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

Re: The Company Behind Many Surprise Emergency Room Bills

#401

Post by hkmurakami » Tue, Jul 25, 2017, 4:19 AM UTC

chasing wrote: post #396

hkmurakami wrote: post #382

Earlier quoted context omitted.

From my observations, neither side has done much to reign in the cost of the cost of hospital services and doctor/nurse compensation, which are out of line with our developed world peers. On the coverage side, the two parties have contrasting stances. Healthcare and Health Insurance are related but distinct topics.

Obamacare does include a bunch of tools to help keep overall healthcare spending down. As far as I'm aware, they have helped. But there's a long way to go. I'm actually not sure the BHCA or AHCA or whatever it's called now has much in it besides slogans and major spending cuts which aren't aimed at making care less expensive -- they're aimed and reducing the overall amount of care provided by shifting costs to those…

Correct, the GOP plan only seeks to "correct" (in their minds) the extent to which a wealth transfer occurs through the health insurance vehicle, via federal programs, direct aid to states, subsidies, etc.

Cost of healthcare, other than the occasional conversation about drug prices and definitions of necessary care (which continues to be abused by practitioners), continues to take a back seat.

For what it is worth, my personal opinion is that the medical professional lobby is a single issue voting constituency that is just as powerful as the NRA and the teachers unions.

Re: The Company Behind Many Surprise Emergency Room Bills

#402

Post by sundvor » Tue, Jul 25, 2017, 4:19 AM UTC

alonmower wrote: post #81

godot wrote: post #29

Earlier quoted context omitted.

I went to ER a couple of months ago for a relatively minor issue and stayed for a few hours total. This was in-network hospital, doctors and so on. Purely by co-pays this ended up being a ~$800 bill after all the insurance kicked in. If I didn't have a comfy software engineer salary, and instead lived paycheck to paycheck, this would've been devastating, even with insurance.

Very similar story, in the US as well. Went in, had a couple of tests that ruled out anything serious and was on my way in ~1.5 hours including all of the various wait times. Saw one doctor for maybe 1 minute and had a couple of nurses spend about 10 minutes with me total during the various tests. Insurance was billed ~10k, with coinsurance I had to pay $1,400. This is after the hospital billing in multiple rounds an…

As a Norwegian expat living in Australia for nearly two decades, that just comes across [insert many expletives] insane. Depending on the nature and urgency of the tests, my guess is you'd not be up for anything at all in either of Norway (which is very similar to all of Europe, I guess) or Australia.

I see USA as a country where, if the car crash didn't kill you, the medical bills certainly will.

Re: The Company Behind Many Surprise Emergency Room Bills

#403

Post by [deleted] » Tue, Jul 25, 2017, 4:32 AM UTC

[deleted]

Re: The Company Behind Many Surprise Emergency Room Bills

#404

Post by prawn » Tue, Jul 25, 2017, 4:36 AM UTC

charlieflowers wrote: post #399

kaybe wrote: post #319

Earlier quoted context omitted.

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.

It's unbelievably horribly fucked up. I think the only reason anyone can think it's OK is (1) they haven't had a major medical expense yet and (2) their political tribe tells them capitalism is the answer for everything. Honestly, healthcare in the US is so broken I don't see how we avoid a crisis in the next few years because of it. Maybe it will somehow pop like a real estate bubble (sad when that's the most optimi…

It's becoming increasingly obvious that the political tribalism is insanely strong. Enough to prop up things that might've seemed outrageous a year or two ago.

Re: The Company Behind Many Surprise Emergency Room Bills

#405

Post by aaronbrethorst » Tue, Jul 25, 2017, 4:45 AM UTC

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…

Best lifehack on health insurance: get your government to move to single payer.

Re: The Company Behind Many Surprise Emergency Room Bills

#406

Post by kobeya » Tue, Jul 25, 2017, 4:47 AM UTC

drewbuschhorn wrote: post #391

chrishynes wrote: post #371

Earlier quoted context omitted.

"The very year ACA took effect my health plan was canceled, my doctor went off-network, my new plan had 3x the annual premium and has grown 30% year over year, and I fight tooth and nail every single charge to make sure it is in network and covered." Same here, and I hear the same exact story from most people I talk to. Plans dropped, premiums skyrocketing. Here in Phoenix we've got a single insurer left, and we'll s…

Post ACA I'm able to get my wife insured (congenital heart issue fixed forever at 14, still used to deny her coverage at 27), and my premiums dropped. We're rather firmly middle class, pretty sure I didn't qualify for any health subsidies, I think student loan deduction and mortgage were it. So there's a face for you, 32 year old, healthy, middle class, white woman who likes cats, rides horses, and has a pet bearded…

Healthy was the key word there.

Re: The Company Behind Many Surprise Emergency Room Bills

#407

Post by toomanybeersies » Tue, Jul 25, 2017, 4:50 AM UTC

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…

Kiwi here. Had a mate drop a ladder on my head and had to get my head stitched together.

Total cost: $0, 9 stitches, and a lecture from the nurse on the dangers of drinking.

Re: The Company Behind Many Surprise Emergency Room Bills

#408

Post by rtpg » Tue, Jul 25, 2017, 5:09 AM UTC

Mz wrote: post #324

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…

This is ludicrous! I have insurance, & still this will completely drain me financially. I'm at the point where I almost think it would be easier to declare bankruptcy and start over! I worked in insurance for over five years. Not this kind of insurance, but it was a kind of health insurance. a) Get a letter of "medical necessity" drafted by your primary care physician. b) Call the insurance company and ask about the…

sounds a lot like there's a startup like that parking ticket startup, but for medical bills.

Re: The Company Behind Many Surprise Emergency Room Bills

#409

Post by morgante » Tue, Jul 25, 2017, 5:25 AM UTC

yourapostasy wrote: post #390

tptacek wrote: post #320

Earlier quoted context omitted.

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 yo…

> ...you're in the individual market... Is the actuarial and outcomes data corpus of the health insurance industry so bad that it makes actuarial sense to segment the markets to individual, medium group, large group, etc. ? I've always wondered what the explanation is for so many cohorts. Are state insurance regulations preventing medical insurance providers using more sophisticated risk modeling to create larger poo…

> Are state insurance regulations preventing medical insurance providers using more sophisticated risk modeling to create larger pools

Especially post-ACA, there are very strict limits on what factors can be used to set premiums. Risk-based assessments are basically outlawed except for a few defined variables like age and smoking habits.

Re: The Company Behind Many Surprise Emergency Room Bills

#410

Post by Fej » Tue, Jul 25, 2017, 5:26 AM UTC

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)?

Some are beginning to march in the streets, actually. Especially those who stand to lose their lives or a relative's should a Republican repeal bill pass. (Ironically, many of these people votes for those Republicans in the first place.)

For the rest who aren't, there's a simple reason: services operated by the government tend to suck (or are at least perceived to be so). It is an American tradition to stand in long lines at the Department of Motor Vehicles to renew your driver's license, or to get your vehicle inspected. The TSA exists to inconvenience travelers. Public schools are perceived to be failing (they are in some places; I was lucky enough to get a very good education in public schools) even if they are not necessarily. The Postal Service is not profitable (even if it doesn't need to be...) and there are always lines at post offices. And so on. (typing on mobile, could give more examples but I'm sure others have their own)

Whether these problems are real or not is irrelevant. Americans distrust the government, especially the federal one. You could call it indoctrination, to a degree. Those who benefit from the system are allowed to persuade the populace, even from birth, and are supported by both major parties. (Drug and other healthcare advertising is legal.)

It is also part of our history. The tradition of the US is a distrust of big government. Before the US Constitution was written, we had a federal government under the Articles of Confederation. It was meant to be permanent. The federal government was extremely weak, gave too much power to the states, and ultimately did not work. So the Founders had to go back and try a second time and gave the federal government more power. And that's where we are today...but that feeling of distrust has persisted through the centuries.

So to sum it up: many like the idea of private healthcare not because they have a choice, but because they believe that the government(s) will screw it up worse.