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The Company Behind Many Surprise Emergency Room Bills

nytimes.com

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Re: The Company Behind Many Surprise Emergency Room Bills

#111

Post by mistermann »

jackmott wrote: post #65
coreyp_1 wrote: post #22

I am having problems with my insurer at this very moment. I went to an in-network hospital for an ER visit, which turned into an 8-day stay (yes, it was serious). Evidently, none of the doctors at the hospital are in-network, however, (claims from various technicians are still "in processing", so I don't know how they will turn out) despite the fact that the hospital itself is definitely in-network. I had no choice a…

vote for candidates who will support single payer.

Changing things so all taxpayers are getting robbed rather than just the individual being treated seems like a sub-optimal solution.

Re: The Company Behind Many Surprise Emergency Room Bills

#112

Post by jaymzcampbell »

richthegeek wrote: post #76
jaymzcampbell wrote: post #31

Earlier quoted context omitted.

Fellow European (UK) here. From what I understand one argument often given, is that there's a mistrust of the government for anything like this and people prefer to "shop" for it themselves. By making their own choice (even if all that actually means is picking from 1 or 2 options given to them by their employer) - they feel empowered and in control of it. There is a general feeling of "if you want it, pay for it". T…

Unfortunately the NHS is, in many ways, pretty bad. They're pretty good at dealing with pregnancies, cancers, and emergencies but try getting seen for a chronic pain and you'll follow this rough timeline: - Try see your GP. Wait 2 weeks until your appointment. - GP will give a cursory examination and recommend a dietary change, taking ibuprofen/paracetamol, and to come back if problem persists. - Problem persists. Bo…

This is very true, but, what saddens me the most is that rather than attempt to fix it (for all of society), the failings are used as an excuse to push further privatisation.

It feels to me that we in the West are going ever faster backwards over fairness in issues like education, health and housing. I'm lucky to be well off & healthy enough to not (yet) be affected by a poor performing NHS but I wish we, as a country, would pull together on this - from top to bottom. Unfortunately, I just don't see it happening anytime soon, we seem to be increasingly more divided - religiously, economically, politically - than ever before.

Society feels increasingly like a "Mad Max" movie in operation. This is only going to end badly for everyone. There is way too much "me me me" from all levels. I find it emotionally exhausting to think about.

I don't begrudge anyone who has the means to get private health care from doing so (my girlfriend and many friends do) - so please don't think I am saying nobody should - I just wish there was a more proactive and pragmatic desire to fix the root issues. Of course, I realise I am living in cloud cuckoo land on that.

I should add that I can certainly empathise and can agree with your comment about chronic pain. My father is suffering from sciatica and it has been over a year to get an operation scheduled. This will involve him travelling from Northern Ireland to the Midlands because there is an even longer (multi year) wait to be seen in NI.

Re: The Company Behind Many Surprise Emergency Room Bills

#113

Post by dungle6 »

istorical wrote: post #10
rwmj wrote: post #4

Over here (in Europe) we get the impression that US has such a crazy healthcare system. Why aren't people marching in the streets? Is it not as crazy as it sounds for most users? If you're taken to ER how are you supposed to know if the doctors are all part of "your network" (whatever that even means)?

Because those in the middle and upper class have employer-paid health insurance which protects from the worst of bills. You only go bankrupt if you're uninsured and usually only those in the lower-middle or lower class are uninsured. And those in the lower echelon of society economically are those least able to have the time or money to march or lobby for change.

Those in the lower echelon of society are unfortunately too stupid not to support powerful groups that have the opposite of their best interests in mind. Ie not many rural poor or lower class support single payer -- the support mostly comes from middle and upper middle class.

Re: The Company Behind Many Surprise Emergency Room Bills

#114

Post by heartbreak »

mistermann wrote: post #105
ydt wrote: post #70

Earlier quoted context omitted.

I had this same thing happen. My daughter was admitted via ER and it turned into a 6 day stay. At the end we received a bill for 40k for being out of network. Luckily I have friends in the industry and it turns out if they fail to inform you within 48 hours that you're not in network you don't have to pay the out of network cost. We ended up paying just our deductible after a letter was drafted. Do not take what the…

Can someone knowledgeable on the subject comment on whether the "Obamacare movement" has been up front in acknowledging this aspect of the problem with health care in the US? My perception is that the problem is typically framed as a lack of insurance problem for financially challenged people, but the "abuse" on the billing side to me seems like at least as big of a problem. And if this is being conveniently ignored,…

Well the progressives including President Obama pushed for single payer (or a public option) which would eliminate abuse on the billing side, at least to the insured.

Re: The Company Behind Many Surprise Emergency Room Bills

#115

Post by mistermann »

mikeash wrote: post #86
rwmj wrote: post #4

Over here (in Europe) we get the impression that US has such a crazy healthcare system. Why aren't people marching in the streets? Is it not as crazy as it sounds for most users? If you're taken to ER how are you supposed to know if the doctors are all part of "your network" (whatever that even means)?

Decades of propaganda has convinced half our electorate that the US's system is the best in the world, and that countries with socialized medicine are hellholes where you have to wait months to get a broken bone looked at.

Similarly, decades of propaganda in Canada has convinced far beyond half our electorate that the Canadian system is the best in the world even though you actually do have to wait several months for treatment if your issue is not "urgent", the definition of urgent being unknown.

Re: The Company Behind Many Surprise Emergency Room Bills

#116

Post by dv_dt »

cortesoft wrote: post #15
pascalxus wrote: post #3

So, basically, if you visit any emergency room then your handing them a blank Check and they can write whatever number on there they want. That's egregious beyond belief. I'm never one to call for legislation and price controls, but in the face of such adversity, I think it may be our last hope. I think they should either provide a quote before they offer the services or there should be a law limiting the amount that…

This is the fundamental problem of treating healthcare like any other market distributed good; you just don't have the ability to use consumer choice. People using an emergency room are not in a position to negotiate price or seek an alternative service. An unconcious accident victim can't say, "That price is crazy I am going to the hospital across town." Single payer is the only viable solution.

> Single payer is the only viable solution.

I would say single payer, or a single regulatory arbiter of procedure and drug prices (within a multi payer context).

When you look at the healthcare costs GDP, the single payer systems still tend to come out ahead multi-payer + regulatory oversight (its one more level of abstraction you pay a complexity cost for...).

Re: The Company Behind Many Surprise Emergency Room Bills

#117

Post by maxxxxx »

TheCoelacanth wrote: post #104
ballenf wrote: post #55

Earlier quoted context omitted.

Germany is two-tier. Public health for the masses, private for those making over 80k or so and healthy. The public system premiums are a % of income. The private is a flat cost, so as you make more become much more attractive (even costing less in many cases). Doctors are sometimes private only or have separate private insurance waiting rooms. Hospitals have separate public and private rooms/beds, etc. It's a two-tie…

Aren't the public premiums only a % of income up to a certain cap? So it's not like super high income people would pay an outrageously huge amount to use the public system, they would just potentially pay somewhat more than they would if they got private insurance.

Correct.

Re: The Company Behind Many Surprise Emergency Room Bills

#119

Post by [deleted] »

richthegeek wrote: post #76
jaymzcampbell wrote: post #31

Earlier quoted context omitted.

Fellow European (UK) here. From what I understand one argument often given, is that there's a mistrust of the government for anything like this and people prefer to "shop" for it themselves. By making their own choice (even if all that actually means is picking from 1 or 2 options given to them by their employer) - they feel empowered and in control of it. There is a general feeling of "if you want it, pay for it". T…

Unfortunately the NHS is, in many ways, pretty bad. They're pretty good at dealing with pregnancies, cancers, and emergencies but try getting seen for a chronic pain and you'll follow this rough timeline: - Try see your GP. Wait 2 weeks until your appointment. - GP will give a cursory examination and recommend a dietary change, taking ibuprofen/paracetamol, and to come back if problem persists. - Problem persists. Bo…

[deleted]

Re: The Company Behind Many Surprise Emergency Room Bills

#120

Post by snuxoll »

sixdimensional wrote: post #83
snuxoll wrote: post #72

Earlier quoted context omitted.

> Props go to the hospital system for taking back their coding after they realized what the third party was doing, but the reality is, it was probably financially benefiting the hospital system too. I doubt the hospital system got anything from it, physician groups usually keep all their revenue from professional services claims - the hospital gets paid whatever they do for their facility claim regardless of what the…

It's possible you're right. Without knowing the details of the relationship, you never know. The reason I say that is the article points out another glaring issue - the shortage of ER docs that we are currently facing. I know this first-hand, as I have a family member who is one and is working harder than ever. Some of these arrangements are to make up for the shortage, and the hospital systems and physician groups a…

> It's possible you're right. Without knowing the details of the relationship, you never know.

This is true, and being a mere software developer I'm in the dark on the contents of any of the contracts my parent company has with facilities either.

> The reason I say that is the article points out another glaring issue - the shortage of ER docs that we are currently facing. I know this first-hand, as I have a family member who is one and is working harder than ever.

Insert my standard rant about restricted med-school/residency admissions and cost of tuition here.

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