I want to complain a little about the journalism (not) being done here. Because I read this article, and I read the (better, but still lacking) Bloomberg Law article it links/rewrites, and I still have no idea what's happening.
The law firm says the surgeon made false claims. (Which claims? Were they false?)
The surgeon reacted with some twitter grandstanding saying she was on the side of the women she cares for who are battling cancer. (Noble, but irrelevant. She can tell the truth for a good cause or lie for a good cause. Which did she do?)
UHC's spokesperson makes a big show of saying there are "no insurance-related circumstances that would ever require a physician to step out of surgery" and they would "never ask or expect that." Happens all the time actually, in part because if you don't work on the insurance company's schedule and answer their calls, you may not be able to talk to them for weeks, and your patient is denied in the meantime. But is that what was happening here? Apparently nobody thought to ask or include that information.
The implication of this news item is that UHC has hired a shakedown operation to chill criticism on social media. Big if true. But it seems to really matter whether the people on either side are telling the truth. Somebody should report that out. Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work, we don't need to be curious about who the hero(ine) and the villain are.
> The law firm says the surgeon made false claims. (Which claims? Were they false?)
The letter seems clear to me, and unfortunately for the doctor they have receipts (phone call recordings and the paperwork)
The biggest problem for the doctor is that they have a record of the doctor conceding that the wrong paperwork was submitted by her office (hence the call) and that the UHC rep asked for her to call back when convenient (not in the middle of surgery).
I think the UHC doctor got carried away, assumed all mistakes were on UHC’s end rather than her own admin staff, and then went to TikTok to tell a viral story with an exaggerated (at best) version of events.
> Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work, we don't need to be curious about who the hero(ine) and the villain are.
This mentality that we must pick a side, where one side is good and the other side is bad, is a huge problem with social media ragebait.
We can admit that the surgeon was wrong to make a viral TikTok with information that was somewhere between very misleading and an outright lie. Admitting this doesn’t make UHC the good guy or the hero.
You don’t have to pick a side. You shouldn’t automatically assume viral TikToks are true because they are targeted at companies you dislike.
> the UHC rep asked for her to call back when convenient (not in the middle of surgery)
I'll echo the above poster - when an insurance rep calls us we drop everything on the floor and rush to answer it because otherwise they will continue to deny our claim and not get back for weeks. Then they reject our claim because it's now outside their 3 month window.
> the claim should have been denied because it was filed incorrectly
Spoken like someone who has never spent hours online with an insurance company. They have told me that they can't see uploaded forms due to a 'glitch'. They have told me fields were missing when I am looking at the same forms and telling them where the field is and what it contains. They have been carefully instructed to tell lie after lie after lie hoping that the consumer finally gives up.
That seems a bit incredible because it suggests that they would be denying 100% of their claims. If they're going to start lying about a form being filled out correctly in one instance, why ever stop? They can just keep lying forever on all claims.
I've had weird experiences online arguing (about shoplifting, as it happened) with people (I assume teenagers) on Discord who seemed to have a genuine belief that buying insurance was a magic positive-sum process for dealing with damages. They hadn't/didn't make the link that the insurer pays out approximately what they take in from premiums. That experience applied to medical insurance leaves me with a strong suspicion that UHC gets a lot of hate because they are the cheap option and people haven't cottoned on to the sad reality that if they want their claims paid out they can't go with the provider that is cheap because it denies a lot of claims. UHC's margins are there but don't seem to be that impressive. It wouldn't be surprising if they have to push back fairly hard or become insufficiently profitable.
These companies - every company - know how to maximize profit. They know how many claims they can deny, they know what kind of claims they can deny, they know who is or isn't likely to fight back.
Hint - the people with the fewest resource are the least able to fight back.
UHC shouldn't have margins. Healthcare and profit are a deadly combination.
Knowing the general madness of US healthcare, I want to stress this isn't rhetorical.
So why are people going with UHC?
EDIT I want to reply to 2 replies with the same comment, so I'll put it here - if the companies are paying & buying known-dodgy insurance, then why aren't they going with a cheap option?
You have very little choice in healthcare in the US. While you have the “option” of trying to get healthcare on your own, if you have an income it’s usually prohibitively expensive as most companies are able to both a: negotiate a better rate as a bulk deal for bringing all of their employees to the plan at once, and b: subsidize the plan for employees.
What this means is that the most choice Americans face is whether to take the high or low deductible option their plan offers and whether they take the single or family plan.
If your company picks UHC and you don’t have a spouse whose job has something better, then you’re getting UHC or nothing
Most get it through work, and most areas have only a handful that count local docs as in-network. If you're lucky, work might offer a choice between two insurers.
Because in the madness of our economy we've decided that people need to pay for their healthcare either out of pocket or through their employer. They have limited choices and often need to take the cheapest because its all they can afford.
Fortunately for health insurance companies, people who need to take the cheapest healthcare could rarely fight back.
No, but my newborn had to go to the ER once and it kicked off 18 months of billing disputes with the hospital. And the thing I learned was the depths of incompetence, malice, and laziness that a hospital billing department was capable of.
One of the key lessons - if a doctor submits an incorrect billing code, insurance can't do anything to change it. If a doctor doesn't want to work with insurance to fix the codes, you as a patient have so few options to do anything.
I'm very sorry to hear that, I've been through any number of ER visits with my child. I have not personally had any issues with hospital billing departments, so perhaps I have been lucky. It is only the insurance I've had problems from.
But it's not the only billing problem I have had. A hospital billed us double for an emergency c-section (once for the mother, and again for the child) and hit us with $300k in claims. A dermatologist once faked a surgery and sent it to my insurance. And don't even get me started on the exploitative agreements hospitals sign with ambulance companies.
We're not even people who spend a lot of time in hospitals - but we are pretty close to a 100% hit rate for billing issues with hospitals. Even during times in my life when I didn't have insurance.
I get that people kind of ascribe all sorts of medical billing problems to insurance companies. But I think a lot of it is kind of ignorance comes from inept hospital management shifting blame. And often doctors and practitioners themselves are very removed and unaware of the awful billing at their own practices.
I've seen the same damned thing. Even when the state has previously gotten involved on behalf of a patient, I've seen insurance try to deny a surgery less than an hour before it was scheduled. Patient's husband called up the state and they said to not worry about it, they'd handle it. But even still, insurance companies do not stop trying it. The penalties they get are a joke to them. Executives need to face criminal penalties and be locked up in federal prison. Fuck it put em in Gitmo, those people are terrorizing us all.
The goal is to wear you out and it's the context missing from the discussion. An external observer could look at any of my contested insurance claims and say 'They asked for more information, you gave it to them, the claim was approved, so what is the problem?"
What's missing is all the days I had to get up, check on my claim, and call them because the claim was still denied and they sure weren't going to call me.
What's missing is the hours I spent on the phone with them taking them step-by-step through the same issue each time.
Most independent doctors billing OON may also need to speak with 3rd party claims processor, in all likelyhood. Same is true for some WC/NF/Lien claims
It also matters whether they are actually reachable at your convenience. A lot of business are virtually impossible to actually talk to unless you answer their call. They say to call back at your convenience, but you will only get their voicemail or an infinite waiting queue.
Why? They presumably have recordings so it's unlikely to going to devolve to a "he said she said" situation, and I'm not sure how else you would rephrase "at your convenience" so the doctor wouldn't scrub out. Does every interaction need a 1 paragraph disclaimer to guard against a social media shitstorm?
The fact that a Doctor has to be worried about this shit at all is damning. The fact that a patient doesn't even pick their insurance (mostly tied to employer HR) is damning. The fact that a group can own the whole vertical is damning. The whole mechanism is a knot and anything less than untying it is going to have scary consequences I think.
You have pesky PHI in the middle. Funny how of all things, PHI hasn't done a thing to prevent data leaks in healthcare, but it has done fairly well in hindering all async communications with payors.
That’s not an excuse. There are messaging systems inside electronic medical record software they can use. If my healthcare provider can communicate to me via a website and show me all my labs and results and even synchronize with the Apple health app on my phone, surely, a doctor should be able to message an employee of the managed care organization.
Right. Specifically all modern EHR applications now support DirectTrust Direct Secure Messaging. This is basically just regular email with standardized encryption and other added security features necessary to make it HIPAA compliant.
I think the false claims were on the Tiktok, but the crux that i detect is the issue "UHC called doctor out of OR" is likely true even if UHC didn't intend it that way.
>>The letter seems clear to me
Where is the letter?
>> doctor conceding that the wrong paperwork was submitted by her office (hence the call)
That is a strong assumption to make. The tack you are taking is that one of the 2 parties noticed a wrong PA was requested (and approved) and tried to do something about it, preop. That's the assumption. IF the PA was fine, and that's 100% shenanigans by UHC. Less likely, but still very possible.
Thank you for such a well articulated response, I agree with you.
I am not a surgeon but I have experience standing right next to them during surgeries. In my opinion, they already know that there is never a need to take a phone call from an insurance company during a case. Other reasons for a call may exist, sure, that part is not out of the ordinary... but insurance approval would have already happened before the case had ever started. Plus the overnight stay is not part of the billing for the surgery itself anyways.
If anything, the doctor is admitting to a potential crime! Medical providers aren't supposed to deny procedures based on insurance coverage. Even if UHC called during surgery to say the claim was denied, it's the doctor's choice to do the surgery of not.
> Medical providers aren't supposed to deny procedures based on insurance coverage.
This is false. There's EMTALA, which requires that emergency services will be provided until a patient can be transferred. But doctors absolutely refuse to provide services based on ability to pay all the time.
Good point. But as the original story made the rounds on social media, it got exaggerated to make it sound like this was a life-threatening surgery. Knowing that it was a routine call and it was a plastic surgery procedure definitely deflates the scandal of the whole thing.
Well that would depend on the facts of a particular case. If a patient presents at the ER with a brain tumor which is causing severe symptoms such as unstable vital signs then under EMTALA the hospital might be legally required to remove the tumor regardless of the patient's ability to pay.
No; the tumor itself would be non-emergent. The symptoms it causes - pain, for example - would be treated, then the patient would be discharged with a suggestion of a follow up with oncology.
Are you certain about that? I think it would really depend on the severity of symptoms. Cases like Munoz v. Watsonville Community Hospital et al indicate that courts have interpreted the legal requirement to stabilize the patient rather more broadly. Just discharging the patient with painkillers and a referral isn't necessarily sufficient to avoid liability.
Yes; that case involves a clearly emergent post-surgical complication.
https://casetext.com/case/diaz-v-division-of-soc-servs-1, as an example, involved a case where chemo was warranted for emergency treatment, but not on an ongoing basis. The court found they could treat enough to stabilize, then discharge, even if that guaranteed an emergent return later on.
I always find it kinda funny in a morbid way when somebody finds out for the first time that the US healthcare system lets people die all the time because they have the wrong insurance or not enough money. Hell they let people die all the time who have the correct insurance and enough money, health insurers just deny and delay long enough to save some money.
There's a good reason Luigi killed the CEO of United Healthcare.
As far as I'm concerned, I still appreciate the propaganda value of a story even if it's full of half-truths like this one, because it's time for a reckoning for these companies. There's a tiny, like 1% chance, that someday we'll have the opportunity to institute single payer and kill these businesses full of sickening, greedy ghouls overnight, and anything that helps convince people of their sins so that they won't doubt that it's worth doing, I'm okay with. They've earned it with their many, many, 100% factual bad deeds. And they've never been above lying.
I admit that taking this attitude toward falsehoods isn't 100% ethical, judged by itself, but if it helps to end a system that has killed many thousands and will continue to do until it is abolished, this is a rare case where I'm ok with the ends justifying the means.
>As far as I'm concerned, I still appreciate the propaganda value of a story even if it's full of half-truths like this one, because it's time for a reckoning for these companies.
Just like "2 weeks to flatten the curve" and "masks don't work"? There's no way that "the ends justifies the means, a little lie to advance our cause" would backfire, right?
Indeed, I didn't like the dishonesty there. There's probably many situations where you're absolutely right. It's just that my hatred for this industry is too strong to grant them any quarter even when they're technically in the right.
Because the fact is true that even though they probably didn't demand to speak to the surgeon immediately, there's a reason the staff deemed it worth pulling her from surgery, and it's because if she didn't get to talk to the caller right now when they were on the phone, it could be any number of days before the matter could be resolved, and the hospital may not be willing to proceed if the insurance company is going to deny the claim, since that could saddle the patient with an unexpected $10,000 bill. In this way, our shitty system, designed on purpose by companies like UHC, forced most of this to happen.
>Indeed, I didn't like the dishonesty there. There's probably many situations where you're absolutely right. It's just that my hatred for this industry is too strong to grant them any quarter even when they're technically in the right.
You know what's arguably worse than insurance companies? Racists. So when there's a mysterious flu coming out of China and racists are latching onto it as a way to hate on Chinese people (eg. "China flu"), we better downplay it[1] so we don't give them any rhetorical ammo.
>there's a reason the staff deemed it worth pulling her from surgery [...]
Sounds like you're giving infinite charity to the doctor/staff and not allowing for any possibility that any sort of mistake on their end. Is this based off of any facts, or your "hatred for this industry is too strong to grant them any quarter even when they're technically in the right"?
You linked an article titled “No Clear Evidence Wuhan Coronavirus Can Spread Before People Show Symptoms” from _January 27 2020_.
The headline is accurate, at that point in time nothing about the virus was clear. The only portion of this article that even tries to downplay anything about China is this portion which as far as I know is still accurate.
> On the call with reporters, Messonnier also seemed to allay concerns that the virus could be transmitted via packages sent from China. Coronaviruses like SARS and MERS tend to have poor survivability, and there’s “very low, if any risk” that a product shipped at ambient temperatures over a period of days or weeks could spread such a virus.
> “We don’t know for sure if this virus will behave exactly the same way,” Messonnier said, but there’s no evidence to support transmission of the virus via imported goods.
Why are you trying to paint that as doctors lying?
>Why are you trying to paint that as doctors lying?
the exact wording I use was "downplay", not "lying".
>The headline is accurate, at that point in time nothing about the virus was clear. The only portion of this article that even tries to downplay anything about China is this portion which as far as I know is still accurate.
Even though the headline is technically accurate, the "downplay" part comes from the CDC trying to imply that the risk was low.
"Messonnier repeated her message that the immediate risk to the US public is low at this point."
I'm sure there was a technical mistake on the doc's end! But it's because UHC wants absolutely everyone to make 'mistakes' constantly, because every mistake delays or avoids a payment. Even a delayed payment moves an expense forward, maybe even into a new period, while the revenues are always captured promptly when your employer pays your premium. So, UHC's processes are purposely designed to add as much uncertainty and to be as easy as possible to derail.
The system insurance companies designed works something like this:
Provider: Enters patient ID, procedure code, date, etc. into the insurance billing system.
Insurance company: Applies an automated check to find reasons why this claim might be denied. For example: "Our records show that you amputated her right arm yesterday, so we can't pay for wrist surgery with a date of today" or "automatically deny all claims for XXXXXX as 'not medically necessary' and wait for them to appeal by following a separate process". If it finds any reasons, claim is denied. Some limited info is sent to the provider or patient, usually with a lot of latency.
Doctor or Patient: Must play a game with the insurance company to figure out (1) why insurance company thinks [insert wrong belief] (2) how to satisfactorily prove to them otherwise and (3) why despite after solving 1 and 2, the claim is still showing as denied. Providers are overwhelmed with hundreds of instances of this at all times, so they can't always handle doing this for you, and patients often lack the documentation, medical knowledge, and legal definitions in the policy, to be able to advocate for themselves.
If it were designed by anyone other than a bunch of ghouls looking to profit off killing people, there would be good ways to asynchronously but promptly enumerate and solve the problems that prevent claims from being paid. This would be tricky to build, but not impossible if the parties involved wanted to cure disease and save lives more than they wanted to be rich.
>Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work, we don't need to be curious about who the hero(ine) and the villain are.
spoken like someone who doesn't have a chronic illness requiring an expensive medication to be delivered every month for the rest of their life, who every year has to fight with the insurance company about the fact that multiple sclerosis does not go away and that the medication is still needed, and yet STILL has lapses in receiving the pre-approved and approved and re-approved treatment which causes new symptoms to occur and old ones to relapse while the bureaucrat at the insurance company who is incentivized to give you the runaround plays delay deny delay deny delay over the medication that has been effective for YEARS and will be needed indefinitely.
No, we really do not need to be curious about who the villain is. If UHC is worried about their image, maybe they should DO THE THING THEIR CUSTOMERS FUCKING PAY THEM TO DO
> maybe they should DO THE THING THEIR CUSTOMERS FUCKING PAY THEM TO DO
Health insurance in America is broadly profitable. But note that UHC just paying out claims puts them in the same place as California home insurers. Part of the job of a health insurer is to deny unnecessary claims, to be a check on providers, both in procedures and their pricing.
> Health insurance in America is broadly profitable
Health insurance is actually a lot less profitable than most big businesses. Something like half as profitable as the S&P 500 average.
But ignoring that, there are also big non-profit insurers. They aren't appreciably different.
There's a big misconception that if we could just remove profit from our healthcare system every problem would be solved. However, if you look at where healthcare dollars go, profit and administrative overhead (insurance, hospital admin, etc.) are a single digit percentage of overall spending. If you could wave your magic wand and make it go away tomorrow, things would barely change.
Note that even countries with socialized medicine have administrative overhead in the single digit percentage range, so it's not actually possible to drive it to zero.
We severely overestimate how much of our healthcare dollars go to profits and executive compensation. I think because those are the only safe targets to be mad at. Nobody wants to engage in conversations about getting surgeons to take lower compensation or limiting certain types of care (which is very much a thing in any medicine system). American healthcare is expensive, but we Americans also consume (and demand) much more healthcare than elsewhere in the world.
We have a lot of unnecessary gatekeeping. Prescriptions come to mind.
Unless it’s addictive or subject to group effects (e.g. antibiotics), it should be OTC. If someone kills themselves self administering another YouTube cure, that’s on the influencer and the patient.
The nice thing about having grown up in and around the underground cash economy that drives the USA is that I never forget that it’s usually cheaper and easier to just call your guy than to go wait in line like a schnook.
My first box of Paxlovid was bought for cash.
When Germany offered me only NSAIDs the 9th day after using a bone saw on me, the black market was there for me too.
Seems cat food would be an easy one. Want me to ask my guys, or are you sorted now?
The cat is dead now, but not before I was squeezed for a few grand by excessive regulation. At the time, I was wishing there was an underground option for blood testing. You don't need a 300k degree to stick a needle in a cat or read a PDF to me.
Kinda like how a barber in my state need a 20k license and 1000 hours of training, but on steroids. At least at home haircuts aren't illegal (yet).
I'm not really sure I understand the rebuttal. Are you implying that pharmacy companies play no role in healthcare generally? If you make that claim I assume you've never had to fill a prescription, ever. Because pharmacies and drug prices play a GIANT role in the cost of healthcare. I mean, even the US government feels this way
> Faced with competition, some pharmaceutical companies are cutting deals with insurance companies to favor their brand-name products over cheaper generics. Insurers pay less, but sometimes consumers pay more.
All of the job of for-profit health insurance companies is to make money for their investors. Everything else they do works towards that goal.
Now all of the job of any for-profit company is to make money for their investors, that in and of itself is not a problem. The problem is that specifically, for health insurance companies, they make money by denying people health care. They have no incentive to pay claims beyond the minimum necessary.
We have public health care too and it isn't perfect but they don't lie to our faces when telling us why they won't cover something.
> Part of the job of a health insurer is to deny unnecessary claims, to be a check on providers, both in procedures and their pricing.
How can this occur with the given incentives? You have parent corp UHG who owns the whole vertical and you've got dumb fucking congress (deduced from Hanlon's razor) saying only a single part of that vertical is capped.
Even Kaiser is bumping up against resource constraints (at least in Washington). I know quite a few Kaiser employed doctors and insureds, and they all report declining quality.
Edit: I scrolled down and saw someone else say the same:
> glad the company that pays for my treatments can be "a check on providers" for me
Outside large hospitals, there is an alternative: pay yourself. You can usually draw down against an FSA or HSA, or just eat the cost. Only works if you’re wealthy, of course. But most small providers have a cash rate they’ll tell you verbally but never in writing that is below their official negotiated rate.
I don't know much about Fortune magazine, but Wikipedia says: "The magazine competes with Forbes and Bloomberg Businessweek in the national business magazine category and distinguishes itself with long, in-depth feature articles"
Which seems incredibly ironic given that this article is 3 paragraphs.
And when people assume bad faith, they needlessly produce unkind responses, which is what happened here.
EDIT: Nope, I checked his comments, every single one is "you clearly know nothing about <blank>" and the next one is "you clearly know nothing about <something else>". Total Hacker News Redditization happening before our eyes.
> Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work
> UHC's spokesperson makes a big show of saying there are "no insurance-related circumstances that would ever require a physician to step out of surgery" and they would "never ask or expect that." Happens all the time actually
You make a good point. UHC has said something that, according to your direct knowledge, is patently untrue, and yet this article contains nothing accusatory against the surgeon that said something contradictory to the statement that you assert is completely wrong.
If one party says something wrong and another party contradicts them, reporting that is a failure of journalism becau
Well as mitchelist points out we don’t even know what claims were made. The third paragraph of this article reads
> On Jan. 7, a plastic surgeon named Elisabeth Potter posted a video of herself on Instagram claiming that UnitedHealthcare called her mid-surgery and asked her to justify an in-patient stay for a woman who has breast cancer and needed a surgical procedure to treat it. Potter then claimed that the insurer denied the patient an overnight stay and threatened her with legal action for her posts.
Are these claims? What does “surgical procedure” mean? In what way is she using the word “denied”? It says UHC threatened her with legal action for her posts but, as mitchelist has surmised, we don’t know what she said or if she said anything at all.
While the article articulates exactly what the surgeon said about UHC and links directly to her video of her saying it [1]… does it? Who knows what’s going on? I’d write more here but I am using speech to text because my dominant hand is stuck inside a jar of honey and my wife’s cries of “stop making a fist” (whatever that means) are getting picked up by my microphone.
I agree, but somehow when a lot of people fall on the “summary execution is warranted and encouraged” side of this debate, the specifics of any single given case end up far below the noise floor.
> The law firm says the surgeon made false claims. (Which claims? Were they false?)
This is in the Fortune story. UHC provided a direct quote, right after some text you quoted, and the post continues on with the claims the lawyers make.
>The implication of this news item is that UHC has hired a shakedown operation to chill criticism on social media. Big if true. But it seems to really matter whether the people on either side are telling the truth.
Implication? UHC uses the services of a high profile law firm that openly advertises itself as specializing in "defamation matters and representing clients facing high-profile reputational attacks" and, sent a surgeon treating a UHC patient, a C&D letter, over a social media post.
The firm worked for Dominion - and if anyone cares to look back, their record, like nearly every other electronic voting company, isn't very good.
There's really nothing in the story that is unbelievable, and by your own admission we can see how they very carefully phrased it as 'never asked or expected'. This means she'd have to prove that missed calls resulted in delayed care for UHC patients - likely possible, but cumbersome...
Frankly it seems like you didn't read the article fully, or you're being disingenuous.
Also discussed on /r/medicine if that piques anyone's curiosity,
https://old.reddit.com/r/medicine/comments/1igp35p/follow_up... ("Follow up: The doctor who was pulled out of surgery to call UHC because they were denying her patient’s stay got a threatening letter from UHC for talking about it on social media", 181 comments)
That links to a post containing the actual letter from the lawyers, which is honestly more revealing than all of the articles and social media ragebait about the situation: https://www.instagram.com/p/DFlR1CrJ688/?img_index=4
I know people will default to believing the physician and not the lawyers, but from my read of the letter it appears UHC’s lawyers have valid points (don’t shoot me, I’m just the messenger)
Specifically, UHC appears to have recordings of the calls and the paperwork which contradict the claims in the social media post.
The two biggest problems I see from my quick read:
1. UHC’s rep said the issue was non urgent and asked for a call back “when convenient to you”. This differs from the social media post claiming that UHC called and demanded she “scrub out of surgery” and “call right now”.
2. UHC has records of the doctor conceding that her office’s submission for inpatient care was erroneous and that they actually meant to request observation care. That’s why UHC was calling.
The fact that UHC came with receipts (recordings of the phone calls) and that the doctor even conceded the error during the call does not put the doctor in a good position. The original claim that the insurance rep demanded she scrub out of surgery immediately was a red flag that something was amiss with the story.
>1. UHC’s rep said the issue was non urgent and asked for a call back “when convenient to you”. This differs from the social media post claiming that UHC called and demanded she “scrub out of surgery” and “call right now”.
Based on my experience with some hospitals, it's possible that something like this happened:
UHC [on phone]: We'd like to speak to Dr. X when possible
Reception [on phone]: Sure, s/he's available
Reception [to doctor]: Stop the surgery! United Healthcare needs to speak to you immediately!
Dr. X [frantically undressing]: I can't believe these vampires are so demanding!
Disclaimer: I contract for hospitals. I usually have good experiences working with management, doctors, nurses, and technologists. Practically all of the bad experiences are with reception and security (a few places are good at it, but not most). I've never seen people more devoted to making sure things don't get done. I am always happy to give them my ID, my company ID, use the metal detector, search the bag — I don't care. But they always, inexplicably, insist on calling someone in the department, who is usually busy, who doesn't need to actually do anything, and nonetheless, we must slow everything down and bother them. I don't know who writes these policies, but I could see this happening.
That's certainly plausible... however, UHC is not saying "the doctor got it wrong, it was her receptionist's fault". They are sending legal threats - "take this speech down or we'll sue you for defamation". This is not a company trying to take their name out of the mud, this is a company trying to cut off their critics' tongues, because the critique is hurting the stock price.
In America - the only jurisdiction that matters in this case - defamation requires knowingly lying or having "a reckless disregard for the truth". If UHC actually sued Elisabeth Potter, they'd lose, although she'd also lose because she would have had to pay at least five figures for a competent defense.
But if you really want to talk about other jurisdictions, there's plenty of opportunities for censorious fuckery. Just off the top of my head (and limited to capital-W Western[0] countries):
- English defamation law is notorious for having a low bar for legal action.
- Japanese defamation law only exempts true statements that are in the "public interest".
The surgeon went to social media blaming UHC for everything, with the assumption that her own staff couldn't have been part of the miscommunication or paperwork errors.
UHC comes back, with receipts, showing that the error is somewhere on the hospital side.
UHC is still legally deficient in that hypothetical. Defamation of a public figure needs actual malice and knowledge (or reckless indifference) of falsehood—both absent.
There's a large gulf between being wrong and being libelous.
That's not actual malice. The doctor has no positive obligation to spend time reading UHC's letters pleading their version of the story, or interact with them in any way at all. Failure to engage with them is not malice.
I don’t record my conversations and if some lawyer tells me that they have a recording of me saying something I’d be more inclined to believe them. “Maybe I actually said that? Maybe I made a mistake? Maybe I don’t remember it now correctly?”
So I’d take it with a pinch of salt but the lawyers might be absolutely correct as well. I’m just saying I can see it as a tactic but maybe I’m a bit paranoid. Wondering if just I jumped to this conclusion?
It's not a bluff, it's basic practice to record calls when the interactions are high stakes. This was just a social media fight, but when the issue is malpractice or someone has died you can guarantee the lawyers will want recordings of those calls.
In states where recording requires consent you will get a pre-recorded message at the beginning of the call warning you that it's being recorded.
My company recently switched to UHC for 2025. My regular monthly out of network claim was fine with Aetna. With UHC? After I filled out a long form with information in a PDF, they mailed me a letter saying they needed more information. The exact information I had already given them, except for one thing trivially looked up, the provider's phone number. They asked that I mail them more information. I don't have a printer. So I had to get PDFs, go to the library, print them, buy envelopes (yes they did not provide one) and stamps, and mail it. I have yet to hear back anything. I am going to have to follow up myself. Is it worth it to me to spend this much time? The frustration is real. Even if the doctor here is technically in the wrong, UHC deserves every negative press possible. What they pull should be illegal, companies like these are a big part of why our healthcare system is a joke.
The jokes write themselves: "Our reputation is in tatters and the pubic cheers for the person who killed our CEO. What should we do" "Let's make our service worse and sue our customers and their doctors"
This feels more like a wounded animal lashing out than like a strategy decided in a board room
The only thing they care about is next quarter's share price.
The wouldn't kill and eat your grandmother if it was legal to make a little money, but 100% without exception they would look the other way and profess innocence if SOMEONE ELSE killed and ate your grandmother and it made them money.
edit: and they would character assassinate and/or sue you for criticizing them in a large enough forum.
I'm sure that using employees who will likely never use your services will improve the quality of their offering. Their website and call wait times surely won't go to shit.
https://www.washingtonpost.com/business/2025/02/10/inhaler-c...
TLDR: UnitedHealth subsidiary Optum cut coverage for inhalers without bothering to tell patients in advance, or to let affected patients know of alternatives that were still/now covered, and a man died because of it. If the case goes to trial Optum is looking at a bankruptcy-level payout.
Obviously nobody in their right mind would defend the bean-counters at UHC. But also picking a side with the hospitals and making this a "them vs us" issue is pretty naive. Hospitals and providers are complicit in their own fair share of awful dealings, and you shouldn't automatically take their side.
In this case, the irony is baked right in. UHC was calling the provider because the provider legitimately screwed up the billing codes and was trying to overcharge the patient!
Kaiser doctors, because they're employees of the same organization that provides the insurance, are much less likely to prescribe treatments that will be denied. Which I like, don't get me wrong, but it's a double-edged sword. Many people with complex or hard-to-treat conditions feel that Kaiser isn't an option for them, because when they need some rare treatment another insurance company might fight you over, Kaiser simply won't prescribe it at all.
My wife is on Kaiser, she was having extreme, persistent back pain. Before she could even talk a specialist, they told her she needed to attend a live webinar about back pain that was scheduled for 3 weeks later...
I don't see how those facts meaningfully changes the conclusion when the margin for the entire group, which includes the subsidiaries you mentioned was 3.6% last year and 6.1% the year before.
JumpCrisscross is saying ignore the 80/20 rule for the insurance side. If you look at UHC's overall parent company profits - the profits after they've calculated in the profit from the supplier side like pharmacy benefit company, pharmacy, doctors, et al - it is 22% gross, 4% net.
In other words the double-dealing only got them 4% net profit.
For my part I think a lot of the extra money is disappearing into administration. Every doctor's office of any size employs extra staff just to deal with insurance company nonsense. Insurance companies employ extra staff to deny claims and fight providers. That extra staff justifies more layers of middle management. This repeats across all specialists and disciplines. Your radiology company? Extra staff to deal with insurance. Lots of people employed to shuffle papers and manage workers.
But we can see the group profits. They’re right at 20 gross and much lower net. You’re arguing they’re double booking profits; that should show more profits. There aren’t more profits.
Also, other comments praise Kaiser for being more consolidated. Is your argument care at Kaiser is much worse?
I think comparison to Kaiser is very telling on the pros and cons. I have options for united and Kaiser at work. Kaiser is slightly cheaper but comes with major pros and cons. Cons are major internal gatekeeping for drugs and procedures. Pros are no getting stuck between provider insurer billing disputes, and most of your data under one roof.
Kaiser works well for people willing to fight their doctors to get the care they want.
United works well for people willing to fight their insurance billing department. It also works for people planning to hit their maximum annual out of pocket limit.
Let's say I'm legally required to use 80% of my salary on cupcakes. My wife makes a cupcake, and I purchase it for $100k. Do we think this was the likely intended result of the legislation?
You’re using hypotheticals when we have actual numbers. (And more-consolidated competitors with higher customer satisfaction rates.)
You have a solid hypothesis. The cross ownership exists. But the hypothesised effect—margin expansion—isn’t observed. The best we can say is they tried to juice margins but failed to, which is neither here nor there, and pins administrative incompetence—not greed—as the culprit.
A large fraction of UHG profits come from their Optum subsidiary selling software to other payer and provider organizations. This is separate from the health insurance business. If broken out separately they would be one of the 20 largest US tech companies.
Unfortunately that is rolling a boulder uphill, and even if you fire all of Congress (on this issue, you'd need to get rid of all the Republicans and at least a third of the Democrats) and replace it with people who give a crap, all it takes is one executive to stop enforcing the rules.
> you'd need to get rid of all the Republicans and at least a third of the Democrats
And then most voters: “71% of U.S. adults consider the quality of healthcare they receive to be excellent or good, and 65% say the same of their own coverage. There has been little deviation in these readings since 2001” [1].
> Quality of healthcare and quality of insurance experience are not the same statistic
The question was specifically about “the quality of healthcare you receive/your healthcare coverage.” Coverage doesn’t cover the insurer on cost, but it does on claims denials.
Most Americans like their coverage. If you want to reform the system, you have to start with that fact and convince them they aren’t risking what they have unnecessarily.
Sure. We want the same system but cheaper. That’s an important difference for someone advocating to scrap the system to make it cheaper. We want those lower costs. But loss aversion marries us to the good enough.
Correct. You've identified why this debate has been frozen in American politics for decades. One man's leech is another's adored Cadillac insurance policy, trusted provider or prescribed placebo. Healthcare reform keeps dying on the rocks of conspiracy theories about the Congress of whatnot. The problem is surfacing a solution the electorate trusts and endorses.
> One man's leech is another's adored Cadillac insurance policy, trusted provider or prescribed placebo.
No, the plans aren’t leeches, the people using the plans aren’t leeches, the entire administrative / leadership staff at health insurance orgs are the leeches.
A majority of the electorate wants government provided healthcare.
> A majority of the electorate wants government provided healthcare
No. (Come on, read your own source.)
A majority say "it is the responsibility of the federal government to make sure all Americans have healthcare coverage." There is a 10-point preference for a "system based on private insurance" versus a "government-run system."
79% of Democrats want a government-run system. But only 46% of independents and 13% of Republicans. Which explains the gridlock. If one side only proposes government-provided healthcare as its solution, it will waste a bunch of energy on it and then be predictably shot down.
> In 2017, 23% of the company’s insurance revenue went toward the provider unit called Optum Health, and 69% went toward OptumRx. So far in 2022, 38% of that money went toward Optum Health, while 56% was captured by OptumRx.
#1 on the list is Walmart, which has a similarly low on-paper 2-3% profit margin, but I don't think anyone is deluded into thinking the company, the Waltons, or its investors are barely scraping by.
#2 is Amazon. Again, low profit margin. Again, plenty of profit.
Nobody is arguing that you can't buy a luxury yacht or whatever with UNH's profits. It's pretty obvious from the original comment[1] is the argument is that even if all the profits were plowed back into approving more claims, that it would only only increase the approval rate by 5-6%, which is a totally minor amount.
Walmart is amazingly efficient and basically the case for how economies of scale benefit the consumer. If you broke it up, prices would go up, not down.
Walton's do great because of the scale, but is a very lean and efficient organization. Take them entirely out of the picture and the consumer would hardly notice.
Isn't profit what the board keeps after they pay for everything including the people in the board's employ? So in that sense the profit margin doesn't mean terribly much because you can always pay more to your senior managers and less to your patients.
The 80/20 rule[0] requires insurance companies to pay out at least 80% of premiums. That's revenue, not profit, and is independent of their costs.
So if they were a charity which magically had 0 costs the most payouts could increase is 20%.
Healthcare demand is infinite and providers have every incentive to inflate costs and recommend as many services as possible. I don't like our healthcare system but as it is, insurance companies play a necessary role of rationing care and there is no magical fix to claim denials.
You keep claiming managed care organizations are earning outsized profit margins, but the audited financials on their 10-Ks indicate otherwise, as do their subpar annual stock returns.
You can either accept that these business do not have a lot of pricing power, and they compete on razor thin profit margins (except UNH, but that is because they sell software and healthcare, not just insurance). Even then, their profit margin is only 5% or so, which is objectively a low profit margins.
Or you think there is a massive fraud and a nationwide conspiracy amongst 7 publicly listed businesses (UNH/Elevance/Cigna/CVS/Humana/Centene/Molina), and numerous non profits like Kaiser Permanente and various BCBS affiliated plans (because their premiums are basically the same as the for profit insurers).
The easiest thing to do though, is ask yourself why shareholders would accept lower annual returns if their business they own earns so much money?
You would think they could do better than SP500 if they were raking it in. Although, UNH did do better, but that is because they sell more high margin stuff like software and healthcare.
> You can either accept that these business do not have a lot of pricing power...
I definitely do not accept that assertion. Especially for the big vertically integrated ones like UHC.
> Or you think there is a massive fraud and a nationwide conspiracy amongst 7 publicly listed businesses (UNH/Elevance/Cigna/CVS/Humana/Centene/Molina), and numerous non profits like Kaiser Permanente and various BCBS affiliated plans (because their premiums are basically the same as the for profit insurers).
Good article, and they definitely do skate on the line, but there aren’t any indictments and it doesn’t seem there is any evidence they are colluding. Just lack of enforcement by the feds means it pays off for everyone to break the rules, but even then, the business is not profiting much.
>Walmart's is lower than that
So? That doesn’t mean 5% is a low profit margin. And the other MCOs are at 3% or less.
> That's why they do stock buybacks.
The effects of stock buybacks are incorporated into the total return calculation, so not sure what the relevance of this is either.
I just don’t see the logical consistency of claiming a business is doing super shady things to earn ridiculous amounts of profit, and then the business not doing better than SP500.
Or why insurance premiums at all the non profits would similar to premiums at all the for profits.
The more likely and simple answer is that it’s a cutthroat business, where almost all revenue goes out as expenses, and that is why all the premiums are similar, because no one can really cut more costs than they already are.
Profit goes to shareholders, not the board. The board is generally supposed to want more money to shareholders, not internal management. The incentives here are not great though, as being a board member is generally a cushy role for which one does not want to rock the boat.
However senior management generally wants to pump the stock price to get comp, not juice their salary. And to pump the stock price, they want money going to shareholders (or growth).
> And to pump the stock price, they want money going to shareholders (or growth).
Paying out dividends hasn't been a major factor in stock picking logic for at least 20 years, and rather than real growth, they'd rather pad their numbers by firing people. Shareholders get their money by buying low and selling high, not through something as quaint as long-term investment.
If they deny less claims, they’ll need fewer adjusters, admin and customer care staff. They will still have 5.5% profit margins but the CEO will get paid less because the net profit won’t perpetually grow and Wall Street doesn’t like that.
If they deny fewer claims then medical expenses will rise for their self funded employer customers, and then those customers will switch their health plans to a competitor like Cigna or Aetna. Most coverage rules are driven by large employers. UHC would be happy to offer a health plan which paid every single claim if that's what employers wanted: it would actually mean higher profits for UHC.
We should up that threshold until these companies start posting consistent losses, then ease up.
I tried researching this, but couldn't come up with an answer: if an insurance company pays doctors to review and dent claims, does that doctor salary count as "quality improvement activities", or administrative?
Surely the entire point of insurance is that the provider takes the financial risk. That is what they have been paid to do. If they cannot afford to do that through premiums then they should make a loss.
Most commercial health insurers no longer bear much financial risk. Instead they primarily administer health plans on behalf of large self-funded employers. Actual insurance is mostly limited to individual and small group plans, which are a much smaller line of business.
While everyone calls them "health insurers", the industry term is "managed care organizations" (MCOs), which sell a variety of services, which may or may not include healthcare, managed care, insurance, negotiated pricing, and even retail pharmacy services.
Depends what their costs are but if all claims would take 85.5 of their premiums with the rest their overhead costs then I think most of their customers would be happy
They bloat the overall health care system to increase the absolute value of that 80% premium. Efforts to human health are overburdened by exercises of human bureaucracy and frankly obviously intentional bad service.
Musk was on TV from the oval office yesterday saying a "significant part of this presidency is to restore democracy"..."what meaning does democracy actually have if the people cannot vote and have their will be decided by their elected representatives".
That was referring to bureaucracy but it seems where America really needs to restore democracy is with things like health insurance where everyone hates it but the consensus is it'll never change because of the money spent lobbying politicians? (Musk thing https://youtu.be/gAuTb-yMNk4?t=63)
Why don't they review the phone records and recordings of their phone calls regarding the patient? They were able to do that for my partner. They record all of their phone calls "for quality assurance purposes." I'm not surprised they're gaslighting now. It's how they always operate in these cases.
I wouldn't be surprised if the person they talked to actually worked for Optum which is why UHC is denying that they would ever do anything so insensitive as call a doctor to deny a claim mid-surgery.
> Why don't they review the phone records and recordings of their phone calls regarding the patient?
They did review the call. The calls did not support the claims in the social media post. The physician posted the letter she received on Instagram and, to be honest, I’m having a hard time siding with the physician: https://www.instagram.com/p/DFlR1CrJ688/?img_index=4
Unless you believe that UHC’s lawyers are lying about their records (which I have no doubt many people will claim) then it appears the errors were primarily in the administration at the hospital.
Specifically, UHC did not demand she scrub out of surgery, but that she call back as soon as convenient. The physician spun it on social media as UHC demanding she leave surgery for the call immediately, but that seems like a miscommunication in the hospital staff.
They also appear to have records that the hospital submitted a request for outpatient surgery but they were doing inpatient surgery, which prompted the calls.
Keep in mind that this is enshittification and that tech enshittifiers are doing the same thing. At one time UnitedHealth was competitive in quality of coverage, while still along with most or all of their competitors being awful by any absolute standard. Now they’re capturing extra money at the expense of their reputation, and aren’t trying to bring their reputation back but merely to slow its decline. If it causes their market share to shrink there are bankruptcies and tax write offs to pursue and their investors can invest in other firms and the deadly grift continues.
Doesn't mean much in a sanctioned cartel. Everyone in the cartel can agree the prices must go up. The industry is rotten and quibbling about who is relatively worst doesn't improve a long term picture.
UHC even manages to be shady with their Medigap plans. Medigap should be the hardest kind of medical insurance for a company to be shady with, but they manage.
Brief background for people who have had no reason to know what the hell Medigap is: in the US if you choose traditional Medicare at 65 [1] it is pretty simple. Various preventative services are covered 100% with no deductible, and other services are covered with a $257 deductible and a 20% copay.
You can buy "Medigap" insurance from private companies that help cover your Medicare copay and sometimes other things Medicare doesn't pay. Medigap plans are standardized by the government named Plan A through Plan N which vary in what they cover and how much they cover it.
It should be hard to be a shady Medigap insurer because they are almost completely out of the loop. You go to your doctor, the doctor says you need say an MRI, you go get that done and the bill is $500. The MRI place sends the bill to Medicare, Medicare pays 80% ($400), and also notifies your Medigap insurer. The Medigap insurer then pays the remaining 20% ($100).
The Medigap insurer doesn't have a say in whether or not they have to cover it. If Medicare approves covering their 80% then the Medigap plan has to cover it too. No saying that you should have went to a cheaper MRI place, or your doctor should have done some other cheaper test instead of an MRI.
So if they can't be shady when it comes to coverage, what can they be shady on? They can be shady when trying to get you to sign up.
Suppose you are in Texas and are turning 65 and are shopping for a Medigap plan. You decide you want plan G. On Medicare.gov for zip code 75002 (first zip code I found when searching for "Texas zip codes") there are 44 plan G Medigap plans available from 33 different insurance companies.
30 of these companies are using "attained age" pricing. Premiums are low for younger buyers and go up as a function of age.
2 of them use "issue age" pricing. Your initial premium depends on your age when you buy, but does not then go up as a function of age.
Finally, one company, UHC, uses "community" pricing. With community pricing the premiums are not a function of age. If you buy a community priced plan with a $200/month premium at 65 you might be paying say $300 at 75, but that won't be because of your age. It will be because of inflation. In particular when you are paying $300 at 75 that is also what someone signing up at 65 that year will be paying. Hence why it called "community" pricing--everyone on that plan pays the same.
For someone at 65 typically an attained age plan will be cheaper than a community plan. So why would you ever buy a community plan? Buy an attained age plan, and a few years later when the price rises above the price of community plans switch plans, right?
The problem with that is that in most states if you are joining a Medigap plan other than in a window around when you turned 65 (and some other exceptional situations) the insurer is allowed to take age and pre-existing conditions into account. They can refuse to sell you a plan, or charge higher premiums, or exclude your pre-existing conditions from coverage.
That means if you are in such a state and either have expensive pre-existing conditions or will be unfortunate enough to develop some later you may be stuck with the Medigap plan you first buy. Then a community rated plan can make a lot of sense. If you are going to be stuck with your plan a $200/month community plan may be more attractive than an attained age plan that is $150/month now that will be rising to $350/month over the next say 20 years.
OK, so now imagine you are 65. You've entered 65 as your age in the plan finder at Medicare.gov. You see all those plan G attained age plans which start at $133/month, and the issue age plans that start at $166/month. And then there are the UHC community plans starting at $166/month.
That sure looks attractive. $166/month that doesn't change as a function of age will in a few years be a better deal than $133/month that goes up as a function of age.
When you follow the link to the plan website and fill in your information you will indeed be told it is $166/month (or close). But under that there is a line that says "$308.39 standard premium" with the $308.39 struck out. And below that it says "Includes $138.78 in discounts".
They are apparently claiming it is a community priced plan because everyone has a standard premium of $308.39, but then they give an age based discount. If you are 65-67 it is 45%. Then it goes down 2% a year through age 79. Then it goes down 3% a year until reaching 0 at age 86.
I fail to see how this is not in fact an attained age plan. Based on what I've read on /r/medicare and other forums where people new to Medicare seek advice I'm sure that there are people who will not notice this and buy that plan thinking the premium won't be going up as a function of age.
I believe that there are other insurers doing this same disguising of an attained age plan as a community plan, but is particularly scummy in the case of UHC because UHC has a deal with AARP to provide these plans under the AARP name.
Medicare.gov does know that the price actually does depend on age. If you change you info on Medicare.gov's plan search to say you are 75 it does show a higher price for the UHC plan just like it does for the attained age and issue age plans, so if you think to do that you might catch that something is fishy.
But if you are already predisposed toward UHC because of the AARP association and because you want community pricing, you might not see a need to try other ages since you would not expect that to matter.
I'm in a state where they don't do those shenanigans. In my state all plans are community rated and if you signed up for Medigap when you turned 65 you can later freely change plans and providers and the new provider has to accept you with no exclusions for pre-existing conditions and with the same premium they charge everyone else.
If UHC tried that discount trick here what would happen is people would sign up with them at 65 to get the 45% discount, and as soon as that discount has declined enough to where what they were actually paying was more than the plans of the other plan G providers they would switch to one of those.
More and more states are liberalizing their rules for Medigap plan switching. Only a few are as liberal as mine (Washington) but several do allow you to easily switch between providers of the same letter plan with no penalties for pre-existing conditions and no higher premiums, and that should be enough to make the discount trick a losing deal for them. It's currently I think around 16 or 17 states that do this. It's a mix of red and blue things so this doesn't seem to be a partisan thing.
[1] In "traditional" Medicare the government is the insurance provider. The alternative is "Medicare Advantage" where the government pays a private company to be your provider. Think of Medicare Advantage as a lot like what you get from plans with employer provided insurance or with plans bought on the ACA marketplace.
Why? Pausing a surgery to take an insurance call is highly unusual. It’s a very serious allegation. Why shouldn’t its veracity be subject to scrutiny and verification by a court?
Fair question. Because there's no meaningfully deterrent penalty for a meritless defamation claim, and the costs and consequences of going to court are highly asymmetric—to the hard-working surgeon in a bloody white coat; as opposed to the lawfare attorney who performs barratry for a living.
It's in the public interest to proactively defend freedom of speech, particularly that of people who have important things to say (i.e. physicians who witness gross insurer abuses), from the speech-chilling effects of a dysfunctional and unjust tort system.
I'm not a lawyer or defamation law expert, so I will quote a person who is both:
- "I don’t know if this doctor lied about United Healthcare. I do know if I had unlimited money and no scruples and wanted to bully people into silence, Claire Locke would be a top choice to hire." –Ken White
Because people need freedom, including freedom to speak their minds, especially about political and social matters, especially about the powerful. If everything you say has to be tried in court with legal expenses, there is no freedom and no check on the powerful.
People make spurious claims all the time, including on news, in commercials, in business and legal contexts, by corporations - look at what UnitedHealth says at times. It's absurd that someone can be sued - there would be no freedom of speech.
Spurious claims that damage someone else's reputation are libel or slander, and are rightly actionable.
I've long thought that doing to this what copyright trolls did to copyright infringement is a road to profit for social media companies. Help connect the outspoken with the damaged and take a cut.
You're ignoring the problem I mentioned above. That's not a solution, just pretending the system you envision is viable. Let's look at the problem and make it viable.
I'd consider it an improvement over the current situation, where discourse is drowned in a sea of sanctionable incivility. Technology that has made spreading the shit easier needs to be matched by technology to control the shit.
It isn't unusual. I worked for Blue Cross Blue Shield's call center 20 years ago. Doctors will def come out of surgery if it's regarding being able to do a heart surgery, or lung transplant, etc etc. Now it's been a long time, but I recall due to HIPAA, I could only talk to the doctor about it. I think the PA/nurse could put the claim in, but I had to talk the PCP/doctor about it.
It’s almost adorable that these people still care about their reputations. These companies only exist because the state protects their racket. No one likes them and even conservatives in other countries cite the US healthcare system as something they do not want.
The law firm says the surgeon made false claims. (Which claims? Were they false?)
The surgeon reacted with some twitter grandstanding saying she was on the side of the women she cares for who are battling cancer. (Noble, but irrelevant. She can tell the truth for a good cause or lie for a good cause. Which did she do?)
UHC's spokesperson makes a big show of saying there are "no insurance-related circumstances that would ever require a physician to step out of surgery" and they would "never ask or expect that." Happens all the time actually, in part because if you don't work on the insurance company's schedule and answer their calls, you may not be able to talk to them for weeks, and your patient is denied in the meantime. But is that what was happening here? Apparently nobody thought to ask or include that information.
The implication of this news item is that UHC has hired a shakedown operation to chill criticism on social media. Big if true. But it seems to really matter whether the people on either side are telling the truth. Somebody should report that out. Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work, we don't need to be curious about who the hero(ine) and the villain are.
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