skaterrj

skaterrj t1_j7vqss3 wrote

None of those examples you gave compare to paying for health insurance and believing you are covered, then discovering it's useless. This one is closest:

> i guess i just don't see it as getting screwed because they are participating in the system and they know how the system works. if i go to a car dealership and the guy blows a bunch of fluff up my ass and i overpay, did i get screwed? or did i participate in an activity that is designed to exploit me for my resources?

If your employer had you paying into a health care plan then you later discovered it was smoke and mirrors, you would be screwed, yes. How in the world would that be your fault?

You're blaming the victims.

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skaterrj t1_j7vmycj wrote

> median individual income in the US in 2022 was $46k, likely with bad/no benefits at that kind of salary, likely with a work schedule/environment that is going to increase long term health issues. in two years, an NFL player on the literal minimum salary possible grosses more than what the median worker makes in 30 years.

You don't have sympathy for them, okay, fine. Does that mean they should get screwed by the NFL plan that they thought provided them coverage? No, of course not. No one should be screwed by health insurance, it doesn't matter how much they make.

> i'm arguing "duh, why wouldn't they deny every claim they can?" that's how they make money.

I made that argument as well, in the first comment of mine you replied to. I'll quote it since you seem to have missed it:

> There's no question that insurance companies make more money when they deny claims, so it's in their interest to do so, which automatically makes them biased against people filing claims.

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skaterrj t1_j7vj9c7 wrote

Part of the problem here is that many of them aren't millionaires. The average career span in the NFL is four years, and most of them do not get signed to those multi-million dollar contracts we're always hearing about. Even if they come out of it with perfect health, most of them are going to have to continue to work to survive the rest of their lives.

Also, I ranted about our health care system elsewhere in this thread so don't go assuming that I think the current system is fine.

Finally, your original comment was:

> do many companies think like this?

And I responded that my health care insurance rarely decline claims. You asked, I answered. Maybe you've had a different experience, and that's legit, too, but then I'm not sure why you asked the original question, which was in response to the NFL plan declining a lot of seemingly legit claims.

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skaterrj t1_j7ve3kb wrote

Let me put it this way - I can't remember the last time my insurance (medical, dental, vision, Flexible Spending Account) denied a claim. Obviously these are more like traditional requests (checkups, pain that isn't going away, dental cleanings, etc.), but they definitely don't seem to have a "deny first" policy in my experience.

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skaterrj t1_j7uax6w wrote

In addition to what /u/314159265358979326 said, note that the NFL plan said that the judge in each of those cases was wrong. The sheer arrogance makes me even more suspicious of this plan - there's no sense of, "Hey, maybe we did get it wrong this time, and we should think about that."

Ever read Grisham's "The Rainmaker"? The movie was good, but the book was much, much better. In the book, the insurance company basically has a plan that they will reject every claim and then set up a loop between underwriting and claims so that no claim was ever paid. Someone dies after not receiving a treatment that should have been covered, which prompts the lawsuit.

While that's fiction, there's no doubt in my mind that there's some root in fact in it. There's no question that insurance companies make more money when they deny claims, so it's in their interest to do so, which automatically makes them biased against people filing claims.

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