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1. Embed this notice
   Jess👾 (jesstheunstill@infosec.exchange)'s status on Thursday, 13-Nov-2025 22:27:50 JST Jess👾

   Healthcare In America:

   Doctor - I see that your gscsttigom isn't working as well as I'd like. I'd like to start you on pjehhdntpf instead.

   Patient - Okay, do you know how much that's going to cost?

   Doctor - Sorry I've got no idea.

   Patient - What do you mean? Like give me a ballpark. Is this a $20/month? $100/month? $500/month? Refinance my house for a month's supply?

   Doctor - Well, it's probably not "refinance your house" level.

   Patient - Umm ... Okay ... That leaves a lot of room in there still.

   Doctor - You'll just have to talk to your insurance.

   Patient - ... Okay

   Later

   Patient - Hey insurance, my doc wants me to start taking pjehhdntpf, can you tell me how much it is going to cost?

   Insurance - Sorry, I have no idea.

   Patient - What do you mean no idea?

   Insurance - well, we won't pay anything until your doctor gets a pre-authorization. And then how much we cover is based on the diagnosis codes, your deductible, the specifics of your plan, whether you get it from an in-network pharmacy or not ...

   Patient - fine, so give me a best case

   Insurance - free if it's approved and in network and you've hit your out of pocket maximum of $100,000

   Patient - ... Really not helping here. So assume it gets approved and I've hit my deductable

   Insurance - which pharmacy?

   Patient - idk ... Umm the CVS down the street

   Insurance - Okay that's going to be $5000/month

   Patient - ... Wait, WHAT?

   Insurance - turns out it's on our exclusions list so we don't cover it unless you get it waved onto the formulary upon appeal

   Patient - but.... I have insurance. Why aren't you helping me pay for my medicine?

   Insurance - we don't allow that medicine on your employers' plan. You should use gscsttigom instead.

   Patient - I'm on that one right now. It doesn't work.

   Insurance - well you'll have to appeal it, but you can't do that until after you get a formal denial.

   Patient - and how long does that take?

   Insurance - well, if your doctor does the preauth paperwork, they'll make a decision about it within 14 business days, unless they need to come back to your doctor for more information. Then they'll mail you the decision within another 7 business days from (insert the location farthest possible away from you in the continental US). Depending on the decision you can appeal the decision, which the appeals process can take a maximum of 180 days, after which you can appeal it again which takes a maximum of 365 days.

   Patient - and if I need to start taking the medicine now?

   Insurance - well you're free to do that out of pocket and file for reimbursement later.

   Patient - at $5000/month?

   Insurance - no it'd have to be at the out of pocket price. For that CVS, it looks like it'd be $15000/month

   Patient furiously googling "how to move to a civilized country"

   Googles "pjehhdntpf price in Mexico" - $12.50 for a 90 day supply.

   • GreenSkyOverMe (Monika) repeated this.
   • Embed this notice
     Gina (gina@fosstodon.org)'s status on Thursday, 13-Nov-2025 22:31:22 JST Gina

     in reply to

     @JessTheUnstill US healthcare sounds barbaric.

     GreenSkyOverMe (Monika) repeated this.
   • Embed this notice
     Jess👾 (jesstheunstill@infosec.exchange)'s status on Thursday, 13-Nov-2025 22:31:29 JST Jess👾

     in reply to

     • Gina
     • zeitverschreib

     @zeitverschreib @Gina Of course we care for your health. In much the same way as a rancher cares for their livestock's health. Do only what is necessary in order to extract the most wealth possible from you then let you die.

   • Embed this notice
     zeitverschreib (zeitverschreib@freundica.de)'s status on Thursday, 13-Nov-2025 22:31:31 JST zeitverschreib

     in reply to

     • Gina

     @Gina

     Care is such a flexible term.

     @JessTheUnstill

     GreenSkyOverMe (Monika) repeated this.
   • Embed this notice
     FoolishOwl (foolishowl@social.coop)'s status on Thursday, 13-Nov-2025 22:42:32 JST FoolishOwl

     in reply to

     @JessTheUnstill It's incredible that claiming that immigrants come to the US for free healthcare doesn't inspire wild bitter laughing.

   • Embed this notice
     Jess👾 (jesstheunstill@infosec.exchange)'s status on Thursday, 13-Nov-2025 22:56:13 JST Jess👾

     in reply to

     • DB Schwein

     @deirdrebeth Which of course, eventually all those costs get passed down to you through higher premiums for lower benefits.

   • Embed this notice
     DB Schwein (deirdrebeth@mas.to)'s status on Thursday, 13-Nov-2025 22:56:14 JST DB Schwein

     in reply to

     @JessTheUnstill

     Oh but wait! The manufacturer offers a discount card that covers up to 15k per month, but you need to sign up with them before its prescribed, otherwise you have to pay out of pocket for the first month. Also if you switch between private (job based) insurance and public (buy it off the exchange or get it from the government) insurance then you have to re-sign up. Why doesn't the manufacturer just sell it for the lesser amount? Because insurance will pay the higher!

     GreenSkyOverMe (Monika) repeated this.
   • Embed this notice
     JohnB (johnb@sfba.social)'s status on Thursday, 13-Nov-2025 23:21:14 JST JohnB

     in reply to

     @JessTheUnstill but I’ve been told socialized medicine is bad

   • Embed this notice
     Jess👾 (jesstheunstill@infosec.exchange)'s status on Friday, 14-Nov-2025 00:15:27 JST Jess👾

     in reply to

     For those of you in civilized countries, this is only barely an exaggeration from experiences me and many of my friends have dealt with. Our system is SO fucked up.

     Steve's Place repeated this.
   • Embed this notice
     Alan K Thompson (aktbar@mastodon.social)'s status on Friday, 14-Nov-2025 07:09:00 JST Alan K Thompson

     in reply to

     @JessTheUnstill This sounds All Too Familiar. I got a denied prior authorization just yesterday....

   • Embed this notice
     Jess👾 (jesstheunstill@infosec.exchange)'s status on Friday, 14-Nov-2025 15:12:04 JST Jess👾

     in reply to

     For all the fight about ACA subsidies, remember - the ACA is a legit dream come true giveaway for insurance and healthcare and pharmaceutical profits. It means millions and millions more people buy into their marketplace plans, AND, the amount they can charge gets subsidized by the feds. So rather than the price of premiums being "max someone can afford", it's "max someone can afford+federal money". When they want more money, they raise rates even more, and then get the feds to increase subsidies to cover the difference. It's a massive giveaway of federal dollars to private corps.

     We COULD have had a single payer system back in 2009 if it wasn't for 2-3 fucking senators who had received millions and millions from the healthcare industry.