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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

#341

Post by joshuaheard »

thephyber wrote: post #268
joshuaheard wrote: post #185

Earlier quoted context omitted.

Ask Charlie Gard how single payer is working out for him.

Single payer wasn't the problem with his case. No health insurance company would have voluntarily paid for an experimental treatment for him. The state has power, even in the USA, to make decisions for the benefit of children if the state decides that the parents aren't acting in the best interest of the child. There is a perfectly valid argument to be made that the state should not have intervened (this is subjectiv…

In the U.S., the doctors do not have standing to appear in court and order treatment, or non-treatment, for a patient. That is solely up to the family, and if there is no family, the court appoints a guardian. There is no way this situation could have happened in the U.S., where the parents were forbid to pay for own treatment.

I think it does concern single-payer. I can only think of the quote, "A government powerful enough to give you everything you want, has the power to take everything you need away". In this case, where the government controls healthcare, it can make decisions for you, even if that is not what you want, or are willing to pay for yourself.

Re: The Company Behind Many Surprise Emergency Room Bills

#342

Post by tptacek »

KekDemaga wrote: post #338
tptacek wrote: post #334

Earlier quoted context omitted.

Can you cite a source for that claim?

You need a source for "people care more about their family budgets than percentages of GDP spent on healthcare"? Take a look on how the middle class voted last election. As for the increase premiums are up 25% in 2017 alone. At the same time deductibles are also rising, its much more money for much less coverage if you are unlucky enough to make over 50k a year or so. http://fortune.com/2016/10/25/obamacare-insurance…

No, I need a source for "the rate of cost increase is steeper under the ACA than it was prior to the ACA".

Re: The Company Behind Many Surprise Emergency Room Bills

#343

Post by isostatic »

Devthrowaway80 wrote: post #291
mistermann wrote: post #235

Earlier quoted context omitted.

> It works in every other developed nation in the world The cost side works in every other developed nation? Surely you're aware of how much more expensive health care costs are in the US, so what might you be referring to?

Yes, I am aware. One of the benefits of single-payer is the reduction in cost of administration. There are other effects as well - nobody is getting away with billing $600 for a 5 minute visit, for instance.

Friend of mine ended up in hospital in the US for a while. He had an accountant visit him at his bedside! WTF does an accountant have to do with healthcare?!

Re: The Company Behind Many Surprise Emergency Room Bills

#344

Post by tptacek »

0xbear wrote: post #340
dankohn1 wrote: post #316

Earlier quoted context omitted.

Because premium growth actually has slowed since Obamacare was passed: http://www.factcheck.org/2015/02/slower-premium-growth-under...

Of course they do. Raise the deductible 5-10x and you can claim some pretty interesting "premium reduction" numbers.

Deductibles haven't 5x'd (let alone 10x'd) under the ACA, which, for what it's worth, caps deductibles. Before Blue Cross made it annoying to do this, we did the standard HSA+HDHP plan (most young families should HSA+HDHP), and it was a little annoying getting a bronze plan from BCBS with a deductible high enough to qualify as an HDHP for our HSA.

Re: The Company Behind Many Surprise Emergency Room Bills

#345

Post by zghst »

notyourday wrote: post #302
protomyth wrote: post #213

Earlier quoted context omitted.

Billing abuse (care provider) and billing fraud (bad agents) are two aspects of the system that need some serious time devoted to them. My thought experiment for some of this. Suppose the US government had a rider on every insurance policy in the US that said the government would pick up the tab for any amount over say $100,000 (think catastrophe insurance). Now, you would make the assumption that looking at the actu…

> Billing abuse (care provider) and billing fraud (bad agents) are two aspects of the system that need some serious time devoted to them. We have a solution. It is called "make it a personal criminal liability". Go after individuals. No matter how low they are on a totem pole and no matter how high they are on a totem pole. Committing such fraud should lead to bankruptcy ( all assets wiped out ) and jail time. You wo…

Enforcement seems very resource intensive and complex.

Re: The Company Behind Many Surprise Emergency Room Bills

#346

Post by KekDemaga »

tptacek wrote: post #342
KekDemaga wrote: post #338

Earlier quoted context omitted.

You need a source for "people care more about their family budgets than percentages of GDP spent on healthcare"? Take a look on how the middle class voted last election. As for the increase premiums are up 25% in 2017 alone. At the same time deductibles are also rising, its much more money for much less coverage if you are unlucky enough to make over 50k a year or so. http://fortune.com/2016/10/25/obamacare-insurance…

No, I need a source for "the rate of cost increase is steeper under the ACA than it was prior to the ACA".

"enrollment-weighted premiums in the individual health insurance market increased by 24.4 percent beyond what they would have had they simply followed trends"

https://www.brookings.edu/wp-content/uploads/2016/07/Fall201...

Re: The Company Behind Many Surprise Emergency Room Bills

#347

Post by deathanatos »

spinlock wrote: post #110
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…

I tried to get a doctor to tell me how much they would bill me for an office visit (not ER) and they kicked me out of the office. It was literally, sign this document agreeing to pay any charge we decide to bill or we will not see you. This was a doctor that I went to only because they were recommended by my insurance company as being in network. They also didn't understand why anyone would even ask the question. The…

I also tried to ask "how much?" on my last doctor's visit. I was looking for a ballpark estimate, not an exact figure. The person at the desk refused to give me one, citing that insurance plans make that too difficult. I insisted that since I was covered by a major insurer that she must surely deal with regularly given their customer base, and that their office was in-network for my plan, she must have some idea, but again, she refused, saying she didn't know.

It's ridiculous, and it should be illegal. At the time, my reason for visiting was a condition that required treatment, so not going to the doctors really wasn't an option. But the inability to even begin to determine what I'm going to pay is ridiculous.

(I did this after a prior visit to a different doctor stiff'd me something like $3k for the use of what amounts to glorified camera. A camera whose photos I never obtained, despite asking for them — to which the doctor replied "we've never had anyone ever ask for that" — i.e., for their medical records. I could understand that medical-grade cameras might not be cheap, but at $3k per use, my gut says money is raining from the sky.)

Re: The Company Behind Many Surprise Emergency Room Bills

#348

Post by dankohn1 »

0xbear wrote: post #340
dankohn1 wrote: post #316

Earlier quoted context omitted.

Because premium growth actually has slowed since Obamacare was passed: http://www.factcheck.org/2015/02/slower-premium-growth-under...

Of course they do. Raise the deductible 5-10x and you can claim some pretty interesting "premium reduction" numbers.

The article I linked to includes links to peer-reviewed research by the Kaiser Family Foundation. They look at the actuarial value (how much of your health costs the plan actually covers) to compare apples-to-apples. If you care about these subjects, I really encourage you to dive in and learn about them, rather than throwing out unsubstantiated anecdotes.

Re: The Company Behind Many Surprise Emergency Room Bills

#349

Post by ozaark »

thephyber wrote: post #255
stronglikedan wrote: post #197

Earlier quoted context omitted.

That applies to any and all insurance - especially mandated insurance policies. The main job of the insurance company is to collect your premiums and the find any way to deny your claims.

As cynical as it sounds, I think I agree with this sentiment even though it's being downvoted. The employees at an insurance company have an ethical responsibility to the company to deny any claims that do not perfectly align with the policy they sold. I don't think every insurance company is the antagonist in The Rainmaker or the car company in Fight Club, but insurance companies will try to reject as many claims as…

No to Rainmaker, but very much aligned with 'car company in Fight Club'.

Re: The Company Behind Many Surprise Emergency Room Bills

#350

Post by Mz »

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,…

The problem isn't abuse on the billing side per se. The problem is that insurance is about risk management. In laymen's terms, it amounts to taking a bet. When you insist that private insurers cover people with pre-existing, incurable, chronic conditions, there is no "bet" to take there. It is all downside for the insurer. It amounts to charity. This fact then seriously distorts the business model, driving up costs for everyone in a big way. It has to be covered somehow.

We need a single payer system because, at the societal level, it makes sense for government to make sure people get their healthcare needs met for the same reason it makes sense for government to provide police and fire protection. But forcing all Americans to get private health insurance makes no sense and indicates a fundamental misunderstanding of what the insurance industry does.

Direct Primary Care, single payer and wellness programs all have a good track record of genuinely getting people healthier while bringing down costs. Obamacare cannot do any of those things and just runs expenses up.

Source/qualifications: Among other things, I worked in insurance for over five years. I have a certificate from a technical college in life and health insurance, paid for by my former employer.

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