"Slow Pay, Low Pay or No Pay": Blue Cross Approved Surgeries Then Refused to Pay

Long read; these bits were notable to me:

> But the insurer’s defense went even further, to the very meaning of “prior authorization,” which it had granted women like Arch to pursue surgery. The authorization, they said in court, recognized that a procedure was medically necessary, but it also contained a clause that it was “not a guarantee of payment.” Blue Cross was not obliged to pay the center anything, top executives testified. “Let me be clear: The authorization never says we’re going to pay you,” said Steven Udvarhelyi, who was the CEO for the insurer from 2016 to 2024, in a deposition. “That’s why there’s a disclaimer.

> At the trial, Blue Cross revealed that it had never considered any of the appeals — nor had it ever told the center that they were pointless. “An appeal is not available to review an underpayment,” acknowledged Paula Shepherd, a Blue Cross executive vice president. The insurer simply issued an edict — the payment was correct.

> On several occasions, though, Blue Cross executives had signed special one-time deals with the center, known as single case agreements, to pay for their wives’ cancer treatment.

This is the frustration that leads to getting a dictator wanna-be elected President. People are SICK SICK SICK of these shenanigans and seriously want it to change.

How does electing a dictator who promises "Vote for me and I will make it worse" help, though? That's the part I don't get.

If the dictator promised to round up these CEOs and send them to El Salvador without a trial, that would be one thing... but the opposite is true, and I think the electorate understood that well enough.

Common people across the board have been sick and tired of the establishment since 2000ish. First it was the tea party, then they voted for Obama because a younger black guy talking about change seemed credible, then occupy wall street, then Maga, then 2020/BLM, then Maga round 2. While these movements have all been coopted to various extents by various bits of the establishment power structure the underlying trend and common theme that is minting these (at least initially) grassroots is very clear and with each round the movements seem to gain a broader base. People of all political positions seek an alternate to the establishment.

If people could pull their heads out of their partisan asses they'd see this. The color of the dictator may as well be the result of a coin toss. This is the result of a long term trend.