American Politics 4.0 - Orangeyou Glad He’s Back?

[Locke]

Originally Posted by Looch City

If the CEO didn't want to be shot, he should've not dressed all fancy with an expensive suit and tie. His shoes alone gave him away and made it worth it.

He was just asking for it!

Rumours persist that he was spotted declining an Insurance Claim right then and there!

[belsarius]

Originally Posted by undercoverbrother

Don't hate the player, hate the game

Dude wasn't a player, he was a game designer.

[Looch City]

Originally Posted by belsarius

Dude wasn't a player, he was a game designer.

He's basically this guy lol

[undercoverbrother]

I'm honestly surprised the bullets didn't bounce right off or pass right through.

[Mazrim]

Originally Posted by Locke

He was just asking for it!

Rumours persist that he was spotted declining an Insurance Claim right then and there!

Rumours also say he was denied coverage for the incident!

Thank you for your recent appeal regarding the denial of coverage for your emergency room visit on December 5, 2024. We have carefully reviewed the additional information you provided, including the attending physician’s notes, photographic evidence of your gunshot wound, and the security footage of the event.

After a thorough re-evaluation of your case, we regret to inform you that the original denial decision has been **upheld**. Our reasons for this decision are outlined below:

1. Insufficient Documentation Supporting Medical Necessity:

While we acknowledge the physician’s statement that your “life was in immediate danger,” we remain unconvinced that the treatment you received in the emergency room was the only appropriate course of action. Specifically, we find the decision to intubate and transfuse blood unnecessarily aggressive when other cost-effective options, such as applying firm pressure to the wound with a clean cloth, could have been attempted first.

2. Failure to Contact Prior Authorization Hotline:

Your appeal asserts that you were “unable to call” due to being “unconscious” after sustaining the gunshot wound. While we empathize with your condition, we remind you that our Prior Authorization Hotline is available 24/7 and can be contacted by a friend, family member, or even a concerned bystander. The failure to delegate this responsibility during your medical emergency further substantiates our denial.

3. Out-of-Network Services:

As stated previously, City General Emergency Department is not part of our network. While we understand that DiscountCare Clinic is 25 miles away and does not operate ambulances, the choice to seek care at a non-network facility remains inconsistent with your plan’s cost-saving guidelines. Our analysis indicates that driving oneself, despite injury, or calling a rideshare service might have provided a viable and more affordable alternative.

4. Policy Exclusions on Firearm-Related Injuries:

Your plan explicitly excludes coverage for injuries resulting from “unapproved use of firearms.” As no evidence was provided to confirm the shooting was accidental or unavoidable, we are unable to overturn this aspect of the denial.

Next Steps:

**This decision is final**. You may choose to escalate your appeal to the Independent Medical Review Board (IMRB) at your own expense. If the IMRB overturns our decision, you may be eligible for partial reimbursement minus a $5,000 “Claim Reconsideration Fee.”

We encourage you to consult our Member Handbook to better understand your plan benefits and avoid similar misunderstandings in the future. Should you find your current coverage unsatisfactory, we invite you to explore our new UHC UltraBasic plan, which offers even fewer benefits at an even lower premium.

Sincerely and in good health,

UnitedHealthCare

P.S. Please note: Our appeals process is designed to promote proactive healthcare decision-making. While this unfortunate incident did not meet policy requirements, we commend your efforts to stay alive and wish you a speedy recovery.

[BigThief]

If the most you can come up with for someone not being shot is "but mechanic!" and "don't hate the player" then maybe buddy wasn't such a good guy

[ResAlien]

Originally Posted by BigThief

If the most you can come up with for someone not being shot is "but mechanic!" and "don't hate the player" then maybe buddy wasn't such a good guy

I was hopeful there'd be some substance to the pearl clutching but it appears instead to be a bit. You win some you luge some

Edit: perhaps there's something else at play here. Reconciling the bloodlust for dead Russians with the distress displayed at a health insurance CEO catching 2 to the chest seems to be an inconsistent logic

[Locke]

Originally Posted by Mazrim

Rumours also say he was denied coverage for the incident!

Well, in fairness 'Death' is a tough medical claim. Usually that one doesnt go through ye ol' Medical Insurance but rather gets kicked down to Life Insurance.

Then you have to go through the whole..."Is he really dead? Are you sure? Describe how he died in 240 characters or less, were there extenuating circumstances, how many villains took him down and were the Thunderbirds summoned?"

And all that crap. You know the usual.

[GirlySports]

Commend your efforts to stay alive!?>

[Locke]

Originally Posted by GirlySports

Commend your efforts to stay alive!?>

What steps were taken in order to mitigate 'Death?' Were any 'Death-Prevention' provisions enacted?

What kind of Anti-Death Policies has the Company enacted under his supervision?

[Just a guy]

Originally Posted by Fuzz

But one system has a third partner, the shareholders who demand a return. So instead of all the money going to patient care, it gets split between the company, taxes they have to pay, salaries for pointless busywork that is unnecessary in a single payer system, shareholders, executives, buildings and infrastructure, software and IT, and holy #### no wonder US health care is twice as expensive as anywhere else on earth.

Ultimately the difference is there is a far lower percentage of money going to patient care.

The tax payer is the third party in the public system and politicians know this and that is where the opposite happens (private shareholder = make more money vs Public taxpayer= wants less money taken (equals more money for tax payer).

Everyone (well almost) wants more money. And that is what drives the system. If a true cost only system were to be set up in either system, it would get corrupted by either cutting services to allow for more/sustained positions (in the case of public) or cutting services for greater profit (in the case of private).

This is human nature and I would doubt that it will change. There are countries that are more socialized and there may be some models to follow, but unless the entire population affected is on board I see it as a pending disaster in North America.

[activeStick]

Pretty wild that she dated Gavin Newsom before and now is with Trump Jr, when you consider how they're on opposite ends of the political spectrum.

https://twitter.com/user/status/1866623893017927923

[Fuzz]

Originally Posted by Just a guy

The tax payer is the third party in the public system and politicians know this and that is where the opposite happens (private shareholder = make more money vs Public taxpayer= wants less money taken (equals more money for tax payer).

Everyone (well almost) wants more money. And that is what drives the system. If a true cost only system were to be set up in either system, it would get corrupted by either cutting services to allow for more/sustained positions (in the case of public) or cutting services for greater profit (in the case of private).

This is human nature and I would doubt that it will change. There are countries that are more socialized and there may be some models to follow, but unless the entire population affected is on board I see it as a pending disaster in North America.

Who do you think pays in the private system? The same people, it's just called an insurance premium(and deductibles!) instead of a tax.

[undercoverbrother]

Originally Posted by BigThief

If the most you can come up with for someone not being shot is "but mechanic!" and "don't hate the player" then maybe buddy wasn't such a good guy

Congrats to you.

#### the rule of law.

Let vigilantism reign.

I'm comfortable with my shooting skills.

[BigThief]

You think if you or I are #### in New York our shooter is going to make national headlines?

The rule of law is very different for them as it is for us.

[Doctorfever]

Originally Posted by BigThief

You think if you or I are #### in New York our shooter is going to make national headlines?

The rule of law is very different for them as it is for us.

Maybe you should just be quiet.

I doubt your shooting skills are as good as my mine. And I highly doubt your shooting skills are anywhere close to UCB.

Best you rely on the ‘rule of the law’

All this talk about “let’s kills the big bad CEO’s” is just silly little people jabbing on their keyboards.

[Wormius]

Originally Posted by Doctorfever

Maybe you should just be quiet.

I doubt your shooting skills are as good as my mine. And I highly doubt your shooting skills are anywhere close to UCB.

Best you rely on the ‘rule of the law’

All this talk about “let’s kills the big bad CEO’s” is just silly little people jabbing on their keyboards.

Who is talking about shooting anyone? Are you off your rocker? He said that if he or UCB got shot in NY, it wouldn’t make the news.

[BigThief]

Originally Posted by Doctorfever

Maybe you should just be quiet.

I doubt your shooting skills are as good as my mine. And I highly doubt your shooting skills are anywhere close to UCB.

Best you rely on the ‘rule of the law’

All this talk about “let’s kills the big bad CEO’s” is just silly little people jabbing on their keyboards.

lmao your shooting skills might be better but your ability to follow a conversation is sh*t.

[Doctorfever]

Originally Posted by Wormius

Who is talking about shooting anyone? Are you off your rocker? He said that if he or UCB got shot in NY, it wouldn’t make the news.

I am just against violence. So must have got triggered.

Sorry

[BigThief]

"I hate violence so much I want to shoot you"