If anyone who works at an insurance company could feel the fear of a brand new parent whose newborn needs assistance, maybe there would never be a horrifying story like this one ever again.
TikTok @doctor.disney shared a frustrating and sad conversation he had regarding an insurance claim for a newborn. He said it was a “peer-to-peer” conversation, which means the insurance company said they wouldn’t pay for a procedure, and he had to talk to the doctor representing the company. Peter explains, “Usually it’s very cordial and things are fine,” but that wasn’t the case here. The doctor asked, “Why did you think that the baby needed all that?” She said she would approve the claim, but repeated that these procedures might not be necessary. As she said, “Do you ever think why Mother Nature lets those things happen?”
Peter said, “For those doctors who sell their souls to those insurance companies, you cannot use the currency of human life to make a profit. There needs to be a line.” Mic drop!
No one could watch that video and not be outraged, and that’s exactly what happened in the comment section. One wrote, “I GASPED.” Another asked whether doctors are supposed to follow the Hippocratic Oath. Then there was the commenter who wrote, “I’m telling Luigi about this.”
Although U.S. health insurance is always top of mind, whether you’re watching an episode of Grey’s Anatomy and a patient doesn’t have coverage, or wondering everyone began talking about Luigi Mangione.
It’s absolutely horrible to imagine any person of any age being denied coverage for any reason, but how can anyone think that a newborn doesn’t need a procedure? Unfortunately, it’s not even a little bit rare for a baby to need help as soon as they come into the world. More than 90,000 babies are in U.K. neonatal hospital units. And many babies in the U.S. end up in the NICU because of a health problem, they weigh under 5.5 pounds, and the mother delivered the baby earlier than 37 weeks. It’s infuriating and shocking to imagine that insurance companies wouldn’t just approve claims for a newborn’s care without a second thought. This doctor said she would “do Peter a solid” and approve it, which is mind-blowing.
Tragically, insurance companies saying no to claims is not a new story. According to a 2023 study, some companies part of the Affordable Care Act deny a stagggering number of claims. In 2020, one company said no to 80% of claims. In 2021, one said no to 49%. As reported by PBS.org, Deidre O’Reilly was stunned at what happened when her son had an anaphylactic response. His life was literally saved, and the insurance company said “not medically necessary.” I’m sorry, I need to process that for a moment.
As one TikTok pointed out, more doctors need to advocate for patients like Peter, especially ones who have just been born! This is yet another case of an insurance company focusing on the wrong thing (aka money) and the doctors and nurses at a hospital doing everything within their power to help the patients they pledged to be there for. If only this situation didn’t keep repeating itself and a new, more uplifting story could be told.
Published: Jan 14, 2025 03:21 pm