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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

#431

Post by kennydude »

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…

Unfortunately the NHS doesn't have the resources it needs right now. Blame the government right now who would rather sell it off to their mates.

Re: The Company Behind Many Surprise Emergency Room Bills

#432

Post by et-al »

Declanomous wrote: post #242
et-al wrote: post #202

Earlier quoted context omitted.

Everyone in the Bay Area loves talking down on Kaiser, but financially they've been the most worry-free experience. Had ringing in my ear for a week, went to the doctor, and she referred me to both an audiologist and MRI. Paid $20 for both of those other visits. If I had been on Blue Cross Blue Shield, I probably would've sucked it up given my super high deductible and navigating the in-network maze.

BCBS IL is super straightforward. Every doctor is $20, unless it's a specialist, then it is $40. I've never actually been billed $40, despite seeing many specialists, so I'm not sure what actually qualifies. I've been hospitalized and paid My biggest complaint about the medical industry is the cost of prescription drugs. It's ridiculous how much we pay for drugs in this country.

Is your BCBS IL plan an HMO? That could explain the simplicity. I used to be on an HMO, but now it's a PPO with BCBS. The flexibility of choosing my provider hasn't been needed for my case.

Re: The Company Behind Many Surprise Emergency Room Bills

#433

Post by parmta »

sah2ed wrote: post #427
parmta wrote: post #370

Earlier quoted context omitted.

I work in investment banking and cover hospital facilities (i.e. the "hospital chains"). You are right that the Kaiser model, or what the industry calls fully integrated systems, can often produce more efficient healthcare. For people that aren't as familiar with the healthcare system, I thought it might be helpful to provide a brief overview of why that is the case. Since the ACA, there has been an emphasis on shift…

This was a long but very illuminating contribution. Mind me asking what kind of work your investment bank does with the healthcare industry?

Thanks, I'm glad it was helpful. We work with 501c3 healthcare providers, like Kaiser, to (a) help them raise capital through the public debt markets and (b) provide strategic advisory/M&A services.

Re: The Company Behind Many Surprise Emergency Room Bills

#434

Post by seanp2k2 »

e59d134d wrote: post #380
dungle6 wrote: post #97

Earlier quoted context omitted.

If you have excellent credit you can simply not pay and make them do the work. I had a $1500 dispute. I was getting tired of wasting time. When it went to collections I drafted the standard leave me alone. The funny thing is now the collection company has screwed up twice on some things. It is their prerogative to sue. I doubt they will. If they do it, it will be annoying but I can respond in kind with a countersuit.…

Agreed, this is just part of business for hospitals. We as honest people feel ashamed if we cannot pay bills. But I make an exception medical bills and other unpredictable broken industries (if any). If someone bought a car or house, they knew their obligations exactly. If they declare bankruptcy, I would lay some fault with them, if not all. But with medical billing, you cannot get a straight answer. If they cannot…

You'd hope they would simplify their systems, but instead they just throw it into higher risk pools and raise prices for everyone to cover the non-payments.

Re: The Company Behind Many Surprise Emergency Room Bills

#435

Post by canhe »

refurb wrote: post #296
mahyarm wrote: post #277

Earlier quoted context omitted.

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

How about we compare Canada's edge cases to countries other than the US. How does it stack up?

I would suspect not too badly.

Re: The Company Behind Many Surprise Emergency Room Bills

#436

Post by nfriedly »

One thing to keep in mind: when you go to the emergency room as a relatively well-off individual who has insurance and pays their bills, you're not only paying for your emergency room visit - you're also paying for the visits of people who don't have insurance and can't afford to pay their medical bills.

Re: The Company Behind Many Surprise Emergency Room Bills

#437

Post by kevinmchugh »

chrishynes wrote: post #371
kobeya wrote: post #368

Earlier quoted context omitted.

I made significant use of my healthcare pre-ACA ($30k-$50k charges before insurance). All of it was in-network, covered, and a small annual premium. 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, as have deductibles, and I fight tooth and nail every single charge to make sure it is in network and covered. Y…

"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…

My partner is middle-class and was able to pursue education and a career more freely because she could remain on parent's isurance until age 26. By the time she hit 26, she was on her employer's insurance.

Consider also the not middle-class recipients of medicaid expansion.

Re: The Company Behind Many Surprise Emergency Room Bills

#438

Post by bb611 »

chimeracoder wrote: post #125
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…

> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%…

Do you have a better source for this data than, well, a bunch of numbers you posted to HN? In particular, an explanation by a researcher or other expert who has actually studied the difference and can explain it?

It's very easy to draw conclusions from statistics. It's much harder to draw correct conclusions from them.

Re: The Company Behind Many Surprise Emergency Room Bills

#439

Post by unclebucknasty »

fapjacks wrote: post #425
unclebucknasty wrote: post #393

Earlier quoted context omitted.

> don't be a wuss about your credit score. I don't get this statement. Not protecting your credit score can cost you real money. Yeah, the whole thing is a racket, and I frickin' hate it, but, pretending like you can ignore your credit score without impact seems counterproductive. I would really rather see this whole racket of a medical billing system held to account versus advocating that we allow them to punish us…

I agree with your second statement, but I have spent most of my 20s and a great portion of my 30s with crazy negative stuff on my credit report. I flatly refuse to pay outrageous collection fees, and there are at least three items on my credit report which are outright lies. For example, switching from Verizon to T-Mobile, and T-Mobile handed out gift Mastercards to pay the early termination fees for getting out of y…

I hear you, and most of us probably have similar stories to tell. There are really two rackets here: credit reporting agencies and medical billing. Then, they have the audacity to add debt collectors to the mix, who primarily harrass you and threaten to blow up your credit score.

Clearing errors involves a byzantine maze and way too much time in an era when everything is digital. There should be stringent regulation around accuracy and we should all have free year-round, real-time access to our credit scores.

But, my point here is not that you can't live a normal life with a few credit dings. It's that those dings represent punishment that can impact you. For instance, you may not have gotten the best interest rate available on your subsequent credit. So, we should be advocating an end to these fraudulent medical billing practices vs accepting punishment from them, then trying to live with it.

Re: The Company Behind Many Surprise Emergency Room Bills

#440

Post by unclebucknasty »

fapjacks wrote: post #425
unclebucknasty wrote: post #393

Earlier quoted context omitted.

> don't be a wuss about your credit score. I don't get this statement. Not protecting your credit score can cost you real money. Yeah, the whole thing is a racket, and I frickin' hate it, but, pretending like you can ignore your credit score without impact seems counterproductive. I would really rather see this whole racket of a medical billing system held to account versus advocating that we allow them to punish us…

I agree with your second statement, but I have spent most of my 20s and a great portion of my 30s with crazy negative stuff on my credit report. I flatly refuse to pay outrageous collection fees, and there are at least three items on my credit report which are outright lies. For example, switching from Verizon to T-Mobile, and T-Mobile handed out gift Mastercards to pay the early termination fees for getting out of y…

>Verizon

BTW, I predict Verizon will soon be the target of some hefty class-action. They are very shady when it comes to contracts. They also have periods wherein substantial numbers of customers report mysterious, frequently dramatic data overages for a time [0] that suddenly disappear. But, they refuse to acknowledge any issues.

And they specialize in making it extremely difficult to achieve resolution, with multiple phone calls, etc.

[0] https://www.wirelessweek.com/news/2016/09/thousands-verizon-...

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