The Company Behind Many Surprise Emergency Room Bills • Hacker News Board

Re: The Company Behind Many Surprise Emergency Room Bills

#261

Post by thephyber » Mon, Jul 24, 2017, 9:06 PM UTC

rgbrenner wrote: post #170

jackmott wrote: post #65

Earlier quoted context omitted.

vote for candidates who will support single payer.

Completely agree. There's no free market in healthcare. They are selling services without providing prices... it completely breaks any market that might exist.

> They are selling services without providing prices...

And it takes a state license for them to operate. The state could require them to provide an accurate and up-to-date price menu in order to remain in business.

I think the problem is also related to the opaque negotiated prices that "in network" providers negotiate with insurance companies, driving up the cost for uninsured or "out of network" consumers.

There are perfectly rational solutions short of single-payer.

Re: The Company Behind Many Surprise Emergency Room Bills

#262

Post by dragonwriter » Mon, Jul 24, 2017, 9:06 PM UTC

joe_the_user wrote: post #256

dankohn1 wrote: post #227

Earlier quoted context omitted.

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-...

> But that's not always the case - Neil Gorsuch was confirmed by a vote to suspend the 60 vote rule

No, as your source accurately states, he was confirmed after a vote to abolish the rule for Supreme Court nominations.

Re: The Company Behind Many Surprise Emergency Room Bills

#263

Post by madengr » Mon, Jul 24, 2017, 9:12 PM UTC

xenadu02 wrote: post #245

madengr wrote: post #14

Earlier quoted context omitted.

Yep. Took my wife to the ER last week for suspect appendicitis or diverticulitis. Last time this happened a CT scan alone was $3k ($11k prior to insurance reduction). My HDP is $4,500 OOP max per family member; $8,500 for family. What really pisses me off is that the HSA max contribution has not kept up with family OOP max. I contribute the max every year and can't end up with $8,500 saved. I had a decent insurance p…

If you work for a company with 10,000 employees or more and don't have a gold-plated health plan then it is by deliberate effort on the part of the company to save money. At that level a company that wants a good plan can demand no exclusions for pre-existing conditions (an issue prior to ACA), same-day partner additions, better drug tiers, lower copays, etc. Often they pay less per person than a 1,000 person company…

"You are getting screwed because the company has decided to do so."

Ha ha, didn't have to tell me that! I bet my coworkers we won't have company health insurance in a few years. Gotta keep that stock high.

Crazy thing is, now that I'm middle age, and my 401k approaches 7 figures, I'm beginning to care more about fund performance to get me to retirement in 20 years than benefits. It's all coasting from now.

Re: The Company Behind Many Surprise Emergency Room Bills

#264

Post by Cerium » Mon, Jul 24, 2017, 9:12 PM UTC

narrator wrote: post #127

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…

When I had back surgery, there were all these therapists coming in the moment I got out of surgery trying to get their 1 minute in. It was throughly ridiculous. One of them was attempting to do physical therapy and pulled on my leg a little and put me into so much pain I went into shock. She probably got her $600 bucks. I am with Kaiser now and it is the most BS free medical experience I have ever had. To fix healthc…

I choose Kaiser as well because it is worry free. I've been admitted to the emergency room and still confidently paid with the cash in my wallet.

Re: The Company Behind Many Surprise Emergency Room Bills

#265

Post by [deleted] » Mon, Jul 24, 2017, 9:13 PM UTC

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?

[deleted]

Re: The Company Behind Many Surprise Emergency Room Bills

#266

Post by sol8 » Mon, Jul 24, 2017, 9:13 PM UTC

21 wrote: post #237

sol8 wrote: post #231

The entire pricing scheme is an elaborate sham if you ask me. My wife had to have surgery. A outpatient laparoscopic procedure that required cutting a tendon. The time she spent at the facility (from the when they took her back and discharged her) was about 3 hours. A month later we got a statement showing they tried to charge $67k and were denied… followed by a separate bill for $7.5k We ignored the bill and contact…

> I can think of no other business where you agree to have work done without an agreed upon price. You can't really compare this with other businesses. Unless you want the doctors to stop the moment they hit your negotiated price (like lets say a building constructor would). However you should be able to get a rough quote for the procedure (assuming no unexpected complications). And I agree with you in general, US he…

That's good point. I wouldn't expect pricing to function like that, especially in life or death situations. In our case, this was a surgery that was planned and scheduled a month in advance and at no time was a price ever mentioned. Just a letter from Anthem saying it was covered. We didn't start to see anything on the monetary side until after it was all said and done with. In advance of the procedure I tried to find some pricing data on the surgery but struck out. Apart from some articles about hospitals in California publishing prices for procedures, I could find nothing for the east cost.

Re: The Company Behind Many Surprise Emergency Room Bills

#267

Post by joe_the_user » Mon, Jul 24, 2017, 9:13 PM UTC

com2kid wrote: post #102

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…

In contrast, to America working for a good employer: 1. Schedule with GP. Say I am in pain. Get in within 2 days. 2. Get a referral to Physical Therapy. Asked if I have any preference where to go. My doctor knows my network and gave me a number of choices that were within network (a number of which were within walking range of where I lived). 3. Call PT office. Schedule an appointment. They apologize that their next…

That is in only the very best US health care.

Chronic pain is an extremely tricky phenomena. A lot of US health care been "dealing" with it by handing out opioids and we can see the devastating effect of that. Even a given physical therapist may not be able to help a given patient (assuming some body of some sort could at all).

Similarly, a smart consumer may be able to find a massage therapist with skills in a bodywork subdiscipline that happens to really help them (I favor trigger point and Shiatsu massage after sample a bunch in my area). This is cost effective compared to just about everything and something I imagine someone in UK could find in the larger cities.

Re: The Company Behind Many Surprise Emergency Room Bills

#268

Post by thephyber » Mon, Jul 24, 2017, 9:13 PM UTC

joshuaheard wrote: post #185

jackmott wrote: post #65

Earlier quoted context omitted.

vote for candidates who will support single payer.

Ask Charlie Gard how single payer is working out for him.

Single payer wasn't the problem with his case. No health insurance company would have voluntarily paid for an experimental treatment for him.

The state has power, even in the USA, to make decisions for the benefit of children if the state decides that the parents aren't acting in the best interest of the child.

There is a perfectly valid argument to be made that the state should not have intervened (this is subjective), but it had very little to do with the NHS being single payer.

And by choosing to use the single most emotionally charged case, you are also skipping all of the perfectly rational arguments against the broken health care system we have now.

Re: The Company Behind Many Surprise Emergency Room Bills

#269

Post by pmyteh » Mon, Jul 24, 2017, 9:17 PM UTC

joshuaheard wrote: post #185

jackmott wrote: post #65

Earlier quoted context omitted.

vote for candidates who will support single payer.

Ask Charlie Gard how single payer is working out for him.

Charlie Gard has nothing to do with single payer. In the UK, if the NHS won't fund something (normally because it doesn't work or is horrifically expensive - see NICE for the gory details) you're free to go private.

In Charlie Gard's case, the parents have raised the money to take him to the US for the pioneering 'treatment'. The court's barred them from taking him because they've ruled that doing so is not in his best interests, and that he should be allowed to die. Which is pretty damned unusual for the English courts, to be honest. And given he got a full hearing at the supreme court, and his own advocate, and it's not a matter of money, I'm inclined to believe the doctors and the judges.

But even if you think they're wrong, it's still not about single payer.

Re: The Company Behind Many Surprise Emergency Room Bills

#270

Post by dragonwriter » Mon, Jul 24, 2017, 9:17 PM UTC

mistermann wrote: post #111

jackmott wrote: post #65

Earlier quoted context omitted.

vote for candidates who will support single payer.

Changing things so all taxpayers are getting robbed rather than just the individual being treated seems like a sub-optimal solution.

> Changing things so all taxpayers are getting robbed rather than just the individual being treated

Government programs set maximum reimbursement rates and also mandate cost accounting mechanisms to assure that actual reimbursement is not merely within pre-set rates but also justified by actual provider costs. The government isn't buying services with no advance information about what the charges may be.

Private insurers impose similar controls.

So single payer (or even universal coverage through private insurers) eliminates the particular kind of “robbery” from undisclosed charges being discussed.