Congress is set to ban most surprise medical bills • Hacker News Board

Re: Congress is set to ban most surprise medical bills

#81

Post by WrtCdEvrydy » Mon, Dec 21, 2020, 4:45 PM UTC

tehjoker wrote: post #47

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…

Price discovery doesn't help you. If you get knocked out, heart attack, your arm cut off, whatever (i.e. a lot of the expensive stuff) you just go to the nearest hospital, no consumer market finagling is even possible other than trying to live near a good hospital. Other times with chronic conditions where theoretically price discovery could help, the problem is that you need care badly so all the chronic care provid…

The biggest fuck you is that Medicare can't negotiate.. it's actually written into the law.

Re: Congress is set to ban most surprise medical bills

#82

Post by [deleted] » Mon, Dec 21, 2020, 4:47 PM UTC

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…

[deleted]

Re: Congress is set to ban most surprise medical bills

#83

Post by freeone3000 » Mon, Dec 21, 2020, 4:48 PM UTC

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…

The courts can only act where there is law. It's a legal system, not an inherent fairness system -- current law upholds the status quo, which is why this measure passing is good news.

Re: Congress is set to ban most surprise medical bills

#84

Post by chapium » Mon, Dec 21, 2020, 4:48 PM UTC

When we had our first child, we carefully selected a pediatrician that was covered by our insurance. It turns out that doctor was only billable to our insurance for delivery, any follow up visits were not covered by the insurer because that same doctor was not considered part of that hospital org. The org she did routine pediatric work was somehow different, yet in the same building. We discovered this as we were leaving the hospital and scheduling a follow up visit. It was very urgent since we had a moderate complication and need a doctor immediately. However our insurer (employer provided) was blacklisted by the doctors group that all doctors in our neighborhood were a part of. Ultimately, on short notice we found a new pediatrician an hour away which began ordering lab work. This is not something you want to go through with a newborn and a new mother. It was also bullshit, because we were hit with a surprise caveat to our researched doctor so late in the process even though we had been trying to do our due diligence to get things squared away months in advance.

This was all because our insurer decided that our doctor was billed by different rules depending on what part of the job she was doing for the same patient. I've been an ardent supporter of single payer ever since.

Re: Congress is set to ban most surprise medical bills

#85

Post by yboris » Mon, Dec 21, 2020, 4:49 PM UTC

cdjk wrote: post #19

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…

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…

> Try getting a price for a procedure or visit beforehand

"I tried to find out how much my son’s birth would cost. No one would tell me." [0]

[0] https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bi...

Re: Congress is set to ban most surprise medical bills

#86

Post by comeonseriously » Mon, Dec 21, 2020, 4:50 PM UTC

lacker wrote: post #76

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…

We don't have a free market in health care at all. In a free market you would be able to buy a coronavirus vaccine right now, instead of waiting months to get it for free. We haven't had a "free market" in health care in my lifetime.

Instead, we have people like @marcorubio, who downplayed the virus, jumping to the head of the line.

Re: Congress is set to ban most surprise medical bills

#87

Post by zaroth » Mon, Dec 21, 2020, 4:53 PM UTC

This essentially takes the patient out of the loop if one of the providers is not in-network / being directly reimbursed by insurance. Now the provider and insurance company have to work together to resolve the bill. Most importantly it would be charged against the patient’s in-network deductible.

It’s really too bad that this bill was watered down in one particular way. The Senate version of the bill would have set the price as the median in-network price for the procedure/service in that market (which ~5x the price that Medicare would pay). Out of network prices are usually another ~5x higher than in-network prices. House Democrats instead pushed for the rate to be set in arbitration, which is the version that will be enacted.

https://www.forbes.com/sites/theapothecary/2020/02/19/house-...

Re: Congress is set to ban most surprise medical bills

#88

Post by lotsofpulp » Mon, Dec 21, 2020, 4:54 PM UTC

yboris wrote: post #85

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…

> Try getting a price for a procedure or visit beforehand "I tried to find out how much my son’s birth would cost. No one would tell me." [0] [0] https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bi...

The answer is always “your out of pocket maximum” if it’s all done with in network providers, and infinity if any out of network providers are involved.

Re: Congress is set to ban most surprise medical bills

#89

Post by campl3r » Mon, Dec 21, 2020, 4:54 PM UTC

dpeck wrote: post #28

curiousgal wrote: post #21

Earlier quoted context omitted.

It's just appalling to see a nation as smart, rich and well accomplished as the U.S. being straight up retarded when it comes to healthcare.

That is inappropriate word choice here or anywhere. Remove your slur.

How so?

Re: Congress is set to ban most surprise medical bills

#90

Post by c22 » Mon, Dec 21, 2020, 4:54 PM UTC

OkGoDoIt wrote: post #56

c22 wrote: post #38

Earlier quoted context omitted.

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

Is this a snarky comment or is this an actual experience that’s happened to you or someone you know? I’m genuinely curious, I can definitely imagine hospitals trying something like this…

I've never "interrogated" a medical professional about their in or out of network status, so I have no first hand knowledge. But I have been charged their ridiculous hourly rates for 5-10 minute "consultations" so I have no reason to believe they wouldn't charge you for this.