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Facebook Photos Lead To Cancellation of Quebec Woman's Insurance
No. 24601 writes "A Quebec woman on long-term sick leave, due to a diagnosis of depression, lost her health benefits after her insurance provider found photos of her on Facebook smiling and looking cheerful at parties and out on the beach. Besides all the obvious questions, how did the insurance company access her locked Facebook profile?"
First question, is she sure it was actually locked down? Some of those settings sound like nonsense to the non-technical.
Second, is she the one that posted the photos? If someone else posted photos of her on a public page, anyone can see them.
-1 disagree is not a modifier for a reason. -1 troll, flaimbait, redundant, overrated are NOT acceptable substitutes.
*sigh* Well, speaking as a depressive I can say that a good part of the treatment that a psychiatrist suggests to their patients, besides their antidepressants, is to engage in social activities outside the home. They also say that staying cooped up at home and failing to get out can lead to a relapse and readmission to hospital. The Insurance company is not licensed to practice medicine, only to read a doctor's diagnosis and pay what's due.
... because people with depression must wear black on the outside, as black as they feel on the inside.
Yet another reason why private healthcare must be stopped. Curing people doesn't come into it - it's about keeping them sick enough to stay profitable.
Suppose she has friended coworkers who know that she is collecting disability pay for depression but is posting party pics. Or suppose that the pics were posted by others who have not limited access to them. If she is tagged and the photos aren't actively blocked to outside viewers, they are fair game.
"Besides all the obvious questions, how did the insurance company access her locked Facebook profile?"
She blindly accepted a friend request from her insurance company's friendly insurance claims adjuster.
I guess she's feeling pretty depressed right now. Does that mean she can have the insurance back?
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Facebook has so many little loopholes and you can be sharing information without realising it. I know a few people who think their accounts are locked down andyou can't view anything from their profile page. However their photo albums show up in other areas even if you can access it from their profile page. I assume they've not set the right settings for that particular album.
This is why I don't use my real name on Facebook or use my exact location. It may mean friends, relatives, etc find it harder to find me but if I want to speak to them then I'll look for them.
Evil insurance company, plain and simple. I am not saying that they all are, but this is beyond grasping at straws. This is healing someone because they are sick, and them kicking them to the curb and throwing them out because they show signs of recovery. She should sue them for making the depression worse. We should get together and figure out how to draw enough attention to put a stop to this, and make an example for other insurance companies.
This is a prime example why I don't think capitalism alone has all of the answers. If A needs B and C to prosper, and C needs A & B, A will rape B dry until C is so bad off that it is also hurting A. How does this make sense?
Like a city whose walls are broken down is a man who lacks self-control.
She also doesn’t understand how Manulife accessed her photos because her Facebook profile is locked and only people she approves can look at what she posts.
Oh, please, you're talking to a generation that grew up watching Dateline and 20/20 where insurance companies hired private investigators to stalk people who would do the following:
So then you'd see the companies hiring PIs to track the people (who allegedly could barely move) tearing it up at Disney World. Yeah, scam artists and fraudsters.
You shouldn't be surprised to see insurance companies being very proactive in their searches to follow up on people. I cannot say whether or not she is legitimately getting the short end of the stick or if she's defrauding the company. Sounds like the former. If she had made claims that she never smiled and couldn't go out in public due to depression then she might have problems. Why doesn't she just get her doctor to send a note to her insurance company explaining that people suffering from this magnitude of depression (and those recovering from it) can force themselves to smile for a picture? I mean, it's likely that the insurance company got tired of paying sick leave for depression unless it could be shown to be a chemical imbalance they probably were just looking for any reason to have to stop forking over pay.
Personally, I was offered $250 by my company's health insurance plan if I signed something that said I had not used tobacco products in the past 6 months. I hadn't but a few years ago I had (what I was told) were Cuban cigars in Mexico. Those friends put pictures of me on Facebook smoking them. So what? Well, if they found contrary evidence to my claim, I faced having my insurance terminated. Not worth the $250. Be aware of what Facebook puts on display for the world--even if you think it's private it's usually not. I mean, it could be as inane as some coworker who doesn't like her sees her other friend at work tagged in a photo with 'depressed' coworker on leave and decided to copy what photos they could see and forward them on to the insurance company?
My work here is dung.
after her insurance provider found photos of her on Facebook smiling and looking cheerful at parties and out on the beach....
Well, she was on benefits because she was diagnosed as depressed, and it's already been said that any psychiatrist worth their salt will tell you to get yourself out there and at least *try* to have a good time.
But seriously, this is a bit out of hand, hasn't anyone at her insurance carrier ever had a picture taken? What does the photographer usually scream at you?
SMILE!!!
"When I am king, you will be first against the wall..."
I think this could rebound terribly (and rightfully) on the insurer.
The worst thing for a clinical depression is to stay closeted away. In the UK, there is no "social prescribing", where a GP may decide that the root of your troubles are a social disconnection. This disconnect raises stress, and is a sizable aspect in depression.
Rather than pump people full of antidepressants, they prescribe you a visit to a local social group that is ratified as being suitable for this (can be activity groups, plain social groups, heading to a gym, or whatever would best fit the person that's available).
This has had marked benefits to many that use the service.
Depression is always a fight, and when you fight it best, there's always a time that you smile. It may not last for long, but every point you can laugh and be brought out is an absolute gem. And there's no surprise that mates will take a pic of you when you're smiling and paste it on Facebook, rather than ones of you looking glum and disconnected.
One of those gems, for me, was years ago, just after my brother had had a massive car smash that left him on life support. One of my friends had first been blunt (there's nothing you can do, so get on with life while this goes on and things work themselves out), then actually managed to get me out and make me laugh. For just a minute; epic effort on his part, but it gave me a moment's respite, for which I'm eternally grateful.
Now, if anyone had dared to say to me in that minute or two of respite that I wasn't upset, torn up and terrified, I'd have torn them several new ones, and stomped on the pieces until the men in white coats dragged me off.
Smiling pictures of a depressive are not evidence they're not depressed. They're evidence that they have a good support network of people who are prepared to do the heavy emotional lifting to keep them going..
Cutting the insurance is going to make anyone depressive (or recovering depressive) fall far back down the treatment path..
Wouldn't be surprised to find this one in litigation sometime soon.
This is a HUGE part of the current problem in the States with health insurance. Health insurance companies are not doctors. You can't make a diagnosis by looking at pictures on someone's facebook account. They teach you that in medical school, I think. I'm all for the public option myself, and I hope it puts the health insurance companies out of business. Frankly, I think anyone who works for an organization as corrupt as an American health insurance company, has it coming, because nobody who works for one can possibly claim ignorance to the crap that goes on with them.
This sounds like some kind of farce... and yet I can't help wonder how long it will take until I read about similar cases in Finland.
We have a great health care system, in theory. In practice everyone who can afford it has private health insurance too, so that you have the option of using private services when the public ones don't deliver.
.: Max Romantschuk
Have you not read any of the previous posts or are you just trolling? Go back to your Mommy's basement and hush...
You're messin' with my Zen Thing, man.....
One thing's for sure. This won't help her depression.
No portion of this post may be rebroadcast without the express, written consent of Major League Baseball.
Where exactly is the false claim? Should people who suffer from depression be depressed every single moment of their lives and not try to make it better?
Yeah.
A cancer patient might be rather sick, but make an extra effort for special events.
What next? They're going to cancel insurance for cancer patients if they look like they're better?
An insurance agent is unlikely to be an authoritative expert on medical matters (or in the rarefied field of "psychiatric diagnosis via facebook photos") - they may know some stuff (just like I do), but when it comes to a court case or other legal stuff it should not be their call to make. If the insurance company has doubts they should insist that the policy holder be examined by a certified expert in the relevant field. After all, it's not unusual that you have to go for a medical examination when you sign up for certain sorts of insurance. They don't just leave it to an insurance agent to say "hmm she looks ok to me".
Too bad if her case is genuine she'll likely be too depressed to sue them (unless she can afford her meds and is still taking them).
If Facebook photos are the standard by which we're judging whether or not people should be paid insurance claims for being depressed, I wonder if I can use that?
No, I'm not depressed. I mean, I have ups and downs like everyone else, but I don't think it's so severe to be classified as a medical condition. Still, I could certainly churn out a few photos when I'm feeling down one day and post them. Then maybe I could call my insurance company and tell them, "See? I'm depressed! It's right there on Facebook!"
people with depression, even deep depression, can smile, laugh, and be outgoing right up until the moment they commit suicide.
It's part of the syndrome that they want to act like a natural, happy person, even if they're on a brink - no matter what. Many won't admit they're ill until fatal results happen.
Insurance companies shouldn't have anything to do with diagnosis, they aren't qualified (not being doctors), and they have a conflict of interest, making money by denying illness. Frankly I think making money by denying health care to people is nearly as unethical as just shooting them up front.
Think of the Irony!
Oh man, you do NOT want to go there. If you get into a battle of anecdotes on the issue of public versus private health care, you will be killed on that debate every time.
Seriously.
Don't make me go digging through all of the stories of people who have been screwed over and scammed by private insurance companies, because it will take at least a couple of weeks to write the book about it.
That isn't even close to the first question. In fact it is what is known as entirely moot. Pictures of someone on the beach smiling, regardless of their origin, aren't even remotely close to proof that they don't experience severe depression. You would have to be some kind of incompetent evil moron to be in a position to make such decisions at an insurance company and still make such a decision. They know damn well what they hold in their hand is not proof of anything. What they hold is an excuse they offer up for their outlandish behaviour . Who cares from whence the excuse is derived?
Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
Truly I'm confused. I thought Canadians had national health care? So is it the national system canceling her or some kind of supplemental plan?
It all starts at 0
Unless of course you argue that depression doesn't work that way.
It doesn't. Everyone has periods of highs and lows. A person with major depressive disorder has highs, as seen on Facebook in this case, but the highs are so short and the lows so long and deep that they interfere with the patient's ability to function for a significant period of time.
Maybe you can get disability for depression if you only show pictures of yourself on facebook depicting deep frowns and somber scenes! That's a diagnosis if I ever saw one!
Blanchard said that on her doctor's advice, she tried to have fun, including nights out at her local bar with friends and short getaways to sun destinations, as a way to forget her problems.
The bar sounds like silly advice, alcohol and anti-depression medication NEVER mix.
Some people are only alive because it's against the law for me to hunt them down and kill them.
One of the major issues in private health insurance today is Recission, the nullification of your insurance contract:
http://www.motherjones.com/kevin-drum/2009/06/healthcare-ceos-shoot-themselves-foot
http://digg.com/health/Understanding_the_rare_practice_of_recission
With group insurance policies, you have a certain amount of protection. But for individual contracts, it really works against the whole point of having insurance in the first place.
My best friend and my brother have both had severe depression problems. It is quite possible to be out and functioning at moderate levels of depression - talking, smiling, looking like you're enjoying yourself. I think one described it something like this:
Dude, you know what. I have depression. There's not an hour where I wake up where I'm NOT thinking about killing myself or everyone else and I just bit my damned upper lip, say life sucks, and move on. I enjoy the fleeting moments of happiness like a fine glass of whiskey and move on, and frankly, getting out and doing something, and having a job, and working, even if you screw it up, is the best thing you can do.
When you go through hell, keep going.
This is my sig.
Apparently you missed that this wasn't Canadian public health care, but a private insurance company.
The story shows the downside of profit-motivated health insurance, no matter where it is.
are PONZI schemes. Insurance is just one of many. Look at the US Federal Reserve system. The
first people to get in on the 'action' reap the biggest profit, while at the same time giving people the hope that if they participate in the system, they will indeed profit from the scheme.
Typical of all pyramid scams.
Imagine a private 'institution' printing money for a government, then selling the printed and minted 'money' back the the government that comissioned the 'money', for a profit. It boggles
the mind, yet many people buy into this scheme.
Something has to change and drastically, to all the major 'institutions' of the world.
from my post on TFA:
Here's the thing, it doesn't really matter if she is plain old lazy, or truly depressed.
The issue here is that the insurance company is making the call, and it is not their job to make that decision.
The insurance company's job is to collect premiums and pay out when the doctor says "this person has a bad back" or "this person has a broken leg" or "this person is clinically depressed".
It is my assumption that this woman has regular meetings with a doctor at which time she is assessed to see - "is she still depressed?", "Has there been any improvement?", etc.
THAT is the ONLY information the insurance company needs to make their decision.
Anything else, such as info from FACEBOOK, does not tell the whole story, hell, it might not tell ANY part of the story. It may be irrelevant, and it may just be misinterpreted completely by someone who lacks the professional designation to be making decisions and pointing fingers in the first place.
The insurance company no doubt will argue that the have to "protect their assets" and that "people scam insurance co. all the time". While that is no doubt true, we must not forget that the insurance companies make plenty of cash by ripping people off on a daily basis. It's a two way street.
Bottom line, insurance companies HAVE to take the advice of "trusted" professionals, trusted or not, really. That is why we have doctors and lawyers etc - we must have someone who has the proper knowledge to make the ultimate decision.
If they want to save money so bad, they can start by firing the person that is paid to browse facebook.
As someone who has known several people with depression and bipolar disorder I'd like call bullshit on your kneejerk "FRAUD!" conclusion.
Most people with depression can be just fine for an hour or two and then spend a long time not even leaving their bed, those who are bipolar can be even worse, they'll be at a party having a blast and in just a few minutes they'll switch over to seriously contemplating suicide right then and there.
And even discounting this and trying to look happy for everyone else's sake there's also the fact that a lot depressed people do seem to really value those times when they can shake their depression for a few minutes or hours, and guess which image of themselves they'd rather show friends and family...
/Mikael
Greylisting is to SMTP as NAT is to IPv4
Photographer: Smile.
Victim: What?
Photographer: Say Cheese.
Victim: Oh Oh CheeeeeeeeeeSeeeeee.
Photographer: (Click, Click, Click)
Insurance Co: Your toasted.
And if I were the insurer, I would question that if someone is functioning well enough to go on vacation, to go out to a bar with friends, etc... is ready to go back to work.
If I were the insurer, I might do the same, but only because it would be in my selfish interest. It would still be either ignorant or dishonest and shouldn't be allowed.
As many others have already pointed out in various ways, a majorly depressed person can easily have a good moment. The thing is, even if she has a good moment of 15 minutes, the rest of the 23 h 45 mins of the day she might still be disfunctional. She might even have decently good full days if her friends take her for a trip and get her involved in a lot of fun stuff, making her forget about her problems for a moment. That doesn't make it last or mean that she'd be fine or able to function normally in normal everyday life. That makes a major difference. Depression may not make you unable to laugh at a joke, but that doesn't make it any less of a problem -- you can't live laughing at a joke all the time.
Of course major depression tends to come with major drop in motivation to do anything, so you might think something requiring arrangements such as a vacation might be out of reach for a majorly depressed person. After all, she'd have to find the motivation to get through the arrangements, choosing a place and activities etc. to actually get out for a vacation, right? Well, maybe she just has good caring friends who arranged it for her.
The insurance company knows full well they'd be in serious trouble if they used a claim of "you look happy so can't be depressed". They know depression is a medical condition.
Here's what I think happened; a co-worker got annoyed with her being on sick leave for such a long time. She grabbed some photos from facebook and sent them to the insurance company with an email saying "See! She's not depressed". The insurance company thought there was probably justification for some sort of investigation. They investigated. They pulled the medical records and their doctor decided that based on the objective evidence there was no reason she was still entitled to sick pay.
The parent wasn't complaining about the insurance companies being robbed. It is your co-workers who pay for your insurance when you cannot. If enough people are so "depressed" that they can't work the insurance company will adjust its rates if it continues long enough. That is exactly why your insurance goes up, because your company is costing the insurance company more to cover you.
While I agree an insurance company has no business using Facebook for determining a case they do have the right to investigate fraud. Keep in mind insurance companies have a whole slew of their own "trusted" professionals that are on their pay role and look after their best interest, not the insured's.
IMAGE VERIFICATION IS EVIL!
health care = medical bills (doctor consultation, treatments in a hospital, x-rays, etc)
prescriptions = cash, private insurance or employment benefits insurance package
disability = private insurance or employment benefits insurance package
You know when the most dangerous time is for someone who has suicidal tendencies. It's when they cheer up - it might mean that they've made the final decision to end it all. They'll be happy, smiling, giving away their stuff, party-party-party - and then they kill themselves.
Not only can you not diagnose whether someone's suffering from depression (it's NOT "gee, I'm depressed") by just looking at pictures - it's actually against the shrinks' professional code here in Quebec to proffer a diagnosis or ANY opinion without actually having examined the patient.
The proper course for the insurance company would have been to get a second opinion.
Not necessarily. When I was suffering from depression I was sometimes able to go out and minimally participate in social situations, though I was rather distant and unresponsive to say the least. But anything requiring mental focus was hopeless - even things as minimal as arranging doctor's appointments took a lot longer than normal, and any attempts to read and take in a document failed miserably.
Cancer is a "simple" disease, not a mental condition. Why do you link the two?
Insurance agents ARE often experts in the field they insure. How else would they do their job? Car insurers know a LOT about cars, that is what they do. They collect as much data as they can and then determine what premium to charge so they can still make a profit by insuring against risks. And one part of it is knowing when a claim is bogus. Don't try to claim seagulls ruined the paint job on your car, in the mountains. Do not claim damage from hail unless you are certain hail did indeed fell in your parking spot, because they DO know. It is their job.
Depression is a very difficult mental diagnosis and people have been known to lie. This woman did NOT just go to ONE special event, but several, in a short time frame. When does depression end and just feeling blue start? When do YOU pay more for your insurance to cover someone else? Oh, that is right. YOU are paying for this woman and the moment YOUR premium goes up, you are crying the company check more carefully.
I could easily create an insurance company that is very nice and kind and considerate, you would also pay through the nose to be insured by it. Want to bet that you don't, that you go for the cheapest possible? Well, then this is how they do it, by investigating claims.
No doubt this will go to court. Sometimes insurance companies get it very wrong, but then, they have calculated the risks of that too and they seem to think that they have the edge here. Nothing I have seen so far convinces me they are wrong. All we got is two stories, why do you automatically presume this woman isn't running a scam?
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
It's the insurance company's job to pay out claims. Period. End of story.
That is what they exist for.
If they don't pay claims then they might as well be all arrested for fraud.
They do their best to avoid paying claims even when there aren't people around willing to make excuses for them.
A Pirate and a Puritan look the same on a balance sheet.
How about the evil people who use evil insurance companies? They want to the lowest cost, and how do they think that is achieved? By the company just taking peoples word for it?
This example is a woman who went for a cheap insurer, then found out that they are cheap because they hate to pay out.
Oh and why does everyone assume this woman is telling the truth? Where is the medical re-diagnosis to prove she is still suffering from depression? last time I checked, that would have been the first thing to do. She didn't. Doesn't that tell you a lot?
Newsflash! People have been known to scam insurance companies.
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
As stated in a dozen comments in this topic, the article is about disability insurance to replace wages, not about access to health care.
If this person ends up a destitute bag lady, she'll still be covered by the Canadian universal health care system.
Friend of mine had some raunchy photos posted of him drunk at a bar with some rather young looking women. There were photos of him "feeding" them alcohol and "undressing' with them in the rather dark club. When he went for his interview a few weeks ago the chief hauled out photos of himself printed directly from a private facebook page. He said they made no effort to hide where the photos came from. It was a direct print off of Facebbook. He couldn't explain him very well and was asked to not apply to the force again and they would be adding these documents for future interviews in other jurisdictions. He has been on a campaign since that interview to find more people like him. He told me that he has found another person that lost his job because of something someone wrote on his wall about an incidental that occurred when he was underage and he threw a guy off a high school stage and caused him brain damage. Scary shit this social networking crap. Young kids just post whatever crap they want on Facebook. Having seeing my younger cousins profile I was shocked that he had posted some of the things he had and I warned him about posting about his mischief online. "Its just kids stuff" sure but does he want it following him around when hes in the job market in 15 years? No!
Spoken like someone that has never had to deal with depression! Tell me, have you ever had thoughts of suicide that would not go away for six months? Thoughts that last a long time in a person's head have a tendency to be acted upon. Are you saying that you would be that selfish with your significant other? (Assuming you have had a significant other...)
The Illuminati would kill me, but I'm not rich enough to take notice of.
This particular story is out of Canada, different health-care system, different incentives.
Rule of Slashdot #0: You and people like you are not representative of the larger population. - A.C.
Although it is entirely possible that the story played out exactly as this woman and her lawyer claim, this may not be the entire story. The news article contains quotes almost entirely from the woman and her lawyer. The insurance company declined to comment (which is smart during a lawsuit) besides a written statement that "We would not deny or terminate a valid claim solely based on information published on websites such as Facebook."
Maybe they are lying and some overzealous office jockey wanted to get himself a bonus by revoking her disability pay. But maybe there is more information about her case that she is not disclosing. Maybe she is trying to sensationalize her case in the media to try to embarrass the insurance company into not canceling her disability pay. It is unfortunate if she really is getting hosed, and I'm confident that if that is the case then the courts will right it, but I have a nagging feeling that we're being taken for a ride on this one. It's difficult to tell when we get reporting from only one side of an adversarial (insurer, insuree) relationship.
It's the insurance company's job to pay out
valid
claims. Period. End of story.
That is what they exist for.
If they don't pay claims then they might as well be all arrested for fraud.
They do their best to avoid paying claims even when there aren't people around willing to make excuses for them.
There. Fixed that for you. If my insurance simply paid any claim I couldn't afford it.
I'm a consultant - I convert gibberish into cash-flow.
Someone recently posted a picture of me that gives evidence that I recently shrunk to the size of a 3rd grader...along with all my old 3rd grade classmates. Do you think I could get insurance payments to cover treatments? Maybe we could use this for a class action lawsuit.
I've been going to Depression/Bipolar Support Alliance (DBSA) meetings for over a year now, in Los Angeles and Maine. (Think of a support group, then subtract the woo, jargon, god and other b.s.) I have my own experience with depression, and I know people who've had it far worse.
According to the article, Blanchard is diagnosed with major depression. A running joke in DBSA groups is that you can tell the new people with depression from those with bipolar because they crack the most jokes. Without the high and low cycles of bipolar, we tend to grasp at any moment of levity we can attain or create. There's a common misconception that depression is a flat, constant low mood. This is rare. Typically one varies between extreme lows and more functional periods, with stops everywhere in between. One also gets very good at faking it for short periods of time.
Meds aren't a magic bullet either, more a set of blunt tools whose effect on any given person will be highly variable. Beginning treatment often means a period of medication roulette, where the prescriber and patient work to balance efficacy, side-effects and (in the U.S. at least) costs. In the long term, lifestyle adjustments, especially increased social involvement, are essential.
The bottom line is, if Blanchard wants to return to the working world, she's been doing exactly what she should be.
Manulife, on the other hand, took a very small risk, which makes perfect market sense. The chances of Blanchard fighting back the way she has were slim, and the financial savings for the company miniscule but real. Faced with the loss of their emergency income, many people with major depression would have retreated further into their shells. Some might have attempted suicide.
Disability insurance companies employ doctors and nurses to review claims periodically. If they have reason to suspect fraud they will hire an investigator to look into the activities of a "disabled" person. In this case we have a "depressed" person on leave for a year and a half. My guess is that length of leave is outside the accepted normal period for depression. They would probably expect a depressed person to receive appropriate medication and counseling and be involved in a return to work program after that length of leave. So they began investigating and terminated the leave to force the issue. Depression is a common trigger for disability these days and often relates to the claimants work environment. I'm not familiar with Canadian insurance funding arrangements but in the US a disability plan for IBM would most likely be self funded meaning the premiums paid by employees coupled with IBM's dollars would be used to fund the claims. Often the insurer has a fiduciary liability to plan participants to protect the plan's assets. Although it is rare the insurer could actually be sued if they didn't investigate and question this claim. Ultimately it should be up to a uniform set of medical guidelines the insurer uses to review such claims. Depression has a well documented set of procedures that should be used to review the case. This evidence by itself seems sketchy but if combined with other factors such as claim duration and other evidence it may be justified. She may have a good lawyer that's doing a snow job on the "big bad insurer". The insurer is also limited by privacy laws as to what they can publicly discuss about the case and her attorney can exploit those rules
As stated in a dozen comments in this topic, the article is about disability insurance to replace wages, not about access to health care.
My point is that in the USA disability benefits are already provided by federal and state governments. Tis a shame that Canadians are unable to provide for the long term needs of the disabled.
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There is only so much Congress can do to effect change in Canada...
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The problem is that doctors are rather incented to declare people sick, so insurers will pay them.
This. This is what is wrong with US health care. The only incentive doctors should have to declare people sick is that the people are sick. If your system is designed to encourage anything else then it's broken by definition.
To put it midly the symptoms of depression are depression, if your insurance is paying for some kind of treatment and you not depressed, then it works, doesn't it? I think that this was a really, really stupid idea on their part, now the client can take them to court and claim that she is depressed again because she isn't on the treatment that the company was paying for. I would hope that even a law student could win this one, and now the insurance company will probably pay out more in settlement money than her origional treatment would have cost.
Just how long should we the other insured people be paying for someone to sit at home feeling bad about themselves?
I know about depression. My wife's family has some serious depression issues and she has struggled with it in the past. She has never missed more than a day of work at a time, calling in only when she feels her mood is so bad that it would be a problem at work. She uses 3-4 sick days a year doing that. She doesn't take medication for it, she just deals with it, some times for months at a time. It helps that I can tell when she's getting worse and can do things to make it easier on her...after seven years, I can usually get her through it without it getting particularly bad.
That said, the insurance company shouldn't be able to arbitrarily suspend her benefits without a serious discussion with the medical professional(s) treating her. After 18 months there *should* be some questions asked: what has been done to treat her, why isn't it working, what else can be done, et cetera. That's a long time to be depressed for any reason, and the insurance company shouldn't be expected to pay out indefinitely for such a vague ailment.
120 characters for a sig? That's bloody useless.
You really can't focus if you are severely depressed, especially on mentally taxing tasks. And we aren't talking about being bummed out because it's Monday and raining. That's not "feeling awfully depressed".
The problem is that doctors are rather incented to declare people sick, so insurers will pay them.
This. This is what is wrong with US health care. The only incentive doctors should have to declare people sick is that the people are sick. If your system is designed to encourage anything else then it's broken by definition.
2 things - 1 - didn't you READ what you quoted? The doctors have an incentive to declare the sick as such - regardless of motivation. Its much better that way than the other way around. And secondly - this is the CANADIAN system that is being discussed. The US system is somewhat different.
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Chronic pain syndromes exist where there is no evident neurological or musculoskeletal reason for the pain. A Chronic Pain Disorder is a mental illness, generally secondary to depression.
Rule of Slashdot #0: You and people like you are not representative of the larger population. - A.C.
Do not negate depression. They ever think for a moment it might have been temporary, or even faked to 'fit in' with her friends?
---- Booth was a patriot ----
If she can function at a bar, she can function at a desk.
Clearly, you have never suffered from depression. Even though she's at the bar appearing functional, keep in mind that that may have been the first time she was able to leave the house in weeks.
What they want is to collect their premiums. They are willing to pay out for some minor sniffles and even the occasional broken bone since if they didn't the premiums would dry up. But starting the very instant you end up with an expensive medical condition, they want nothing more than for you to die of it as quickly (and cheaply) as possible. Their ideal customer is the guy who never has a sick day in his life right up until he is killed instantly in a traffic accident, preferably while on his way to see a cardiologist about his recent chest pains.
I'm glad you've never had depression.
Very few be it public or private, in Canada or the US, health insurance policies cover long term disability unless there is a rider for it. Typically the employee gets a disability insruance policy or adds an additional rider to their exsisting health insurance. The health insruance company will still pay doctors and procedures but the disability insurance/rider will pick up living expenses, groceries, utilites, etc. during the time the person is disabled.
"I don't necessarily agree with everything I say." - Marshall McLuhan
There are lots of state programs for the disabled, which this person will presumably now be eligible for.
In the US, is it unusual for employees to be covered by an insurance policy paid by the employer?
First of all, she lost disability payments not health care coverage (the story says nothing of healthcare benefits). Secondly, all information in the story including the claim that the disability was ended was provided by the Quebec woman. Thirdly, people do abuse disability leave.
Tjstork shouldn't be modded "troll". Our constitution guarantees us "life liberty and the PURSUIT of happiness". Happiness is not a given.
Next thing to consider is, all of the medical practices are considered "arts". Psychiatry is not a science, with quantifiable, qualitative states. It's all guesswork. You can't plug someone into a freaking machine, and say, "I can measure x units of schizophrenia, x units of depression, and x units of whatever else".
At least with physical health, much of what might be wrong with a patient is measurable. Blood pressure, pulse, respiration, blood chemistry, urine and stool specimens. You have nothing like that with psychiatry.
Parent has a valid point, in that people with physical problems often have to work, unless that physical problem measurably impairs their ability to work. Psych problems? Fat chance. All we have is the doctor's word. How can we know this is NOT yet another scam to take the insurance companies for a ride?
Part of the reason I'm skeptical of shrinks is, I've read and heard plenty of stories about people who had grave psych problems, who were admitted into various programs to "cure" them. Amazingly, many are "cured" just about the time that all available funding expires. What a coincidence, huh? IMHO, they were scams from start to finish.
As for those who say the insurance companies are ripping us off, so they deserve to be ripped off - I ask, "Why not fix the real problem?" Here in the states, at least, we have healthcare reform on the table right now. Part of the goal is to limit the insurance company's ability to rip us off, and another part is to limit the ability of "customers" to rip off the insurance. Why the hell should 95% of honest, working people have to foot the bill for those 5% dishonest insurers, care providers, as well as customers? FFS, if we could eliminate the graft and corruption, ALL OF OUR BILLS could be cut by 20% or more!!
Send all the thieves to jail, and stop trying to justify your favorite thief.
"Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
SEE!! I Told you everything you see on the internet is true!! Just ask Manulife!!
And this woman's defense is that she doesn't know how the insurance company accessed her photos that she posted on the Internet... come on.
I didn't read that as a defense, but an accusation - if they used illegal means to access the pictures, they could be additionally liable.
In the US, is it unusual for employees to be covered by an insurance policy paid by the employer
No, that's the common case, yes. But disability coverage is usually pretty short, like maybe a few months, after which, long term disabled get tossed onto the government.
This is my sig.
I honestly don't see why we can't have the best of both worlds.
For example, we have a thriving public education system which guarantees almost universal education. We also have a thriving private education system for those who, for whatever reason, don't want to take advantage of public eduction. Sure, right-wingers gripe about our public eduction system, and I know that there are people out there would like to see it systematically dismantled, but the truth is that it works pretty well. Especially when you get to the university level, such as state colleges and universities.
Speaking of education, we have a fantastic student loan system as well. As a student, you can borrow money from the federal government to attend college. You can also borrow money from private lenders. You have a choice.
I guess I don't understand why health care can't work the same way. We have a public system to take care of everyone's basic medical necessities. We have a private system to take care of what people want above and beyond that. (Private rooms, name-generic prescriptions, specialists who charge above the normal rates, elective procedures, etc.) No one has to go bankrupt because they get sick. No one has to decide between having a broken bone set or buying dinner that night. If for whatever reason you don't like the public health system, you're free to go spend money out-of-pocket on either a private plan, or if you have enough, pay the health care providers directly.
It seems to me that those who are fighting against the public option are the ones who want to limit our choice, not the other way around.
I agree with most o the comments here, that the insurance company was not right to make the call based on photos they found on the internet, it's the doctor's decision.
However, if you're well enough to go on holiday (be it depression or anything), then surely you're well enough to go to work.
I know if I took sick leave from work and bunked off on holiday during that time, I'd get fired on the spot.
This is fucked and exemplifies one of the major problems with beaurocrats and businessmen making crucial health coverage decisions - they uyse whatever excuse they can tonot have to pay for what they are supposed to have to pay for, and will weasel out of any claim they can.
A person can have acute/major depression and be on the verge of suicide, that doesn't mean that they will never smile or laugh.
I have (as we all have) heard many of these stories - but usually it's involving teens drinking or getting high or something and someone finding that on facebook - this situation, if were getting the full story, should never have happened, regardless of how she "looks in her photos."
With that said, unfortunately in this day and age you have to be careful what sort of info you put on social networks.
If you want to post pictures of yourself flashing at mardi gras, yet you aren't independently wealthy and still may need to get hired or do anything that someone night take as an invitation to look into your past/social life, you may wish to not post such photos, or post them under a pseudonym account.
So..., you're saying that some kind of evil bureaucracy is being allowed to get between a patient and his or her doctor? And meddle in the healthcare decisions that are made by patient and doctor? Why, that's scandalous! We should protest such bureaucratic meddling and demand that our rights as patients be protected from same.
Oh, wait...
zo, doktor Freud sayz ze cure for depression maybe to go out wiz your friendx und enjoy life and stop uzing facebook all day.
www.boznz.com Simple solutions to complex problems.
(there are a lot of stickywickets here and not enough details.. but reading between the lines and going with my gut based on my dealings.. this is my take)
Everyone want to rant about the evils of health care and I agree with damn near all of it. But as someone who has dealt with depression for a couple of decades and with (actually pretty good) healthcare assistance, I'm inclined to think she's taking advantage of the system and deserves to be dropped.
As I understand it, sick leave in Canada is paid sick leave (like maternity leave here in the US) which over insurance premiums. Sick leave is designed for medical recovery that would inhibit your ability to perform you job.
Now believe me.. coping with depression can definitely include going to the beach and smiling for pictures, but by doing those things in the capacity mentioned in the article, she's demonstrating that she is in fact capable of doing tasks where she had previously claimed her depression would inhibit her job performance. As she's being paid, she's now defrauding the system.
I'll give her the benefit of the doubt that she is depressed. In her case, her sick leave is designed to allow her time to visit therapists, psychologists for medications, or even prolonged hospital visitation if required. She should be using the paid sick leave to take real advantage of her medical coverage.
I suffer from depression and I also have supplemental health insurance with Manulife. Obviously I am calling them tomorrow to cancel.
A few years ago they funded 6 weeks off work for my depression. Now I am hoping there aren't any photos of me floating around the net from that time, otherwise they might come around demanding that money back!
On this picture you see two members of the German national football (soccer) team. One of them killed himself on November 10th by leaping in front of a train, suffering from severe chronic depression. Guess which one.
(You'll find the solution here. If you picked the right answer, you may want to consider a career in insurance. I'd suggest this one for starters.)
most of what follows is true
Me: Doc, Do I have rectal Cancer?
Doc: Email me a pic so I can tell.
----------
To: Doc
Subject: Rectal diagnosis photo
Attachment: hello.jpg (25 KB)
Here you go.
----------
I'm not surprised a desk jockey at an insurance company decided to make a medical decision on this. Insurance desk monkeys don't usually have any medical training, and become a hindrance.
I once had a patient come into the office. He was in near tears. I took him to the exam room, and found out that his insurance company (Molina in the US) had canceled his coverage for dialysis. He was a critically ill patient, and was panicking. I called the insurance to find out what was going on. I was told by the desk monkey that they did not cover 'elective' procedures. At this point I was incredulous. I tried a couple times to tell him dialysis was not a choice, and certainly not elective. No dice.
I had to argue for close to an hour to get a supervisor. This flunky was going to cut all coverage to this man's dialysis. No if's, and's, or but's. The supervisor reversed the decision on the spot, but damn. Most nurses don't have the kind of day they can devote an hour of arguing with an insurance company. The patient isn't medically trained, and certainly wasn't in a state to do it, what with being critically ill, and coming to grips that he was not going to ever get off of dialysis.
That's the worst of my experiences, but I can't say it was isolated. After ten years of nursing the episodes of crackpot crazy insurance company behavior just keeps happening more and more. It's not that uncommon.
This particular story is out of Canada, different health-care system, different incentives.
But... but... I've been reading Slashdot for years - so I know this sort of thing only happens in America! The rest of the world is run by virtuous, thoughtful, caring, intelligent individuals who act only in their population's best interests!
#DeleteChrome
But what the pictures show her out and active several times a week - over many weeks?
That would seem to at least warrant a review of her claim.
TO: All Employees
SUBJECT: New Sick Leave Policy
SICKNESS:
No excuse...We will no longer accept your doctor's statement as proof. We believe that if you are able to go to the doctor, you are able to come to work.
AN OPERATION:
We are no longer allowing this practice. We wish to discourage any thoughts that you may need an operation. We believe that as long as you are an employee here, you will need all of whatever you have and should not consider having anything removed. We hired you as you are, and to have anything removed would certainly make you less than we bargained for.
DEATH:
Other than your own: This is no excuse for missing work. There is nothing you can do for them, and we are sure that someone else can attend to the arrangements. However, if the funeral can be held in the late afternoon, we will be glad to allow you to work through your lunch hour and subsequently let you leave 1 hour early, provided your share of the work is ahead enough to keep the job going in your absence.
Your own death: This will be accepted as an excuse. However, we require at least two weeks notice as we feel it is your duty to train your replacement.
ALSO:
Entirely too much time is being spent in the restroom. In the future, we will follow the practice of going in alphabetical order. For instance, those whose names begin with "A" will go from 8:00-8:15, and so on. If you're unable to go at your time, it will be necessary to wait until the next day when your time comes again.
We appreciate your cooperation,
THE MANAGEMENT
This is an old joke (and way older from what I know, than the linked newspaper article). But anyway tistork, you might still agree with it agree with it even if it is a joke. If so, then you definitely have real management potential.
On another note, well before the public internet and email, I took this and ummm copied my high school's official letterhead and signature section (with the school principal's signature) onto it. Then I made around 500 copies and left them lying around all over the place (2000 student population). It was excellent to see how many people freaked out before they figured out it was a joke. Amazing how people look for the worst some times... and amazing how much fun you can have with that too, sometimes. :) In the end the principal actually told me he thought it was one of the better jokes pulled at the school. :D
-- I ignore anonymous replies to my comments and postings.
Its not the system that is broken but doctors themselves. Greed gets in the way of the Hippocratic Oath and doctors just look at this as a way to get money. No doctor should ever look at the profession as symbol of status or way to make money.
This particular story is out of Canada, different health-care system, different incentives.
Yes, but this sort of insurance is PRIVATE INSURANCE. Were it covered under the Universal health care, it would not be an issue. A private company has a profit motive, and therefore usually tries to come up with ways to DENY CLAIMS. Now, perhaps this is a wrong instance, perhaps it is a right instance... I'm not informed enough to know.
But certainly, a fraud claim under the public system would require much more evidence than just "we saw some pictures of her smiling." This is more like the guy claiming he couldn't work cuz he has a bad back, and then people seeing him building a house (god I've seen this at last 3 times, fucking scammers). Those people need to be OUTED big time, because we are paying for those pricks to collect $$$ for nothing; and worse, they then work under the table on side jobs and pay no taxes BACK into the system!!!
Manulife is acting EXACTLY like the US health care system. EXACTLY.
"The problem is that doctors are rather incented to declare people sick, so insurers will pay them."
And This.
Insurance companies are incented to deny claims. :)
So the doctor declares you sick and assigns expensive treatment. You go along with it thinking your insurance will take care of it. A few months later you get a bill from the doctor with either a part or none of the bill paid for by the insurer.
Both the doctor and the insurance company win, and you get stuck with the bill. The system works great as long you pay.
Depression? Don't talk to me about depression.
Did I mention the pain in all the diodes down my left-hand side?
Confucius say, "Find worm in apple - bad. Find half a worm - worse."
Amen.
Anyone who attempts to issue definitive, action-taking diagnoses based on snapshots alone should put it in software under a public license and let us all use the WebShrink online doctor.
Yes, I am sarcastic and don't for a second believe this is possible or accurate.
I wholeheartedly and immediately believe that there are bone-headed actions such as this that insurance companies take every day in order to avoid paying for care or claims. And this is why for-profit healthcare is an oxymoron.
After some thought, I think we as tax payers have decide not to bail out AIG.
Cool story bro. Now why the fuck should someone who is depressed be paid not to work? There is no rational though plan that allows for paying people disability payments for working based on "depression". How many poor ass people are poor because they're depressed and _never_ worked, are we going to pay them a significant portion of a normal salary because they're depressed? My rule, being sane, is that you never pay disability for something which someone can very, very easily fake - even if they're not faking it.
Any sort of work would require her showing up regularly to her workplace. Anyone with a history of depression will tell you this is hard. Can you summon the energy to go out and pretend to have a good time when a friend asks you out? Sure, especially if you know it means a lot to them. But to do that *every single day*? There will be days when you can't really get out of bed, because the world just feels too heavy, and it may ruin you company's presentation, or deadline, or whatever.
So yes, your mental illness may be such that you can function at a party, but not cope with the responsibilities of a job. The point is, this is not up to the insurer: there are doctors to verify the diagnosis.
As for the woman herself, if she lives in a system where she can get paid while she battles with depression, should she refuse it? Sure, she may be scamming them, but the photos don't prove anything.
The problem is that doctors are rather incented to declare people sick, so insurers will pay them.
This. This is what is wrong with US health care. The only incentive doctors should have to declare people sick is that the people are sick. If your system is designed to encourage anything else then it's broken by definition.
2 things - 1 - didn't you READ what you quoted? The doctors have an incentive to declare the sick as such - regardless of motivation. Its much better that way than the other way around. And secondly - this is the CANADIAN system that is being discussed. The US system is somewhat different.
Please double-check your reading comprehension. Re-read it: "... doctors are rather incented to declare people sick, ...". It does not say "to declare sick people sick". It says "to declare people sick". Those people may not be sick at all. Your other points are valid, but your argument is flawed on this one.
Yeah, Canada, where you can't even just switch doctors if the one you've got keeps failing to do his job. I'm not particularly against a semi-state funded healthcare system, but looking at the Canadian healthcare system I can completely understand why US citizens are so afraid of socialized healthcare.
A good education is a bit like a STD - it makes you unsuitable for a lot of jobs and gives you a desire to spread it.
Except that the doctor shortage is not a function of universal health care, it's a function of the self-regulated medical profession maintaining control over how many doctors are certified every year. They keep the numbers down, so everyone has to scramble for a doctor, and the doctors can pick and choose patients. If the gov stepped in and mandated more seats in medical schools, there would be more doctors and less of a shortage.
The Canadian system isn't perfect, hell it isn't even very good, but it covers everybody, and it's more than twice as efficient as the current US system. But hey, if you enjoy the taste of the shit that the insurance companies feed you, by all means, keep right on eating it.
Rule of Slashdot #0: You and people like you are not representative of the larger population. - A.C.
Yeah, Canada, where you can't even just switch doctors if the one you've got keeps failing to do his job. I'm not particularly against a semi-state funded healthcare system, but looking at the Canadian healthcare system I can completely understand why US citizens are so afraid of socialized healthcare.
You've obviously never actually "looked" at the Canadian health care system, or you couldn't post such crap. You're just repeating right wing propaganda.
The Canadian system isn't perfect, and there are real improvements which could be made to it. But apparently it's good enough that right wingers have to make up bullshit in order to sufficiently discredit it.
Now excuse me, I have to attend a euthanasia board meeting to determine whether its time to terminate grandma.
Loose lips lose spit.
Once again, those facebook/myspace/twitter posts bite another one in the butt. Anyone who posts ANYTHING on the internet, no matter how hard you try to lock it down, is just naive to think that someone can't find a way to access it. The ones I love are idiots who paste videos of them doing something illegal, then are shocked when the police show up.
Depressed people are usually very good at hiding it. I have a severly depressed friend who is medicated to all hell but yet manages to come have a good night out on the town, including laughter.
The insurance company shouldn't actually have a case, depression does not automaticly make one incapable of smiling for a camera, and it doesn't then follow smiling = not depressed.
After logging in slashdot still does not take you back to the page you were on. It's been that way for 20 years.
This. This is what is wrong with US health care. The only incentive doctors should have to declare people sick is that the people are sick. If your system is designed to encourage anything else then it's broken by definition.
That's nice but actually it's offtopic, FTA ...
A Quebec woman on long-term sick leave is fighting to have her benefits reinstated after her employer's insurance company cut them
Quebec is in Canada and long-term sick leave is a disability or workman's comp benefit not a healthcare benefit
Apocalypse Cancelled, Sorry, No Ticket Refunds
And to belabor a point, this is exactly why H1N1 rates are being reported so highly.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
The Doctor doesn't really win here either, he/she is the one that has to hire an extra person to deal with these asinine third-party payers. They'll sent denials for any or no reason, about 10% of benefits claims get rejected in the hopes that somebody will just forget to resubmit the claim. Get to the end of a month or a quarter and you can really tell when they are over budget for claims payments for the accounting period because payments will come to a halt.
Apocalypse Cancelled, Sorry, No Ticket Refunds
Not all depressive conditions are continuous. There can be intervals of light and happiness between prolonged pits of despair.
I know this since a former lover was bipolar (manic-depressive). She could be exuberant, playful, spirited, horny, full of life, and fun to be with in every possible way. But as it reached its crescendo, it would transform into helpless depression, and accompanied by a deep malevolence aimed with fearful precision at all those close to her - those she could hurt. Family and friends would suffer or flee until she could be checked into an institution for a month or so. Her medications probably helped a bit, but could not prevent the cycles or make much difference to the amplitude of her emotional oscillation.
An insurance company could easily have arranged for photos to be taken during the good phases, when she was better than merely good, even better than ecstatic as she approached the brink. It would not have altered her progression into the abyss, or the depths she plumbed therein. It was more than 20 years ago, and I am still scarred by the memories.
[posting as AC for personal reasons]
I'd LOVE to see proof that they limit how many people can enter med school / graduate from med school every year. Otherwise, you're just flat out lying to justify a broken system. I've heard similar arguments from people like yourself that "they manipulate interest rates to make sure poor people stay poor". That is just a laughbly false.
If you have a shortage of doctors, it's much more likely that it's because the Canadian doctors are paid far less, therefore many say "It's not worth going through the hell that is med school for that little money".
Also, if the government "mandated" that there were more doctors certified each year, you'd just have a bunch of unqualified doctors running around.......which is much, MUCH worse than having a shortage of doctors.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." ~Thomas Jefferson
And a lower average quality of physician. The government can’t mandate skill or talent among its citizens.
How can you use my intestines as a gift? -Actual Hong Kong subtitle.
It is difficult to measure brain serotonin levels in a person, not without biopsying brain tissue. I did read about a blood serum test for serotonin - apparently, the levels in your bloodstream are not indicative of what's present in your synapses. It's used for detecting certain types of cancer.
I agree, however it looks like the Dems are finally caving in to insurance co. demands; whereas the Republicans were already long in insurance co. pockets.
Such a big "system" is wide open for abuse, from all parties involved. It belongs at the same order of complexity as voting systems, given all the people, computer systems, etc. involved.
My hat's off to the Dems for at least trying to fix such an obviously fucked-up system. But bad on them for trying to fix it in such a short time, and with limited transparency.
Our system of government is so antiquated, makes it easy to buy off politicians. While I'm not an anarchist, the fact that we're still running the country under a super-narrow hierarchy makes it really easy to corrupt.
O lord, bless this thy holy hand grenade, that with it thou mayest blow thine enemies to tiny bits, in thy mercy.
If the gov stepped in and mandated more seats in medical schools, there would be more doctors and less of a shortage.
If the government stepped in? The government has already stepped in, by creating this system in the first place!
The government needs to step out, by abolishing medical licenses. Once that's done, the market will come up with its own system of certification. And just like that, everyone will have real choices. Maybe some people will choose to go with a doctor who offers his services at rock-bottom prices, even though he has fewer years of schooling than the government would like. That might not be their first choice, but at least they would have that choice.
Now you might be thinking, 'Why should people have to make decisions based on how much money they have? Shouldn't everyone get the best doctor in the world?'
Sadly, we live in a world of scarcity, and no system - not even universal health care - can change that. So choices have to be made. I'd much rather make those choices myself.
Probably true, but not really germane to my point, which was that it's the scarcity of med school seats, not the universal health care system, that's causing a doctor shortage.
Rule of Slashdot #0: You and people like you are not representative of the larger population. - A.C.
When this causes her to become even more depressed and she commits suicide, how much is the insurance company going to be paying to her estate?
I'm a good cook. I'm a fantastic eater. - Steven Brust
I know for a fact that the insurance companies have non-medically qualified people denying claims on the basis of JPEGS of radiograms.
There's a lot to be said for the idea that they should be sued for practising medicine without a license.
Reality is the ultimate Rorschach.
You're hilarious. Are you the kind of libertarian who wants just enough government to protect the rich from everyone else? Good luck with that.
Private health care works great in the US, don't it? Where you have the least efficient health care system in the developed world. By a factor of two. No really. Basically you have the private sector insurance companies who spend 40-60 percent of their revenues on denying claims. How is that a good thing? Insurance companies can get away with this because when it comes to their health, people get desperate. So basically, left without regulation, the insurance companies can deny you services that you've already paid for. How is even less regulation going to fix this?
The only part of your health care system that works reasonably well is Medicare. You know about Medicare, right? That government-funded insurance that pays for people who can't get insurance elsewhere?
The fact is, the numbers just don't bear out the libertarian position when it comes to health care. The US spends $6000/person/year on health care, and 45 Million people go uncovered by insurance. The next best developed nation spends $3000/person/year, and has coverage for everyone. And for this horrible value, the US has one of the sickest populations in the developed world. Not exactly getting your money's worth, are you?
Basically, your libertarian argument comes down to this: you want to live in a well-functioning, healthy society, but you don't want to pay for it. Well guess what, that doesn't work. When the poorest people get healthier, everyone benefits. That's why things like healthcare, education, public works, etc are worth paying taxes for, to make life better for everyone. But you guys are too selfish to see that.
Rule of Slashdot #0: You and people like you are not representative of the larger population. - A.C.
Blame it on Canada, the theme never gets old here.
The issue is much more nuanced than most arguments would indicate.
Unlike most, I live near Canada, worked in Canada and even been to the hospital in Canada. Canadian Hospitals are not as comfy as the ones I go to in the US. They seem more institutional and less customer focused. That being said, they seem just as competent. (life expectancy and infant mortality are much better in Canada than here in the US)
Anyone with real money (and suckers like myself who pay 10 Grand a year) will likely have a better experience in the US system than the government system in Canada.
The other 60% would do much better in Canada. No more worries about loosing insurance when they loose a job, or worries about scrounging up insurance money, no more co-pays driving people to the brink.
BTW, us IT workers need to learn from the Canadian Doctors. Imagine if we controlled who could enter the IT field? We also could create artificial shortages and boost our salaries as well.
And a lower average quality of physician.
Oh my god! No, we can't have that.
In fact, we need to raise the average quality of physician. But how? I know! How about, we only hand out one medical license every four years to the brightest medical student in the world? That would cause the average quality of physicians to sky rocket! Sure, a bunch of people would die from lack of health care, but we mustn't let facts get in the way of good central planning.
I suppose some people would say that we need to balance physician quality with the need for health care. But how? How do you get the supply of physicians just right? It's like...you have supply on one hand...and demand on the other. How do you balance supply and demand? I think there's some kind of system for that...hmmm...but, I guess they didn't teach me that in central planning school.
"Also, if the government "mandated" that there were more doctors certified each year, you'd just have a bunch of unqualified doctors running around.......which is much, MUCH worse than having a shortage of doctors."
Maybe. Let's suppose that the gov mandated that more people were put INTO the school. Let's assume that a number of people don't even make the grade. Maybe they reach internship, and find that they can't carry the load. Not a total loss - we have a pool to draw from for paramedics, and maybe physician's assistants. Let's say that before we ever get to internship, we've lost a lot of people. If they've completed the first two years of med school, they are qualified to be EMT's, without question. (I am an EMT - all the training I've received in my life maybe equals 1 year of med school, certainly not much if any more.)
The gov need not lower the bar for qualified physicians. Even if 80% of that increase in students never become doctors, we've STILL managed to increase the number of doctors by that 20%. It looks like a win/win situation to me. Every workplace should have an EMT, paramedic, or industrial nurse available. These are the people who must stabilize and transport the patient, before any doctor ever looks at him/her. The real life savers are always found out in the field, believe it or not.
"Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
I agree with that, provided:
1) the medical fraud tribunal is impartial
2) if found guilty, the doctor is punished with enough severity to effectively disencourage other doctors from doing the same.
Those are the two items that are missing in most countries medical systems today. Medical fraud is investigated by commissions formed by doctors alone, who have no incentive to punish other doctors. Even in the cases where doctors are found guilty, all they get is a wrist slap.
The inevitable outcome? Medical malpractice suits, where layperson juries award millions in compensation to victims. Side effects are either enormously expensive private insurance (USA) or a heavy burden to taxpayers (other countries).
Unfortunately, I see no way out. I can't think of any incentive system that would preserve the best interest of patients while, at the same time, preventing patient-doctor complicity in defrauding insurance companies. This is especially true in psychiatric cases where the assessment whether a patient is depressed or not depends mostly on the opinion of the doctor that's treating the patient.
While depression has many causes, vitamin D deficiency may help explain why there is more depression in the winter months:
http://www.vitamindcouncil.org/depression.shtml
"However, it is not to early to heed the following advice: If you suffer from depression, get your 25(OH)D level checked and, if it is lower than 35 ng/mL (87 nM/L), you are vitamin D deficient and should begin treatment. If you are not depressed, get your 25(OH)D level checked anyway. If it is lower than 35 ng/mL (87 nM/L), you are vitamin D deficient and should begin treatment."
More treatment details here:
http://www.vitamindcouncil.org/treatment.shtml
"If you refuse to see a physician, or can't find a knowledgeable one, purchase the 1000 IU/day vitamin D3 cholecalciferol pills that are available over-the-counter in North America or a 5,000 IU capsule. Take an average of 5,000 IU a day, year-round, if you have some sun exposure. If you have little, or no, sun exposure you will need to take at least 5,000 IU per day. How much more depends on your latitude of residence, skin pigmentation, and body weight. Generally speaking, the further you live away from the equator, the darker your skin, and/or the more you weigh, the more you will have to take to maintain healthy blood levels."
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
Where I work, we have short term disability (1-6 months I think) and long term disability (greater than 6 months) and they are separate coverage, and if you have something that prevents you from working for under one month, you don't get any disability coverage. They recommend keeping leave on the books (and they have generous leave, so that's not hard)
Learn to love Alaska
That's not depression, that's just not enjoying your job. Try going to bed dreading the idea of waking up in the morning - every single day - for months on end.
Ahh - My eye!
The doctor said I'm not supposed to get Slashdot in it!
Psychiatry is not simply guesswork despite the standard on /. of marginalizing anything non tech related. Anybody who has met a handful of shrinks will tell you there is certainly skill involved.
Why should the quality go down? The limiting factor is medical school places and presumably funds, not a shortage of people able to fill these places and qualify.
There really isn't such a thing as a stupid doctor.
Blarney Quality Restaurant, Plants
Our constitution guarantees us "life liberty and the PURSUIT of happiness".
That's in the Declaration of Independence, not the Constitution.
Sadly I would far less surprised to see this end in suicide than litigation.
First off, you're assuming that they limit how many people can get in. As I asked the person who posted above me, prove it. Secondly, if they are not limiting how many people can get in (which they most likely aren't), then forcing them to accept people that they'd normally turn away (due to lack of ability to do the work), then you're forcing them to have unqualified students.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." ~Thomas Jefferson
Wow, what a wonderful argument. You make a ridiculous claim that they limit how many people can enter / exit med school each year in a vast conspiracy to up doctors pay, then when asked to provide a shred of evidence for your claims, you make childish insults.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." ~Thomas Jefferson
It's the insurance company's job to
make as much money as possible for the shareholders and
pay out
AS LITTLE AS THEY CAN IN
claims. Period. End of story.
That is what they exist for.
If they don't pay claims then they might as well be all arrested for fraud.
They do their best to avoid paying claims even when there aren't people around willing to make excuses for them.
There. Fixed that for you. If my insurance simply paid any claim I couldn't afford it.
There Corrected the Misconception for all of you
regards
dave mundt
YAB - http://blog.beemandave.com/
The Public Option has been so watered down that it only will pick up the slack for a tiny percentage of the people without insurance. The rest are going to be REQUIRED to BUY insurance. So this will NOT put the health insurance companies out of business. It will make them rich. We have the best political system money can buy . . . Not that it matters, since she's in Canada.
I'd love to change the world but I can't find the source code.
This is about the same as saying that 'there really isn't such a thing as a stupid slashdot poster'.
Seriously. Get a grip. I can name two doctors I have seen in the last 12 months who could easily qualify under the heading of 'stupid'.
That is: ... ... (I want my money back :( )
1. They make stupid mistakes
2. They fail to properly diagnose (or don't know / have forgotten how / don't care)
3. They fail to communicate (asking a patient questions you would normally ask someone of the opposite sex only?!?)
4. Stating to have an 'interest' or 'specialty' in a subject area they clearly only have passing knowledge in (I am SO glad someone knows that medicine X can *really* help with condition *Y*. I didn't know that. Really. Haven't known it for more than half my life. No, the medicine does not work for me. Really. Just believe me. No, don't write a prescription, I'm not going to have it filled. Why waste my money, and the government's, on something that I know won't work [yes, used it before; yes, I am in that 10% of people for which have no response. Here is my list of what I've done in the last decade and a half with this ailment. Why don't you recognise that half of what's on this list comes from the Authorities on this disease? Oh. Right. Because you only have a PASSING interest. *sigh*)
5. Inability to diagnose (what should be) straightforward standard complaints / issues
(having to diagnose myself, research the symptoms, validate the information, write it all up then present that to the doctor [to whom I am paying FOUR HUNDRED DOLLARS AN HOUR (FRAUD! MORON! IDIOT! ASS!)] and to a second doctor to read it and say 'yes, well, that appears to be very accurate')
I'm going to stop here. Look, it's entirely possible that you just happen to be one of the wonderful people on this planet who inadvertently make open and broad reaching statements. Please stop doing so. People may come to believe that you are trolling.
Now, back to our original story topic.
Shame this isn't America; couldn't the person with her insurance cut could possibly sue the insurance company for acting on unproven evidence, possibly with a side of 'will the company now prove that the evidence used is not fake' ?
You have a sick, twisted mind. Please subscribe me to your newsletter.
It's the insurance company's job to
make as much money as possible for the shareholders and
pay out
AS LITTLE AS THEY CAN IN
claims. Period. End of story.
That is what they exist for.
If they don't pay claims then they might as well be all arrested for fraud.
They do their best to avoid paying claims even when there aren't people around willing to make excuses for them.
There. Fixed that for you. If my insurance simply paid any claim I couldn't afford it.
There Corrected the Misconception for all of you
regards dave mundt
Actually, it depends on the way the insurance company is incorporated. A mutual insurance company is owned by the insured, so any claims come directly out of the insured's collective pocket through higher premiums either directly or a reduced dividend. At any rate, they should pay valid claims while still reducing their total payout in a reasonable fashion. Reviewing disability claims certainly is not unreasonable; independent of how they did it in the cited story.
I'm a consultant - I convert gibberish into cash-flow.
I agree. In this case the insurance company could have used the information to see how many other patience relied on a diagnoses from the same doctor and perhaps launched an investigation into the doctor if they felt he was committing fraud. Or if they felt his diagnoses where hinky, they could have lodged a complaint with the collage of physicians and let them handle the matter.
But as you say it is not their place to reverse a diagnoses based on a few photos on facebook.
You can't switch doctors? Would you care to back this up with some evidence? The reason people are afraid of "socialized" healthcare is that people like you spread vicious rumors, lies, falsehoods, incorrect information about something you know nothing about. Why don't you go look this up somewhere from an independent source of information, (that is to say, not fox news, not the insurance companies' own brochures, etc.) and then come back and discuss the merits of the two systems?
Furthermore, how easy is it for you to switch your doctor here in the united states? Can you just go to any doctor? NO, you can't. You have to deal with your insurance company first, and they can deny you the right to switch doctors (well, they can't stop you from switching, but they can stop paying, which is EXACTLY the same thing). And if you need evidence of this, simply call up your insurance right now and ask them if you can switch.
-1 disagree is not a modifier for a reason. -1 troll, flaimbait, redundant, overrated are NOT acceptable substitutes.
who are severely depressed. there are people who outwardly seem morose and never smile but are emotionally well-balanced. the external mask you choose to wear or think you need to wear due to social convention or social pressure has no relation to internal chemistry. a depressed person very well could be a morose shut-in, but there are plenty of people who are very depressed who do not fit this description at all
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
I'm no expert on Canadian anything, but I think this is not health insurance but disability insurance, kinda like AFLAC. It doesn't pay your medical bills, it replaces your income, although probably not all of it.
I see even classic Slashdot is now pretty much unusable on dial up anymore.
The doctor only "wins" if you pay in full and on time, which likelihood is reduced if you went into things thinking that the insurance company was going to pick up most of the expense.
Doctors and insurance companies are not "all in this together".
I see even classic Slashdot is now pretty much unusable on dial up anymore.
her insurance provider found photos of her on Facebook smiling and looking cheerful
This may well be an unfair action on the part of the insurance provider. Depression does not necessarily mean that you are gloomy 24/7; it is a lot more complicated than that, and this general misperception causes many to overlook or misinterpret what is actually a genuine depression. As an example of just one of the possible explanations for the woman's behaviour, see http://en.wikipedia.org/wiki/Atypical_depression (Atypical Depression).
I hope she brings them to court and wins this one, I hate Facebook for this.
It is not because the picture on facebook shows a woman smiling that her doctor has deemed her cured, *ssholes.
I hate insurance companies even more. I seriously hope that some lawyer takes her case, and pushes it way
far enough to put a cringe into any insurance company's head whenever they think of this type of strategy again.
I originally read this story on CBC last week and wrote up a comment explaining how A) this was the wrong thing to do, both ethically, and legally as they are not qualified to make that determination based on the information they found, and B) how they were likely going to get sued for their actions anyway (and lose), and C) How anyone that puts this stuff online should not expect that if will be kept private. I also detailed how security is a personal responsibility, and all the technological wizbangs in the would will not keep your information secure if you are an idiot, or at least not careful about what you do. I also illustrated how easy it would be to get at her information on facebook and outlined a step by step procedure should one want to do something unethical. It mostly involved just googling her old high school chums, finding one without a facebook account, creating an account posing as the friend, and then sending a friend request, and bingo bango you have full access to all her photos, as likely they will accept the request. While this is unethical I don't think this is particularly illegal (though you might break the facebook EULA, if you can call such a flimsy agreement legally binding), and really just outlines how lax security in on facebook, and also how blithely unaware most people are about how secure their information is. Anyway after writing that all up and posting that, also indicating that while I am posting that while there is a degree of protection also on the CBC commenting forum, not to treat it like you are anonymous or something, because you are not (just look at the teacher that resigned due to posting inappropriate things on a news paper comments section down in the US). In any event, after writing that all up.... it seems CBC took some exception to something I said thinking I must have violated their submission guidelines (though I am not sure how, perhaps they thought by laying out step by step instructions about how to circumvent facebook security I was somehow encouraging people to do so, if that is even illegal in the first place. Key is my whole point was that it wasn't an ethical action for which they were likely being sued. The other point being to be careful about what you post online as it isn't as safe as you might think.), and decided to censor my comments entirely. Its their site, I suppose they have the right to if they so choose. However I just thought if was funny given the topic.
My girlfriend and I previously have worked for a private investigation company concerned entirely with insurance fraud. There are many similar companies, but ours was a nationwide company with clients like Walmart, AIG, the Hartford, Prudential, GEICO and many others you can think of. Insurance co's will use any information they can get to deny your coverage, and they will take very extreme steps. Once an investigator followed a target to firefighter training and participated in a daylong course with a hidden camera showing the target hauling heavy gear and "injured" people.
While there are many frauds out there, and the vast majority of cases in our company were almost certainly fraudulent, it's important to know that the VERY first thing they do is a regular Google/Facebook/Myspace search. It's amazing how many people don't keep their profiles privately viewable. (One pattern I noticed was a common tendency to use Myspace as proof of one's "coolness" and you don't want that private when there's a whole world who needs to know.)
If you ever are on disability or making insurance claims that might LOOK shady, you should know that there will almost certainly be someone watching you from the street in a car with curtains on the windows. They will follow you across state lines, they will follow you to Walmart, they will follow you to the strip club and they will sit outside your house and photograph you when you come out to check the mail. The photos and videos will be presented to you in court, if not beforehand.
The insurance company's job is to collect premiums and pay out when the doctor says "this person has a bad back" or "this person has a broken leg" or "this person is clinically depressed".
Bottom line, insurance companies HAVE to take the advice of "trusted" professionals, trusted or not, really. That is why we have doctors and lawyers etc - we must have someone who has the proper knowledge to make the ultimate decision.
The above statements could only be completely true in a world where fraud did not exist. Medical billing fraud is a multi-billion dollar problem and it hurts EVERYONE. Your costs and mine are higher because of medical billing fraud. Insurance companies, whether they be private insurers or the government, absolutely have a right to take steps to ensure that they are paying for reasonable services properly rendered. This doesn't excuse insurance companies from taking arbitrary and capricious actions that could deny payment for genuinely needed services. Nevertheless there are lots of corrupt patients and more than a few corrupt doctors out there. It is a real problem.
Please note, I'm not making any judgments one way or the other about this particular Facebook case. I'm merely asserting that insurance providers (private or public) do have a right to protect themselves from fraud and it is in all of our interest that they do just that.
I have severe depression but I smile and laugh sometimes. I guess I should just go kill myself so I don't have to burden my insurance company. This is the problem with all health insurance companies; they take your money when you are healthy but they drop you like a hot potato when you are sick.
Nope, that's just being a cry-baby. People like that either need to get over it or just go ahead and kill themselves. There's already far too many people in this world, the last thing we need are whiners.
"He who can destroy a thing, controls a thing." --Paul Atreides, Dune
I'd hate to be your elderly parent.
look sig is kool
Basically you have the private sector insurance companies who spend 40-60 percent of their revenues on denying claims... The only part of your health care system that works reasonably well is Medicare. You know about Medicare, right? That government-funded insurance that pays for people who can't get insurance elsewhere?
You do realize that the medicare denial rate is twice that of private insurance, right?
Please don't let facts get in the way of a good rant, though. God forbid the rabid dogs on the left and right actually look at the real data, stop propagandizing the issues and actually try to solve the REAL problems.
Go look at the data from other countries, not just your own. Seriously, every single developed nation has a health care better than your own. Every single developed nation has a mixed public/private system or a public only system. Go look it up. If you like facts, there are lots out there. Or keep eating the shit your masters feed you. Makes no difference to me, I live in Canada.
Rule of Slashdot #0: You and people like you are not representative of the larger population. - A.C.
I'm not asserting any position other than propaganda and rhetoric are hijacking the entire debate. Regardless of what your position is, if you intend to only use facts convenient to what you THINK is the correct approach rather than what the data would lead you to believe.
And, you are correct that the US has a mixed health care system like the majority of the world. ~60% of our health care expenditures are payed by government. Not admitting those facts in the debate are as bad as not admitting that big insurance company bureaucracies create tons of unnecessary costs.
All I was saying is that, despite how easily the issue is personalized, we need to separate emotion and agenda from the discussion and deal with the facts. Claiming that a government bureaucracy is a better alternative to a private sector bureaucracy is asinine. The health care issue in the US is that too many people besides doctors and patients have their hands in the pot. Regardless of who controls the bureaucracy, it will always make things more expensive and less effective.
I'm not proposing any particular approach here other than both sides stop pretending that they're not catering to THEIR special interests. If people just want to shout each other down rather than take a REAL look at how the world works and can work, then we're just going to create a whole new mess to deal with later rather than any lasting solution.
many people have commented many different things. Some that understand depression and others that CLEARLY do not. I am not bringing up facebook privacy or insurance company methods. What I want to know is how this bit(h was able to get 1.5yrs of paid leave when I, myself suffer from major depression and I have to trudge my ass into work every day? We both work for fortune 500 companies, both are at the peak of technical advancements and mine(and I am quite sure her) insurance are the best a large technology company can afford. Different insurance companies and I am in the US, but regardless. I have am the same age as this woman and I have been trying multiple different medications over the last 7yrs that make me groggy, spun out or a whole slew of other side effects that interfere with my job and above all DON'T WORK, yet she gets to sit at home...paid, or in this case, take a nice vacation. I'd like a fu(king vacation after 7yrs...maybe I WILL pull the trigger this time, THAT would be the ultimate vacation...I never have to come back.
"That's right...I said it."
"Canada, where you can't even just switch doctors if the one you've got keeps failing to do his job."
Yes you can.... switch all you like... I mean I can't get the doctor I want atm cause he has too many clients and can't accept anymore but that's his decision. But what you said is completely false.
We have solved the health care, diagnosis via Facebook and Twitter.
I cannot help thinking that someone is practising medicine via some images on Facebook.
Practising medicine without a license is illegal and if someone had a license I expect it would be at risk because of this.
Worse this is apparently a mental health issue involving depression. We could all review the video of the Army Psychiatrist accused of killing 13 people at Fort Hood. Does he look crazy? The evidence is growing that he was.
There was no external facebook clues for the High School kids some miles down the tracks from here at Gunn HS in Palo Alto, CA
http://www.sfexaminer.com/local/High-school-mourns-second-student-death-on-tracks-in-a-month-46861617.html
Mental health problems can have serious consequences.
Truth is stranger than fiction, but it is because Fiction is obliged to stick to possibilities; Truth isn't. Mark Twain.
One thing no one has asked is, when were the photo's taken? They could have been taken before she was depressed. Mental illnesses I'm familiar with tend to have good days and bad days. The problem is you have little to no control over when you'll have a good day or a bad day.