Day 27 Based on a true story: www.medpagetoday.com/special-... More info about the lawsuit: www.aaem.org/envision-lawsuit/ 30 Days of US Healthcare • 30 Days of US Healthcare
Most of this series has been a depressing downward spiral into the most twisted depravity that US healthcare system is capable of. But this video… this one brought a smile to my face.
As a Radiologist, this skit has changed my perception of Emergency Medicine from those guys who order all those unnecessary scans to the hero we need but didn’t deserve. ❤️
We order those tests because we’re the last safety net left for a very broken system and if I don’t get the images while they are in the ER it’ll be months before they get their test if they get it at all. Yes, we’re all acutely aware that we order too many tests but I don’t know if the other doctors that patient saw were careful and thoughtful or if they caved to the admins telling them to minimize testing. Frankly I don’t have the time to piece it all together, you save who you can, help who you can and move on because the whole system is under-resourced and overworked. Sorry for contributing to that workload (and I’m totally behind more Radiology/ER collaboration) but you guys help us save lives every day, we couldn’t do it without you. It’s worth ordering 9 negatives studies to catch that one aneurysm that’s been to 10 doctors who blew them off.
EM physician from down Under here. I heard an interesting statistic from a boss of mine the other day. Apparently statistically 6/7 of the scans we order in ED should be negative. If it's less than that we're probably missing things. If it's more we're over ordering. I found it interesting that the number of normal scans needed to be so high. Also, would like to reiterate, very much appreciate having you guys doing the job you do. Definitely helps me sleep at night
As a fellow Radiologist, I agree. Also wanted to point out that Dr. G failed to mention the Private Equity impact with Radiology (and anesthesia, and Dentistry for that matter).
@purpleXpotion better idea, cut your losses with private insurance and vote for free public Healthcare. The idea that Healthcare needs to be profitable is sheer lunacy.
@@cybergothstudios94 It’s actually not.. & if you care to hear me out.. here’s why. ..Maintaining a ‘Private Healthcare Sector’ (which is also reasonably taxed to help subsidize a smaller ‘Socialized Healthcare Sector’ for the poor/underprivileged) is *”Absolutely Essential”* in order to _‘Preserve Reasonable Access’_ to Quality medical services for the majority of citizens, in a reasonably Timely manner. ..Directly BECAUSE, such (by in large) helps to ensure that the majority of doctors will receive fair compensation for their care provided ..& on a more consistently predictable basis. Now if this means doctors need to boycott & just stop accepting ANY & ALL forms of insurance for a time, while only accepting self-pay directly from their patients.. then so be it!! (Because where things stand now, what do most patients or doctors _really_ stand to loose anyway?)🤷🏻♀️ ..A crippling botch-job surgical procedure that patients are likely Better Off without ..considering there’s a high likelihood the preforming doc is already expecting to get ripped-off while simultaneously being told _‘it’s unethical to deny people access to health services due to inability to pay’..)_ 😬 Ehh well, if we actually stop to analyze that concept for a moment 🤔..such notion inherently means there IS (in fact) an incredibly ironic argument being made that: _“Access to Care from _*_’Enslaved Doctors’_*_ is simply a _*_‘Basic Human Civil Right’_*_ now.”_ Hmm.. 👌👀 but… Good Luck expecting to actually _UTILIZE THAT_ health’care’ plan too often and/or for very long!! 💀 That WILL result in consolidating whatever ‘greed’ currently exists amongst private insurance, into that of a select few dictators.. and _quality of care_ will inevitably become EVEN FURTHER REDUCED to doctors having to tell ALL patients, 🙌equally:🙌 _”sorry, no narcotic pain meds are currently available due to government healthcare budget caps, but here’s a ‘generous’ Generic Brand Tylenol you can take 30 minutes prior to your leg amputation surgery.. compliments of our great leader.”_ 💀 Now if a doctor is already financially blessed & can afford to offer providing charitable healthcare services ON THEIR OWN ACCORD, that’s one thing. However, since doctors are human beings & not robots, then the government FORCING them to provide labor intensive healthcare services to the entitled public masses at whatever expense, cost, and/or personal detriment that may cause to a doctors own individual well being, would be nothing short of *‘Government Mandated Slavery.’*
Hope to see this actually happening. Private Equity and health care really can not go well. Let alone E.R patients who are the most vulnerable and lack choices.
Emergency medicine is one of the few areas Canada’s single payer system does well. Where it all falls apart is that for 95 percent of people its their only access. (Lack of infrastructure and personnel) so it gets plugged up with things that are very much not emergencies.
I know this is about medicine, but as a teacher and administrator working in private education this is so similar to what we deal with it's scary! Great work as always!
@@privacyvalued4134 in the US at least there is a strong push to privatize education to the point where a lot of places have “school vouchers” that allow people to divert money from the public school funds to private schools. Charitably it makes private schools more affordable, realistically it further starves public schools making them less effective and driving more people to send children to private schools. The end goal is complete capture of education by private equity after which prices start going up.
@@privacyvalued4134 As may have come to your attention, for PE to be interested, there must be large amounts of free-flowing money. In some communities where vouchers (a portable per student educational appropriation) are readily available, PE has or will set up schools. These schools pocket a portion of that money and spend the remainder on educating young people. Regulation around pocketing/profit/revenue vs spending and educational requirements and standards can vary considerably by jurisdiction. There is a growing push for vouchers in some communities. So far, voucher availability has been rather limited, but if it becomes widely available, expect large-scale PE “investment” in education.
Patient centered care may struggle too, but showing that private equity is NOT a superior business model could really make a difference. Thank you no surprises act.
I actually screamed yes when i heard private equity was being sued for unlawfully practicing medicine. Not even American, but you guys deserve better and it has been such a throughline of the story on this channel that it feels like the climax of a story.
Especially with the "us against them" division, this two party system we have going really just destroys most people's ability to think for themselves when it comes to voting, sadly
As a long term esketamine patient with United Healthcare, I just want to say that doctors and United Healthcare both bring me to tears for very very different reasons. Thank you to all the healthcare professionals out there willing to fight for us when we frequently don't know how to fight for ourselves.
As a new nurse in the 1970's until now, I've watched our healthcare nightmare with increasing despair. You've done a great thing with this series- brilliant. And infuriating.
You would think with all this modern technology people would be suffering less but it's the opposite people are suffering more than ever .... All because of greed people are suffering and dying all for the sake of profit
I’ve been sitting here waiting for this to upload for two hours. No joke. Every video you make is incredible. The health insurance month is your best idea yet. Keep making people laugh and see the Truth!
Please let that lawsuit be true! And please let it succeed! Please let the whole myth of "corporations are people" be skewered by finally making one of those bastards responsible for breaking the law so egregiously, and soundly punished for it. Maybe by putting every single person who made decisions for that organization behind bars for a while. (daydreams continue...).
The lawsuit is real, check the video description. That said, I would LOVE with all my soul to see the "corporations are people" come back to bite them in the ass by the fact they are being sued as a person, not as a corporation. The Judgment was that corporations are people, but they never said people can be a corporation!
Yes, corporations are groups of people with special needs. They fund elections and pick the Supreme court they want. Well they fund the campaigns which is pretty much the same thing since only certain people get the money and win the primary.
“Private equity and healthcare are incompatible.” As someone who has spent 20 years working in big pharma, I can confirm this is absolutely true 😢 We still do it, because patients need medicine and with as f***ed as the rest of the system is, pharma is about the only one who can afford to make it, but I’m pushing hard for the day when what I do is publicly funded and no longer for profit ❤
"For Profit" is a good motivation, I actually don't think there is anything wrong with it. There should just be strong regulation how big your profit can be if you have a monopoly and customers without choice... No one is going to skip making profit just because it is capped....
How would a public funding mechanism direct resources to illnesses that are rare and expensive to treat? And what makes you think it'd be run efficiently at all, our public spending schemes in healthcare and entitlements already make up most of the unfunded obligations we're facing within the next decade.
@@FarmerSchinken “For Profit” is a very effective motivation *within a fundamentally capitalist economic system.* I find it hard to consider that a point in its *favor*…
Wait - what!?! Seriously? Really!? FINALLY 😂 BOTH Private Equity going bankrupt AND the physicians suing them for practicing medicine as corporations. I love 💕 it!!! I hope MORE follow their lead.
I would think so. Even if it doesn't go to trial, just having the discovery phase showing how healthcare/insurance companies conduct business would be extremely enlightening and that would be the best event to happen.
I don't think so, inspite of what he says, if understand correctly pa"s procedures are written by docros from inside the insurance company and the appeals process also includes doctors.
@@justahugenerd1278trust me doctors want to sue insurance probably more than patients. Why? Because doctors who are ordering treatments procedures or medicine for their patients are the ones getting the no on the phone by insurance. No doctor wants to look incompetent so they try to do the right thing that gets the best outcome so you like them and leave a good review on your survey or refer your friends
Read the links in the description and its a very welcome sight. Envision trying to dismiss the lawsuit and is being denied, medical associations supporting the on-going lawsuit(I learned a new latin term! Amicus Curiae) I can imagine the other specialists sensing Envision's physiological change as the lawsuit continues. Cardio notes the tachycardia, opththa notes mydriasis as fear kicks in, neuro and psych note the panic setting in, family med experiences a sudden urge to create a plan for Envisions end of life care.
Private Equity has lost $900 Million up to this point, but with your help, we can change that. Fight now for proper healthcare legislation and together we can permanently bankrupt Barthelme.
I really look forward to a day that the people of U.S.A. all collectively realise exactly what you're saying, Doctor😁 Business/insurance and medical care of any kind are not just incompatible but diametrically opposed.
This is true of just about every business model, but it's most obvious with Healthcare. the US Ideal of "businesses exist to make money" will ALWAYS result in businesses prioritizing margins over product/service quality, regardless of which sector it is. We, as a society, need to put aside the notion of "make mo money" as a goal for businesses. Making money is a result of providing quality goods and services.
@@fasdaVT You may not win but the concept of companies practicing medicine without a license gets to aired out in public. Also, the discovery phase of the trial should be an eye-opener showing how their business model works.
@@NeuroatypicalKirbymight want to talk to the 50k Indians a month lifted out of poverty thanks to capitalism. So much of what people think is “capitalism” is cronyism. Very different. It’s not a perfect system, but the alternatives have a tendency to result in mass graves.
You manage to take your normal, charming, Dr. G face and turn it into the smarmy, slappable Bartholomew Banks face. I salute your acting and will resist the urge to slap Mr. Private Equity.
Just because they watch doesn't mean they'll listen or learn. Big-reputation politicians will only listen if you have a flat-screen on the back of a truck slowly dumping money onto them.
Wait, what? This is real? I am concerned that if I pinch myself hard enough to wake up from this dream I will emerge in a world where I can't afford to go to an ER to have the injury treated. LOVE LOVE LOVE this series!!!
I always thought that I cannot be prouder than I am for being an emergency medicine physician but This video actually increased that proudness to a whole new level!!!
As someone who fell into a deep hole of depression and hopelessness after being denied treatment (and still being denied treatment) over and over and over again for a dibilitating injury your U.S. Healthcare series helped me feel a little less isolated, confused, lost, hopeless and angry about my situation as a result of the greed of U.S. Healthcare "insurance" companies. I feel stronger knowing that there are thousands upon thousands of other people like me who want nothing more than to help the physicians and the policy makers fight the good fight and do something to stop "health insurance" companies from causing direct harm to people in need of medical care on a massive scale.
Emergency Medicine has found it necessary to treat one of the more pernicious disorders in our society. He was always a superhero, but today I think we owe him a shirt with a shield on it.
Have loved this dude for years. I bet United HC and all other HC insurers absolutely loathe him. Keep up the good work, Dr. G. Roast away! Mockery is hilarious. People respond to being laughed at probably more than by being shamed.
Turning things into a business is usually fine, though some things like prisons and hospitals you shouldn't try and take away from the government because people will suffer if you try to min max it.
Is there any hope that insurers can be sued out of existence for practicing medicine without a license when they deny treatment? I would cheer for joy.
Most the psychiatrists I know of take cash and let the patience get reimbursed. They can’t even stay in business and actually treat patients if they tried to live off what insurance gives them.
Physicians and Nurses and PAs and every single member of allied health who got into this to help people (as most of us do) need to shout this from the rooftops, advocate within our systems (even when the higherups want to shut us down) and most importantly take LEGAL action. Its the only language these people understand. What an amazing series from an amazing doctor. Thank you!!!
This kind of nonsense literally prevented me from joining the medical field. I want to help people. But my desire to help does not outpace my desire to maintain a shred of mental health. I cannot physically work for organizations whose entire existence is founded on turning abject human suffering into personal profit. For organizations that deliberately weaponize our own empathy against us for profit. Pure evil.
Thia series is all about the fact that the US allows for nearly everything to become merchandise, even people's lives. A life and it's quality shouldn't not be some sort of trading good. It should not take a whole society in shambles for you guys to notice (and even then some do not notice).
"You can only cut costs so much before you sacrifice patient care...and the people who do the work won't let that happen." That's the problem, here, and it's similar to the one in both of my fields. As a musician and educator (in my case, at two state universities), I'm acutely aware of the concept that the corporate and administrative powers that be will try to cut budgets to the bone and then some, but that we will still strive to do the best work we can because we care. But here’s the problem: they know that. The powers that be know that when they tear everything down, we will pick up the slack. And when we can no longer do that, when we can do nothing else but fail, we'll be the ones to take the blame. Pay me? Don't pay me? I'll still do the best I can. And not only do thise f****rs know that, they absolutely depend on it!
Yep. A couple of years ago I got really sick. Norovirus became dehydration became decreased kidney function in a matter of two days. My husband dragged semi-conscious me to the nearest "Emergency Room," which was one of those private-equity places next to our local grocery store. They drew some blood and put me on IV fluids. Bloodwork showed decreased kidney function. They told me they’d need to transfer me to an actual hospital because they couldn’t treat me there. I was put in a private ambulance and driven to a real hospital, where I was put in the ICU for three days. I got a bill from the private-equity emergency room. AFTER my insurance paid them, I owed them over $12,000. $12,000 for a basic set of lab tests and one bag of IV saline. They billed my insurance company for more than $20,000, and this $12,000 was what wasn’t covered or negotiated by them. My total bill for three days in the ICU was less than $6,000, after insurance. I told my husband to NEVER take me to a private emergency room again. Either we go to a real hospital or I just die. Those are my only options. Having both an autoimmune disease and a neurological disease, I’m sick all the time and can’t work more than about quarter-time most of the year. I have no money. My husband is retired, so we have a pretty fixed income. I decided the private-equity folks weren’t getting a penny from me. That was robbery at gunpoint, as far as I’m concerned. They got enough from my insurance to cover their lab tests and bag of fluids, plus extra for the doctor who spent five minutes with me and the nurse who drew blood and started the IV. I’ve gotten about 500 collection letters, threatening phone calls, and even someone lying over the phone claiming they were a process server from the county trying to serve me with…some sort of papers. When I asked for the county case number on the paperwork so I could look it up, they hung up. Their phone number belonged to a collection agency in another state, too. Idiots. Not getting a cent. They can’t even sue me now because the debt is past the statute of limitations for a debt-collection lawsuit in my state. It pays to know things! I didn’t pay the hospital, either, but that’s because I filled out paperwork showing my household income. My outstanding balance was removed after that. Rich people get to pay it instead, since people like me are one of the reasons costs go up for everyone. You rich people don’t want single-payer universal healthcare? Then you can pay my medical bills.
I wish more people understood this! People who have decent income are *already* paying for low-income people to receive healthcare. And they're paying much more for it than they would if we had a healthcare model like Germany or other similarly developed countries.
Proof that there are ways of dealing with the system, especially now that awareness is going up, we just need to know what we're uniting against rather than letting companies manipulate us into being divided
Hmmm...suing insurance corporations for practicing without a license...this could come in handy for getting back at the insurance I had as a high schooler for refusing to cover a medication I needed during cancer treatment to keep my immune system from crashing.
This one actually made me smile. I love all your videos and even though this month has been grueling yet enjoyable, this video was comforting. Keep up the good work and I look forward to the next one!
I love the way this man covers the sad state of affairs in the American Healthcare system. While at the same time making it entraining and dryly humorous as possible.
Thank you. I needed that bit of optimism and reassurance. Things might be okay as long as we all follow along, and its nice to have hope again. Thank you for you service.
Seeing the smug look of satisfaction in emergency's face when private equity finally understands that people stand up for themselves. Best facial expression in the entire catalogue thus far.
If those emergency physicians win the lawsuit against private equity, could it be used as precedent to sue insurance companies? Since most have people who are not certified medical professionals making medical decisions for patients on what is "needed".
My two cents worth: my cousin is a renowned specialist who worked in NY city for a few years and she came back to Canada with her family. The main reason for this was that while she had the expertise to help patients, she was constantly fighting restrictions imposed by non medical decision makers, ie insurance companies. In Canada, there is no limit. She does what she has to save/improve lives regardless of anything. All of the developed world has universal health care. There is absolutely no reason for the United States to not have it as well.
Silly investors. If your customers die young because they can't afford the healthcare you want them to pay for, you're loosing out on decades and decades of money.
I love this!!! Private Equity gets his comeuppance and Emergency Medicine strikes back!!! I love "Emergency Medicine, Board Certified ", a great introduction.
Please do something about how private equity is replacing doctors with nurse practitioners while charging patients the same amount. Sure it's unethical, but think of how many yachts admin can buy because your daughter or grandmother didn't get to see a doctor for that sudden headache and vomiting!
You sir, are a boon to this planet.... We need about 1 million more of you. ...... Please raise as many children as possible. Adopt, procreate, do what you got to do just raise them with your values 💞
CPOM (Corporate Practice of Medicine) prohibits or otherwise restricts the ownership of medical or medical-adjacent practices or businesses by non-licensed medical professionals. Currently, 33 states have CPOM regulations that are enforced to varying degrees. States that do not have a CPOM Ban include Alabama, Alaska, the District of Columbia, Florida, Hawaii, Idaho, Indiana, Mississippi, Missouri, Montana, Nebraska, New Mexico, Utah, Vermont, Virginia, and Wyoming. ^saved you some google searches
My father and I withdrew from our practice yesterday after nearly 30 years in business in an underserved community. In the last few years the amount of denials and chart audits skyrocketed. This is in addition to most insurances flat out slashing reimbursements in half or more. One insurance even demanding payment for "over reimbursement" from years ago. We have also sensed a growing disdain in the community for medical professionals as we often bare the physical face of these denials. There was no way to continue. We were attacked on all fronts and had to step away.
I'd like to get in on that lawsuit. The back of the doctors have been practicing medicine based on insurance saying what they can and can't do for procedures, and what procedures have to be done before other procedures can be done, has caused irreparable harm to myself and other family members. I absolutely think that we should be able to sue the insurance company for practicing without license.
If corporations are people (Citizens United v FEC, 2010, yes I know that’s about political speech but still), then we should be able to get them all out of healthcare, since I doubt that every single person in a “healthcare” corporation has a medical license.
I've worked in healthcare for over 20yrs and have learned so much from this series. Most of my career has been in registration so, I know a lot of the depravity that insurances try and pull but never knew to the extent they go. As long as we have private health insurance companies running our healthcare systems, you better understand that they work for the shareholders. Their bottom line is king not your health. I'm reading a great book called The People's Hospital by Ricardo Nuila. I highly recommend people read it if you want to learn how American healthcare really "works". Thanks for making these videos.
Yes!!!!! ED is still my favorite doc! Everyone reading this, please keep track of any United Healthcare commercials you see from this point forward. I am looking to see how they counter this series. I've encountered one so far.but I didn't pay attention to its content to back up my suspicion (as listed in the prevous sentence).
Next do the FTC lawsuit against US Anesthesia Partners, Inc and their private equity backers. They attempted to buy out anesthesiology practices in Texas, monopolizing the market and driving up prices. Article in Medpage Today.
