My husbands suicide shows theres something very wrong with US insurance industry

petilon

Yes, there is something wrong with the insurance industry. But there is something wrong with the hospitals, doctors and drug companies too. The whole system is broken. Hospitals try to eke out the most out of insurance companies, often providing services that are unnecessary. Pharmaceutical companies charge US patients significantly higher rates than in other countries. Don't put all the blame on insurance companies.

recursive

This is a far cry from the gravity of the post, but here's my personal anecdote about trying to navigate health care and insurance. A month or two ago, I was trying to set up a pediatric dentist visit for my son. Not a medical emergency, but a matter of some urgency. I spent about three hours on a total of a dozen phone calls or so. Some to the insurer, and some to various dentist offices in the region to inquire about scheduling and logistics. I learned that I needed to switch my son's primary office before he would be eligible to receive care. This could only be done once per month. Fortunately, by luck, this would take effect at the close of business on that very day. Next I needed to find a covered provider. Of course, the insurer could not tell me which ones would have openings at short notice, so I had to call several. Then I learned that in order for a pediatric visit to be covered, it needed a referral from a general dentist. The pediatric office helped me find a dentist who could fill out this paperwork, which felt lucky. I verified that my policy worked with this dentist office. Several hours on the phone, but I had a sense of accomplishment for sorting it all out. The day of the appointment came. The visit went smoothly. Then I found out that it wouldn't be covered because the insurance will not cover pediatric dentistry above the age of 6, but my son is 7. I think I'm going to opt out of dental insurance altogether in the next enrollment. All the individual people seemed to be doing their best to help me, but the end result is a system that is impossible for me to use.

daheza

As someone who just recently was re-diagnosed for active major depression after a major back surgery this article hits very hard. I recently discussed inpatient treatments with my psychiatrist too. I can understand what the husband was feeling... that the nothing of death was greater than the feelings of life. It's difficult to work with healthcare in general - add a mental issue on top of that and it feels impossible. You have to constantly advocate for yourself since each doctor will only do what is required for their subspecialty and you also have to fight insurance on the other side. Specifically regarding mental related items are treated as lesser than physical issues. I have Kaiser who has actively been punished by the US Department of Labor [1](2026) [2](2021) for delays in behavioral health care and pushing for out of network therapist. They tried to push these therapist on me twice, both through RULA and it was really a terrible experience. The therapist literally ended my meeting 10 minutes into our discussion when I told him I hadn't finished reading the book he recommended. I am now with an in-house kaiser therapist that is working well. I worry about the psychiatric side of the house as well, they set me up to only meet with my psychiatrist once every three months. That doesn't feel frequent enough to get my medication tuned right. I don't see this getting better in the future with the current leadership in the US advocating for a "return control to the patients" by reducing SSRI prescriptions. [3] My only advice for people out there is to take their mental health seriously, if you are having suicidal thoughts talk to your doctor. It may end up being a difficult journey but its better than being alone. 1. https://www.dol.gov/newsroom/releases/ebsa/ebsa20260210 2. https://calmatters.org/health/2023/10/kaiser-permanente-cali... 3. https://www.pharmacytimes.com/view/announcing-new-initiative...

JohnTHaller

The goal of their insurance company is to make a large return for their shareholders. And, thus, a large bonus for the C-suite execs. Their goal is not to provide care. In this particular instance, the insurance company saved money to give to shareholders and their C-suite by not treating the patient further. They lose no money by allowing him to die. This is all by design.

mvdtnz

Anyone who moans about the state of healthcare in USA should be required to reveal their voting habits. Collectively, America gets the healthcare system it desires, and deserves.

pyuser583

I’ve been through this situation with family members. I understand the frustration and agony. I also understand the hesitancy to pay for two months at a “retreat-like inpatient psychiatric facility.” In publicly funded system, it’s likely facilities like this would not exist or would be strictly private pay. I’m not aware of any country that makes such a thing available on short notice like this. I also understand the frustration, as often times facilities like this are all that exist in terms of medium-term care. And often times some of their services are at least formally in-network. The understanding is you pay for it by selling your house. We’ve been tempted to do this (sell our house), but been advised against it - but the reasoning in our case is patient specific. I wish insurance was clearer about what covered and what isn’t. I wish we had more mainstream (not retreat-like) medium term care places. Maybe I’m misreading the phrase retreat-like. But id this isn’t something a public system would pay for, it seems inappropriate to blame a private system to not pay for it, unless it’s clearly in the wording. Regardless, mental health care in America stinks, and you can always argue over the details.

anonymousiam

This article makes a good case for the abolition of health insurance. If everybody had to pay for medical care, medical care would need to be affordable to survive. It's hard for me to believe that a doctor couldn't afford medical care for her husband. She just couldn't get outside of the box and consider that the treatment was more important than the cost.

arjie

In my experience, one can always continue care if one is willing to pay. Insurance companies do not deny care; they deny claims for care. In fact, numerous times they make mistakes and deny valid claims. Only the healthcare provider can choose to not provide care: either because they believe they will not get paid or they believe you don’t need it or some other such reason. Considering this person has a high-paying job and it seems like a short-term intervention would have created a long-term positive outcome, it’s not clear to me why they didn’t simply insist on the care without insurance coverage. My contingency plans for these situations are to pay out of pocket and figure out reimbursement later. In practice, paying out of pocket is just a promise to pay out of pocket. Often one isn’t charged until afterwards and I experienced sufficient mechanisms to delay payment until the whole thing had been sorted out. Permanent conditions (like, say, brain death) are a different story. But in my case, the bill I was ostensibly facing was hundreds of thousands of dollars and I proceeded with it on the grounds that rapid intervention would yield results and I can figure out the payment structure later. If I were facing the worst case scenarios of a family medical bill bankruptcy or family member loss I think that usually I’d prefer the former. It’s hard to make a decision in the moment, but if the healthcare provider determines that more care is required and the insurance provider that it is not, I am more likely to follow the former though not without bound.

tracker1

I've had to go through this with treatments for my eyes... that I haven't been able to see a doctor on for about a year and a half because as a contractor my insurance sucks and even when I've had good insurance it was often problematic... wierd codes and then a back and forth call the insurance, call the provider only to ever get answers if I 3-way called them both and held them both to account. More than once I was on the hook for a $15k set of injections that I had to run on a credit card. At this point, I'm maxed out, paying out of pocket for what I can and it sucks... I'm hoping to convert to a City employee (temp) vs contractor which at least gets decent medical, but my own experience has me doubtful even then. I've worked my whole adult life, didn't even take vacation time through my 20's and 30's... and never planned to retire... I don't want to, but I'm facing a reality that may not give me a choice in the long run. I don't think shifting to public healthcare is the answer in the US... but would like something similar to fiduciary safeguards around medicine and insurance.

ButlerianJihad

> I am an emergency physician living in the U.S., and we had one of the top commercial health insurance plans. You see, dear, your critical error was in believing that psychiatry is “medicine”, and that mental health treatment is “health care”. Oh for sure, they present you “doctors” and “nurses” with the same credentials, wearing white lab coats, ties, scrubs, and even stethoscopes. They can prescribe “drugs” and run “hospitals”. From the outside, they are indistinguishable from physicians who treat the physical body, but it is all a satiric cosplay. It is done this way for reasons, chiefly not to scare people too much. Mental health should be considered more of the “Pre-Crime Division” or Department of Corrections For Stuff That’s Not Your Fault. Don’t ever believe they’re in “Health Care”. This is a fatal category error.

mitchbob

https://archive.ph/nLvxS

silexia

She doesn't mention the root issue; her and her colleagues absurdly high salaries and the tight limits on new doctors in the US that make medical care scarce and unaffordable but keep their salaries high.