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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

#131

Post by JshWright »

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…

> ignoring that it costs £2200 per person

So... less than 1/3rd of what the US pays on a per capita basis? I'd be cool with that...

Re: The Company Behind Many Surprise Emergency Room Bills

#132

Post by moheeb »

eatbitseveryday wrote: post #74
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…

> 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. Curious, can you perhaps provide evidence of this? Seems like a good thing to know. > Call an attorney. This is itself a cost, and maybe only makes sense if you owe ≥ $10k but for procedures billed as $1k when they should be $400 I don't think w…

I agree with dungle6, whose comment is now dead. I say screw them and don't pay. Ignore collections for a few years and don't be a wuss about your credit score. Problem solved.

Re: The Company Behind Many Surprise Emergency Room Bills

#133

Post by jaymzcampbell »

chimeracoder wrote: post #125
richthegeek wrote: post #76

Earlier quoted context omitted.

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…

> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%…

I'm unfamiliar with how the US stats get collected - is that 90% of "everyone who had prostate cancer" survives 5+ years; or is that "everyone who had prostate cancer and private medical insurance"? If so then that is rather shocking.

Prostate cancer may be something of an outlier given the hesitation people have in discussing it. This is something that has only really recently been attempted to be addressed in the UK. Campaigns fronted by comics like Bill Bailey have tried to make it normal to talk about. The British as a society are still so reserved that I imagine thousands die of preventable cancers and diseases simply out of embarrassment.

Edit - I've just had a look at Cancer Research's figures[1], [2] and, using data from 2010/11 - prostate cancer had a UK survival rate of ~84% or so - i.e. nearly the same as the US.

[1] http://www.cancerresearchuk.org/health-professional/cancer-s...

[2] http://www.cancerresearchuk.org/health-professional/cancer-s...

Re: The Company Behind Many Surprise Emergency Room Bills

#134

Post by EliRivers »

madengr wrote: post #14
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…

Yep. Took my wife to the ER last week for suspect appendicitis or diverticulitis. Last time this happened a CT scan alone was $3k ($11k prior to insurance reduction). My HDP is $4,500 OOP max per family member; $8,500 for family. What really pisses me off is that the HSA max contribution has not kept up with family OOP max. I contribute the max every year and can't end up with $8,500 saved. I had a decent insurance p…

They didn't get to be in the fortune 100 by handing out benefits to their resources. Resources are there to benefit the company; not the other way around.

Re: The Company Behind Many Surprise Emergency Room Bills

#135

Post by vkou »

cortesoft wrote: post #20
occultist_throw wrote: post #2

Does anyone know if a lawsuit has been lodged questioning these practices? I've always thought that my informed consent should also apply to cost of procedure - I have a right to say "NO" to something in the medical establishment. And had I known the price and the success rate, I would have said "No". Now, I'm not asking "What is my exact rate?", although that would indeed be nice. But given minimal complications, I…

Lots of patients in the ER are incapacited; either unconcious, in severe pain, or under a serious time constraint to get their problem fixed. They can't just ask about price while unconcious.

And most of them are conscious, in control of their capacities, and may be willing to trade off some time for cheaper treatment. They can't get a quoted price, either.

According to the article, ~50% of hospital admissions today go through the ER.

Re: The Company Behind Many Surprise Emergency Room Bills

#136

Post by sixdimensional »

snuxoll wrote: post #120
sixdimensional wrote: post #83

Earlier quoted context omitted.

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 me…

It's sad but true that we are getting to a point where all we have are standard rants about these topics, but can't find the solution. I'm guilty of the same too.

Stalemate.

We need to go through Kurt Lewin's change model process - "unfreezing, change, and refreezing" and find something better. It's like, we need agile healthcare or something - fail fast and iterate faster... without costing people their lives or their savings. https://en.wikipedia.org/wiki/Kurt_Lewin#Change_process

Re: The Company Behind Many Surprise Emergency Room Bills

#137

Post by dragonwriter »

sehugg wrote: post #58
astockwell wrote: post #43

Earlier quoted context omitted.

It is exactly as crazy as it sounds, unfortunately. But due to many years (decades!) of pre-meditated political maneuvering, one of our political parties has managed to inextricably relate any kind of desire for "single-payer" or "socialized" medical system with effectively being a communist USSR apologist. No exaggeration.

Except for Medicare.

Medicare is not a single payer system (which is why I get confused when sibgle-payer advocates say they want “Medicsre for All”); it's more like “Obamacare with an public option for some services”; the prescription drug program (Part D) is private plans with public subsidy, and Medicare Advantage (Part C) is private plans for public subsidy as well. Parts A and B are public plans for core inpatient and outpatient services, but theres been a big push to Advantage plans (including as a vehicle to handle Medicare/Medicaid “dual eligibles”.)

Re: The Company Behind Many Surprise Emergency Room Bills

#138

Post by dv_dt »

chimeracoder wrote: post #125
richthegeek wrote: post #76

Earlier quoted context omitted.

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…

> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%…

And yet the UK life expectancy is 81.2 vs 79.3 in the US. For men in the two nations, the gap is even bigger - 79.4 vs 76.9.

https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

Re: The Company Behind Many Surprise Emergency Room Bills

#139

Post by Chardok »

notadoc wrote: post #118

What are the specific benefits to having an immensely expensive administrative bureaucracy lodged between the actual patient and actual health care provider? This should be easy to answer and explain.

Shifting costs from the hospitals and insurance to the patients, plain and simple.

This is merely the tip of the iceberg for what for-profit healthcare is developing into. You cannot have sound medical decisions being made when money is so deeply intertwined in the process.

Re: The Company Behind Many Surprise Emergency Room Bills

#140

Post by chimeracoder »

jaymzcampbell wrote: post #133
chimeracoder wrote: post #125

Earlier quoted context omitted.

> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%…

I'm unfamiliar with how the US stats get collected - is that 90% of "everyone who had prostate cancer" survives 5+ years; or is that "everyone who had prostate cancer and private medical insurance"? If so then that is rather shocking. Prostate cancer may be something of an outlier given the hesitation people have in discussing it. This is something that has only really recently been attempted to be addressed in the U…

> I'm unfamiliar with how the US stats get collected - is that 90% of "everyone who had prostate cancer" survives 5+ years; or is that "everyone who had prostate cancer and private medical insurance"? If so then that is rather shocking.

It's looking at people with prostate cancer, regardless of insurance status.

> Prostate cancer may be something of an outlier given the hesitation people have in discussing it.

It's not limited to prostate cancer; for survival rates, the NHS does pretty terribly on almost every form of cancer compared to the US. I picked prostate cancer because it's something that's very treatable - the upper limit is close to 100% for five-year survival, which makes the UK's outcomes that much more unacceptable. But the story is the same for all other common cancers (let alone rare cancers, which the NHS is not optimized as a system to treat).

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