General Discussion

all anecdotal (but I'm sure some are real as further discussed), no real details, and many of them would not have been paid or approved by our model government programs or many plans in European countries.

One was a clinical trial that might not have met government program requirements for reimbursement such as under Medicare.

One was having trouble with insulin cost. I would too, but that's big pharma charging $800 and incurring shortages. And, Congress got off its rear and corrected that.

Another was a mother -- rather than a doctor -- trying to get her daughter into an inpatient facility for drug addiction rehab. Well, government programs have requirements too-- patient has to be capable and desirable of participating in treatment; cannot engage meaningfully; and even after entering rehab, patients must meet Medicare's ongoing benchmarks to maintain their stay. Some even require outpatient treatment.

I stopped at that point.

Some of the examples are true and regrettable (those are a prime target for lawsuits) and many would happen under government programs here and in other countries; but I know for a fact the other components of our so-called system are just a guilty, maybe more so.

If Congress would act, we either wouldn't have health insurers, or they would would be highly regulated -- including denials and reports to consumers -- and audited for compliance.

Instead, Congress is probably laughing its rears off while we point fingers at private insurance and praise Luigi. No, reason for them taking action. Heck, I think one reason Congress does nothing is that they don't want the heat of complaints that are inevitable.

What would really be convincing is if you found legal cases where patients, their family, estate, etc., sues an insurance company for death because of a denial. I would find that quite convincing.

One can sue if the company acts negligently, wrongfully denies a claim, or drags out the process. You can also sue if the insurance company misrepresents the terms or benefits of your policy, or engages in fraudulent activities.