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Majority of debtors to US hospitals now people with health insurance

theguardian.com

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Re: Majority of debtors to US hospitals now people with health insurance

#171

Post by mindslight »

devilbunny wrote: post #163
mindslight wrote: post #150

Earlier quoted context omitted.

Your explanation doesn't seem like anything but a well polished justification for what is ultimately a dubious shakedown. Without actually consulting with a patient and agreeing upon pricing well ahead of a scheduled surgery, you have absolutely no business requesting any payment directly from them. These billing charades revolve around some utterly perverse idea that obtaining someone's identifying information someh…

> Without actually consulting with a patient and agreeing upon pricing well ahead of a scheduled surgery, you have absolutely no business requesting any payment directly from them. Well, if you want to turn this into a rant on how incredibly backward the way things are done is, I'll agree with you that it's a terrible method. But it is the way things work. Don't believe me? Ask your insurance company. Your deductible…

> But it is the way things work

Sure, it's the way things are done. What I'm questioning is why it should even be expected to "work", apart from people's seemingly misguided sense that what essentially amounts to a request for a tip is somehow a binding debt they're obligated to pay. What you've described is the exact same set up as a waiter at a restaurant. And yet despite waiters often handling identifying information, nobody gets a post-hoc bill in mail asking for arbitrary table service fees. And if some waiter did try this hustle, the recipient would likely roll their eyes and toss it in the bin.

> Your deductible is not payable to the insurance company; they require the billing entity to collect it themselves

Sure. I wouldn't call this backwards - rather inconvenient but still legally sound. The provider enters into a contract with the "insurance" company that requires this. The customer enters into a contract with the provider by requesting and using their service, so the provider can bill the customer.

What you (and most of the industry) are somehow claiming is that even though the patient already has a business arrangement with the hospital for treatment, that the hospital calling in a subcontractor means that subcontractor is somehow entitled to bill the patient directly despite having no business relationship.

Re: Majority of debtors to US hospitals now people with health insurance

#172

Post by wolverine876 »

yunwal wrote: post #159
crazygringo wrote: post #103

Earlier quoted context omitted.

It sure works in a bunch of other countries. I don't think there's anything special about the US that it wouldn't. And it enables things like optimizing for patient outcomes that can't be achieved with private insurance.

The thing that is unique to the US is the level of corruption. Politicians are 100% beholden to corporate interests and nothing else. America’s dominance is entirely reliant on industry, so nothing can be done to upset the big corps.

Is corruption actually worse in the US than in countries with single-payer? I doubt it. Let's stop making excuses for ourselves and get it done.

Maggie Thatcher, who I don't pretend to love, once said (IIRC what I read, paraphrasing), 'Ask military leaders if something can be done, and they'll give you a hundred reasons that it can't. Tell them it will be done and ask how, and you'll get a hundred solutions.'

Adjourn the 'can-we-will-we-it's-so-hard' meeting, and convene the 'how' meeting.

Re: Majority of debtors to US hospitals now people with health insurance

#173

Post by wolverine876 »

verve_rat wrote: post #141
wolverine876 wrote: post #106

Earlier quoted context omitted.

> The illusion of impact by writing to your congressman is really just that, a proverbial carrot in front of the donkey of democracy. This is the hopelessness I'm talking about in the GP. It was edgy and clever to despair, but it's really for losers. Let's get serious; people are dying, democracy is dying; our predecessors managed to achieve great things and there's no excuse for us to sit on the sidelines and whine.

I don't disagree with your fundamental message, but as a non-American watching from the sidelines, what are you doing in a practical sense, other than whining on an internet forum?

I am certainly not whining! :)

Re: Majority of debtors to US hospitals now people with health insurance

#174

Post by meepmorp »

wolverine876 wrote: post #168
crazygringo wrote: post #162

Earlier quoted context omitted.

> EDIT: People need to stop debating whether they are powerless, and the 999 ways they are powerless, the hopelessness of powerlessness - and start posting solutions. Well since you're the one claiming the problem is us , which is a pretty bold accusation -- what's your solution? If you're making accusations that we're not doing enough, what are you doing then? Very curious to hear.

That's a common comeback - and again, it's doing nothing, spinning wheels, talking on the sidelines. The distractions are endless, but there's only one thing to do - get in the game.

It's entirely fair to ask what you are doing if you are exhorting others to action.

Re: Majority of debtors to US hospitals now people with health insurance

#175

Post by positr0n »

wing-_-nuts wrote: post #45
taeric wrote: post #7

That has included me, in the past. It is stupid easy to accidentally have a debt to a hospital. For families, sensible privacy rules at clinics can mean that it is very hard to choke point bills to a single person. To the point that I asked every time if I owed money when I did checkups to be told that we did not. Only to later find that my family did, in fact, have a bill due. For a while. Recently I'm getting it wi…

One thing my mom has been dealing with recently is where the insurance EOB and the bill differs substantially. My mom called the hospital to ask for an explanation and poof the bill is magically lowered by a several hundred dollars. How the heck is this not criminal fraud? Why are people allowed to simply bill whatever they feel like it, and why is my mother getting 'balance billed' for random amounts? They're still…

I had major emergency surgery a couple years ago. The hospital sent me a bill for $9k (out of $135k total) after a few months but the status on my insurance website indicated they were still figuring it out.

I called and asked how they had arrived at the numbers in the bill and the person on the phone basically told me "it looks like someone just guessed, go ahead and ignore the bill and we'll send you a correct one later."

(Resolution: Thankfully I had excellent health insurance at the time. I think I paid a few hundred bucks to the surgeon and that along with prior expenses filled up my yearly out-of-pocket maximum. I never saw another bill from the hospital)

Re: Majority of debtors to US hospitals now people with health insurance

#176

Post by BenjiWiebe »

beaeglebeached wrote: post #146
antisthenes wrote: post #143

Earlier quoted context omitted.

I'd rather pay taxes on $4000 than $0.40

I honestly thought the jig here was lying about the 96k. If the bottle actually costs 96k then I don't begrudge the 4% risk for hauling to the desert.

The jig here is that even though profit is a reasonably slim 4%, the water bottle is being sold at an outrageously high price.

IOW, medical insurance is both expensive and not very profitable because hospitals are charging tremendous sums (and implied that they are overcharging).

Re: Majority of debtors to US hospitals now people with health insurance

#177

Post by BenjiWiebe »

alwa wrote: post #39

Buried midway down, they mention that the commercial health plans available to people without conventional employers (Obamacare) can (and routinely do) set deductibles as high as $9,450. And that’s in addition to the premium-which, in New York City for example, starts at $618/month for the very worst plan for an individual. Sure, that’s subsidized for lower-income households — but who among those has a spare $10K lyi…

Interesting. I am using an obamacare plan (in Kansas). It's in no way an amazing plan, but I only pay single digit (or was it $10, idr) premiums per month, and my deductible is $1200. I've been pretty pleased with obamacare for the three years I've had a plan with it.

Re: Majority of debtors to US hospitals now people with health insurance

#178

Post by BenjiWiebe »

hanniabu wrote: post #16

because insurance doesn't pay full amounts, and often are left with a larger bill than if you didn't have insurance due to the "insurance premiums" that are charged because they know insurance won't approve the full amount

That's what I thought too, but someone who should know told me recently that's illegal (bill more to insurance than what the self-pay amount would be). Is that true or no?

Re: Majority of debtors to US hospitals now people with health insurance

#179

Post by beaeglebeached »

BenjiWiebe wrote: post #176
beaeglebeached wrote: post #146

Earlier quoted context omitted.

I honestly thought the jig here was lying about the 96k. If the bottle actually costs 96k then I don't begrudge the 4% risk for hauling to the desert.

The jig here is that even though profit is a reasonably slim 4%, the water bottle is being sold at an outrageously high price. IOW, medical insurance is both expensive and not very profitable because hospitals are charging tremendous sums (and implied that they are overcharging).

That doesn't explain the denials though. My point was that they're apparently doing mass denials and still barely breaking a profit. It suggests the consumer wouldn't be able to afford the insurance that doesn't, if it's not a small piece of the puzzle, otherwise they'd pay more for that.

Re: Majority of debtors to US hospitals now people with health insurance

#180

Post by wolverine876 »

meepmorp wrote: post #174
wolverine876 wrote: post #168

Earlier quoted context omitted.

That's a common comeback - and again, it's doing nothing, spinning wheels, talking on the sidelines. The distractions are endless, but there's only one thing to do - get in the game.

It's entirely fair to ask what you are doing if you are exhorting others to action.

It's fair, but it's a waste of time. It's fair to pick your nose, but not responsible to your community, the people who built it, and the people who will come after you.
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