Weight Loss Thread

Khane

Khane

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sleevedraw said:
Work at one and maybe you'll get a different perspective on things. Doctors and hospitals aren't saints either.
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I worked for a benefits company that offered a stored value debit card for healthcare spending for 18 years. I wrote software that processed all kinds of claims data including information from pharmacy benefits managers who negotiate a lot of this shit. Who's claiming doctors and hospitals are saints?
 
BrutulTM

BrutulTM

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A friend of mine worked at an insurance company and he said he had to quit out of conscience. He said "You spend half of your time telling people you're going to take care of them and the other half trying to avoid paying them any benefits when they have a claim."
 
sleevedraw

sleevedraw

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I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
 
Kithani

Kithani

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sleevedraw said:
I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
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Imagine being the insurance prior auth team and considering yourself the good guy lmao
 
Izo

Izo

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sleevedraw said:
I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
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I'm evil. I bill zero. Muahahaha.
 
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unhappyendings

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Every level of the system has significant actors trying to claim their piece of the pie with incompetence and negligence sprinkled in. It is just a game of whack-a-mole for the patient to locate the dick coming to fuck them next. Many do not even realize they are getting fucked.

Every level has people trying to do the right thing as well.
 
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Cad

Sheriff Cad

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sleevedraw said:
I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
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I don't do health insurance stuff but we are coverage counsel for some of the big property and casualty companies. Claimants are absolutely trying to rip the insurance companies off on every single claim. Lots of them are represented by sophisticated counsel trying to rip the insurance companies off. (I'm careful not to say "us" here on purpose, I am not my clients, put down the pitchforks.)

It's an emotional issue regarding health care because "somebody" has to be the one to say no to care... and doctors sure aren't... (as if we don't all also complain about the cost of care in the next breath) while also thinking *our* care should be 100% covered even if it's expensive.

The problem as I see is that the process just isn't accurate/efficient enough - people get denied that probably should be covered, and people get covered that probably should be denied, and there's enough overlap that everyone is fucking pissed about both of those situations.
 
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Noodleface

Noodleface

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sleevedraw said:
Here's the article if you want to do do a deep dive.

There are some cost savings realized from weight reduction, but (a) GLP-1s have their own set of complications such as pancreatitis which can eat into their cost savings similar to bari surgeries having complications, (b) bari surgeries also achieve some cost savings from weight reduction, so that needs to be factored in, and (c) medication adherence is an issue with GLP-1s.
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Interesting read. Thanks
 
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Aldarion

Aldarion

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This is one of the best and most honest pieces I've read on weight loss in a long time.
substack.com

Is the Fattest Place in America the Starbucks Drive‑Through?

Sweet coffee, whipped cream, liquid sugar, and why exercise can’t save us
substack.com substack.com
We do not need another campaign telling people to count calories harder or buy gym memberships in January.

We need to say, clearly, that:
  • Sweet makes us fat, especially when it comes in liquid form and especially when it comes early and often.
  • Coffee chains and “healthy” juice bars that sell liquid dessert for breakfast are part of the fast‑food problem, not an escape from it.
  • Ultra‑processed, corn‑ and soy‑based products designed to be eaten quickly with those drinks are not “food” in the evolutionary sense. They are feed.
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