Insurance Companies Are Going To Hate Me For This, Doctor Mike, 14.8M subscribers, YouTube (13 min), May 6, 2026 (417,000 views by May 10)
From the transcript:
0:25 – You most likely won’t be paying for your healthcare out of pocket. No, you’ll be relying on America’s hybrid health care system. You see, many countries around the world offer what’s known as a single payer system where the government provides health care to its citizens free of charge, usually funded by taxes.
The US is a bit different, running a hybrid system in which government funded health care covers some people and others are paid for by employers, individuals, or a combination of the three. It’s rarely simple.
And who manages all those claims? mostly for-profit health insurance companies.
I’m not saying healthcare outside the US is perfect. … But the US health insurance system is deeply and uniquely flawed. …
2:49 – Stephanie [needs] therapy to keep fighting her cancer and relieve her joint pain with a drug called Infiximab. Unfortunately, Stephanie’s insurance provider denied the medication, saying Infiximab didn’t meet guidelines for coverage and was experimental. …
6:28 – But let’s look at this at a bigger scale. Zoom out to what we actually see in the United States. What if my care had millions of customers and millions of stockholders who own pieces of my now publicly traded health insurance company? Well, on one hand, I’d be very rich from owning that stock. And as CEO, my responsibility would not actually be to provide solely good healthcare. It would be to provide a strong financial return to my shareholders and my end-of-year bonus. There would be incredible pressure to raise premium costs, deny coverage, or at the very least make it harder to get approvals. You know, shady stuff.
So, as CEO of my care, I have an idea. What if I build an AI supercomputer to oversee the whole thing and tell it to just increase the rate of denials by just a few percentage points? You know, random rejections left and right, even if the patient is genuinely sick and our policy is supposed to cover them.
Well, patients would file appeals, hire lawyers, and sue me for failing to hold up my end of the bargain, right? Actually, yes, that is right. But it only works if patients actually do it.
This is the bet insurance companies are making. They’re gambling that you will be overwhelmed, confused, defeated, and not bother filing an appeal. In fact, they’re just following basic statistics and human psychology. The more hoops they make you jump through, the less money they’ll have to spend. Health insurers routinely deny 850 million claims a year in the US, and less than 1% of people appeal a denial. That’s a lot of profit that is likely not legitimate. But get this, when patients do appeal, they win over 50% of the time. This is why you’ll hear me say, “Always argue the bill.” Okay, Dr. Mike. So, I’m ready to appeal my denial.
How do I do that? Let me give you a list of everything you need to get your money. Stick with me through the end here, and I’ll also give you a shortcut that can make this much easier. First, find the specific reason you were denied. Whether that’s not medically necessary, experimental, or step therapy required. Then, build your evidence file. This is all the documentation of what you’ve been through so far. doctor’s notes, prior authorizations. … Writing a personal impact statement conveying to the insurer what kind of difference in your life this care will make can have a huge impact on the decision.
Once you have everything together, send it to multiple recipients at once. Not just the insure. Send it to your state department of insurance, attorney general, department of labor, your employer’s leadership, and your congressional representatives.”
[ Then, Dr. Mike recommends “Claimable” – a for-profit company that facilitates these appeals. He emphasizes that he is taking no money for this video. ]
Comment:
By Jim Kahn, M.D., M.P.H.
Dr. Mike is a highly successful social media presence. According to Wikipedia, “Dr. Mikhail “Mike” Varshavski, DO, is a … board-certified family medicine physician and hugely popular YouTuber known for making medical education entertaining and accessible. … He has over 30 million followers across platforms, where he debunks health myths, explains medical cases, and promotes health literacy.”
Great gig. Power to him – extremely effective communicator, and for what I’ve seen accurate.
But in this video he misses a huge opportunity. He has a massive audience, and he identifies how poorly US health insurance functions compared with single payer in other nations. So: Please Mike, endorse single payer. Use your powerful voice, your microphone, to advocate for a real solution.
Don’t shill for an improvised, for-profit solution (Claimable) for a problem which arises from our misguided for-profit insurance “hybrid.”
HJM readers: If you can, share this post (or the sentiment) with Dr. Mike. And let me know if you have a way I can reach him.
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