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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

#311

Post by Merad »

rwmj wrote: post #4

Over here (in Europe) we get the impression that US has such a crazy healthcare system. Why aren't people marching in the streets? Is it not as crazy as it sounds for most users? If you're taken to ER how are you supposed to know if the doctors are all part of "your network" (whatever that even means)?

Basically, events like TFA where someone gets shafted even with insurance are fairly rare. The system is bad, but many (most?) people aren't exposed to just how bad it really is. The elderly, who require the most healthcare, have Medicare helping them. Working adults often get insurance subsidized by their employer, and young adults/kids under age 26 can stay on their parents insurance plans. With insurance, especially "good" insurance, you don't see all the insanity unless you dig into the itemized details of your medical bills... even then most people will shake their heads, pay their (relatively small) portion of the bill, and move on.

Re: The Company Behind Many Surprise Emergency Room Bills

#312

Post by amalcon »

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…

While this sounds nice, I've heard too many Kaiser horror stories from family in the DC area to ever consider them even if it were an option. They've nearly killed at least three relatives of mine. If your current doctor's approach is not working, there's usually nothing you can do about it. You are only allowed two opinions, both of whom work for the same people.

Re: The Company Behind Many Surprise Emergency Room Bills

#313

Post by zanny »

mistermann wrote: post #286
tptacek wrote: post #249

Earlier quoted context omitted.

The fact that the problems addressed by the Democratic health care bill are orthogonal to some other problem you care deeply about is not, logically, evidence that the Republicans and Democrats are "indistinguishable" when it comes to health care. The status quo ante of the ACA was a system in which millions of people were locked out of insurance by fiat due to pre-existing condition bans. For those people, all provi…

Right, which increases revenue for the medical establishment, while also helping some people (and harming others) in the process. For me to consider the Democrats as the true party of the people rather than a tool of corporations, I'd want to see the cost side of health care addressed as well. My question is: was it?

On one hand, the Democrats did not have control of congress to pass whatever they wanted when the ACA was passed. On the other hand, the Democratic party of the US has never fought with any fervor against Republicans on pretty much anything. The closest I have seen in my lifetime to democratic resistance was to the most blatantly and obviously stupid and racist decisions Trump has made like travel bans and appointing fossil fuel and wall street banker execs and investors to every cabinet position. In the Bush years, there was practically no resistance at all. Bipartisan support for the evil Patriot Act and disastrous No Child Left Behind. No adherence to any ideology or conviction.

Probably the most important realization for the average American in the current political climate is how no party establishment represents you. Both have their sponsors, and none of them are the American people. Individual politicians might have more empathy than others and some might try to help the common man more than another, but they all still have their bosses and despite whatever rhetoric we throw around in almost every election (aside the scant few in contested states and counties) the people are not holding their leash, so they don't work for you.

It is like climate change. It doesn't matter how you want to argue about solving it, it is simply acknowledging the reality that has to happen first and moving on from there on a unified foundation of fact.

Re: The Company Behind Many Surprise Emergency Room Bills

#314

Post by rangibaby »

mistermann wrote: post #287
heartbreak wrote: post #273

Earlier quoted context omitted.

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.

The bill goes to the government, who gets its funding from the people. This in no way stops any systemic over-billing that may be occuring.

See: Japan where the government decides the price of procedures.

On national health insurance (monthly cost depends on your salary but for an average person it is a few hundred bucks per month) the hospital pays 70% and patient pays 30%.

It means basic visits to the doctor or dentist are very cheap here. Like $20 for consultation + medicine. ER+X-rays and MRI (appendicitis, sigh) was a little bit over $100.

Re: The Company Behind Many Surprise Emergency Room Bills

#315

Post by KekDemaga »

tptacek wrote: post #306
0xbear wrote: post #300

Earlier quoted context omitted.

As far as I can tell by looking at my premiums, it actually significantly sped up the growth of costs. I don't know how anyone could argue otherwise with a straight face.

That's not the cost we're measuring! We're measuring cost on the macro scale, in terms of the percentage of the economy spent on health care and, in particular, the percentage of the federal budget spent on health care entitlements. That's the cost curve we're talking about bending, because the pre-ACA projections were literally prima facie untenable. Any number of effective cost-saving measures could be passed that…

Unfortunately for the DNC, the costs many voters were measuring last November wasn't healthcare spending compared to GDP it was actual out of pocket costs that have risen dramatically for many working class Americans.

Re: The Company Behind Many Surprise Emergency Room Bills

#316

Post by dankohn1 »

0xbear wrote: post #300
ComradeTaco wrote: post #297

Earlier quoted context omitted.

Obamacare only reduced the growth of healthcare costs, it did not stop the growth. The approach that most democrats believe would reduce cost is single payer or Medicaid for all.

As far as I can tell by looking at my premiums, it actually significantly sped up the growth of costs. I don't know how anyone could argue otherwise with a straight face.

Because premium growth actually has slowed since Obamacare was passed: http://www.factcheck.org/2015/02/slower-premium-growth-under...

Re: The Company Behind Many Surprise Emergency Room Bills

#317

Post by 0xbear »

tptacek wrote: post #306
0xbear wrote: post #300

Earlier quoted context omitted.

As far as I can tell by looking at my premiums, it actually significantly sped up the growth of costs. I don't know how anyone could argue otherwise with a straight face.

That's not the cost we're measuring! We're measuring cost on the macro scale, in terms of the percentage of the economy spent on health care and, in particular, the percentage of the federal budget spent on health care entitlements. That's the cost curve we're talking about bending, because the pre-ACA projections were literally prima facie untenable. Any number of effective cost-saving measures could be passed that…

You can measure whatever you like, but my costs have gone up nearly threefold and my plan is worse now than it used to be. I'm not interested in solving world peace here. I just want to understand why insuring a relatively healthy family of three under a very high deductible plan costs $1700/mo, and why is it now illegal to not go along with this ridiculous rip off.

Re: The Company Behind Many Surprise Emergency Room Bills

#318

Post by Shivetya »

jaymzcampbell wrote: post #31
rwmj wrote: post #4

Over here (in Europe) we get the impression that US has such a crazy healthcare system. Why aren't people marching in the streets? Is it not as crazy as it sounds for most users? If you're taken to ER how are you supposed to know if the doctors are all part of "your network" (whatever that even means)?

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…

Not that I think the our system (US resident) is all that great but our government runs two of the worst systems that exist in the country, the Veterans Administration which nearly everyone hears about but also the Indian Health Service which sadly flies under the RADAR.

so it is a very hard sell to get more Federal involvement when we have constant stories of VA issues and more available just by searching. throw in rules that actively prevented insurers from making multi state offers and the system was bound to be a mess.

however one of the problems not discussed is that many receive their health insurance from their employers and while this has been going away slowly, this idea like income taxes, tends to remove the cost component from people's minds. you don't see the cost in whole or in large lump sums so its easy to not think about it.

the big hurdle will be convincing people there will be limits of what can be treated. the US infant mortality statistics are one area of exaggeration to the bad simply because to the extent money will be spent to save a newborn that many other system won't

Re: The Company Behind Many Surprise Emergency Room Bills

#319

Post by kaybe »

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…

These stories have me at 'WTF USA'. Like seriously, how does the US society think this is ok? Can anyone explain this to me?

Is it a 'won't happen to me' sentiment? Preferring the freedom of literally landing on the streets with one accident since you're presumably fully in charge? I do not understand, though there must be an understandable reason.

Re: The Company Behind Many Surprise Emergency Room Bills

#320

Post by tptacek »

0xbear wrote: post #317
tptacek wrote: post #306

Earlier quoted context omitted.

That's not the cost we're measuring! We're measuring cost on the macro scale, in terms of the percentage of the economy spent on health care and, in particular, the percentage of the federal budget spent on health care entitlements. That's the cost curve we're talking about bending, because the pre-ACA projections were literally prima facie untenable. Any number of effective cost-saving measures could be passed that…

You can measure whatever you like, but my costs have gone up nearly threefold and my plan is worse now than it used to be. I'm not interested in solving world peace here. I just want to understand why insuring a relatively healthy family of three under a very high deductible plan costs $1700/mo, and why is it now illegal to not go along with this ridiculous rip off.

Your plan was already going up before the ACA was proposed, even if you were in medium or large group markets. (My firm offered health insurance to employees in California, New York, and Illinois from ~2006-2012.) Family health insurance on the group market was something like 1100-1200 pre-ACA.

If you're paying for your own insurance, you're in the individual market, which is significantly more expensive, and what you're seeing is, in part, the market absorbing the cost of guaranteed issue, something we decisively did not have before the ACA, when health insurers could lock people out of coverage on suspicion of a medical condition, and later rescind care. Pre-ACA and post-ACA insurance is for that reason also not an apples-apples comparison.

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