More doctors are charging fees to respond to patient messages • Hacker News Board

Re: More doctors are charging fees to respond to patient messages

#71

Post by FireBeyond » Fri, Mar 08, 2024, 6:00 PM UTC

EvanAnderson wrote: post #61

smallmancontrov wrote: post #27

Earlier quoted context omitted.

So why is our healthcare twice as expensive as the countries who actually do have socialized health care? When is that competition going to kick in and bring down costs? https://www.healthsystemtracker.org/chart-collection/health-...

Because Americans don't want to let people who can't pay for emergency care die (which I'd argue is a good thing) but also can't have a serious conversation about how to pay for that.

As a paramedic (part-time) and someone who has worked in claims benefit management systems, EMTALA (the rules/laws around emergency stabilizing care) are not what make our healthcare astronomical. It's prescriptions, imaging, and labs. You can easily be charged several thousand dollars for diagnostic imaging. My insurance covers labs 100% but a recent stool sample test charged $780 to see if I had blood in a stool.

Speaking of DI, DI is a money-printing machine, with CT and MRI machines that range from a few hundred thousand to over a million have breakeven points well under two years. And the DI companies work to find and gather physicians who want to start a DI practice. Offer financing, consulting, and then, shockingly, we find that physicians who own a DI practice or a share in one tend to over-refer their patients to imaging.

Re: More doctors are charging fees to respond to patient messages

#72

Post by bilater » Fri, Mar 08, 2024, 6:03 PM UTC

CharlesW wrote: post #4

Here's American health care: • I needed refills for two prescriptions that I've been taking for years. This time, for opaque reasons, I needed to talk to a doctor first. • Fine, but I couldn't accommodate an in-person check-in. I chose a "video visit" that, due to logistics, I had to do while away from home. Because they were a half-hour late, I was effectively forced to do this from the couch of a Costco floor displ…

The whole prescription business is such a grift. Doctors deliberately give you max 2 years of a prescription that you know you will need for longer (such as allergy meds, eye prescriptions) and then you have to waste your time and spend money just to renew it.

Re: More doctors are charging fees to respond to patient messages

#73

Post by mindslight » Fri, Mar 08, 2024, 6:06 PM UTC

annoyingnoob wrote: post #31

You think that is bad. Try working with an attorney, they charge you to read your email and not respond at all.

That's nicer than my experience! My attorney charged me to respond to my emails without reading them. And when the relationship inevitably ran aground at the 11th hour, he feigned ignorance of everything I had been telling him. I do my own low-pressure legal work now.

Re: More doctors are charging fees to respond to patient messages

#74

Post by EvanAnderson » Fri, Mar 08, 2024, 6:07 PM UTC

FireBeyond wrote: post #71

EvanAnderson wrote: post #61

Earlier quoted context omitted.

Because Americans don't want to let people who can't pay for emergency care die (which I'd argue is a good thing) but also can't have a serious conversation about how to pay for that.

As a paramedic (part-time) and someone who has worked in claims benefit management systems, EMTALA (the rules/laws around emergency stabilizing care) are not what make our healthcare astronomical. It's prescriptions, imaging, and labs. You can easily be charged several thousand dollars for diagnostic imaging. My insurance covers labs 100% but a recent stool sample test charged $780 to see if I had blood in a stool. S…

EMTALA (and the ACA) drives the socialism / capitalism bickering that I think is a primary cause of conversations about reform to run aground.

Re: More doctors are charging fees to respond to patient messages

#75

Post by beej71 » Fri, Mar 08, 2024, 6:09 PM UTC

Volundr wrote: post #70

bodiekane wrote: post #58

Earlier quoted context omitted.

Because Obamacare legislation ended up as a terrible version of socialism/pork-barrel spending/crony-capitalism in order to get the required support to pass. The democrats wanted to get subsidized healthcare for low income people and people with existing health issues that would guarantee they would be uneconomical to insure. The healthcare providers, insurance companies and pharma companies wanted to remain viable,…

I'm old enough to remember health care prior to Obamacare, and I can assure you it was broken before too. Frankly the difference I noticed post Obamacare was a friend of mine was able to get insurance in time to not go bankrupt treating her colon cancer. I can't get behind the idea that Obamacare is somehow what broke our medical system.

It was actually worse in that you could be denied health insurance. And I know a lot of people who are denied health insurance for very mundane reasons.

Insurance companies had teams of people who, if you made a substantial claim, would look over your application for anything that was amiss. And if they found it, they'd drop you so they wouldn't have to pay.

Your health record became a criminal record. You just hoped there was nothing on it that would prevent you from getting coverage in the future.

Obamacare has some very serious problems, but at least you can't be denied insurance just because you have back pain.

Re: More doctors are charging fees to respond to patient messages

#76

Post by anon-sre-srm » Fri, Mar 08, 2024, 6:12 PM UTC

bachmeier wrote: post #30

CharlesW wrote: post #4

Here's American health care: • I needed refills for two prescriptions that I've been taking for years. This time, for opaque reasons, I needed to talk to a doctor first. • Fine, but I couldn't accommodate an in-person check-in. I chose a "video visit" that, due to logistics, I had to do while away from home. Because they were a half-hour late, I was effectively forced to do this from the couch of a Costco floor displ…

Back in 2020, my son needed a Covid test for some event related to school. We called his doctor's office and made an appointment for the test. We showed up for the appointment, and we had to wait an extra 20 minutes because the doctor was late, only to be told "we don't do that testing". Then got a bill for $100 for a doctor's appointment.

Change doctors. Don't reward abuse or failure.

Re: More doctors are charging fees to respond to patient messages

#77

Post by D13Fd » Fri, Mar 08, 2024, 6:12 PM UTC

Honestly, I wish I could pay my doctor $25 after insurance and get a prompt response from him to an e-mail. That would be incredible.

As things stand, I have to call. He doesn't take e-mails. If I have a quick question, I can schedule a virtual appointment. There is usually a 2-3 month wait. The appointment is scheduled for a day, not a time, and is limited to 15 minutes. They'll let me know the time about 30 minutes in advance, and it could be any time of day. If I miss or can't make the video call, it's usually another 2-3 months before he has availability again. There are no other doctors with the relevant specialty nearby, so this is what I get.

Re: More doctors are charging fees to respond to patient messages

#78

Post by anon-sre-srm » Fri, Mar 08, 2024, 6:14 PM UTC

danielschonfeld wrote: post #10

CharlesW wrote: post #4

Here's American health care: • I needed refills for two prescriptions that I've been taking for years. This time, for opaque reasons, I needed to talk to a doctor first. • Fine, but I couldn't accommodate an in-person check-in. I chose a "video visit" that, due to logistics, I had to do while away from home. Because they were a half-hour late, I was effectively forced to do this from the couch of a Costco floor displ…

American healthcare is the epitome of capitalism run amok. It’s terrible and the only thing worse than the exorbitant fees is the complete and utter lack of consideration to the patient’s time.

No, the worst part is dying of a painful terminal illness while being sued into bankruptcy in your dying days having to fight to keep minimal possessions because the hospitals and doctors want money.

Re: More doctors are charging fees to respond to patient messages

#79

Post by [deleted] » Fri, Mar 08, 2024, 6:16 PM UTC

freeAgent wrote: post #55

rpearl wrote: post #25

Earlier quoted context omitted.

Typically, when you are talking to a lawyer, you have signed a contract, paid a retainer, and have an explicit hourly rate negotiated for interactions with that specific firm.

Yeah, and typically when you do the same with a doctor the fee you pay has been negotiated with your insurance provider. This is no worse than anything else billing-related in healthcare.

[deleted]

Re: More doctors are charging fees to respond to patient messages

#80

Post by DaveExeter » Fri, Mar 08, 2024, 6:16 PM UTC

Matheus28 wrote: post #46

DaveExeter wrote: post #21

Earlier quoted context omitted.

[flagged]

It’s been a long time since I’ve seen someone say something this wrong on HN. Calling the American health care system socialist in any way is laughable.

That's just a reflection of how thick the wool over your eyes.