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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

#271

Post by mahyarm »

HeyLaughingBoy wrote: post #199
mistermann wrote: post #107

Earlier quoted context omitted.

> So, I asked them to tell me what the maximum they might bill would be. And, they kicked me out of the office. Sounds like dental care in Canada.

The funny thing is that dental care in the US is the exact opposite. If you ask $RANDOM_DENTAI_CLINIC what the cost for $RANDOM_PROCEDURE will be, they can quote you a price that will generally be pretty accurate. I'm told this came about because historically more people had to pay for dental services out of pocket, so dental offices were used to having standard fees that they could just look up.

Also most dental insurance will only pay up to $10-5k total per year, so its not some unlimited spout of money you can abuse like medical insurance in the USA. Some dentists offer a direct subscription plan that costs around the same amount of costs as a dental plan directly as a result.

Re: The Company Behind Many Surprise Emergency Room Bills

#272

Post by joe_the_user »

dragonwriter wrote: post #262
joe_the_user wrote: post #256

Earlier quoted context omitted.

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.

I think that's quibbling. If votes to abolish the rule for a case are available, it's reasonable for a single suspension vote to be possible to.

Both sorts of actions decrease the power of individual senators. If anything, abolishing for a whole category reduces senator's power more - if you also read the article, the basic point is the action indeed altered the power dynamic, what those considering individual senator power are worried about.

Re: The Company Behind Many Surprise Emergency Room Bills

#273

Post by heartbreak »

mistermann wrote: post #238
heartbreak wrote: post #114

Earlier quoted context omitted.

Well the progressives including President Obama pushed for single payer (or a public option) which would eliminate abuse on the billing side, at least to the insured.

> which would eliminate abuse on the billing side, at least to the insured How does single payer fix that? If the hospital gives you a bill and won't negotiate down, how does the government "fix" this? Which is kind of what my question is: were specifics given in the ACA on how that problem will be fixed?

Well since single payer typically refers to the government being the single payer, the bill goes to the government because you the insured are not the payer of the bill.

Re: The Company Behind Many Surprise Emergency Room Bills

#274

Post by dv_dt »

thephyber wrote: post #253
dv_dt wrote: post #161

Earlier quoted context omitted.

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.

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

Every employer outside of the health insurance and drug industries should be furious at the price they pay to pay their employees health benefits. Besides having a distraction that operating businesses in other nations don't have, they're likely paying more than double than what they need to in this area to maintain competitiveness against other nations. It's even worse for startups.

Re: The Company Behind Many Surprise Emergency Room Bills

#275

Post by dankohn1 »

joe_the_user wrote: post #272
dragonwriter wrote: post #262

Earlier quoted context omitted.

> 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.

I think that's quibbling. If votes to abolish the rule for a case are available, it's reasonable for a single suspension vote to be possible to. Both sorts of actions decrease the power of individual senators. If anything, abolishing for a whole category reduces senator's power more - if you also read the article, the basic point is the action indeed altered the power dynamic, what those considering individual senato…

It's a perfectly reasonable question to ask whether the 60 vote threshold can survive for any kind of legislation in the future. In particular, here is an argument that American democracy is doomed because of the way partisanship ratchets towards more extreme mechanics over time: https://www.vox.com/2015/3/2/8120063/american-democracy-doom...

However, it remains the case that in 2009, 59 senators were ready to vote for a public option, but there was no 60th. By contrast, there were nowhere close to even 50 votes for removing the filibuster and changing to a 50 vote threshold.

Please do not miss the fact that Lieberman had no rational justification for opposing the public option and that one of the keenest observers at the time accused him of being "driven more by a pathological dislike of the liberals who dogged him in 2006 than by any remotely rational policy judgment." http://voices.washingtonpost.com/ezra-klein/2009/12/lieberma...

Re: The Company Behind Many Surprise Emergency Room Bills

#276

Post by specialist »

jrs235 wrote: post #254
specialist wrote: post #179

Earlier quoted context omitted.

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?

Similar story. Lab is "out of network", declined insurance's offer of payment. No one bothered to check coverage beforehand. I didn't even know to ask.

Re: The Company Behind Many Surprise Emergency Room Bills

#277

Post by mahyarm »

refurb wrote: post #246
canhe wrote: post #169

Canadian here. Had a pain in my right side for about 3 weeks (thinking muscle pull). Called Doctor's office at 10am had appointment at 11am, had exam and referred electronically to local hospital for X-Ray, had X-Ray at 11:45am, out the door at 12pm. Doctor called me personally the next day to say it's probably a muscle pull and call back in a couple of weeks if still sore. $0 out of pocket, just showed my government…

System works here. Sure people can cite edge cases, but they are relatively rare. Not sure these are just "edge cases"... http://www.cbc.ca/news/canada/british-columbia/patients-live...

Lets compare the 'horrible edge case' rate of the USA compared to Canada now.

Re: The Company Behind Many Surprise Emergency Room Bills

#278

Post by mahyarm »

thingschanged wrote: post #216

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.

That quickly becomes single payer, since prices will be set to a price ceiling of whatever medicare (the gov't) sets it at. Good luck!

Re: The Company Behind Many Surprise Emergency Room Bills

#279

Post by Paul-ish »

richthegeek wrote: post #76
jaymzcampbell wrote: post #31

Earlier quoted context omitted.

Fellow European (UK) here. From what I understand one argument often given, is that there's a mistrust of the government for anything like this and people prefer to "shop" for it themselves. By making their own choice (even if all that actually means is picking from 1 or 2 options given to them by their employer) - they feel empowered and in control of it. There is a general feeling of "if you want it, pay for it". T…

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…

It is interesting that people go straight to single payer in their mental model when they think of changing the healthcare system. Germany has a multi payer system (although the government does provide a large % of the total funds) that seems to work for them. Why do so many in the US look to single payer systems as the ideal model?

Re: The Company Behind Many Surprise Emergency Room Bills

#280

Post by dragonwriter »

joe_the_user wrote: post #272
dragonwriter wrote: post #262

Earlier quoted context omitted.

> 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.

I think that's quibbling. If votes to abolish the rule for a case are available, it's reasonable for a single suspension vote to be possible to. Both sorts of actions decrease the power of individual senators. If anything, abolishing for a whole category reduces senator's power more - if you also read the article, the basic point is the action indeed altered the power dynamic, what those considering individual senato…

> I think that's quibbling. If votes to abolish the rule for a case are available, it's reasonable for a single suspension vote to be possible to.

A suspension is both procedurally (or textually) more complicated (it either requires changing the rules twice, changing the rules to add a suspension provision and then acting separately to exercise it, or changing the rules to include a tailored exception that applied only to the case at issue) and more politically fraught (rather than publicly defending the case that the general rule is outdated, it requires legislators to defend that the rule is generally valid but should not be applied to the immediate case.) It's very much not the same thing as abolishing the filibuster for a well-defined class of cases.

This is particularly true in the Gorsuch case where the recent Democratic action to remove the filibuster from other Presidential appointees made applying the “nuclear option” to Supreme Court justices much less “nuclear” than it had seemed previously when it been considered.

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