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I literally gasped watching this Caleb Hammer asks how this transgender guest paid for his transition surgery, specifically “the boob job” He replies “That was free — Colorado taxpayers” - Transition surgery free - Boob job free - Hormones medications free All this was free, paid for by American...

1,894,704 Aufrufe • vor 2 Monaten •via X (Twitter)

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Americans are tired of seeing medication they need denied by insurance but watching transgender people get hundreds of thousands of dollars in nonessential surgeries covered for free by our tax dollars “I think that the entire concept of getting hundreds of thousands of dollars of cosmetic surgery, like non-essential surgery, covered by insurance, including universal American health insurance, is unfair. There is one prescription that I need that's a medical necessity that insurance won't even cover. For an actual disorder that I have with my body.” American woman also have a huge problem with gender affirming care being covered for transgender people but not biological women “I also think that gender-affirming care should be covered for women if it's going to be covered for transgender people. For example, if you're a woman and you feel like your body is too masculine, then you should also be able to get facial feminization surgeries or a breast augmentation, because that also might be affecting you mentally. Like, if you have a completely flat chest as a woman and you're shaped like a box, like I was when I was 18, I feel like it would be fair for you to, I don't know, get these surgeries” She’s right, transgenders get these surgeries 100% for free 15 states explicitly cover transgender breast augmentation, implants, under Medicaid But it gets worse Chest and genital procedures are covered more often than facial or other surgeries for transgenders but all are covered 27 states and DC have Medicaid policies that explicitly or protectively cover some gender-affirming care including surgeries We are paying for all of this

Wall Street Apes

42,406 Aufrufe • vor 18 Tagen

My last case of 2025 and my first case of 2026 tell you everything you need to know about our healthcare system. Last week, I was scheduled to do a DIEP flap for a patient who had been waiting a long time. We had asked her insurance company if we could do the surgery in network at @Redbudsurgerycenter, where we have everything needed to safely and efficiently take care of her. They hadn’t approved that, so the surgery had to be scheduled at an older hospital in town. When we arrived, the hospital was having HVAC issues. The humidity levels were not safe for surgery. We waited for hours, and ultimately the case had to be canceled. It wasn’t just her surgery. Multiple surgeries were canceled that day because operating under those conditions would have been a fire risk. We weren’t able to reschedule her surgery before the end of the year, which means her deductible resets. I could have safely done her surgery at Redbud that day but insurance rules wouldn’t allow it. This is what closed networks and rigid systems look like in real life. Now here’s the contrast. The first case I’m doing in 2026 is also a woman who needs breast reconstruction with DIEP flaps. This time, instead of traditional insurance, her employer uses a third party administrator. They came to me directly and asked what I would charge if they paid fairly and transparently. On Monday, we’re doing her bilateral DIEP flap at @Redbudsurgerycenter. I can control the environment, the costs, and the care. It’s better for the patient and significantly less expensive for the employer. This is called Direct Specialty Care. It’s not direct primary care. It’s specialty care delivered without unnecessary barriers. It’s happening. We’re starting the year this way. And I’m going to keep pushing the boundaries and keeping you informed.

Elisabeth Potter MD

136,464 Aufrufe • vor 7 Monaten

This is yet another instance of private health insurers going back on their commitments. Many middle-class citizens are increasingly turning to private health insurance providers as a critical lifeline for themselves and their families. These plans boast of a robust coverage and hassle-free claims, while charging customers exorbitant premiums. But when insurers fail to honour genuine claims, it leaves citizens vulnerable and puts a Question mark on the safety net of health insurance. As per information given by the IBAI (Insurance Brokers Association of India), the best performer in the Claims Paid Ratio (The total number of claims paid divided by the total number of Claims available for processing) was New India (Public Sector General Insurers) with 95.04%, followed by Aditya Birla Health (Standalone Health Insurer) at 94.52%. Other Large General Insurers such as IFFCO Tokio, Bajaj Allianz, SBI General have claims paid ratio of 91.70%, 90.29% and 88.86%. Other Standalone Health Insurers such as Niva Bupa, Manipal Cigna and Care Health have around 88% claims paid ratio. However, if one takes a look at the Claims Paid Ratio on the Amount of Claims (The Total amount of Claims paid divided by the Total amount of Claims available for processing), New India, Oriental Insurance, National Insurance - all public sector - have impressive ratio of 98.74%, 97.35% and 87.95%. The same for Standalone health insurers Aditya Birla Health, Niva Bupa, Manipal Cigna, Care Health and Star Health are all less than 71%. Similarly, the Health Claims Paid Ratio based on the amount for Small Private Sector General Insurers such as Liberty General, Acko, Zurich Kotak & Royal Sundaram reflect poorly. This is not to target anyone, but highlighting the need for better regulation and grievance redressal for the customers. After all, in the 2022-23 period, the health insurance sector issued 2.26 crore health insurance policies. And these policies provide coverage to an impressive 55 crore individuals. But not even one private insurance provider reported payment of more than 90% of the amount claimed and only 3 paid more than 80% of the amount claimed in 2022-23. During a Zero Hour discussion on December 4, 2024, I had raised the need for fair claim settlements for the citizens of the country relying on health insurance. I once again urge IRDAI to look into this issue and rein in such unethical practices. Ministry of Finance Ministry of Health

Tejasvi Surya

242,033 Aufrufe • vor 1 Jahr