Navigating the Complexities of the American Health Care System: A Journey (Full Transcript)

Speaker 1: Wow, look at this place. Well, hello there. Looking to get some insurance? No, my friend's mom already has insurance with your company. Oh, great. You're here to pay your bill. No, no, we're not here to give you money. We're here to file a claim for my friend's medication. Oh, you want money from us? Right through that door over there.

Speaker 2: Hello.

Speaker 3: We want to file a claim to get my friend's weight loss drugs paid for.

Speaker 2: Oh, okay.

Speaker 3: Do you want to know his policy number or anything?

Speaker 2: Let me just speak with our medical director first. Yeah, yeah, okay.

Speaker 4: Sorry, but we don't pay for medicines for obesity because it's not a disease. Who was that? That was the medical director. The medical director decides what claims are valid for us to pay for.

Speaker 5: But you didn't say who the patient was or what was wrong with him.

Speaker 4: Right. The medical director's job is just to say no.

Speaker 5: Look, my friend's mom has been paying you people for years, and his doctor says his weight is a medical concern and obesity is a disease. Oprah Winfrey said so.

Speaker 6: Okay, okay, calm down. Calm. Down. I didn't realize I was dealing with someone who had so much determination. If you do a little more work, I think we can get your medications paid for. What? We can? Yeah, you see, the doctors and the pharmaceutical companies and the insurance companies all kind of work together. So all you have to do is navigate the American health care system.

Speaker 1: We're gonna navigate the American health care system. It's there for you and me. Just fill out these forms. We're gonna get better and we're gonna be strong and as healthy as can be. I need to send you to imaging. Let's navigate the American health care system. Just fill out these forms. I just, I just filled them out in the last place. It's so much fun to be getting it done.

Speaker 6: I can't sign this for insurance. His original doctor needs to sign this.

Speaker 1: We go back to the doc to get that thankful insurance. Then go back to insurance.

Speaker 6: We need you to get a second opinion from a doctor who's in network.

Speaker 1: We're navigating the American health care system. Now just watch us go. We're getting things done, taking care of our health. We need these filled out and then faxed to your insurance company. We're filling out forms and we're scanning those forms and then we're emailing those forms to get them back to insurance.

Speaker 6: We need confirmation from a different specialist.

Speaker 1: Let's go and navigate the American health care system. It's the best system of them all. No, we already talked to the insurance company. They were supposed to talk to you. We go back to the doctor. We go back to the specialist who talks to the insurance company. The fax to the medical advisor who's on the phone in the mountains. And we're going in one place and we're coming out the other place. And we're back over here now and I was just over there. And I'm getting confused and it's getting dark. And my mind is all different colors. And I think I'm lost. Hey fellas, I think I'm lost in the American health care system. Fellas, fellas, help.