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(CBS Miami)   This is amazing for two reasons. A man's severed fingertip is completely regenerated including the nail using a template made from pig bladder cells. The second is the insurance company is now making medical decisions. Care panels   (miami.cbslocal.com) divider line 78
    More: Cool, florida, pig bladder, Delray Beach, judicial panel  
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6182 clicks; posted to Main » on 17 Sep 2013 at 7:22 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-09-17 03:02:23 AM
Pretty sure insurance companies only make financial decisions.
 
2013-09-17 06:29:42 AM

colinspooky: Pretty sure insurance companies only make financial decisions.

The insurance company wanted the rest of the finger amputated.


And I'm pretty sure if every actuary in the country was arrested on RICO charges, the world would be a better place.

Or we could just strafe the buildings with Warthogs. They have a lot of options for payloads. I'm sure at least some of them don't go the WHOLE way through office buildings. Maybe we could design an "office buster" smart bomb that only goes in 3-6 meters and then explodes with a less-lethal payload than conventional military weapons. Tear gas instead of boomex or whatever they use these days.

www.airforce-technology.com
 
2013-09-17 07:17:24 AM
The second is the insurance company is now making medical decisions. Care panels

Don't blame ObamaCare for that.  This has been going on for years.  On the other hand the insurance companies will say that they're not making decisions.   They're just telling you that they're not going to pay for something that you want, and you agreed to this when you purchased their policy.  If you want something that's not covered, you're welcome to pay for it yourself.
 
2013-09-17 07:20:36 AM
ECM is amazing stuff. Not that you'd learn anything about it from TFA.
 
GBB
2013-09-17 07:28:25 AM
"I can count on one hand how many fingers I have left"
 
2013-09-17 07:28:51 AM
The real question is: Can the regenerated fingertip unlock his iPhone?
 
2013-09-17 07:30:05 AM
"The insurance company wanted the rest of the finger amputated."

Fair's fair...I want insurance execs amputated.

They want anesthetics?

Oh, no...that's not covered.
 
2013-09-17 07:31:49 AM
Whoa whoa whoa wait... You mean we can accomplish this WITHOUT human embryonic stem cells?  I'm so confused, i though that was the only way to keep Michael J Fox alive
 
2013-09-17 07:37:51 AM
Health Insurance companies are so resistant to experimental procedures and treatments I'm surprised they pay for other things besides leeches, bleeding, and trepanning.
 
2013-09-17 07:38:08 AM

Earguy: The second is the insurance company is now making medical decisions. Care panels

Don't blame ObamaCare for that.


To be fair, the submitter said Care panels.  ObamaCare has DEATH panels.
 
2013-09-17 07:38:09 AM
It's unfortunate it grows back so blurry.
 
2013-09-17 07:38:53 AM

doglover: colinspooky: Pretty sure insurance companies only make financial decisions.

The insurance company wanted the rest of the finger amputated.


And I'm pretty sure if every actuary in the country was arrested on RICO charges, the world would be a better place.

Or we could just strafe the buildings with Warthogs. They have a lot of options for payloads. I'm sure at least some of them don't go the WHOLE way through office buildings. Maybe we could design an "office buster" smart bomb that only goes in 3-6 meters and then explodes with a less-lethal payload than conventional military weapons. Tear gas instead of boomex or whatever they use these days.

[www.airforce-technology.com image 620x371]


I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that. Most doctors would have done the same thing, do you want to firebomb them as well? Do you really think that if/when we move to single-payer, there isn't going to be a similar set of restrictions and approved procedures? Everyone biatches that their insurance company is too greedy to cover an experimental treatment, we'll just end up trading that for biatching that the public health service won't cover it either.
 
2013-09-17 07:39:55 AM
Jeebus, some of the comments on that site are just derptastic.
 
2013-09-17 07:41:51 AM
It's all well and good, but it's left his finger looking a bit blurry
 
2013-09-17 07:43:20 AM

GBB: "I can count on one hand how many fingers I have left"


Well, with one hand that has five fingers you can count to 31!

/Geek
 
2013-09-17 07:43:25 AM

Earguy: The second is the insurance company is now making medical decisions. Care panels

Don't blame ObamaCare for that.


Except now we have a Care Commissar.

/don't turn around, he's in town, uh oh
 
2013-09-17 07:45:25 AM

r1niceboy: Health Insurance companies are so resistant to experimental procedures and treatments I'm surprised they pay for other things besides leeches, bleeding, and trepanning.


Let's not be hasty...leeches don't grow on trees, you know.  The patients can darned well drain their OWN blood.

Trepanning can be outsourced to a local body shop, to keep costs down.  We've got executive bonuses to pay.
 
2013-09-17 07:47:06 AM

edmo: It's unfortunate it grows back so blurry.


hahahaha. thanks. i mean it.
 
2013-09-17 07:47:10 AM
So, you tie a pig bladder to things and fingers grow inside it? Am I retarded since that article left me more confused than I usually am?
 
2013-09-17 07:51:50 AM

Harvey Manfrenjensenjen: I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that


Yeah, bloodletting and ye olde bead mould. It if moft beneficial for diverf maladies.
 
2013-09-17 08:00:01 AM
I, for one,hail and bow down to our new lizardmen overlords.
 
2013-09-17 08:03:30 AM

doglover: Harvey Manfrenjensenjen: I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that


Yeah, bloodletting and ye olde bead mould. It if moft beneficial for diverf maladies. I've got nothing, so here's some bullshiat false equivalency strawman.

FTFY.
 
2013-09-17 08:14:54 AM

Crunchy Frog: Jeebus, some of the comments on that site are just derptastic.


some?
 
2013-09-17 08:20:03 AM
Was this article written by a remedial high school English dropout or is this what passes for acceptable writing in the USA now?
 
2013-09-17 08:21:09 AM

Harvey Manfrenjensenjen: I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that


The problem is that reflexive adherence to standardized procedure, especially when that is driven by a desire to reduce costs rather than improve outcomes, impedes innovation and progress. Example:

Patient: My soon to be exwife just chopped my dick off over an article she saw in Cosmo!

Doctor: Okay we can totally fix that using this new technology which it grow it back and probably leave you with feeling in it too!

Insurance Company: Whoa, whoa, whoa. Hold on there, Tex. The standard procedure is to just tie off the stump and teach him to sit when he pees.
 
2013-09-17 08:22:48 AM
FTFA:  It's a difficult horse and is had history using our training methods," Halpern recalled.

Are they teaching the horse history?

/and is had
 
2013-09-17 08:23:02 AM

SAN66: Was this article written by a remedial high school English dropout or is this what passes for acceptable writing in the USA now?


Yes
 
2013-09-17 08:23:53 AM

poe_zlaw: So, you tie a pig bladder to things and fingers grow inside it? Am I retarded since that article left me more confused than I usually am?


Nah, the article was definitely lacking in details.  I'm confused as well.
 
2013-09-17 08:25:24 AM
Some of you guys think you know what you're talking about... I'm getting a kick...

With that out of the way - my company deals with insurance company moronity every day. We concluded long ago (15+ years) that the insurance company's sole "job" is to find ways to deny claims or state they never received them.

Many of these payers have long had medical staff that review the procedure to determine if it was, in their sole opinion, medically necessary. We have a certain speciality or two that we bill for that we take to the point of having a particular insurance company's staff sign off on the treatment plan to ensure it will be paid for and even then we occasionally have to appeal - reminding them they signed off on it. This is beyond authorization to the point where the patient's chart and treatment plan is reviewed with the payer's medical staff, just to get them to pay for something they would have in the first place.

CSB -

Many years ago, before electronic claim submission was even regularly used, we would send a stack of 50 claims or so to a payer in alphabetical order. After a few weeks we would call in to check on these claims and would find that maybe 25 of them would have made it into the payer's system - but that 25 would be made up of various letters throughout the alphabet so it was clear to us they received all the claims - half of them just never made it into the system. Most physician's offices are too busy to follow up and try to find them so the payer wins.

Another kicker is authorizations - God help you if you don't call and get authorization first. Even though the payer would have paid for *everything* you did, if you didn't ask permission first they're not paying you a penny and they're laughing at you for working for free. At least our Medicaid is decent about retroactive authorization - they pay crap but they're generally pretty easy to work with in my state.

With today's electronic systems and claim acknowledgements the reason for not processing claims has changed to missing information. It's funny that all the other claims submitted in that batch were ok tho.
 
2013-09-17 08:30:54 AM

slykens1: With that out of the way - my company deals with insurance company moronity every day. We concluded long ago (15+ years) that the insurance company's sole "job" is to find ways to deny claims or state they never received them.


Hence RICO.

We send them to the pen forever like the mob they are.
 
2013-09-17 08:36:54 AM

Monkeyhouse Zendo: Harvey Manfrenjensenjen: I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that

The problem is that reflexive adherence to standardized procedure, especially when that is driven by a desire to reduce costs rather than improve outcomes, impedes innovation and progress. Example:

Patient: My soon to be exwife just chopped my dick off over an article she saw in Cosmo!

Doctor: Okay we can totally fix that using this new technology which it grow it back and probably leave you with feeling in it too!

Insurance Company: Whoa, whoa, whoa. Hold on there, Tex. The standard procedure is to just tie off the stump and teach him to sit when he pees.


Again, I see everyone biatching about it, but I see no alternatives offered. Are you suggesting that insurance companies and/or the government pay out for whatever some random doctor decides to do?

And I never said you can only do the standard procedure - innovate as much as you want and one day it may just become the new standard procedure - just recognize that until then alternatives may not be covered in the same manner and don't whine about it.
 
2013-09-17 08:38:12 AM

Kentucky Fried Children: poe_zlaw: So, you tie a pig bladder to things and fingers grow inside it? Am I retarded since that article left me more confused than I usually am?

Nah, the article was definitely lacking in details.  I'm confused as well.


The treatment is a powder or membrane containing the components of extracellular matrix, the raw material used to manufacture it is pig bladders.

The ECM promotes ingrowth of cells, some of which are pluripotent and differentiate into the various types of cells that normally populate that area of the body.  What exactly signals them to turn into an epithelial cell, or reconstitute the subcutaneous tissue layer, or form new vascular networks is unknown.  Probably Jesus.
 
2013-09-17 08:43:09 AM

Vertdang: Crunchy Frog: Jeebus, some of the comments on that site are just derptastic.

some?


Now that I think about it, it seems like just about all of the major news sources websites comment sections have become the new "opinions" page. Filled with the least educated, derpiest, most completely off-the-wall insane statments that I've ever had the misfortune of reading. Don't these mental midgets have something better to do with their time than expose others to their idiocy?

My current "facepalm so hard I punched my brain through the back of my skull"
scontent-a-lax.xx.fbcdn.net
 
2013-09-17 08:47:24 AM

Harvey Manfrenjensenjen: Again, I see everyone biatching about it, but I see no alternatives offered. Are you suggesting that insurance companies and/or the government pay out for whatever some random doctor decides to do?


Nice straw man, you get those in bulk? I'm suggesting that care be driven by outcomes rather than minimizing cost. If a doctor comes up with a treatment that is outside the range of standard treatments, that is between the doctor and his patient, but should be submitted to an independent board for review to determine whether it is medically justified.

And I never said you can only do the standard procedure - innovate as much as you want and one day it may just become the new standard procedure - just recognize that until then alternatives may not be covered in the same manner and don't whine about it.

Why shouldn't procedures which can be demonstrated to improve outcome be covered? We make far too many medical decisions based on short term cost rather than long term outcome.
 
2013-09-17 08:52:05 AM

Vertdang: Don't these mental midgets have something better to do with their time than expose others to their idiocy?


What do little people have to do with this?
 
2013-09-17 08:52:52 AM

Vertdang: Vertdang: Crunchy Frog: Jeebus, some of the comments on that site are just derptastic.

some?

Now that I think about it, it seems like just about all of the major news sources websites comment sections have become the new "opinions" page. Filled with the least educated, derpiest, most completely off-the-wall insane statments that I've ever had the misfortune of reading. Don't these mental midgets have something better to do with their time than expose others to their idiocy?

My current "facepalm so hard I punched my brain through the back of my skull"


See, but it's kind of good in a way. At least his acquaintances and neighbors can know how stupid he really is and stay the fark away from him. Local papers are doing a public service by outing these morons.
 
2013-09-17 09:00:54 AM

doglover: slykens1: With that out of the way - my company deals with insurance company moronity every day. We concluded long ago (15+ years) that the insurance company's sole "job" is to find ways to deny claims or state they never received them.

Hence RICO.

We send them to the pen forever like the mob they are.


This is why I just want ins. companies to adhere to 'truth in advertising.'  They are not in business to pay claims, they are in business to make money, keep stockholders happy, and the only way to do those 2 things is to take in more dollars from premiums than they pay out in benefits.  Stop telling us, 'we care,' when you don't, pay the benefits we purchased, and then it's on us to read our contacts before we purchase, to determine the best value for our needs.
 
2013-09-17 09:02:00 AM

Gothnet: GBB: "I can count on one hand how many fingers I have left"

Well, with one hand that has five fingers you can count to 31!

/Geek


22's the shocker.
 
2013-09-17 09:08:14 AM

colinspooky: Pretty sure insurance companies only make financial decisions.


You've got a bit of learning to do, back to work.
 
2013-09-17 09:15:21 AM

colinspooky: Pretty sure insurance companies only make financial decisions.


financial decisions ARE care decisions when your business is health insurance. Are you dense?
 
2013-09-17 09:17:33 AM
Free Market Bureaucrats are best bureaucrats.
 
2013-09-17 09:20:19 AM

cherryl taggart: doglover: slykens1: With that out of the way - my company deals with insurance company moronity every day. We concluded long ago (15+ years) that the insurance company's sole "job" is to find ways to deny claims or state they never received them.

Hence RICO.

We send them to the pen forever like the mob they are.

This is why I just want ins. companies to adhere to 'truth in advertising.'  They are not in business to pay claims, they are in business to make money, keep stockholders happy, and the only way to do those 2 things is to take in more dollars from premiums than they pay out in benefits.  Stop telling us, 'we care,' when you don't, pay the benefits we purchased, and then it's on us to read our contacts before we purchase, to determine the best value for our needs.


I want insurance to be illegal or the mob to be legal. I don't really care which way that cookie crumbles, as expirentially it will be win-win for us little folken. Either the insurance is made illegal and healthcare has to adapt (read: get cheaper) or the mob becomes legal and we can all make more money leaning on the neighbors and running "legitimate business" tax free so we can afford better policies.
 
2013-09-17 09:22:03 AM
Monkeyhouse Zendo:The problem is that reflexive adherence to standardized procedure, especially when that is driven by a desire to reduce costs rather than improve outcomes, impedes innovation and progress. Example:

Patient: My soon to be exwife just chopped my dick off over an article she saw in Cosmo!

Doctor: Okay we can totally fix that using this new technology which it grow it back and probably leave you with feeling in it too!

Insurance Company: Whoa, whoa, whoa. Hold on there, Tex. The standard procedure is to just tie off the stump and teach him to sit when he pees.


You bastard. You made me have to shut off my internet before someone could see why I was laughing! +1
 
2013-09-17 09:28:09 AM
You know you're on Fark when there's an article about a doctor regrowing a guy's amputated finger, and the thread contains nothing but arguing about what health insurance should cover.

This is actually kind of amazing, guys. I'm just sayin'.
 
2013-09-17 09:28:42 AM

Earguy: The second is the insurance company is now making medical decisions. Care panels

Don't blame ObamaCare for that.  This has been going on for years.  On the other hand the insurance companies will say that they're not making decisions.   They're just telling you that they're not going to pay for something that you want, and you agreed to this when you purchased their policy.  If you want something that's not covered, you're welcome to pay for it yourself.


Yep.
 
2013-09-17 09:31:54 AM

doglover: healthcare has to adapt (read: get cheaper)


What happens if it can't (or won't) get cheaper?
 
2013-09-17 09:31:59 AM

gglibertine: You know you're on Fark when there's an article about a doctor regrowing a guy's amputated finger, and the thread contains nothing but arguing about what health insurance should cover.

This is actually kind of amazing, guys. I'm just sayin'.


To be fair, there are some comments about how poorly written the article is.
 
2013-09-17 09:36:01 AM

Madbassist1: colinspooky: Pretty sure insurance companies only make financial decisions.

financial decisions ARE care decisions when your business is health insurance. Are you dense?


Nope, not dense. You really think insurance companies will worry unduly about the patient exclusively over and above any financial implication?  Ho ho. Are you dense?
 
2013-09-17 09:39:51 AM

neversubmit: FTFA:  It's a difficult horse and is had history using our training methods," Halpern recalled.

Are they teaching the horse history?

/and is had


Yes, I think the author had a stroke mid-sentence. The whole quote is mind-boggling:  "After the treat it made a mistake. It's a difficult horse and is had history using our training methods"
 
2013-09-17 09:42:59 AM

Earguy: Don't blame ObamaCare for that.  This has been going on for years.  On the other hand the insurance companies will say that they're not making decisions.   They're just telling you that they're not going to pay for something that you want, and you agreed to this when you purchased their policy.  If you want something that's not covered, you're welcome to pay for it yourself.


What insurance company do you have, because I didn't receive a list of what procedures are covered before or after making my insurance choice. That's information that I learn on a piecemeal basis whenever I go to the doctor. I suppose you could say that I agreed to allow them to make arbitrary decisions regarding what health care procedures they'll cover but it's not like there's an alternate provider that doesn't demand that concession.

What I agreed to is number of covered checkups, copay, percentage of care covered, and limits on total cost per unit time. When I agreed to that 80/20 split on what they pay vs what I pay I didn't see an itemized list of procedures that applies to and I suspect that if such a list exists, it is locked away in a vault at the provider's HQ with a sign on the door stating "Beware of the jaguar".
 
DuX
2013-09-17 09:49:43 AM
Getting into my slow season, I'm thinking of taking an extra job as a Shill or Troll on online forums for the insurance industry, how does it pay? Do the entry-level positions offer any perks and benefits like 401k's or medical insurance that won't screw you over and covers Viagra™ and other important things like that?
References and contact info for HR would also be appreciated.
Thanks.

/I'm dreaming of a white Christmas
 
2013-09-17 09:49:58 AM

gglibertine: You know you're on Fark when there's an article about a doctor regrowing a guy's amputated finger, and the thread contains nothing but arguing about what health insurance should cover.

This is actually kind of amazing, guys. I'm just sayin'.


How amazing is it when you can grow a finger, but you have to be at least a millionaire before you can afford it? Then it just becomes "Big farking deal. So what.
 
2013-09-17 09:50:53 AM

colinspooky: Madbassist1: colinspooky: Pretty sure insurance companies only make financial decisions.

financial decisions ARE care decisions when your business is health insurance. Are you dense?

Nope, not dense. You really think insurance companies will worry unduly about the patient exclusively over and above any financial implication?  Ho ho. Are you dense?


I think my sarcasm meter might be broken :(
 
2013-09-17 09:56:13 AM

King Keepo: It's all well and good, but it's left his finger looking a bit blurry


I suspect that's a side effect of paper. The doctor probably wants to publish a paper about the procedure, and journals don't like stuff that has been published elsewhere. The doctor can claim that a photo which is not blurry has not been published elsewhere. He wants his headline and his cake too.
 
2013-09-17 10:04:48 AM

Madbassist1: colinspooky: Madbassist1: colinspooky: Pretty sure insurance companies only make financial decisions.

financial decisions ARE care decisions when your business is health insurance. Are you dense?

Nope, not dense. You really think insurance companies will worry unduly about the patient exclusively over and above any financial implication?  Ho ho. Are you dense?

I think my sarcasm meter might be broken :(


Ha, maybe. Perhaps just gone out of skew on the treadle.
 
2013-09-17 10:05:11 AM
This is not new to me. My wife recently had either a very bad case of vertigo or a terrible migraine that effected her vestibular system. Almost 1 month later, she still isn't able to walk normally and had to go on STD. Her insurance is supposed to top up her EI payments to her normal salary while she's sick. Despite letters from her family doctor, vestibular specialist, and neurologist saying she's not healthy enough to go back to work, the insurance company is only topping up 2 weeks worth of pay because "that's how long it should take someone to recover" according to them... despite what actual doctors are saying. Dicks.
 
2013-09-17 10:06:42 AM

Parthenogenetic: unknown


The miracle of pork.
 
2013-09-17 10:35:07 AM
my dad lost his finger tip to the bottom of the finger nail about 30 years ago in an oil industry accident.  It grew back on its own.  apparently they do that.
 
2013-09-17 10:39:38 AM

Noticeably F.A.T.: doglover: healthcare has to adapt (read: get cheaper)

What happens if it can't (or won't) get cheaper?


Stop me if you've heard this one before..."but we have to do SOMETHING!!!"
 
2013-09-17 10:45:24 AM
What about ythose ?religions" that forbid using parts from another animal? Pig parts are used quite extensively. Heart vales, all kindsa partsare fine for medicine, but get someone near a pork chop, and they freak the fark out, only curablr by an apology and a boatload of money.
Same with stem cells. I feel that those who opposed funding of that, should be precluded from any positive medical benefits of any derivative treatments. "Mr. Smith, we can treat this with a stem cell based treatment. Oh, I see you opposed stem cell research, so you're not eligible.The alternative treatment you're eligible for is going home and lighting a candle."
 
2013-09-17 10:58:51 AM

Noticeably F.A.T.: doglover: healthcare has to adapt (read: get cheaper)

What happens if it can't (or won't) get cheaper?


It can and should be cheaper. It's cheaper everywhere else in the world. The question is why. The answer appears to be the system.

What's wrong with America's current system? Don't have all the deets, but it's a fair guess that a mandatory extortion racket is going to drive up prices. That's what usually happens with extortion schemes. So, let's bust them up RICO style and see what happens.
 
2013-09-17 11:08:29 AM

neversubmit: FTFA:  It's a difficult horse and is had history using our training methods," Halpern recalled.

Are they teaching the horse history?

/and is had


The writer screwed up trying to put in a direct quote. If you watch the video, the guy almost said this exactly-not quite, but pretty close. In the written part of the story they should have just cut the quote off at 'It's a difficult horse' .
 
2013-09-17 11:16:38 AM

Ex-Texan: What about ythose ?religions" that forbid using parts from another animal? Pig parts are used quite extensively. Heart vales, all kindsa partsare fine for medicine, but get someone near a pork chop, and they freak the fark out, only curablr by an apology and a boatload of money.
Same with stem cells. I feel that those who opposed funding of that, should be precluded from any positive medical benefits of any derivative treatments. "Mr. Smith, we can treat this with a stem cell based treatment. Oh, I see you opposed stem cell research, so you're not eligible.The alternative treatment you're eligible for is going home and lighting a candle."


Who is opposed to stem cell treatment?  I'm not aware of any religious groups that do.  Oh you are talking about embryonic stem cells, the ones that butthurt liberals were crying for federal funding for, despite the lack of any benefits, meanwhile non-embryonic stem cells are out there curing dozens (hundreds) of ailments?  Gotcha.
 
2013-09-17 11:21:00 AM

insano: neversubmit: FTFA:  It's a difficult horse and is had history using our training methods," Halpern recalled.

Are they teaching the horse history?

/and is had

Yes, I think the author had a stroke mid-sentence. The whole quote is mind-boggling:  "After the treat it made a mistake. It's a difficult horse and is had history using our training methods"


very, very heavy bertation tonight.....
 
2013-09-17 11:28:44 AM

Gothnet: GBB: "I can count on one hand how many fingers I have left"

Well, with one hand that has five fingers you can count to 31!

/Geek


There are 10 kinds of people in this world. Those who understand binary, and those who don't.
 
2013-09-17 11:57:51 AM

Harvey Manfrenjensenjen: Monkeyhouse Zendo: Harvey Manfrenjensenjen: I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that

The problem is that reflexive adherence to standardized procedure, especially when that is driven by a desire to reduce costs rather than improve outcomes, impedes innovation and progress. Example:

Patient: My soon to be exwife just chopped my dick off over an article she saw in Cosmo!

Doctor: Okay we can totally fix that using this new technology which it grow it back and probably leave you with feeling in it too!

Insurance Company: Whoa, whoa, whoa. Hold on there, Tex. The standard procedure is to just tie off the stump and teach him to sit when he pees.

Again, I see everyone biatching about it, but I see no alternatives offered. Are you suggesting that insurance companies and/or the government pay out for whatever some random doctor decides to do?

And I never said you can only do the standard procedure - innovate as much as you want and one day it may just become the new standard procedure - just recognize that until then alternatives may not be covered in the same manner and don't whine about it.


How about insurance companies tjat refuse to pay for procedure treatment because they refused to update their lusts for 20plus years?

Pay for a medication regiment that has been around for 10 years for life? Fu@% that! We will wait for tje required joint replacement every 10 years when medication costs less than 1 surgery!

/i see your point, I hope you can see ours
 
2013-09-17 12:06:26 PM
Monkeyhouse Zendo:


Harvey Manfrenjensenjen: I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that

The problem is that reflexive adherence to standardized procedure, especially when that is driven by a desire to reduce costs rather than improve outcomes, impedes innovation and progress. Example:

Patient: My soon to be exwife just chopped my dick off over an article she saw in Cosmo!

Doctor: Okay we can totally fix that using this new technology which it grow it back and probably leave you with feeling in it too!

Insurance Company: Whoa, whoa, whoa. Hold on there, Tex. The standard procedure is to just tie off the stump and teach him to sit when he pees.


It's not quite as cut-and-dried (hyuck!) as that. My mom worked as both a Policy Analyst and an Appeals Analyst for one of the Blue Crosses for years. She was in fact on Death Panels, and the way it works is:

A) Doctor performs or requests procedure.

B) The claim is broken down and "coded" using recognized procedure codes.

C) The tier-1 claims processor looks over the claim and approves standard stuff, and if it looks iffy rejects unnecessary stuff or things considered experimental.

D) The doctor can then appeal any rejected parts of the claim, whereupon...

E) it goes to a medically trained appeals analyst, who reviews the literature about the contested procedure and evaluates it in light of the individual case.

F) The appeals analyst can then recommend the procedure be approved or denied.

It's not *just* a cookie-cutter approach, and it does consider outcomes. Yes, insurers are all about denying everything possible, but they're not *just* looking at a table and stamping REJECTED on anything they don't like. This helps cut down on absurd crap like people wanting to pay chiropractors to treat lung cancer, or (my favorite) the person who wanted "equine therapy" for their little Johnny because he fidgeted in class. i.e. they wanted the insurer to pay for his horse riding lessons because he was a six-year-old boy hyperactive.

It's not perfect, but if you've got a better suggestion on how to deal with fraud and demands for expensive + low-outcome procedures, I'm sure we'd love to hear it.
 
2013-09-17 01:38:27 PM

Monkeyhouse Zendo: Harvey Manfrenjensenjen: I'm not seeing the problem here. Someone comes in with the tip of their finger bitten off, and there is a relatively standard procedure for that

The problem is that reflexive adherence to standardized procedure, especially when that is driven by a desire to reduce costs rather than improve outcomes, impedes innovation and progress. Example:

Patient: My soon to be exwife just chopped my dick off over an article she saw in Cosmo!

Doctor: Okay we can totally fix that using this new technology which it grow it back and probably leave you with feeling in it too!

Insurance Company: Whoa, whoa, whoa. Hold on there, Tex. The standard procedure for the cheapo coverage option you chose to save some bucks is to just tie off the stump and teach him to sit when he pees.


FTFY
 
2013-09-17 02:07:53 PM

Priapetic: for the cheapo coverage option you chose to save some bucks


This is even a consideration in medical care? And we say we are exceptional? Exceptionally greedy. Exceptionally barbaric, maybe.
 
2013-09-17 02:30:49 PM

colinspooky: Pretty sure insurance companies only make financial decisions.


Youre right, this does seem like a pretty ham handed decision on their own part.

/ Your hate, I will roll in it.
 
2013-09-17 02:52:25 PM

Madbassist1: Priapetic: for the cheapo coverage option you chose to save some bucks

This is even a consideration in medical care? And we say we are exceptional? Exceptionally greedy. Exceptionally barbaric, maybe.


Of course it's a consideration. In what farking world do you live where a system where it's not could be sustainable? Do you think countries with national healthcare systems will just give you any treatment you demand regardless of cost or proof of positive outcome? Here's a clue: They won't. If you want a really expensive experimental treatment, you have to either pay for it, find a study that needs participants, or pay an insurance company who's found a way to make a business model out of letting people write doctors blank checks.
 
2013-09-17 03:25:14 PM

Vertdang: My current "facepalm so hard I punched my brain through the back of my skull"


I can only hope Bill Thomas is trolling... If not, I can only hope he hasn't bred, and he manages to Darwin himself soon...

/But, in reality, he's probably about 85 years old, and already has a few hundred children, grandchildren, great grandchildren, and so on...
 
2013-09-17 03:44:22 PM
MMMMmmmmmm  Bacon!

drawception.com
 
2013-09-17 03:54:32 PM

doglover: It can and should be cheaper.


Cheap enough to get it without insurance paying?

doglover: It's cheaper everywhere else in the world.


Is it? I know a lot of people around the world don't pay as much, but I also know they have good insurance.
 
2013-09-17 06:35:05 PM

thurstonxhowell: Of course it's a consideration. In what farking world do you live where a system where it's not could be sustainable? Do you think countries with national healthcare systems will just give you any treatment you demand regardless of cost or proof of positive outcome? Here's a clue: They won't. If you want a really expensive experimental treatment, you have to either pay for it, find a study that needs participants, or pay an insurance company who's found a way to make a business model out of letting people write doctors blank checks.


Nope, but they will give everyone access to the same treatment, while at the same time not denying those with money to burn the opportunity to get a nicer room, have things done on their timescale rather than the health services', or go for something unproven. And all for far less than US healthcare, because we don't have an entire profession of rent-seeking middle-men.
 
2013-09-17 08:40:26 PM
The insurance company wanted the rest of the finger amputated

I don't get it. If the horse only took to his first knuckle then why'd the want to take the whole thing off?
 
2013-09-17 10:09:58 PM

morg: The insurance company wanted the rest of the finger amputated

I don't get it. If the horse only took to his first knuckle then why'd the want to take the whole thing off?


To some people "amputation" means "cut the whole damn thing off".

If the level of the traumatic amputation was at or around the joint at the end of the finger (the distal interphalangeal joint for you medical pedants) and there was not enough local tissue to cover the bony stump, then the standard procedure is to revise the amputation by shortening the bone (i.e. do a bony amputation at a more proximal level) and advancing the soft tissues (preferably the thicker, more durable, and more densely innervated palmar flap) over the tip of the stump to obtain adequate coverage.  Maybe the bite left a little nubbin of the base of the distal phalanx, and a surgeon recommended that the rest of the distal phalanx (not the rest of the finger) should be excised.

If the level of the traumatic amputation is at the level of the index finger proximal phalanx, in some cases an index ray amputation (i.e. cutting the whole damn thing off) may be more functional than leaving an itty bitty painful stump o' digit.  Or not.  Most people in that case will learn to use the middle finger to pinch, and an index ray amp reduces the width of the palm, which may reduce strength when gripping or twisting.

░░░░▒▒▒▒▓▓▓▓
The More You Know
 
2013-09-18 04:01:19 AM

Earguy: The second is the insurance company is now making medical decisions. Care panels

Don't blame ObamaCare for that.  This has been going on for years.  On the other hand the insurance companies will say that they're not making decisions.   They're just telling you that they're not going to pay for something that you want, and you agreed to this when you purchased their policy.  If you want something that's not covered, you're welcome to pay for it yourself.


No kidding.  You'd have to be living under a rock to think this is something new.
 
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