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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

#251

Post by siliconc0w »

Similar experience where I went to an ER and like six people interacted with me for less than 1-2 minutes apiece plus scans and an unneeded IV which came with a generous offer of Opioid pain meds when I specifically said, multiple times, I wasn't in pain. I got like seven different bills, each for randomint(0,1000). Worse, after wasting a day there - all they could do is just refer me to a specialist. The bills didn't even really explain what they were for, they just kept coming for almost a year after - apparently one for every person who may have looked in my direction plus each scan or test.

So I switched to Kaiser which is slightly better from the billing side but feels pretty mediocre care-wise. I don't hear back from the GP about questions/tests ordered and I've waited literally all night just to get something for a bad cough.

Healthcare in America is truly and thoroughly fucked.

Re: The Company Behind Many Surprise Emergency Room Bills

#252

Post by sethrin »

mistermann wrote: post #240
hockley wrote: post #190

Earlier quoted context omitted.

It was a problem before ACA; it's a problem now. The law didn't really change that aspect of the system.

This is my uninformed impression of the matter as well, and if true (please, anyone with a rebuttal please weigh in), to me it is further proof that the true motive of the ACA is to line the pockets of health care provider donors, by spreading the costs over the entire population and get rid of the politically damaging stories of overcharges causing individual bankruptcy. Socializing this theft turns it into Just Ano…

Having an expansive definition of theft merely serves to raise the noise floor.

The "true" purpose of the ACA was to do something about spiraling health care costs. What was passed was a "compromise" where the people pushing for a public option got nothing and the most onerous restrictions on the monied interests were rolled back. This has not been an effective solution in many senses. I decline to further characterize the issue, however; this is extremely close to a political discussion, and those are ban-worthy here.

Re: The Company Behind Many Surprise Emergency Room Bills

#253

Post by thephyber »

dv_dt wrote: post #161
cookiecaper wrote: post #141

Earlier quoted context omitted.

The insurance model is at the heart of the medical system's issues; it distorts the market by disconnecting prices from providers and consumers and severely disaligns their interests. The provider must set a high sticker price so that they can give the insurer the expected 60-80% discount to get in-network (and still tolerate underpayment and other shenanigans). The consumer is either intentionally misled or confused…

Not only the insurance model, but the encouragement of health insurance as an employer benefit. It adds one more aspect of indirection to an already complex health system.

Almost any politician will tell you that taxing employer-sponsored health insurance is a "3rd rail".

Almost any economist will say this is one of the largest problems with US health care costs and employment mobility.

Re: The Company Behind Many Surprise Emergency Room Bills

#254

Post by jrs235 »

specialist wrote: post #179
coreyp_1 wrote: post #22

I am having problems with my insurer at this very moment. I went to an in-network hospital for an ER visit, which turned into an 8-day stay (yes, it was serious). Evidently, none of the doctors at the hospital are in-network, however, (claims from various technicians are still "in processing", so I don't know how they will turn out) despite the fact that the hospital itself is definitely in-network. I had no choice a…

I'm sorry for your current struggles. I too was recently bitten; billed $4500 for a $40 blood test, with no recourse. -- My state's bad ass Insurance Commissioner is trying to mitigate this problem: Surprise billing legislation passes state House of Representatives https://www.insurance.wa.gov/news/surprise-billing-legislati... Be sure to call and voice support. Public pressure matters. Long-term fix is single payer,…

> billed $4500 for a $40 blood test

Please elaborate. How did that happen?

Re: The Company Behind Many Surprise Emergency Room Bills

#255

Post by thephyber »

stronglikedan wrote: post #197
seppin wrote: post #144

Earlier quoted context omitted.

> Do not take what the hospital/insurance Co say at face value. Call an attorney. What a terrible industry.

That applies to any and all insurance - especially mandated insurance policies. The main job of the insurance company is to collect your premiums and the find any way to deny your claims.

As cynical as it sounds, I think I agree with this sentiment even though it's being downvoted.

The employees at an insurance company have an ethical responsibility to the company to deny any claims that do not perfectly align with the policy they sold. I don't think every insurance company is the antagonist in The Rainmaker or the car company in Fight Club, but insurance companies will try to reject as many claims as they can, straddling the line of losing reputation with consumers.

Re: The Company Behind Many Surprise Emergency Room Bills

#256

Post by joe_the_user »

dankohn1 wrote: post #227
joe_the_user wrote: post #203

Earlier quoted context omitted.

If the democrats were serious, they could have deployed the "nuclear option" on this (suspend Senate rules). But of course there was more than one person's objection going on.

There are far less than 50 votes from either party to suspend the 60-vote filibuster rule because it gives more power to each individual senator. By contrast, Lieberman single-handedly killed the public option.

Ipso facto there weren't enough votes to suspend the 60-vote in the health care case.

But that's not always the case - Neil Gorsuch was confirmed by a vote to suspend the 60 vote rule. So the rule is available for things that a strong party consensus.

https://www.nytimes.com/2017/04/06/us/politics/neil-gorsuch-...

Re: The Company Behind Many Surprise Emergency Room Bills

#257

Post by enraged_camel »

spinlock wrote: post #91
sbov wrote: post #60

Earlier quoted context omitted.

We had a similar experience about 8 months ago, but only one night in the hospital. Raise hell with everyone. The out of network doctors were resolved the fastest for us, and the longest was the hospital stay itself, which our insurance didn't agree to pay until 8 months after the stay. It was a seriously draining experience, and luckily my wife doesn't work so I didn't have to take time off for all the phone calls a…

I think there are "bad" guys. I've pointed out to a doctor that their agreement said that I would agree to pay any charge they decided to bill me for. I pointed out that I was in their office because they were in network for my insurance and that I couldn't agree to pay literally anything they decided to bill. So, I asked them to tell me what the maximum they might bill would be. And, they kicked me out of the office…

>>So, I asked them to tell me what the maximum they might bill would be. And, they kicked me out of the office.

There are of course shitty doctors, but playing devil's advocate for a minute: you were arguing about theoretical billing scenarios while there were other patients in line waiting to be seen. So it's not exactly surprising that he got fed up and kicked you out.

Re: The Company Behind Many Surprise Emergency Room Bills

#258

Post by thephyber »

bdamm wrote: post #167
astockwell wrote: post #75

Earlier quoted context omitted.

> luckily my wife doesn't work so I didn't have to take time off for all the phone calls and following up that was required This. This is so horrifically true, it takes call after call after call (and emails, and faxes, and snail-mail claims forms that take "30 days" to "process") to get anything changed, and by then you have collections companies harassing you and your credit goes down the drain. Meanwhile you must…

A friend of mine was in a sports accident almost two years ago. He had a good medical insurance plan for exactly this possibility. He fractures his pelvis into 14 pieces, and broke another dozen major bones including both femurs. The surgeries are still ongoing although he is mostly himself again. But even two years later, he is facing a daily barrage of calls, being put on hold, no callbacks, paper shuffling, record…

> It's like the insurance company is trying to kill him with stress.

A health insurance company, no less.

Re: The Company Behind Many Surprise Emergency Room Bills

#259

Post by Spoom »

icebraining wrote: post #218
jsisksod wrote: post #148

Earlier quoted context omitted.

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?

Before I answer this, let me frame my opinion: I very much want single payer in the United States, and were it plausible to do it on a state-by-state basis, I would support it.

Apparently, states are unable to restrict entry into state benefit programs such as healthcare. They can't set up a waiting period for people moving into the state before they are eligible; that was declared unconstitutional by a previous Supreme Court. So if states were to do their own single payer system, in theory sick people could move into the state and immediately gain free healthcare simply by virtue of being a resident. Conversely, they could then move back to their home state that doesn't charge higher taxes.

So it wouldn't be feasible on a state-by-state basis unless a future SCOTUS reverses their precedent. This is unlikely in the short term, given the current Court's make up.

Re: The Company Behind Many Surprise Emergency Room Bills

#260

Post by AndrewKemendo »

sixdimensional wrote: post #223
AndrewKemendo wrote: post #158

Earlier quoted context omitted.

how big and complex the systems are now, how much money they represent, and how many interests are involved I don't follow what you're saying. Are you proposing that the root of the problem is that it's a huge, expensive, complex industry, where a lot of people work?

Yes, I'm proposing that the high level of complexity and ambiguity involved (which originates from the intersection of the technology, organizations, politics, finances and people) in the US healthcare and health insurance system is the root cause of the problem. It is another giant machine, like the military industrial complex, for example. I don't want to go so far as to say all huge institutions have problems like…

Thanks for clarifying. I think however it's the wrong measure. There are industries that are as large or larger with as much if not more complexity that aren't failing to such a degree that their size is a systemic risk.

For example the US Real estate market is 7.4 Trillion, about 2X the size of the health care market with many more players and much more predicable outcomes. Finance and insurance are about the same size as well and are not terribly broken.

[1]https://en.wikipedia.org/wiki/Economy_of_the_United_States#G...

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