STS-135

@Matt_Pinner @jameslabrie 🤘

Can you name ONE famous Canadian?

@propublica Something has got to give. Americans pay obscene amounts of money to these insurance companies only to be denied over and over. We can’t go on doing this.

UnitedHealth is the nation’s largest health insurance conglomerate. ProPublica obtained what is effectively the company’s internal playbook for limiting and cutting therapy costs. Here’s what we found. propublica.org/article/united…

@WineFlair @Aetna @pissedconsumer @ohio_of94647 @MedicareGov @AetnaHelp @Aetna don’t give a damn about anything but their profits. I’ve posted many times on here about my struggle to get treatments covered. They never listed to anything my doctor told them over the past eight months. Just deny deny deny and keep the money rolling in.

@Aetna's email:" We show up every day for our members....We’re listening to members." NO. #AETNA won't fill a ROUTINE Rx w/o precertification; call center rep knows more than my surgeon? #Fail #scam @pissedconsumer @ohio_of94647 @MedicareGov

@ronrule And I’ve had servers in lower priced restaurants work circles around some higher end ones. To me, the guy doing the better job deserved the better tip.

Percentages make no sense for tipping. I go to a restaurant and order a $20 steak. Guy at the table next to me orders a $100 steak. If I tip $5 I’m considered a great tipper, but he’s expected to tip at least $20. Why? The server literally did the same amount of work!

Until I was diagnosed with MOGAD last year and begin a months-long fruitless and frustrating battle with @Aetna trying to get treatments, I had no idea how bad things were with insurance. It’s been frustrating for my neurologist too and I’m thankful for all the hard work and effort he and his staff and put only this fight. Just wish we would’ve broken through Aetna’s defenses.

This is the disconnect. Insurance companies talk about populations. Physicians are responsible for the patient in front of them. But when I am taking care of one patient, I am also thinking about every other patient who will face the same barriers, the same delays, and the same denials. This is not just about one person. It is about a pattern that keeps repeating. And I am speaking for the many physicians who have reached out and want their experiences to be heard. This was part of my interview with @nytopinion, in conversation with Dr. Troyen Brennan, former chief medical officer at CVS Health, which owns Aetna insurance. If you want to watch the full interview, it’s here: youtube.com/watch?v=3YZhd9…

@TexMexFrank Heck yeah! The charro beans that come with the chips and salsa at Lupe Tortilla are so good.

If the restaurant gives me beans with my chips it is an automatic 5 stars.

Another rant to myself. I have a rare autoimmune disease. Rare enough that none of the current treatment options are FDA-approved. Even so, IVIG is often considered to be highly effective at preventing flare ups and reducing further damage to the optic nerves. My doctors have spent a great deal of time filing prior authorization requests and appeals since August to get me started on treatments. But these ultimately are off-label use and as a result of this, my insurance company, @Aetna, refuses to cover them. I just wonder what they want me to do? My diagnosis and symptoms are very real and have a daily effect on my life. Additional damage could leave me disabled. It’s so frustrating being stuck in this limbo knowing there are treatments that can help, but I can’t get access to them because of my insurance company. I have insurance just for situations like these, and they coldly rubber stamp denial after denial despite the immense amount of paperwork my docs have submitted to them. The manufacturers of these medicines sometimes offer financial assistance, but again, not for those of us in the off-label boat. This is a terrible system.

@Stormi_luv Diet Dr Pepper

@EPotterMD @nytopinion My issue is that my doctors have exhausted appeals in four PA requests. We’re asking for these treatments because I need them. But @aetna refuses to listen to what my docs have told them. Eight months of denials and I’m still dealing with my symptoms. What more can I do?

I don’t want to work in a system that requires heroic effort to get to the appropriate outcome. This interview with @nytopinion made something very clear. Dr. Troyen Brennan, a former chief medical officer at CVS Health, which owns Aetna insurance, shared that denials can be appealed and often overturned. And technically, that is true. But what happens in real life is different. Many denials are never appealed. People are exhausted, they are sick, and they do not have the time or support to keep fighting. So the care does not get overturned. It simply does not happen. Applying resistance to both the patient and the physician often leads to that outcome, not because the care is inappropriate, but because the process becomes too difficult to sustain. We should be building a system where doing the right thing for the patient is the easiest path, not the hardest one. If you have ever been told no by your insurance, this is part of why. You can watch the full interview on YouTube here: youtube.com/watch?v=3YZhd9…

It’s been wild to come to the realization over the past year that there are people at @AetnaHelp @Aetna who genuinely have the attitude that my health doesn’t matter. Their profits matter. They have proven this to me by aggressively fighting me and my doctors for eight months.

@DividendBreeder The thing is, I don’t need insurance to cover minor, occasional expenses. I have paid thousands and thousands over decades to @AetnaHelp for situations like I have now where I need help with expensive treatments and they deny it. They are worthless.

My daughter recently had an ear infection. Took her to the doctor, who prescribed an antibiotic. That doctor visit cost $244. My insurance covered $60, so we owe $184 out of pocket. I pay $556/month for family health insurance. Something seems broken.

@NationalEclipse It was certainly a great day in Dallas. One I will never forget.

Today is April 8. Depending on the weather, two years ago was either one of the greatest or worst days you've ever had.

@FatKidDeals You know it! Some of the best pizza I’ve ever had.

This is one of the best Pizzas I've ever had. Peaquads in Chicago.

@1ssve It’s even better when you’ve stayed at the job largely for the insurance plan and then when you need that insurance to come through for you, they deny coverage. Really start to rethink things then.

the mental discomfort of being super grateful for the job you fucking hate

Big round of congrats to @AetnaHelp @Aetna for winning the external appeal I had. You guys did it! You dragged me through with months of hell to deliver the final blow. You get to keep your money and I get to lose my vision. Congrats on the victory!

@EPotterMD @nytopinion Thank you for your efforts. I have been left feeling completely frustrated and hopeless in my very long battle with @aetna.

This interview just came out in @nytopinion and I want you to listen in. I traveled to New York to sit down with an insurance executive for their new show Divided, and this conversation was the result. You have heard me speak briefly about these issues before, but this is different. This is a full conversation, and I hope you will take the time to listen. There is so much I want to share with you. No matter where you are in healthcare, this matters. It matters if you are a patient. It matters if you are a provider. It matters if you work inside an insurance company. If there was a part of me walking into this conversation feeling tired and wondering if we are ever going to change healthcare or move things in a better direction, that part of me shifted. Dr. Troyen Brennan, is a former chief medical officer at CVS Health, which owns Aetna insurance. On paper, we are at odds. But we chose honest, thoughtful, civil conversation. I am proud of what we accomplished in that room, and I would value hearing what you think after you watch it. You can watch the full conversation on YouTube here: youtube.com/watch?v=3YZhd9… Thank you @astocktonfilms and @nytopinion for having me. Thank you Dr. Troyen Brennan for having this conversation.

@IowaCajun1 Reminds me of my mom’s cornbread. It was what I call true Texas cornbread. not sweet or cakey and we actually referred to it as “sour cornbread” around others. It was simple and served plain with pinto beans. The best cornbread I’ve ever had and nothing comes close.

No it's Not Jiffy. It is not cake or sweet lol. It is The Best Cornbread across The South. And of course the Entire Midwest, East or West. It's not our family's recipe. A friend of mine back home. Just a guy cooking. Best Damn Cornbread.....

@weiss_hadas 🥰

i bring a sort of “none of this means anything” vibe to the workplace that no one there appreciates