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Insured, but Still Owing $109K for a Heart Attack

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Re: Insured, but Still Owing $109K for a Heart Attack

#351

Post by maxerickson »

nojvek wrote: post #332
ChuckMcM wrote: post #246

Earlier quoted context omitted.

Absolutely, and it is this sort of practice that all Americans could get behind legislation that made it illegal. Unfortunately we can't seem to have a civil discussion on health care to find the issues we have in common.

Our total bill for a normal delivery was 25k. 25k for a doctor and nurse to pull a baby out of the vag! It took 2 months for the bill to arrive. Healthcare in US is like legal extortion. You could literally bill for breathing hospital air and people would have to pay.

Their liability insurance has to cover the costs of lifetime care for any babies that are injured during delivery (juries have made this clear enough). It's not strange that they pass this cost on to mothers.

Re: Insured, but Still Owing $109K for a Heart Attack

#352

Post by ta76567656 »

lacker wrote: post #36
jhayward wrote: post #11

Earlier quoted context omitted.

> Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them. No, St. David's has already fully recouped their costs and then some. They were simply trying to extract as much money as the stone could bleed.

I was going to respond saying that most hospitals are nonprofits and aren't actually making a great profit margin off this sort of overcharging. But then I looked it up and St. David's, despite having a religious nonprofit-sounding name, is actually owned by HCA Healthcare, which is a for-profit that has almost 4x'd its stock price over the past five years while acquiring more hospitals to grow. So, yeah, this one is…

Maybe they could change their name to "Hospital of the Temple Moneychangers"

Re: Insured, but Still Owing $109K for a Heart Attack

#353

Post by maxerickson »

The way out of this for the US is to have lots more doctors.

So tax hospital revenues (yes, revenues) to fund residencies and have an objective standard for accrediting medical schools, where meeting the objective standard automatically qualifies the seats.

Of course patients will then be paying for the residencies, but that's fine, it even makes sense.

Having more nurse practitioners and physicians assistants would also help, but doctors lobby against them starting independent practices.

Re: Insured, but Still Owing $109K for a Heart Attack

#354

Post by nerdponx »

woobar wrote: post #316
nerdponx wrote: post #119

Earlier quoted context omitted.

The whole warped part of this is that the consumer has no way to anticipate cost in advance, and often the individual providers (doctors, nurses, etc.) don't either. Shouldn't the burden be on the insurance company to investigate and discourage excessive billing? Or are they too strict as it is, leading providers to play games with billing?

I think in this particular case insurance did investigate actual (or within a reason) costs and paid them. But there is no business relationship between the insurance company and an out-of-network provider. Should they go to the court on behalf of the patient? As a customer I'd like this. But it looks like combining health and legal insurances. Another option is maybe to require that language on the "patient responsi…

Is there an analogy in the car insurance world? Let's say I know nothing about cars and I get in a collision somewhere far away from home. I need a repair th let's say I know nothing about cars and I get in a collision somewhere far away from home. I need some bodywork and a replacement for the flimflam crankslap in the engine. The shop knows that I don't know anything about cars, and they know that I am covered by insurance. What is stopping them from charging me an exorbitant rate for a new crankslap, and then me getting screwed when the insurance won't cover it?

Re: Insured, but Still Owing $109K for a Heart Attack

#355

Post by InitialLastName »

s73v3r_ wrote: post #183
bmmayer1 wrote: post #133

Earlier quoted context omitted.

> squeezing money out of insurance companies because they can FTFY. But seriously, how can it possibly be the hospital's fault for doing exactly what the law and market incentives give them every reason to do? There's almost no downward pressure on prices: little competition, no transparent pricing, huge barriers to market entry, and third party payers.

"But seriously, how can it possibly be the hospital's fault for doing exactly what the law and market incentives give them every reason to do? " Because they're the ones actually doing it? Because they're run by adults who are fully capable of taking responsibility for their actions?

The US (and others, but the US especially) has a long-standing practice of divesting corporations from the responsibility for their actions.

Worse, it's frequently the same people who argue that corporations are "people" arguing that corporations as a whole shouldn't be held responsible for their actions.

Re: Insured, but Still Owing $109K for a Heart Attack

#356

Post by prirun »

antisthenes wrote: post #215
loeg wrote: post #211

Earlier quoted context omitted.

> Hospitals should be legally mandated to accept replacement of materials in lieu of payment. > If I can source the same stents for cheaper than the hospital bills me, they should be required to erase them from the bill and accept them as material replacement. Meh. The only reason they inflate supply costs is because that's where insurance negotiations let them. Mandating supplies must be available at-cost to consume…

Trivially disproven by UK's health care system, which consistently ranks #1 in the world by outcomes and employs price caps for health care suppliers. https://www.commonwealthfund.org/press-release/2017/new-11-c... > Mandating supplies must be available at-cost to consumers is just a stupid cost-shifting game. That's not what I suggested in my post at all. Also, if it reduces costs for the end consumer, what's the ha…

Are you suggesting that a sick person, recovering from an operation, be responsible for researching prices on the parts that were used in surgery? Most do not have the time or expertise for that, nor would anyone want to do it.

Re: Insured, but Still Owing $109K for a Heart Attack

#357

Post by cimmanom »

luminaobscura wrote: post #346
cimmanom wrote: post #185

I thought this was one of the things the ACA was supposed to prevent, with out-of-pocket maximums?

out of max doesnt apply to balance bills since it is not insurance's responsibility.

Then what's the point of an out of pocket max? Shouldn't it make the bill the insurer's responsibility?

Re: Insured, but Still Owing $109K for a Heart Attack

#358

Post by megamindbrian2 »

tluyben2 wrote: post #343
megamindbrian2 wrote: post #308

Earlier quoted context omitted.

I've read that it can only be done once every 7 years.

What happens when you do it more often? You have no money so...

I think it was just from the credit score side, maybe it takes that long for it to be discounted from your credit score.

Re: Insured, but Still Owing $109K for a Heart Attack

#359

Post by wang_li »

aaroninsf wrote: post #293
wang_li wrote: post #135

Earlier quoted context omitted.

Unless the NHS has no approved treatment, in which case you die instead of being able to go abroad for care.

Higher mortality means higher mortality. Lower lifespan means lower lifespan. Scary stories intended to distract from systemic dysfunction are also just what they are.

The issues you mention are not directly health care related. There have been analysis of the mortality rate in the US, and when you remove people who die from things like being murdered or in automobile accidents and dying without receiving care, the US has the best mortality rate among developed nations. The data is old, but there's no reason to think it has changed dramatically in the last decade.

Obesity rates and chronic diseases that are the result of lifestyle choices are not health care issues, they are public health issues or public health policy issues. No doctor can legitimately be assigned responsibility for citizens who live unhealthy lifestyles.

When comparing cancer survival rates the US is, again, among the top for many types of cancers. It's almost impossible to compare infant mortality rates because the US doesn't adhere to any international norm for what is considered a live birth and reviews of the data have shown that the US will frequently label an extremely low birthweight child as a live birth, while many other countries will label the birth as a still birth.

The reality is that actual care in the US is what you'd expect from a developed country. The reports that put the US down the list of first world health care systems universally factor in cost and accessibility. These are real issues, but it's not the same thing as "paying more for crappy outcomes."

Countries with different systems have their own issues, which is why I pointed out situations like Alfie Evans. There was also Oliver Evans whom the NHS said could not be saved and would not get treatment. The family paid $170,000 out of pocket and crowd funded another $100,000 to bring him to the US where surgeons in Boston successfully removed a non-cancerous tumor from his heart and saved his life.

Re: Insured, but Still Owing $109K for a Heart Attack

#360

Post by antisthenes »

prirun wrote: post #356
antisthenes wrote: post #215

Earlier quoted context omitted.

Trivially disproven by UK's health care system, which consistently ranks #1 in the world by outcomes and employs price caps for health care suppliers. https://www.commonwealthfund.org/press-release/2017/new-11-c... > Mandating supplies must be available at-cost to consumers is just a stupid cost-shifting game. That's not what I suggested in my post at all. Also, if it reduces costs for the end consumer, what's the ha…

Are you suggesting that a sick person, recovering from an operation, be responsible for researching prices on the parts that were used in surgery? Most do not have the time or expertise for that, nor would anyone want to do it.

Have your spouse/relative shop around for replacement while you recover. Or be destitute for 10 years after being bankrupted by medical bills. I know which one I'd prefer.

> Most do not have the time or expertise for that, nor would anyone want to do it.

Is that a joke? You can find most of those things with a 30 second Google search. I thought this was a forum with technically apt people?

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