26
Unless you have Healthcare that is amazing and costs $100 a month you need to be supporting universal Healthcare. Fuck the Canada nonsense. Just look at the stats for all nations and costs. Oh the too big of a country thing is a joke, run it by state with fed oversight to meet requirements.
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u/AKBearmace Aug 28 '26
I have chronic hemiplegic migraine. At my worst, I'm experiencing migraine 26 days out of the month. With preventatives, Botox, the preventative shot Ajovy and rescue meds like Ubrelvy, I've gotten down to 5 days a month. The downside is Ajovy makes me wildly ill every time I take it, so I need to take it on a friday so I can feel like shit all weekend and be able to be back at work monday. My insurance stopped allowing early pickup of my refill injections, so I can no longer schedule my refill on/close to a friday unless I wait extra days to take it, and I start getting more migraines in the last week of the month as Ajovy wears off.
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u/LizMoonstar Aug 28 '26
does your insurance offer home delivery? i get mine (aimovig but it takes the same schedule and handling) shipped to me 3 months at a time that way. i mean, the overarching point that they're a bunch of bastards remains, but if they offer that, it might ease the scheduling a bit. they pack it in ice packs so it stays safe during the shipping.
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u/throwfaraway212718 Aug 29 '26
My insurance company tried to do this with me regarding a life saving inhaler. My doctor did an appeal stating that Iâve tried their preferred drug, it didnât work, and when I had an attack, I JUST managed to make it to a CVS that was about 50 feet in front of me, typed out on my phone what was happening, and handed it to the pharmacist. They called 911 and got me to a hospital that thankfully only a few mins away. Insurance denied it again. My doctor scheduled a peer to peer and went BALLISTIC. Finally, I now have the right inhaler back. I came minutes away from death because of a company that didnât want to shell out an extra $30 every 90 days.
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u/donkey_xotei Aug 30 '26
Damn if that were me Iâd be calling the ambulance every day and let the insurance company foot the bill after that second deny. Donât want to spend like $20 on an inhaler? Hereâs a daily bill of $20000.
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u/throwfaraway212718 Aug 30 '26
They tried to bill me for the ambulance ride and I flat out refused. Told them had they listened to me and my doctor it never wouldâve happened. Once they sent it to collections, I threatened legal action. Wouldnât you know it went away shortly thereafter.
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u/Separate-Pickle9963 Aug 31 '26
Insurance is rent seeking and a result of the concentration of capital by engaging in an M-M' loop. This is why things like the ACA and even single payer will always failâthey just subsidize the problem instead of fixing it. The solution is the end of capitalism outright. Fortunately, the Revolutionary Communist International is here to help.
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u/ShadowCivic Sep 01 '26
My favorite shit defense of the American healthcare system is they say in Canada you have to wait for treatment. We suspected my autistic son was having seizures, heâs 7 and largely non verbal, he canât tell us what heâs feeling. I call the local pediatric hospital neurodevelopment center, after getting a referral from his pediatrician they informed me the wait to get him seen by the neurologist, not the wait for an EEG mind you, just the evaluation was going to be a seven month wait. Okay sure guys, Iâll just let my son have seizures for the next half a year, sounds great.
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u/icedmuffin Aug 26 '26
I regret switching to UHC and I hate that I canât even get in contact with the local health department to be switched to a different provider at this point cause my father talked me into switching two years ago and Medicare isnât picking up the god damn phone.
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u/BoisterousBard Aug 26 '26
"My wife up and died, on the cabin floor.
And I ain't got no home in this world anymore."
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u/gay_annabeth Aug 26 '26
hc insurance companies haing a "preferred" medication should be illegal. Like, why do you prefer it? Does your cousin hold a stake in the company making that specific one?
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u/Connect-Ant-2081 Aug 27 '26
If you don't think shareholder value should come before the health of small children, well, that's just communist!
/s
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u/30CrowsinaTrenchcoat Aug 29 '26
Once a year, my insurance denies my life saving medication because it isnt their preferred medication. The one I need is $1500 a month. They believe i should be on the one that is $30 a month and doesnt work.
My insurance believes i should die so they can save $1470 a month.
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u/defaultusername-17 Aug 29 '26
i ~really~ don't think people without seizure disorders can understand how terrifying they can be.
like, nevermind that they can be literally life threatening, in the moment you 'feel' like you're dying too.
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u/Kitty_LaRouxe Aug 29 '26
The USA does not have a health care system. It has a medical racketeering system.
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u/Little_SmallBlackDog Aug 29 '26 edited Aug 29 '26
Ah step therapy. It's really awful. I had to fail three classes of medications before medication that is actually for the treatment of migraine was approved. It was hell.
For folks from the states, there is something that we can do to help. There are bills in the house and senate called the Safe Step Act that create a work around the insurance step therapy requirement.
I encourage every US resident to contact their reps and ask that they cosign on the bills. Here's the details:
House: https://www.congress.gov/bill/119th-congress/house-bill/5509?hl=Safe+step+act&s=1&r=2
Senate: https://www.congress.gov/bill/119th-congress/senate-bill/2903?hl=Safe+step+act&s=1&r=1
If you aren't sure who your reps are, you can find that info here: https://www.congress.gov/members/find-your-member
I'm part of an headache disorder advocacy group. We've been trying to get this bill passed for years!
Please pass this info along and/or bump this comment so more people can see it. I just really want other folks to not have to go through what I went through.
Edit to add: some states do have state level legislation in place like the Safe Step act. If you are currently doing step therapy check if your state has legislation that could help. https://steptherapy.com/step-therapy-legislation-by-state/
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u/NerdyTimes_IDK Aug 29 '26
Remember kids, some kinds of seizures can immediately make you braindead or kill you! Ask me how I know if you want to be really, really sad.
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u/Hang10arts Aug 30 '26
This is a thing with all neurological disorders. Migraines. MS. You name it, the health insurance will deny the more expensive meds first because they want you to take beta blockers or steroids first because they're cheap
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u/rk1146 Aug 30 '26
Stories like this happen countless times every day. Universal healthcare is the answer.
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u/Silly_Pack_Rat Aug 30 '26
As a migraine sufferer, I tend to rely on triptans to bring me relief. The issue with triptans, though, is that you are only supposed to take so many in a month - anywhere from 9-12, depending on the medication.
In my case, I really need a preventative medication, and have already been on Metoprolol with no change, my doctor decided to put me on Topamax, because we have to start at the bottom.
Talk about a nightmare!
I was on it for three weeks before I was able to talk my doctor into letting me get off it...and I took a couple of weeks to taper off.
So then she tried to put me on Qulipta. I met the qualifications put forward by UHC, so it should have been a no-brainer.
No. They denied me.
So, she aimed high - Vyepti! It's an infusion that is administered every three months and apparently is pretty effective.
NO.
She tried Qulipta again.
NO.
So now she's trying an injectable. Either Aimovig or Emgality...and we're waiting to hear back. I am fully expecting yet another denial.
The part that sucks about this is that my husband is on Qulipta with the very same policy and he pays absolutely nothing for the medication. He also had no issues getting the prescription.
I have tried a few other medications, like Nurtec and Ubrelvy, and the Ubrelvy works great for me ..but UHC doesn't like to cover either of those medications and requires authorization every few months for Nurtec.
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u/Summon_Ari Sep 01 '26
Johns Hopkins no longer accepts UHC, besides at All Children's Hospital, because UHC says Hopkins shouldn't decide what care patients receive.
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u/CaptainKenway1693 Sep 01 '26
Frequent repeat seizures have a high risk of causing brain damage. So United is giving children permanent brain damage to maybe save a few bucks. I am not a violent person, but the type of person who would do this to a child...
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u/bigpaparoid Sep 01 '26
Have not been the same since I saw that study Bernie did that proved our government would save money with a universal healthcare system. It's hard not to feel like cruelty is the point.
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u/SixBirdsInAShoebox Sep 01 '26
I take a very common, basic SSRI. I have found, consistently, that I respond well to this medication from a couple specific manufacturers of the "authorized generic" and do not respond at all well when it comes from other manufacturers. This was discovered after a long process of elimination and trial and error.
Rather than have to either go through hell for several months out of the year, or go pharmacy shopping and hope that one of them might, possibly, maybe have it in stock from one of the right manufacturers (often for them to have it from a different one next time, and thus having to repeat this process with every refill and often end up with the shitty version anyway), my doctor wrote that the brand is medically necessary.
UHC denied it.
He appealed.
They denied it again.
We trialed a different SSRI. It was a nightmare.
We went back to the original one, because the actual brand or authorized generic works great, so long as I'm not dealing with different manufacturers every time.
Oh, also, UHC decided that it will only cover prescriptions if we either get them from their mail-order pharmacy or get a three month supply at a time.
I'm now stuck with the shitty version for the time being, and... I mean, it's not great. Really, really not great.
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u/SixBirdsInAShoebox Sep 01 '26
Oh, I've also been denied coverage for seeing a specialist. The only kind that specializes in my rare neurological condition. I just... didn't get to see one.
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u/StraightConfidence Sep 01 '26
It's strange to me that it is in any way ethical for an MD to work for health insurance companies. I mean, their job is basically doing harm in order to make some rich people richer.
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Aug 26 '26
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u/hundredBald Aug 26 '26
"Works wonders" is a bit of an overstatement, its not like its a replacement for good anti seizure medication.
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u/Icy_Fish_2154 Aug 26 '26
For some people, it's the best option. For others, it's not.
It should be an option.
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Aug 26 '26 edited Aug 26 '26
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u/Cenn_cruach65 Aug 26 '26
How many cases have you seen?
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u/CorrectBed3828 Aug 26 '26
Not original reapondant but I've seen 3 cases personally where cannibas helped tremendously. I would not replace with actual seizure medication but when your fighting the system sometimes one does what one has to do.
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Aug 26 '26 edited Aug 26 '26
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u/thelionqueen1999 Aug 26 '26
Iâm a pediatric neurology resident physician in my intern year. A few points;
- Too many people use social media videos as a substitute for clinical research when the two are obviously not equal in quality or credibility. Always take medical information from social media videos with a pound of salt.
- There is a purified form of CBD called Epidolex that is FDA approved as an anti-seizure medication for rare and severe forms of epilepsy, including genetic syndromes. This is a prescription-only drug in contrast to cannabis oil, which can be bought over the counter and isnât well-regulated.
- Epidolex is a MAINTENANCE/PREVENTATIVE drug, and cannabis oil has been shown to have some preventative effects in terms of seizure frequency. However, cannabis oil is not effective for aborting an active seizure, and should never be used as a replacement for an actual seizure rescue medication, chiefly diazepam. Why? Because the mechanism through which cannabinoids act on your brain is too slow to stop an active seizure, hence why theyâre better for prevention but not for an acute seizure. Please please please donât spread this kind of misinformation.
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u/pippyfist Aug 26 '26
As an epileptic who experiences worsening seizures with cannabis. I'm so tired of these trust me bro potheads.
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Aug 26 '26
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u/thelionqueen1999 Aug 26 '26
If we were talking about something like cold/flu, then yeah, Iâm all for home remedies.
But weâre talking about seizures, a serious diagnosis that can be and has often been fatal (look up SUDC and SUDEP). I donât believe in home remedies for conditions with such a high morbidity/mortality potential. You can believe what you want, but I will always advocate for health providers pushing back against misinformation and misguided sentiments so we can let the people know whatâs really up.
Health literacy is already in the gutter; we canât stay silent while people continue to destroy it further.
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u/pippyfist Aug 26 '26 edited Aug 26 '26
I get preference for natural, or holistic health approaches in some cases. But as a seizure enjoyer /s I have learned that preferences don't really matter, seizures can be deadly, and even when they aren't they cause so many problems that messing around with your healthcare is extremely dangerous. People with absolutely no experience with seizures either through having or treating them should just keep their mouths zipped.
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Aug 26 '26
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u/thelionqueen1999 Aug 26 '26
Again, we are talking about a condition that can kill you. I do NOT agree with experimentation for a condition that can kill you.
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u/pippyfist Aug 26 '26
Are you epileptic? This argument you're having is really dumb. Anticonvulsants aren't really a choice once you start having seizures.
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u/Right_Ear_2230 Aug 26 '26
The antiseizure component is cannabidiol (CBD) sold as epidiolex for certain forms of epilepsy. Does it work on other forms?
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u/pippyfist Aug 26 '26
I'm epileptic, Cannabis lowers my seizure threshold and causes seizures. You can like your drug without spreading dangerous information like this.
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u/throwawaydanc3rrr Aug 26 '26
I am going to take everything in that comment a true, just to make the following point.
If you believe that nationalized healthcare systems do not limit care by requiring the lower cost options be exhausted first (this would be the suffering listed in the OP) then you are delusional.
In Canada there are reports of MAID (medical assistance in dying) being offered as the treatment for otherwise treatable issues.
Someone somewhere needs to determine how to allocate scare resources, and it is not more noble when that is done by a government bureaucrat instead of a capitalist one.
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u/supercleverid Aug 26 '26
Just for the record, MAID is not just some thing that the Canadian healthcare system decides for patients. It's not even unique to Canada or nationalized health care. It's also not something that just any patient is eligible for. It is an option in many places, including in the US where it's legal, for patients with serious illnesses or disabilities in a state of irreversible decline. It's something those patients must choose for themselves. The illnesses may be treatable but they must be incurable for a patient to be eligible, and their decline must be irreversible, and the patient must be of sound mind and body, and they must decide for themselves. This is not an example of someone else determining how to allocate health care resources.
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u/throwawaydanc3rrr Aug 26 '26
I chose MAID in Canada as the most extreme case to highlight the example from the OP.
You have healthcare providers in Canada in conversations stating that MAID is great because it saves money. Patients with treatable diseases (within accepted standards of care that include quality of life) being offered MAID.
When a national health service decides that a patient must try the less expensive medication (as in the example) before getting approved for the more expensive medication thay are making the same decision that OP is complaining about.
There are not unlimited anything and how to allocate scare resources is done by rationing. The US rations healthcare by cost (caveats apply), Canada rations healthcare by waitlists of government allocations. I offer no commentary of either, I am merely pointing how it is done.
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u/supercleverid Aug 26 '26
But the program you chose is a conversation between a patient and their doctor, not some health care administrative decision. And I'm sure objectively the program does save money which they might tout as an advantage in addition to giving patients an opportunity to choose the circumstances with which they live or die. I don't think it's correct to characterize it as their national healthcare service making decisions about how to treat people for any reason, since that's not what it is.
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u/throwawaydanc3rrr Aug 26 '26
Here is a link https://nationalpost.com/news/canada/i-did-not-want-to-die-miriam-lancaster-medical-assistance-in-dying
Where the doctor offered MAID before diagnosis.
And here is a link.
In late 2025, Saskatchewan resident Jolene Van Alstine, who has a rare but surgically treatable form of parathyroid disease (normocalcemic primary hyperparathyroidism causing severe pain, nausea, etc.), sought and received initial MAID approval amid long waits and barriers to accessing the needed surgery/endocrinology referral in-province. She has stated she preferred treatment; external help (including offers of U.S. care) later intervened, and full MAID provision did not proceed on the initially discussed timeline.
Now in that second case the patient asked about MAID because the rationing mechanism for their treatment was waitlists and bureaucratic barriers.
Had the patient chosen MAID they would have had no waitlist.
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u/supercleverid Aug 26 '26
You're equating a systemic capacity constraint with deliberate administrative rationing, and your examples don't structurally support your claim.
In the Canadian system, waitlists are a non-monetary rationing mechanism. They occur when patient demand outstrips the physical supply of doctors, specialists, and hospital beds. It's a natural limitation of finite resources. Health care providers aren't just sitting around waiting for the state to afford treatment. They're actively working through backlogs caused by staffing shortages and high demand.
The OP is describing an administrative rationing mechanism where an insurance firm has a codified bureaucratic policy like step therapy to deliberately block access to an available prescribed treatment to enforce a cheaper alternative purely to protect profit margins.
MAID isn't an extreme outcome of the OP's example because MAID isn't a centralized administrative decision. The Canadian healthcare system doesn't prescribe MAID to replace treatment to save money. In the first article you linked, an individual doctor offered MAID prematurely. That's an example of a bad doctor breaching standard of care and not a national health service issuing a systemic mandate to withhold treatment.
A province hitting a physical capacity limit for surgeries or a single doctor making an inappropriate suggestion is structurally different from an insurance firm actively executing a corporate policy to deny medication. Conflating them ignores the actual mechanisms of how and why the care is delayed.
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u/throwawaydanc3rrr Aug 27 '26
Prices are a proxy for finite-ness of resources whether it be the United States healthcare system or in the Canadian proventally run system.
And those provinces have the same sort of protocols that the OP was complaining about.
The Ontario system for BRIVARACETAM says it can only be used after two other anticonvulsant therapies.
https://www.formulary.health.gov.on.ca/formulary/limitedUseNotes.xhtml?pcg9Id=281200178
And the BC system has the same requirement.
https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/pharmacare/programs/limited-coverage-drug-program/limited-coverage-drugs-brivaracetamThey limit the expensive drug treatments for the same reason the evil insurance company limits them, cost.
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u/supercleverid Aug 27 '26
You just abandoned your primary argument. Your initial claim was that Canada uses MAID as a rationing tool and you equated that to an insurance company denying medication. When that structural equivalence fell apart you moved the goalposts to provincial pharmacare formularies.
Yes publicly funded systems use step therapy for drug coverage. But you're committing a false equivalence fallacy by matching the administrative action while completely ignoring the economic incentive.
The OP specifically criticized the incentive structure of forcing suffering to make shareholders more money. A public health ministry restricting a medication to stretch a finite tax pool to treat as many citizens as possible is a resource allocation constraint. A private corporation denying that exact same medication to extract surplus capital and return it to investors is profit protection. The action is the same but the math driving it is entirely different and that differing incentive is the entire point of the original criticism.
It's also worth pointing out that the scarcity in the private system is artificially inflated. The same amount of money held by a private insurer would go much further if the profit motive was removed. A public system rations because the physical resources are strictly finite. A private system rations to ensure a percentage of the available capital is extracted for investors rather than spent on patient care.
This difference in efficiency is backed by the numbers. The United States spends over $14,000 per person on healthcare while Canada spends approximately $7,000 per person. Despite spending half as much per capita the Canadian system produces better overall health outcomes including a longer life expectancy. The private system doesn't ration to be more efficient. It rations to protect profit at the expense of both the patient and the overall cost of the system.
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u/Crackmin Aug 26 '26
It's a little bit more noble because the decision makers aren't skimming off the top for themselves
The incentive of "keep our citizens alive, healthy, and voting for us" will always be able to find more resources than the other side, which runs off the structure of "make money by withholding resources"
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u/throwawaydanc3rrr Aug 26 '26
Hard disagree.
You said "It's a little bit more noble because the decision makers aren't skimming off the top for themselves"
It is not that, and it is naive for you to think so. What it actually is, is the power of the state deciding which favored group gets the resources. The 20th century gave the world plenty of examples of how that goes poorly.
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u/Crackmin Aug 27 '26
Universal healthcare not working under fascism isn't really a good response to private companies just killing people when they feel like it, like, we can do neither
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u/NasusEDM Aug 26 '26
Are people falling for these ai bots? Doctors can override anytime if they think any of the drugs from uhc aren't useful in a case. Also the failures are about different drugs, not like it's suggested that it seems you have to fail the same preferred drug over and over again.
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u/SaltMage5864 Aug 26 '26
Why do degenerates like you think you can lie about everything son?
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u/NasusEDM Aug 26 '26
It took me 30 seconds to google if it's true or not. But sure go ahead trust a random bot that feeds you rage bait.
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u/Sea_School_2949 Aug 26 '26
Apparently you did not because while doctors can help challenge insurance decisions they cannot actually override them
Source- https://bocapharmacygroup.com/what-to-do-when-your-insurance-stops-covering-your-medication/
See? Not that difficult
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u/DarlingDaddysMilkers Aug 26 '26
I can appreciate that youâre a Nasus main, it doesnât take much brain power to play.
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u/SaltMage5864 Aug 26 '26
Just answer the question son. Anyone in the real world knows that you are lying
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u/Sheerluck42 Aug 26 '26
It's not a bot. The username is of a known medical professional. And this was a legit post from that username.
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u/NasusEDM Aug 26 '26
No it's not because it's both false and shows it doesn't know the procedure that a doctor can bypass the preferred status
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u/SaltMage5864 Aug 26 '26
When your betters call you out on your lies son, doubling down is never going to work
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u/hyp3rpop Aug 26 '26 edited Aug 26 '26
It took me forever to get my meds overridden after they decided to take the psych meds Iâd been on since 16 off the list and force me to randomly switch psych meds. Even when I got a doctor that got them to re-approve it, still took another week for insurance to respond. A child can have many many seizures in a week, and my request was put in immediately. If theyâre requiring the kid to follow up after that the medication didnât work and then putting in the request it would be more like multiple weeks of seizures. For some peopleâs seizure disorder that could be dozens or more, which I would say qualifies as a shitload when the metric is seizures.
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u/Propugnator-Deorum Aug 26 '26
The doctor can give them the medication, but if the medication was not approved by UHC, the cost falls to the patient - and likely, they will not be capable of affording it.
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u/Hatshepsut99 Aug 26 '26
what in earth are you even talking about? Doctors canât override insurance decisions, all they can do is make their recommendation.
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u/Little_SmallBlackDog Aug 29 '26
It may be different where you are. Step therapy requirements do exist in the US. Some states do have state legislation that allows for patients and providers to bypass the insurance step therapy requirement. That legislation is not in federally level yet.
Here's the info on the federal legislation from my other comment on this post:
"For folks from the states, there is something that we can do to help. There are bills in the house and senate called the Safe Step Act that create a work around the insurance step therapy requirement.
I encourage every US resident to contact their reps and ask that they cosign on the bills. Here's the details:
House: https://www.congress.gov/bill/119th-congress/house-bill/5509?hl=Safe+step+act&s=1&r=2
Senate: https://www.congress.gov/bill/119th-congress/senate-bill/2903?hl=Safe+step+act&s=1&r=1
If you aren't sure who your reps are, you can find that info here: https://www.congress.gov/members/find-your-member
I'm part of an headache disorder advocacy group. We've been trying to get this bill passed for years!
Please pass this info along and/or bump this comment so more people can see it. I just really want other folks to not have to go through what I went through."
Speaking from experience, a certain number of classes of drugs must be 'failed' before a more targeted class of drug is approved. There is also a set period of time that these medications must be trialed. Most trial periods are three months. Imagine the disease progress and harm that can occur in that time.
I had to 'fail' a beta blocker, an antidepressant, and an anticonvulsant med before I could have targeted medications (anti-CGRP, gepants, and/or botox approved). As a result, my chronic migraine evolved into high frequency chronic migraine that is now difficult to treat. Step therapy requirements do cause harm to patients.
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Aug 26 '26
[removed] â view removed comment
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u/NasusEDM Aug 26 '26
The bot says "i work in pediatric neurology", plus talks as if IT recommends something and the insurance says no. Fail many times with our generic brand, which a quick google search is enough to find out they have several medicines on their preferred list not one and fail means once.
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u/GravNak Aug 26 '26
Why aren't you sharing the info you're searching? Are you accusing people of trusting bots and then taking Google AIs word for things?
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u/Dangerous-Change2136 Aug 26 '26
Worked in a neurosciences clinic, we got an approved out of network referral for a woman in her 80s with a large aneurysm. However, they refused to approve the surgery she needed to clip it because there was a pediatric neurosurgeon in network who they insisted could do the surgery. She had to wait an additional 8 months to get the surgery while they forced her to see the peds surgeon repeatedly, who told them from the beginning he couldnât do the surgery as he doesnât operate on adults.
Health insurance is a scam.