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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

#471

Post by abritinthebay »

ionised wrote: post #443
abritinthebay wrote: post #204

Earlier quoted context omitted.

UK but live in the US now - simply because to them this is always how it has been. The UK cried and moaned when the NHS was introduced but now (aside from Conservative efforts to "starve the beast" on it) most wouldn't go back for the world (though it could be improved , obviously). The US has a mentality that it's the best in the world for everything. Even when it's objectively not true (like in healthcare) this col…

> The US has a mentality that it's the best in the world for everything. Fundamentalism, basically. Or maybe fanaticism is a better word.

Simple nationalism really. Quite importantly different from patriotism.

Re: The Company Behind Many Surprise Emergency Room Bills

#472

Post by mistermann »

mikeash wrote: post #459
karakot wrote: post #456

Earlier quoted context omitted.

I have some anecdotes 1. A friend of mine had severe back pains, all what he got from a family doctor was some painkillers and some stories that his back pain due to to weak muscles and he has to exercise more and wait a bit (3-6 months) before he can get some tests done. Anyways he moved to the US and week later made some tests to find that he has cancer in some serious stage. He started treatment but it was too lat…

1 and 2 both sound quite familiar in the US system too. Ineffective and dismissive treatment for back pain is a common complaint, and long ER waits for non-life-threatening conditions are normal. Anecdotes don't really do anything for us besides give us pointless things to argue about. You need to look at statistics like life expectancy, quality of life, average wait times, unnecessary deaths, etc. The fact that you…

> average wait times

Your doctor in Canada refusing to give you a referral to a specialist makes comparing these numbers not terribly useful.

> I don't get it when people bring up situations like your #2. I'm sure it really, really sucked to wait six hours in the ER with an injury like that, but is it worse than staying home and trying to treat it yourself because you can't afford to visit the ER? Is it worse than dying from a simple condition because you can't afford to see a doctor?

A system that allowed consumers to inject additional money into the system would increase the budget and managed properly(!), allow more total health care services to be provided to everyone.

Of course, "this will never work, all doctors will just move to the private sector" will be the refrain. Under our current society and so-called legal system perhaps, but put me in charge, I will put mandatory guidelines and levels of service in place, and then when doctors knowingly break the rules because based on history they well know they can do it without punishment, put a few of them in prison for 10 years, and watch compliance magically improve.

Re: The Company Behind Many Surprise Emergency Room Bills

#473

Post by mistermann »

chasing wrote: post #361
mistermann wrote: post #105

Earlier quoted context omitted.

Can someone knowledgeable on the subject comment on whether the "Obamacare movement" has been up front in acknowledging this aspect of the problem with health care in the US? My perception is that the problem is typically framed as a lack of insurance problem for financially challenged people, but the "abuse" on the billing side to me seems like at least as big of a problem. And if this is being conveniently ignored,…

> it feeds my conspiracy thinking that the Democrats are actually largely indistinguishable from Republicans Have you been watching anything that's been happening with the healthcare debate over the past, oh, 25 years? The Democrats have been trying with varying degrees of success to inch this country in the direction of a more sensible healthcare system and the Republicans have pitched a generation-long hissy fit ab…

I'd challenge anyone to present a link to a substantial article or video where a noteworthy democratic politician actually addresses in detail some of the very big problems in the current system, rather than just speak in feel-good generalities that if implemented could easily allow corporations to continue charging at current levels for delivery even under a single-payer system.

Until then, I will continue to believe democrats and republicans serve the same master and only differ in language to provide an illusion of choice.

Re: The Company Behind Many Surprise Emergency Room Bills

#474

Post by stolsvik »

Declanomous wrote: post #248
mistermann wrote: post #233

Earlier quoted context omitted.

Sigh. Do you think I was suggesting that emergency rooms in Canada should adopt a FIFO approach? > Once you have you'll quickly realise that the 'long wait times' narrative is complete propaganda FUD. This is a decent example of the typical Canadian attitude I was referring to, blind refusal to even acknowledge any issues, such as the well documented long waiting times for non-emergency procedures, as well as the out…

My understanding, as an American, is that people in single-payer countries tend to see doctors much sooner than Americans do. Say I'm sitting around and I finally decide to get pain in my wrist looked at that I've had since I broke it ten years ago. I could see a specialist in less than a week. However, I probably would have had it looked at 7 or 8 years ago if I was in a single-payer system. Maybe I would have had t…

This is a very interesting point. I actually thought Americans with insurance went to the doctor for absolutely anything, and felt very entitled to that since they pay so much for their insurance. What you point out is that it might be the exact opposite - and although I do often think "oh, I won't bother them with this..", I never consider cost to be an issue..

Re: The Company Behind Many Surprise Emergency Room Bills

#475

Post by seppin »

thephyber wrote: post #255
stronglikedan wrote: post #197

Earlier quoted context omitted.

That applies to any and all insurance - especially mandated insurance policies. The main job of the insurance company is to collect your premiums and the find any way to deny your claims.

As cynical as it sounds, I think I agree with this sentiment even though it's being downvoted. The employees at an insurance company have an ethical responsibility to the company to deny any claims that do not perfectly align with the policy they sold. I don't think every insurance company is the antagonist in The Rainmaker or the car company in Fight Club, but insurance companies will try to reject as many claims as…

> insurance companies will try to reject as many claims as they can, straddling the line of losing reputation with consumers.

the health insurance industry shouldn't exist.

Re: The Company Behind Many Surprise Emergency Room Bills

#476

Post by hockley »

sethrin wrote: post #252
mistermann wrote: post #240

Earlier quoted context omitted.

This is my uninformed impression of the matter as well, and if true (please, anyone with a rebuttal please weigh in), to me it is further proof that the true motive of the ACA is to line the pockets of health care provider donors, by spreading the costs over the entire population and get rid of the politically damaging stories of overcharges causing individual bankruptcy. Socializing this theft turns it into Just Ano…

Having an expansive definition of theft merely serves to raise the noise floor. The "true" purpose of the ACA was to do something about spiraling health care costs. What was passed was a "compromise" where the people pushing for a public option got nothing and the most onerous restrictions on the monied interests were rolled back. This has not been an effective solution in many senses. I decline to further characteri…

There were provisions that addressed cost containment (ACOs, Quality-Based reimbursement models for Medicare). In fact, medical cost inflation has come more in line with general inflation since about 2009/2010. But, you're right, the market based reforms like cost and quality transparency were left to fight another day. The ACA focused more on access to coverage than it did cost.

I would not put too much weight on conspiracy theories though. The healthcare system is massively complex. It will take multiple reforms to eat this elephant.

Re: The Company Behind Many Surprise Emergency Room Bills

#477

Post by Declanomous »

stolsvik wrote: post #474
Declanomous wrote: post #248

Earlier quoted context omitted.

My understanding, as an American, is that people in single-payer countries tend to see doctors much sooner than Americans do. Say I'm sitting around and I finally decide to get pain in my wrist looked at that I've had since I broke it ten years ago. I could see a specialist in less than a week. However, I probably would have had it looked at 7 or 8 years ago if I was in a single-payer system. Maybe I would have had t…

This is a very interesting point. I actually thought Americans with insurance went to the doctor for absolutely anything, and felt very entitled to that since they pay so much for their insurance. What you point out is that it might be the exact opposite - and although I do often think "oh, I won't bother them with this..", I never consider cost to be an issue..

Yeah, the thing is that our health insurance has a deductible still, and it's generally a percentage of the cost of the visit. Since prices aren't published, you have no idea how much anything will cost until afterwards. Even the doctors can't tell you how much anything will cost.

It reminds me of an old joke about things that don't have a listed price: "If you have to ask, you can't afford it." I think that mentality is really prevalent in the US when it comes to healthcare, regardless of how expensive the procedure would actually be.

Re: The Company Behind Many Surprise Emergency Room Bills

#479

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Re: The Company Behind Many Surprise Emergency Room Bills

#480

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