Is this related to the article? Probably not. But I never get enough chances to point out the myriad abuses and misuses of the health care system.
This is likely due to an inability to access "regular doctor" care. Either for lack of insurance (which they can't afford), or a giant deductible (which they also can't afford). The doctor's office can turn them away for an unpaid bill; the ER cannot.
Specifically, people without insurance end up at the ER because the ER can't legally turn them away for not having insurance or not being able to pay.
Another predictable consequence is patient dumping, where patients who cannot pay at one hospital are sent to the ER at another.
Perhaps you are in a local minima of bad conditions.
Even if what you saw is widespread, it is still no excuse for this kind of stupid response from insurers. It is not even close to justified.
The idea that the ER can't triage non-emergency care is some sort of bureaucratic construction designed to facilitate making money.
That would only make the situation even worse, hospitals would raise their absurd gouging rates even higher if government required it.
Reform is needed but on both sides of that table.
But it's very profitable.
Physician salaries have certainly outpaced inflation over the past 50 years (in most specialties - pediatrics and internal medicine seem to have dropped slightly) and the profit share of insurance companies has drastically increased over the last 20 years.
After Obamacare, health insurer profitability has actually improved, and health insurance stocks have outperformed the S&P 500 by more than 100%.
If you want a cut, you should really buy some stock.
So, not the patient, who has played by the rules their entire life, and properly paid into the system, is now literally fighting for their life, probably without a job, and is now denied the healthcare that they had paid for their entire life.
And when a case manager denies their claim and saves the company $500K, they get promoted for killing the patient.
This is not rumor. This is sworn testimony before congress.
"Fuck these people" indeed!! (except they may no longer qualify as people)
Citation please?
It was systemic in the industry before it was banned by the ACA/Obamacare. This is one of the most important features of the ACA.
I've posted below only one of the first appearing links to articles on the testimony of industry insiders [1]. I don't have handy the link to the video I found most memorable. It was a woman who worked at a large insurer, who rescinded the insurance of a man with an expensive disease, who'd never missed a payment, and who died fighting to get the insurer to pay. so he could get treatment. She felt badly enough about it to testify, and was also promoted for saving the company money.
Just because it sounds outrageous and dishonest does not mean that people won't do it.
[1] https://abcnews.go.com/Business/Health/story?id=7911195&page...
Maybe a stretch, but possible.