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

Re: Congress is set to ban most surprise medical bills

#121

Post by herbstein » Mon, Dec 21, 2020, 5:22 PM UTC

jsperson wrote: post #48

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…

> The existing health insurance industry is far from free market. Try getting a price for a procedure or visit beforehand. Oh, I know. I've tried getting prices in the past. Traditional providers can't do it. One thing that has opened my eyes is using a Direct Primary Care (DPC) provider. I pay $75 a month for direct access to my doctor (email, text message, cell phone etc.). The access is great, but an unexpected si…

> Other countries seem to have solid solutions for "socializing" medicine

What baffles me the most is that most "socialized" systems functions much like a tax-paid insurance policy that covers everything and has no profit motive.

Even in a normal insurance situation you're "paying for someone else's treatment". That's the whole point of insurance.

Re: Congress is set to ban most surprise medical bills

#122

Post by nickthemagicman » Mon, Dec 21, 2020, 5:23 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…

I've been saying this for a long time.

Supply and demand don't apply to healthcare.

You can only adjust supply.

Peoples demand for their health is infinite.

Re: Congress is set to ban most surprise medical bills

#123

Post by mattkrause » Mon, Dec 21, 2020, 5:24 PM UTC

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)

I asked my new dentist why her recommendations were so different from her predecessor.

She said that there's not always one "correct" treatment. Some dentists will try to nip potential problems in the bud, lest they get worse. Others have more of a wait-and-see attitude which can avoid some procedures but make others worse.

Doctors, plumbers, builders, and mechanics all do the same thing. Do you replace the brake pads now, while the wheels are off anyway, or do you squeeze another season out of them since there's still a bit left? Rebuild the whole deck, or maybe just replace the more banged up boards and wobbly railing?

Re: Congress is set to ban most surprise medical bills

#124

Post by jccooper » Mon, Dec 21, 2020, 5:25 PM UTC

colejohnson66 wrote: post #98

lacker wrote: post #78

Earlier quoted context omitted.

Yeah, we got a bill from the hospital once with a footnote saying, some of these procedures may have actually been for another patient, not for you, we don't have complete records. But your insurance agreed to pay it, so we recommend you don't worry about it.

How is that not straight up fraud? If you don’t know if a procedure was for me or someone else, you’re lying by billing me!

Insurance and hospitals basically do bulk deals. Insurance is probably paying for the service one way or another, so they don't care much to whom the record is attached. And if you're not out of pocket, doesn't matter much to you either.

Re: Congress is set to ban most surprise medical bills

#125

Post by RHSeeger » Mon, Dec 21, 2020, 5:25 PM UTC

mehrdadn wrote: post #18

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…

> What are you supposed to do, interrogate every person that comes in the room? I'm curious too. Some people must have tried filing a lawsuit... what do judges think people should be doing?

I had to go into surgery last year and had to sign a "I will pay whatever my insurance doesn't" form. I wrote in a clause saying that any out of network elements (persons, etc) must be personally approved in writing by myself or my proxy before they can do anything they bill for. I don't know if it would have held up in court, but it made me feel a little safer.

Re: Congress is set to ban most surprise medical bills

#126

Post by adamredwoods » Mon, Dec 21, 2020, 5:26 PM UTC

jsperson wrote: post #48

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…

> The existing health insurance industry is far from free market. Try getting a price for a procedure or visit beforehand. Oh, I know. I've tried getting prices in the past. Traditional providers can't do it. One thing that has opened my eyes is using a Direct Primary Care (DPC) provider. I pay $75 a month for direct access to my doctor (email, text message, cell phone etc.). The access is great, but an unexpected si…

Lab costs are outsourced, and they charge separately from a doctor's bill. Biopsies are completely separate as well.

Re: Congress is set to ban most surprise medical bills

#127

Post by what2build » Mon, Dec 21, 2020, 5:26 PM UTC

StreamBright wrote: post #110

bfieidhbrjr wrote: post #57

Earlier quoted context omitted.

There's no "market" in healthcare in the US. Long ago, it became illegal to open a hospital without a 'certificate of need' from the State. That's why so many towns have only one hospital - it's a government granted monopoly like cable companies in the 80s. Differential pricing is also illegal. You fly cheap on Sunday at 3am, expensive on Monday at 9am. Healthcare providers are not allowed to charge less when it's ch…

Exactly. Many people think that free market healthcare is bad because the US healthcare system. Once you are pointing out it is not a free market system they are surprised. The 20% profit cap also not very open market like.

The so-called by many, Father of Capitalism, Adam Smith, only defined market in terms of a free labor market.

He also wrote that whatever type of government existed in a nation, it would likely need to enforce equality of condition to avoid what we’d call monopoly of labors agency.

He was openly hostile to extreme division of labor, paraphrasing, it would turn humans into the dumbest creatures to ever exist.

Labor hardly seems free when Fed policy has been to tighten screws on workers, growing worker insecurity, to keep them circling back to that cubicle every morning: https://www.nytimes.com/1997/02/27/business/job-insecurity-o...

Look at that. Hundreds of years ago humans realized exactly what humans are capable of emotionally and warned against it.

Reminds of me of the ancient Greeks who, again paraphrasing, wrote they hope the rubes do not some day realize there are no gods atop Olympus. Just men on thrones manipulating their fears.

Re: Congress is set to ban most surprise medical bills

#128

Post by jschwartzi » Mon, Dec 21, 2020, 5:27 PM UTC

mauflows wrote: post #112

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…

I've become more staunchly single payer after I had my first major medical hurdle of my adult life this year. I had switched insurance in January, but apparently my old insurance had a bug in their system. The effect was that they were accepting my claims, but then denying them. So I had to coordinate both insurances and get them on the same page. Then I had to call every one of my many providers, get them to underst…

Imagine having to do this every time you change jobs.

Re: Congress is set to ban most surprise medical bills

#129

Post by mattkrause » Mon, Dec 21, 2020, 5:28 PM UTC

HeyImAlex wrote: post #70

I had to provide a urine sample to get my ADHD medication. It was sold to me under the auspices of drug testing, even though ADHD meds are out of your system in 48h. A month later I received an explanation of benefits from my insurance company that said they received a 14k bill and had paid 4k of it, so I was on the hook for the other 10k. Furious I went to my psych. They casually said “we’ve taken care of it, you sh…

At $14k/test, they could nearly afford to buy a used but functional GSMS system system just for you(!).

Re: Congress is set to ban most surprise medical bills

#130

Post by Triv888 » Mon, Dec 21, 2020, 5:29 PM UTC

I don't pay surprise bills ... (and I don't think it affects my credit because I had a couple in the last year and my FICO score is still at about 800) ... I'm not going to pay a random bill that comes 3 months after a doctor's visit that they never told me about and I already paid $400 for the emergency 30-min visit (not sure what the insurance paid)