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

Biggest health insurer plans to deny ER bills if it doubts you had an emergency

arstechnica.com

Post reply on HN
Print view View original

41–50 of 89 posts

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#41

Post by jvanderbot »

ping_pong wrote: post #9

What a bunch of fucking scumbags. Politicians need to step in and make this illegal. This industry is disgusting. Now you are talking about regular people trying to self diagnose to avoid going to the ER in fear of getting a large medical bill. Fuck these people.

When is the last time you went to an ER? We went recently in southern california, and it was saturated by people stopping in for sniffles, flu, and other things that should have been handled in a regular doctor visit. The nurse said as much when we asked if we should go somewhere else for (what turned out to be) an actual emergency. We got right in, thanks to triage.

Is this related to the article? Probably not. But I never get enough chances to point out the myriad abuses and misuses of the health care system.

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#42

Post by gpm »

dahdum wrote: post #17

While I have no sympathy for the insurance companies, many hospitals are all too eager to gouge the hell out of emergency services and resist attempts to reduce costs. It's where you get slammed with out-of-network specialists.

So what, that's not something under the patients control. You (as a society) can't (morally) go "oh, well some hospitals are malicious, so we're just going bankrupt random people who get unlucky".

The insurance companies should lobby to make that illegal, if it's already illegal lobby to have that law enforced (if criminal) or take them to court (if civil) or both (if both). In the meantime they shouldn't be shifting the liability to the patients.

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#43

Post by andrewmcwatters »

schaefer wrote: post #14

I was born in the USA, but every day I question if I will be able to afford to retire in this country, or if I need to plan to emmegrate elsewhere while I still can. My primary concern is healthcare costs. How am I supposed to budget for healthcare costs during retirement when it's already so complicated. 530,000 American households are bankrupt each year due to medical costs [1]. It seems like the most complex piece…

Some few months ago I was trying to think of some sort of asset protection vehicle to prevent medical organizations from seizing everything I own in the event I face some catastrophic health issue. I don't think you can transfer property to a trust to shelter you from such events, though. They'd just go after the trust as far as I know.

The bigger issue is that I shouldn't have to think about this sort of problem in my emergency or estate planning.

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#45

Post by handrous »

derbOac wrote: post #11
netizen-936824 wrote: post #6

Earlier quoted context omitted.

Are there cases in which a rash is a legit emergency?

Yes, depending on the scenario. MRSA and other bacterial infections are good (and unfortunately too common) examples.

Yep, the gap between the point where most people would start to think a skin-infection-caused rash is bad enough that they might need help, and the point at which it's moved deeper in the body and begun to infect other tissue, can be pretty damn short, and by the time you've noticed (say) joint aches or immobility, it may be too late for simple solutions. If you've hit that point on a Saturday morning but think "well it's the weekend, I'll try to see my doctor on Monday" but then it's looking really bad by Saturday night (not implausible) and you can't get to an urgent care for whatever reason (none nearby, or just not open), you really don't want to wait until Monday to have a professional look at it. ER's not a crazy choice. If it's truly bad that's where the urgent care will probably send you, anyway.

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#46

Post by toss1 »

ping_pong wrote: post #9

What a bunch of fucking scumbags. Politicians need to step in and make this illegal. This industry is disgusting. Now you are talking about regular people trying to self diagnose to avoid going to the ER in fear of getting a large medical bill. Fuck these people.

Yup, these are the same people who run software to scan for plausible errors in past insurance applications, focusing on people who get the most expensive diseases, then use those errors (e.g., a misstatement or omission of a completely minor and unrelated condition or treatment), as a pretext to now deny coverage.

So, not the patient, who has played by the rules their entire life, and properly paid into the system, is now literally fighting for their life, probably without a job, and is now denied the healthcare that they had paid for their entire life.

And when a case manager denies their claim and saves the company $500K, they get promoted for killing the patient.

This is not rumor. This is sworn testimony before congress.

"Fuck these people" indeed!! (except they may no longer qualify as people)

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#47

Post by ceejayoz »

jvanderbot wrote: post #41
ping_pong wrote: post #9

What a bunch of fucking scumbags. Politicians need to step in and make this illegal. This industry is disgusting. Now you are talking about regular people trying to self diagnose to avoid going to the ER in fear of getting a large medical bill. Fuck these people.

When is the last time you went to an ER? We went recently in southern california, and it was saturated by people stopping in for sniffles, flu, and other things that should have been handled in a regular doctor visit. The nurse said as much when we asked if we should go somewhere else for (what turned out to be) an actual emergency. We got right in, thanks to triage. Is this related to the article? Probably not. But…

> We went recently in southern california, and it was saturated by people stopping in for sniffles, flu, and other things that should have been handled in a regular doctor visit.

This is likely due to an inability to access "regular doctor" care. Either for lack of insurance (which they can't afford), or a giant deductible (which they also can't afford). The doctor's office can turn them away for an unpaid bill; the ER cannot.

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#49

Post by musicale »

jvanderbot wrote: post #41
ping_pong wrote: post #9

What a bunch of fucking scumbags. Politicians need to step in and make this illegal. This industry is disgusting. Now you are talking about regular people trying to self diagnose to avoid going to the ER in fear of getting a large medical bill. Fuck these people.

When is the last time you went to an ER? We went recently in southern california, and it was saturated by people stopping in for sniffles, flu, and other things that should have been handled in a regular doctor visit. The nurse said as much when we asked if we should go somewhere else for (what turned out to be) an actual emergency. We got right in, thanks to triage. Is this related to the article? Probably not. But…

As I understand it, it's not primarily an abuse of the system by greedy and wicked freeloaders, but a very predictable result of the lack of safety net coverage in the US.

Specifically, people without insurance end up at the ER because the ER can't legally turn them away for not having insurance or not being able to pay.

Another predictable consequence is patient dumping, where patients who cannot pay at one hospital are sent to the ER at another.

Re: Biggest health insurer plans to deny ER bills if it doubts you had an emergency

#50

Post by avereveard »

majormajor wrote: post #35
netizen-936824 wrote: post #6

Earlier quoted context omitted.

Are there cases in which a rash is a legit emergency?

That sounds like a question for a doctor. If something happened in the middle of the night to you, where you would find a doctor in the middle of the night if not at the ER?

Just copy Italy, we have a backup for the primary care/general practitioner under the form of Guardia medica, which does the same level of triage they'd do but in night shifts
Post reply on HN