"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.

Because people are desperate for something to change. The status quo is literally killing people.

I'm not saying I agree with their voting decision, but I can, in part, understand their frustration.

I see this tactic exploited to the maximum by foreign state propaganda machines.

In my country which was targeted to the max by Russian propaganda, they are using the same playbook as in the US right now.

1. take any real complicated issue and blow it out of proportion so people think that it is a life and death situation.

2. heavily promote the most unfit person for the job

3. blame the worsen outcome to the predecessor

Rinse and repeat and you'll see the country drown in chaos and everyone blames everyone.

You can always argue that it is the real people, but if you look really close to the systems of promoting the divisive content - the powerhouse of it is always bot networks only followed by real people.

I think that the most of the division in western societies have to be studied from the perspective of foreign influence.

The primary reason why Russia can exploit the failures of the system is that those failures exist. Western political elites are locked into old alignments and captured by special interests groups. They became more opportunistic and less values-driven, ignoring modern challenges and demographic changes and becoming less competent in general. This is why in Europe, which is more democratic than USA, we see significant changes in political landscape with new parties emerging on the right and on the left and getting visible share of votes. USA has a major flaw that doesn’t allow the country to escape bipartisan system, so it’s going to agonize in its current state until it finally breaks. Foreign influence here is really a secondary matter.

Ironically the fix for this is quite simple. Use score voting instead of first past the post.

Score voting is simple: It's the voting system the judges use in the Olympics. Voters give each candidate a score. Highest average (i.e. the one who would get the gold) gets the seat.

The flaw in first past the post is that it gives any viable third party the powerful incentive to merge with the major party they're most similar to, because otherwise they split the vote and both lose. So you get a two party system. Score voting doesn't have that, you don't have to change any other part of the system to make it work, and then the two party system everybody hates goes away.