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Congress is set to ban most surprise medical bills

nytimes.com

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Re: Congress is set to ban most surprise medical bills

#31

Post by leetcrew »

kayodelycaon wrote: post #9

> Some private-equity firms have turned this kind of billing into a robust business model, buying emergency room doctor groups and moving the providers out of network so they could bill larger fees. If this doesn’t describe evil, I don’t know what else would.

I wouldn't reject this out of hand, but I do find that the complexities around healthcare and the obvious political implications lead to a lot of exaggeration and outright falsehoods being propagated.

it's my understanding that the affordable care act requires insurers to treat any emergency services (if covered at all) as in-network. can anyone explain either a.) how I am wrong, or b.) how this can be circumvented?

Re: Congress is set to ban most surprise medical bills

#32

Post by HeyImAlex »

mehrdadn wrote: post #24
cdjk wrote: post #19

Earlier quoted context omitted.

The existing health insurance industry is far from free market. Try getting a price for a procedure or visit beforehand. Compare that to dental insurance. I’m always shocked when I get a treatment plant after 5 minutes that outlines exactly what the dentist needs to do, how much insurance will pay, and how much I will need to pay. Of course the set of possible treatments for dental work is a lot smaller, but it seems…

> I’m always shocked when I get a treatment plant after 5 minutes that outlines exactly what the dentist needs to do, how much insurance will pay, and how much I will need to pay. What you don't know (unless you get 2nd/3rd/4th opinions from good dentists) is how necessary those truly are. Some dentists just work around things by recommending things you don't need. (Fill teeth, taking panorex, etc. unnecessarily)

Seriously, I’ve had dentists differ in opinions by an order of magnitude. Turns out “necessary” is a pretty broad grey area.

Re: Congress is set to ban most surprise medical bills

#33

Post by cdjk »

mehrdadn wrote: post #24
cdjk wrote: post #19

Earlier quoted context omitted.

The existing health insurance industry is far from free market. Try getting a price for a procedure or visit beforehand. Compare that to dental insurance. I’m always shocked when I get a treatment plant after 5 minutes that outlines exactly what the dentist needs to do, how much insurance will pay, and how much I will need to pay. Of course the set of possible treatments for dental work is a lot smaller, but it seems…

> I’m always shocked when I get a treatment plant after 5 minutes that outlines exactly what the dentist needs to do, how much insurance will pay, and how much I will need to pay. What you don't know (unless you get 2nd/3rd/4th opinions from good dentists) is how necessary those truly are. Some dentists just work around things by recommending things you don't need. (Fill teeth, taking panorex, etc. unnecessarily)

True, but at least the dentist can tell me how much I will need to pay.

Re: Congress is set to ban most surprise medical bills

#34

Post by shreyansj »

nottorp wrote: post #27
lordnacho wrote: post #11

> Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay. How do courts uphold this? You go to a restaurant, they say you can buy the tas…

From what I know about the US even your restaurant example has hidden service fees and mandatory tips and taxes that aren't on the menu?

But generally the tips and taxes is something you know about if you are a US resident. And you might not be unconscious at the time of payment :) And restaurant staff getting paid a decent wage without relying on tips is also something that should get fixed sooner than later.

Re: Congress is set to ban most surprise medical bills

#35

Post by HarryHirsch »

HenryKissinger wrote: post #7
standardUser wrote: post #3

The change does not apply to ambulances (except for air ambulances), ensuring the United States remains one of the few places in the world where a seriously ill person needs to debate if they're willing to risk their health and life to avoid a financially crippling trip to the hospital.

"‘As I was being eaten, I was thinking about my insurance’: Woman who lost face in bear attack on why she’s voting for Bernie Sanders" https://www.independent.co.uk/news/world/americas/us-electio...

/r/nottheonion

Re: Congress is set to ban most surprise medical bills

#36

Post by AdmiralAsshat »

bearjaws wrote: post #25

Having gone through cancer treatment here in the USA, I have received over a dozen 'after the fact bills' over the past 5 years, sometimes over 9months after the procedure, mainly involving blood work and CT scans. I missed one bill that came months after chemotherapy for $87 in 2015, it only had a 60 day notice before sending to collections. Mind you I was on disability from my employer that paid well. -80pts on my…

If it's any consolation, that time should now be 180 days, and I'm pretty sure the counter should start at the time the collection agency receives it, not from the date of service.

IANAL, though, so don't quote me on that.

Re: Congress is set to ban most surprise medical bills

#37

Post by dandersh »

standardUser wrote: post #3

The change does not apply to ambulances (except for air ambulances), ensuring the United States remains one of the few places in the world where a seriously ill person needs to debate if they're willing to risk their health and life to avoid a financially crippling trip to the hospital.

When our youngest was born the nurses (incorrectly) thought his blood sugar was low and had him transferred to a different hospital via ambulance. We were able to fight and get the $2000 bill waived on account of the fact that it was a needless trip. Unfortunately my wife spent the night alone as I was with our son.

On a somewhat related note in the span of 10 years the cost to us to deliver our kids doubled. Same hospital too.

Re: Congress is set to ban most surprise medical bills

#38

Post by c22 »

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

It won't work. They'll still charge you for the interrogation!

Re: Congress is set to ban most surprise medical bills

#39

Post by mehrdadn »

cdjk wrote: post #33
mehrdadn wrote: post #24

Earlier quoted context omitted.

> I’m always shocked when I get a treatment plant after 5 minutes that outlines exactly what the dentist needs to do, how much insurance will pay, and how much I will need to pay. What you don't know (unless you get 2nd/3rd/4th opinions from good dentists) is how necessary those truly are. Some dentists just work around things by recommending things you don't need. (Fill teeth, taking panorex, etc. unnecessarily)

True, but at least the dentist can tell me how much I will need to pay.

Which one is better probably depends on if you value your money more, or your body.
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