Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Emergency room patients can face steep bills even when treatment is declined

vox.com

Post reply on HN
Print view View original

151–160 of 249 posts

Re: Emergency room patients can face steep bills even when treatment is declined

#151

Post by ahoy »

mfoy_ wrote: post #85
Ensorceled wrote: post #45

I recently had a spot appear in my vision. Went to my GP same day, the receptionist called around to get me into a local optometrist who determined it was a detached retina, she called and got me into the local hospital as an emergency case. It was busy but I got my first treatment that evening. The entire journey, my green OHIP card was all I needed, no insurance forms, no pre-approvals, no extra charges. 5 hospital…

You forgot: 3. Canadians pay for their health care in tax, anyways. (However: https://www.investopedia.com/financial-edge/0411/do-canadian... )

You forgot:

4. Americans pay for health insurance through private companies, anyway. And then they still don't get the care they need.

Re: Emergency room patients can face steep bills even when treatment is declined

#152

Post by falsedan »

assblaster wrote: post #130
sjg007 wrote: post #38

Earlier quoted context omitted.

It’s predicated on the HMO model where you pay a copay and your insurance company negotiates the rates. Under the guise of consumer choice insurance companies have expanded copays and coinsurance to shift the burden to the insured. Out of network Hospitals and doctors balance billing needs to be outlawed. They should only be able to balance bill up to the Medicaid rate.

Medicaid is already at the lowest payment rate, so balance billing to that would be a net negative actually. Why should hospitals and doctors be forced to accept contacts from insurers that underpay for services rendered for nothing in return (being part of limited network)?

> so balance billing to that would be a net negative actually

If the regulated standard treatment costs were somehow lower than the actual delivery costs, sure. But how on eath could that happen? It's in everyone's best interest for hospital administrators to be heavily involved in setting these costs, and they have no interest in losing money.

Re: Emergency room patients can face steep bills even when treatment is declined

#153

Post by falsedan »

gnode wrote: post #138
Ensorceled wrote: post #45

I recently had a spot appear in my vision. Went to my GP same day, the receptionist called around to get me into a local optometrist who determined it was a detached retina, she called and got me into the local hospital as an emergency case. It was busy but I got my first treatment that evening. The entire journey, my green OHIP card was all I needed, no insurance forms, no pre-approvals, no extra charges. 5 hospital…

> my green OHIP card was all I needed In the UK, the entitlement is even more ubiquitous and fluid. I was diagnosed by my GP, referred to hospital and undergoing surgery under general anaesthetic, in half a day, without showing any form of ID.

This freaked me out, especailly when the admitting nurse couldn't match us to our GP's practice: "don't worry, we'll sort it out eventually, enjoy the rest of your night!"

Re: Emergency room patients can face steep bills even when treatment is declined

#154

Post by gsnedders »

mfoy_ wrote: post #85
Ensorceled wrote: post #45

I recently had a spot appear in my vision. Went to my GP same day, the receptionist called around to get me into a local optometrist who determined it was a detached retina, she called and got me into the local hospital as an emergency case. It was busy but I got my first treatment that evening. The entire journey, my green OHIP card was all I needed, no insurance forms, no pre-approvals, no extra charges. 5 hospital…

You forgot: 3. Canadians pay for their health care in tax, anyways. (However: https://www.investopedia.com/financial-edge/0411/do-canadian... )

And Americans pay more per-capita for federal-funded healthcare than Canadians do… just the Canadians get universal coverage for it. The US manages to spend as much public money on healthcare as most other western countries do, and gets much less for it.

Re: Emergency room patients can face steep bills even when treatment is declined

#155

Post by maxerickson »

kalleboo wrote: post #71
a-saleh wrote: post #32

Earlier quoted context omitted.

As far as I know, point of the exorbitant fees is the weird process of collective bargaining between the care-providers and insurers. I.e. you, as the hospital, inflate your price, by X00% margin over what you actually plan to charge the insurance. Then you let the insurance negotiators negotiate, and you negotiate down to the reasonable price. This looks really good on the paper. Unfortunately, you as a patient, if…

> that you didn't really have the chance of negotiating Not American, but from what I've read in these types of news articles, you often CAN negotiate it down a lot, but when you get a huge bill in the mail, the first thing you think isn't "I'm going to try to haggle down my $5000 bill with this huge hospital" you think "I'm so screwed. Time to google 'personal bankruptcy', was it 7 years?". Pharmaceutical companies…

If you use insurance they are less willing to negotiate.

(but you are getting the negotiated price anyway; the paranoid part of my brain thinks they run a scam here by recoding bills that come after the deductible has been met, which is a different sort of negotiation than agreeing on prices for services)

Re: Emergency room patients can face steep bills even when treatment is declined

#156

Post by DanBC »

gnode wrote: post #138
Ensorceled wrote: post #45

I recently had a spot appear in my vision. Went to my GP same day, the receptionist called around to get me into a local optometrist who determined it was a detached retina, she called and got me into the local hospital as an emergency case. It was busy but I got my first treatment that evening. The entire journey, my green OHIP card was all I needed, no insurance forms, no pre-approvals, no extra charges. 5 hospital…

> my green OHIP card was all I needed In the UK, the entitlement is even more ubiquitous and fluid. I was diagnosed by my GP, referred to hospital and undergoing surgery under general anaesthetic, in half a day, without showing any form of ID.

> without showing any form of ID.

That's changing a bit under the hostile environment.

https://www.gov.uk/government/publications/guidance-on-overs...

Re: Emergency room patients can face steep bills even when treatment is declined

#157

Post by icebraining »

mfoy_ wrote: post #85
Ensorceled wrote: post #45

I recently had a spot appear in my vision. Went to my GP same day, the receptionist called around to get me into a local optometrist who determined it was a detached retina, she called and got me into the local hospital as an emergency case. It was busy but I got my first treatment that evening. The entire journey, my green OHIP card was all I needed, no insurance forms, no pre-approvals, no extra charges. 5 hospital…

You forgot: 3. Canadians pay for their health care in tax, anyways. (However: https://www.investopedia.com/financial-edge/0411/do-canadian... )

"In 2004, Canada government-spending was $2,120 (in US dollars) per person, while the United States government-spending $2,724."

https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_s...

Re: Emergency room patients can face steep bills even when treatment is declined

#158

Post by [deleted] »

spsrich wrote: post #22

Any parent has similar stories. Consumer law does not seem to apply to doctors and hospitals. Imagine if you took your car into the shop - there is no price list, they won't give you an estimate, and for weeks after they send you random bills without indicating what it's for? This affects everybody in the US, and I don't understand why it's allowed to continue, except the medical industry has bought off all the polit…

[deleted]

Re: Emergency room patients can face steep bills even when treatment is declined

#159

Post by corpMaverick »

Meekro wrote: post #113
toomanybeersies wrote: post #9

How can people read and hear about stories like this, and even possibly think it's OK or even normal? How do lawmakers in the USA convince people that this is acceptable? I have never directly paid a single cent for healthcare, and neither has anyone I know. When I had to get 6 stitches in my forehead at 2 AM on a Sunday morning, it cost me nothing. When my friend needed to get the tip of his finger reattached, it co…

I've never met anyone (of either party) who thinks that stories like this are acceptable. The issue, as always, is how do we fix it? Pointing to European democracies merely shows that it can be done, it doesn't necessarily offer a blueprint for how to make it happen in a country with very different size and culture. Bernie Sanders' "medicare for all" is the plan I've seen get the most support. If we got single payer…

... and it is easy to do gradually. i.e. Lower the age two years every year. In ten years people born in 1983 would be covered.

Re: Emergency room patients can face steep bills even when treatment is declined

#160

Post by mazelife »

lr4444lr wrote: post #105
spsrich wrote: post #22

Any parent has similar stories. Consumer law does not seem to apply to doctors and hospitals. Imagine if you took your car into the shop - there is no price list, they won't give you an estimate, and for weeks after they send you random bills without indicating what it's for? This affects everybody in the US, and I don't understand why it's allowed to continue, except the medical industry has bought off all the polit…

That may be changing soon: https://www.infectiousdiseaseadvisor.com/practice-management...

I think price transparency is a bit of a red herring. That's not to say I don't support the idea of requiring hospitals to be upfront about costs, but it isn't going to fix issues with ER visits referenced in the Vox article. Emergency medical treatment is not really a consumer good, where if you don't like the price your can shop around or just decline to spend money. What's more, there is massive information asymmetry. If a physician diagnoses you with X and recommends treatment Y, you're not in a position to evaluate whether there's some cheaper option Z instead. Price transparency is great for elective care, but most medical treatment is not elective in nature.
Post reply on HN