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What I learned from reading a thousand emergency room bills

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Re: What I learned from reading a thousand emergency room bills

#41

I was a victim of the surprise out of network bill in the Portland, OR area. I did all my research before hand: hospital in network, surgeon in network, etc. but ONE person in that operating room was not in network and SURPRISE i'm out thousands of dollars. The worst part about this is my state passed a bill to stop this prior to my surgery, but the bill's effective date was roughly 3 months later. Talk about bad tim…

You can try to appeal it.

Re: What I learned from reading a thousand emergency room bills

#43
post #25

Earlier quoted context omitted.

> But it is unfair to have no idea what costs you are facing and whether any of those costs are out of network on your insurance. It's practically impossible to make an informed economic decision about truly emergency medical care without heavy regulation. It's not uncommon to be literally unconscious while all the care decisions for you are being made by others. See this article for an example: some uninsured woman…

Considering she was unconscious she could not possibly have consented to those transactions. What laws exist that allow these companies to unilaterally create these transactions, and what limitations do they have?

On the flip side, what laws exists to say a hospital can't treat any unconscious person since they can't consent. Damned if you do, damned if you don't.

Re: What I learned from reading a thousand emergency room bills

#45
post #24

Earlier quoted context omitted.

I was not an advocate for gov't health care, but I am now for the same reason you stated. I have a high deductible plan, and have tried to get quotes in advance, but never can. I have been ripped off multiple times, despite trying to do my research, etc. My wife is a doctor, and at this point, I think single-payer is the least bad option.

>have tried to get quotes in advance, but never can. >I have been ripped off multiple times, >I think single-payer is the least bad option. Can you help me understand why if everyone is paying for everyone's healthcare in a socialize system - how that reforms the transparency and stops the abuses?

The party responsible for payment (the government, in this case) can tell a billing party "I won't pay you more than ___ for that service, and if you don't like it, you can sue me" without taking on the same risk that an individual would. Lawsuits are a pretty inefficient, high-overhead way to bill out, so billing parties are incentivized to not raise accountants and auditors eyebrows.

Re: What I learned from reading a thousand emergency room bills

#46

I was a victim of the surprise out of network bill in the Portland, OR area. I did all my research before hand: hospital in network, surgeon in network, etc. but ONE person in that operating room was not in network and SURPRISE i'm out thousands of dollars. The worst part about this is my state passed a bill to stop this prior to my surgery, but the bill's effective date was roughly 3 months later. Talk about bad tim…

From what I understand (which is honestly not much), I think in cases like this you can contact the hospital and just insist on paying the same amount your insurance would have paid, and they'll often take it. That's just what I hear, though.

Re: What I learned from reading a thousand emergency room bills

#47
post #18

I wonder what healthcare bills would look like if they were itemized so that things like Ibuprofen were literally billed at cost ($0.25 per?) and there were line items for services/labor that captured the real cost of being a medical professional: - Emergency room wait: $0.10 for lights - OTC eyedrops (4 drops): $0.20 - Triage by on-duty nurse: $100 (@ $300/hr) - Consult by on-duty physician: $220 (@ $600/hr) - Late-…

It would look like they should pay their nurses a lot more, according to this bill.

Re: What I learned from reading a thousand emergency room bills

#48
post #5

I'm not an advocate of government paid health care, but hospitals and medical providers should see that this train is coming and if they don't become more transparent it's going to be forced upon them. I don't have a problem with ER care being more expensive -- that isn't necessarily unreasonable when you are getting care in an expensive facility open 24x7, fitted out with equipment to handle any possible medical eme…

For non-life-threatening ER visits an app that has your insurance info and lists the Doctor prescribed treatments with their itemized cost would be ideal to see before you consent or choose what to do. For those without smartphones, the software can also be in the hospital computers ready to give a print-out. Wouldn't presenting it beforehand drive down costs? I'd be in favor of legislation requiring up-front costs to be honored, and it's on the hospital to estimate properly and/or get additional consent for added items (or have the patient sign an additional line item waiver with a limit in exchange for some incentive for the patient such an overall discount).

The app and insurance profile should also allow you put in guidance on what is allowed if you're brought in unconscious. Some may not want to be resuscitated.

Re: What I learned from reading a thousand emergency room bills

#49
post #6

Reading this article and seeing all the startups sprouting in the field of health care and medicine tells me that there's still a lot more areas to innovate and disrupt in this industry. One big issue though are that lobbyists who wanted to keep prices high - to squeeze in as much profit as they can out of these. Drugs, Antibiotics, Procedures, Medical Professionals. I know it would be far-fetched to standardize and…

One way to disrupt the industry might be to have everyone be in one giant insurance pool, perhaps paid for via taxes, and then give everyone access to health care via some kind of non-profit entity. Sounds crazy, right? It worked well for my family and I during the many years I spent in Italy, which has health care costs that are something like half of what they are in the US in terms of GDP.

This is the same in Canada - universal health care administered in each province.

Although I seemed to have noticed a lot of increase as well in terms of pricing and services.

There's just really no cure for an appetite of greed.

Re: What I learned from reading a thousand emergency room bills

#50
post #45

Earlier quoted context omitted.

>have tried to get quotes in advance, but never can. >I have been ripped off multiple times, >I think single-payer is the least bad option. Can you help me understand why if everyone is paying for everyone's healthcare in a socialize system - how that reforms the transparency and stops the abuses?

The party responsible for payment (the government, in this case) can tell a billing party "I won't pay you more than ___ for that service, and if you don't like it, you can sue me" without taking on the same risk that an individual would. Lawsuits are a pretty inefficient, high-overhead way to bill out, so billing parties are incentivized to not raise accountants and auditors eyebrows.

I must admit I'm skeptical of the claim that "only government can negotiate a better price"... I think anyone that's worked on government systems knows that is not typically the case.

Why wouldn't insurers argue for better prices now?

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