Submitted by washingtonpost t3_10x8hqo in sports
skaterrj t1_j7uax6w wrote
Reply to comment by PangwinAndTertle in How the NFL avoids paying disabled players — with the union’s help by washingtonpost
In addition to what /u/314159265358979326 said, note that the NFL plan said that the judge in each of those cases was wrong. The sheer arrogance makes me even more suspicious of this plan - there's no sense of, "Hey, maybe we did get it wrong this time, and we should think about that."
Ever read Grisham's "The Rainmaker"? The movie was good, but the book was much, much better. In the book, the insurance company basically has a plan that they will reject every claim and then set up a loop between underwriting and claims so that no claim was ever paid. Someone dies after not receiving a treatment that should have been covered, which prompts the lawsuit.
While that's fiction, there's no doubt in my mind that there's some root in fact in it. There's no question that insurance companies make more money when they deny claims, so it's in their interest to do so, which automatically makes them biased against people filing claims.
coronavirusrex69 t1_j7v5tw0 wrote
> there's no sense of, "Hey, maybe we did get it wrong this time, and we should think about that."
do many companies think like this? I've had tons of wrongfully denied claims via insurance and yet they still deny claims as much as they can. most of the time i don't even know what it means or why it was denied or it's just "because we said so," and so I have to pay. Companies are not in the business of giving things away, and if they were suddenly approving claims without trying to deny them first, they would make less profit.
skaterrj t1_j7ve3kb wrote
Let me put it this way - I can't remember the last time my insurance (medical, dental, vision, Flexible Spending Account) denied a claim. Obviously these are more like traditional requests (checkups, pain that isn't going away, dental cleanings, etc.), but they definitely don't seem to have a "deny first" policy in my experience.
coronavirusrex69 t1_j7vian4 wrote
tbh without going into details of my life, that's really great for you. IMO, we should have nationalized healthcare/insurance so that everyone can have that same luxury. until rich NFL players start arguing for me to have the same healthcare as them, i'm not going to feel bad about millionaires who had to work for a few years to retire not having the benefits they feel they deserve.
skaterrj t1_j7vj9c7 wrote
Part of the problem here is that many of them aren't millionaires. The average career span in the NFL is four years, and most of them do not get signed to those multi-million dollar contracts we're always hearing about. Even if they come out of it with perfect health, most of them are going to have to continue to work to survive the rest of their lives.
Also, I ranted about our health care system elsewhere in this thread so don't go assuming that I think the current system is fine.
Finally, your original comment was:
> do many companies think like this?
And I responded that my health care insurance rarely decline claims. You asked, I answered. Maybe you've had a different experience, and that's legit, too, but then I'm not sure why you asked the original question, which was in response to the NFL plan declining a lot of seemingly legit claims.
coronavirusrex69 t1_j7vl4ny wrote
>Part of the problem here is that many of them aren't millionaires. The average career span in the NFL is four years, and most of them do not get signed to those multi-million dollar contracts we're always hearing about.
"rookies with zero years of service will earn a minimum salary of $705,000."
median individual income in the US in 2022 was $46k, likely with bad/no benefits at that kind of salary, likely with a work schedule/environment that is going to increase long term health issues. in two years, an NFL player on the literal minimum salary possible grosses more than what the median worker makes in 30 years.
>And I responded that my health care insurance rarely decline claims. You asked, I answered. Maybe you've had a different experience, and that's legit, too, but then I'm not sure why you asked the original question, which was in response to the NFL plan declining a lot of seemingly legit claims.
Because every claim denied increases profits, and insurance companies are businesses? I get that you haven't had any claims denied, but the more claims they successfully deny, the further they go towards accomplishing their goal. as long as healthcare/insurance stays a for profit system, this will be the case.
NFL players should use their platform to promote nationalized healthcare/insurance programs if they want my sympathy. i'm not arguing that no claims get denied unfairly, i'm arguing "duh, why wouldn't they deny every claim they can?" that's how they make money.
skaterrj t1_j7vmycj wrote
> median individual income in the US in 2022 was $46k, likely with bad/no benefits at that kind of salary, likely with a work schedule/environment that is going to increase long term health issues. in two years, an NFL player on the literal minimum salary possible grosses more than what the median worker makes in 30 years.
You don't have sympathy for them, okay, fine. Does that mean they should get screwed by the NFL plan that they thought provided them coverage? No, of course not. No one should be screwed by health insurance, it doesn't matter how much they make.
> i'm arguing "duh, why wouldn't they deny every claim they can?" that's how they make money.
I made that argument as well, in the first comment of mine you replied to. I'll quote it since you seem to have missed it:
> There's no question that insurance companies make more money when they deny claims, so it's in their interest to do so, which automatically makes them biased against people filing claims.
coronavirusrex69 t1_j7vos91 wrote
i guess we're not disagreeing then we're just talking in circles on something we agree about.
>You don't have sympathy for them, okay, fine. Does that mean they should get screwed by the NFL plan that they thought provided them coverage? No, of course not.
i guess i just don't see it as getting screwed because they are participating in the system and they know how the system works. if i go to a car dealership and the guy blows a bunch of fluff up my ass and i overpay, did i get screwed? or did i participate in an activity that is designed to exploit me for my resources?
if i go play roulette and put all of my life savings on 00 and it hits any other number, did I get screwed? if i go kick a venomous snake and get bit, screwed? if i go drink and drive and get pulled over, did i get screwed?
did anyone put a gun to these guys heads and force them to playing the NFL? because maybe i'm missing that part.
skaterrj t1_j7vqss3 wrote
None of those examples you gave compare to paying for health insurance and believing you are covered, then discovering it's useless. This one is closest:
> i guess i just don't see it as getting screwed because they are participating in the system and they know how the system works. if i go to a car dealership and the guy blows a bunch of fluff up my ass and i overpay, did i get screwed? or did i participate in an activity that is designed to exploit me for my resources?
If your employer had you paying into a health care plan then you later discovered it was smoke and mirrors, you would be screwed, yes. How in the world would that be your fault?
You're blaming the victims.
coronavirusrex69 t1_j7vt0ln wrote
>believing you are covered, then discovering it's useless.
i can believe that i'm a snake whisperer. it doesn't mean it's true.
>If your employer had you paying into a health care plan then you later discovered it was smoke and mirrors, you would be screwed, yes. How in the world would that be your fault?
my brother in christ, I do pay into my employers health care plan and it is smoke and mirrors. this isn't me being screwed or anything. this is me living in America where health insurance is a profit driven business. Also, my employer health care plan doesn't cover me once I'm no longer employed by them.
there are no victims. this is the system that we live by in the US. i'm not sure if you're here or what, but we aren't the victims. we vote for the people who design these laws. there were major presidential candidates (well, one) that ran on universal healthcare, and the US overwhelmingly voted for the guy who specifically said he would VETO any universal healthcare bill. this is the system, by design, not a surprise.
you're acting like you see an advertisement that says "Best pizza on the planet!" and feel screwed when it's, shockingly, not the best pizza you have ever tasted. saying stuff like your health matters to us and blah blah is marketing - ie smoke and mirrors, and yes, that is how the US health system is run... if you believe everything you read in an advertisement, you are going to have a bad time here.
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