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

arstechnica.com

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

#81

Post by hallway_monitor »

pkaye wrote: post #53
pavlov wrote: post #34

Earlier quoted context omitted.

Why doesn't this problem exist anywhere else in the world? The insurance companies have contributed to making American healthcare so dysfunctional. They are not the victims here.

One thing I read is public hospitals seem to be overwhelmed with uninsured patients who often come for emergency care because they have no other options. Private hospitals are able to grab the insured patients. Medicaid funding is not enough to pay for the cost of care for low income patients so hospitals survive on those private insurers to balance the books. There was a recent Frontline documentary about this. http…

So the "free" healthcare provided to ingident people because it's mandated by law causes insane costs on hospital bills for those that actually can pay. As always, obscure requirements and incentives lead to incomprehensibly perverse outcomes. This is why the libertarian standpoint holds so much attraction - anything the government becomes involved in always gets worse.

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

#82

Post by pavlov »

hallway_monitor wrote: post #81
pkaye wrote: post #53

Earlier quoted context omitted.

One thing I read is public hospitals seem to be overwhelmed with uninsured patients who often come for emergency care because they have no other options. Private hospitals are able to grab the insured patients. Medicaid funding is not enough to pay for the cost of care for low income patients so hospitals survive on those private insurers to balance the books. There was a recent Frontline documentary about this. http…

So the "free" healthcare provided to ingident people because it's mandated by law causes insane costs on hospital bills for those that actually can pay. As always, obscure requirements and incentives lead to incomprehensibly perverse outcomes. This is why the libertarian standpoint holds so much attraction - anything the government becomes involved in always gets worse.

What’s the libertarian solution to healthcare? Let people die in the street in front of the hospital if their credit card can’t handle an $18k charge?

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

#83

Post by maxerickson »

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…

How many of those households are on Medicare?

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

#84

Post by maxerickson »

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…

At my local hospital, the ER and walk-in clinic have doors next to each other.

The idea that the ER can't triage non-emergency care is some sort of bureaucratic construction designed to facilitate making money.

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

#85

Post by effingwewt »

hpoe wrote: post #64
hibern8 wrote: post #19

I will never be able to understand a person who doesn't think healthcare is a human right.

Well I don't think it is a human right for the simple reason that medical care is technically a limited resource.l, there is not an infinite supply of doctors or medicine there is a limited supply no matter what that theoretical limit is. Ergo it can't be a human right because it is limited, a right is something that everyone should have. Also what do we mean by "healthcare" is it anyone should be allowed to have any…

Healthcare isn't zero-sum. You aren't not going to receive healthcare because someone else is. Because we don't all get sick/injured at the same.

In any common sense Healthcare is most definitely not a limited resource. In fact, due to more preventative Healthcare options available it would definitely decrease the loads on hospitals.

See- every other developed nation with basic health care.

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

#87

Post by gotostatement »

slownews45 wrote: post #32
gotostatement wrote: post #27

Earlier quoted context omitted.

this has been going on since before COVID https://www.fiercehealthcare.com/payer/big-name-payers-earne... In particular see the chart that shows 2018 and 2019 profits

These will generally be also tied to various govt programs that are getting milked and are not market driven. You'll have honest / primary care providers going bust under Medicare / Medical and folks who get aggressive on billing / switch to lucrative areas (medicare advantage is mentioned) and milk like crazy. Large corps shop and cost shift to employees who also shop on price etc so margins are poorer there (where…

None of what you're saying has anything to do with the issue. The situation is that UHC is posting record profits but they are trying to implement a cost-cutting policy that will punish patients who make the "mistake" of not retroactively knowing their symptoms did not represent an emergency. All your points are about unscrupulous doctors but this policy punishes the patients, not the doctors.

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

#88

Post by toss1 »

fouric wrote: post #63
toss1 wrote: post #46

Earlier quoted context omitted.

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,…

> sworn testimony before congress Citation please?

Just Google "health insurance recision congressional testimony". There were many, many hours of testimony about the dishonest practice.

It was systemic in the industry before it was banned by the ACA/Obamacare. This is one of the most important features of the ACA.

I've posted below only one of the first appearing links to articles on the testimony of industry insiders [1]. I don't have handy the link to the video I found most memorable. It was a woman who worked at a large insurer, who rescinded the insurance of a man with an expensive disease, who'd never missed a payment, and who died fighting to get the insurer to pay. so he could get treatment. She felt badly enough about it to testify, and was also promoted for saving the company money.

Just because it sounds outrageous and dishonest does not mean that people won't do it.

[1] https://abcnews.go.com/Business/Health/story?id=7911195&page...

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

#89

Post by slownews45 »

pavlov wrote: post #82
hallway_monitor wrote: post #81

Earlier quoted context omitted.

So the "free" healthcare provided to ingident people because it's mandated by law causes insane costs on hospital bills for those that actually can pay. As always, obscure requirements and incentives lead to incomprehensibly perverse outcomes. This is why the libertarian standpoint holds so much attraction - anything the government becomes involved in always gets worse.

What’s the libertarian solution to healthcare? Let people die in the street in front of the hospital if their credit card can’t handle an $18k charge?

Most other countries offer a baseline of health care that DOES NOT go to extraordinary lengths (ie, 10M) that is free to everyone. They pay those doctors a salary, often also cover the medical education for them etc.

Then people can and do pay on top of that for private care. Super wealthy are in their own system, many others go for basic stuff to public option but might pay privately for speed / fancier results.

This mirrors libertarian model in most cases.

The US is a bit unique. For example, end of life care is both fully covered in most cases and insanely expensive - we spend far more than many other countries on things like last 3-6 months of life doing "heroic" measures, full intensive care etc etc. Again very lucrative to hospitals so don't see it stopping, but yes, other countries do not do this unless you pay yourself.

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