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The Company Behind Many Surprise Emergency Room Bills

nytimes.com

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Re: The Company Behind Many Surprise Emergency Room Bills

#211

Post by mmagin »

purple-again wrote: post #174
occultist_throw wrote: post #26

Earlier quoted context omitted.

Unfortunately, We've tried. It does little good. This last Saturday, there was a peaceful protest of around 200 people held in DC in front of Congress. One of my friends attended this protest. Around 150 of them were arrested, and then given bullshit charges, like crowding, obstructing, incommoding, or resisting arrest (of what charge were they being arrested for, angering Trump...).* When you try to "peacably protes…

We have rules in place that allow the population to peacefully protest without interfering with the business of others. These people didn't follow the rules and were punished accordingly just like every other law on the books. If you are unable to enact the change you want from within the system it's because not enough people agree with the change you are proposing. Welcome to the complexities of Society. If you don'…

Would you perhaps be referring to such things as https://en.wikipedia.org/wiki/Free_speech_zone ?

Because that's some bullshit.

Re: The Company Behind Many Surprise Emergency Room Bills

#212

Post by beat »

chimeracoder wrote: post #125
richthegeek wrote: post #76

Earlier quoted context omitted.

Unfortunately the NHS is, in many ways, pretty bad. They're pretty good at dealing with pregnancies, cancers, and emergencies but try getting seen for a chronic pain and you'll follow this rough timeline: - Try see your GP. Wait 2 weeks until your appointment. - GP will give a cursory examination and recommend a dietary change, taking ibuprofen/paracetamol, and to come back if problem persists. - Problem persists. Bo…

> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%…

2/3 of prostate cancer occurs in men over 65. That's the results of being on Medicare, the largest single payer health care system in the world.

Re: The Company Behind Many Surprise Emergency Room Bills

#213

Post by protomyth »

maxsilver wrote: post #128
mistermann wrote: post #105

Earlier quoted context omitted.

Can someone knowledgeable on the subject comment on whether the "Obamacare movement" has been up front in acknowledging this aspect of the problem with health care in the US? My perception is that the problem is typically framed as a lack of insurance problem for financially challenged people, but the "abuse" on the billing side to me seems like at least as big of a problem. And if this is being conveniently ignored,…

> My perception is that the problem is typically framed as a lack of insurance problem for financially challenged people, but the "abuse" on the billing side to me seems like at least as big of a problem. If anything, the billing abuse is a much, much larger problem than lack of insurance. At least, that has generally been true since the ACA/"Obamacare" changes passed.

Billing abuse (care provider) and billing fraud (bad agents) are two aspects of the system that need some serious time devoted to them.

My thought experiment for some of this. Suppose the US government had a rider on every insurance policy in the US that said the government would pick up the tab for any amount over say $100,000 (think catastrophe insurance). Now, you would make the assumption that looking at the actuarial tables this would reduce the cost of health insurance because no insurance company is on the hook over $100,000 (thus no need to worry about the million $ payout).

I am more and more convinced that hospitals would screw this up with over billing for every damn thing and every visit requiring a stay would get jacked to > $100,000.

Re: The Company Behind Many Surprise Emergency Room Bills

#214

Post by xenihn »

sixdimensional wrote: post #39

In a past life, I worked in health insurance fraud detection. Everybody should know, the health insurance system in the US is fundamentally broken and has been almost since its inception in the early 20th century. The lack of adequate consumer protection, transparency, health systems and appropriate government regulation, in addition to organizational oversight, has lead to a situation where we have poor systems that…

This really sucks. I don't even see how an overhaul could be done.

Re: The Company Behind Many Surprise Emergency Room Bills

#215

Post by dragonwriter »

chimeracoder wrote: post #206
dragonwriter wrote: post #171

Earlier quoted context omitted.

> The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%. Such survival rates are from date of diagnosis; IIRC, because prostate cancer detected early usually doesn't have interventions that are less harmful than the cancer is likely to be, there's considerable debate about the utility of screening; there has been considerable argument that the US tends to overscreen a…

> Such survival rates are from date of diagnosis; IIRC, because prostate cancer detected early usually doesn't have interventions that are less harmful than the cancer is likely to be, there's considerable debate about the utility of screening; there has been considerable argument that the US tends to overscreen and over-intervene for prostate cancer. Over-intervention and over-screening are two different problems, p…

> Over-intervention and over-screening are two different problems, particularly for prostate cancer, where screening is low-cost and low-risk

They are distinct but not unrelated, particularly in a system where treatment decisions are highly patient driven, especially for patients with financial means.

But my point is less about over screening than that differences in screening practices naturally produce difference in five-year survival statistics even in cases when they have no meaningful outcone in terms of disease progression, mortality, and quality of life, because more screening will detect more cases of disease earlier, even cases for which intervention would never be clinically indicated. If you do a lot better job at diagnosing cases for which there would never be intervention, you get a better 5-yesr survival rate but haven't done any better at dealing with the disease.

Note that I'm not arguing about whether the UK does deal with prostate cancer well, in fact what I've seen using mortality rates suggest they are a bit worse than the US, though much less bad then you'd think from 5-year survival rates. I'm just staying there 5-year survival rates aren't great metrics for systems that are different in conditions that lead to diagnosis.

Re: The Company Behind Many Surprise Emergency Room Bills

#216

Post by thingschanged »

In any other field all of these billing scams would be a federal crimes.

Congress could solve this issue overnight by passing a 1 line law:

If a patient is using services that is not covered by their insurance, or if they have no insurance, no medical service provider can change more than the official medicare standard rate for any services rendered.

Problem solved.

Re: The Company Behind Many Surprise Emergency Room Bills

#217

Post by chimeracoder »

dragonwriter wrote: post #215
chimeracoder wrote: post #206

Earlier quoted context omitted.

> Such survival rates are from date of diagnosis; IIRC, because prostate cancer detected early usually doesn't have interventions that are less harmful than the cancer is likely to be, there's considerable debate about the utility of screening; there has been considerable argument that the US tends to overscreen and over-intervene for prostate cancer. Over-intervention and over-screening are two different problems, p…

> Over-intervention and over-screening are two different problems, particularly for prostate cancer, where screening is low-cost and low-risk They are distinct but not unrelated, particularly in a system where treatment decisions are highly patient driven, especially for patients with financial means. But my point is less about over screening than that differences in screening practices naturally produce difference i…

> I'm just staying there 5-year survival rates aren't great metrics for systems that are different in conditions that lead to diagnosis

I agree. That's why looking at all common cancers as well is important. Leukemia and lung cancer are the opposite end of the spectrum - early intervention is critical for leukemia and most lung cancers. And the UK does a much worse job at treating those than almost all other developed countries, and particularly the US.

So yes, some portion of the difference can be attributed to differences in screening practices, but screening practices are a relevant aspect of the entire system, and screening practices alone can't explain the UK's abysmal record for treating the more aggressive cancers which they do detect.

Re: The Company Behind Many Surprise Emergency Room Bills

#218

Post by icebraining »

jsisksod wrote: post #148
Devthrowaway80 wrote: post #122

Earlier quoted context omitted.

Yeah, it won't work. It works in every other developed nation in the world, and they all pay less money for better healthcare outcomes, but hey, the US is Totally Special.

The US is larger than 50 developed nations combined, so yes, we are Totally Special.

Then setup a single-payer system per state. What's the excuse against that?

Re: The Company Behind Many Surprise Emergency Room Bills

#219

Post by icebraining »

dsfyu404ed wrote: post #154
Devthrowaway80 wrote: post #122

Earlier quoted context omitted.

Yeah, it won't work. It works in every other developed nation in the world, and they all pay less money for better healthcare outcomes, but hey, the US is Totally Special.

Except that's not how it works everywhere else. Everywhere else the government shoves a telephone pole up the ass of taxpayers and then takes a few splinters to pay for healthcare.

Reminder: the US already spends more public money on healthcare as a percentage of GDP than Belgium, the UK, Switzerland, Finland, Canada and many others.

http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS?year_high...

Re: The Company Behind Many Surprise Emergency Room Bills

#220

Post by mapster »

pascalxus wrote: post #196
mapster wrote: post #152

Earlier quoted context omitted.

sinks the whole 'the free market will self-police' fallacy. esp re: health and environment, finance, and worker safety, corporations need regulation, badly.

this is a unique situation. Customers can't shop around for the best price because there are laws in place that prevent insurance companies from offering plans that are sufficiently cost effective in such emergency room visits (and a host of other conditions as well). Otherwise, I'm sure someone would have recognized these problems and offered an insurance plan that protects you from this. Free-market can't do anythi…

unfettered market results in unfettered greed. means even insured people file bankruptcy for 4 day hospitalization.
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