31–40 of 89 posts
There are some good points in here. However, it feels disingenuous with the author being a former surgeon general. "the onus of the entire amount still fell on me due to my high-deductible health plan (HDHP)." I mean, yeah, that's how HDHP works. Anyone in healthcare should understand that.
I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty drugs. CVS insists on calling me to confirm they can ship it to my house. F no! I'm not running an IV for myself. Sort it out with the hospital. Last go around, the hospital coded the drug as coming from their supply instead of CVS so I got a surprise bill for…
I am on an HDHP and arrange my finances and budget with the expectation that I will reach my out-of-pocket maximum. I am thankful that I am in a position to do that. The backside being that I am under enormous constraint in terms of my employer. They literally own my health, as while I am skilled and valued, I doubt that I am skilled and valued enough for another employer to keep me after poaching me away. I would expect something in the off-the-record review comments of "...health care costs are how much!?!?" followed by quiet PIP-and-dismissal or dismissal outright under the laws of my state-of-residence in the United States. Yes, I live in a right-to-work state, meaning that my employment can be terminated at any time, by either party, for any reason, or no reason given at all.
I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty drugs. CVS insists on calling me to confirm they can ship it to my house. F no! I'm not running an IV for myself. Sort it out with the hospital. Last go around, the hospital coded the drug as coming from their supply instead of CVS so I got a surprise bill for…
You joke, but this is what my wife does for her infusion. Drugs get shipped to our house, and nurse comes to the house to administer the infusion. She gets to spend the time on the couch watching TV instead of in a hospital. And as a another indictment to the broken health care system, this is actually cheaper to the insurer!
Earlier quoted context omitted.
I believe that's the way it works. And then you have to transfer to in network provider as soon as humanly possible (perhaps not as humanely possible...)
One of the problems here is that the patient can believe they're at an in-network provider — and be correct about that — and still get hit with "out of network" charges. One of the linked articles[1] explains it slightly better: > Surprise medical bills happen when a doctor or other provider who isn’t in a patient’s insurance network is unexpectedly involved in a patient’s care. Patients may go to a hospital that acc…
What I find interesting is how in OP's original tweet, more than half of the comments blame him for the cost. Shouldn't have gone to that hospital! (it was the closest one). Should've drunken more water! etc. pp. Like the proverbial crabs in a bucket, only pulling each other down. https://x.com/JeromeAdamsMD/status/1761375417351430595
"Shop around" is a great capitalist mantra, except that medical emergencies are pretty obviously a situation where you're absolutely not going to shop around.
I knew full well the ER visit was going to sting, but I had no idea how much. The amount after insurance was almost exactly what was quoted in this article (almost like they plan that). That pretty much maxed out his OOP max, but I'm not wealthy enough that 5k doesn't make me mad. It shouldn't matter, but it feels worse that it was just a stomach bug, so $2 worth of anti nausea meds (that the hospital charged $150 for) was all we got out of it.
Rationally, I don't really see a way out for (possible) emergencies. That care is expensive, and HDHPs are a bit of a gamble that usually pay off if you're healthy. The OOP max ensures you won't be financially ruined, and 'cadillac plans' or gov care just means you pay far more in premiums or taxes for the majority of the years.
Aren't you assuming that the healthcare system operates for the good of the patients? From my point of view, that doesn't seem to be the case in the U.S.
In all these cases, there is one constant: the patients get treated, and treated well. That's not the issue. It operates for the good of the patients (whereas for example, the NHS often gets criticized ...) It's the billing afterwards that's the issue.
Absolutely anyone who’s ever dealt with healthcare system will tell you otherwise. From being denied necessary medical procedures because insurance doesn’t agree with it to subpar quality of care because how stretched the doctors and healthcare professionals are, US medical system is far from treating everyone well.
The incentives in US health care are so upside-down that Americans pay significantly more for the same results as many of the other western nations. While the public systems of the UK and former colonies aren't perfect, they are still significantly cheaper to run for approximately the same outcomes. Ditto for other European countries. I don't understand why this hasn't become a boil-over issue for Americans yet.
Media keeps people distracted with idpol